Zidovudine monotherapy is an effective treatment for symptomatic human immunodeficiency virus (HIV) disease, but its use in persons with asymptomatic infection remains controversial. Zidovudine therapy has been associated with a slowing in the clinical ...

Controlled trials have shown that treatment with zidovudine (Retrovir) late in the course of infection with the human immunodeficiency virus (HIV) type 1 results in decreased rates of disease progression and death,¹,² but there is no consensus on the ...

Surgical replacement of malfunctioning aortic and mitral valves has dramatically improved the prognosis for patients with valvular heart disease,¹ despite the complications of infection,² thrombosis,³ paravalvular incompetence,⁴ and thromboembolism.⁵ The ...

Human ehrlichiosis was first described in the United States in 1987.¹ Of more than 400 cases that have been reported since that time, most have occurred in small groups, or sporadically in isolated cases, usually after exposure to ticks.²–¹¹ Annual ...

The X-linked hyper-IgM syndrome is a rare immunodeficiency disease in which the ability of B cells to switch immunoglobulin production from IgM to IgG, IgA, and IgE is defective.¹ A variety of mutations of the gene encoding the CD40 ligand cause the ...

Figure 1. The thumbs protrude from the clenched fists of a 24-year-old man who presented with congestive heart failure due to severe chronic aortic regurgitation and left ventricular dysfunction. Arachnodactyly (“spider finger”) and loose joints account ...

The primary immunodeficiency disorders reflect abnormalities in the development and maturation of cells of the immune system. These defects result in an increased susceptibility to infection; recurrent pyogenic infections occur with defects of humoral ...

Presentation of Case

A 44-year-old woman was admitted to the hospital because of headache, blurred vision, and an intrasellar mass.

She had been well until nine months earlier, when a vaginal hysterectomy was performed because of uterine prolapse; no ...

Nobody is well served by the practice of reporting the same study in two journals, publishing a review of the same subject nearly simultaneously in two journals, or splitting a study into two or more parts and submitting each to separate journals. A ...

Early treatment of asymptomatic human immunodeficiency virus type 1 (HIV-1) infection remains controversial. In the AIDS Clinical Trials Group 019 study, zidovudine was shown in 1990 to slow the clinical progression to AIDS in infected but asymptomatic ...

Ten tick-borne diseases are now recognized in the United States. Three of these have been discovered in the past three decades: Lyme disease in the 1970s, human ehrlichiosis (caused by Ehrlichia chaffeensis) in the 1980s, and a new human ehrlichial ...

It is estimated that there will be an excess of approximately 165,000 specialist physicians in the United States in the year 2000.¹,² Consistent with these projections are anecdotal reports that physicians completing residency training in some specialties ...

To the Editor: Smith et al. (Feb. 9 issue)¹ report the use of transesophageal echocardiography to diagnose aortic trauma in a series of 121 patients at the University of Kentucky Medical Center over a 24-month period. The same authors have reported on ...

To the Editor: Lindpaintner et al. (March 16 issue)¹ conclude that the presence of the angiotensin-converting–enzyme (ACE) genotype does not alter the risk of myocardial infarction or coronary artery disease. We think that the results of their study may ...

To the Editor: Barnett et al. (Jan. 26 issue)¹ state that “neutropenia occurs early but is reversible after the cessation of [ticlopidine].” Unfortunately, this is not always true. Six patients who died of irreversible ticlopidine-induced bone marrow ...

To the Editor: Toribara and Sleisenger (March 30 issue)¹ reviewed screening for colorectal cancer. Since 1992 prospective and case–control studies, such as that by Wahrendörf et al.,² have shown a decreased mortality rate for colorectal cancer with the ...

To the Editor: The bleak conclusions that Etchason and colleagues offer about the limited usefulness and high costs of autologous blood donation (March 16 issue)¹ seem premature and unwarranted. The ability to test and eliminate most donors with ...

To the Editor: I wonder how many readers of the Journal can understand the photograph by Lipsky entitled “Bountiful Baskets, Kyoto, Japan” (April 20 issue).¹ It shows casks of sake (a brewed alcoholic beverage made from fermented rice), each wrapped in a ...

In this short, serious, and well-written book, Sir Roy Calne joins the ranks of many others who have expressed their concern about the world population explosion. He endorses the conclusions of the world's national academies of science (which are included ...

Francis D. Moore, better known to one and all as Franny Moore, was a giant in the academic surgical world for a generation of surgeons, not only because of his own major contributions to our understanding and management of the metabolic changes associated ...

Many criminal cases in recent years have attracted the interest of the lay public and professionals interested in the sociology of the criminal trial. These are cases in which serious crimes have been committed and the responsibility of the perpetrator is ...

This book about English medical law presupposes some knowledge of legal concepts and terminology and of British health care, and therefore it cannot be recommended unreservedly to an American medical audience. Furthermore, it is poorly edited: cases are ...

Over the past 30 years bioethics has developed into a full-fledged academic discipline. The field has professional societies, university degree programs, and clinical fellowships. The forum for scholarly discourse includes textbooks, edited anthologies, ...

Management of Primary Hyperlipidemia Review Article, N Engl J Med 1995:332;1491-1498.. On page 1494, in the second paragraph under the heading “Treatment,” after the first sentence, the following sentence should have appeared: “Categories of risk and ...