Herbal therapies are unconventional treatments in wide use for many diseases. They are sold as nutritional supplements for numerous illnesses, including the common cold (echinacea),¹ benign prostatic hypertrophy (saw palmetto),² and depression (Saint ...

Status epilepticus is a life-threatening emergency that affects 65,000¹ to 150,000² people in the United States each year. Generalized convulsive status epilepticus is the most common and most dangerous type.

Phenobarbital,³–⁵ phenytoin,⁶–¹⁴ diazepam plus ...

Cardiac disease is the single most important cause of death among patients receiving long-term dialysis therapy, accounting for 44 percent of overall mortality.¹ Approximately 22 percent of these deaths from cardiac causes are attributed to acute ...

For many years, the Food and Drug Administration (FDA) regulated botanical dietary-supplement ingredients, in most circumstances, under the provisions for food additives of the Federal Food, Drug, and Cosmetic Act to ensure that they were safe and ...

Figure 1. A 19-year-old man presented to the emergency room after sustaining a gunshot wound to the right side of his chest. He had a hemopneumothorax, but his condition was otherwise stable, and a chest drainage tube was inserted. Sixteen hours after ...

The debate over firearm policies in the United States has developed a well-established rhetoric in the past few decades; some might even argue that it has reached a stalemate. Issues of debate include the Second Amendment to the U.S. Constitution and ...

Under normal physiologic conditions, acid–base balance is maintained by renal excretion of hydrogen ions generated during the metabolism of dietary protein and other metabolic processes. In normal subjects, these so-called fixed acids are produced at an ...

Stage

A 43-year-old man was hospitalized because of a three-day history of epigastric pain, pain in the right upper quadrant, and constipation. The pain was intermittent and not associated with nausea, vomiting, fever, or eating.

Stage

The patient had ...

Presentation of Case

A 57-year-old man was referred to the hospital because of fever and jaundice.

The patient had been in good health until four years earlier, when a noninvasive, papillary transitional-cell carcinoma of the bladder, grade 1 on a scale ...

What is there about alternative medicine that sets it apart from ordinary medicine? The term refers to a remarkably heterogeneous group of theories and practices — as disparate as homeopathy, therapeutic touch, imagery, and herbal medicine. What unites ...

Chronic renal insufficiency (defined by a serum creatinine concentration of 1.5 to 3.0 mg per deciliter [133 to 265 μmol per liter]), chronic renal failure (serum creatinine concentration, >3.0 mg per deciliter), and end-stage renal disease should be ...

In the United States, the rates of injury and death due to firearms and the rate of crimes committed with firearms are far higher than those in any other industrialized nation. Every hour, guns are used to kill four people and to commit 120 crimes in our ...

To the Editor: Recently, we have been deeply disturbed by the decision of several families to use alternative therapies exclusively as front-line treatment for their children's cancer, or to use alternative rather than adjuvant therapy after radical ...

To the Editor: Asian patent medicines are one component of what are called traditional Chinese medicines. Asian patent medicines comprise multiple products, including herbs, plants, animal parts, and minerals, which are formulated into tablets, pills, or ...

To the Editor: Ingestion of γ-hydroxybutyric acid, marketed as a “body-building supplement,” may result in coma and apnea. Its sale has recently been banned by the Food and Drug Administration (FDA), but similar alternative products continue to be ...

To the Editor: The results of AIDS Clinical Trials Group Study 243, reported by Hall et al. (May 7 issue),¹ show that neither cytarabine nor regimens of one or two reverse-transcriptase inhibitors affect the course of progressive multifocal ...

To the Editor: We have three questions about the article by Gleave et al. (April 30 issue)¹ on cytokine therapy in patients with metastatic renal cancer. First, the incidence of “spontaneous” remissions was higher than that previously reported. Was there ...

To the Editor: We wish to alert readers to two errors in Table 1 in our article on lamotrigine for generalized seizures associated with the Lennox–Gastaut syndrome (Dec. 18 issue).¹ First, the information on the number of patients in each group is ...

To the Editor: In the May 7 issue, Drs. Ansari and Rockswold described the case of a 46-year-old woman with signs and symptoms of cervical myelopathy.¹ A magnetic resonance image (MRI) was featured that showed multiple disk herniations from C3 to C7, ...

To the Editor: Testicular lesions containing adrenal-like tissue can be found in some males with congenital adrenal hyperplasia.¹ These lesions are often multifocal and bilateral.² A young woman with congenital adrenal hyperplasia in whom virilization ...

Unconventional medical care was once thought to be the exclusive domain of the charlatan and the gullible minority. Currently referred to as complementary and alternative medicine by its proponents, its influence has now spread from the tabloid headlines ...

A colleague of mine, after attending a lecture on bone disease, remarked that the vitamin D pathways looked just like chicken wire — an apt observation, because it emphasizes that this “vital amine” is actually a steroid hormone with complex metabolism ...

The locked-in syndrome is a complication of a cerebrovascular accident in the base of the pons. The patient is alert and fully conscious but quadriplegic, with lower-cranial-nerve palsies. Only vertical movements of the eyes and blinking are possible. At ...