Coronary-artery bypass grafting (CABG), introduced in 1968,¹ results in longer survival and a better quality of life in specific subgroups of patients with multivessel coronary artery disease than does an initial strategy of medical therapy.²–⁶ Since the ...

The editorial comment “children of women with renal disease used to be born dangerously or not at all — not at all if their doctors had their way,”¹ reflects an early view of the effect of kidney disease on pregnancy. However, among pregnant women with ...

Kaposi's sarcoma–associated herpesvirus (KSHV; also known as human herpesvirus 8)¹,² is found in over 95 percent of Kaposi's sarcomas of all types, but rarely in solid tissue from control patients with neither the acquired immunodeficiency syndrome (AIDS) ...

The relation between peptic ulcer and gastric carcinoma has long been a matter of controversy.¹ A coexisting gastric cancer has been reported in 2 percent of patients given a diagnosis of gastric ulcers,² but follow-up studies have failed to demonstrate ...

Figure 1. A 35-year-old man presented with epigastric pain of several months' duration. An esophagogastroduodenoscopy revealed an active duodenal ulcer. Biopsy of the gastric antrum showed chronic active gastritis with innumerable Helicobacter pylori ...

The publication of “report cards” on the performance of health care providers is rapidly becoming both more common and more controversial.¹–⁶ Until recently, data on the quality and outcome of care have not been routinely available to the public. Now, ...

Hypertensive disorders are the most common medical complications of pregnancy and are an important cause of maternal and perinatal morbidity and mortality worldwide.¹ During normal pregnancy, systolic pressure changes little; however, diastolic pressure ...

Presentation of Case

A 62-year-old woman was referred to the hospital because of progressive exertional dyspnea and reticulonodular pulmonary infiltrates.

The patient had been well until six years earlier, when progressive exertional dyspnea began, ...

In this issue of the Journal, the results of the Bypass Angioplasty Revascularization Investigation (BARI), a large clinical trial comparing coronary-artery bypass grafting (CABG) with percutaneous transluminal coronary angioplasty (PTCA), are presented.¹ ...

Of all the medical disorders that add risk to pregnancy, renal disease has long ranked among those most feared by physicians. Not only are the renal and vascular manifestations of preeclampsia the most common medical complication of pregnancy, affecting 5 ...

In 1993, a National Institutes of Health Consensus Conference declared infection with Helicobacter pylori to be an important cause of duodenal and gastric ulcers.¹ Soon thereafter, the International Agency for Research on Cancer classified H. pylori as a ...

Within the past five years, two U.S. female gymnasts at the Olympic level, Christy Henrich and Julissa Gomez, died from medical problems related to their sport. Christy died from complications of anorexia nervosa and Julissa from complications of spinal ...

To the Editor: Harpaz et al. (Feb. 29 issue)¹ provide a well-documented description of the transmission of hepatitis B virus (HBV) from a surgeon to at least 19 patients. The surgeon received the diagnosis of hepatitis B in February 1992, after the ...

To the Editor: Nelson et al. (March 7 issue)¹ studied the outcome of cerebral palsy and its association with specific heart-rate patterns on electronic fetal monitoring. Their analysis confirms, and Dr. MacDonald's companion editorial² supports, previous ...

To the Editor: Mandel et al. (March 21 issue)¹ suggest that contributing factors, such as resistance to activated protein C, may be needed for thrombosis to occur in patients with moderate increases in plasma levels of homocysteine. However, isolated ...

To the Editor: From September 1993, the month in which the marketing of cisapride (Propulsid, Janssen Pharmaceutica, Titusville, N.J.) began, to April 1996, the Food and Drug Administration's MedWatch reporting program (telephone number, 1-800-FDA-1088) ...

To the Editor: Daoust and Schapiro describe a 41-year-old man with human immunodeficiency virus infection and histoplasmosis in their Image in Clinical Medicine (March 14 issue).¹ Panel B is reported to show a segmented neutrophil with an intracellular, ...

The goal of Primary Care Orthopaedics is to familiarize medical students and primary care practitioners with the most common orthopedic conditions and injuries. Primary care providers are broadly interpreted to be pediatricians, family practitioners, ...

In an age in which the management of low back pain is primarily driven by market forces, this book provides a clear, logical approach based on clinical findings. The author communicates his rich experience as an orthopedic surgeon who has lived through ...

According to the Bureau of the Census, 1 in 10 adult Americans lives with a major disability. Most people have episodes of musculoskeletal pain that limit their function at some time during their lives. Yet physicians in training receive very limited ...