In 1994, the Pediatric AIDS Clinical Trials Group Protocol 076 demonstrated the efficacy of a three-part regimen of zidovudine prophylaxis in reducing perinatal transmission of the human immunodeficiency virus (HIV) from 25.5 percent to 8.3 percent.¹ On ...

In 1954 a patient with symptoms suggesting that a stroke was imminent underwent successful removal of a stenosed segment of the carotid artery.¹ From that initial experience, carotid endarterectomy evolved. In 1985 it was performed 107,000 times in the ...

Little information exists about long-term outcomes after radiosurgical or microsurgical treatment of acoustic neuromas. Most reports of microsurgical resection have dealt with results immediately after the procedure¹–⁸; only a few have systematically used ...

In many industrialized countries, the proportion of infants born before term (at less than 37 weeks of gestation) has increased in the past 20 years. In Canada, for instance, the proportion of infants born at less than 37 weeks of gestation increased from ...

Figure 1. A 27-year-old man presented with a two-week history of left sensorineural hearing loss and tinnitus. A T₁-weighted gadolinium-enhanced axial image through the posterior fossa at the level of the cerebellopontine angle shows the typical ...

Since its introduction in 1954, carotid endarterectomy for the prevention of stroke has been controversial.¹ Rates of carotid endarterectomy rose until the mid-1980s, when a number of studies were published demonstrating very high rates of perioperative ...

In patients with renal diseases characterized by proteinuria, the initial insult to the kidney is usually followed by a progressive decline in the glomerular filtration rate. This decline has been thought to be due to changes in renal hemodynamics ...

Presentation of Case

A 71-year-old woman was admitted to the hospital because of fever, dyspnea, and hypotension.

Her history included an inferior myocardial infarction 19 years earlier; hypertension; renal insufficiency ascribed to chronic pyelonephritis,...

In this issue of the Journal, Wade and colleagues¹ present data on the outcomes of short, prophylactic courses of zidovudine administered to infants born to women infected with the human immunodeficiency virus (HIV) who presented for obstetrical care in ...

The use of carotid endarterectomy is on the rise again. After a six-year decline, the number of such operations rose by 94 percent between 1991 and 1996. As shown in Figure 1, however, this has happened before: between 1980 and 1985, the incidence rose by ...

Acoustic neuromas (vestibular schwannomas) are benign tumors of the eighth cranial nerve. They are unilateral and typically become symptomatic after the age of 30 years. Bilateral tumors usually are present in type 2 neurofibromatosis, are transmitted in ...

To the Editor: Miller et al. (July 2 issue)¹ are to be commended on their report of the randomized trial comparing full-dose chemotherapy with limited chemotherapy and involved-field radiation for the treatment of localized intermediate-grade and high-...

To the Editor: The results of the carefully conducted study by Adams et al. (July 2 issue)¹ of the value of transfusion in preventing strokes in children with sickle cell anemia and abnormal results on transcranial Doppler studies were impressive and ...

To the Editor: The article by Ayanian and colleagues (June 25 issue),¹ reporting agreement among specialists with respect to indications for cardiac catheterization, provides reassuring data for patients seeking second opinions. These data, however, are ...

To the Editor: The diagnosis of acute appendicitis is often, but not always, straightforward. Imaging studies, such as ultrasonography and computed tomography, may be helpful. When other diagnoses seem more likely, colonoscopy may be performed,¹,² ...

Approximately 40 million people in the world are blind and another 100 million have substantial visual impairment. The principal causes of blindness and visual disability are quite distinct in developed as compared with developing countries, and where ...

Inspection of the oral cavity and neck is part of any routine physical examination. Frequently, a swelling in the neck may be due to an infection. Thorough inspection of the oral cavity and palpation of the neck, paired with a detailed history taking (...

A 60-year-old man who had endured panic disorder during an earlier period of his life awoke with crushing substernal chest pain radiating down his arm and up to his jaw. Observing him diaphoretic, nauseated, and in pain, his wife called an ambulance. On ...

Sometimes the taxi driver knows the diagnosis. Before the child arrives for his developmental evaluation, the driver is thinking, “This kid has cerebral palsy.” But recognizing cerebral palsy is not always so easy. It is even more difficult to articulate ...