In pediatrics the routine use of whole-cell vaccines against Bordetella pertussis has been a matter of continuous debate.¹–⁴ Acellular vaccines, consisting of purified proteins, have been in use for the primary immunization of two-year-old children in ...

The most widely used vaccine against pertussis is whole-cell pertussis vaccine, which is given in three primary injections in infancy,¹ usually followed by booster injections at preschool age.² Acellular vaccines, which are likely to cause fewer reactions ...

The age-adjusted incidence of breast cancer varies more than fivefold internationally,¹ and among descendants of migrants from low-incidence to high-incidence countries, the incidence rates of breast cancer are close to those of the new country.²,³ These ...

Cardiac muscle is commonly affected in muscular dystrophies.¹–⁴ X-linked Duchenne's muscular dystrophy and Becker's muscular dystrophy are caused by mutations in the gene encoding dystrophin,⁵,⁶ a membrane cytoskeletal protein.⁷ In skeletal and cardiac ...

Figure 1. An eight-year-old girl was found to have proteinuria and microscopic hematuria on a routine examination. A photomicrograph (Panel A) shows an enlarged, lobulated glomerulus with irregular thickened glomerular capillary walls, often with a double-...

Relationships between academic institutions and industrial organizations have again become a topic of lively policy debate in the life sciences. As in the early 1980s, policy makers interested in reducing federal expenditures are suggesting that with the ...

Abnormalities of glucose, insulin, and lipoprotein metabolism are common in patients with hypertension. These changes can also be discerned in normotensive first-degree relatives of hypertensive patients. They are not present in patients with secondary ...

Presentation of Case

A 40-year-old woman was admitted to the hospital because of the recent onset of paraplegia.

Two weeks before admission progressive low back pain developed, which soon radiated to the posterior surfaces of both legs and later to the ...

Whole-cell vaccines, which are suspensions of killed Bordetella pertussis organisms, are among our most effective and least satisfactory vaccines. Before immunization was routine, pertussis was endemic in the United States, with up to 260,000 cases and ...

The conduct of medical research is in increasing jeopardy. Scarce funds for research have been strained by the emergence of new problems requiring intensive work. But a more insidious problem is compromising the ability to make progress in medical ...

As marketplace competition becomes the dominant force for change in the delivery of health care in the United States, its effects on the quality of health care are being sharply debated. There is increasing demand for more data on the quality of care to ...

To the Editor: The article by Hausknecht on the use of methotrexate and misoprostol to terminate early pregnancy (Aug. 31 issue)¹ and the earlier article by El-Refaey et al. on the induction of abortion with mifepristone (RU 486) and oral or vaginal ...

To the Editor: Kobashigawa and coworkers (Sept. 7 issue)¹ report that therapy with pravastatin beginning shortly after transplantation led to a reduction in the rates of hemodynamically important cardiac rejection and mortality and a lower incidence of ...

To the Editor: Nichol et al. (Oct. 5 issue)¹ report that during one influenza season, immunization against influenza significantly reduced the frequency of respiratory illness in healthy, working adults. About three quarters of the subjects had not ...

To the Editor: Hummel et al. (Oct. 5 issue)¹ report the polyclonality of Reed–Sternberg cells in 6 of 12 cases of Hodgkin's disease. In three other cases, there were mixed polyclonal and monoclonal populations of Reed–Sternberg cells, and in three cases ...

To the Editor: Dr. Lieber's article on medical disorders of alcoholism (Oct. 19 issue)¹ is an articulate and comprehensive review of the many complications of alcoholism, including malnutrition, exposure to toxic metabolites, carcinogenesis, liver and ...

To the Editor: Inhalation of foreign bodies by children is common yet often missed.¹–³ We report a case of inhalation of a LEGO piece that was difficult to identify.

A five-year-old boy presented with a cough of two months' duration that was precipitated ...

Suppose that instead of feeling sick, sore, and sensitive after 36 hours on call as an intern, you felt alive and energized, eager to admit that next patient in shock:

I also had an extended and rather odd conversation with the chairman of my department . ...

This book offers interesting reading in the philosophy of science and social psychology. It provides a brief overview of concepts of pain throughout history without maintaining strict scientific criteria for what constitutes pain. The primary goal is “...

At the beginning of the Metaphysics, Aristotle exalts sight above the other senses for its power to lead us to knowledge. Presumably, the more and the better we can see, the more we will know. In this fascinating account of the invisible world opened up ...

In this easy-to-read book for nonspecialists, L. Luca Cavalli-Sforza and his son Francesco tell the story of human diversity through an overview of the 40-year work of the elder Cavalli-Sforza. In contrast to The Bell Curve (R.J. Herrnstein and C. Murray. ...

Book Review of Effects of A-Bomb Radiation on the Human Body Book Review, N Engl J Med 1995:333;1787-1788.. In the publishing-information paragraph on page 1787, the name of the translator, Brian Harrison, should have been included.