Lyme disease is an infectious disease caused by the tick-borne spirochete Borrelia burgdorferi.¹ Although it is not present in all patients, the earliest and most easily recognized manifestation of B. burgdorferi infection is the skin lesion known as ...

The role of external irradiation in patients with locally advanced prostate cancer is controversial.¹,² At this stage of the disease the tumor extends beyond the capsule of the prostate; it may infiltrate neighboring structures and involve regional lymph ...

Since Pantridge and Geddes¹ ushered in the current era of advanced cardiac life support by emergency medical personnel, rates of survival to discharge as high as 43 percent have been reported.² However, overall survival after out-of-hospital cardiac ...

Since 1987, several reports have described neurosyphilis and other complications of syphilis in patients infected with the human immunodeficiency virus (HIV),¹–⁷ often after the patients have been treated with penicillin G benzathine, as recommended by ...

Tuberculosis is the only opportunistic infection related to infection with the human immunodeficiency virus (HIV) that threatens the general public. The spread of HIV-related tuberculosis has been well documented, with transmission to both HIV-infected ...

Figure 1. A 32-year-old man presented with a five-day history of nonpruritic, copper-colored palmoplantar macules and papules (Panels A and B), several of which were crossed by creases. The patient did not have a history of syphilis but had noted a ...

Low back pain affects 70 to 80 percent of adults at some time.¹ In the United States and Canada,²–⁴ low back injuries constitute 15 to 25 percent of the injuries covered by workers' compensation and account for 30 to 40 percent of workers' compensation ...

Presentation of Case

A six-year-old boy was admitted to the hospital because of recurrent abdominal pain with vomiting and weight loss.

The boy had been well until 3 1/2 months earlier, when he began to experience recurrent periumbilical pain once or ...

I have criticized managed care in these pages several times before,¹–⁷ and I am about to do so again. This time I am concerned not about access to care, incentives to undertreat, or the loss of physicians' integrity, but about the policies and ...

The treatment of localized prostate cancer is a matter of considerable controversy. For decades experts vigorously debated the relative merits of radical prostatectomy and external-beam radiotherapy. During those years the proportion of patients who ...

For much of this century the countries of the industrialized world have grappled with the problem of covering disabling back pain under workers' compensation insurance plans.¹ These insurance programs entitle an injured worker to clinical remedies and ...

To the Editor: Ginzberg and Ostow (April 3 issue)¹ rightly predict that managed care's days are numbered. Less clear is whether others will acquire the authors' insights the easy way or the hard way (i.e., through foresight or through the forehead). If ...

To the Editor: Curtis et al. (March 27 issue)¹ conclude that patients undergoing bone marrow transplantation have an increased risk of new solid cancers later in life. The authors calculated the observed numbers of solid cancers on the basis of data from ...

To the Editor: In the Swedish Rectal Cancer Trial (April 3 issue)¹ more than 100 surgeons at 70 hospitals operated on 1168 patients in three years — fewer than 17 patients per hospital in three years, or fewer than 6 patients per hospital per year. With ...

To the Editor: Ridzon et al. (March 27 issue)¹ report a case of the transmission of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) from a single source, followed by unusually long times to seroconversion for both viruses. We report a ...

To the Editor: With regard to the excellent review article by Spirito et al. (March 13 issue),¹ we wish to report data on percutaneous transluminal septal myocardial ablation, which Sigwart introduced in 1995 as a new option for the treatment of highly ...

To the Editor: Brugada et al. (March 27 issue)¹ reported the mapping of familial atrial fibrillation in three kindreds to a locus on chromosome 10q, but they did not discuss the locus on 10q for dilated cardiomyopathy with mitral-valve prolapse, which ...

To the Editor: Anisakis simplex is a nematode (Anisakidae family, Ascaridoidea superfamily) that parasitizes sea mammals. Common intermediary hosts include the codfish, hake, sardine, anchovy, salmon, tuna, mackerel, and squid.¹ Humans acquire the larvae ...

Richard Epstein has never seen a market he does not like. In Mortal Peril he argues that the market in health care should be expanded, not just for the provision of health care services but also for the sale of organs for transplantation and babies for ...

Regina Herzlinger, a leading analyst of the health care business and a professor at the Harvard Business School, has written an engaging book about the changes in the American health care industry. It is a multifaceted work in which Herzlinger addresses ...

September 4, 1946, marked the first membership meeting of Group Health Cooperative of Puget Sound. A Group Health organizer arrived to find the room filled with severely disabled people. Word had gotten out that Group Health would enroll anyone, ...

This very timely book arose from a national health forum at the University of Florida in 1992, and the contributions have been written especially for the book. It provides an extremely useful and fresh analysis of this nation's attitudes toward and past ...

Hazards of the Job traces the development of the field of occupational health from a “highly diverse, localized, and contradictory” body of knowledge to a more modern science based on quantitative, experimental techniques.

In late-19th-century America, ...

Inflammation, Aspirin, and the Risk of Cardiovascular Disease in Apparently Healthy Men Original Article, N Engl J Med 1997:336;973-979.. On page 974, the sentence that begins in line 13 under the heading “Laboratory Analysis” should have read, “The C-...

Outcomes of Medical-Malpractice Litigation Correspondence, N Engl J Med 1997:336;1680-1681.. On page 1680, in the second paragraph of the first letter, the second sentence should have read, “The authors themselves could not identify the same events in the ...

Lyme disease, which is caused by the tick-transmitted spirochete Borrelia burgdorferi, ¹ usually begins with an expanding skin lesion, erythema migrans, accompanied by malaise and fatigue, fever, headache, stiff neck, and myalgias or arthralgias.²,³ Weeks ...