Primary hyperparathyroidism in the Western world has evolved from a disease of “bones, stones, and groans” to a disorder that is asymptomatic in most patients.¹–⁵ As a result, common questions include the following: When is surgery — the definitive ...

Hepatitis B virus (HBV) infects more than 300 million people worldwide, contributing to debilitating illness and death.¹ Until recently, the only antiviral drug for the treatment of hepatitis B was interferon.²–⁴

In preliminary studies of patients with ...

Idiopathic pulmonary fibrosis is characterized by a fibroproliferative response with only minor signs of inflammation, and it almost always causes rapid fibrotic destruction of the lung.¹ Regardless of treatment, the median survival is four to five years ...

Electrocardiographic artifact can simulate ventricular tachycardia. The literature regarding electrocardiographic artifact is limited to case reports,¹–⁷ proposed classifications,⁸,⁹ and diagnostic criteria.¹⁰ There is little information regarding the ...

Figure 1. An 84-year-old woman with a history of falling was found on the ground unable to get up. On admission to the hospital for evaluation of syncope, she had a normal pulse and blood pressure. Examination revealed a masklike face, bradykinesia, gait ...

Heart failure is a leading cause of mortality in the United States. As a result of advances in genetic technology, a molecular basis of heart failure is emerging.¹,² This review highlights the ways in which these insights are leading to new therapeutic ...

BehÇet's disease is an inflammatory disorder of unknown cause, characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesions.¹,² All these common manifestations are self-limiting except for the ocular attacks. Repeated attacks ...

Presentation of Case

A 44-year-old man was admitted to the hospital because of tracheal stenosis.

The patient had been well until three years earlier, when a cough developed, accompanied by purulent sputum, spikes of fever, exertional dyspnea, difficulty ...

Hypercalcemia, and subsequently primary hyperparathyroidism, is discovered in two ways. Most commonly, hypercalcemia is discovered when serum calcium is measured as a screening test or in patients who have fatigue, weakness, or other symptoms of physical ...

Idiopathic pulmonary fibrosis is a chronic condition of the lung parenchyma involving progressive injury, inflammation, and fibrosis. Data collected from October 1988 through September 1990 in the population-based registry of patients with diffuse lung ...

In June 1998, the House of Delegates of the American Medical Association (AMA) adopted a set of recommendations for reform of the health care system. They were outlined in a report by the AMA's Council of Medical Service.¹ In this report we call for a ...

To the Editor: I have always been proud of the great succession of editors at the Journal — Garland, Ingelfinger, Relman, and Kassirer. Their distinguished leadership and integrity transformed a fine regional medical journal into a national and ...

To the Editor: In the study by Oral and colleagues on the efficacy of ibutilide for facilitating transthoracic cardioversion of atrial fibrillation (June 17 issue),¹ patients with atrial fibrillation of more than 48 hours' duration were excluded unless “...

To the Editor: Multifetal births are a calculated risk of induction of ovulation, because the number of ova that will be fertilized is unknown. By contrast, the number of transferred embryos in in vitro fertilization can be controlled, which is important ...

To the Editor: The evaluation of a 53-year-old man with fever and rapid neurologic deterioration in the January 14 Case Record¹ is a good example of the use of laboratory tests for the diagnosis of bacterial meningitis that have little or no clinical ...

To the Editor: In his letter to the editor (June 24 issue),¹ Dr. Olshansky correctly asserts that deglutition syncope is classically associated with intense vagal afferent activation and bradycardia. We believe, however, that intense afferent vagal ...

To the Editor: Parkinson's disease, like most chronic conditions, often announces itself in subtle but telling ways. We recently encountered a 68-year-old woman whose presenting symptom was that of time standing still.

The woman's husband had given her ...

The Birth of the Cell is a thorough, scholarly, and informative book on the development and establishment of the theory of cellular structure in plants and animals. It covers the 17th, 18th, and 19th centuries and parallels the development of the light ...

How do scientists explain disease? In trying to find an example from the recent past to answer this question, one could hardly do better than the fascinating history of how scientists have explained peptic ulcers. As readers of the Journal are surely ...

On April 19, 1910, Paul Ehrlich announced the development of a specific cure for syphilis, a drug soon known worldwide as Salvarsan (arsphenamine). Salvarsan was not the “magic bullet” that Ehrlich predicted, since its assault on a pathogen was coupled ...

Whither Continuity of Care? Correspondence, N Engl J Med 1999:341;850-852.. On page 851, the first sentence in the right-hand column should have read, “By definition, hospitalists hired to care for patients formerly cared for by residents do not teach the ...

In January 1999, President Bill Clinton placed the issue of long-term care on the nation's health care agenda. He proposed that families be given a $1,000 annual tax credit to help pay for home health care visits, adult day care, and other needed long-...