Life expectancy is shorter, and mortality rates greater, for black than for white Americans.¹ Recently, these two discrepancies have widened.² Cardiovascular disease, the leading cause of death for all Americans, is the most important single determinant ...

Nationwide and statewide studies in the United States indicate that young and middle-aged black Americans have disproportionately high morbidity and mortality¹–⁵ and that differences between socioeconomic groups in premature mortality may be increasing.⁶ ...

Primary invasive carcinoma of the vagina is a rare gynecologic cancer, accounting for between 1 and 4 percent of primary malignant tumors of the genital tract in women.¹–⁴ Vaginal carcinoma in situ (vaginal intraepithelial neoplasia type III), which may ...

X-linked severe combined immunodeficiency is a recessive hereditary disease characterized by severe and persistent infections starting in the first months of life and associated with diarrhea and failure to thrive.¹ Affected infants almost invariably ...

Figure 1. A 78-year-old woman who had undergone right hemicolectomy to treat carcinoma of the cecum with involvement of regional lymph nodes noticed a new periumbilical subcutaneous swelling two months after her surgery. Biopsy revealed an adenocarcinoma ...

Figure 1. A 44-year-old man was found to have an umbilical tumor. Examination revealed the lesion to be firm and subcutaneous, approximately 5 cm in diameter, with erythema around the navel. The cervical and inguinal lymph nodes were enlarged. Computed ...

Primary biliary cirrhosis is a chronic, progressive cholestatic liver disease of unknown cause that usually affects middle-aged women and eventually leads to liver failure and the need for liver transplantation. It is diagnosed more frequently now than it ...

The incidence of burn injury has declined steadily over the past several decades in the United States and in some other developed countries. In-hospital fatality rates have also declined and are now only about 4 percent among patients with major injuries ...

Presentation of Case

A 37-year-old right-handed man with the acquired immunodeficiency syndrome (AIDS) was admitted to the hospital because of increasing confusion and disorientation.

The patient had tested positive for antibodies against human ...

Cardiovascular disease remains the leading cause of death and the greatest contributor to excess mortality among black Americans in the 1990s.¹–⁴ Rates of death from cardiovascular causes among black Americans are among the highest in the industrialized ...

Until recently, cancer of the uterine cervix was a major cause of death among women of reproductive age in the United States.¹ In the 1960s, the pioneering work of Papanicolaou and Traut on the cytologic examination of exfoliated cells from the uterine ...

The membership of health maintenance organizations (HMOs) now exceeds 50 million people and may grow by an additional 50 million by the year 2000. But all is not well in HMO-land. An angry and determined backlash is spreading across the nation. In 1996 ...

To the Editor: We reviewed 113 articles published over a three-decade period to calculate the rate of survival to hospital discharge after cardiopulmonary resuscitation (CPR).¹ Long-term survival after in-hospital CPR was 15.2 percent (95 percent ...

To the Editor: Fisher et al. (June 27 issue)¹ report on the treatment of septic shock with the tumor necrosis factor (TNF) receptor:Fc fusion protein (TNFR:Fc). The results of their study are a disappointment to those of us who hoped that modification of ...

To the Editor: Schreiber et al. (June 27 issue)¹ estimate the risk of transmitting the human immunodeficiency virus (HIV), the human T-cell lymphotropic virus (HTLV), the hepatitis C virus (HCV), or the hepatitis B virus (HBV) from units of screened ...

To the Editor: Disseminated microsporidian infections have been reported in several patients with human immunodeficiency virus (HIV) infection, and hematologic dissemination is thought to be most likely.¹ We describe an HIV-infected patient with ...

To the Editor: Case 15-1996 (May 16 issue)¹ describes a typical case of celiac disease in an adult in whom a complicating T-cell lymphoma led to death. The chronically ill and malnourished condition of the patient, the multifocal nature of the lymphoma, ...

To the Editor: Both the article by Gurley et al.¹ and the editorial by Campion² (June 27 issue) address the fear expressed by those living alone — that after an emergency, they may be incapacitated for a long time before being found. Of the 367 persons ...

Bernadine Healy is a distinguished physician who has served as professor of medicine at Johns Hopkins School of Medicine, chair of the Research Institute of the Cleveland Clinic Foundation, and director of the National Institutes of Health — the first ...

This book was written in response to a survey of practicing obstetricians and gynecologists who were asked which problems would benefit from an update of information. Its sections are largely organized according to specialties: cardiovascular medicine, ...

Osteoporosis is a common disease, but it is not simple. The goal of this textbook is to help primary care physicians understand and apply the rapidly growing body of knowledge derived from bone-related research. The first two sections discuss physiology ...

Interest in osteoporosis has grown exponentially in the past two decades, with the diversification of research well beyond traditional areas into such fields as engineering and epidemiology. A small number of excellent journals and textbooks on various ...

Pharmacotherapy for Obesity — Do the Benefits Outweigh the Risks? Editorial, N Engl J Med 1996:335;659-660.. On page 659, the sentence that begins 11 lines from the bottom of the right-hand column should have read, “Although the severity of the pulmonary ...