Mammography and clinical breast examination are the two principal means of screening for breast cancer.¹ The effectiveness of breast-cancer screening has been well documented in eight randomized, controlled trials,² but there has been less attention to ...

Pacemaker technology and clinical practice in the United States permit the use of either single-chamber ventricular pacemakers or dual-chamber pacemakers for patients who require cardiac pacing. To date, the choice of cardiac pacemaker has not been based ...

Acute arterial occlusion of the legs is associated with a substantial risk of limb loss and death despite surgical intervention primarily consisting of thrombectomy or bypass grafting.¹–³ Percutaneous, catheter-directed infusion of thrombolytic agents has ...

Many neonatologists treat premature infants who cannot be weaned from ventilator support with dexamethasone to improve pulmonary compliance and facilitate extubation.¹–⁴ Overall, however, these apparent short-term benefits of dexamethasone therapy are not ...

Globoid-cell leukodystrophy is an autosomal recessive disease due to greatly diminished or absent activity of the lysosomal enzyme galactocerebrosidase.¹ The disease is characterized by the progressive loss of central and peripheral myelin and by ...

Figure 1. Symptoms of intermittent claudication and a painful ulceration of the right heel developed in a 50-year-old woman who smoked one pack of cigarettes per day and had diet-controlled diabetes mellitus. Her only regular medication was flurbiprofen. ...

Before marketing a new drug, the manufacturer almost never tests the product in pregnant women to determine its effects on the fetus. Consequently, most drugs are not labeled for use during pregnancy. Typically, descriptions of drugs that appear in the ...

Presentation of Case

A 68-year-old man was admitted to the hospital because of laryngeal stenosis.

Six years before admission, polyuria and polydipsia had developed. Glucose levels and a test for glycosylated hemoglobin were normal. A dexamethasone ...

Despite many high-quality randomized trials, the balance of harm and benefit attributable to breast-cancer screening is not known for women 40 to 49 years of age. In this issue of the Journal, Elmore et al.¹ describe a high rate of false positive results ...

Cardiac pacemakers have become increasingly sophisticated during their half-century of clinical use. Each new component has been designed to simulate normal physiology more precisely. Is such complexity necessary? In this issue of the Journal, Lamas and ...

Since the initial clinical description by Tillett and associates¹ more than 40 years ago, thrombolytic therapy has been hovering on the outskirts of medical practice. Despite intense interest by the pharmaceutical industry and a plethora of anecdotal ...

Postpone Population Screening until Problems Are Solved

Recent controlled clinical trials have demonstrated that periodic fecal occult-blood testing can reduce deaths from colorectal cancer.¹–³ As a result, the U.S. Preventive Services Task Force, the ...

To the Editor: I commend you and Dr. Angell (Jan. 1 issue)¹ for recognizing that “the best public health approach is to concentrate on measures to prevent obesity” and stressing the importance of avoiding weight gain. However, even a modest degree of ...

To the Editor: Stevens et al. (Jan. 1 issue)¹ present 12-year mortality in relation to body characteristics in a large cohort of Americans. The authors mention but do not discuss the implications of known errors of self-reporting of height and weight. ...

To the Editor: Epidemics of hepatitis A occurred in four of the six years preceding the Monroe efficacy trial ¹ of an inactivated hepatitis A vaccine (VAQTA).² Post-trial surveillance included semiannual household telephone surveys, county disease-report ...

To the Editor: The report by Walpoth et al. (Nov. 20 issue)¹ on survivors of accidental deep hypothermia and circulatory arrest was very interesting. I was impressed by their favorable results. From the published characteristics of the patients it is ...

To the Editor: Solovey et al. reported an increased number of activated circulating endothelial cells in patients with sickle cell anemia (Nov. 27 issue).¹ Although the mechanism that releases endothelial cells into the circulation is unclear, several ...

To the Editor: We recently analyzed the results of the evaluation forms for nine speakers who participated in a continuing-medical-education (CME) symposium. There were 245 attendees, of whom 94 (38 percent) submitted evaluation forms. One speaker had to ...

The fifth edition of Nathan and Oski's Hematology of Infancy and Childhood lives up to its reputation as the bible of pediatric hematology. There simply is no other book that approaches either the breadth or the depth of content for the specialist in ...

In the past several decades, advances in fetal sonography, neonatal intensive care, and pediatric surgery have greatly expanded our understanding of the variety of diseases that may afflict the youngest of humans. Perinatal tumors are among the rarest of ...

The field of pediatric neurology is extraordinarily wide. It includes material from general pediatrics and adult neurology, genetics and dysmorphology, metabolism and biochemistry, intensive care and neurosurgery, and neonatology. In addition, it must ...