A short interval between pregnancies has been associated with adverse perinatal outcomes,¹–⁷ but whether it is an independent risk factor or whether the association is due merely to confounding by other factors (such as maternal age, socioeconomic status, ...

Surveillance data suggest that foodborne outbreaks account for less than 5 percent of reported cases of hepatitis A in the United States.¹ Most outbreaks occur in a single food establishment and result from contamination of uncooked or previously cooked ...

Twin and adoption studies strongly suggest that genetic transmission accounts for most of the familial aggregation of schizophrenia.¹,² However, little is known about the contribution of familial aggregation to the occurrence of schizophrenia in the ...

There are approximately 2 million Americans with congestive heart failure, and about 400,000 new cases are diagnosed each year.¹ The population-based mortality rate from congestive heart failure is 1.8 times as high for black men as for white men and 2.4 ...

Figure 1. A 31-year-old woman who had had amenorrhea for 53 days was found to have a left tubal pregnancy. Ultrasonography (Panel A) demonstrated a gestational sac (GS) containing an embryo (E) and a yolk sac (YS). A cross section of the fallopian tube (...

Epidemiologic studies have identified differences according to race and sex in the treatment of patients with cardiovascular disease in the United States.¹–¹⁸ Some studies have found that blacks and women are less likely than whites and men, respectively, ...

Nosocomial pneumonia is a leading cause of death from hospital-acquired infections, with an associated crude mortality rate of approximately 30 percent.¹ Ventilator-associated pneumonia refers specifically to nosocomial bacterial pneumonia that has ...

Presentation of Case

A 17 1/2-year-old girl was admitted to the hospital because of a thoracoabdominal aneurysm.

The patient had been born after a normal pregnancy and delivery, and her early growth, development, and health were normal. Four years before ...

Is there a “natural” interval between pregnancies in humans? Our nearest animal relatives, the chimpanzees and gorillas, breast-feed their offspring for long periods, and the median time from the birth of one offspring to the conception of the next is ...

Although its incidence has declined in the past decade, hepatitis A is still responsible for nearly 60 percent of the cases of acute viral hepatitis in the United States. In about half these cases, no source of infection is identified. The investigation ...

Schizophrenia is one of our most important public health problems. It is a common, tragic, and devastating mental illness that typically strikes young people just when they are maturing into adulthood. Once it strikes, morbidity is high (60 percent of ...

To the Editor: Neither Grumbach et al. in their article on primary care physicians' experience of financial incentives in managed-care systems (Nov. 19 issue)¹ nor you, Dr. Kassirer, in your accompanying editorial² have addressed the fundamental conflict ...

To the Editor: In their review of doxorubicin-induced cardiomyopathy (Sept. 24 issue),¹ Singal and Iliskovic advise frequent monitoring of the ejection fraction during therapy with doxorubicin and cite the recommendations of the Cardiology Committee of ...

To the Editor: A 57-year-old man with a diagnosis of advanced, inoperable pancreatic cancer received palliative treatment consisting of gemcitabine (1000 mg per square meter of body-surface area given intravenously on days 1, 8, and 15) with antagonists ...

To the Editor: I disagree with Annas about how best to identify the mother and father of a child born of a gestational (biologically unrelated) surrogate (Sept. 24 issue).¹ People with firsthand knowledge about surrogacy know that it would nearly always ...

To the Editor: A 13-year-old boy awoke from sleep with a sharp pain on the left side of his neck. He killed a large black spider in the bed. Because of local neck pain and muscle cramps migrating into his chest, abdomen, and legs, he sought care at a ...

This book reviews the history of the clonal-selection theory and the debate about the generation of antibody diversity. The theory of clonal selection that was advanced independently by Burnet and Talmage in 1957 is now a generally accepted concept among ...

Your 10-year-old child has been invited to a friend's birthday party. The main attraction will be a large, inflated castle for bouncing. You accompany your child and watch the pleasure generated as he or she bounces high. Gradually, however, as more and ...

In his lecture to first-year medical students entitled, “The Internist as Sherlock Holmes,” Stanford hematologist William Creger described the “crimes” (illnesses) that strike patients and the “clues” (the patient's medical history and the results of ...

Emerging Infections is the first of a new series entitled Biomedical Research Reports created to address topics of broad clinical and social import. This book is a collection of in-depth reports by leading researchers on major emerging infections. Its ...

Treatment of Hypokalemia Correspondence, N Engl J Med 1999:340;154-155.. On page 155, the first sentence of Dr. Gennari's reply should have referred to the treatment of hypokalemia, not hyperkalemia, as printed.

Treatment of Asthma with Drugs Modifying the Leukotriene Pathway Review Article, N Engl J Med 1999:340;197-206.. On page 198, in Table 1, the recommended oral dose of montelukast for children should have given the age range as “6–14 yr,” not “6–12 yr,” as ...

During the 1990s, the delivery of health care services was increasingly influenced by the demands of investors and investor-owned firms. A growing number of hospitals, health maintenance organizations (HMOs), nursing homes, home care services, and ...