More than 30 epidemiologic studies have found that postmenopausal women who use estrogen are at lower risk for coronary disease than those who do not use estrogen¹; however, most data are for estrogen alone.² Progestins added to estrogen reduce or ...

During the past 20 years the rate of increase in the incidence of adenocarcinoma of the esophagus has outstripped that of all other tumors.¹–⁴ This dramatic change has been accompanied by a shift in the biologic behavior of esophageal cancer toward poorer ...

An estimated 7 million episodes of acute cystitis occur annually in the United States,¹ and the annual costs of caring for these infections in young women are thought to exceed $1 billion.² Thus, improved means of preventing acute cystitis could lead to ...

Figure 1. A 90-year-old woman presented with a three-month history of progressive dysphagia, postprandial vomiting, and weight loss. Barium contrast studies of the upper gastrointestinal tract showed an irregular narrowing in the midesophagus (Panel A, ...

Laparoscopically assisted vaginal hysterectomy has come into widespread use, primarily because morbidity is presumed to be less when the large abdominal incision and invasive intraabdominal manipulations associated with total abdominal hysterectomy are ...

Laparoscopic procedures have been rapidly introduced into clinical practice over the past decade, often before they have been critically compared with standard procedures. Laparoscopically assisted vaginal hysterectomy has been promoted as a substitute ...

Heart failure is a complex of symptoms — fatigue, shortness of breath, and congestion — that are related to the inadequate perfusion of tissue during exertion and often to the retention of fluid. Its primary cause is an impairment of the heart's ability ...

Presentation of Case

A 38-year-old man was admitted to the hospital because of fever, cough, and sweats.

The patient had been in excellent health until three weeks earlier, when he began to have a continuous fever; he did not take his temperature and was ...

Ten years ago several educators proposed that the teaching of clinical medicine should shift from inside to outside the hospital. They observed that there was a discrepancy between the kinds of patients seen on the inpatient services and those seen in ...

In the Western world the incidence of adenocarcinoma of the esophagus has risen markedly in the past three decades. Barrett's specialized columnar-cell metaplasia (Barrett's esophagus), which is the most important predisposing factor, is found in more ...

The association between sexual intercourse and acute cystitis in women has been recognized for generations in folk wisdom (e.g., “honeymoon cystitis”), but researchers have been less certain of this association.¹ In fact, a causal relation between two ...

Except for abortion, laparoscopically assisted vaginal hysterectomy has generated more controversy and discussion than any other type of gynecologic surgery in recent times. Is it because hysterectomy is itself controversial? Could it be that the benefits ...

The explosive growth of managed care has led to an increased role for general internists and other primary care physicians in the American health care system. This change is welcome in many respects, since generalists have perennially been undervalued by ...

To the Editor: The February 1 issue contained reports on attitudes toward physician-assisted suicide and voluntary euthanasia. Bachman et al.¹ found that “most Michigan physicians prefer either the legalization of physician-assisted suicide or no law at ...

To the Editor: Drs. Testa and Simonson (March 28 issue)¹ raise important issues in measuring the quality of life. Oncology trials generally report only a single dimension — time, as in the duration of remission or median survival. A three-dimensional ...

To the Editor: Gane et al. (March 28 issue)¹ found that five years after liver transplantation, rates of graft and overall survival were similar between patients with and those without hepatitis C virus (HCV) infection. However, they also showed that ...

To the Editor: Casadevall et al. (March 7 issue)¹ described the development of autoantibodies against erythropoietin in a patient with pure red-cell aplasia. The authors report the presence of IgG antibodies against endogenous erythropoietin, but there ...

To the Editor: Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone have been reported in patients treated with sertraline (Zoloft).¹–³ We describe the rapid onset of hyponatremia in an 82-year-old woman who was hospitalized ...

To the Editor: As members of a two-physician family we were very interested in Baker's article (April 11 issue)¹ on differences in earnings between male and female physicians. We are curious about whether Baker has any data on two potentially confounding ...

A physician helps a suffering patient die. Newspapers across the country cover the story, engendering a nationwide debate over whether the doctor is a murderer or a humanitarian.

These events have a modern ring, but they actually occurred in 1915. Long ...

The first edition of Leukemia, published by Grune and Stratton in 1958, was a pioneering account by two preeminent hematologists, William Dameshek of Boston and Fred Gunz of Christchurch, New Zealand, of the origins of leukemia, the manifestations of its ...

The third edition of Clinical Practice of Transfusion Medicine is a valuable general reference work on the practical, clinical, and technical aspects of transfusion practices. Since the second edition in 1989 (edited by Lawrence D. Petz and Scott N. ...

This book reviews almost everything about the laboratory aspects of hematology and hematologic cancers. It contains comprehensive reviews of erythrocyte, leukocyte, and platelet disorders, as well as hemostasis, fibrinolysis, and the leukemias. For each ...

Columbia/HCA and the Resurgence of the For-Profit Hospital Business Special Report, N Engl J Med 1996:335;362-368.. On page 364, in Table 1, the number of licensed beds at year end for the year 1992 should have been 4938, not 42,245, as printed.