Asthma-associated mortality is reported to have increased in the United States and throughout the world¹–¹¹. The reports are derived from vital statistics on the number of deaths per capita, classified according to their underlying causes in a geographic ...

Since 1978, the rate of mortality from asthma has increased substantially in the United States¹–³. Although it has been suggested that this trend may be spurious,⁴ the rate has also increased in other countries¹. Neither more frequent diagnosis nor aging ...

Resection of hepatocellular carcinoma is associated with high rates of morbidity and mortality¹–³. This is because the majority of patients have cirrhosis, and hepatectomy causes further deterioration of liver function⁴ due to the loss of functioning ...

Primary hyperoxaluria is an autosomal recessive disorder caused by defects in hepatic enzyme systems important in the metabolism of glyoxylate, a major precursor of oxalate¹. In type I primary hyperoxaluria, a deficiency or mistargeting of hepatic alanine-...

The most frequent laboratory abnormality in patients with idiopathic deep-vein thrombosis is resistance to activated protein C¹. Depending on the selection criteria, in vitro resistance to activated protein C can be identified in 20 to 50 percent of ...

Figure 1. Digitalis purpurea (Foxglove).

In 1775 William Withering demonstrated that the leaves of the foxglove plant alleviated certain forms of dropsy (edema), and in 1799 John Ferriar ascribed their beneficial effects to a primary action on the heart. ...

Idiopathic dilated cardiomyopathy (IDC) is a primary myocardial disease of unknown cause characterized by left ventricular or biventricular dilatation and impaired myocardial contractility¹. Depending on the diagnostic criteria used, the reported annual ...

Presentation of Case

A 52-year-old woman was admitted to the hospital because of weakness, diarrhea, and lymphadenopathy.

The patient had been well until two months earlier, when fatigue developed. Several weeks later diarrhea developed, with the passage ...

Death from asthma is rare. In 1988 only 4580 U.S. death certificates listed asthma as the primary cause of death. Why then is so much attention being paid to this topic in the medical and lay literature? The answer lies not in the absolute number of ...

Nearly two decades ago, Richard Dawkins proposed the concept that genes possess an inherent property of “selfish replication.”¹ He argued, anthropomorphically, that these basic units of heredity behave in a manner that guarantees their self-perpetuation. ...

To the Editor: Neumann et al. (July 28 issue)¹ indicate that the cost of having one child with in vitro fertilization begins at $66,667 and can rise as high as $800,000. This cost analysis is inappropriate. It includes such variables as travel time to ...

To the Editor: With regard to the clinical image depicting the “Brockenbrough-Braunwald sign” (July 28 issue),¹ the authors of the 1961 article that initially described the diminished pulse pressure in the post-extrasystolic beat were Brockenbrough, ...

To the Editor: Uren et al. (July 28 issue)¹ conclude that the coronary vasodilator response is severely impaired after myocardial infarction, in both infarcted and uninfarcted myocardial regions. However, the results of their studies are complicated by ...

To the Editor: In their study of the correlation between the allelic loss of chromosome 18q and survival among patients with colorectal cancer (July 28 issue),¹ Jen et al. used microsatellite polymorphisms to distinguish between two alleles in tumor DNA. ...

To the Editor: Dickens et al. (July 28 issue)¹ describe a patient who underwent directional coronary atherectomy with an excimer laser. The procedure was complicated by chest pain and the acute onset of blurred vision. Funduscopic examination revealed a ...

To the Editor: Although distal renal tubular acidosis is often associated with immune-mediated diseases, autoantibodies against renal tubular cells have been detected only sporadically.¹–³ We report the case of a 34-year-old woman with Graves' ...

To the Editor: In his review of my book, Experiences of Schizophrenia (June 23 issue),¹ Lewis misquotes me as saying that schizophrenia is a “metatheory.” What I said was, “I should like to propose as an alternative to monistic forms of thinking... a ...

It is easy, in the late 20th century, to acknowledge the importance of popularization in any well-rounded understanding of the social aspects of medicine. It is far harder to define “popularization” precisely and to study it in detail using specific ...

Regardless of official political or religious policy, attempts to control fertility have been made since antiquity. Women have usually initiated limitations on fertility, a subject that in many societies has been, and still is, considered unsuitable for ...

Viral Diseases in Pregnancy is an excellent book for obstetricians, perinatologists, family practitioners, internists, infectious-disease specialists, and others involved in the care of pregnant women. The unique circumstance of pregnancy forces ...

The strongest feature of this comprehensive textbook on clinical prevention is the clear presentation in several introductory chapters of the criteria for the evaluation of preventive maneuvers. Multiple sources of error can easily lead to a conclusion ...

It is truly unfortunate that two books, titled identically but approaching the subject of intracerebral hemorrhage from two different perspectives, have appeared at nearly the same time. They are likely to compete for the same readership, when in fact ...

Principles of Neurosurgery fills a unique niche in the world of neurosurgery textbooks. Already the authors of an extensive multivolume textbook in the field, Rengachary and Wilkins have endeavored in this edited textbook to produce a “book for beginners.”...

Case Records of the Massachusetts General Hospital (Case 28-1994) Case Records of the Massachusetts General Hospital, N Engl J Med 1994:331;181-187.. On page 185, the sentence that begins 24 lines from the bottom of the left-hand column should have read, “...

Case Records of the Massachusetts General Hospital (Case 37-1994) Case Records of the Massachusetts General Hospital, N Engl J Med 1994:331;1005-1012.. On page 1010, in the sentence that begins in line 10 of the right-hand column, the leukocyte alkaline ...