Activation of the sympathetic nervous system is one of the cardinal pathophysiologic abnormalities in patients with chronic heart failure. Levels of circulating catecholamines increase in patients with heart failure in proportion to the severity of ...

The temporal order in which patients with early-stage invasive breast cancer receive chemotherapy and radiation therapy after breast-conserving surgery may affect the clinical outcome.¹–³ To our knowledge, no previous randomized trial has addressed this ...

Pelvic inflammatory disease is the most serious sexually transmitted bacterial infection affecting women.¹ Recent studies have more clearly defined the ascending route of infection. Lower genital tract infection can lead to endometrial and tubal infection ...

Complete deficiency of adenosine deaminase causes severe combined immunodeficiency that is inherited as an autosomal recessive trait. The patients present in infancy with recurrent infections, lymphopenia, defective proliferative responses to mitogens, ...

Figure 1. A 43-year-old man with bullous emphysema was admitted to the hospital with pneumonia. On admission a chest film (Panel A) showed a bulla (white arrow in Panels A through G), which had also been present 15 months earlier, adjacent to right-lower-...

Euthanasia is defined as administering medication or performing other interventions with the intention of causing a patient's death.¹ Unlike the practice of withholding or withdrawing life-sustaining treatments, which is generally well accepted in the ...

Theophylline has been a popular medication for asthma for over 50 years. However, the introduction of newer pharmacologic agents, concern about the toxicity of theophylline, and recommendations in widely disseminated guidelines have recently contributed ...

Presentation of Case

A 36-year-old left-handed woman was admitted to the hospital because of progressive, bilateral hand weakness and numbness, bilateral facial weakness, and loss of truncal sensation.

She had been well until five years earlier, when she ...

Only in the past decade have well-conducted clinical trials advanced the treatment of congestive heart failure from palliation to prolongation of life. In 1986, the Veterans Administration Cooperative Vasodilator–Heart Failure Trial I (V-HeFT I) ...

For decades, the order of the therapeutic steps in early-stage, invasive breast cancer was largely unchallenged, proceeding according to the widely accepted priorities of Halsted with their emphasis on local tumor control: “curative” mastectomy was ...

Pelvic inflammatory disease and its severe, costly consequences are preventable. “Pelvic inflammatory disease” refers to infection of the endometrium, fallopian tubes, and contiguous structures. Although it is often caused by multiple infectious organisms,...

Public and professional sentiment about assisted suicide and euthanasia has led to intense debate, controversy, and confusion. In an era of unprecedented technological progress and postponement of death, considering actions to precipitate death seems ...

To the Editor: I stopped reading the Clinical Problem-Solving article by Keljo and Squires (Jan. 4 issue)¹ when I reached the second line of the second column, which gives the erythrocyte sedimentation rate as 38 mm per hour. I was dissatisfied with the ...

To the Editor: In “Tissue Plasminogen Activator [t-PA] for Acute Ischemic Stroke” (Dec. 14 issue),¹ it is reported that treatment with t-PA increases a patient's chance of recovering from an ischemic stroke without any, or only minimal, disability or ...

To the Editor: The conclusion by Kay et al. (Dec. 14 issue)¹ that low-molecular-weight heparin improves the outcomes of patients with acute ischemic stroke can be questioned for two reasons. First, aspirin should have been administered to the patients in ...

To the Editor: Reynen (Dec. 14 issue)¹ provides an extensive and informative review of cardiac myxomas. He points out that myxomas are histologically benign but may be lethal because of their strategic position. He further states that the malignant ...

To the Editor: Prenatal screening and diagnostic services for fetal Down's syndrome have been offered to women since the early 1970s, when reliable techniques of chromosome analysis became available. Screening was initially based only on the pregnant ...

In their contribution to this excellent monograph, Kovacs and Bastiaens may have sensed the growing impatience as the reader struggles with the mountain of studies presented. They write: “Although, over the past 15 years, considerable advances have been ...

It may not be too long before the entire range of information in our genomes can be downloaded onto magnetic cards we can keep in our wallets. We may then be able to obtain information about our medical future in the form of several hundred selected ...

Based on papers presented at a conference held in Oxford, United Kingdom, in 1992, this book is a valuable addition to the small body of practical knowledge regarding medically unexplained somatic symptoms. The contributors are experienced psychiatrists ...

This book is a brief overview of how the brain works to repair itself after injury. It directly contradicts a long-held notion that the brain cannot regenerate, but the authors, internationally recognized neuroscientists, provide ample scientific evidence ...

Androgens in Men — Uses and Abuses Review Article, N Engl J Med 1996:334;707-715.. On page 710, in the left-hand column, in lines 9 and 13 from the bottom, the term should have been, “serum prostate-specific antigen,” not “serum prostate-specific androgen,...

Oats in Celiac Disease Correspondence, N Engl J Med 1996:334;865-866.. On page 866, in the left-hand column, the second author of the first letter was Margot Shiner, not “Margot Shine,” as printed.