In the past 50 years, the proliferation of antimicrobial agents for use in humans and animals has placed an unprecedented selective pressure on microorganisms.¹ Drug resistance in patients with Mycobacterium tuberculosis infection became apparent soon ...

Atherosclerosis leading to coronary heart disease is complex in origin. Involved in the pathogenesis of atherosclerosis are hemodynamic, thrombotic, and carbohydrate–lipid metabolic variables, along with intrinsic characteristics of the arterial wall.¹ ...

Intensive therapy aimed at achieving plasma glucose concentrations and glycosylated hemoglobin values as close to normal as safely possible has been recommended for most patients with type I diabetes mellitus, because such treatment lowers the risks of ...

In children with acute lymphoblastic leukemia (ALL) who are older than one year of age, certain presenting features, such as a white-cell count above 50,000 per cubic millimeter,¹–³ an age of 10 years or older,⁴,⁵ the presence of bulky disease,¹,³,⁶ T-...

Ingestion of fish or grain contaminated with methylmercury resulted in epidemics of severe neurotoxicity and death in Japan in the 1950s and 1960s¹ and in Iraq in 1972.² The World Health Organization and other organizations have warned of the dangers of ...

Figure 1. A 62-year-old man presented to the hospital with an inability to walk unaided. He had noticed progressive weakness of his legs over the previous two weeks and had a three-month history of thoracic back pain, night sweats, and a weight loss of 10 ...

Descriptive studies of the use of health care services typically document higher per capita use by women during the adult reproductive period, followed by a crossover in later years, with higher per capita use among elderly men.¹–⁵ The explanations for ...

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A 58-year-old woman was admitted to the hospital because of chest pain. The night before admission, the patient awoke with crushing, nonpleuritic chest pain radiating down her left arm, with associated presyncope and diaphoresis. The pain was like ...

In this issue of the Journal, Pablos-Méndez et al., on behalf of the World Health Organization–International Union against Tuberculosis and Lung Diseases Working Group on Anti-Tuberculosis Drug Resistance Surveillance, report data on drug resistance in 35 ...

Early in the next century, cardiovascular disease will probably be the number-one killer worldwide.¹ Despite important successes in the past 30 years, unfavorable trends in some coronary risk factors may have contributed to a slowing of the rate of ...

Exposure to mercury and its potential toxic effects is a subject that involves everyone, because we are all frequently exposed. The toxicologic literature has clearly established the dangers of excessive exposure to mercury. What is less clear is the dose ...

Although sex differences in health care expenditures have been observed,¹ it is unclear whether they are related to differences in patterns of illness or preferences for care or to sex bias among health care providers. As health care resources become more ...

To the Editor: The article by Stelfox et al. (Jan. 8 issue)¹ is ambiguous and undermined by a self-fulfilling prophecy. The authors concluded that there is no evidence of conflict of interest but not before compiling confusing information to the ...

To the Editor: In the study by Maria et al. (Jan. 22 issue)¹ comparing botulinum toxin and saline for the treatment of chronic anal fissure, the injection of botulinum toxin is referred to as noninvasive. Although obviously less invasive than surgery, ...

To the Editor: In their study of SYT–SSX gene fusion in synovial sarcoma, Kawai et al. (Jan. 15 issue)¹ found a significant relation between the SYT–SSX2 subtype and metastasis-free survival. Adjuvant ifosfamide-based chemotherapy did not appear to be a ...

To the Editor: Fetal anemia secondary to maternal Rh alloimmunization is a major cause of intrauterine and postnatal morbidity and mortality. The relations between fetal sex and the antenatal course and outcome of Rh alloimmunization have been unclear.

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To the Editor: Vincenti et al. (Jan. 15 issue)¹ reported that daclizumab, a monoclonal antibody that blocks the interleukin-2 receptor, reduced the frequency of episodes of acute rejection by 37 percent during the first six months after renal ...

To the Editor: A 37-year-old man who had had severe diabetes since the age of 7, including complications of retinopathy, nephropathy, neuropathy, macroangiopathy, and microangiopathy, and who had received a cadaveric kidney–pancreas transplant three ...

To the Editor: With respect to the January 22 Case Records,¹ we would like to point out several limitations to the diagnostic value of an assay of adenosine deaminase activity. Some studies have shown that the specificity of an adenosine deaminase assay ...

To the Editor: The Massachusetts Medical Society Committee on Nutrition wishes to go on record as opposing the editorial entitled “Losing Weight — An Ill-Fated New Year's Resolution” (Jan. 1 issue).¹ The editorial contradicts the position held by the ...

Imagine being the physician called to the bedside of the most powerful and beloved man in the world after he awoke with severe chest pain. This daunting task fell to Dr. Howard M. Snyder when President Dwight Eisenhower summoned him in the early-morning ...

Internists considered cardiology difficult when they had to base their diagnosis on auscultation and electrocardiograms. Therapy was difficult as well, since the drugs available were limited more or less to digitalis, nitrates, and diuretics; operations ...

There are 43 million uninsured Americans (and millions more underinsured), because the richest country in the world has yet to develop the consensus that would provide every citizen with access to an appropriate range of health care services, regardless ...