Motor vehicle collisions are a leading cause of death in North America; they are the single most frequent cause of death among children and young adults and account for one fatality every 10 minutes.¹–³ During an average year, about 1 person in 50 will be ...

Renal-artery stenosis is the most common cause of secondary hypertension, with a prevalence of about 1 percent in the general population of people with hypertension.¹,² Severe arterial stenosis may also lead to inadequate renal plasma flow and impair the ...

Isolated cardiac amyloidosis appearing late in life (senile cardiac amyloidosis) was first described in the 19th and early 20th centuries.¹,² Pathological studies established its greater prevalence with increasing age, but the distinction between atrial ...

Microsporidia are obligate, intracellular, spore-forming protozoa that are parasitic in every major animal group.¹ Cerebral microsporidial infection was first described in 1922 in rabbits with granulomatous encephalitis,² and the organism was named ...

Figure 1. A 63-year-old woman in whom two hamartomatous polyps had been removed by colonoscopic polypectomy 18 years earlier presented with intermittent abdominal pain in the right lower quadrant and melena of approximately two weeks' duration. ...

Numerous studies have reported racial differences in the use of cardiac procedures.¹–¹⁵ These studies have often relied on medical-claims data, however, which do not contain important clinical information needed to identify patients with coronary artery ...

Cystic fibrosis is an autosomal recessive disease caused by mutations of a gene located on the long arm of chromosome 7.¹ The gene product is the 1480-amino-acid cystic fibrosis transmembrane conductance regulator (CFTR), a protein that normally regulates ...

Presentation of Case

A 24-year-old Asian woman was admitted to the hospital because of left cervical lymphadenopathy and fever.

The patient had been well until two weeks earlier (one week after returning from a visit to her native Hong Kong), when she ...

Lawmakers in many countries are waiting for direct evidence that the use of cellular telephones in cars contributes to roadway collisions. In this issue of the Journal, a study of collisions in Toronto provides the first such evidence.¹ By comparing the ...

In past decades, rheumatic heart disease, syphilitic heart disease, hypertensive heart disease, and even nutritional deficiencies were common enough for physicians to consider these diagnoses in patients presenting with congestive heart failure. In recent ...

Each year thousands of reviewers contribute their expertise to peer review, a process that contributes critically to the quality of the Journal. The editors and the authors of the papers submitted to the Journal are grateful for the help of all our ...

Microorganisms and other agents continually threaten the intestinal mucosa, calling for the gut to prevent damage, restore epithelium in regions in which cells are lost, and suppress inflammation. How does the intestine tackle these problems? Although ...

Managed care scares me, but with patients enrolled in health maintenance organizations (HMOs) now making up a quarter of my internal-medicine practice, I've found it essential to think positive thoughts. This often means discerning silver linings where ...

To the Editor: The recent report by Abenhaim et al. for the International Primary Pulmonary Hypertension Study Group (Aug. 29 issue)¹ has received considerable attention in the media. Patients were excluded who had pulmonary hypertension due to many ...

To the Editor: Davies et al. (Aug. 22 issue)¹ identify an annual incidence of 1.5 cases of invasive group A streptococcal disease in Ontario, Canada, in 1992 and 1993. The mortality rate was 15 percent. This prospective study relies on identifications ...

To the Editor: The report by Tarr et al. (Aug. 29 issue)¹ and the accompanying editorial² make clear the importance of Shiga-toxin–producing Escherichia coli belonging to serotypes other than O157:H7. However, in their editorial Drs. Rondeau and Peraldi ...

To the Editor: The mechanisms and severity of trauma associated with dissection of the internal carotid artery vary. Participation in many types of sports, prolonged hypertension, forced rotation of the head, and various routine activities are all ...

The central tension in managed-care systems is between policies and practices that provide all the care that is in the best interest of the patient, and only that care, and an American tradition in which all possible care is provided, especially heroic ...

This is an important book that is not as good as it ought to be. Malcolm K. Sparrow is probably the only American academic with a serious interest in health care fraud. His topic is timely, and some of his observations and commentary are immensely ...

In its 19 chapters, this book examines a broad set of issues involving conflicts of interest in medicine, and it does so from an even broader set of perspectives. Often a book of contributed chapters is an uncertain proposition, particularly when the ...

This is a splendid book about the most awful things a child can experience, in places such as South Africa, the Persian Gulf, and inner-city America. Its authors articulately describe events whose effects would seem to defy any attempt at treatment. How ...

Alcohol Consumption and Mortality among Women Original Article, N Engl J Med 1995:332;1245-1250.. On page 1248, in Table 2, the 95 percent confidence interval for death from injury with an external cause at an average alcohol intake of >30.0 g per day ...

Case Records of the Massachusetts General Hospital (Case 1-1997) Case Records of the Massachusetts General Hospital, N Engl J Med 1997:336;118-125.. On page 124, in the legend to Figure 6, the stain should have been identified as trichrome, not ...