The treatment of primary (idiopathic) pulmonary hypertension is problematic. Long-term anticoagulation with warfarin has been associated with improved survival without affecting symptoms, suggesting that it slows the progression of the disease.¹,² Calcium-...

Multiple sclerosis is a disease of the central nervous system characterized by multicentric inflammation and destruction of myelin. The primary cause of multiple sclerosis is unknown. Environmental risk factors¹ and multiple genetic loci²–⁴ contribute to ...

Hepatitis A virus (HAV) infection rarely causes fulminant hepatic failure in people with no underlying chronic liver disease.¹ The outcome of hepatitis A in patients with chronic hepatitis B has been addressed in a few reports.² To determine whether the ...

The Wiskott–Aldrich syndrome is a life-threatening X-linked recessive disorder. Affected males present with recurrent infections, eczema, and thrombocytopenia with small platelets. The immune defect involves both humoral and cellular immunity and ...

Figure 1. A nine-year-old boy presented with a two-day history of extreme pain in his right shoulder girdle after an upper respiratory tract infection that was accompanied by fever (temperature, 39.5°C). Physical examination revealed paresthesia of the ...

Papillary and follicular (differentiated) thyroid carcinomas are among the most curable cancers. However, some patients are at high risk for recurrent disease or even death. Most of these patients can be identified at the time of diagnosis by using well-...

Developmental dyslexia is characterized by an unexpected difficulty in reading in children and adults who otherwise possess the intelligence, motivation, and schooling considered necessary for accurate and fluent reading. Dyslexia (or specific reading ...

Presentation of Case

A 32-year-old man was admitted to the hospital because of unilateral vitreous hemorrhage and mediastinal lymphadenopathy.

The patient had been well until 7 1/2 weeks earlier, when he experienced the gradual onset of blurred vision in ...

To the Editor: The study by Overgaard et al. (Oct. 2 issue)¹ was designed to address the capacity of radiation therapy after mastectomy to reduce the frequency of distant relapse or to delay it significantly in women with stage I or II breast cancer, but ...

To the Editor: Human T-cell lymphotropic virus type I (HTLV-I) is the causative agent of adult T-cell leukemia–lymphoma (ATL) and HTLV-I–associated myelopathy–tropical spastic paraparesis (HAM–TSP), a neurologic disorder. The virus is transmitted through ...

To the Editor: We question whether the study of monoclonal antibody cA2 to tumor necrosis factor α, reported by Targan and colleagues (Oct. 9 issue),¹ specifically establishes the efficacy of the strategy of using antibody to tumor necrosis factor α. The ...

To the Editor: Reflex sympathetic dystrophy is an outdated term that tends to be used to describe pain that persists when the patient does not respond to therapy. The term implies that the sympathetic nervous system is somehow involved in the pain state; ...

To the Editor: I enjoyed John Iglehart's report on the recent Private Sector Conference at Duke University (June 19 issue).1 However, I must take issue with his assertion that “Duke . . . has an academic medical center with no major academic competitor.” ...

Advances in medical technology, such as mechanical ventilation and renal dialysis, have increased the ability of physicians to prolong the life of patients who formerly would have died. Many patients greatly benefit from these developments, but as disease ...

Rothman's book is an engaging, interesting, and complex one, easy to read, more difficult to evaluate. It is most obviously a collection of essays on what the author calls “decisive moments in the evolution of American public policy and public attitudes.” ...

All of us know Thomas Henry Huxley (1825–1895) as the earliest and most ardent advocate of the then heretical view Charles Darwin expounded in The Origin of Species. “My good & kind agent for the propagation of the Gospel,” Darwin called him. In fact, it ...

In 1891, Romberg described the autopsy findings in a patient with unexplained pulmonary hypertension.¹ For decades thereafter, case reports and small series added to this original report. About a half-century later, after the introduction of right-heart ...

Virtually every textbook of neurology or general medicine includes chapters on demyelinating diseases, with most of the attention devoted to multiple sclerosis. The concept of multiple sclerosis as a demyelinating disease is deeply ingrained. The early ...

X-linked recessive disorders affect males, whereas female carriers are generally spared. This is due in part to the random inactivation in females of one of the two X chromosomes in all somatic cells. Normal females are thus a mosaic of two cell ...