Cigar sales in the United States increased nearly 50 percent between 1993 and 1997. Over the same period, sales of large, “premium” cigars increased by 68 percent,¹ reversing a 20-year decline in cigar consumption that began in the early 1970s. The upward ...

The National Institute of Neurological Disorders and Stroke (NINDS) Recombinant Tissue Plasminogen Activator Stroke Study was a double-blind, placebo-controlled, randomized study conducted in two parts, both of which showed a significant benefit at three ...

The identification of antibodies against neuronal proteins in the serum and cerebrospinal fluid of patients with both cancer and a specific neurologic disorder (paraneoplastic syndrome) has uncovered the existence of antigens shared by some tumors and the ...

A conceptus must successfully attach itself to maternal tissue in order to survive. The process of implantation has never been directly observed in humans, and its timing remains uncertain.¹,² In 1959, results were published of a study of 210 fertile ...

Figure 1. A 67-year-old woman has multiple telangiectasias on her hands, as well as on her arms, legs, ears, lips, and nasal mucosa. She has had numerous episodes of epistaxis and gastrointestinal bleeding since her mid-20s. Endoscopic evaluation revealed ...

The incidence of cardiovascular disease differs significantly between men and women, in part because of differences in risk factors and hormones.¹ The incidence of atherosclerotic diseases is low in premenopausal women, rises in postmenopausal women, and ...

Modern imaging techniques are increasingly discovering arteriovenous malformations of the brain, many of which are still unruptured. Advances in microsurgery, endovascular techniques, and radiotherapy have expanded the options for therapy and have come at ...

Presentation of Case

A 42-year-old asplenic man was admitted to the hospital because of gram-negative sepsis.

The patient had been well until one week earlier, when his left upper teeth began to ache. Four days before admission, he had abdominal cramps ...

Dr. Harold Varmus, director of the National Institutes of Health (NIH), recently circulated for comment a bold and wide-ranging proposal for NIH sponsorship of a Web site for the publication of all new biomedical-research reports.¹,² Called “E-biomed,” ...

In his historic 1964 report, Surgeon General Luther Terry concluded that “cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.”¹ Time and again since 1964, however, we have had to ...

The paraneoplastic neurologic disorders are models of the way in which rare diseases can shed light on common clinical problems. Paraneoplastic neurologic disorders, which are neurologic degenerative disorders that occur in patients with neoplasms outside ...

The survival of each animal species depends on its ability to recognize invading pathogens and respond to them rapidly. Many such defenses against microbes are innate rather than adaptive to the particular pathogen. Just as infants instinctively respond ...

To the Editor: Most of the data in our letter to the editor on the absence of human T-cell lymphotropic virus type I in cutaneous T-cell lymphoma (Jan. 23, 1997, issue)¹ cannot be verified. The letter is therefore invalid, and we wish to retract it. We ...

To the Editor: When Hartmann and colleagues (Jan. 14 issue)¹ analyzed the outcomes of prophylactic mastectomies, they expressed the results as a relative risk reduction. They reported that prophylactic mastectomy reduces the incidence of breast cancer by ...

To the Editor: Phillips et al. (Jan. 14 issue)¹ are to be commended for their lucid deconstruction of the “one in nine” statistic, a figure seized on by the lay and medical media and one that has aroused concern that we are facing an unprecedented ...

To the Editor: Some normal subjects and a substantial proportion of patients with various illnesses in the United States and northern Europe have vitamin D insufficiency,¹–⁴ but information from countries located in more southern latitudes is scarce.

We ...

To the Editor: In their analysis of infected dog and cat bites, Talan et al. (Jan. 14 issue)¹ found that pasteurella species could be isolated from 50 percent of infected dog-bite wounds. In the accompanying editorial, Fleisher² mentioned the importance ...

To the Editor: In their Image in Clinical Medicine, Giladi and Avidor (Jan. 14 issue)¹ describe a 17-year-old boy who was treated with 14 days of oral ciprofloxacin for an infection with Bartonella henselae after being scratched on the neck by a cat. ...

To the Editor: Penicillin resistance has been an increasing problem in the treatment of infections due to gram-positive cocci over the past 15 years.¹ Much of the concern has related to the rising minimal inhibitory concentrations (MICs) of antibiotics ...

Alternative medicine is still exotic territory. Books that survey this terrain resemble earlier travel guides to new worlds. Depending on the writer's position, the reader is treated to tales ranging from Rousseau's accounts of noble savages to Hobbes's ...

The demand for increasing accountability with respect to the cost of health care has escalated pressure on physicians to manage an increasing fraction of their patients' illnesses in the outpatient setting. Primary care physicians, in conjunction with an ...

This book brings together two disciplines — rheumatology and adolescent medicine — in an authoritative yet practical fashion. It is short by today's standards, only 18 chapters and 349 text pages, but it covers several topics not available in either of ...