In patients with unstable angina, persistent or worsening symptoms and signs of ischemia despite full medical therapy indicate a poor prognosis¹–⁶. However, at the time of hospital admission, it is not possible to predict whether unstable angina will ...

Deafness affects approximately one person in two by the age of 80 years¹. Hearing loss also affects about one in every thousand children¹,². More than 60 percent of the cases of profound early-onset deafness are caused by genetic factors, in most cases ...

In follow-up studies over a period of one to two years, the HHV-6 genome persisted in blood mononuclear cells after primary infection in 37 of 56 children (66 percent). Reactivation, sometimes with febrile illnesses, was suggested by subsequent increases ...

Neurologic symptoms due to electrolyte disorders are common, occurring in patients with diarrhea, diabetes mellitus, head injury, renal failure, and many other disorders, especially in infants and the elderly. The clinical syndromes of dehydration and ...

Figure 1. Floppy Mitral Valve.

A 71-year-old man presented with acute pulmonary edema and cardiogenic shock nine years after his mitral and aortic valves had been replaced by Bjork-Shiley prostheses. Cinefluoroscopy showed that the minor strut of the ...

The present direction of health care reform in the United States is uncertain. With multiple insurers or tiers of coverage, even universal coverage would not necessarily guarantee equal coverage or care. Moreover, questions have been raised about access ...

Injection-drug use has become an important risk factor for infection with the human immunodeficiency virus (HIV), and HIV infection has become well established among drug users in North America, Europe, South America, and Southeast Asia¹–³. In the United ...

Presentation of Case

A 25-year-old man was admitted to the hospital because of the recent onset of congestive heart failure and atrial fibrillation.

The patient had been well until four months earlier, when he had a severe upper respiratory tract ...

Recent research suggests that focal inflammation in the coronary arteries may be involved in the genesis of unstable coronary syndromes. In this issue of the Journal, Liuzzo et al.¹ report that the acute-phase reactants, C-reactive protein and serum ...

In the past few years, new genetic techniques have been used successfully to locate and characterize genes for several types of hereditary hearing loss. The effects of this new knowledge on clinical practice and the lives of people with hearing loss will ...

Arguments about the need for universal health insurance coverage are based on medical as well as ethical and economic considerations. Some who doubt the need for universal coverage claim that in our present health care system even the uninsured manage to ...

Only 30 years ago, 93 percent of medical students in the United States were men, and 97 percent were non-Hispanic whites. Today, the profile of U.S. medical students has changed dramatically. Forty percent of the 67,000 students in the nation's 126 ...

To the Editor: In their analysis of proposals to control costs at the end of life, such as the use of advance directives and hospice care, Emanuel and Emanuel (Feb. 24 issue)¹ somehow conclude that an annual saving of $29.7 billion is less than ...

To the Editor: Dr. Murphy and his colleagues (Feb. 24 issue)¹ substantiate the fact that elderly patients both understand the implications of prognostic information concerning the results of cardiopulmonary resuscitation (CPR) and are willing to alter ...

To the Editor: The recent article by Baron and colleagues (March 10 issue)¹ provides further evidence that Bayesian principles are essential as physicians consider the appropriate prognostic stratification of candidates for major vascular surgery. When ...

To the Editor: In their report on the treatment of acute herpes zoster (March 31 issue),¹ Wood et al. state that “intravenous and oral acyclovir in immunocompetent patients are associated with significant improvements in the rate of healing and the ...

To the Editor: In the Images in Clinical Medicine section (March 31 issue),¹ Rosencrance presents an excellent clinical photograph of herpes zoster involving the right trigeminal nerve. He mentions that the patient was treated with intravenous acyclovir, ...

To the Editor: Pastuszak and her colleagues (March 31 issue)¹ report embryopathy in 1 of 49 infants born alive after first-trimester maternal varicella. In the meta-analysis of their own results and those of four comparable published studies, they ...

To the Editor: Torres et al. (March 31 issue)¹ conclude that surveillance scanning of children with medulloblastoma has limited clinical value. Unfortunately, the surveillance program that they describe can hardly be considered aggressive, as evidenced ...

To the Editor: A 51-year-old woman who had recently come from sea level presented with cough and congestion at our emergency room in Frisco, Colorado (altitude, 9300 ft [3200 m]). She described a “swishing sound” in her breasts. She had had saline breast ...

The distinguished and meticulous journal for which I write this review asks all contributors to declare any prejudicial interest. This I am happy to do. Approaching 86 years of age, I am a fully qualified member of the cohort (a favored term of the ...

Dr. Gillick, a clinical geriatrician, uses the stories of her own family and her patients to explore the controversies surrounding medical care in old age. She considers the unique circumstances of four kinds of patients: the demented, the robust, the ...

This is not a book that promises extended longevity if the author's advice is followed. Examples in that category are the book by Roy L. Walford with a similar title (Maximum Life Span. New York: W.W. Norton, 1983) and a more recent one by Deepak Chopra ...

Daniel Fox has written a brave and important book. Combining his expertise as a historian and a policy analyst, he reveals the soft underbelly of the debate over health care reform -- its problematic assumptions and its fundamental limitations. We are ...

Beyond Medicare proves that we need a new policy for long-term care. Malvin Schechter describes how this care should be prescribed, delivered, managed, and financed. By the year 2011, the current middle-aged population will have reached the age of 65 or ...

Treating Chronic Idiopathic Thrombocytopenic Purpura -- A New Application of an Old Treatment Editorial, N Engl J Med 1994:330;1609-1610.. On page 1609, the sentence that begins 16 lines from the bottom of the right-hand column should have read, “When the ...

Hypopituitarism Review Article, N Engl J Med 1994:330;1651-1662.. On page 1652, in Figure 1D, the minus sign at the hypothalamus indicating the effect of growth hormone on somatostatin secretion is incorrect; it should have been a plus sign.