Mortality from coronary heart disease (CHD) has declined steadily in the United States for the past 30 years.¹,² Between 1990 and 1994, age-adjusted mortality from CHD among people 35 years of age or older in the United States declined by 10.3 percent³; ...

Neisseria meningitidis can cause a spectrum of diseases ranging from transient fever and bacteremia to meningitis and fulminant septicemia. Meningitis is spread by airborne droplets or direct contact with discharge from the nose or throat of an infected ...

Mood disorders are common among nursing home residents¹,² and are associated with substantial excess morbidity and mortality.³–⁹ Although major depression is treatable in frail elderly persons,¹⁰ including nursing home residents,¹¹ there is concern that ...

The term “pulmonary tumorlets” describes multiple microscopic nests of neuroendocrine cells in the lungs.¹ Like bronchial carcinoid tumors and small-cell carcinomas, pulmonary tumorlets arise from Kulchitsky's cells. In the lung the abnormalities in these ...

Figure 1. A 24-year-old man with the acquired immunodeficiency syndrome presented in May 1997 with proteinuria and renal insufficiency. The most recent assessment of viral burden revealed a human immunodeficiency virus (HIV) type 1 RNA level of 62,000 ...

Diseases involving the renal glomeruli are encountered frequently in clinical practice and are the most common causes of end-stage renal disease worldwide. In the United States alone, glomerular diseases accounted for 51 percent of the 305,876 cases of ...

Doxorubicin (Adriamycin) has been used in oncologic practice since the late 1960s. It held promise as a powerful drug in the fight against cancer. The tumors most commonly responding to doxorubicin when it is given as a single agent or in combination with ...

Presentation of Case

A 30-year-old woman (gravida 2, para 0) was admitted to the hospital at 27 weeks' gestation because of increasing hypertension and proteinuria.

The patient had been well until 10 years earlier, when polyarthralgia developed. Nine ...

In the late 1940s, recognition of coronary heart disease (CHD) as the leading cause of death in the United States prompted efforts to identify factors promoting its occurrence, in the belief that the resultant insights would advance knowledge of the ...

The familiar triad of pathogens responsible for most cases of bacterial meningitis was first shown to yield to treatment with β-lactam antibiotics and chloramphenicol over four decades ago. Chloramphenicol proved to be an effective alternative for the ...

Committing a patient to a course of drug therapy, particularly a long-term one, often represents a delicate balancing act in which the physician must juggle estimates of benefit and risk — and increasingly, must factor in costs as well. As with so many ...

To the Editor: Glynn et al. (May 7 issue)¹ have shown that infections due to a strain of Salmonella enterica serotype typhimurium, known as definitive type 104 (DT104), that is resistant to ampicillin, chloramphenicol, streptomycin, sulfonamides, and ...

To the Editor: The encouraging results of the study conducted by Belshe et al. (May 14 issue)¹ of a live attenuated influenzavirus vaccine that can be administered intranasally to young children should be placed in context. In an earlier study, we ...

To the Editor: In the article by Sankila et al. (May 7 issue)¹ on the occurrence of cancer among the offspring of childhood-cancer survivors, a total of 44 cancers were diagnosed among 5847 offspring of 14,652 survivors. After excluding 22 cases ...

To the Editor: Dighiero et al. (May 21 issue)¹ conclude that the treatment of early-stage chronic lymphocytic leukemia (CLL) with alkylating agents not only is ineffective but also may adversely affect survival. This study confirms the long-held ...

To the Editor: Although I agree with Aaltonen et al. (May 21 issue)¹ that there is a need for a reliable diagnostic test for hereditary nonpolyposis colorectal cancer, I am concerned about their recommendations. To propose testing for replication errors (...

To the Editor: Urinary microscopy is widely used for the evaluation of patients with hematuria, but distinguishing between renal and nonrenal causes of hematuria can be difficult. Signs of renal disease, particularly glomerular disease, include casts ...

To the Editor: Redelmeier et al. (May 21 issue)¹ write, “Mother Nature has no mercy. As a consequence, the presence of one disease usually provides no immunity against others.” This assumption underpins the methods by which they demonstrated that ...

To the Editor: I recently received promotional material from the frequent-flyer program of American Airlines touting the fact that all its passenger jets are now equipped with cardiac defibrillators and other materials that will enable medically ...

To the Editor: An independent review of the data from a case–control study of gun ownership as a risk factor for homicide in the home, reported by my colleagues and me (Oct. 7, 1993, issue),¹ has identified an inaccuracy in our response to the letters to ...

The story of the radium watch-dial painters is a classic case in the history of occupational disease. Attracted by easy work and high wages, these young women painted the luminous numbers on wristwatches that, designed for soldiers involved in the trench ...

The authors have chosen to use the term “medical harm” rather than “iatrogenic disease,” principally because they are referring to incidents that occur during or as a result of treatment given not only by physicians but also by medical personnel of all ...

Iatrogenic disease is an important topic. It is often neglected despite compelling evidence of its frequency in published accounts and clinical experience. Paradoxically, interested parties outside medicine cite published estimates that 5 to 10 percent of ...

Molecular biology began as a scientific discipline with the discovery of the double helical structure of DNA by Watson and Crick in 1953 and the establishment of the complete genetic code by Nirenberg in 1966. In rapid succession came the discoveries of ...

Americans love babies and technology, and most Americans applaud the ability of the new assisted-reproduction techniques to help infertile couples have children. But these techniques have also given birth to a wide variety of new legal issues, including ...