Percutaneous transluminal coronary angioplasty (PTCA) is more effective in improving symptoms, exercise performance, and the quality of life than medical treatment in patients with single-vessel coronary artery disease.¹,² Two recent randomized, ...

Over the past decade, numerous germ-line mutations have been discovered that increase the risk of inherited cancers. Clinical applications of these findings include genetic testing for the diagnosis of inherited syndromes in patients with cancer and ...

Acute tubular necrosis is an acute, severe, and sustained decrease in renal function that can result from both ischemic and nephrotoxic insults to the kidney. Despite the availability of dialysis, the morbidity and mortality are high.¹–³ Atrial ...

Intrahepatic cholestasis with a paucity of interlobular bile ducts, or ductopenia, has been described as a common pathologic feature of many heterogeneous conditions, either inherited or acquired in childhood or adulthood.¹ In children, ductopenia has ...

Human T-cell lymphotropic virus type I (HTLV-I) is associated with adult T-cell leukemia and a chronic progressive neurologic disease, HTLV-I–associated myelopathy–tropical spastic paraparesis (hereafter referred to as HTLV-I–associated myelopathy).¹–⁵ ...

Figure 1. A single diagnosis explains the unusual findings in this 79-year-old woman.

In this article, we review the randomized clinical trials of aspirin, of heparin, and of fibrinolytic therapy in patients with suspected acute myocardial infarction to determine which of these treatments have been shown to improve survival and other major ...

Presentation of Case

A 39-year-old woman was admitted to the hospital because of a gastric mass and pernicious anemia.

She had had sporadic abdominal pain and chronic anxiety for many years. Two years before admission, the results of an upper ...

Genetic testing for susceptibility to familial adenomatous polyposis has considerable importance for the relatives of patients with the disease, because a mutation in the adenomatous polyposis coli (APC) gene, if present, invariably causes colon cancer. ...

Acute tubular necrosis is common in acutely ill hospitalized patients, with mortality rates exceeding 50 percent.¹ The regenerative capacity of kidneys damaged by acute tubular necrosis is substantial, and minimizing renal injury or accelerating renal ...

To the Editor: Chambers et al. (Oct. 3 issue)¹ report birth outcomes after prenatal exposure to fluoxetine but fail to provide results for infants of mothers with mood disorders who were not treated or who received other antidepressant drugs. Although ...

To the Editor: Hsich et al. (Sept. 26 issue)¹ described a new premortem diagnostic test for Creutzfeldt–Jakob disease and the related transmissible spongiform encephalopathies that consists of an immunoassay for the detection of the 14-3-3 brain protein ...

To the Editor: Vascular malformations of the brain stem are relatively uncommon and represent about 7 percent of all vascular malformations of the brain.¹ They may be manifested as subarachnoid or intraparenchymatous hemorrhages, seizures, or fluctuating ...

To the Editor: The diagnostic error we are invited to learn from in the interesting Clinical Problem-Solving article by Brown et al. (Oct. 3 issue)¹ would not have occurred if the original clinicians had been familiar with the medieval logical tool known ...

To the Editor: Paz et al. (Sept. 26 issue)¹ studied the effects of ethanol on obstruction of the left ventricular outflow tract in hypertrophic cardiomyopathy. They noted an increase of 63 percent in the mean outflow tract gradient in response to 50 ml ...

To the Editor: We describe a 13-year-old boy with attention deficit–hyperactivity disorder in whom fever, rash, conjunctivitis, hepatitis, myocarditis, and eosinophilia developed and who died about two months after the start of carbamazepine therapy. The ...

To the Editor: Gallstone ileus results in considerable morbidity and mortality. Ileus is due to obstruction of the bowel by a large biliary stone that wedges in the terminal ileum or any other intestinal location (e.g., the colon). Prior formation of a ...

To the Editor: The Special Report by Kessler et al. (Sept. 26 issue)¹ on the regulation of tobacco products by the Food and Drug Administration (FDA) failed to mention an important preventive action — namely, the reduction of nicotine levels. Fortunately,...

We stand at a pivotal moment in the history of human experimentation. Long-standing suspicions about research are fading, along with an unconditional commitment to informed consent. The distinction between investigation and therapy is blurring; fears ...

The debate about assisted suicide arouses such passion on both sides that it is difficult to know what the argument is really about. Some believe that it is wrong for physicians to participate actively in the deaths of their patients, no matter what the ...

This book explores the ethical issues that modern reproductive technologies have made real. Many of the principles guiding the treatment of medical problems come from traditional medicine; only later are philosophical and moral questions examined, and ...

The title page of this book includes a magnificent painting of a hospital sick ward in Bruges done in 1778 by Johannes Beerblock. Entering the book through this picture is symbolic of the experience of reading it and browsing through its illustrations, ...

Whenever you might think that the world as you perceive it will soon disappear, always remember that the actual situation is better than you think. A reminder of that comforting principle recently crossed my desk in the form of the McGill Journal of ...

The social transition that must follow the political transition in South Africa will pose major challenges for many decades. The need to reduce inequities is undisputed. However, the means of effectively and sustainably achieving this reduction are less ...