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June 22, 1995  Vol. 332 No. 25

Original Articles
1661-1665

Deep-vein thrombosis has a reported annual incidence of about 1.6 per 1000 in urban populations.1 The incidence of first episodes of pulmonary embolism in acute care hospitals in the United States has been estimated to be 0.23 per 1000.2 For both these ...

1666-1670

Since 1962, approximately 1 million to 2.2 million women in the United States and Canada have received silicone breast implants as part of reconstruction following surgery for breast cancer or prophylactic mastectomy or for cosmetic reasons.1,2 Silicone ...

1671-1677

Complete remission can be achieved with chemotherapy in approximately 70 percent of adults less than 60 years of age with newly diagnosed primary acute myelogenous leukemia (AML).13 However, only about 45 percent of older patients who receive similar ...

1678-1683

More than 40 percent of patients with acute myelogenous leukemia (AML) are over 65 years old at the time of the diagnosis.1,2 A high rate of treatment-related mortality keeps the rate of complete remission below 50 percent and the median survival between ...

Images in Clinical Medicine
1684
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Figure 1. Confluent vesicular lesions of herpes zoster in consecutive dermatomes are visible in two distinct locations in a 20-year-old man with miliary tuberculosis. The patient was being treated with four antitubercular drugs; he also received ...

Review Articles
1685-1690

Pain can be effectively diminished by various endogenous mechanisms within the central nervous system. One region where these mechanisms have been well characterized is the dorsal horn of the spinal cord, in which impulses from peripheral nerves are ...

1691-1699

Neuromuscular blocking drugs are routinely used during the administration of anesthesia to allow surgical access to body cavities, in particular the abdomen and thorax, without hindrance from voluntary or reflex muscle movement. The introduction of these ...

Case Records of the Massachusetts General Hospital
1700-1707

Presentation of Case

A 55-year-old woman was admitted to the hospital because of acute respiratory distress and thrombocytopenia.

The patient had been in stable health until several weeks earlier, when an upper respiratory tract infection developed, with ...

Editorials
1709-1710
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The word “publishing” has taken on new meaning. For centuries, publishing required an intermediary, someone who had an editorial staff and a press — in short, a publisher. Today, anyone equipped with a computer, a modem, and a connection to the Internet ...

1710-1712

Over the past 20 years, the results of well-designed randomized trials in patients with deep-vein thrombosis have provided reliable information about the treatment of this common disorder. Patients with deep-vein thrombosis should receive adequate doses ...

1712-1714

The treatment of acute myeloblastic leukemia (AML) is often portrayed as one of the successes of modern hematology. In 1966, the year before I qualified as a doctor, the median survival of adults with acute leukemia was 40 days.1 Only 10 percent had ...

Correspondence
1714-1715

To the Editor: Regarding Dr. Hampton's timely review of the care of the woman who has been sexually assaulted (Jan. 26 issue),1 most rape victims are initially evaluated in the emergency department, where accurate and compassionate detection, ...

1715-1716

To the Editor: In the study of zofenopril reported by Ambrosioni et al. (Jan. 12 issue),1 the subgroup analysis (their Table 5) showed beneficial effects in patients concomitantly treated with calcium-channel blockers during the six-week treatment ...

1716-1717

To the Editor: I am disappointed to be faced with a visible contradiction between the two papers on the treatment of benign prostatic hyperplasia in the January 12 issue.1,2

In his review article, Oesterling1 states that the complications of ...

1717-1719

To the Editor: The report by Zittoun et al. (Jan. 26 issue)1 on a comparison of allogeneic or autologous transplantation and chemotherapy for acute myelogenous leukemia (AML) illustrates a flaw in the study design that is common in trials of treatment ...

1719

To the Editor: Lee et al. (Jan. 5 issue)1 described three young liver-transplant recipients in whom smooth-muscle tumors containing the Epstein–Barr virus (EBV) genome developed. In the same issue of the Journal McClain et al. reported an association of ...

1719

To the Editor: The caption to the transmission electron microphotograph of the human immunodeficiency virus (HIV) that shows HIV-1 budding from a cell (Jan. 26 issue)1 states that during the budding process, “The membrane proteins of the cell are left ...

1719-1720

To the Editor: In the Pathological Discussion of the case of a 19-year-old man with rapidly progressive lower-extremity weakness and dysesthesias after a respiratory tract infection (Nov. 24 issue),1 Dr. Megan B. Murray makes a diagnosis of Mycoplasma ...

1720-1721

To the Editor: Levonorgestrel (Norplant, Wyeth–Ayerst Laboratories, Philadelphia) is a subdermally implanted synthetic progestin that has been available in the United States since 1991. Intracranial hypertension developed in two women seen at the Oregon ...

1721

To the Editor: Mass fainting by members of rock-concert audiences has been a well-recognized phenomenon since the time of Elvis Presley and the Beatles, but it has been neglected in the medical literature. To investigate its mechanisms, we joined the ...

Book Reviews
1722

Euthanasia in early-20th-century Germany has often been linked to other bioethical issues, such as abortion, sterilization, concentration-camp experiments, and to the events of the Holocaust. These linkages often influence the assessment of the German ...

1722-1723

Sickness and Healing is a book with a mission. Robert Hahn, an epidemiologist and anthropologist, intends to persuade his readers of the importance of incorporating an anthropologic perspective into the practice of biomedicine. Through theoretical ...

1723-1724

Mary Rowland, a frontier physician who died in 1966 at the age of 93, was a strong-willed woman who practiced medicine long before the passage of women's suffrage. Her memoirs offer powerful portraits of patients with cancer, mental illness, infectious ...

1724

Everyone who has ever done research knows that it can be fun as well as hard work, but the latter is only marginally reflected in the book. Jan Waldenström is best known for his research on macroglobulinemia, and he is also recognized for his ...

Health Policy Report
1727-1731

The sharp divide between Democrats and Republicans on most major health policy issues largely disappears when the subject turns to how federal and state governments should provide medical care to the vulnerable populations that are eligible for Medicaid ...