Acute venous thromboembolism is usually treated with a five-to-seven-day course of unfractionated or low-molecular-weight heparin, followed by a three-month course of oral anticoagulant therapy.¹ Subgroup analyses of the results of a number of recent ...

The overall incidence of gastric adenocarcinoma is declining despite the increasingly frequent occurrence of proximal gastric tumors. Nevertheless, stomach cancer remains an important cause of death worldwide. In the Netherlands, gastric cancer ranks ...

Alcohol abuse is one of the most common causes of adult-onset seizures.¹ Although primary prevention of seizures during alcohol withdrawal has been reported,²–⁶ only a few studies have addressed the treatment and prevention of recurrent seizures related ...

Coronary heart disease is the leading cause of death in the United States and other industrialized countries. In 1995, an estimated 481,287 deaths in the United States resulted from coronary heart disease, representing more than 1 of every 5 deaths.¹ In ...

Figure 1. An 88-year-old Japanese woman had a six-week history of black stools and fatigue. Her hemoglobin level was 6.7 g per deciliter, and a fecal occult-blood test (Hemoccult) was positive on two occasions. A chest x-ray film showed a round, soft-...

Managed care, the dominant force in health care delivery in the United States,¹,² is shaping the educational experiences of medical students and residents.³–⁶ Faculty members, as the chief transmitters of attitudes, knowledge, and values about the ...

Postoperative pulmonary complications are an important part of the risk of surgery and prolong the hospital stay by an average of one to two weeks.¹ Much of the literature on the assessment of perioperative risk has focused on identifying the now well-...

Presentation of Case

A 75-year-old woman was admitted to the hospital because of weakness and a tendency to fall.

Eight months earlier, a temporal-artery biopsy, with negative results, had been performed elsewhere because of frequent headaches and an ...

The lethal complication of deep-vein thrombosis is pulmonary embolism. Since about 80 percent of the patients who die of pulmonary embolism succumb within two hours of the onset of symptoms,¹ intervention must focus on prevention. Patients who have had a ...

In this issue of the Journal, Bonenkamp et al.¹ report the results of a Dutch trial in which 711 patients with gastric cancer were randomly assigned to gastrectomy with either a limited (D1) lymph-node dissection (380 patients) or an extended (D2) lymph-...

Meta-analysis — the formal combination of the research results from multiple studies — is widely used, but with little general understanding of its limitations and uncertainties. There is something quite appealing about collecting all the available ...

Students, residents, faculty members, and deans at medical schools in the United States don't like managed care. In this issue of the Journal, ¹ Simon et al. report the results of a 1997 telephone survey of a national sample of medical students, residents,...

To the Editor: In their Sounding Board article, Ubel and Caplan (Oct. 29 issue)¹ identified many important ethical issues with respect to organ allocation. Unfortunately, they included some factual errors and erroneous assumptions.

The adoption of a ...

To the Editor: In their impressive four-year study of blood pressure in 53 patients undergoing dialysis, Argilés et al. (Nov. 5 issue)¹ found that the patients' blood pressures were higher in the winter than in the summer and that this variation was not ...

To the Editor: Isolated noncompaction of the ventricular myocardium is a rare congenital disorder. We have reported elsewhere that the incidence of this unique cardiomyopathy is 0.05 percent in adults.¹ In the report of the 1995 World Health Organization–...

To the Editor: Gainer et al. (Oct. 29 issue)¹ show that the short-term effects on blood pressure and renin levels of a single oral dose of 25 mg of captopril in sodium-depleted normotensive and hypertensive subjects can be reduced by a simultaneous ...

To the Editor: Acute infection with human immunodeficiency virus type 1 (HIV-1) is associated with a self-limited, mononucleosis-like illness in the majority of persons. Symptoms may include fever, pharyngitis, lymphadenopathy, rash, oral and genital ...

To the Editor: In the descriptions in the Images in Clinical Medicine (Oct. 29 issue)¹,² of two patients with buffalo hump and infection with the human immunodeficiency virus (HIV) who were receiving antiretroviral therapy, the authors suggest a ...

To the Editor: A 43-year-old man in a persistent vegetative state was admitted to the hospital with recurrent bouts of vomiting — bilious emesis without coffee-ground material. He received gastric-tube feedings through a 20-French Foley catheter. During ...

Interest in the health issues affecting immigrants has grown over the past 10 to 20 years, as the number of immigrants in the United States has increased dramatically — from under 10 million in 1970 to almost 26 million in 1997. Although a few states ...

Not long after I started working at the prison in Walpole, Massachusetts, a patient came to my office during sick call and breezily announced that he had just swallowed 37 Tylenol tablets. He declined ipecac, stating almost as an afterthought, “Oh yeah, ...

On February 9, 1999, Laurent Fabius, former Prime Minister of France; Georgina Dufoix, minister of social affairs under Fabius; and her subordinate, Edmond Hervé, stood before a tribunal in the Court of Justice of the Republic, where they were charged ...

This is a timely book. Despite voluminous data from large-scale randomized trials that have allowed evidence-based use of endarterectomy in the treatment of carotid atherosclerosis, catheter-based endoluminal therapies are challenging endarterectomy as ...

A Controlled Trial of Exercise Rehabilitation after Heart Transplantation Original Article, N Engl J Med 1999:340;272-277.. On page 275, the sentence that begins on line 10 of the right-hand column should have read, “In addition, these patients increased ...

Renal Atrophy Associated with Long-Term Treatment with Indinavir Correspondence, N Engl J Med 1999:340;392-393.. On page 392, in lines 11-12 and 28-29, the dosage for indinavir should have read “800 mg orally three times a day,” not “2400 mg orally three ...

Inadequate Prescription-Drug Coverage for Medicare Enrollees — A Call to Action Sounding Board, N Engl J Med 1999:340;722-728.. On page 722, the first sentence in the third paragraph of the right-hand column should have read, “Among Medicare enrollees who ...