The discovery in the mid-1980s that the acquired immunodeficiency syndrome (AIDS) could be transmitted by transfusion heightened public concern about blood safety. Over the past decade, efforts have been made to quantify the risks of transfusion-...

Approximately 36,000 of the 6 million people who donate blood each year in the United States repeatedly test positive when screened for antibody to the hepatitis C virus (HCV),¹ and about half are found to be carriers of HCV who require counseling and ...

Severe sepsis causes substantial morbidity and mortality among critically ill patients. Despite advances in critical care, the incidence of sepsis continues to increase, with a mortality rate of approximately 40 percent.¹,² The 13th most common cause of ...

In patients with chest pain and stenosis of moderate severity as assessed by coronary angiography, evaluation and treatment are challenging. Often, many diagnostic tests are performed and no clear diagnosis of the cause of the chest pain results. In a ...

Figure 1. A 26-year-old man with a one-day history of mild headache and fever was admitted to the hospital after having a seizure at home. He had had no contact with other sick people. On admission the patient's consciousness was impaired (score on the ...

Health care providers and emergency-medical-services personnel are sometimes called on to assist when elderly people are found in their homes in need of emergency attention and unable to summon help. In a typical case, a neighbor notices an elderly person'...

Tumor necrosis factor (TNF) and lymphotoxin-α were isolated more than 10 years ago, on the basis of their ability to kill tumor cells in vitro and to cause hemorrhagic necrosis of transplantable tumors in mice.¹ The complementary DNAs and genes encoding ...

Presentation of Case

A three-hour-old boy was admitted to the newborn intensive care unit after a premature delivery.

The infant was born of a 35-week triplet gestation to a 25-year-old primipara, who had received Rh₀(D) immune globulin at 28 weeks. A ...

Transfusions are an indispensable part of medical and surgical therapies. Packed red cells, platelets, and plasma infusions allow patients to be treated intensively for cancer, undergo transplantation, survive surgery despite extensive blood loss, and ...

Over two centuries ago, Heberden described a strangling type of chest pain that was later associated with stenotic lesions of the coronary arteries. With the development of coronary arteriography in 1959, it became possible to visualize coronary arterial ...

For anyone who has ever worked in an emergency room, the presentation is all too familiar. The ambulance brings in a patient who is stuporous and dehydrated, often with decubitus ulcers and covered with feces and urine. No one knows of any family members, ...

Data from the recent Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) indicate that the care of hospitalized dying patients continues to be inadequate.¹ We propose a restructuring of hospital care for dying ...

To the Editor: In their article “A Reversible Posterior Leukoencephalopathy Syndrome,” Hinchey et al. (Feb. 22 issue)¹ described several cases of a condition that is clinically and radiographically similar to hypertensive encephalopathy²,³ and the ...

To the Editor: In their article on the medical disaster response after an earthquake (Feb. 15 issue),¹ Schultz et al. propose an early response by volunteer physicians who have been given supplemental training and are equipped with medical backpacks. ...

To the Editor: The review of acute spinal injury by Chiles and Cooper (Feb. 22 issue)¹ is long overdue. The scope of the article is impressive, but there are some points that require clarification. In the discussion of the neurologic evaluation, the ...

To the Editor: In his discussion of Case 6-1996, which involved Mycobacterium avium bronchiolitis, Murphy (Feb. 22 issue)¹ mentions that he is not aware of a reported case of M. avium complex infection in a patient without predisposing factors, chronic ...

To the Editor: We studied a series of unusual creatinine values in a 38-year-old man with end-stage cardiac disease and acute renal failure. The initial plasma creatinine levels ranged from 4.0 to 4.8 mg per deciliter and gradually decreased to 2.0 to ...

Like the “great imposter,” syphilis, in earlier times, the human immunodeficiency virus (HIV) challenges the clinician to develop a broad spectrum of clinical expertise. Over the past 10 years, a substantial body of knowledge has developed regarding ...

The worldwide scourge of HIV infection and AIDS has had a profound and indelible effect on the practice of medicine. With an estimated 18 million people infected already and with a prolonged latency period between initial infection and chronic sequelae, ...

This collection of essays takes a fresh look at the stories and the people at the heart of the AIDS epidemic. It extends beyond the normal boundaries of scientific discourse to find new and important insights, particularly about the meaning of sex roles ...

After a progressive decline that began in the 19th century, the incidence of tuberculosis in the United States began to climb again in the mid-1980s. This resurgence of tuberculosis was due to a number of factors, including the epidemic of HIV infection, ...