Better understanding of the dynamics of the replication of human immunodeficiency virus type 1 (HIV-1) in vivo¹–⁴ has provided an important rationale for early and aggressive treatment of this infection. The advent of combination antiretroviral therapy ...

Combinations of drugs that inhibit viral reverse transcriptase and protease control infection with human immunodeficiency virus type 1 (HIV-1) in many people by reducing the levels of viral RNA in plasma and depleting the pools of virus in lymphoid ...

Unstable angina is a critical phase of coronary heart disease that is defined by clinical symptoms and is associated with a high risk of myocardial infarction and death.¹ The underlying pathophysiologic mechanism involves rupture or erosion of ...

The human prion diseases include Creutzfeldt–Jakob disease, Gerstmann–Sträussler–Scheinker disease, fatal familial insomnia, and the recently described new variant of Creutzfeldt–Jakob disease. Much evidence argues that a post-translational, noncovalent ...

Figure 1. A 45-year-old man presented with pancytopenia due to myelodysplastic syndrome. The bone marrow showed marked trilineage dysplasia. Electron microscopy revealed that the majority of hematopoietic cells in the marrow had ultrastructural features ...

In most of the United States, patients with chest pain thought to be due to acute coronary ischemia are taken by ambulance to the nearest hospital rather than to tertiary centers that treat a large number (high volume) of patients with acute myocardial ...

The myelodysplastic syndromes are clonal hematologic disorders characterized clinically and morphologically by ineffective hematopoiesis. The natural history of these syndromes ranges from a chronic course that may span years to a rapid course of leukemic ...

Presentation of Case

A 71-year-old, right-handed man was admitted to the hospital because of progressive muscle weakness and difficulty swallowing.

The patient had been well until one year earlier, when he had several bouts of pulmonary and paranasal-...

After the summary dismissal of the editor-in-chief of the Journal of the American Medical Association (JAMA) several months ago, protests about the violation of editorial independence appeared in the pages of many medical journals.¹–⁴ Despite strenuous ...

Over the past 18 years the human immunodeficiency virus type 1 (HIV-1) epidemic has evolved, with the disease shifting from a syndrome whose cause was undefined to one in which the etiologic agent of AIDS was isolated and identified, but for which ...

In 1920 and 1921, Creutzfeldt and Jakob described a rapidly progressive form of dementia that was apparently sporadic; the description of the familial form appeared shortly thereafter.¹ Between 1928 and 1936, Gerstmann, Sträussler, and Scheinker described ...

Twenty years ago, Luft and colleagues¹ showed that hospitals that had higher volumes of specific surgical procedures had significantly lower inpatient mortality rates than did their lower-volume counterparts. Since that time, scores of articles pertaining ...

To the Editor: We firmly believe that you were correct in saying (Feb. 11 issue)¹ that editors should have the liberty to publish articles or advance the publication of articles that create “a lively forum for exposure and discussion of important issues ...

To the Editor: Eradication of the human immunodeficiency virus (HIV) is a difficult goal to achieve, because a reservoir of replication-competent HIV is established in resting CD4 T lymphocytes soon after infection and persists after years of highly ...

To the Editor: The negative result obtained by Kelsen et al. in their trial of preoperative chemotherapy for operable esophageal cancer (Dec. 31 issue)¹ is somewhat surprising, since Herskovic et al.² reported positive results for similar chemotherapy ...

To the Editor: Metastatic relapse after the complete resection of an apparently localized primary tumor indicates that disseminated cancer cells, present at the time of surgery, are sometimes undetectable by current methods. Using monoclonal antibody Ber-...

To the Editor: The article on Creutzfeldt–Jakob disease by Johnson and Gibbs (Dec. 31 issue)¹ gives the impression that case–control epidemiologic studies have been numerous and have found no link to “dietary eccentricities.” We are aware of only a small ...

To the Editor: In compliance with the Journal's editorial rules regarding disclosure of affiliations and according to my understanding of those rules, I provided a single institutional affiliation when I submitted a letter to the editor concerning ...

To the Editor: I was recently hospitalized in a major university hospital for the Guillain–Barré syndrome. While there, I had blood drawn, usually twice a day. During my two weeks in the intensive care unit, my hematocrit dropped from 43 to 31.

As chair ...

More than 50 years after the end of World War II, Adolf Hitler continues to fascinate, as evidenced by the dozens of biographies and political analyses published during the past several years. The shadow of the Holocaust he created continues to darken the ...

A small article appeared in the New York Times on March 24, 1999, in which it was noted that Samuel Manzie, a 17-year-old who had pleaded guilty to strangling 11-year-old Eddie Werner as he sold candy door to door, offered to testify at the trial of a 45-...

It has been almost a century since the initial description of what we now call attention-deficit–hyperactivity disorder (ADHD) appeared in the English-language medical literature, and it is remarkable that the disorder continues to provoke strong feelings ...