In children, the outcome of cardiac arrest outside the hospital has been poor, with very high rates of mortality and neurologic morbidity.¹ Many survivors remain in a persistent vegetative state,¹ recovery from which is unlikely.² Recently, much has been ...

Preeclampsia is a hypertensive disorder of late pregnancy that resolves shortly after delivery. It occurs in up to 10 percent of all pregnancies and is a major cause of maternal and fetal morbidity and mortality.¹–³ Although the pathophysiologic ...

The development of B cells proceeds through a series of well-defined stages characterized by sequential rearrangements of immunoglobulin genes and by the expression and extinction of enzymes and structural proteins required for presentation of the ...

Modern concepts of cancer immunology originated from the classic observations by Jensen, Loeb, Tyzzer, and Little in the early years of the 20th century of the rejection of transplanted allogeneic tumors and the acceptance of syngeneic tumors.¹ Despite ...

Figure 1. Fetal facial expressions are sometimes seen during ultrasonography. This yawning fetus, studied at 34 weeks' gestation, was born vigorous and healthy at term.

There is persistent concern in the United States that veterans of the Persian Gulf War may have had a higher rate of postwar mortality than other veterans and that certain causes of death may have been especially frequent.¹,² Excess numbers of deaths from ...

During the Persian Gulf War, there were far fewer combat and medical casualties among U.S. military personnel than expected.¹–⁷ Since returning from the Persian Gulf, however, some veterans have reported a variety of symptoms.⁷–⁹ The Departments of ...

Presentation of Case

A 57-year-old woman was admitted to the hospital because of fever, sweats, neuropathy, and multiple pulmonary nodules.

The patient had been well until nine months earlier, when weakness developed in the left ankle. During the ...

A rare disease can represent irrelevant esoterica to some but an interesting challenge to others — an oddity or an opportunity. Ogden Bruton's observations in a boy with unusual susceptibility to bacterial infections show how clinical acumen and simple ...

In 1990 the United States and its allies sent close to a million troops to the Persian Gulf. Fewer than 150 Americans died during the six-week war against Iraq,¹ but many veterans now fear that the Persian Gulf War ruined their health. Six years later, ...

The interaction between the human immunodeficiency virus (HIV) and its cellular target once seemed fairly simple: the virus attached to the CD4 molecule on the cell surface, entered the cell, and began its replicative cycle.¹ However, in the past few ...

To the Editor: In the study by Scholes et al. (May 23 issue),¹ which examined whether screening for and treatment of chlamydia prevented pelvic inflammatory disease, 1009 women were randomly assigned to screening and treatment, but only 645 were actually ...

To the Editor: Landesman et al. (June 20 issue)¹ report that the risk of transmission of the human immunodeficiency virus type 1 (HIV-1) from mother to infant increases rapidly when the amniotic membranes rupture more than four hours before delivery. ...

To the Editor: In their image entitled “Angioedema of the Intestine” (June 20 issue),¹ Gregory and Davis did not mention the duration of lisinopril treatment. Since the diagnosis of recurrent swelling of the tongue and pharynx associated with the ...

To the Editor: Iglehart's discussion of the quandary over graduates of foreign medical schools in the United States (June 20 issue)¹ highlights several issues. We train residents to provide the country with the work force needed for the next 30 years and ...

To the Editor: In response to intense market competition and severe cost pressures, many academic medical centers are attempting to unbundle their complex patterns of conjoint activities and cross-subsidization in order to examine the processes and costs ...

To the Editor: Severe poisoning with β-adrenergic–receptor blocking agents, which leads to decreased production of cellular cyclic AMP and impaired release of calcium from the sarcoplasmic reticulum, causes bradycardia and hypotension that can be ...

The debate about the organization, financing, and delivery of medical care in the United States has been the theme of the 1990s, and the cost of medical care is its driving force. Access, equity, and quality are touted as the rationale for the ...

A large segment of the world population still suffers from poor sanitary conditions, inadequate access to health care, and an unsteady supply of food. In spite of our understanding of the causes of many of these problems, integrating that knowledge with ...

Dougherty's stated goal in this book is to “identify key moral values, display their roots and general structures, and apply them to the health care system.” He seeks to critique the vast power of market forces in health care and provide a normative ...

There seems to be no aspect of [psychiatric] practice more fraught with rancor and contentiousness than that of managed care,” states Arthur Lazarus in the afterword to this book. As the editor, Lazarus poses critical questions on the relation between ...