Earlier trials of lipid-lowering drugs in the primary prevention of coronary heart disease have demonstrated that lowering cholesterol levels in middle-aged men with hypercholesterolemia reduces the incidence of myocardial infarction.¹–⁴ However, these ...

Plant sterols, including sitosterol, stigmasterol, and campesterol, are present in the Western diet in an amount almost equal to dietary cholesterol intake — that is, 160 to 360 mg per day.¹ Since the 1950s, large amounts of these sterols, mainly ...

Vitamin E is a fat-soluble antioxidant that prevents lipid oxidation in membranes. The various forms of vitamin E, such as α-, β-, γ-, and δ-tocopherol, are absorbed from the small intestine and transported in chylomicrons to the liver. In the liver, α-...

Lyme disease, which is transmitted by ticks and caused by the spirochete Borrelia burgdorferi (now properly described as B. burgdorferi sensu lato, including the subspecies B. burgdorferi sensu strictu, B. afzelii, and B. garinii), is the most common ...

Figure 1. A 70-year-old man presented with a history of rheumatoid arthritis, insulin-dependent diabetes mellitus, chronic renal insufficiency, and hypertension. He had had rheumatoid arthritis for 17 years, was seropositive for rheumatoid factor, and had ...

Most health maintenance organizations and over 90 percent of health insurance plans review the provision of health care to their enrollees in order to control costs.¹–⁴ Numbers of hospital admissions and days of inpatient care have been shown to decrease ...

There is an urgent need to control the global epidemic of human immunodeficiency virus type 1 (HIV-1) infection. Although educational approaches to modify risk-taking behavior are a critical component of prevention, we focus this discussion on the status ...

Presentation of Case

A 55-year-old man was admitted to the hospital because of increasing dyspnea and abnormal radiographs of the chest.

The patient had been well until three years earlier, when he began to have gradually worsening exertional dyspnea. ...

In several major cities, authorities have announced their intention to sell, close, or drastically cut the services of public hospitals.¹–³ Reductions in payments for the elderly and poor from federal, state, and local governments threaten the viability ...

Expert panels in the United States and Europe have reinforced guidelines on lowering cholesterol as one of the fundamental preventive measures to reduce mortality from coronary heart disease.¹,² Last year the report of the Scandinavian Simvastatin ...

Neurology textbooks are replete with descriptions of clinical syndromes of ataxia due to various forms of spinocerebellar degeneration. The most common autosomal recessive type, Friedreich's ataxia, was described in 1876, and the most prevalent dominant ...

Utilization review has become a ubiquitous component of efforts to limit the costs of medical care in the United States. This monitoring process encompasses a broad, heterogeneous group of interventions, most commonly involving the prospective review of ...

To the Editor: The data from the Nurses' Health Study, reported by Colditz et al. (June 15 issue),¹ show a significant increase in the risk of breast cancer with hormone-replacement therapy. I am at a loss, however, about how to counsel my patients on ...

To the Editor: Suarez et al. (July 6 issue)¹ found that “people who identify themselves as severely lactose-intolerant may mistakenly attribute a variety of abdominal symptoms to lactose intolerance.” The lack of information about their subjects' ...

To the Editor: The study by Lipshultz et al. (June 29 issue)¹ has confirmed the results of an earlier study of 150 survivors of cancer who were treated at the Children's Hospital of Philadelphia.² Our study, published in 1993, analyzed abnormalities in ...

To the Editor: Acute diarrhea is the most common illness in travelers to high-risk areas, with up to half of those engaged in short-term travel affected.¹ Although most episodes are mild and self-limiting, there is considerable morbidity and disruption ...

To the Editor: There may be interesting parallels between the mass fainting at rock concerts reported by Lempert and Bauer (June 22 issue)¹ and the epidemics of Tanzwuth (dancing mania) during the Middle Ages, in which music caused victims to dance until ...

Why should anyone buy a textbook about women's health? Many general internists have at least one textbook of ambulatory medicine on their bookshelves. Before deciding whether to purchase a separate book on women's health, these physicians must first ...

Primary Care of Women is a book I turn to in the midst of a busy day in the office to find helpful answers to clinical questions. This book admirably fulfills its purpose: to be a concise, practical reference for clinicians engaged in the primary care of ...

To date, there have been only two comprehensive textbooks in the field of reproductive medicine: Clinical Gynecologic Endocrinology and Infertility, edited by Leon Speroff, Robert H. Glass, and Nathan G. Case (5th ed. Baltimore: Williams and Wilkins, 1994)...

The Institute of Medicine appointed a committee to study the causes, consequences, and prevention of unintended pregnancy. This book presents the committee's findings and recommendations.

The committee defines unintended pregnancies as both unwanted and ...

My Years at the Journal — So Far Editorial, N Engl J Med 1995:333;654-655.. On page 654, in line 9 of the left-hand column, the references cited should have been 4,5,8, not 8,9, as printed. Reference 9 should have been deleted from the reference list. We ...

A Controlled Trial of Zidovudine in Primary Human Immunodeficiency Virus Infection Original Article, N Engl J Med 1995:333;408-413.. On page 411, Table 2 contained a number of incorrect values. The corrected table appears below.

Table 2. Changes in CD4 ...