Men and women who drink alcoholic beverages regularly have, in comparison with abstainers, higher death rates from injuries,¹,² violence,² suicide,² poisoning,³ cirrhosis,⁴ certain cancers,⁵ and possibly hemorrhagic stroke,⁶,⁷ but lower death rates from ...

Lumbar epidural analgesia is the most commonly used form of regional blockade for pain relief during labor. With the increasing availability of this safe and effective form of analgesia, there has been an increase in the number of women who receive ...

Atopy is characterized by the formation of IgE antibody in persons with a genetic predisposition, who respond with immediate hypersensitivity on exposure to specific allergens. Atopy is common, affecting up to 40 percent of populations of Western ...

Autologous saphenous veins are the first choice of graft material for infrainguinal arterial bypass surgery. Without adjunctive therapy, the patency rates can be as low as 50 percent at two years for femoropopliteal or femorotibial (i.e., below the knee) ...

Figure 1. A 76-year-old man with hypertension and a history of stroke reported headache, difficulty walking, and loss of appetite. He denied using alcohol, having a recent fall, or being assaulted. The initial neurologic examination demonstrated slowed ...

The hepatitis B virus (HBV), discovered in 1966, infects more than 350 million people worldwide.¹ Hepatitis B is a leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma, accounting for 1 million deaths annually. Knowledge of the ...

When ventilatory support is delivered without establishing an endotracheal airway, it is termed noninvasive ventilation. Traditionally, noninvasive ventilation has been given with the use of devices that apply intermittent negative extrathoracic pressure. ...

Presentation of Case

A 41-year-old man was admitted to the hospital because of fever of three weeks' duration.

Twenty-one years earlier, the patient had had Hodgkin's disease, with cervical, axillary, mediastinal, and perihilar lymphadenopathy. A staging ...

On July 8, investigators from the Mayo Clinic and Meritcare held a press conference to announce a study of two dozen patients that linked valvular heart disease to a combination of widely used diet pills, fenfluramine and phentermine (fen–phen). The press ...

Alcohol occupies a unique place in many human societies; it is a widely used drug, tolerated physiologically and socially, with a place in religious ceremony, in ritual, in spontaneous celebration, and in everyday social transactions, but also a drug that ...

In 1992, the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists issued a joint statement on pain during labor that included the following: “Labor results in severe pain for many women. There is no other ...

Interleukin-4 is a critical cytokine in the expression of atopy and allergic diseases. Through its receptor, which consists of a unique α chain and the common lymphoid-receptor γ chain, it signals target cells and tissues to mount a response. When ...

According to the ethical principle known as the “rule of double effect,” effects that would be morally wrong if caused intentionally are permissible if foreseen but unintended. This principle is often cited to explain why certain forms of care at the end ...

To the Editor: Nineteen of the 24 patients described by Connolly et al. (Aug. 28 issue)¹ in the primary report linking fenfluramine and phentermine with cardiac valvular abnormalities were identified in Fargo, North Dakota, a city with only 74,111 ...

To the Editor: A growing body of evidence implicates the anorectic drug fenfluramine and its d-isomer, dexfenfluramine, in the development of pulmonary hypertension and valvular heart disease.¹,² Pulmonary hypertension is thought to occur because of the ...

To the Editor: A 24-year-old woman received the diagnosis of systemic lupus erythematosus at 11 years of age. Since then, she has had episodic flares characterized by fatigue, fever, malar rash, arthralgias, abdominal pain, and lupus nephritis. Dialysis ...

To the Editor: Standard therapy for early esophageal carcinoma is surgical resection or chemoradiotherapy followed by resection.¹ In advanced stages, palliative measures are important. Endoscopic placement of a stent is a safe, effective, and noninvasive ...

To the Editor: The purpose of this letter is to clarify a misunderstanding in our editorial on hospitals' high administrative costs (March 13 issue).¹ We quoted the 1996 report of the Prospective Payment Assessment Commission (ProPAC), which stated that ...

To the Editor: I am frankly amazed that people are still debating the merits of investor-owned and not-for-profit hospitals. I thought we had entered the age of enlightenment on this issue and accepted the fact that all hospitals, whether for-profit or ...

Medical textbooks no doubt sell, rightly or wrongly, on the perceived scientific or clinical standing of the editor and contributors. No slouch himself, Braverman has assembled many of the players in the premier league for his Diseases of the Thyroid. ...

Our fascination with the complex workings of the brain has only recently been superseded by our morbid obsession to reduce health care expenditures. With one fell swoop, the introduction of computed tomography addressed both these issues and ...

Over the past 10 to 15 years, the role of imaging in the diagnosis and treatment of liver diseases has grown dramatically. The combination of new imaging techniques and diagnostic contrast agents has greatly improved our ability to examine the liver. In ...

Costs of Care and Administration at For-Profit and Other Hospitals in the United States Special Article, N Engl J Med 1997:336;769-774.. On page 773, the sentence that begins eight lines from the bottom of the left-hand column should have read, “Scant ...

Valvular Heart Disease Associated with Fenfluramine–Phentermine Original Article, N Engl J Med 1997:337;581-588.. On page 587, the sentence that begins in line 10 of the right-hand column should have read, “Commonly used doses of these medications are 20 ...