Photochemotherapy using oral methoxsalen (8-methoxypsoralen, or psoralen) and ultraviolet A radiation (PUVA) is a highly effective treatment for severe psoriasis.¹ However, long-term therapy increases the risk of squamous-cell carcinoma of the skin.²–⁴ In ...

The idea that the consumption of fish reduces the risk of coronary heart disease is supported by data from five prospective epidemiologic studies,¹–⁶ two case–control studies,⁷,⁸ and one secondary-prevention trial.⁹ However, the results of other studies ...

Bleeding in the upper gastrointestinal tract is an important cause of hospital admission and death, with an overall incidence of approximately 150 hospital admissions per 100,000 population per year.¹ Endoscopic techniques are widely used to treat ...

Hepatitis-associated aplastic anemia was first described in 2 case histories in 1955,¹,² and by 1975 more than 200 cases had been reported.³ As a syndrome of bone marrow failure, hepatitis-associated aplastic anemia is not uncommon, with hepatitis ...

Figure 1. A 22-year-old man lacerated the back of his left index finger while cleaning his fish tank. When seen three months later, he had a verrucous, crusted plaque at the site of the injury and two subcutaneous nodules along the line of lymphatic ...

In chronic inflammatory diseases, such as asthma, rheumatoid arthritis, inflammatory bowel disease, and psoriasis, several cytokines recruit activated immune and inflammatory cells to the site of lesions, thereby amplifying and perpetuating the ...

Transmission through sexual contact accounts for 75 to 85 percent of the nearly 28 million infections with the human immunodeficiency virus (HIV) that have occurred so far.¹ The probability of infection through sexual contact, although it varies greatly, ...

Presentation of Case

A 51-year-old man was admitted to the hospital with respiratory failure.

He was known to have had chronic obstructive pulmonary disease since the age of 46 years, and he had a history of long-standing alcohol abuse. At 36 years of age,...

Severe, widespread psoriasis is a devastating skin disease that can disrupt professional, social, and private life. The effectiveness of photochemotherapy with oral methoxsalen (psoralen) and ultraviolet A radiation (PUVA)¹ in inducing and maintaining the ...

During the past 50 years, mortality from acute bleeding in the upper gastrointestinal tract has remained at 6 to 10 percent, despite improved medical and surgical treatments, the development of diagnostic and therapeutic endoscopy, and the availability of ...

Even in antiquity it was known that inflammation has both beneficial and adverse effects, but only recently have we begun to elucidate how the body maintains a balance between host defenses and tissue injury. This balance is especially important in the ...

Among health care workers who have occupational exposures to the human immunodeficiency virus (HIV), a recent case–control study indicates that treatment with zidovudine after exposure decreases the odds of HIV infection by 79 percent.¹ Although this ...

To the Editor: In the clinical debate over the treatment of choice for acute myocardial infarction (Oct. 24 issue),¹,² Lange and Hillis argue in favor of thrombolysis. Table 2 in their rebuttal contains two important errors that may mislead many readers. ...

To the Editor: The report by Every et al. (Oct. 24 issue)¹ on the analysis of data from the Myocardial Infarction Triage and Intervention (MITI) registry underscores an important debate regarding the current standard of care for acute myocardial ...

To the Editor: Coronary embolism is an uncommon clinical problem that can occur in association with valvular heart disease, prosthetic valves, endocarditis, intracardiac thrombosis, or cardiac catheterization.¹ Coronary embolization of malignant tissue ...

To the Editor: The concise review of adrenal insufficiency by Dr. Oelkers (Oct. 17 issue)¹ was excellent, but the corticotropin stimulation test is even less valuable than he suggests, and the incidence of clinically significant secondary adrenal ...

To the Editor: The study of Lyme disease in children by Gerber et al. (Oct. 24 issue)¹ describes the high rate of success when children with erythema migrans lesions are treated early with antibiotics, but it does not convey the entire picture. The ...

To the Editor: Spontaneous bleeding from the iris into the anterior chamber of the eye is a rare problem.¹ We report a case associated with the ingestion of Ginkgo biloba extract, an over-the-counter herbal medication that has recently also been linked ...

To the Editor: Thomas et al. (Oct. 24 issue)¹ touch on a controversial issue when they state that “radiographic confirmation of tube placement should be mandatory before material is lavaged through nasogastric tubes.” There are a great many nasogastric ...

To the Editor: The photograph of the strange East Asian medical technique of cupping (Oct. 24 issue)¹ was wonderful and evocative. I suspect, however, that this bizarre anthropologic “other” is actually a case of the forgotten historical “self.” The use ...

The Textbook of Primary Care Medicine is the second edition of The Textbook of General Medicine and Primary Care, which was published in 1987 by Little, Brown (Boston). John Noble is editor-in-chief of both editions, and his experience and that of his ...

This book is a collection of images, mainly color photographs but also x-ray films, magnetic resonance images, computed tomographic scans, biopsy slides, and even photographs of urine and stool samples. The book is divided into sections covering parts of ...

These essays were written in response to a request by Delese Wear, the editor, for each contributor to provide “a personal narrative about her feminism . . . and to describe how she enacts her feminism in medical school or university settings and in her ...

The nutritional needs of women merit special attention. Women have additional nutritional requirements during menarche, pregnancy, lactation, and menopause; are at higher risk than men for obesity, breast cancer, and osteoporosis; have long been neglected ...

Few would argue that vitamins are not important to health and well-being. Despite the leaps in knowledge that the science of nutrition has made in this century, especially as it relates to the function of vitamins, popular science has made many claims for ...

The Effects of Preparations of Human Chorionic Gonadotropin on AIDS-Related Kaposi's Sarcoma Original Article, N Engl J Med 1996:335;1261-1267.. On page 1264, the sentence that begins in line 7 of the left-hand column should have read, “One patient had ...

Dietary Trends in the United States Correspondence, N Engl J Med 1997:336;583-585.. On page 583, the first sentence of the third paragraph of the second letter should have read, “In 1973, Rathje started the Garbage Project at the University of Arizona,” ...