About half a million African children die each year as a result of cerebral malaria. The recommended therapy is parenteral quinine, but the case fatality rate is 10 to 30 percent despite treatment.¹,² Quinine has several other limitations. Because of its ...

Since the cinchona alkaloids were introduced as a specific treatment for agues 350 years ago, the treatment of severe malaria has changed little. Quinine and quinidine remain the drugs of choice for severe chloroquine-resistant malaria due to Plasmodium ...

Hot summer weather cannot be prevented; however, morbidity and mortality related to summer heat can be reduced.¹ Previous research shows that the excess mortality associated with sustained hot weather affects predominantly high-risk populations living in ...

For the past 30 years, a combination of melphalan and prednisone has been the standard treatment for myeloma. Extensive trials of other drug combinations have not led to major improvements in clinical outcome. Myeloma remains an incurable malignant tumor ...

Figure 1. A 40-year-old Nigerian woman with a history of malaria was admitted at 36 weeks of pregnancy after 4 days of intermittent fever, with temperatures up to 40°C (104°F), and lower abdominal pain. The base-line fetal heart rate was 108 beats per ...

In 1912, Hashimoto described four women in whom the thyroid gland was enlarged and appeared to have been transformed into lymphoid tissue (“struma lymphomatosa”).¹ Although the patients were not initially hypothyroid, they became so after thyroid surgery. ...

Venous thromboembolism is an uncommon but leading cause of illness and death during pregnancy and the puerperium.¹,² It has been reported to occur in 1 in 1000 to 1 in 2000 pregnancies,³,⁴ although few studies have used objective diagnostic techniques. ...

Presentation of Case

A 52-year-old man was admitted to the hospital because of severe back pain.

The patient had been well until 13 months earlier, when he had low back pain after lifting a 45-kg object. Three months later, he returned to work. Four ...

The impact of malaria is almost inconceivable to those who do not live in the tropics or subtropics. Each year, there are 300 million to 500 million new plasmodium infections and 1.5 million to 2.7 million deaths from malaria in the developing world. ...

Heatstroke is common and often deadly. The pathophysiology of the syndrome is understood, and effective treatment has been well defined.¹–³ Clinicians know that patients' chances of survival depend on prompt diagnosis and rapid cooling. Otherwise, a ...

Effective medication for the treatment of cocaine overdose and addiction is a major unmet need of worldwide importance. In contrast to heroin, for which there are effective medications to treat both overdose (naloxone) and addiction (methadone), there are ...

To the Editor: Dr. Salzman gives a moving account (Jan. 11 issue)¹ of his 20 years as a patient with progressive Parkinson's disease. His description of the various phases of the illness and his struggle to stay in control present a fine model for other ...

To the Editor: Sgarbossa and colleagues (Feb. 22 issue)¹ use data from the GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) trial to suggest improvements in the accuracy of the ...

To the Editor: A 61-year-old man was hospitalized because of an unexplained weight loss of 8 kg and fatigue. Eight years earlier, he had undergone a total hip arthroplasty on the left side (with a prosthetic femoral component of titanium and an ...

To the Editor: Rosenberg (Feb. 8 issue)¹ laments the increasing secrecy about methods and results in medical research. But if researchers are interested only in the search for truth, there is no reason for concealment in any kind of research, whether it ...

To the Editor: We strenuously object to Dr. Levinsky's contention (Feb. 22 issue)¹ that “managed-care organizations introduce into the doctor–patient relationship powerful third parties whose economic goal is to limit medical care in order to reduce ...

To the Editor: Perhaps the problems detailed in the article on patient advocacy by Weston and Lauria (Feb. 22 issue)¹ would not have occurred if the physicians involved had been more honest with the parents. The seriousness of the illness should have ...

To the Editor: Intravenous quinidine, the treatment of choice for patients with life-threatening falciparum malaria, is no longer available at many hospitals. A four-year-old boy, born in the United States, was brought to San Francisco General Hospital ...

This book deals only with juries in medical-malpractice cases, not with the tort-litigation system, although the jury has a central role in that system. The author challenges the view that juries are irrational, biased against physicians and hospitals, ...

Conflict in health care is intensifying. Antagonisms grow between “risk-sharing” physicians and capitated patients, “nonessential” nurses confront hospitals that are downsizing, and cutthroat competition for healthy patients builds among for-profit firms. ...

Risk tradeoffs are ubiquitous in modern society, and ordinary citizens as well as public officials regularly weigh risks and countervailing risks, either explicitly or implicitly, in making decisions. Sometimes these decisions are informed by careful ...

This is one of the most brilliant books to appear in the field of bioethics, and also one of the most troubling. It is not surprising to hear that we live in a pluralistic society and that the pluralism complicates ethical and political theory. The genius ...

Inflammatory Bowel Disease Review Article, N Engl J Med 1996:334;841-848.. On page 846, the sentence that begins 24 lines from the bottom of the left-hand column should have read, “Another approach is the use of omega-3 fatty acids to divert arachidonic ...