Randomized clinical trials have established that adjuvant chemotherapy or hormonal treatment prolongs the survival of patients with breast cancer.¹–⁴ As a result of these studies, large numbers of women with breast cancer now receive one or both of these ...

Trials of postoperative radiotherapy for breast cancer conducted during the 1960s and 1970s showed significant reductions in rates of locoregional recurrence but no improvement in overall survival.¹,² This result has been attributed to micrometastases, ...

Cystic fibrosis, one of the most common life-threatening autosomal recessive disorders, can be difficult to diagnose, and its recognition is therefore often delayed. In 1995, the mean age at the time of diagnosis was 2.9 years in the United States.¹ At ...

Few medical advances in recent decades have affected pediatric infectious diseases as much as conjugate vaccines against Haemophilus influenzae type b disease.¹ In the United States, before the advent of conjugate vaccines, H. influenzae type b meningitis ...

Figure 1. A 37-year-old man was admitted to the hospital because of hoarseness and progressive difficulty in walking. The patient's face had the characteristic beak-like appearance of Werner's syndrome (left panel). Examination disclosed juvenile ...

In the past decade, the field of inpatient rehabilitation has grown dramatically. From 1986 through 1994, the number of Medicare-certified rehabilitation hospitals and units increased by 87 percent, from 545 to 1019.¹ In addition, between 1985 and 1989, ...

In postindustrial societies, overeating, inactivity, and obesity have emerged as new challenges in public health.¹,² Considerable effort is now being devoted to determining the pathophysiologic consequences of overeating. Several lines of evidence suggest ...

In this issue of the Journal, two papers address the role of radiation therapy in patients with breast cancer treated with adjuvant chemotherapy. These prospective, randomized trials from Denmark¹ and Canada² present 15-year results. Although this long ...

Cystic fibrosis is one of the most common inheritable diseases among white people, and without treatment most patients with this disease die in infancy or early childhood. The steadily increasing survival of patients with cystic fibrosis in countries in ...

The nation's preoccupation with the transformation of the health care delivery system to managed care has tended to obscure the importance of a number of other, simultaneous trends. These include the declining ability of health care providers to deliver ...

One of the great challenges in medical research is to conduct clinical trials in developing countries that will lead to therapies that benefit the citizens of these countries. Features of many developing countries — poverty, endemic diseases, and a low ...

To the Editor: Regarding the editorial by Roelke and Bernstein (May 22 issue)¹ on electromagnetic interference with pacemakers caused by cellular telephones ²: We are concerned about the editorial's recommendation that physicians test patients with ...

To the Editor: The study of acute myocardial infarction by Tu et al. (May 22 issue)¹ presents a contrast between two nations, in which the rate of revascularization in the United States is five times that in Canada. The study suggests that the enormous ...

To the Editor: Insulin lispro is a new insulin analogue that acts more rapidly than regular insulin. To date, there are no reports on fetal outcomes after therapy with insulin lispro in pregnant women; indeed, pregnancy has been a contraindication for ...

To the Editor: Patients with hypothyroidism and organic depression may need both levothyroxine and antidepressant drug therapy. In nine levothyroxine-treated patients with hypothyroidism (Patients 1 through 9) who were treated with sertraline (Zoloft, ...

To the Editor: Splawski et al. (May 29 issue)¹ and others² have shown at the molecular level that the Jervell and Lange–Nielsen syndrome (prolonged QT interval on the electrocardiogram, associated with profound congenital deafness) may be caused by a ...

To the Editor: Molmenti (May 22 issue)¹ presented an Image in Clinical Medicine showing a perforated duodenal ulcer. The surgeon closed the ulcer with several stitches but subsequently performed a vagotomy. Vagotomy was once the standard surgical ...

To the Editor: Older people in the United States who use the medical services of the Veterans Health Administration are frequently also entitled to health care through Medicare. Although most do not use both these federally funded systems at the same ...

To the Editor: We are concerned that readers of the review by Rotheram-Borus of AIDS and People with Severe Mental Illness: A Handbook for Mental Health Professionals (May 1 issue)¹ will not understand the contents of our book.

Rotheram-Borus emphasizes ...

In the wake of an epidemic of bovine spongiform encephalopathy, or “mad cow disease,” in Great Britain that afflicted nearly a million head of cattle, and the recent emergence there and in France of a new variant of Creutzfeldt–Jakob disease that ...

Not so long ago, even neurologists struggled with the pronunciation of Creutzfeldt–Jakob disease, one of the transmissible spongiform encephalopathies or prion diseases. Now, with the emergence of bovine spongiform encephalopathy, or “mad cow disease,” ...

The subject of this book has been covered, with varying degrees of alarm, in newspaper stories, fiction, and films. The message has been that exotic viruses are incubating and swarming around the world as “doomsday agents in waiting.” Given the right ...

Case Records of the Massachusetts General Hospital (Case 15-1997) Case Records of the Massachusetts General Hospital, N Engl J Med 1997:336;1439-1446.. On page 1439, the sentence that begins in the seventh line under the heading “Presentation of Case” ...

Treatment of Cytomegalovirus Retinitis in Patients with the Acquired Immunodeficiency Syndrome Review Article, N Engl J Med 1997:337;105-114.. On page 106, the orientation of the panels in Figure 1 is incorrect. Both panels should have been rotated 90 ...