Multiple sclerosis affects 1 in 1000 people in Western countries,¹ mainly women in their childbearing years.²,³ In general, the rate of relapse has been thought to decrease during pregnancy and increase in the postpartum period, but the studies have been ...

Osteoporosis is perhaps the most predictable and debilitating complication of long-term glucocorticoid therapy,¹,² with bone loss that ultimately leads to fractures in up to 50 percent of patients.³–⁵ Estrogen, vitamin D and its analogues, and calcitonin ...

Herpes simplex virus (HSV) is a leading cause of corneal opacification and infection-related visual loss. An estimated 400,000 Americans have had ocular HSV disease, and there are nearly 50,000 new and recurrent cases each year in the United States.¹

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Combination treatments with agents that inhibit protease and reverse transcriptase of human immunodeficiency virus type 1 (HIV-1) decrease mortality and slow disease progression.¹ The development of resistance to these drugs, however, limits the benefit ...

Figure 1. A 43-year-old man with moderate hypercholesterolemia and a long history of fainting after venipuncture was monitored by transcranial Doppler ultrasonography of the middle cerebral arteries and continuous noninvasive measurement of blood pressure ...

Preterm birth, which occurs in 11 percent of all pregnancies, is responsible for the majority of neonatal deaths and nearly one half of all cases of congenital neurologic disability, including cerebral palsy.¹ Although all births before 37 weeks of ...

In 1981, de Bold and his colleagues made the seminal observation that infusion of extracts of atrial tissue into rats caused a copious natriuresis.¹ This then led to the isolation and cloning of atrial natriuretic peptide, the first member of a family of ...

Presentation of Case

A 76-year-old woman was admitted to the hospital because of gastrointestinal blood loss and worsening anemia.

The patient had a long history of hypertension with mild azotemia and asymptomatic idiopathic thrombocytopenia. Eight weeks ...

Multiple sclerosis, an organ-specific autoimmune disease of the central nervous system, affects 250,000 to 350,000 persons in the United States. It is at least twice as common among women as among men — a sex distribution common to most autoimmune ...

Eye disease due to herpes simplex virus (HSV) is the most common infectious cause of corneal blindness in the industrialized world.¹ In a long-term study in Rochester, Minnesota,²,³ the incidence of new cases of ocular HSV infection was 8.4 per 100,000 ...

The addition of human immunodeficiency virus type 1 (HIV-1)–protease inhibitors to the armamentarium of antiretroviral drugs has dramatically improved the prognosis for HIV-infected persons.¹–³ Although these agents do not eradicate the virus,⁴–⁶ they can ...

To the Editor: The recent study by Thomas et al. (March 19 issue)¹ aroused concern that a substantial proportion of U.S. adults may be deficient in vitamin D. In this Boston-area study, more than half of the patients studied had serum 25-hydroxyvitamin D ...

To the Editor: Krum and colleagues (March 19 issue)¹ make the clinically important observation that the orally active endothelin ET_A- and ET_B-receptor antagonist bosentan causes a sustained reduction of blood pressure in patients with essential ...

To the Editor: The clinical relevance of the conclusion of Monzon et al. (March 26 issue)¹ that patients with multiple melanomas have a germ-line mutation of the CDKN2A gene that predisposes them to melanoma is difficult to ascertain because no ...

To the Editor: Abnormal melanocytic nevi are a potent risk factor for sporadic melanoma. In persons with a family history of melanoma, the presence of this phenotype is commonly used to identify candidates for screening and surveillance because their ...

To the Editor: The articles by Yeomans et al. and Hawkey et al. (March 12 issue) demonstrate the efficacy of omeprazole as compared with either ranitidine¹ or misoprostol² for ulcers associated with nonsteroidal antiinflammatory drugs (NSAIDs). Thus, all ...

To the Editor: The susceptibility to osteoporotic fracture varies markedly among ethnic groups, and the differences are partly independent of differences in bone mass. For example, hip fractures are rare in elderly black Africans and in Asians, even ...

This is an era of indifference to and poverty of skill in auscultation, which is unfortunate, since many of us trained in earlier days learned to relish the challenge, stimulus, and revelations that come from auscultation of the heart, lungs, great ...

In The Spirit Catches You and You Fall Down, Anne Fadiman tells the story of a Hmong family's experience with the American health care system and highlights many of the weaknesses of what some describe as the best health care system in the world. Fadiman ...

Dr. Aronowitz champions the holistic approach to the care of patients in the face of what he sees as the current science-oriented, reductionist approach to the practice of medicine. For example, he believes that in the past, the creation of new disease ...