Inhaled glucocorticoids are considered the first-line treatment for patients with moderate-to-severe, persistent asthma.¹–³ However, many patients taking an inhaled glucocorticoid continue to have symptoms and need additional treatment. Inhaled β₂-...

Inhaled glucocorticoids have become the mainstay of therapy in asthma, with dose titration until control is achieved.¹ Although it is effective, the long-term consequences of such treatment are not known.² Furthermore, because of the prevalence of asthma ...

Ultraviolet irradiation from the sun has deleterious effects in human skin, including sunburn, immune suppression,¹ cancer, and premature aging (photoaging). Sunburn and immune suppression occur acutely in response to excessive exposure to the sun, ...

Most patients with corticotropin-independent Cushing's syndrome have an adrenal adenoma or carcinoma,¹ but a few have bilateral adrenal hyperplasia. Three patients with Cushing's syndrome and corticotropin-independent bilateral adrenal hyperplasia²–⁴ and ...

Figure 1. In 1990, a 55-year-old woman presented with an acral lentiginous melanoma of the left sole. A radical extirpation of the tumor (tumor stage, T2; tumor thickness, 1.5 mm) and an elective dissection of the inguinal lymph nodes were performed. ...

The Nuremberg Code

1. The voluntary consent of the human subject is absolutely essential.

This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the ...

Pernicious anemia is the most common cause of vitamin B₁₂ deficiency. Vitamin B₁₂ deficiency has many causes; the term “pernicious anemia” applies only to the condition associated with chronic atrophic gastritis. A recent population survey revealed that ...

Presentation of Case

A 65-year-old woman was admitted to the hospital because of a persistent dry cough, diarrhea, and paroxysmal atrial fibrillation with orthostatic hypotension.

The patient had had hypertension for 40 years and diabetes mellitus for 6 ...

Over the years we have received numerous queries from readers and reporters about controversial editorials. Many of these inquiries suggest considerable confusion about the purpose of Journal editorials and Sounding Board articles (opinion pieces written ...

Asthma presents a difficult problem — despite effective therapy, many patients have frequent symptoms and hospitalizations. In the United States, the prevalence of asthma, associated death rates, and outpatient visits for asthma have risen by almost 50 ...

Dermatologists see many patients seeking help because of skin aging. Sagging and wrinkling of the skin can be the signs of time spent on the beach in younger years or on the golf course in middle years or just a visible reminder of the inescapable aging ...

The potential for misuse of personal information by insurers and employers has heightened concern about the confidentiality of medical records. Despite the absence of documented abuses related to approved research projects,¹ legislation has been passed in ...

To the Editor: The study of the possible association between acute lymphoblastic leukemia (ALL) in children and residential exposure to magnetic fields by Linet and colleagues (July 3 issue)¹ was well designed and conducted. The evidence does not support ...

To the Editor: The review article by Drs. Carabello and Crawford (July 3 issue)¹ included useful insights into the pathophysiology and care of patients with valvular heart disease. Mitral regurgitation is a very common valvular lesion and is often ...

To the Editor: The excellent review article by Kouchoukos and Dougenis (June 26 issue)¹ on surgery of the thoracic aorta did not mention the utility of gadolinium-enhanced, three-dimensional magnetic resonance angiography,² perhaps because the most ...

To the Editor: The Image in Clinical Medicine presented by Harris and Rosenbloom (June 26 issue)¹ clearly illustrates the presentation and clinical consequences of a penetrating atheromatous ulcer in the descending aorta. Typically, the clinical ...

To the Editor: Casarett and Ross (June 26 issue)¹ ignore an important ethical principle that argues for resuscitation of a patient who has had an iatrogenic cardiopulmonary arrest — the principle of patient autonomy. The wishes of the patient were ...

To the Editor: Some physicians in the United States generate substantial incomes by testifying as expert witnesses in malpractice cases — frequently against other physicians. They hawk their wares in legal journals, offering their services to either side ...

To the Editor: The issuing of a certificate of registration by the Drug Enforcement Administration (DEA) of the U.S. Department of Justice is a privilege granted only to physicians for the purposes of prescribing controlled medications (narcotics) and ...

Malignant tumors in endocrine organs are rare, but when taken together account for more than 2 percent of all cancers. Their treatment is dispersed among specialized departments (endocrinology, gastroenterology, pneumology, hypertension, neurology, ...

The development and understanding of hormone physiology and its disturbances were initially based on bioassays, but from the mid-1960s the increasing accuracy of immunoassays heralded numerous rapid advances. The steroid era gave way to the peptide period,...

Pituitary diseases may present with a wide array of symptoms and signs, and patients with these disorders may initially contact a general practitioner, an ophthalmologist, a neurologist, or an orthopedist before they are finally referred to an ...

Fatal Pulmonary Hypertension Associated with Short-Term Use of Fenfluramine and Phentermine Original Article, N Engl J Med 1997:337;602-606.. On page 602, the sentence that begins eight lines from the bottom of the right-hand column should have read, “The ...

Poison on Line — Acute Renal Failure Caused by Oil of Wormwood Purchased through the Internet Original Article, N Engl J Med 1997:337;825-827.. On page 826, the sentence that begins in line eight of the left-hand column should have read, “The ingredient ...