Friedreich's ataxia, an autosomal recessive neurodegenerative disorder, is the most common hereditary ataxia. Its estimated prevalence in European populations is 1 in 50,000. In 1988 the locus of the genetic defect was mapped to chromosome 9.¹ The ...

Major depression is a complex disorder reflecting genetic, developmental, and environmental factors. Although its pathophysiology is not clearly understood, depression is associated with hypothalamic dysfunction — specifically, hypercortisolism, the ...

Heart failure is estimated to affect over 3 million people in the United States.¹ Approximately 400,000 new cases of heart failure are diagnosed each year despite the widespread use of antihypertensive therapy, advances in early intervention during ...

Apoptosis, or programmed cell death, is a highly regulated and active process that contributes to the control of cell number during development and to the maintenance of many adult tissues.¹–³ It is triggered by the activation of an internally encoded ...

Figure 1. A 41-year-old woman presented with a four-week history of recurring fever (temperature, 40.5°C), headache, and diffuse myalgias. She was one of three family members in whom relapsing fever developed after they vacationed in a rustic, rodent-...

Physicians routinely make difficult decisions about which patients with acute myocardial infarction should undergo angiography, which to refer for revascularization, and which type of revascularization procedure to use.¹ Although clinical trials have ...

The hypothalamic–pituitary–adrenal axis has an important role in the body's ability to cope with stresses such as infections, hypotension, and surgery. The hypothalamus is subject to regulatory influences from other parts of the brain, especially the ...

Presentation of Case

A 44-year-old woman was admitted to the hospital because of hyperparathyroidism with a hypercalcemic crisis.

At the age of 29 years, the patient had been told she had a calcium level of 11.0 mg per deciliter (2.75 mmol per liter). No ...

Beginning in 1991, our understanding of the molecular bases of nine important neurologic diseases has burgeoned. A new class of molecular disease has been identified, defined by the abnormal, unstable expansion of DNA-triplet repeats in the mutant, causal ...

Apoptosis (or programmed cell death) is a central feature of normal tissue development in the fetus and of cell replacement in certain adult tissues (e.g., the thymus).¹ In contrast to necrosis (or accidental cell death), apoptosis is a tightly regulated ...

Capitation and decapitation have nothing to do with each other, but you could hardly tell the difference when observing the intense debate over the value and risks of capitation in health care payment. Those who favor capitation seem to regard it as the ...

The Health Care Financing Administration (HCFA) has announced the approval of a new diagnosis code for palliative care, which was included in the International Classification of Diseases, 9th Revision, Clinical modification on October 1, 1996.¹ The new ...

To the Editor: In their discussion of pitfalls of genetic testing (May 2 issue)¹ Hubbard and Lewontin seriously misrepresent several issues with regard to predictive genetic testing for mutations in the BRCA1 gene, and specifically testing for the ...

To the Editor: Monini et al. (May 2 issue)¹ reported very high rates of human herpesvirus 8 (HHV-8) detection by nested polymerase chain reaction (PCR) in semen from patients undergoing surgery for varicocele who were negative for the human ...

To the Editor: In a recent letter to the editor (May 16 issue),¹ Rogers raised questions about the cost effectiveness of treatment of hypercholesterolemia. His calculations were derived from the West of Scotland Coronary Prevention Study.² I propose that ...

To the Editor: Recht et al. (May 23 issue)¹ describe the effect of sequencing of chemotherapy and radiation on the risk of relapse and death in 244 women with early-stage breast cancer. Two points need to be made. First, distant metastases developed in ...

To the Editor: The prevalence of hypertension is increased in patients with insulin resistance and hyperinsulinemia. This observation has led to the hypothesis that insulin causes hypertension, and insulin-induced stimulation of renal sodium reabsorption,...

To the Editor: In their Brief Report (April 25 issue),¹ Kreuder et al. report the aggravation of rhabdomyolysis by fever and suggest thermolability of the mutant enzyme as a possible cause for the increase. An additional or alternative explanation is ...

To the Editor: As members of the Human Embryo Research Panel of the National Institutes of Health (NIH), we wish to correct what we believe are misrepresentations of the panel's report in the article about human-embryo research by Annas et al. (May 16 ...

Technological changes in societies give rise to changing patterns of illness in populations. Shifts from farming, hunting and gathering, and reliance on walking or use of animals for transportation to mechanized modes of industry, communications, and ...

A century ago, any worker who could no longer maintain gainful employment because of injury or illness had little recourse but to charity. Many could only take to the streets, where 15 percent of the population of the industrial cities eked out a living ...

This may be the largest textbook published in the United States on a subdivision of surgery. It weighs 10 lb (4.5 kg). The enthusiasm of the editors is commendable, as is their attempt to cover practically every aspect of penetrating trauma and to follow ...

Injury is the leading cause of death between the ages of 1 and 44 years. Unintentional injury cost this country $407 billion in 1993 alone. Despite this enormous economic toll, we spend relatively little on the prevention and care of trauma as compared ...

The field of hand surgery is rich with multivolume textbooks of encyclopedic proportions, and Clayton Peimer presents us with yet another, purported to be “the single largest source for information about the hand and entire upper extremity.” Records aside,...

With the cutting precision we expect of neurosurgeons and anatomists, the editors have dissected the topic of central nervous system trauma into 111 sections written by thoughtful and experienced clinicians and researchers. Their book is divided into 72 ...