Chronic hepatitis C infection is now recognized as an important health care problem.¹ Nearly 4 million Americans are estimated to be infected, and cirrhosis will eventually develop in at least 15 to 20 percent of them.²–⁵ In the United States, infection ...

Nearly 4 million people in the United States and 100 million worldwide are infected with the hepatitis C virus (HCV).¹ Of these, approximately 70 percent have chronic hepatitis and 15 to 20 percent will eventually have cirrhosis.²–⁴ Chronic hepatitis C is ...

Congenital deafness occurs in approximately 1 in 1000 live births, and 50 percent of these cases are hereditary.¹ Nonsyndromic recessive deafness, defined as lack of hearing with no other associated clinical features, accounts for approximately 80 percent ...

Since the advent of combination chemotherapy with the MOPP (mechlorethamine, vincristine, procarbazine, and prednisone)¹ and ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) regimens,² only minor progress has been made in the treatment of ...

Figure 1. A 54-year-old man who had had stage IVA follicular small-cleaved-cell lymphoma for 10 years was admitted with a 3-week history of progressive cough, shortness of breath, fatigue, and night sweats. When his disease was first discovered he had ...

Managed-care organizations use a variety of strategies to influence the practice styles of primary care physicians. One of the most controversial of these methods is the use of financial incentives, particularly incentives designed to encourage physicians ...

Congestive heart failure affects about 1 percent of adults in the United States¹ and is a contributing factor in over 250,000 deaths annually.² It is diagnosed in 400,000 Americans each year³ and is the primary diagnosis for over 900,000 hospitalizations ...

Presentation of Case

A 54-year-old, left-handed woman was admitted to the hospital because of pain and paresthesias in the legs and a gait disturbance.

The patient had been well until eight weeks earlier, when she had pain in the soles of her feet and ...

Many American doctors are unhappy with the quality of their professional lives. Abundant anecdotal evidence and several surveys identify some of the factors that underlie their discontent. The actions doctors are taking confirm that there is substantial ...

There has been tremendous progress in research on the genetic basis of deafness. Ten different genes for nonsyndromic (uncomplicated) deafness have been identified since May 1997.¹ It has always been assumed that single-gene defects were responsible for ...

Advanced Hodgkin's disease is usually defined according to the Ann Arbor clinical staging system. Patients often have stage III disease (involvement of lymph nodes on both sides of the diaphragm) or stage IV disease (involvement of one or more extranodal ...

About 4 million people in the United States and probably more than 100 million people worldwide are infected with the hepatitis C virus (HCV).¹ The majority have no symptoms, although they can transmit this blood-borne virus to others. People who have ...

To the Editor: Stefanick et al. (July 2 issue) were unable to demonstrate a reduction in low-density lipoprotein (LDL) cholesterol levels with diet alone.¹ We believe, however, that dietary intervention alone may be effective in lowering LDL cholesterol ...

To the Editor: In their paper describing the association between the reported use of misoprostol in unsuccessful attempts to terminate pregnancy and Möbius' syndrome in infants, Pastuszak et al. (June 25 issue)¹ conclude that the “administration of ...

To the Editor: The hepatitis E virus (HEV) is known to cause enterically transmitted epidemic and sporadic forms of hepatitis in tropical and subtropical countries. HEV has been reported occasionally in areas where the disease is not endemic¹; however, ...

To the Editor: In his article on pulmonary embolism, Dr. Goldhaber (July 9 issue)¹ states that unfractionated heparin “constitutes the cornerstone” of treatment, and he mentions fractionated, or low-molecular-weight, heparin only in the discussion of ...

To the Editor: Professor Annas's arguments against cloning (July 9 issue)¹ demonstrate why the term “cloning” should be banned and the term “somatic-cell genetic transfer” should be substituted. Many of his arguments assume either that a person created ...

To the Editor: While reading the July 9 issue of the Journal, my eye was caught by the striking photograph entitled “Ladybug on Aster.” What also caught my attention was that the beetle depicted is actually a spotted cucumber beetle (Diabrotica ...

To the Editor: Children whose mothers smoke have an increased risk of smoking during adolescence.¹ One mechanism underlying this relation may involve early learning of flavors, since a variety of flavored substances that are transmitted from the mother's ...

For readers steeped in the literature of medical malpractice, this excellent, well-written book takes a novel, insightful, and humane approach. On the basis of records and detailed interviews with physicians, lawyers, other experts, and insurance ...

In A Time to Die, Charles F. McKhann offers a comprehensive and thoughtful guide to the hotly contested issue of physician-assisted death. The author draws on extensive clinical experience in the treatment of patients with cancer, detailed interviews with ...

In the current debate about physician-assisted suicide, proponents argue that legalization would respect contemporary values of patient autonomy and that the practice, if legalized, would be limited in application. Opponents maintain that physician-...

Case Records of the Massachusetts General Hospital (Case 28-1998) Case Records of the Massachusetts General Hospital, N Engl J Med 1998:339;755-763.. In the table of contents on the cover of the September 10, 1998, issue, the title of the Case Records ...