Vaccines are the most cost-effective public health intervention.¹ Children² and the elderly³,⁴ are at risk for insufficient immunization coverage. Much effort has been spent attempting to increase the coverage among children. All 50 states have adopted ...

One of every six white women will have a hip fracture during her lifetime.¹ Many potential risk factors for hip fracture, such as lower body weight, cigarette smoking, caffeine intake, use of long-acting sedatives, and inactivity, have been identified in ...

Achalasia is a disorder of esophageal motility characterized by the absence of peristalsis, an elevated pressure of the lower esophageal sphincter, and the failure of the lower esophageal sphincter to relax during swallowing. The usual treatment for ...

In 1988, when this study was planned, the recommendation of the Centers for Disease Control and Prevention for the treatment of known or suspected tuberculosis in patients with human immunodeficiency virus (HIV) infection was that at least three drugs (...

Figure 1. A 38-year-old woman's left thumb was amputated by a boat propeller while she was scuba diving, and it was not retrieved. Panel A shows her left hand three weeks after the accident. Four months after the accident skin from the groin was attached ...

Most cases of Pneumocystis carinii pneumonia (PCP) in children infected perinatally with the human immunodeficiency virus (HIV) occur in infants between three and six months of age.¹ Because PCP is the most common opportunistic infection classified as ...

Harvey W. Cushing's 1932 description¹ of the syndrome that results from long-term exposure to glucocorticoids has not been improved upon, but our understanding of its pathophysiologic features and our ability to diagnose and treat the disorder have ...

Presentation of Case

A 60-year-old man was admitted to the hospital because of left-sided abdominal pain and diarrhea.

The patient had been in stable health until three or four years earlier, when he began to have intermittent pain in the left flank that ...

With so much concern about threats from emerging new infections and from antimicrobial resistance in common organisms, it is easy to become complacent about infections that are under control and have become clinical rarities. In this issue of the Journal, ...

Hip fractures are among the most important causes of ill health and death among elderly people. Of white North American women 50 years of age, 17.5 percent will have a hip fracture during their remaining lifetime,¹ as will 6 percent of white men of ...

Achalasia, described by Thomas Willis in 1674, was initially treated by dilation of the lower esophagus with a whalebone. The forceful disruption of the lower esophagus by this means relieved dysphagia and other obstructive symptoms. Current procedures, ...

The failing heart is a challenge to clinicians, scientists, and those who grapple with the problems of economics and equity in the provision of medical services. Numerically, the problem is enormous: 400,000 new cases and $10.2 billion in direct medical ...

To the Editor: Steinbach et al. (Oct. 13 issue)¹ address an important and contentious issue — the transmissibility of Burkholderia (formerly Pseudomonas) cepacia among patients with cystic fibrosis. The authors used genomic fingerprinting of B. cepacia ...

To the Editor: The study by Polaneczky et al. (Nov. 3 issue)¹ demonstrates clearly that the choice of the levonorgestrel implant (Norplant) by adolescent mothers for contraception is associated with higher rates of continued use and lower rates of ...

To the Editor: To a Canadian rheumatologist, Coyte et al.'s description of rapid access to orthopedic surgeons and subsequent knee-replacement surgery (Oct. 20 issue)¹ seems utopian. Imagine my surprise on finding that the description was of my own ...

To the Editor: In their study comparing the rates of allogeneic bone marrow transplantation for chronic myeloid leukemia in 10 countries (Oct. 20 issue), Silberman et al.¹ found that Swedish patients were the most likely to receive transplants. In an ...

To the Editor: Barrett et al. (Nov. 10 issue)¹ conclude that for children with acute lymphoblastic leukemia (ALL) in a second remission, bone marrow transplants from HLA-identical siblings result in fewer relapses and longer leukemia-free survival than ...

To the Editor: Chagas' disease, which is common in Brazil, often involves the esophageal neural plexus, resulting in clinical, manometric, and histologic findings resembling those of achalasia. Therefore, its management could be similar.

Patients with ...

To the Editor: Pneumocystis carinii pneumonia is the most common opportunistic infection in pregnant women with human immunodeficiency virus (HIV) infection.¹,² We report a case of maternal–fetal transmission of P. carinii involving an HIV-infected ...

Recently, a scientist who had cloned a gene for achondroplasia was asked by a reporter for National Public Radio to comment on the use of prenatal genetic testing by prospective parents with very short stature who wanted to be certain that all their ...

The advances of the past two decades in molecular biology have produced powerful new methods of diagnosing and treating many diseases. As a result, physicians are challenged to keep abreast of highly visible developments in genetics that are profoundly ...

The objective of this book, edited by Barnes and Stockley, is to help specialists in respiratory disease who have little or no knowledge of molecular biology understand its power and limitations. The editors have set as their goal, “making the ...

This book, which has contributions by some 70 leading authorities in molecular endocrinology, can be recommended as a detailed reference for clinical endocrinologists and investigators in basic science. Molecular Endocrinology maintains a high scientific ...

This book is a compilation of formal presentations and subsequent discussions from a two-day workshop held in London in the summer of 1993. “Ethnic factors” in the context of this book refers essentially to comparisons among Europe, North America, and ...