New strategies for preventing ischemic complications during percutaneous coronary revascularization have focused on the platelet surface-membrane glycoprotein IIb/IIIa receptor.¹ In a previous large-scale trial (Evaluation of 7E3 for the Prevention of ...

Despite its wide acceptance, coronary angioplasty is limited by rates of restenosis of 30 to 60 percent.¹ In recent years, much has been learned about the mechanism of restenosis, which can be divided into two broad components. The first component, recoil ...

Although treatment with zidovudine significantly reduces the likelihood of mother-to-infant transmission of the human immunodeficiency virus (HIV),¹ perinatally acquired infections still account for the majority of new cases of the acquired ...

Neurofibromatosis type 1 is an autosomal dominant disorder with an incidence of approximately 1 in 3500 people.¹ Patients with the disease have a predisposition to particular benign and malignant neoplasms, which arise primarily from cells of neural-crest ...

Figure 1. A 27-year-old woman was admitted because of a three-day history of constant epigastric pain radiating to the back, associated with nausea and vomiting. For several years, as a result of an emotional disturbance, she had been eating her own hair. ...

Requiring patients to share the cost of emergency services reduces the total number of visits to emergency departments. O'Grady et al. found that patients in a fee-for-service medical care system who had a coinsurance requirement for emergency visits used ...

Mammals need to maintain a nearly constant internal temperature. If the internal temperature deviates substantially from normal, metabolic functions generally deteriorate. The human thermoregulatory system usually maintains a core body temperature near 37°...

Presentation of Case

A 78-year-old man was admitted to the hospital because of a stricture of the sigmoid colon.

Five years earlier, a rectal mass had been found on a routine sigmoidoscopic examination. An examination with a flexible sigmoidoscope showed ...

Something new is happening in Washington: Congress is practicing medicine. In recent months, Congress overwhelmingly passed legislation forcing health plans to pay for 48-hour hospital stays for women delivering babies, passed a resolution promoting ...

Interventions aimed at opening occluded coronary arteries continue to evolve. Two fundamental problems that limit the clinical efficacy of coronary interventions are restenosis after coronary angioplasty or atherectomy,¹–³ reported since the early days of ...

The use of cost-sharing strategies such as copayments, deductibles, and coinsurance by health insurance plans is controversial. In shifting a portion of health care expenses from the insurance purchaser or provider to the patient, cost sharing invariably ...

Although transplantation is the best treatment for many people with end-stage renal disease, the gap between the number of organ donors and the number of potential recipients continues to widen.¹ Patients are often treated with dialysis for years while ...

To the Editor: Blum et al. (Jan. 2 issue)¹ reported the results of endovascular grafting for infrarenal aneurysms but did not address one emerging concern regarding the stability of the attachment site in the aorta. After successful exclusion from the ...

To the Editor: Dr. Schievink (Jan. 2 issue)¹ provides an authoritative review of recent developments in the field of intracranial aneurysms. In view of the high case fatality rate associated with aneurysmal bleeding, it is crucial not to miss the ...

To the Editor: I was surprised that for the study by Stoute et al. (Jan. 9 issue),¹ in which human subjects were intentionally infected with a known disease-producing agent, we are told only that the study was “approved by an institutional review board.” ...

To the Editor: Cancer after transplantation has long been recognized to be a risk associated with immunosuppression, but Kaposi's sarcoma is a rare tumor in this situation.¹ A 39-year-old man with end-stage renal disease received an allograft from a ...

To the Editor: Several studies have suggested that among persons with tubular adenomas detected by sigmoidoscopy that are diminutive (<5 mm in diameter) or small (6 to 9 mm in diameter) there is not a substantial number of advanced adenomas or cancers ...

To the Editor: As the great academic health care centers of the United States respond to a marketplace increasingly driven by finances, in which the cost per unit of service becomes the key measure of interest to managed-care organizations, there is ...

To the Editor: A 40-year-old woman presented to our emergency department with acute throat discomfort. She had been thirsty and described having taken a long, deep swallow from a soft-drink can. She felt a sudden pain in her oropharynx and assumed that ...

The Hastings Center sponsored a project on the ethics of policies and practices regarding long-term contraception, which included conferences and presentations held between 1992 and 1994. As part of its series titled Hastings Center Studies in Ethics, the ...

Pelvic inflammatory disease is an enormous health problem for women. The preface to this excellent book states that pelvic infections affect a million American women annually, at a cost to our health care system of $4 billion. The difficulty of ...

A mere decade or two ago, most clinicians believed that the cause of male sexual dysfunction was largely psychogenic, and epidemiologic data from the 1940s suggested that fewer than 5 million men had erectile dysfunction. In the intervening period we have ...

Biblical tradition holds that God's first commandment to mankind was to “be fruitful and multiply.” As with many divine instructions, this one is sometimes easier said than done. In Western countries today, it is estimated that infertility affects as many ...