Approximately 24 million operations are performed annually in U.S. hospitals by an estimated 133,000 surgeons.¹ The Centers for Disease Control and Prevention (CDC) estimate that 1900 U.S. surgeons are chronically infected with hepatitis B virus (HBV), ...

Screening of blood donors for antibodies to hepatitis C virus (HCV) has reduced the incidence of transfusion-associated hepatitis C. Use of the first enzyme immunoassays for screening was associated with an 80 percent reduction in the risk of infection ...

Since the initial report by Sigwart et al.¹ of the placement of metallic stents in coronary arteries, coronary-artery stenting has been shown to optimize the geometry of the coronary lumen after balloon angioplasty,^2,3 reducing procedural complications^4,5 ...

The length of the cervix may be useful in predicting the risk of premature delivery, with a shorter cervix predicting a higher risk. Traditional methods to evaluate the cervix in pregnancy are limited and unsatisfactory. Digital examination, the standard ...

Figure 1. An umbilical cord with a true knot was discovered immediately after delivery of a baby girl to a 33-year-old woman. The mother had had two previous pregnancies and had delivered at full term with no complications. This pregnancy was complicated ...

Metformin (dimethylbiguanide) is an orally administered drug used to lower blood glucose concentrations in patients with non-insulin-dependent diabetes mellitus (NIDDM).¹ It improves insulin sensitivity and thus decreases the insulin resistance that is ...

The endogenous catecholamines — norepinephrine and epinephrine — are involved in the regulation of virtually every organ system. Norepinephrine acts as a neurotransmitter at certain sites in the central nervous system and in the sympathetic nervous system ...

Presentation of Case

An eight-year-old, right-handed boy was admitted to the hospital because of intractable seizures.

The child sat at the age of 7 months, walked at 14 months, and talked meaningfully at 24 months. At the age of four years he began to ...

Hepatitis B virus (HBV) is known to have been transmitted during invasive procedures from 34 infected health care providers to at least 350 patients in the United States and elsewhere since the early 1970s.¹ All the health care providers who were tested ...

Premature delivery is one of the most troublesome problems in obstetrics. Occurring in 10 percent of all pregnancies, premature delivery is the second most important contributor to perinatal mortality, after fetal anomalies.¹ Despite a great deal of ...

To the Editor: Having had the privilege of being trained in one of the best-organized public hospitals in America (Bexar County Hospital in San Antonio, Texas) I cannot but deplore the prospects you describe in your thoughtful editorial.¹ Helping an ...

To the Editor: Careful medical management has improved perinatal outcomes among women with diabetes that antedates pregnancy, but the benefits of diagnosing and regulating glucose intolerance that develops during pregnancy are less clear. The study by de ...

To the Editor: Polvikoski et al. (Nov. 9 issue)¹ have convincingly demonstrated that there is a greater accumulation of β-amyloid protein in the brain and more neurofibrillary tangles in elderly Finnish subjects with the ε4 allele of apolipoprotein E ...

To the Editor: Vigneri et al. (Oct. 26 issue)¹ compared five maintenance therapies for reflux esophagitis but did not comment on their costs. In addition, there is no mention of the way compliance was measured in any of the groups. In the discussion, the ...

To the Editor: The article by Walter et al. (Oct. 19 issue)¹ provides important evidence that the infusion of donor–derived CD8+ cytotoxic T-cell clones specific for human cytomegalovirus proteins can promptly reconstitute cellular immunity against human ...

To the Editor: Acute myeloid leukemia (AML) occurs in up to 15 percent of patients treated with cytotoxic drugs, radiation, or both.¹ In the leukemic cells of these patients, losses of chromosome 5, 7, or both are most common; a balanced translocation ...

To the Editor: Idiopathic lichen planus is a pruritic papulosquamous eruption that typically occurs in middle-aged persons. The estimated prevalence of this disorder is less than 1 percent, and its cause is unclear.¹ Drug-induced lichen planus has been ...

The United Kingdom's National Health Service (NHS), created in 1948, is a publicly financed system that provides universal access to health care within a moderate and fixed budget. Reforms introduced in 1991 by the government led by Prime Minister ...

This book surveys the history of the Western medical tradition from the time of Hippocrates (fifth century b.c.) to about 1800, when it began to break down under the impact of major changes in medical theory and therapeutics. It was basically a Greek ...

Since 1962, when Congress required proof of the efficacy and safety of drugs approved by the Food and Drug Administration (FDA), the FDA's summary opinions have been fairly consistent with those of the medical profession, as outlined in pharmacology ...

Throughout the 19th century, midwives delivered a large portion of the babies born in the United States. In the late years of the century, however, a gradual decline in midwife-assisted births began. By 1930, less than 15 percent of births in this country ...

Fetal research is embroiled both in the controversy over abortion and in the controversy surrounding the independence and integrity of scientific research. Although the vast majority of Americans favor a woman's right to terminate a pregnancy, most would ...