Intracranial aneurysms are common.¹–⁶ Autopsy studies have shown that the overall frequency in the general population ranges from 0.2 to 9.9 percent (mean frequency, approximately 5 percent),⁵,⁶ suggesting that 10 to 15 million persons in the United ...

The Rh blood-group system is involved in hemolytic disease of the newborn, transfusion reactions, and autoimmune hemolytic anemia.¹ Despite the widespread use of Rh immune globulin prophylaxis in RhD-negative pregnant women, Rh isoimmunization still ...

Penicillium marneffei is a dimorphic fungus that can produce systemic mycosis in humans. This fungal infection is most commonly found in Southeast Asian countries and Hong Kong and other parts of southern China.¹ The recent increase in the number of cases,...

Modern immunosuppressive regimens, consisting of cyclosporine-based triple-drug therapy, with or without monoclonal or polyclonal antibodies, have dramatically increased survival among organ-transplant recipients. However, these regimens improve graft ...

Fatty-acid oxidation has a major role in energy production during periods of fasting. When body glucose is depleted, fatty acids are mobilized from adipose tissue, taken up by the liver, and converted to ketone bodies, a major alternative source of energy ...

Figure 1. Intracranial aneurysms often have catastrophic effects but are rarely seen at the moment of rupture. A 35-year-old woman with no previous neurologic history presented with severe headache and photophobia, with no localizing neurologic findings. ...

Carvedilol is a β-adrenoreceptor–antagonist drug with α₁-adrenoreceptor–antagonist activity. It was approved in the United States in September 1995 for the treatment of patients with essential hypertension and in May 1997, on the basis of the results of ...

Presentation of Case

A 41-year-old woman was admitted to the hospital because of thrombocytopenia and anemia.

The patient had been well until a few weeks earlier, when her menses, which had been profuse in recent years, became even heavier. Five days ...

Modern diagnostic techniques allow the detection of many potentially dangerous conditions before patients get sick, often before symptoms occur. The ability to detect four such conditions — asymptomatic carotid-artery stenosis,¹ atrial fibrillation ...

Hemolytic disease of the fetus and newborn was first described in 1609 in a set of twins by a French midwife: the first twin was hydropic and stillborn, and the second was deeply jaundiced and subsequently died of what we now call kernicterus. The two ...

War, famine, pestilence, and poverty have had obvious and devastating effects on health throughout human history. In recent times, human rights have come to be viewed as essential to freedom and individual development. But it is only since the end of ...

To the Editor: In the study of long-term salmeterol treatment for exercise-induced asthma reported by Nelson et al. (July 16 issue),¹ a flaw in the procedure for selecting patients was that not all subjects were receiving concurrent therapy with inhaled ...

To the Editor: Lai et al. (July 9 issue)¹ provide important data on the clinical and virologic efficacy of lamivudine for the treatment of hepatitis B virus (HBV). However, because of the potential for mutations of the gene encoding the RNA-dependent DNA ...

To the Editor: Kidney 11β-hydroxysteroid dehydrogenase 2 protects against mineralocorticoid excess by oxidatively converting cortisol, which binds to mineralocorticoid receptors as well as does aldosterone, to cortisone. Loss-of-function mutations in the ...

To the Editor: Ruzicka et al. (Sept. 18, 1997, issue)¹ reported that tacrolimus (FK 506) ointment is beneficial in the treatment of atopic dermatitis. It is remarkable that an immunosuppressant agent produced a significant improvement in the symptoms of ...

To the Editor: I am troubled that in their examination of the potential cost savings from legalizing physician-assisted suicide, Emanuel and Battin (July 16 issue)¹ relegate what I consider a central issue to an afterthought: the costs borne by ...

To the Editor: People with renal failure must reduce their dietary potassium intake. It is important to recognize that a water softener may be an important source of dietary potassium.

A 78-year-old man with diabetes and hypertension was referred because ...

John Gregory was a Scottish physician who taught at the famed medical school of the University of Edinburgh in the latter half of the 18th century. Scion of a family of renowned mathematicians, he moved in the company of brilliant minds, such as David ...

Commenting on the narrow defeat of referendums to legalize physician-assisted suicide in Washington and California in the early 1990s, Peter Filene writes, “Fifteen years earlier — no more than a minute or two of cultural-historical time — Americans had ...

Evidence-based medical practice has become something of a Holy Grail, particularly in the academic setting. Residents and medical students seem to form a chorus of white-coated crusaders with their refrain, “Show us the evidence.” They are among the ...

The ability of patients to make informed decisions about their care may be compromised by their illness, the effects of medication or hospitalization, or mental disorders such as delirium, dementia, or major depression. If patients are deemed incompetent ...