Congestive heart failure is a serious disease that can be exacerbated by many factors unrelated to ventricular dysfunction. One important factor in determining the symptoms and clinical course of patients with severe congestive heart failure is the ...

The hepatitis C virus (HCV) is the most common cause of hepatitis after blood transfusion. Severe liver damage from hepatitis C has become one of the leading indications for liver transplantation.¹–⁴ Children who have had multiple transfusions as a result ...

Sudden death from cardiac causes, often due to ventricular fibrillation, claims at least 250,000 persons annually in the United States.¹,² The American Heart Association guidelines for advanced cardiac life support state that antiarrhythmic medications ...

Severely obese (ob/ob) mice are deficient in the adipocyte-derived hormone leptin, which acts on the hypothalamus to control appetite and energy expenditure.¹ The administration of leptin to these mice corrects their obesity by reducing their food intake ...

Figure 1. A 76-year-old man who had taken various doses of corticosteroids and methotrexate for Churg–Strauss syndrome was seen for anorexia, weakness, and painful “bumps” on his scalp. A creamy yellowish material spontaneously drained from some of the ...

Domestic abuse, or battering, is a pattern of psychological, economic, and sexual coercion of one partner in a relationship by the other that is punctuated by physical assaults or credible threats of bodily harm.¹ Battering can be seen as a set of learned,...

The past two decades have witnessed an increase in the number of patients who are immunocompromised as a consequence of a primary or secondary immunodeficiency disorder or from the use of agents that depress one or more components of the immune system. ...

Presentation of Case

A 68-year-old woman was admitted to the hospital because of rapidly progressive dementia and a gait disorder.

The patient had been well until about one year earlier, when she began to have vague problems with her memory. Three months ...

In 1920 Sir James Mackenzie reported that atrial fibrillation was present in 80 to 90 percent of patients who had congestive heart failure, which at that time was called “dropsy.”¹ In patients with symptomatic heart failure today, the prevalence of atrial ...

Recent data indicate that an estimated 2.7 million people in the United States are chronically infected with hepatitis C virus (HCV).¹ Hepatitis C has become the most common reason for liver transplantation and has been called the silent epidemic in ...

In humans, the relative long-term constancy of body weight, the difficulty of successfully sustaining intentional weight loss, and the metabolic and behavioral alterations that accompany weight change provide strong evidence that body fat is biologically ...

To the Editor: Iglehart (Jan. 7 issue)¹ has undertaken the admittedly difficult exercise of tracking how Americans spend money on health care. In Table 2 of his article, which shows expenditures in 1970, 1980, and 1990 and projected expenditures in 1998 ...

To the Editor: In their placebo-controlled study, Lowance et al. (May 13 issue)¹ found that treatment with valacyclovir markedly reduced the incidence of cytomegalovirus (CMV) disease after renal transplantation. The reduction in CMV disease among CMV-...

To the Editor: Ornithine transcarbamylase deficiency is the most common inherited disorder of the urea cycle.¹,² It is an X-linked disease that can range in severity from hyperammonemic coma in neonates to the absence of symptoms in adults.¹,² Liver ...

To the Editor: Jacques and colleagues (May 13 issue)¹ report data showing that the 30 percent of the Framingham Offspring Study cohort who took B vitamin supplements had a substantially lower mean plasma homocysteine concentration that the members of the ...

To the Editor: Physical exercise is effective therapy for patients with type 2 diabetes mellitus. Therefore, my colleagues and I asked the following question: Would the effects of partial immersion in a hot tub simulate the beneficial effects of exercise?...

In his book of essays, In the Country of Hearts: Journeys in the Art of Medicine (New York: Delacorte Press, 1990), John Stone writes, “[The heart] provides three billion heartbeats for the average person in a lifetime — and even that huge number, as we ...

Coronary bypass is the most exhaustively studied operation in the history of surgery, and it has achieved widespread use because its benefits have been so thoroughly documented. Yet the dominance of coronary bypass is being threatened by the success of ...

This outstanding, thoroughly comprehensible and comprehensive, well-edited book succeeds admirably in its intention to serve as a resource on clinical trials in cardiovascular disease for those in research and in clinical practice. It provides an ...