Antiretroviral therapy directed at the reverse transcriptase of human immunodeficiency virus type 1 (HIV-1) has had limited success because of drug toxicity and the emergence of viral resistance.¹ With the recent appreciation of the continuous, high-level ...

Conception can occur only near the time of ovulation. However, the number of fertile days before or after ovulation is uncertain. Estimates range from 2 days per menstrual cycle¹,² to 10 days or more.³,⁴ Other issues related to fertility also remain ...

Poor cardiac performance is a major cause of morbidity and death in patients who undergo open-heart surgery, especially older patients and those with extensive disease or poor ventricular function.¹ Physicians therefore are challenged to improve ...

The clinical use of nucleoside-analogue inhibitors of reverse transcriptase is limited by toxic effects and the emergence of mutants of the human immunodeficiency virus (HIV) that resist these drugs.¹ HIV type 1 (HIV-1) protease cleaves the viral Gag-Pol ...

It is generally agreed that patients with intermediate- or high-grade non-Hodgkin's lymphoma who have a relapse after initial therapy have a poor prognosis.¹,² A retrospective study in 1984 from France and England showed a clear relation between the ...

Figure 1. Scanning electron micrographs show macrophages on the surface of peritoneal-dialysis catheters after the devices had been removed because of infectious complications. Panel A shows a sessile macrophage (M) with pseudopodia (P) scavenging ...

Patients with cardiopulmonary disease often have respiratory distress, which physicians refer to as dyspnea. Dyspnea is responsible for substantial disability and for millions of patient visits each year. Although dyspnea has been defined in several ways,^...

Many of the problems and hopes associated with gene therapy are exemplified in preclinical studies of genetically altered muscle cells (skeletal, cardiac, and smooth). Smooth-muscle cells of the arterial wall are being genetically engineered to synthesize ...

Stage

A 22-year-old, non–English-speaking Laotian woman came to the clinic because she had abdominal pain. The history was obtained with her husband acting as interpreter. The pain was epigastric, described as a heartburn, and was somewhat relieved by ...

Changes in pituitary–thyroid function occur in patients with virtually all illnesses and those undergoing major surgical procedures. Although such changes are referred to as the euthyroid sick syndrome, the key changes — namely, decreases in serum ...

The optimal timing of sexual intercourse in relation to the day of ovulation in order for pregnancy to result is a topic of broad interest. Of obvious relevance to fecundability, on the one hand, and contraception, on the other, the timing of intercourse ...

Multiagent chemotherapy including anthracyclines can induce long-term disease-free survival in 40 to 45 percent of patients with intermediate-grade, aggressive non-Hodgkin's lymphoma. The other 55 to 60 percent of patients either do not have complete ...

To the Editor: Tugwell et al. (July 20 issue)¹ found that “patients with severe rheumatoid arthritis and only partial responses to methotrexate had clinically important improvement after combination therapy with cyclosporine and methotrexate.” We are ...

To the Editor: Kirwan et al. (July 20 issue)¹ found that “in patients with early, active rheumatoid arthritis, prednisolone (7.5 mg daily) given for two years in addition to other treatments substantially reduced the rate of radiologically detected ...

To the Editor: Lipid-lowering drugs are generally expensive and frequently have bothersome side effects. Although primary-prevention trials have shown that lipid-lowering therapy can reduce the incidence of coronary heart disease in middle-aged men, meta-...

To the Editor: Losartan (Cozaar, Merck) is a new, orally effective blocker of the angiotensin II receptor. The currently available angiotensin-converting–enzyme (ACE) inhibitors block the degradation of bradykinin, which is also metabolized by ACE. The ...

To the Editor: The patient with a huge hydatid cyst of the pericardium (July 20 issue)¹ died, I suspect, because of the attempted removal of the lesion.

It is always tempting to remove such lesions in toto, in an attempt to avert rupture with local ...

To the Editor: With regard to your editorial on the Internet and the Journal (June 22 issue),¹ the availability of biomedical services on the Internet promises to change many aspects of contemporary medicine. The Human Molecular Genetics Network (e-mail ...

This scholarly and generally balanced book provides a comprehensive review of developing knowledge about the clinical assessment and management of suspected sexual abuse of children. It includes contributions by 35 authors from five countries. The reader ...

Schizophrenia is a most interesting and vexing disease. Its prevalence is high (0.85 percent), its economic impact is severe, and the disease processes undermine a myriad of brain functions, causing distinctively human impairments. Patients have altered ...

Deconstructionism is a philosophical approach to knowledge that has come to have a profound influence on American intellectual life, so it is not surprising that the tools of deconstructionist thought should be brought to bear on the history of ...

Major medical textbooks have recently started to appear in full text on CD-ROM. This new form of technology offers superior searching capability, with split-second retrieval time, compact storage (i.e., an entire shelf of medical books can be put on a ...