Stroke is a leading cause of morbidity and mortality in many countries.¹ Among the risk factors for stroke, potentially hazardous but modifiable behavior such as alcohol consumption has drawn increasing attention in recent years, especially after a U-...

Multiple myeloma accounts for approximately 1 percent of all cancers and 10 percent of hematologic cancers. It is incurable with conventional chemotherapy.¹ Melphalan-based high-dose chemotherapy with hematopoietic stem-cell support increases the rate of ...

Homocystinuria due to a deficiency of cystathionine β-synthase, hereafter referred to simply as homocystinuria, is an inborn error of the metabolism of sulfur-containing amino acids that results in ectopia lentis, mental retardation, osteoporosis with ...

Corticotropin-independent Cushing's syndrome is usually caused by cortisol-secreting adrenal adenomas, carcinomas, or (rarely) bilateral adrenal hyperplasia. In some patients with this syndrome, the excess secretion of cortisol is caused by abnormal ...

Figure 1. A 57-year-old woman was admitted because of ischemia of the feet (Panel A). A monoclonal IgG- λ gammopathy and type I cryoglobulinemia (cryocrit, 13.8 percent) were found in the serum, and a bone marrow biopsy revealed multiple myeloma with ...

Handgun ownership is common in the United States; 16 to 19 percent of the population (26 to 30 percent of men and 7 to 8 percent of women) own a handgun.¹–³ Handguns are acquired more frequently for self-defense than for all other reasons combined.³ The ...

Many patients consult their doctors because of dizziness or poor balance. Dizziness is nonspecific; it may result from a disorder of almost any organ system. Thus, the differential diagnosis for such patients is broad and should include medical, ...

Presentation of Case

A five-month-old girl was admitted to the hospital because of coffee-grounds vomitus and a gastric lesion.

She had been born of a full-term pregnancy by spontaneous vaginal delivery and was in good health until 1 1/2 months of age, ...

Cerebrovascular disease accounts for a substantial worldwide burden of death and disability. In addition to well-established risk factors such as hypertension, myocardial infarction, diabetes mellitus, and smoking,¹ an increasing body of evidence suggests ...

One of the most devastating tragedies of modern medicine was set into motion by the over-the-counter marketing of thalidomide in Europe during the late 1950s for the treatment of morning sickness. The drug was withdrawn in the 1960s after the appearance ...

The article by Wintemute et al.¹ in this issue of the Journal adds to the growing literature that connects firearms with increased risks of suicide and homicide.²–⁶ Some of these studies have examined the risks associated with the possession of firearms, ...

Today, at the dawn of a new century, genuine medical professionalism is in peril. Increasing-ly, physicians encounter perverse financial incentives, fierce market competition, and the erosion of patients' trust,¹–⁷ yet most physicians are ill equipped to ...

To the Editor: My recent article in the Journal (Sept. 23 issue)¹ has received some attention from the media, and I would like to clarify the facts.

In February 1998, Dr. Alastair Wood, editor of the Journal 's Drug Therapy series, invited me to submit a ...

To the Editor: Lasker and Marquis (July 29 issue)¹ offer a simple scheme to deal with the complexities of reimbursement for medical services, but it suffers from two major flaws, which the authors themselves point out. First, the system can easily be “...

To the Editor: Ponec et al. (July 15 issue)¹ reported that treatment with neostigmine rapidly decompresses the colon in patients with acute colonic pseudo-obstruction who have not had a response to conservative therapy. Symptomatic bradycardia, however, ...

To the Editor: Indeed, vaccines are among the triumphs of medical science. However, the enthusiasm of Seder and Gurunathan (July 22 issue)¹ must be tempered with prudent restraint. They understate the potential harm to the patient evoked by “a strong ...

To the Editor: First Sieradzki et al.¹ and then Climo et al.² presented evidence that combinations of vancomycin and β-lactam antibiotics were synergistic in vitro and in vivo against vancomycin-resistant Staphylococcus aureus. We performed population ...

To the Editor: Women who have infertility due to anovulation in association with the polycystic ovary syndrome are particularly difficult to treat. A substantial proportion have no response to the induction of ovulation, and those who do have a response ...

On July 16, 1982, the Centers for Disease Control reported the occurrence of Pneumocystis carinii pneumonia in three male patients with severe hemophilia A and no other underlying disease. The clinical and immunologic features — which were those of the ...

Does viral hepatitis merit a 649-page, 10-lb review? It certainly does. Readers and the publisher appear to agree, because Viral Hepatitis has now appeared in a second edition. Hepatitis viruses are important agents of disease worldwide, and hepatitis B ...

In the opening chapter of Infections and Human Cancer, Parkin and colleagues estimate that in 1990 there were 1.2 million new cases of cancer worldwide that were due to infectious agents. This figure accounts for about 15 percent of all cancers. These ...

Treatment of Asthma with Drugs Modifying the Leukotriene Pathway Review Article, N Engl J Med 1999:340;197-206.. On page 201, in Table 2, the oral dose of zafirlukast should have been “20 mg twice daily,” not “40 mg twice daily,” as printed.

Zolpidem in Progressive Supranuclear Palsy Correspondence, N Engl J Med 1999:341;543-544.. On page 544, the sentence that begins on line 10 of the left-hand column should have read, “Zolpidem, unlike levodopa or placebo, improved voluntary saccadic eye ...