Many physicians are reluctant to administer analgesic drugs to neonates undergoing circumcision, despite evidence that this procedure causes intense pain.¹–³ The most frequently cited reasons are lack of familiarity with techniques of administration and ...

Primary systemic amyloidosis is an uncommon disease characterized by deposits of fibrillar aggregates of monoclonal immunoglobulin light chains in vital organs. These amyloid deposits cause cardiac or renal dysfunction and, ultimately, death. The Mayo ...

The coronary microcirculation is a dynamic vascular bed that responds through changes in arteriolar resistance to metabolic tissue demands, changes in blood flow, and neurohormonal stimuli.¹–³ Adrenergic stimuli may modulate coronary vasomotor tone at ...

Alzheimer's disease is a neurodegenerative disorder characterized by loss of memory and other cognitive abilities. Neuropathologically, the disease is characterized by the presence of neurofibrillary tangles and senile plaques, impaired synaptic function, ...

Figure 1. A 64-year-old man who died with extensive metastatic adenocarcinoma of the lung had worked as a carpenter for the previous 25 years and had smoked cigarettes for even longer. One year before his death he was treated with local radiation and ...

Sarcoidosis is a systemic disorder of unknown cause that is characterized by its pathological hallmark, the noncaseating granuloma. Its presenting features are protean, ranging from asymptomatic but abnormal findings on chest radiography in many patients ...

Presentation of Case

A 32-year-old man was admitted to the hospital because of IgG antibody and Coombs'-positive hemolytic anemia resistant to corticosteroid treatment.

The patient had been well until about five months earlier, when he began to have low-...

Artists often understand us better than we understand ourselves. A cartoon in the March 26 edition of the Philadelphia Daily News shows a physician who, after exhaustively reviewing the literature, offers to flip a coin to help a woman decide whether to ...

Historically, infants undergoing circumcision have not been given analgesia. The rationale was that infants do not feel, localize, or remember pain. In reality, they have all the anatomical and functional components required for nociception, and they ...

The development of drugs for the treatment of Alzheimer's disease remains in its infancy. In the United States, only two drugs have been approved: tacrine, approved in 1993, and donepezil, released this year. Neither affects the underlying process that ...

In Los Caprichos, Francisco de Goya's etchings depicting human follies, number 43 is entitled “El sueño de la razón produce monstruos.” The story Dr. Andrews and his colleagues tell in this issue of the Journal ¹ calls for Goya's vitriol. They describe a ...

In the late summer of 1994, thousands of Cubans tried to flee to the United States, using crude rafts to make the trip across the Caribbean to the Florida coast.¹ The reason for this exodus was their increasing frustration with deteriorating economic ...

To the Editor: Rubin and colleagues (Nov. 7 issue)¹ conclude that advanced epithelial ovarian cancers in patients with germ-line BRCA1 mutations have a better prognosis than their sporadic counterparts. Although this may eventually prove to be correct, ...

To the Editor: Ohman et al. (Oct. 31 issue)¹ discussed the usefulness of measuring cardiac troponins in the assessment of prognosis and early stratification of risk in patients with acute coronary syndromes. In the accompanying editorial, Van de Werf² ...

To the Editor: We agree with the statement by Vongpatanasin et al. (Aug. 8 issue)¹ that an understanding of the normal auscultatory findings associated with each type of prosthetic heart valve in each location is central to an assessment of prosthetic-...

To the Editor: Kovacs et al. (Oct. 31 issue)¹ report that the administration of interleukin-2 (18 million IU per day for five days every two months) in patients with human immunodeficiency virus (HIV) infection resulted in progressive increases in CD4 T ...

To the Editor: Heaven help us! Diets in university hospitals may be lacking in nutritional value, according to Singer et al. (Nov. 7 issue).¹ Perhaps we should question whether a “healthy diet” given to a helpless patient during a 2- to 10-day hospital ...

To the Editor: The Image in Clinical Medicine in the November 7 issue¹ shows the strangest looking Klebsiella pneumoniae I have ever seen, since it appears to be a diploid coccobacillus that has one flat edge, much like a coffee bean. Are you sure that ...

To the Editor: The development of coagulation defects and associated hemorrhagic complications after envenomation from a crotalid (pit viper) has been well described.¹,² Common manifestations include ecchymosis and oozing, hypofibrinogenemia, ...

Paul de Kruif's Microbe Hunters, published in 1926, was already 34 years old in 1960, yet its stirring tales of discovery and heroism by the pioneers of microbiology provoked the imagination of at least one budding young microbiologist and influenced the ...

Most historians and musicologists know too little science and medicine to discuss the illnesses of their subjects, and most physicians are ill equipped to examine historical and biographical material. Franken is one of a small group of physicians with ...

The progress of medicine in the past half-century is nowhere better illustrated than in the elucidation of the immune system and with it the emergence of a multifaceted armamentarium for treating both immunologic diseases themselves and nonimmunologic ...

According to the foreword of this book, there were 75,000 negligence claims in the United States in 1994, for approximately $5 billion. It has been estimated that 80 percent of obstetrician–gynecologists have been sued once for medical malpractice, and 25 ...

Apoptosis in the Heart Editorial, N Engl J Med 1996:335;1224-1226.. On page 1225, the sentence that begins in the fourth line of the right-hand column is inaccurate. Narula et al. actually found that 5 to 30 percent of cells were labeled by the TUNEL ...

Intracranial Aneurysms Review Article, N Engl J Med 1997:336;28-40.. On page 32, the legend to Figure 3 should have read, “Funduscopic Photograph of a Subhyaloid Hemorrhage in the Left Eye of a 45-Year-Old Woman with a Ruptured Aneurysm of the Middle ...