Unsustained ventricular tachycardia in patients who have had a previous myocardial infarction and have left ventricular dysfunction has been associated with a two-year mortality rate in the range of 30 percent.¹–³ Antiarrhythmic therapy has been widely ...

The World Health Organization has estimated that more than 1.7 billion persons are infected with Mycobacterium tuberculosis worldwide.¹,² A puzzling feature of mycobacterial infection is that clinically evident disease occurs in only a small proportion of ...

Ovarian cancer, the leading cause of death from gynecologic cancer in the United States, is one of the few solid tumors in which the five-year survival rate for patients has improved in recent years.¹,² Nevertheless, most women with advanced ovarian ...

The attenuated strain of Mycobacterium bovis bacille Calmette–Guérin (BCG) is the most widely used vaccine in the world. In most children, inoculation of live BCG vaccine is harmless although it occasionally leads to a benign regional adenitis.¹ In rare ...

Figure 1. A 69-year-old white man had progressively more severe headaches for five weeks, and sudden persistent hearing loss developed four days before admission to the hospital. He had been healthy and had no history suggesting immune compromise or ...

The accuracy of the litigation system governing medical malpractice in the United States is widely debated.¹,² Many physicians assert that malpractice litigation is haphazard and that suits are brought with little regard to the quality of the care the ...

The measurement of blood pressure is now firmly established as an important component of the routine pediatric physical examination. Nevertheless, blood pressure in children has been given serious attention only since the mid-1960s. The first report of ...

Presentation of Case

A 58-year-old man was admitted to the hospital because of respiratory distress and hypotension.

Seven years before admission, a routine radiograph of the patient's chest had been reported to show a “black spot” in a lung. He declined ...

Physicians have long struggled with the vexing problem of how best to treat patients with myocardial infarction, reduced left ventricular function, and asymptomatic unsustained ventricular tachycardia who may be at risk for sudden death due to ventricular ...

The federal Employee Retirement Income Security Act (ERISA)¹ is the federal law that governs employee-benefit plans offered by private employers and unions. ERISA has long hindered state efforts to expand access to health care, because it prohibits states ...

Typical damn day. I am running behind, swilling lukewarm coffee, and whittling away at the tower of charts and messages the nurse has stacked on my desk. I peep around the corner to survey the crowded waiting room, and I recognize every dependable name ...

To the Editor: A review article on hip fracture (June 6 issue)¹ is certainly welcome. The diagnosis, prevention, and treatment of osteoporosis and the assessment of risk factors and prevention of falls are not only critical if we are to decrease the ...

To the Editor: In their review of the evaluation of dementia (Aug. 1 issue),¹ Geldmacher and Whitehouse expressed their “opinion . . . that apolipoprotein E testing will not be ready for clinical use as either a predictive or a diagnostic test until ...

To the Editor: Nelson et al. (Aug. 1 issue)¹ report that seropositivity for the human immunodeficiency virus (HIV) declined among Thai military conscripts from a range of 10.4 to 12.5 percent in the period 1991 to 1993 to 6.7 percent in 1995, and they ...

To the Editor: In patients infected with human immunodeficiency virus type 1 (HIV-1), immunosuppression limits the choice of drugs that may be used to treat psoriatic erythroderma. We describe a patient who had a dramatic therapeutic response to ...

To the Editor: The Image in Clinical Medicine of the peripheral-blood smear from a patient with vitamin B₁₂ deficiency (Aug. 1 issue)¹ beautifully captures many of the features of megaloblastic anemia. The author mentions that the patient's mean ...

To the Editor: The acute coronary syndromes — myocardial infarction, unstable angina, and sudden cardiac death — have been shown to be triggered by heavy physical exertion, including snow shoveling,¹ anger, and other types of emotional or physical ...

This book dramatically recounts the discovery of the cause of a local outbreak of sudden, severe parkinsonism in a group of young adults in northern California and how this discovery led to greater insight into Parkinson's disease. Langston is the Bay ...

Many people say we have learned more about the brain in the past 20 years than in all of recorded history. Much of this explosive growth in knowledge emanates from the technological advances that are revolutionizing all of biomedical research. These ...

From 1783 to 1785, a woman named Kate Hudson plagued England's Nottingham General Hospital with visits prompted by the mysterious appearance of needles, nails, and pieces of bone beneath her skin. Her medical record, which may be the first recorded ...

For many years, mental health professionals who work with children have been asked by parents, “Will my child grow out of it?” Those of us who have been careful to base our responses on the literature have had to reply in a way that undoubtedly seemed ...