With the recognition of cardiovascular disease as the number-one cause of death among women in the United States,¹ considerable interest has been focused on the study of sex-based differences in the outcome of myocardial infarction. However, after about a ...

Coronary heart disease is the leading cause of morbidity and mortality among women as well as men in the West. Each year in the United States, there are 1.5 million hospitalizations for acute coronary syndromes, including unstable angina, myocardial ...

Streptococcus pneumoniae is the most common bacterial cause of community-acquired pneumonia, meningitis, otitis media, and sinusitis. The emergence of resistance to antimicrobial agents commonly used for the treatment of pneumococcal disease has led to ...

Diabetes mellitus is the most common metabolic disease in the world.¹ Over 90 percent of patients with diabetes have type 2, and although the primary factors that cause this disease are unknown, it is clear that insulin resistance has an important role in ...

Figure 1. Examination of a 48-year-old man with a two-hour history of chest pain and dyspnea revealed him to be acutely ill, with tachypnea, a blood pressure of 100/60 mm Hg, a pulse rate of 117 beats per minute, and severe pulmonary edema, necessitating ...

Insulin was discovered more than 75 years ago, but only recently have we begun to understand the mechanisms by which insulin promotes the uptake of glucose into cells. This review discusses recent advances, their contribution to our understanding of the ...

Magnetic resonance cholangiopancratography (MRCP) is a radiologic technique that produces images of the pancreaticobiliary tree that are similar in appearance to those obtained by invasive radiographic methods, such as endoscopic retrograde ...

Presentation of Case

A 68-year-old woman with refractory multiple myeloma was admitted to the hospital because of pancytopenia with bleeding.

Multiple myeloma had been diagnosed 10 years earlier but had not been treated until 7 years after the diagnosis, ...

The news that cardiovascular disease is the leading cause of death among women has been so prominently publicized recently that researchers are occasionally asked to explain this apparent epidemic. In fact, cardiovascular disease has been the leading ...

Over the past 100 years, the development and widespread use of vaccines against infectious agents has been one of the triumphs of medical science. One reason for the success of these vaccines is that they excel at inducing antibodies, which are the ...

In the February 25 issue of the Journal, Schulman et al. claimed that the “race and sex of a patient independently influence how physicians manage chest pain.”¹ Their study received extensive coverage in the news media. It was reported in most major ...

To the Editor: We were surprised by the conclusion of Schulman et al. (Feb. 25 issue)¹ that “the race and sex of a patient independently influence how physicians manage chest pain.” In fact, their data do not support this statement. The results of the ...

To the Editor: In their article on racial differences in the outcome of left ventricular dysfunction, Dries et al. (Feb. 25 issue)¹ conclude that “black patients with asymptomatic or symptomatic left ventricular systolic dysfunction appear to be at ...

To the Editor: Myocardial ischemia is an important cause of sudden death and syncope in children with hypertrophic cardiomyopathy.¹,² Yetman et al. (Oct. 22, 1998, issue)³ reported an association between intramyocardial incorporation and compression of ...

To the Editor: There are few reports describing the pathophysiologic features of paraneoplastic arthritis in patients with solid tumors.¹–³ We report on a patient with oligoarthritis as the initial manifestation of renal-cell carcinoma.

A 60-year-old man ...

To the Editor: Buckley and colleagues (Feb. 18 issue)¹ deserve recognition for their ongoing contribution to the treatment of patients with severe combined immunodeficiency. It is disappointing, however, that they conclude from this experience that “in ...

To the Editor: Trichomonal resistance to metronidazole was reported soon after its introduction and has been reported in many areas in the world. Although a sexually transmitted disease with dire consequences related to human immunodeficiency virus ...

To the Editor: Koff states in his editorial on childhood vaccination against hepatitis A (Feb. 25 issue)¹ that “a strategy of universal early-childhood immunization beginning at the age of two should . . . be implemented immediately.” Both the ...

To the Editor: In stating that selective decontamination of the digestive tract has no effect on mortality, Dr. Kollef (Feb. 25 issue)¹ ignores two recent meta-analyses,²,³ both of which showed a significant reduction in mortality. The magnitude of the ...

Becoming a physician involves the acquisition of both knowledge and skills. With the ever-increasing emphasis on the accumulation of facts, some may doubt that recent medical school graduates have adequate basic skills. In this era of high-technology ...

The decrease in mortality and morbidity from infectious illness among children has shifted the focus of pediatric medicine to developmental and behavioral problems for parents and health professionals. The American Board of Medical Specialties and the ...

Harvey Cushing described the pituitary gland as “a tiny organ, which lies enveloped by an additional capsule and membrane like the nugget in the innermost of a series of Chinese boxes.” The neurosurgeon has occupied center stage in the management of the ...

A Comparison of Three Months of Anticoagulation with Extended Anticoagulation for a First Episode of Idiopathic Venous Thromboembolism Original Article, N Engl J Med 1999:340;901-907.. On page 904, the sentence that begins 10 lines from the bottom of the ...

Racial Differences in the Outcome of Left Ventricular Dysfunction Original Article, N Engl J Med 1999:340;609-616.. On page 611, in Table 1, the NYHA functional class values should have read as follows:

With many academic medical centers reeling from the combined financial pressures of managed care and the Balanced Budget Act of 1997, their advocates have descended on Washington seeking relief. They stand a reasonable chance of winning some relief from ...