Bisphosphonates are pyrophosphate analogues that inhibit the formation and dissolution of calcium phosphate crystals in vitro. In vivo, bisphosphonates bind strongly to hydroxyapatite on the bone surface. Used therapeutically, bisphosphonates inhibit ...

Most sudden deaths in athletes are due to cardiovascular disease.¹–¹⁰ Atherosclerotic coronary artery disease is the most common cause of sudden death in athletes over 35 years of age.²,⁴,⁵ Hypertrophic cardiomyopathy has been implicated as the principal ...

Crohn's disease is a chronic inflammatory disorder of the bowel whose cause is unknown. During the acute phase of the disease, glucocorticoids such as prednisolone and prednisone are commonly used.¹,² However, this treatment is often associated with ...

Human granulocytic ehrlichiosis was first described in the United States, in the northern Midwest, in 1994.¹ Human granulocytic ehrlichiosis is caused by an organism, still referred to as the agent of human granulocytic ehrlichiosis, that is similar to ...

Figure 1. A 46-year-old woman was bitten on the left arm by a brown recluse spider (Loxosceles reclusa), which was recovered and identified. Twenty-four hours later, the bite was only moderately painful (Panel A). The patient was treated with cool packs ...

The gain in life expectancy is an important outcome of many medical interventions. It can help patients and physicians decide whether the benefits of an intervention outweigh its harm or help an insurance company decide whether or not to cover a new ...

Diuretic drugs are widely used for the treatment of patients with edema. Among these drugs, loop diuretics such as furosemide are perhaps the most frequently prescribed, and their clinical pharmacology is better understood than is that of other diuretics. ...

The reorganization of health care is profoundly influencing the roles, responsibilities, and even the loyalties of physicians. The accelerated disappearance of the solo practitioner has been matched by an increase in the number of physicians who belong to ...

The clinical use of bisphosphonates has increased dramatically during the past five years. The most common indication for these compounds is osteoporosis, but their use in osteolytic bone disease has grown very rapidly. The Food and Drug Administration's ...

Inflammatory bowel diseases are the second most common chronic inflammatory disorder after rheumatoid arthritis. Of these, Crohn's disease afflicts hundreds of thousands of patients, particularly in developed countries, and its incidence is increasing.¹ ...

Patients, providers, payers, politicians, and the public are keenly interested in evaluating the worthiness of diverse health care interventions. Sometimes the attention is focused on existing interventions (such as childhood immunizations); at other ...

To the Editor: Palella et al. (March 26 issue)¹ reported that the use of more intensive antiretroviral therapies is responsible for declines in both morbidity and mortality in patients with AIDS. We conducted a study to evaluate the impact of protease ...

To the Editor: Close inspection of Figure 1 and Figure 2 in the article by Schwartz et al. (March 26 issue)¹ suggests that the effects of troglitazone may have been waning when the study ended at 26 weeks, because the values for both glycosylated ...

To the Editor: Since November 1997, we have observed contact dermatitis in three technicians working in a genetics laboratory in Leuven, Belgium, and in two working in the University Laboratory of Bacteriology in Strasbourg, France. The patients, all of ...

To the Editor: In his excellent review article “Imaging the Brain” (March 19 and 26 issues),¹ Dr. Gilman introduces us to the fascinating role of magnetic resonance imaging (MRI) in the evaluation of patients with multiple sclerosis. He states that “MRI ...

To the Editor: Lowenstein and Alldredge's excellent review of status epilepticus (April 2 issue)¹ contains one misunderstanding that we hear often: “Patients should receive 100 percent oxygen by nasal cannula or a nonrebreathing mask.” Airway management ...

To the Editor: Dr. Levinsky (March 26 issue)¹ recommends “telling patients the truth” as the best way for doctors to deal with the problem of rationing of medical care. As appealing as this advice is, it falls short of solving an important contemporary ...

The evolving status of anesthesiology has been the subject of much thought and plenty of talk. Initially developed because of the dire need to prevent intolerable surgical pain, anesthesiology has evolved into a scientifically based and clinically skilled ...

In the past decade there has been explosive growth in the use of ambulatory surgery, stimulated by the development of noninvasive surgical techniques, such as endoscopy and laser surgery, and short-acting anesthetic agents with few side effects, such as ...

In the United States, the recognition of emergency medicine as a distinct specialty has been a long process, requiring at least 10 years and many separate steps. The evolution of emergency medicine has included the development of independent training ...

Case Records of the Massachusetts General Hospital (Case 12-1998) Case Records of the Massachusetts General Hospital, N Engl J Med 1998:338;1138-1143.. On page 1138, the sentence that begins 13 lines from the bottom of the right-hand column should have ...

Inhibition of the Platelet Glycoprotein IIb/IIIa Receptor with Tirofiban in Unstable Angina and Non–Q-Wave Myocardial Infarction Original Article, N Engl J Med 1998:338;1488-1497.. On page 1496, in addition to J.G. Diodati, the following investigators are ...