Erectile dysfunction (impotence) affects approximately 10 million to 20 million men in the United States.¹,² It becomes more frequent with age,³ but is not an inevitable consequence of normal aging.⁴ It is usually due to organic factors or diseases, such ...

Increased use of flexible sigmoidoscopy as a screening examination for colorectal carcinoma has led to increased detection of benign adenomatous polyps <5 mm in diameter (referred to as diminutive) in the rectosigmoid of asymptomatic patients.¹,² Although ...

The routine management of aortic aneurysms is surgical, with placement of a graft in the involved segment.¹,² Surgical treatment of nonruptured abdominal aortic aneurysms is associated with an overall mortality rate of 1.4 to 7.6 percent,³–⁵ and the rate ...

Transient hypothyroxinemia after birth is common in premature infants.¹–⁷ The degree of hypothyroxinemia is related to gestational age and the severity of neonatal disease.¹,³,⁵–⁷ It has been assumed that low plasma thyroxine concentrations in premature ...

Figure 1. A 76-year-old man with a three-day history of crampy abdominal pain presented to the hospital with melena and a near-syncopal episode. Sixteen years earlier he had undergone successful surgery to repair an abdominal aortic aneurysm. His blood ...

Intracranial aneurysms are acquired lesions that are most commonly located at the branching points of the major arteries coursing through the subarachnoid space at the base of the brain (Figure 1). A subarachnoid hemorrhage due to the rupture of an ...

The indications for providing nutrients by the enteral or intravenous route (nutritional support) are not well defined, and the efficacy of nutritional support in many circumstances is unproved. Nonetheless, nutritional support is widely used for several ...

The U.S. Supreme Court will decide later this year whether to let stand decisions by two appeals courts permitting doctors to help terminally ill patients commit suicide.¹ The Ninth and Second Circuit Courts of Appeals last spring held that state laws in ...

While the Supreme Court is reviewing the decisions by the Second and Ninth Circuit Courts of Appeals to reverse state bans on assisted suicide, there is a unique opportunity to engage the public, health care professionals, and the government in a national ...

In 1951 the treatment of abdominal aortic aneurysms was revolutionized when Dubost et al. successfully replaced such an aneurysm with a homograft.¹ Before that seminal operation, the treatment of abdominal aortic aneurysms was ineffective because there ...

Teaching hospitals from Boston to San Francisco are merging and transforming themselves into so-called integrated health care systems. Massachusetts General Hospital and Brigham and Women's Hospital, both affiliated with Harvard, have merged into a new ...

To the Editor: The National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study Group would like to respond to comments by the Multicenter Acute Stroke Trial — Europe (MAST-E) investigators (July 18 issue),¹ who claimed that the ...

To the Editor: Minimally invasive procedures involving endoscopic instruments have become routine in many surgical specialties. In cardiac surgery, only a few procedures have been performed with such devices, such as ligation of a patent ductus ...

To the Editor: Substantial direct and indirect harm may occur during the removal of cord blood from infants. Large amounts of blood are needed to obtain sufficient numbers of stem cells for transplantation. The procedure for removing cord blood can be ...

To the Editor: Resting energy expenditure has been variably reported as increased,¹ inconsistently elevated,² and decreased³ in patients with human immunodeficiency virus (HIV) infection. The determinants of this variability are not yet understood. Given ...

To the Editor: The legend accompanying the Image in Clinical Medicine of placental malaria (July 11 issue)¹ states that the mother's red cells were infected but the baby's were not. My concern is that this is not always the case. Sometimes there are ...

To the Editor: Your portentous parable (Aug. 8 issue)¹ of the Panglossian, albeit Procrustean, practices of health maintenance organizations (HMOs) did not include one important element of the game — mergers. When two HMOs merge, each terminates ...

Robert Spitzer's The Politics of Gun Control is a balanced and illuminating overview of the gun-control debate as it existed before the 1995 Oklahoma City bombing: a battle centered on crime and pitting an omnipotent National Rifle Association (NRA) ...

Richard Isay has made a career of the struggle to make psychoanalysis safe, available, and effective as a treatment for gay men. In his first book on the subject, Being Homosexual: Gay Men and Their Development (New York: Farrar, Straus & Giroux, 1989), ...

There has always been a close fit between social norms and medical diagnosis and treatment. The treatment of homosexuality is a case in point. In no other diagnostic area can one find greater confusion between social mores and scientific judgment.” With ...

With the graying of baby boomers has come increased interest in men's health, particularly prostate disease. Benign enlargement of the prostate begins in the fourth decade of life, culminating in a prevalence of nearly 100 percent by the ninth decade. ...

Cardiovascular medicine has become highly specialized, but the front line of the battle against cardiovascular disease will always be the realm of primary care physicians. Therefore, primary care physicians must be familiar with the clinical presentation, ...

Hypopyon Images in Clinical Medicine, N Engl J Med 1996:334;1512.. The sentence that begins in the third line of the legend should have read, “Treatment with chlorambucil and prednisolone eye drops,” not “prednisone eye drops,” as printed.