Vigorous physical training¹–⁵ and even moderate exercise⁶–⁹ can interrupt the menstrual cycle, perhaps by suppressing the pulsatile release of gonadotropin-releasing hormone.¹⁰,¹¹ This effect of physical activity may lower a woman's cumulative exposure to ...

Cigarette smoking and hypercholesterolemia are well-known risk factors for atherosclerotic heart disease.¹ In addition to its association with premature atherosclerosis,² cigarette smoking is a risk factor for acute myocardial infarction³ and possibly ...

In January 1994, Smyth et al.¹ described five children with cystic fibrosis in the United Kingdom in whom submucosal fibrosis affecting primarily the proximal colon developed. Additional cases have since been reported from the United Kingdom, Denmark, and ...

High-dose chemotherapy for non-Hodgkin's lymphomas is feasible because of improvements in patient care, especially the use of hematopoietic growth factors and stem-cell support.¹–⁴ In late 1987, we started a randomized study to compare MACOP-B (...

The α- and β-thalassemias are due to mutations of the α- or β-globin genes that markedly decrease or completely prevent the production of α- or β-globin chains.¹ They are the most common inherited single-gene disorders in the world, with the highest ...

Figure 1. A 65-year-old man was admitted to our hospital with fatigue, weight loss, night sweats, and multiple pruritic erythematous nodules and plaques on his left shoulder, one of which contained two central ulcers (Panel A). Physical examination ...

Acute renal failure that requires renal-replacement therapy is a relatively common condition, with an annual incidence of at least 30 cases per 1 million population.¹ Historically, the replacement of renal function in acute renal failure has involved ...

Most cases of breast cancer are related to lifestyle or environment, but exactly which factors affect the risk of breast cancer is difficult to define. The preponderance of breast cancer in women as opposed to men, the reproductive patterns common to ...

Smoking, elevated levels of plasma lipids, and hypertension are known to increase the number of atherosclerotic plaques in the aorta and coronary arteries.¹,² The influence of these cardiovascular risk factors on the structure and composition of ...

With better knowledge of the genetics of various diseases, testing for the underlying defects with the use of biochemical and molecular techniques is increasingly possible. The practical aim of these tests is the prevention and treatment of disease. The ...

Medicine has always embraced the concept of public accountability but until now has not had to face its reality. Those of us fortunate enough to have lived through the past three or four decades — medicine's halcyon era — recall with longing the public's ...

To the Editor: Fang et al.,¹ Geronimus et al.,² and Gillum³ (Nov. 21 issue) address interracial and intraracial disparities in cardiovascular and other causes of mortality among blacks and whites. Similar patterns in reproductive-health outcomes have ...

To the Editor: Ling et al. (Nov. 7 issue)¹ conclude that patients with serious mitral regurgitation due to flail leaflet do better with early surgical management. Their patients in New York Heart Association class I or II had an annual mortality rate of ...

To the Editor: The article by Roldan et al. on valvular heart disease associated with systemic lupus erythematosus (Nov. 7 issue)¹ prompts two remarks. First, the authors did not give any data on antiphospholipid antibodies. There are at least five ...

To the Editor: Schindler et al. (Nov. 14 issue)¹ report the clinical predictors of unsuccessful resuscitation in children who had out-of-hospital cardiac or respiratory arrest. Among the predictors of unsuccessful resuscitation identified in the study ...

To the Editor: Schobel et al. (Nov. 14 issue)¹ present convincing evidence, based on intraneural recordings of sympathetic-nerve activity in muscle-nerve fascicles, that preeclampsia is accompanied by sympathetic overactivity. We would like to offer an ...

To the Editor: Porphyria cutanea tarda is characterized by reduced activity of uroporphyrinogen decarboxylase, with hepatic accumulation of uroporphyrins, and photosensitive skin lesions. The clinical symptoms are effectively treated by phlebotomy. ...

To the Editor: Artemisinin compounds are used to treat Plasmodium falciparum infections in many countries worldwide.¹,² We describe a patient with acute cerebellar dysfunction that was temporally associated with the ingestion of artesunate.

In July 1996, ...

To the Editor: In his attempt to provide a balanced view of the backlash against health maintenance organizations (HMOs) (Nov. 21 issue),¹ Bodenheimer fails to describe adequately the sense of alarm that many physicians feel about recent changes in the ...

To the Editor: Regarding the interpretation of the Image in Clinical Medicine entitled “A Fetal Yawn” (Nov. 14 issue)¹ showing an ultrasonogram in which a 34-week-old fetus is reported to be yawning, the literature fails to define yawning in a fetus, ...

Why are people with obvious psychiatric disease homeless on the city streets of America? Why are jails and prisons becoming de facto state hospitals? Why do there seem to be an increasing number of violent acts committed by people described as mental ...

All the time, physicians hear patients tell their stories, the particulars of suffering or newly worrisome lives. In return, the ailing or alarmed man or woman hopes (sometimes hopes against hope) for a responsive medical story: an account of what has ...

The severely mentally ill are at risk for human immunodeficiency virus (HIV) infection, challenging mental health providers to develop new services for them. This book is a primer for the large number of providers who have not recognized the risk of HIV ...

AIDS is now the leading cause of death among women 25 to 44 years of age in urban areas across the United States, including more than a dozen cities in the Northeast, Miami, and Oakland, California. The rate of new human immunodeficiency virus (HIV) ...

Allopurinol-Induced Orotidinuria — A Test for Mutations at the Ornithine Carbamoyltransferase Locus in Women (N Engl J Med 1990:322;1641-1645). Because of an analytic error, the data in Table 1 and Table 2 and Figure 1 and in parts of the Abstract and ...

Endometrial Carcinoma Review Article, N Engl J Med 1996:335;640-649.. On page 647, the sentence that begins eight lines from the bottom of the left-hand column should have read, “Doxorubicin, cisplatin, and carboplatin have substantial activity (a ...