Rheumatoid arthritis is a chronic, recurrent inflammatory disease that leads to substantial disability, loss of productivity, and increased mortality.¹–³ The traditional⁴ approach to drug treatment emphasizes the stepped use of one medication at a time. ...

Rheumatoid arthritis causes the inflammation and progressive destruction of joints. Nonsteroidal antiinflammatory drugs help to control symptoms. Specific antirheumatoid drugs (such as gold salts, penicillamine, and methotrexate) suppress inflammation but ...

Outbreaks of postoperative surgical-site infections or bloodstream infections are usually thought to be related to the surgeon or the surgical procedure. In May and June 1990, the Centers for Disease Control (CDC) were notified of the simultaneous and ...

There are racial and geographic differences in the incidence and severity of essential hypertension. In the United States, the prevalence of essential hypertension is greater among blacks than among whites at all ages after young adulthood¹,²; the higher ...

The search for genetic factors that influence the occurrence of birth defects has been more successful than the search for environmental factors, particularly with regard to malformation syndromes. Specific DNA deletions associated with specific ...

Figure 1. A 56-year-old man from Saudi Arabia presented with dyspnea. A chest film (Panel A) revealed a large mass in the left hemithorax, with contralateral mediastinal shift and depression of the gas-filled stomach (arrow). Computed tomography after the ...

Renal osteodystrophy, the term used to describe the skeletal complications of end-stage renal disease, is a multifactorial disorder of bone remodeling. The actions of some of the factors involved are well defined, and successful strategies have been ...

Presentation of Case

An 82-year-old woman was admitted to the hospital because of odynophagia and a large superior mediastinal mass.

The patient had severe kyphoscoliosis, with extensive intervertebral disk disease and associated degenerative changes. She ...

Patients with rheumatoid arthritis have symmetric synovitis of their peripheral joints and various degrees of joint destruction. In short-term studies, slow-acting antirheumatic drugs relieve symptoms and retard joint destruction, but many patients ...

Infections following operative procedures are always of great concern to the surgeon. In the United States, the rates of wound infection after clean, clean–contaminated, contaminated, and dirty procedures during the period 1987 to 1990 were approximately ...

Although the epidemic of disease and death from smoking is played out in adulthood, it begins in childhood. Every day another 3000 young people become regular smokers.¹ A person who has not started smoking as a teenager is unlikely ever to become a ...

To the Editor: Sung et al. (Jan. 19 issue)¹ reported that in patients with Helicobacter pylori infection and gastric ulcers unrelated to the use of nonsteroidal antiinflammatory drugs, “one week of antibacterial therapy without acid suppression heals the ...

To the Editor: The article by Kovacs et al. on interleukin-2 therapy in patients with human immunodeficiency virus (HIV) infection (March 2 issue)¹ highlights the dilemma that this disease poses: how to get rid of a virus whose replication is enhanced by ...

To the Editor: Naber's excellent article about the detection of neoplasia (Dec. 1 issue)¹ focuses on the molecular analysis of rearranged antigen-receptor genes as a clonal marker in lymphoid neoplasia by Southern blot analysis or polymerase chain ...

To the Editor: The report by Kaufmann et al. (Feb. 23 issue)¹ on the remarkable clinical course of a patient with mantle-cell lymphoma offered an ingenious explanation for the recurrent spontaneous remissions they observed. However, their demonstration ...

To the Editor: I appreciate many of the points that Dr. Blumenthal made in his article, “Health Care Reform — Past and Future” (Feb. 16 issue).¹ However, I believe that he overlooks many of the major reasons for the political defeat of federal health ...

To the Editor: A previously healthy 13-year-old girl arrived at the hospital 19 hours after ingesting two handfuls of Tylenol Extended Relief (McNeil Pharmaceuticals), a new extended-release formulation of acetaminophen containing 650 mg per caplet. ...

Edward J. Larson joins a growing group of American historians studying the eugenics movement of the early 20th century. His new book traces the origins, development, and demise of eugenics in the deep South: South Carolina, Georgia, Florida, Alabama, ...

During the late 18th century a popular political proposition was advanced — that all people are created equal. The science of the following century provided an underpinning for the potentially contradictory concept that all people are created different. ...

In 287 pages of text and photographs, M. Susan Lindee describes the early history of the Atomic Bomb Casualty Commission in Japan in some detail, with particular reference to its work on possible radiation-induced genetic effects. She appropriately ...

When one thinks of the scholars studying alcohol use among Native Americans, the team of Stephen J. Kunitz and Jerrold E. Levy may come to mind. A physician and an anthropologist, they have provided scholars with expertise and perspectives on the topic ...