The association between cancer and venous thromboembolism is well known.¹ Over 100 years ago, Trousseau reported cases of episodic migratory thrombophlebitis in patients with cancer.² The pathogenic mechanisms for the association include ...

Several ocular and systemic diseases and circumstances, including fifth-nerve palsy, viral infections, chemical burns, corneal surgery, abuse of topical anesthetics, neurotrophic keratitis, diabetes mellitus, and multiple sclerosis, can cause corneal ...

Chronic obstructive pulmonary disease, which is estimated to affect 14 million persons in the United States, is “characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema.”¹ In chronic bronchitis, airflow is obstructed by ...

Systemic sclerosis is a connective-tissue disease of unknown origin that is characterized by cutaneous and visceral fibrosis; production of autoantibodies, including anticentromere and anti-topoisomerase antibodies; and prominent microvascular changes, ...

Figure 1. Antonio Gaudí, a world-famous architect, was a leader of the artistic movement known as modernism, which is based on the use of natural forms. In 1906, he built La Pedrera, one of his most prominent buildings in Barcelona, Spain. The arcades of ...

There are strong arguments for and against easing the legal constraints on physician-assisted suicide and euthanasia in the United States. Public-opinion polls suggest that a majority of people favor legalization.¹ Currently proposed regulatory guidelines^...

The nephrotic syndrome is defined by a urinary protein level exceeding 3.5 g per 1.73 m² of body-surface area per day. At the turn of the century, clinicians distinguished a nephritic syndrome of inflammatory origin and a nephrotic syndrome of presumed ...

Presentation of Case

A 23-year-old man was seen in the clinic because of progressive weakness and paresthesias.

He had been well until six months earlier, when he began to have difficulty climbing a flight of stairs quickly and noted intermittent tingling ...

For more than a century we have known that deep venous thrombosis or pulmonary embolism may be the presenting feature of an occult cancer. The association between venous thromboembolism and cancer raises three questions: What is the mechanism, how strong ...

In 1986 Rita Levi-Montalcini won, with Stanley Cohen, the Nobel prize for the discovery of nerve growth factor, a polypeptide they found to be integral to the growth and development of the nervous system. In her Nobel lecture reviewing 35 years of ...

The mythological Chimera is described as having the head of a lion, the body of a goat, and the tail of a serpent. In medicine, the term “chimera” is used to indicate a body that contains cell populations derived from different individuals. To pioneers in ...

To the Editor: Physicians and pharmacists should be alert to a serious error that can occur in the preparation of replacement albumin solutions for plasmapheresis.

Plasmapheresis was performed in an elderly man who had myeloma with renal insufficiency. ...

To the Editor: In their well-conducted trial, Bigger et al. (Nov. 27 issue)¹ found no evidence of improved survival among patients with a depressed left ventricular ejection fraction and an abnormal signal-averaged electrocardiogram in whom a ...

To the Editor: The article by Taipale et al. (Dec. 4 issue)¹ raises further questions regarding methodologic flaws common in the literature on nuchal-translucency screening for Down's syndrome during the first trimester. The principal role of such ...

To the Editor: In attempting to equate the medical practice of terminal sedation with euthanasia, Orentlicher (Oct. 23 issue)¹ argues from the premise that terminal sedation can be a form of euthanasia, but his conclusions follow only if terminal ...

To the Editor: A disturbingly large percentage of dying patients experience unrelieved pain.¹ This percentage is far higher than it should be, given the availability of pain medications and the knowledge of how to use them.

Many physicians believe that ...

To the Editor: Anorexia nervosa is considered to be a Western-culture–bound syndrome occurring mainly in young, white women. In Western culture, the preoccupation with thinness and sociocultural pressures to diet have been regarded as etiologic factors ...

To the Editor: Blumenthal et al. (Nov. 20 issue)¹ present a picture of academic health centers that is difficult to reconcile with the centers' current activities. Many of these centers have taken aggressive steps to purchase and assimilate medical ...

To the Editor: Phibbs (Nov. 13 issue)¹ recommends the development of national panels of acknowledged experts, presumably to replace paid expert witnesses in cases of medical malpractice. If as he alleges, some physicians engage in “scientific perjury” in ...

Epidemic diseases have inspired many fine works of historical scholarship, including Charles Rosenberg's The Cholera Years (Chicago: University of Chicago Press, 1962) and Richard Evans's Death in Hamburg (New York: Oxford University Press, 1987). Howard ...

Sexually transmitted diseases remain a major public health issue in our country. A recent report from the Institute of Medicine highlighted the impact of continuing high rates of both viral and bacterial sexually transmitted diseases and their ...

Henry K. Beecher chose “The Powerful Placebo” as the title for his influential paper published in 1955 in the Journal of the American Medical Association (vol. 159, pp. 1602–1606). In it he recounted the effects of placebos in 15 clinical trials involving ...