The plasma levels of total cholesterol and low-density lipoprotein (LDL) cholesterol are important risk factors for coronary heart disease.¹–⁴ However, the relation between plasma cholesterol and coronary events appears to be stronger if levels are at ...

The selective inhibitor of serotonin reuptake fluoxetine (Prozac) has become the most commonly used antidepressant drug in the United States. Despite its wide use in patients of both sexes and all ages, its safety in pregnant women has not been adequately ...

Alendronate sodium, an aminobisphosphonate, is a selective inhibitor of osteoclast-mediated bone resorption. In a recently reported study of alendronate (Fosamax, Merck) for the treatment of postmenopausal osteoporosis, the drug progressively increased ...

Infections with group A rotaviruses are common among infants and young children worldwide.¹–⁶ The outcome ranges from asymptomatic infection to severe, life-threatening diarrhea.⁶–¹⁰ Rotavirus is the leading cause of severe diarrhea among children and ...

The mucopolysaccharidoses are lysosomal storage disorders caused by a genetic deficiency of enzymes that catalyze the degradation of glycosaminoglycans (mucopolysaccharides). These disorders are clinically variable and commonly associated with mental ...

Figure 1. A 72-year-old Spanish woman admitted to the hospital for high fever and leukopenia had neither hepatomegaly nor splenomegaly, as assessed by physical examination and abdominal ultrasonography. A bone marrow aspirate shows intracellular and ...

Continuing medical education, peer-review organizations, consensus conferences, and practice guidelines have been advocated as ways of improving the quality of medical care. However, evidence of their effectiveness is lacking.¹–⁶ Another way to change ...

Methotrexate, a folic acid antagonist, is used extensively not only for the treatment of cancer but also for the treatment of rheumatoid arthritis, psoriasis, and autoimmune disease and for the prevention of graft-versus-host disease after ...

Stage

A 50-year-old black man was brought to the emergency room. He had been unable to move his legs for four days and complained of impaired speech.

Response

The lesion in this patient may be in the lower-cranial-nerve area, perhaps due to a basilar ...

In the August 29 issue of the Journal, we published an Original Article by Abenhaim et al., entitled “Appetite-Suppressant Drugs and the Risk of Primary Pulmonary Hypertension.”¹ It dealt with the increased risk of primary pulmonary hypertension in ...

Pregnancy is frequently thought of as a time of emotional well-being for women, but it does not protect them from mood instability. In fact, it is a risk factor for depressive illness, defined as a state of psychological pain with dysregulation of mood.

...

Esophageal mucosal injury from the noxious effect of gastric contents refluxing up the esophagus is a common condition. Much less common is esophagitis from injurious agents passing down the esophagus, seen in its most dramatic form after the ingestion (...

Quality of care is making a comeback. After more than two decades of preoccupation with the costs of health care, more attention is being devoted to quality. But much of the attention is coming from unlikely sources — organizations more often associated ...

To the Editor: We appreciate the opportunity to present our perspective on the events surrounding the publication in the Journal of our editorial “Pharmacotherapy for Obesity — Do the Benefits Outweigh the Risks?” (Aug. 29 issue).¹ We hope this letter ...

To the Editor: Hennekens et al. and Omenn et al. (May 2 issue)¹,² report further failures to find a positive correlation between dosing with “beta carotene” and a reduced incidence of malignant neoplasms. Since the main stimulus for this and other ...

To the Editor: Post-marketing reports of severe esophagitis associated with the use of alendronate sodium, reported in this issue of the Journal by de Groen et al.,¹ prompted us to reexamine in detail adverse esophageal effects in our three-year ...

To the Editor: We would like to comment on the study by Lindpaintner et al. (April 18 issue)¹ reporting no association or genetic linkage between the angiotensin-converting–enzyme (ACE) gene and left ventricular mass.

Genetic linkage between the ACE ...

To the Editor: Weiss et al. (April 25 issue)¹ report an association between the Pl A2 allele and the risk of myocardial infarction or unstable angina. Because spurious results are common in studies of allelic associations, additional studies with ...

To the Editor: Late complications after pneumonectomy include excessive mediastinal displacement to the ipsilateral side with bronchovascular compromise, bronchopleural fistula with empyema, and decreased pulmonary reserve in the event of a respiratory ...

Have you ever seen a crowd of medical students and house officers watching intently as the professor repeatedly strokes the sole of a patient's foot, trying to decide whether the great toe goes up, down, or nowhere? Is the Babinski sign present? If not, ...

Few people would dispute the need for an updated review of tropical neurology, a subject that has languished without a textbook since Spillane's classic treatise, published almost 25 years ago (Tropical Neurology. London: Oxford University Press, 1973). ...

Jean-martin Charcot (1825–1893) made extraordinary contributions to the nosology of neurologic diseases and played a pivotal part in establishing neurology as a clinical specialty. Despite Charcot's accomplishments, the only comprehensive biography of him ...

There is a long and venerable history of physicians serving as political activists. Rudolf Virchow pioneered the “irritation” theory of cancer and the principles of cellular pathology in the middle of the past century, but he was also the leader of a ...

This book chronicles the experiences of a young family doctor practicing in an inner-city clinic in Philadelphia, where, apparently, he is surprised to find complex and seemingly intractable social problems among a patient population mired in severe urban ...

Chronic Autoimmune Thyroiditis Review Article, N Engl J Med 1996:335;99-107.. On page 105, the first sentence under the heading “Associations with Other Diseases” should have read, “Although chronic autoimmune thyroiditis is common in the general ...