About 10 to 15 percent of patients with parenterally transmitted non-A, non-B hepatitis have no evidence of hepatitis C virus (HCV) infection after extensive evaluation and can therefore be classified as having non-A–E hepatitis.¹–⁴ As compared with ...

Cloning of the hepatitis C virus (HCV)¹ and sensitive serologic and molecular assays established HCV as the predominant cause of non-A, non-B hepatitis.²,³ Conversely, it has been shown that approximately 20 percent of cases of community-acquired ...

Cigarette smoking is a well-established risk factor for the development and progression of coronary heart disease¹–⁴ and is strongly related to morbidity and mortality from cardiovascular causes.⁵,⁶ Conversely, the excess risk of cardiovascular events ...

Over 10 million U.S. women of childbearing age have undergone tubal sterilization, and by 1990 more women had undergone tubal sterilization than were using any other method of contraception.¹ Pregnancy is unlikely to occur among sterilized women; when it ...

Figure 1. A 54-year-old woman presented with paresthesias of the arms, occipital headache, and pain in the back of the neck. Neurologic examination revealed evidence of decreased sensitivity to pinprick, temperature, and light touch over the lower part of ...

In 1990, administration consumed, on average, 24.8 percent of total hospital spending in the United States¹ — nearly twice the share in Canada.² Many assume that the growth of for-profit hospitals in the United States is attributable to lower costs and ...

Hypertrophic cardiomyopathy is a complex cardiac disease with unique pathophysiologic characteristics and a great diversity of morphologic, functional, and clinical features.¹–⁸ The heterogeneity of the disease is accentuated by the fact that it afflicts ...

Presentation of Case

A 65-year-old man was admitted to the hospital because of severe abdominal pain and recurrent diarrhea.

The patient had been well until five years earlier, when he and his wife had nausea, vomiting, and diarrhea after consuming meat ...

Over the past 30 years, five hepatitis viruses have been identified and named A, B, C, D, and E.¹ Hepatitis A and E viruses are transmitted enterically and induce acute hepatitis, but they rarely cause chronic hepatitis. Hepatitis B virus (HBV) and ...

Tubal sterilization was initially performed at the time of cesarean delivery to avoid the necessity of a second cesarean section.¹ Today, however, most tubal sterilizations are elective (i.e., they are “interval” sterilization procedures not performed at ...

In a health care world of negotiated budgets and cost-based reimbursement, it was important for those who paid the bills to focus on the individual cost items that were presented for reimbursement. This is the type of world that existed when Medicare was ...

The demands inherent in certain practice specialties are popularly believed to contribute to the risk of divorce among physicians.¹,² Several demographic and personal factors thought to affect the risk of divorce may also influence medical students' ...

To the Editor: In “Quality of Care — What Is It?” (Sept. 19 issue),¹ the first article in the series on the quality of health care, Blumenthal asks the wrong question. He should have asked, “Who should be the judge?” Blumenthal discusses how the experts ...

To the Editor: The editorial by Drs. Angell and Kassirer (Sept. 19 issue)¹ is cute but fails to answer the question, Where did all those elephants — whose excreta is unmanageable — come from? At a time of hand wringing in medicine, we seem to be blind to ...

To the Editor: We would like to add to the excellent review of renal-cell carcinoma by Motzer et al. (Sept. 19 issue)¹ updated information concerning the treatment of patients who have metastatic renal-cell carcinoma with interleukin-2. The authors cite ...

To the Editor: Porphyria cutanea tarda can occur in patients with chronic renal failure who are treated with hemodialysis.¹,² These patients are probably predisposed to porphyria cutanea tarda because of a preexisting decrease in hepatic uroporphyrinogen ...

Brave indeed are those who set out to write a book about chronic fatigue syndrome. Here is a condition (many authors, including Demitrack and Abbey, wisely avoid calling it a disease) for which a consensus definition has yet to be achieved and that has no ...

Alzheimer's disease is a mass affliction of the elderly. The lifetime risk of dementia is 20 percent; at the age of 90 one of every two people has Alzheimer's disease. Despite the magnitude of the problem, the general diagnostic and therapeutic outlook ...

This book is an excellent review of the neurology of trauma. It addresses neurologists, neurosurgeons, and emergency medicine physicians. There are comprehensive sections on head trauma, spinal trauma, plexus and peripheral-nerve injuries, post-traumatic ...

This book, the combined effort of 136 authors in 95 chapters, covers a broad spectrum of neurologic disorders. After I read it, the days seemed distant when neurology was considered a specialty with an intricate nosology, an abundance of clinical names, ...

Vertigo, dizziness, and balance disorders occur in many sometimes very different diseases. More than 100 pathologic conditions can cause these disorders, so nearly all medical specialties have to deal with them.

This book describes in detail the anatomy, ...

Book Review of The Flight from Science and Reason Book Review, N Engl J Med 1997:336;300-301.. On page 301, the sentence that begins in line 10 of the left-hand column should have read, “And more radically, most adherents of this so-called constructivist ...