Each year 5 million patients with chest pain are evaluated in hospital emergency rooms in the United States¹. Less than 30 percent of the patients admitted to a coronary care unit are subsequently found to have myocardial infarction²–⁶. The cost of caring ...

An adequate transfusion program for patients with thalassemia major can prevent death from anemia in infancy and permit normal growth and development during childhood. Because the body lacks any effective means for excreting excess iron, transfusion ...

The prognosis of patients with transfusion-dependent homozygous β-thalassemia (thalassemia major) has been improved by regular transfusion and iron-chelation therapy¹. Before the introduction of therapy with deferoxamine, an iron-chelating agent, in the ...

Escherichia coli O157:H7 is increasingly recognized as a common cause of both epidemic and sporadic disease, notably bloody diarrhea and hemolytic-uremic syndrome. Common-source outbreaks have been traced to the consumption of contaminated hamburger,¹–⁶ ...

Figure 1. Adenocarcinoma of the Esophagus.

The esophagus of a 69-year-old man with progressive dysphagia was visualized by several methods. Barium esophagography (Panel A) demonstrated a long, irregular distal stricture (arrows) just proximal to the ...

Wilms' tumor is the most common intraabdominal solid tumor of childhood, affecting 1 in 10,000 children worldwide. Treatment includes surgical resection and chemotherapy for virtually all affected children and additional radiotherapy for those with ...

Although over 40 years have elapsed since its effects on mania were first described,¹ lithium is still a mainstay in the treatment of mood disorders. Indeed, it remains the standard against which new mood-stabilizing, or thymoleptic, drugs are measured. ...

For molecular biologists in search of clues to cell function, the ultimate object of inquiry is the gene. A scientist looking for a particular gene faces a formidable challenge, because each cell contains more than 100,000 different genes scattered over ...

Stage

A 37-year-old man came to the emergency room complaining of chest heaviness “similar to having somebody standing on his chest.” The pain had begun while he was changing clothes in the locker room at work. It radiated to both arms and was associated ...

A crucial step in confirming or ruling out the diagnosis of acute myocardial infarction is the measurement of myocardial enzymes in the serum. The levels of creatine kinase (CK) and especially of CK-MB (the myocardial-specific isoform) have served as ...

β-Thalassemia is one of the most common single-gene disorders. More than 100 mutations in or around the β-globin gene are known to cause decreased production of β-globin, which in turn leads to the excess accumulation of unstable α-globin chains, ...

To the Editor: The controversy in the lay press after the publication of the findings of the Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group (April 14 issue)¹ was understandable. Clearly, the public was confused by yet another unfulfilled ...

To the Editor: A randomized nutritional-intervention trial similar in scope and size to the Finnish alpha-tocopherol and beta carotene trial¹ has been completed in Linxian, China, an area with one of the world's highest rates of esophageal and stomach ...

To the Editor: In his review of Coronary Heart Disease: The Dietary Sense and Nonsense (March 31 issue),¹ Dr. Stone writes about the report of one very large review² that it is “truly critical and comprehensive.” However, that report, in dealing with ...

To the Editor: In 1979 my colleagues and I had an article published in the Journal that reported that asymptomatic children with elevated dentine lead levels had significant cognitive and behavioral deficits after covariate adjustment¹. I wish to correct ...

To the Editor: In his review on bone marrow transplantation (March 24 issue),¹ Dr. Armitage has provided an excellent overview of transplantation therapy for hematologic cancers, with a brief discussion of preliminary results when the technique is used ...

To the Editor: In the otherwise excellent article on management of urinary tract infections, by Stamm and Hooton (Oct. 28 issue),¹ I was surprised to note one small yet important omission. Nowhere in the article is reference made to the frequent need to ...

To the Editor: The two-part article by Bartecchi and colleagues (March 31 and April 7 issues)¹,² describes different aspects of tobacco use. However, there is an important issue that was not discussed. Although cigarette smoking remains an important ...

To the Editor: Quitter's nail (April 7 issue)¹ can be a false positive sign of smoking cessation. The same week you illustrated this physical sign, I was pleased to observe it in a patient with asthma who smoked heavily. My joy turned to sorrow, however, ...

When the definitive history of AIDS research in Africa is written, many of the 70 contributors to this 728-page book will feature in it prominently. The book includes chapters on the biology of retroviruses, including the simian pathogens, the ...

This book is a useful source of information for therapists, physicians, nurses, and other health care professionals who care for people at risk for, or living with, HIV or AIDS. That includes virtually all medical and mental health professionals who are ...

Alzheimer's disease, a major health problem, can have devastating consequences. In its early stages there is subtle loss of memory, which then worsens inexorably over five to seven years to a virtual vegetative state, robbing the patient of humanity, and ...

This excellent and accessible book contains papers presented at the meetings of the American Psychopathological Association. Over the years, this old and distinguished society has provided a meeting ground for some of the best clinicians and scientists ...

Edgerton's revised edition of his 1967 book, The Cloak of Competence: Stigma in the Lives of the Mentally Retarded (Berkeley: University of California Press), retains its relevancy even though patients who are mildly cognitively impaired, the subjects of ...