In the United States and Canada, up to one quarter of all infants are delivered by cesarean section¹–⁵; approximately half these procedures are performed only because the woman has had a previous cesarean section.¹ For years, allowing labor after a ...

Without prophylactic anticoagulation, the frequency of deep-vein thrombosis after total hip replacement is high, in the range of 50 to 60 percent.¹,² With various methods of anticoagulant therapy, this frequency can be substantially reduced,³,⁴ the best ...

Venous thromboembolism is a common, life-threatening complication of major trauma.¹–⁵ Pulmonary embolism has been observed in 2 to 22 percent of patients with trauma,⁴–⁶ and fatal pulmonary embolism is the third most common cause of death in patients who ...

Jansen's metaphyseal chondrodysplasia¹ is a rare form of short-limbed dwarfism caused by severe abnormalities of the growth plates. The condition is typically associated with asymptomatic hypercalcemia and hypercalciuria due to increased bone resorption, ...

Figure 1. A 36-year-old woman received prophylactic subcutaneous heparin injections after an elective cesarean section. On the fifth postoperative day, subcutaneous edema, redness, and pain developed at the injection site, and heparin was discontinued. ...

Although research on patterns of obesity and serum cholesterol concentrations suggests possible differences in diet according to race and socioeconomic status, few nationally representative studies in the United States describe dietary differences related ...

Ganciclovir is a nucleoside analogue of guanosine, a homologue of acyclovir, and the first antiviral drug to be effective in the treatment of cytomegalovirus (CMV) disease in humans.¹–⁴ It inhibits not only all the herpesviruses but also the ...

Antibodies can bind with high affinity and specificity to molecules of virtually any shape and to antigens ranging from small organic compounds to large proteins. These characteristics have led to the widespread use of antibodies as laboratory reagents, ...

The delivery of one of every four infants by cesarean section in the United States during the late 1980s and early 1990s aroused concern that many of these operations were unnecessary. Professional organizations established guidelines in an attempt to ...

Building on the insight gained from their initial identification of a mutation in the receptor for parathyroid hormone (PTH) and parathyroid hormone–related peptide (PTHrP) in a patient with Jansen's metaphyseal chondrodysplasia,¹ Schipani et al. provide ...

Apart from occasional failures of our sanitation and food-protection systems, common sense tells us that common foods or nutrients as such cannot be lethal and, furthermore, that the effect of any given food on health must be minimal because of the vast ...

Methods for advance medical planning were originally developed to ensure that patients' preferences would guide the nature and intensity of their future medical care. Increasingly, however, advance planning is viewed as a tool to limit care. For example, ...

The prospect of a Medicare Trust Fund bankrupt by 2001 and of staggering deficits in the decades thereafter, as the baby-boom generation retires, is bound to preoccupy everyone, young and old. The options will be a nightmare for politicians, who will be ...

To the Editor: We are concerned about the report by Kurz et al. (May 9 issue)¹ of a randomized clinical study in which intraoperative hypothermia was shown to increase the incidence of surgical-wound infection and prolong hospitalization as compared with ...

To the Editor: Kuipers et al. (April 18 issue)¹ describe an increased risk of atrophic gastritis, associated with an increased risk of gastric cancer,² in patients with reflux esophagitis and Helicobacter pylori infection who are treated with omeprazole. ...

To the Editor: In their study of recombinant erythropoietin for the treatment of anemia in inflammatory bowel disease (March 7 issue),¹ Schreiber et al. found that treatment with oral iron and recombinant erythropoietin can raise hemoglobin levels. ...

To the Editor: Dr. Fine (May 2 issue)¹ concludes, on the basis of guaiac (Hemoccult) testing, that patients with celiac sprue have a high prevalence of occult gastrointestinal bleeding. A fact mentioned, but not discussed, is that the testing was ...

To the Editor: In Dr. Krawitt's excellent review of autoimmune hepatitis (April 4 issue),¹ he discusses the importance of distinguishing autoimmune hepatitis from acute viral hepatitis. In the differential diagnosis, he mentions hepatitis A, B, C, and E ...

To the Editor: Cysticerci of Taenia solium (parasites of the subclass Cestoda) evaginate in vitro¹,² and in the human eye,³,⁴ where the scolex, the anterior end of the organism, protrudes and reinvaginates and may change from a subretinal to a vitreous ...

To the Editor: We describe a 63-year-old woman whose stomach was perforated after she ingested a blister-wrapped capsule while hospitalized for treatment of depression. She was treated with oral lormetazepam (Noctamid), paroxetine (Deroxat), buspirone (...

Today's headlines — welfare reform; community activism against an asphalt plant in a minority neighborhood; the growing number of uninsured people in the presence of managed care, capitation, mergers, and the consolidation of health care institutions; ...

Every country's health system is in crisis. In the absence of clear “best practices,” cynics might remark that reform usually consists of replacing one set of problems with a new set, and then beginning a new process of change. International comparisons ...

This monograph deals with the present and projected health care problems facing the elderly according to U.S. and Western European students of the subject. The outgrowth of a two-year research project organized by the Institute for Bioethics, Maastricht, ...

In the policy and budget debates of the 1990s, no issue has such political force and significance for millions of Americans as federal entitlements for the elderly. Social Security cash benefits, Medicare health benefits, and Medicaid assistance bolster ...

Pregnancy and Renal Disease Editorial, N Engl J Med 1996:335;277-278.. On page 277, the sentence that begins 7 lines from the bottom of the right-hand column should have read, “One of the study patients had an initial serum creatinine concentration of 2.7 ...