Bone marrow transplantation is an increasingly effective treatment for leukemia and several other malignant and nonmalignant diseases. However, there is growing concern about possible late consequences of compromised immune function and of treatment, ...

Atrial fibrillation, the most common sustained cardiac-rhythm disturbance,¹ affects more than 2 million Americans,² with an overall prevalence of 0.89 percent. The prevalence increases rapidly with age to 2.3 percent between the ages of 40 and 60 years ...

Sepsis is associated with a mortality rate of 30 to 50 percent and with substantial morbidity.¹ The relative contributions of the inflammatory response and infection to these adverse outcomes are unknown.²,³ In animal models of sepsis, treatment with ...

Human immunodeficiency virus type 1 (HIV) and hepatitis C virus (HCV) are blood-borne viruses that pose occupational hazards to health care workers exposed to the blood of infected patients. As of June 1996, 51 documented and 108 possible cases of ...

Figure 1. In this electron micrograph of a platelet aggregate from a normal person, the “eye” of the bunny-like figure is a serotonin-containing dense granule; microtubules are seen immediately below this structure. Also visible are alpha granules (large ...

The lower esophageal sphincter regulates the flow of food between the esophagus and the stomach. It is now clear that both the intrinsic smooth muscle of the distal esophagus and the skeletal muscle of the crural diaphragm constitute the sphincter ...

Despite impressive advances in the safety of the blood supply,¹ the search for therapeutic alternatives to blood continues.²,³ Erythropoietin (along with iron, vitamin B₁₂, and folic acid) has been recommended as a specific medication “that should be used ...

Presentation of Case

A 68-year-old woman was admitted to the hospital because of hepatic encephalopathy.

The patient had been well until several years earlier, when she began to gain weight and experience exertional dyspnea. Fourteen months before ...

The recent death of former U.S. Senator Paul Tsongas at the age of 55 from complications of bone marrow transplantation was a reminder that we have not cleared this treatment of its most difficult problems. The senator had received two marrow transplants —...

In their article in this issue of the Journal, Brugada and coworkers¹ describe three families, all from the same region in northern Spain, in which 21 of 49 family members had atrial fibrillation. Two died of cerebrovascular accidents at 36 and 68 years ...

A remarkable number of clinical trials have been performed in the past decade to evaluate drugs for the treatment of sepsis. The mechanism of action of most of these agents is based on one of two unproved assumptions relating to sepsis in humans. The ...

Autonomy has become a dominant bioethical value in the Western world. It is the basis of many ethical decisions, and considerations of autonomy influence legislators, judges, and the public alike. The predominance of autonomy has been described by one of ...

To the Editor: Nonautoimmune atrophic gastritis of the fundus is commonly considered chronic, progressive, and irreversible and is closely associated with gastric carcinoma and endocrine-cell tumors.¹,² Recent investigations support the hypothesis that ...

To the Editor: In their editorial, Corey and Holmes (Oct. 10 issue)¹ state, “All persons with HIV [human immunodeficiency virus] infection who have CD4 cell counts below 500 cells per cubic millimeter should be encouraged to begin antiretroviral therapy.”...

To the Editor: The long-awaited results of the Cholesterol and Recurrent Events (CARE) trial (Oct. 3 issue)¹ confirm and extend the results of the virtually unbroken string of coronary disease prevention trials demonstrating the efficacy of substantial ...

To the Editor: In his review of the treatment of cancer pain (Oct. 10 issue),¹ Levy states that methadone is not recommended for routine (or initial) therapy. He goes on to state that an oral dose of 10 mg of methadone every six to eight hours is ...

To the Editor: In their study of complications of endoscopic biliary sphincterotomy (Sept. 26 issue),¹ Freeman et al. found that the rates of complications were similar in patients with bile-duct stones whether sphincterotomy was performed after or in ...

To the Editor: Hydroxyurea has been used in the treatment of sickle cell anemia to elevate hemoglobin levels and reduce clinical complications.¹ The potential usefulness of hydroxyurea in the thalassemia syndromes is considerably less clear.¹,² In ...

To the Editor: Manganese intoxication is a well-known cause of parkinsonism and dementia. It affects miners, welders, steelworkers, pyrotechnists, and workers in other occupations. The diagnostic hallmarks are occupational exposure, a compatible clinical ...

To the Editor: The Image in Clinical Medicine of leishmanial amastigotes (Oct. 3 issue)¹ was striking, and the clinical history was unusual, but I was left with several questions: What was the leishmanial species? Was this woman an immigrant from an area ...

To the Editor: I have two comments to make about the interesting Sounding Board article by Tereskerz et al. in the October 10 issue.¹

First, the prompt initiation of prophylaxis (within one to two hours) after percutaneous exposure to the human ...

Those who hold the reins of power commonly regard underdogs with apprehension. Politicians keep a wary eye on the generally liberal women's vote and wonder nervously whether working class resistance will crystallize into revolution. In Born to Rebel, ...

Demonic Males is a fascinating account that draws on data ranging from observations of apes (the authors' main interest) to findings of human paleontology, molecular biology, and ancient history, and even modern fiction. Its thesis is that in our species ...

Disorders of attention and overactivity are commonly diagnosed in North American children. Some studies estimate that attention-deficit–hyperactivity disorder (as defined by the American Psychiatric Association) affects as many as 24 percent of children ...

One sentence in this book fairly leaps off the page. In one of several short essays depicting the responses of people in various cultures to death, historian John Demos reproduces a description of the dying days of Sarah Lippet, an 18th-century New Jersey ...