The average risk of transmission of human immunodeficiency virus (HIV) to a health care worker after percutaneous exposure to HIV-infected blood has been estimated as 0.3 percent.¹–⁴ However, the factors that influence this risk have not been determined, ...

Low-fat, high-carbohydrate diets have been widely recommended as a way to reduce the risk of coronary heart disease because populations with low intakes of saturated and total fat tend to be at low risk and because saturated fat increases low-density ...

Deep accidental hypothermia (core temperature, <28°C) causes circulatory and neurologic disturbances.¹–⁸ Even with immediate treatment, mortality rates are high.⁹–¹³ Successful management has been reported only in isolated cases.¹⁴,¹⁵ The long-term ...

Most patients with primary hyperparathyroidism in the United States are asymptomatic.¹–³ Although the usual treatment for this disorder is surgical removal of the abnormal parathyroid gland or glands, the need for surgery has been questioned because of ...

Figure 1. Mucormycosis of the hand and forearm occurred in a 28-year-old woman after a thermal burn of the right thumb caused by tap water (Panel A). The patient had mild diabetes mellitus that had been treated with 10 mg of glyburide per day for four ...

Vasculitis is inflammation of vessel walls. It has many causes, although they result in only a few histologic patterns of vascular inflammation. Vessels of any type in any organ can be affected, a fact that results in a wide variety of signs and symptoms. ...

Over the past 30 years, a new man-made ecosystem has developed — the controlled indoor environment within the sealed exterior shells of modern office buildings. This new environment has considerable potential to affect public health because more than half ...

Presentation of Case

A 58-year-old man with ulcerative colitis was admitted to the hospital because of bloody stools and fever.

The patient had been well until three years earlier, when diarrhea and hematochezia occurred, and a diagnosis of ulcerative ...

In April 1988 a health care worker here at the National Institutes of Health's Warren G. Magnuson Clinical Center became infected with the human immunodeficiency virus (HIV) after an occupational exposure. The worker had lacerated her finger when a glass ...

The value of hardened (trans) unsaturated fats in our food supply is probably best exemplified by the glazed doughnut. At room temperature, a glazed doughnut can be easily eaten with one hand, but warmed up it requires two hands and a napkin. That's what ...

The leading causes of accidental hypothermia in urban medical centers in the United States are exposure due to alcoholism, drug addiction, or mental illness and accidents involving immersion in cold water.¹ Accidental hypothermia is classified as mild (...

Familial Mediterranean fever is an inherited condition prevalent among people of the Near East — Arabs, Turks, Armenians, and Sephardic Jews.¹ Transmitted as an autosomal recessive trait, familial Mediterranean fever is characterized by sporadic episodes ...

Academic health centers have long enjoyed positions of power and prestige in the health care system. However, the restructuring of health care — exemplified by the spread of competition and managed care — threatens the intricate system of financial and ...

To the Editor: Cumming et al. (July 3 issue)¹ concluded that “the use of inhaled corticosteroids is associated with the development of posterior subcapsular and nuclear cataracts” without considering possible confounders, including a history of atopic ...

To the Editor: In her comprehensive review, Dr. Rapin discussed many aspects of autism (July 10 issue).¹ However, we believe certain recent findings deserve greater attention than they received in the article. Evidence that abnormalities in central ...

To the Editor: The conclusion of van der Horst et al. (July 3 issue)¹ that the combination regimen of higher-dose amphotericin B plus flucytosine, followed by consolidation therapy with oral fluconazole, is safe and effective and should now be considered ...

To the Editor: In enterococci vancomycin resistance of the VanA phenotype is usually due to the presence of seven genes organized in a cluster on a transposon (Tn1546).¹,² The recent emergence of vancomycin-resistant enterococci is believed to be due to ...

To the Editor: Moreland et al. (July 17 issue)¹ report that the administration of a recombinant human tumor necrosis factor receptor (p75)–Fc fusion protein (TNFR:Fc) to adults with refractory rheumatoid arthritis results in significantly more ...

To the Editor: Van der Wouw and Bax (Feb. 6 issue)¹ reported on a woman with massive pulmonary embolism who died five hours after initiation of treatment with tissue plasminogen activator. Recently, a 51-year-old man was admitted to our cardiac care ...

An older colleague of mine once suggested that the work product of an environmentalist is controversy. Fear and the threat of unseen, unchosen hazards enhance fund-raising for environmental political organizations and fund environmental research, he ...

Cancer can involve the nervous system in many ways. Metastases to brain parenchyma occur in 20 to 40 percent of patients with cancer, spinal cord compressions are diagnosed in over 5 percent of patients with cancer, and leptomeningeal involvement is seen ...

Over the past 10 years, dramatic changes have occurred in the discipline of urologic oncology. The use of laparoscopy and the concept of minimally invasive surgery with organ-sparing techniques have gained wide clinical acceptance. A better understanding ...

The public health and medical communities, for the most part, advocate screening healthy women for the early detection of breast cancer. Beginning in 1963, the Health Insurance Plan of New York conducted the first formal demonstration of screening ...

Low-Molecular-Weight Heparins Review Article, N Engl J Med 1997:337;688-699.. On page 694, several of the values in Table 5 were wrong. The corrected table appears below.