The optimal use of coronary reperfusion therapies relies on a rapid diagnosis of evolving myocardial infarction.¹,² For most patients presenting with cardiac chest pain, the electrocardiogram is a powerful aid in diagnosing the cause of the pain and ...

Multiple myeloma is a cancer of plasma cells that is characterized by osteolytic bone destruction.¹ The bone disease can lead to pain, pathologic fractures, spinal cord compression, and hypercalcemia and is a major cause of morbidity and mortality in ...

Both acute medical illness and treatment with immunosuppressive drugs are occasionally complicated by neurologic abnormalities, including altered mental function, visual loss, stupor, and seizures. These abnormalities appear to be the result of an acute ...

The efficacy of allergen immunotherapy in allergic rhinitis has been repeatedly demonstrated, and the technique is widely used.^1,2 Immunotherapy in allergic asthma continues to be controversial, however, despite studies of immunotherapy with grass pollen, ...

In normal males, luteinizing hormone (LH) regulates the function of Leydig cells and, hence, male sexual differentiation, pubertal androgenization, male sexual function, and fertility. Abnormalities in the function of Leydig cells result in primary ...

Figure 1. A 73-year-old man presented with a two-week history of nausea, anorexia, weight loss, and fatigue. He had progressive renal failure, with marked proteinuria (protein excretion, 3.5 g per 24 hours) despite a finding of 1+ proteinuria on dipstick ...

The goal of management of injury of the spinal cord or cauda equina is, if possible, to reduce the resultant neurologic deficit and prevent any additional loss of neurologic function. In a patient with a suspected bony injury of the spine, the spine must ...

Presentation of Case

A 40-year-old man was admitted to the hospital because of a persistent productive cough, dyspnea, and bilateral apical infiltrates.

The patient had been well until two months earlier, when “tightness” developed in the chest, followed ...

When a patient presents to the emergency room with an acute episode of cardiac ischemia, the challenges for the physician are to determine whether the patient is having a myocardial infarction or has unstable angina and to determine the amount of ...

Osteolytic lesions are a hallmark of multiple myeloma. At the time of diagnosis, most patients have bone lesions whose extent is directly related to the mass of the tumor. About 30 percent of patients also have hypercalcemia. Bone lesions and ...

Although allergen immunotherapy has been used to treat allergic asthma for over 70 years, its role remains controversial. The consensus report on diagnosis and management of asthma of the National Institutes of Health recommends that allergen ...

During the past 30 years, the autonomy of patients has displaced beneficence on the part of physicians as the chief tenet of medical ethics.¹ Respect for patients' autonomy is now considered fundamental to the practice of medicine. It is best exemplified ...

To the Editor: The review article (Nov. 9 issue)¹ by Dr. Hollander entitled “The Management of Cocaine-Associated Myocardial Ischemia” needs some clarification. First, it suggests that cocaine blocks the “reuptake of . . . excitatory amino acids” in ...

To the Editor: Manton and Vaupel (Nov. 2 issue)¹ suggest that the white population of the United States has lower mortality between the ages of 80 and 100 years than the populations of Japan, Sweden, France, and England. They cite one of our papers as ...

To the Editor: The Clinical Problem-Solving article (Nov. 2 issue)¹ describing a patient with hypereosinophilic syndrome who had a particularly comprehensive series of diagnostic and ultimately misleading or fruitless tests provides an excellent example ...

To the Editor: Recent studies have demonstrated the presence of a new gamma herpesvirus–like DNA sequence, designated Kaposi's sarcoma–associated herpesvirus (KSHV) or human herpesvirus-8, in different forms of Kaposi's sarcoma in patients infected with ...

To the Editor: What are the lessons from Stillman's essay describing his efforts to practice gastroenterology in Philadelphia (Oct. 19 issue)¹ and from the article by Billi et al. on the decreasing revenues from specialty practice at the University of ...

In this decade of cost containment in medicine,¹,² many of us have encountered insurance carriers that denied coverage for certain medically indicated procedures or treatments. Managed care has also led to centralized planning and reimbursement for ...

This book discusses the short-term and long-term medical effects of atomic radiation in about 150,000 of the people who survived the atomic bombings of Hiroshima and Nagasaki in 1945. These people have been the subject of a continuing study conducted by ...

New motives and new methods for controlling pain have recently emerged. Pain control is increasingly — and appropriately — seen as key to patients' quality of life and satisfaction with medical care. Pain is also recognized as a biologic cascade whose ...

In the belief that patient care, medical education, and research are all best served by improving interdisciplinary communication, we greeted the prospect of a new compendium devoted to cervical cancer enthusiastically. This book by Shingleton and Orr is ...

This truly exhaustive treatise on oncology encompasses basic-science aspects of all disciplines, as well as the diagnosis and treatment of virtually all neoplastic diseases. It is a substantial effort and a largely successful one. The book is very well ...