Although digoxin is one of the most commonly prescribed drugs for the treatment of heart failure, there is uncertainty about its long-term efficacy and safety.¹–³ Several recent short-term, randomized trials indicated that withdrawing digoxin worsens ...

Infertility affects about 15 percent of all couples attempting pregnancy,¹ with the man responsible in approximately half the cases. It is best defined as the inability to conceive after one year of unprotected intercourse, and thus the definition ...

The therapeutic use of hypothermia in a patient with traumatic brain injury was first reported in 1943.¹ However, since neither this report nor several subsequent reports provided comparative data on patients kept at normal temperatures, they failed to ...

The Bunyamwera serogroup (family Bunyaviridae, genus bunyavirus) contains more than 20 serologically cross-reactive viruses, 7 of which have been isolated in North America.¹ Cache Valley virus, first isolated in Utah in 1956,² has been recovered mainly ...

Figure 1. A 71-year-old woman had recently undergone mitral-valve replacement after being treated with digoxin for 12 years for atrial fibrillation. After the operation, the same dose of digoxin was administered intravenously, despite rising creatinine ...

The U.S. mental health care system has been criticized for restricting the access to care of uninsured people who are unable to pay.¹ However, some believe that too many mental health care resources are already devoted to people with low levels of need ...

Paget's disease of bone is a localized, monostotic or polyostotic disease characterized by increased bone remodeling, bone hypertrophy, and abnormal bone structure that leads in symptomatic patients to pain and bone deformity. Complications involve the ...

Presentation of Case

A 69-year-old man was admitted to the hospital because of severe abdominal pain.

The patient had become anorectic two days before admission. On the next day he had diffuse, dull abdominal pain with nausea and “dry heaves.” That ...

The role of digitalis in treating cardiovascular disease has been at the center of the oldest continuing controversy in the history of medicine. Ever since its clinical introduction by William Withering more than 200 years ago,¹ physicians have disagreed ...

Infertility affects approximately 1 man in 25. In about 30 to 40 percent of affected men, the results of semen analyses are abnormal but no cause of the infertility can be found. Therapeutic approaches are limited because there is inadequate knowledge of ...

Medical care can be managed so as to ensure quality, distribute resources rationally, and control costs. The specific market-based variant of managed care that has flourished in the United States has been designed primarily to control costs. Outpatient ...

In the summer of 1485, a rapidly fatal infectious fever struck England: “A newe Kynde of sickness came through the whole region, which was so sore, so peynfull, and sharp, that the lyke was never harde of to any mannes rememberance before that tyme.”¹

...

To the Editor: Popkin et al. (Sept. 5 issue)¹ compared dietary trends among racial and socioeconomic groups in the United States between 1965 and 1989–1991. Judged on the basis of today's dietary wisdom, persons with high incomes in 1965 had especially ...

To the Editor: We are concerned about the report of Bergqvist et al. (Sept. 5 issue)¹ and the implications it may have for patient care. They reported that among patients who had total hip arthroplasty, the rate of venography-confirmed deep-vein ...

To the Editor: We view with concern the claim of Geerts et al. (Sept. 5 issue)¹ that the potent anticoagulant low-molecular-weight heparin can safely be used as routine prophylaxis against deep venous thrombosis in trauma victims. The study compared low-...

To the Editor: The association between seropositivity for cytomegalovirus (CMV) and restenosis after coronary atherectomy reported by Zhou et al. (Aug. 29 issue)¹ is intriguing, but their analysis leaves open several questions. The authors included four ...

To the Editor: In the September 5 Image in Clinical Medicine¹ the appearance of the skin lesion described as heparin-induced skin necrosis is also compatible with a diagnosis of ecthyma gangrenosum. The authors do not state whether the heparin injected ...

To the Editor: We report two cases of a progressive spongiform leukoencephalopathy that, to our knowledge, has not been reported previously in the United States. The disease occurred after the patients inhaled heated heroin vapor, a practice known as “...

There is a long history of productive collaboration between behavioral neurologists and neuropsychologists, but differences in terminology, methodology, and philosophy between the two groups continue to frustrate students, clinicians, and researchers. In ...

Dr. Raymond D. Adams, coauthor of the authoritative textbook Principles of Neurology (4th ed. New York: McGraw-Hill, 1989), is, along with Dr. Bruce O. Berg, a revered founder of child neurology. In an interview in 1990, Adams avowed that his greatest ...

Reviewing a book on women's health care requires a vision of this field if one is to have a standard against which to test the book's coverage and organization. There is no consensus on such a vision. For some, women's health care is nothing more than a ...

Great title. For that matter, great chapter titles: “Mating Madness,” “A Dog's Life,” “The Gland Grafters,” “A Very Infertile Species.” Meant for the general reader, this lively and good-humored book by a well-known professor of reproductive biology at ...

Early Progression of Disease in HIV-Infected Infants with Thymus Dysfunction Original Article, N Engl J Med 1996:335;1431-1436.. On page 1432, in the last column of Table 1, the median number of CD4+ lymphocytes in the controls should have been 3142, not ...