The general approach to prenatal screening for Down's syndrome is to estimate a woman's risk of having an affected pregnancy on the basis of factors such as maternal age, serum concentrations of various analytes, and ultrasound measurements that have been ...

Despite advances in pharmacotherapy for grass-pollen allergy, there has been a marked increase in the prevalence of summer hay fever in countries with a Western lifestyle.¹ Although topical nasal corticosteroids and the new nonsedating antihistamines are ...

In patients with limited small-cell lung cancer, chemotherapy combined with thoracic radiotherapy yields complete response rates of 50 to 85 percent, a median duration of survival of 12 to 20 months, and 2-year disease-free survival rates of 15 to 40 ...

In neonatal intensive care units seizures occur in 1 to 2 percent of neonates, but there is no agreement concerning either the most appropriate diagnostic tests or the most appropriate treatment for such infants.¹–⁵ Most seizures are due to hypoxic ...

Figure 1. A 39-year-old man with homozygous familial hypercholesterolemia because of a G→C mutation at the acceptor-splice site of intron 7 of the low-density lipoprotein (LDL) receptor had undergone coronary-artery bypass grafting at the age of 29 years ...

Hair has many useful biologic functions, including protection from the elements and dispersion of sweat-gland products (e.g., pheromones). It also has psychosocial importance in our society, and patients with hair loss (alopecia) (Table 1) or excessive ...

Arteriosclerosis of the coronary and peripheral vasculature is the leading cause of death among men and women in the United States¹ and worldwide.² In 1992, for example, cardiovascular disease accounted for 38 percent of deaths from all causes among men ...

Presentation of Case

A 65-year-old man was admitted to the hospital because of impaired cognition and a gait disorder.

The patient had been well until 10 months earlier, when he began to have a diffuse, mild, nonprogressive headache that was continuous. ...

Since the introduction of amniocentesis for the prenatal detection of genetic diseases, there has been a progressive refinement of the criteria used to determine who should be offered the test. Initially, amniocentesis was offered to women considered to ...

Allergic rhinitis, or hay fever, afflicts 10 to 20 percent of people in the United States and northern Europe. The disease occurs either during the seasons of airborne pollens and molds or throughout the year, triggered by indoor allergens such as dust ...

Small-cell lung cancer, the type of lung cancer most strongly associated with tobacco exposure, accounts for 20 to 25 percent of all cases of lung cancer (approximately 45,000 new cases per year in the United States). The majority of patients are treated ...

At a recent meeting of the human subjects committee of which I am a member, we discussed a proposed protocol involving an analysis of human immunodeficiency virus (HIV) infection in pregnant women and subsequent follow-up of their offspring in rural areas ...

The Declaration of Helsinki requires revision because it is defective in two important respects. First, it relies on a distinction between therapeutic and nontherapeutic research; all documents that rely on this spurious distinction contain errors not ...

To the Editor: We do not agree with Lagergren et al. (March 18 issue)¹ that the risk of esophageal adenocarcinoma is independent of Barrett's esophagus. We would suggest that gastroesophageal reflux disease causes Barrett's esophagus and that it is the ...

To the Editor: The results of the randomized trial comparing extended (D2) and limited (D1) lymph-node dissection for gastric cancer, reported by Bonenkamp et al. (March 25 issue),¹ should be interpreted with caution. Patients in the D2 group had a ...

To the Editor: Kearon et al. (March 25 issue)¹ tested the hypothesis that patients with a first episode of idiopathic venous thromboembolism would benefit from a course of anticoagulant therapy lasting more than three months. The authors found that ...

To the Editor: Gatzoulis et al. (March 18 issue)¹ report that adult patients are more likely to have persistent atrial fibrillation and atrial flutter or to have these arrhythmias after surgical closure of an atrial septal defect if they are older than ...

To the Editor: A 25-year-old nulliparous woman was admitted to our hospital for recurrent menometrorrhagia and secondary anemia. She had received a renal transplant for infantile polycystic kidney associated with congenital hepatic fibrosis that was ...

To the Editor: Case 9-1999 (March 25 issue)¹ involves a 75-year-old woman with Wegener's granulomatosis. Dr. Schwartz's discussion of the neurologic aspects of this patient's illness is scholarly. However, he fails to address important parts of the ...

To the Editor: Woloshin and Schwartz (March 18 issue)¹ recommend against the prostate-cancer stamp on the basis of the conclusion of the U.S. Preventive Services Task Force that there is evidence for excluding prostate-cancer screening from a periodic ...

To the Editor: Progressive supranuclear palsy is an atypical Parkinsonian syndrome characterized by motor symptoms (voluntary-eye-movement abnormalities, akinesia, rigidity, postural instability, dysarthria, and dysphagia), personality changes, and ...

About 10 years ago, because I had previously served as registrar to Sir Herbert Seddon at the Royal National Orthopaedic Hospital in London, I was asked whether his book on injuries to the nerves, Surgical Disorders of the Peripheral Nerves (2nd edition. ...

If we are ever to make substantial progress in reducing the burden of disability from back pain in developed countries, credit will be due Gordon Waddell and a small group of persons who, through their insight and research, have helped forge a new ...

The first edition of Diabetic Neuropathy, edited by Peter James Dyck, was published in 1987. This long-awaited second edition is an excellent contribution to the literature on the most problematic complication of diabetes mellitus. Neurology is a branch ...

Gastrointestinal Toxicity of Nonsteroidal Antiinflammatory Drugs Review Article, N Engl J Med 1999:340;1888-1899.. On page 1896, in Table 2, the recommendation for “Active gastroduodenal ulcer NSAID discontinued” should have read, “Treatment with an H₂-...

Benefit of Abciximab in Patients with Refractory Unstable Angina in Relation to Serum Troponin T Levels Original Article, N Engl J Med 1999:340;1623-1629.. On page 1626, the curves in Figure 2B were mislabeled. The corrected figure appears below.

...