Several studies have identified maternal, obstetrical, and infant characteristics associated with perinatal transmission of human immunodeficiency virus type 1 (HIV-1).¹–¹⁴ However, these studies were conducted primarily before the widespread use of ...

Little was known of the biology of perinatal transmission of human immunodeficiency virus type 1 (HIV-1) when zidovudine treatment was proposed and subsequently proved effective for reducing the risk of neonatal infection.¹ Clarification of the relative ...

Spontaneous bacterial peritonitis is a common and severe complication in patients with cirrhosis and ascites.¹–⁷ It probably originates with the passage of bacteria from the intestinal lumen to the systemic circulation and then to the ascitic fluid.⁸,⁹ ...

Clinical trials have demonstrated that cholesterol-lowering therapy reduces the incidence of major cardiac events in patients with coronary heart disease who have levels of low-density lipoprotein (LDL) cholesterol of 130 mg per deciliter (3.4 mmol per ...

Figure 1. A 43-year-old man known to have hepatitis C infection and a long history of alcohol abuse was admitted to the hospital with ascites and edema. For the previous year he had noticed painless enlarged veins on his abdomen. Examination revealed ...

For-profit ownership of health plans, hospitals, and other health care facilities has grown dramatically in recent decades. Although for-profit hospitals are still in the minority, accounting for about 12 percent of all U.S. hospitals, 192 hospitals ...

Excess body fat is a cause of cardiovascular diseases, several important cancers, and numerous other medical conditions¹ and is a growing problem in many countries. In the United States, for example, the age-adjusted prevalence of obesity increased by ...

Stage

A 44-year-old, previously healthy man presented with a three-week history of fatigue and temperatures as high as 38.2°C (100.8°F). The man was a medical resident at a municipal hospital.

Response

Despite the long list of causes of fever and fatigue, ...

The findings of AIDS Clinical Trials Group (ACTG) Protocol 076¹ opened the door to a major effort to reduce perinatal infection with the human immunodeficiency virus (HIV). We have witnessed a dramatic decline of more than 60 percent in the incidence of ...

Patients with cirrhosis and ascites are often on the brink of renal failure. Their renal function is vulnerable because of the poorly understood, complex hemodynamic abnormalities that occur in advanced cirrhosis. These abnormalities include an increase ...

Few trends could so thoroughly undermine the very foundations of our free society as the acceptance by corporate officials of a social responsibility other than to make as much money for their stockholders as possible.

— Milton Friedman¹

Market medicine'...

To the Editor: Truog et al. (March 11 issue)¹ propose expanding the categories of research for which institutional review boards could waive the requirement for obtaining informed consent beyond the categories currently allowed under applicable federal ...

To the Editor: El-Serag and Mason (March 11 issue)¹ report an increase in the incidence of hepatocellular carcinoma in the United States and suggest that the hepatitis B virus (HBV) and hepatitis C virus are the cause. Similar trends in the incidence of ...

To the Editor: Transitional-cell carcinoma of the bladder is the fourth most common cancer among American men, with approximately 50,000 new cases and 10,500 deaths from the disease every year. Fifty to 80 percent of affected patients have local ...

To the Editor: In the article by Kulke and Mayer (March 18 issue),¹ it is stated with respect to the biochemical diagnosis of carcinoid tumors that measurement of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in a 24-hour urine collection ...

To the Editor: As a surgeon I am disturbed by the study by Lau et al. (March 11 issue),¹ which compared endoscopic methods of the late 1990s with surgical practices of the 1970s for the management of recurrent bleeding after initial endoscopic control of ...

To the Editor: The article by the Parkinson Study Group (March 11 issue)¹ and the accompanying editorial by Cummings² emphasize the potential benefits of clozapine for patients with psychosis resulting from medications used to treat Parkinson's disease. ...

To the Editor: The clinical course of acute Helicobacter pylori infection in adults is not well known. Information on the clinical features and natural course of acute H. pylori infection is available from only a few voluntary-ingestion studies and ...

Robert Hooke had one of the most creative minds in the history of science. His original Micrographia, a 1665 masterpiece of scientific observation, weighed 3 pounds, yet it can now be held in the hand and savored as one's own private copy in the form of a ...

In the first successful public demonstration of surgical anesthesia, dentist William T.G. Morton administered “Letheon,” his patented preparation of diethyl ether, to a patient on October 16, 1846, at Massachusetts General Hospital. But long before that ...

In the early 20th century, tuberculosis was the leading cause of death. Tens of thousands of people wasted away as a result of the white plague. Sanatoriums offered fresh air, bed rest, regular meals, and gradual exercise, but with the discovery of ...

Informed Consent and Approval by Institutional Review Boards in Published Reports on Clinical Trials Correspondence, N Engl J Med 1999:340;1114-1115.. On page 1115, in Table 1, the heading for the third column should have read, “Both Informed Consent and ...

Acute Necrotizing Pancreatitis Review Article, N Engl J Med 1999:340;1412-1417.. On page 1416, the sentence that begins 12 lines from the bottom of the right-hand column should have read, “A subsequent report of a larger study by the same authors ...