Aldosterone has an important role in the pathophysiology of heart failure.¹–⁴ Aldosterone promotes the retention of sodium, the loss of magnesium and potassium, sympathetic activation, parasympathetic inhibition, myocardial and vascular fibrosis, ...

Hereditary hemochromatosis is a common inherited disorder of iron metabolism.¹–⁴ Recently, a new major-histocompatibility-complex class I–like candidate gene (HFE) for hereditary hemochromatosis containing two missense mutations was identified on ...

The term “hemochromatosis” was used by von Recklinghausen in 1889 to denote an iron-storage disease with widespread tissue injury.¹ In 1996, a candidate gene for hereditary hemochromatosis (HFE) was identified.² The majority of patients with ...

Hypoglycemia is a condition commonly seen in the emergency department and is usually caused by insulin or sulfonylurea therapy for diabetes mellitus. Tumor-induced hypoglycemia occurs more rarely and can involve several mechanisms, according to whether ...

Figure 1. A 47-year-old woman with obesity and poorly controlled diabetes mellitus presented with a five-day history of fever, dysuria, and left-flank pain refractory to intravenous antibiotics and intravenous fluids. On admission, her blood urea nitrogen ...

The primary function of the skin is to serve as a protective barrier against the environment. Loss of the integrity of large portions of the skin as a result of injury or illness may lead to major disability or even death. Every year in the United States ...

Stage

A 34-year-old man with paraplegia after a snowmobile accident came to the emergency department with a three-day history of fever, malaise, and abnormally colored urine. Moderate abdominal pain and anorexia had developed one day before his visit. The ...

This week I succeed Jerome P. Kassirer as editor-in-chief of the Journal. Kassirer's highly successful tenure was cut short after eight years when the Massachusetts Medical Society, which owns and publishes the Journal, decided not to renew his contract. ...

Chronic heart failure occurs most commonly after earlier myocardial infarction or in the presence of long-standing hypertension. The inability of this normally efficient muscular pump to eject or receive blood results in characteristic symptoms and signs. ...

Hereditary hemochromatosis is the most common genetic disorder in whites. The prevalence of this condition (i.e., of homozygosity for the faulty gene) in the white population is approximately 1 in 250.¹,² The localization of the gene to the short arm of ...

Hypoglycemia is a common medical emergency. Among hospitalized patients, it is most common in those with diabetes mellitus, but it also occurs in patients with renal insufficiency, liver disease, malnutrition, congestive heart failure, sepsis, or cancer.¹,...

Programmed cell death (apoptosis) was unknown to William Osler and Paul Dudley White, but physicians today must grapple with the uneasy knowledge that all of our cells actively maintain the machinery of self-destruction and must continuously hold it in ...

To the Editor: In the report by Kenny-Walsh and the Irish Hepatology Research Group (April 22 issue)¹ on the outbreak of hepatitis C in Ireland in 1977 associated with the administration of anti-D immune globulin contaminated with hepatitis C virus (HCV),...

To the Editor: Human ehrlichial infections are increasingly being recognized as common tick-borne diseases in the United States. Clinical characteristics of ehrlichiosis include fever, headache, and malaise with leukopenia, thrombocytopenia, and elevated ...

To the Editor: Bräuninger et al. (April 22 issue)¹ identified a common germinal-center B-cell precursor for both Reed–Sternberg cells and non-Hodgkin's lymphoma cells in two patients with composite lymphoma. We studied five patients who had classic ...

To the Editor: The definition of “chronic myeloid leukemia” (CML) in Sawyers's excellent review article (April 29 issue)¹ describes the disease as “a malignant clonal disorder of hematopoietic stem cells that results in increases in not only myeloid ...

To the Editor: In their otherwise admirable review of the pathogenesis of melanoma (April 29 issue),¹ Gilchrest et al. misrepresent some of the epidemiologic evidence. The authors cite a paper I coauthored² to indicate that incidence is inversely related ...

To the Editor: As Bodenheimer (April 15 issue)¹ acknowledges, small health maintenance organizations (HMOs), medical groups, and community clinics lacking the resources to implement programs of chronic disease management may need to contract with a ...

To the Editor: In his Sounding Board article (April 22 issue),¹ Goodwin wrote, “Modern medicine does not work well for old people.” Goodwin acknowledges that preventing diseases may be desirable but assails the treatment of “proto-illnesses,” such as ...

To the Editor: Maple syrup urine disease is an inborn error of the metabolism of branched-chain amino acids named after the characteristic sweet aroma, reminiscent of maple syrup, present in the body fluids of affected patients.¹ This aroma has been ...

Jaundice was recognized as a disease as long ago as the fifth century b.c., and its infectious nature was suspected as early as the eighth century a.d. Large epidemics of hepatitis, first reported in the Middle Ages, have continued to occur into the 20th ...

The five editors of the Oxford Textbook of Clinical Hepatology, all renowned European hepatologists, endeavored to produce a comprehensive account of clinical hepatology. Their main purpose was to provide a useful book for both general clinicians and ...

In this era in which pathogens are emerging, patterns of susceptibility to antimicrobial drugs are evolving, and new antimicrobial agents are becoming available, this new reference book, which is targeted to physicians and clinical pharmacists interested ...

Treatments for Wasting in Patients with the Acquired Immunodeficiency Syndrome Review Article, N Engl J Med 1999:340;1740-1750.. On page 1742, two lines from the bottom of the left-hand column, the dose of glutamine should have been given as “40 g per day,...