Patients who come to the hospital with acute myocardial ischemic syndromes represent a continuum of disease from unstable angina to acute infarction. The duration, frequency, and timing of ischemic symptoms are important long-term prognostic factors¹,² ...

In patients with chest pain at rest but no ST-segment elevation on the electrocardiogram, the diagnoses of unstable angina and non–Q-wave myocardial infarction are usually considered together because they cannot be distinguished clinically or ...

The symptoms of infection with the human immunodeficiency virus (HIV) result from a progressive immunodeficiency due to the destruction of CD4 T lymphocytes, which ultimately renders HIV-infected patients susceptible to opportunistic infections and ...

First-degree relatives of patients with non-insulin-dependent diabetes mellitus (NIDDM) have a lifetime risk of diabetes of approximately 40 percent.¹ In these relatives, insulin resistance is the best predictor of the development of diabetes and probably ...

Insulin-like growth factor I (IGF-I) mediates the majority of the growth-promoting effects of growth hormone (GH) after birth.¹ In the prenatal period, GH does not appear to have a major influence on fetal growth, whereas IGF-I does. Infants with ...

Figure 1. A 35-year-old woman fell off her bicycle, striking her chin on the pavement. She initially reported bilateral neck pain and headache and later had photophobia and weakness and paresthesia in the right arm. Examination revealed anisocoria but no ...

Most immune responses depend on the activation of T cells. This class of lymphocytes consists of functionally and phenotypically distinct populations, the best characterized of which are helper T cells and cytotoxic T cells. Distinctive molecules on the ...

Presentation of Case

A 50-year-old woman was admitted to the hospital because of cardiac arrest in ventricular fibrillation.

She had been in excellent health until four years earlier, when she abruptly lost consciousness. Evaluation elsewhere revealed ...

Acute coronary syndromes have a common pathophysiologic mechanism. A coronary atherosclerotic plaque ruptures and a mural or occlusive thrombus forms, impairing or interrupting the perfusion of myocardial tissue.¹ Consequently, the clinical spectrum in ...

The importance of insulin-like growth factor I (IGF-I) in regulating the effects of growth hormone on postnatal growth and development is well established, but its role during the prenatal period is not. Postnatally, the synthesis and release of IGF-I and ...

To the Editor: Masuko et al. (June 6 issue)¹ described hepatitis GB virus C (HGBV-C) infection in patients on hemodialysis, reporting a prevalence of 3.1 percent among 519 Japanese patients on hemodialysis as compared with 0.9 percent among 448 healthy ...

To the Editor: Hepatitis G virus (HGV), a newly discovered hepatotropic flavivirus¹ that can induce persistent infection, has been associated with acute and chronic liver disease.²,³ There are only limited data concerning the prevalence of HGV in ...

To the Editor: Spector et al. (June 6 issue)¹ conclude that oral ganciclovir “promises to be a useful drug for prophylaxis against CMV [cytomegalovirus] disease in persons with AIDS [the acquired immunodeficiency syndrome].” The results of their study do ...

To the Editor: Several reports of ganciclovir-induced psychiatric disturbances have been reported in the medical literature.¹–³ Two cases involved patients with mild renal insufficiency¹,² and one a patient who was undergoing hemodialysis.³ Since ...

To the Editor: The study by Belluzzi et al. (June 13 issue)¹ suggests that fish oil reduced the frequency of relapse in patients with Crohn's disease. However, there is a serious flaw in the design of this study: the placebo group received a mixture of ...

To the Editor: In his essay on the responsibilities of people with human immunodeficiency virus (HIV) infection to their sexual partners (June 6 issue),¹ Bayer concludes that personal responsibility has a central role in AIDS prevention and that “matters ...

Physicians interested in the direction historians of medicine are increasingly taking with respect to the examination of health care institutions can do no better than to read this book. The subject of this work is how London hospitals in the 18th century ...

This book is pleasant to read, upbeat in challenging times, and a very personal account. The author — successively physician, investigator, administrator, and now writer — has interviewed 32 physicians about their careers. In his preface, Laster warns ...

The American College of Cardiology “was at the beginning, of course, a miserable organization but I can well see that perhaps . . . it is headed for better days.” That is how Paul Dudley White, the leading academic and clinical cardiologist of his day, ...

William Felch's delightful and highly readable medical autobiography is also a record of the scientific, socioeconomic, political, and philosophical issues arising in medicine during the span of Felch's practice. Dr. Felch, who has just retired after 40 ...

The Department of Veterans Affairs has embarked on the reformation of its often-criticized health care system, an insular system that Congress has protected from the tumultuous forces that are reshaping other parts of American medicine. The department is ...

Postmenopausal Estrogen and Progestin Use and the Risk of Cardiovascular Disease Original Article, N Engl J Med 1996:335;453-461.. On page 453, the first two sentences of the Results paragraph of the Abstract should have read, “We observed a marked ...

Use of Alternative Techniques of Hysterectomy in Ohio, 1988–1994 Special Article, N Engl J Med 1996:335;483-489.. On page 488, the sentence that begins in line 10 of the right-hand column should have read, “Although we found that the mortality rates ...