In perinatally acquired human immunodeficiency virus type 1 (HIV-1) infection, it is possible to make precise estimates of the time of infection and observe the subsequent changes in plasma viremia. Measurement of the viral load may be of considerable ...

Over the past decade, the numbers of infants infected by the transmission of human immunodeficiency virus type 1 (HIV-1) from their mothers have increased greatly.¹ In general, the depletion of CD4 cells and the progression of HIV-1–related disease are ...

Cardiac enlargement is associated with increased morbidity and mortality among healthy middle-aged and elderly people.¹–³ Increased cardiac size is also an important determinant of clinical outcome in patients with coronary heart disease⁴–⁸ and in ...

Morbidity due to asthma is disproportionately high among inner-city residents,¹ for reasons that are not completely understood. Proposed explanations include increased exposure to allergens,² poor air quality,³ psychosocial problems,⁴ and inadequate ...

Figure 1. This cell was found in the bone marrow aspirate of a 62-year-old woman with long-standing myelodysplasia, a disorder in which all cell lines of the bone marrow (myeloid, erythroid, and megakaryocytic) show dysplastic changes. This question-mark–...

Plastic anemia, which is pancytopenia with a fatty or “empty” bone marrow, is remarkable for the simplicity of its pathologic picture and the direct derivation of its clinical manifestations.¹ Although it is not a common disease, the drama of an ...

Presentation of Case

A 30-year-old woman was admitted to the hospital because of intractable seizures.

The patient was born of an uneventful full-term pregnancy. Her first seizure, at the age of 23 years, was characterized by an aura of “dizziness” with a ...

Heart failure is common, has a poor prognosis,¹ and can be treated.² The incidence is increasing, partly because of improved survival after myocardial infarction and partly because the population is aging and heart failure is a disease of the elderly. The ...

The increase in the prevalence and severity of asthma over the past 35 years has been observed in perennial rather than seasonal disease and in many different countries. Asthma is now the most common chronic disease of childhood. In many countries, the ...

To the Editor: In their articles on physician-assisted death in the Netherlands (Nov. 28 issue), van der Maas et al.¹ and van der Wal et al.² omit some information that has been of particular concern to international observers and is contained in their ...

To the Editor: In his excellent review of primary biliary cirrhosis (Nov. 21 issue),¹ Dr. Kaplan states that the serum alkaline phosphatase concentration is “invariably elevated” in this disorder. However, several studies have reported that the alkaline ...

To the Editor: In his excellent review of endometrial carcinoma (Aug. 29 issue),¹ Dr. Rose correctly describes the important etiologic role of unopposed estrogen, pointing out that “excessive estrogen is associated with most of the risk factors that have ...

To the Editor: The November 28 Image in Clinical Medicine¹ showed an endometrial polyp in a patient who was taking tamoxifen. We believe “Endometrial Polyp” would have been a more accurate title than “Tamoxifen-Induced Endometrial Polyp” because in both ...

To the Editor: The causes of congenital hypothyroidism are poorly understood. Recently, two different missense mutations in the extracellular domain of the thyrotropin receptor were identified in three siblings who had elevated serum thyrotropin ...

To the Editor: Lymphomas of the thyroid are almost exclusively of B-cell origin.¹ We report a case of thyroid lymphoma with a γ/δ T-cell phenotype.

A 59-year-old Japanese woman was seen because of marked goiter. Chronic thyroiditis had been diagnosed one ...

To the Editor: In her editorial (Nov. 28 issue), Dr. Wilfert¹ presciently notes that research on mother-to-child transmission of the human immunodeficiency virus (HIV) has advanced to the point where the prevention of a large percentage of neonatal ...

To the Editor: In his review of the initial management of burns (Nov. 21 issue),¹ Dr. Monafo does not mention the very first aid, which should be given at once — that is, putting cold water on the burned skin. This is a well-accepted practice, especially ...

To the Editor: In 1960, when I was a second-year medical student, my intern at Bellevue Hospital charged me with this grave mission: “Look for the person with a glass eye and a big liver.” I have spent the intervening 37 years engaged, among many other ...

Physicians used to have mixed feelings about the treatment of hyperlipidemia. They knew that high lipid concentrations cause heart disease, but they also knew that the lifestyle changes required to correct hyperlipidemia could be difficult to implement ...

Do we need another book on stroke? Two decades ago there were only a few small books of mainly anecdotal value, but in recent years a variety of works have appeared ranging from weighty encyclopedias to slim “do-it-yourself” books. The arena is quite ...

The historical perspective with which this book begins informs us that the ancient Greeks considered the heart to be the seat of the human spirit and that the ancient Egyptians used bleeding to improve breathlessness. In modern times heart failure has ...

Neurology and rheumatology are specialties that in the words of the authors are “branches of medicine with intertwining roots and common interests.” Neurorheumatology, the marriage of these two cognitive specialties, is a “frontier” area that has few ...

Hyperhomocysteinemia as a Risk Factor for Deep-Vein Thrombosis Correspondence, N Engl J Med 1996:335;974-976.. In Table 1, on page 975, the heading “Homocysteine Level” should have been “Hyperhomocysteinemia.” The sentence beginning in the second line of ...