Androgen-ablation therapy has been a mainstay of treatment for prostatic adenocarcinoma since the pioneering work of Huggins and coworkers nearly 60 years ago.¹,² However, its role as a primary therapy for early stages of prostate cancer and the timing of ...

Patients undergoing major vascular surgery are at risk for serious perioperative cardiac complications, such as nonfatal myocardial infarction and death.¹ A combination of clinical assessment and noninvasive cardiac testing can be used to identify ...

Visceral leishmaniasis (kala-azar) is caused by infection of the spleen, liver, bone marrow, and reticuloendothelial system by leishmania that are acquired from sandfly bites. There are an estimated 500,000 cases per year¹ in Asia (primarily India), South ...

Autism is a developmental disorder characterized by qualitative abnormalities of social interaction, impairments in communication, and unusual forms of repetitive behavior.¹ Research on drug treatment has been directed toward the management of symptoms. ...

Figure 1. A 37-year-old man died of massive gastrointestinal bleeding from esophageal varices caused by biopsy-proved cirrhosis due to hepatitis C virus. He had been given a diagnosis of Fanconi's syndrome at the age of one year, when he presented with ...

Dramatic improvements in the quality of instrumentation have established endoscopy as the primary method for diagnosing and treating many pancreatic and biliary diseases. Endoscopic retrograde cholangiopancreatography (ERCP) is the most commonly used ...

Skin is the primary interface between the body and the environment. The spectrum of insults to which skin is susceptible includes disorders caused by chemical and microbial agents, thermal and electromagnetic radiation, and mechanical trauma. The most ...

Presentation of Case

A 72-year-old, right-handed woman was admitted to the hospital because of slurred speech and agitation.

The patient had a long history of hypothyroidism, hyperlipidemia, and angina pectoris. Five years before admission, a St. Jude ...

The dependence of the growth of prostate cancer on androgens is well documented. Androgen ablation triggers a cascade of biologic events that ends in irreversible damage to the DNA of androgen-sensitive prostate-cancer cells.¹ Such treatment, ...

“Avoid hypotension.” That recommendation has appeared at the end of many preoperative consultation notes for patients undergoing major noncardiac surgery. This not-so-helpful advice has reflected the state of the science of perioperative cardiac risk ...

Miltefosine was originally developed as an antineoplastic drug, but it has the potential to become the first highly effective, orally administered drug for treating visceral leishmaniasis, a life-threatening parasitic disease. We do not know whether ...

In this issue of the Journal, Sandler and colleagues report the negative results of a double-blind, placebo-controlled trial of a single intravenous dose of synthetic human secretin in children with autism or pervasive developmental disorder.¹ Autistic ...

It was the best of times. The last war had ended a generation earlier, and a European war had just been avoided. Prosperity was visible. There were new medicines for frightening diseases. As snow blanketed the Virginia countryside, the young nation's ...

To the Editor: Dr. Brennan's case against revising the Declaration of Helsinki (Aug. 12 issue)¹ makes many good points but seems problematic with respect to cultural valuation, distributive justice, and utilitarianism. That not all countries “have the ...

To the Editor: We would like to call attention to two critical limitations of the Atorvastatin versus Revascularization Treatment (AVERT) study (July 8 issue).¹ First, we take exception to the authors' conclusion that “aggressive lowering of LDL [low-...

To the Editor: Familial hypertrophic cardiomyopathy is a heterogeneous disease caused by mutations in eight different genes that encode cardiac sarcomeric proteins. Relatives of affected persons are at low risk for the disease in later life if the ...

To the Editor: Otto et al. (July 15 issue)¹ reported that the presence of aortic-valve disease without stenosis was associated with an increased risk of death from any cause and death from cardiovascular causes among the participants in the ...

To the Editor: In the July 29 Case Record,¹ a 10-month-old infant with pulmonary tuberculosis was discharged while receiving antituberculous treatment that included ethambutol. The use of ethambutol in a patient of this age is fraught with danger.

...

To the Editor: Since 1985, when the use of latex gloves by health care workers became common, 5 to 10 percent of health care workers have been sensitized to latex.¹ We report a case in which dermatitis, nasal congestion, and asthma developed in a 46-year-...

At the end of this millennium, psychiatry is facing revolutionary changes that have already affected the training of psychiatrists and the ways in which they deliver care. The implications of these changes for the future of psychiatry are the subject of ...

A brilliant book, this carefully detailed account is intended by its author to be “a study of the history of psychological healing in the care and cure of human ailments.” Stanley Jackson is a psychiatrist, medical historian, and all-around scholar at the ...

A century ago, Emil Kraepelin described profound mental disturbances in patients with the illness he termed dementia praecox, which is known today as schizophrenia. These patients had not only the hallucinations and delusions that are commonly associated ...

This book opens with a chapter, written by the editors, on “poor-outcome bipolar disorders.” It is as though they are challenging readers with the idea that this disorder, once thought to have a good prognosis, does not have a favorable outcome. The rest ...

Prevention of Neural-Tube Defects with Folic Acid in China Original Article, N Engl J Med 1999:341;1485-1490.. On page 1485, the sentence that begins on line 14 of the Results paragraph of the Abstract should have read, “The greatest reduction in risk ...