Cardiogenic shock complicates 7 to 10 percent of cases of acute myocardial infarction and is associated with a 70 to 80 percent mortality rate.¹,² Cardiogenic shock remains the leading cause of death in patients hospitalized with myocardial infarction in ...

The Zollinger–Ellison syndrome is characterized by severe peptic ulcer disease that results from gastrin-secreting tumors (gastrinomas) of the gastrointestinal tract.¹,² In about 75 percent of patients the tumors are sporadic, and 25 percent of patients ...

Tuberculosis is a major public health concern worldwide.¹–⁴ Although the lung remains the commonest site of infection, extrapulmonary disease is becoming more prevalent,²–⁶ and the increase is more pronounced among young women⁶ and immigrants from ...

In epidemiologic studies, physical activity has been associated with a decrease in the risk of coronary heart disease,¹,² but data on women have been sparse. Moreover, the specific role of walking, the most common form of exercise among women,³ has not ...

Figure 1. Abdominal examination of a 37-year-old woman with a week-long history of nausea and vomiting revealed only midabdominal fullness. An upper gastrointestinal series revealed proximal dilatation of the duodenum, with a high-grade obstruction in the ...

Labor is the physiologic process by which a fetus is expelled from the uterus to the outside world. Labor is defined as an increase in myometrial activity or, more precisely, a switch in the pattern of myometrial contractility from irregular contractures (...

Diabetic retinopathy has been and probably remains one of the four major causes of blindness in the United States.¹,² The risk of retinopathy is directly related to the degree and duration of hyperglycemia.³ After diabetes mellitus has been present for 20 ...

Presentation of Case

A three-week-old girl was admitted to the hospital for the treatment of hypertrophic pyloric stenosis.

The infant had been delivered by cesarean section because of an abnormal fetal-heart tracing. She was born at 39 weeks' gestation ...

Because the officers of the Massachusetts Medical Society and I could not resolve our differences over administrative and publishing issues, they decided to seek a new editor-in-chief, and I leave the post in a few days. Shepherding the Journal through ...

During the past two decades, revolutionary changes in our understanding of both the pathogenesis and the treatment of acute myocardial infarction have resulted in impressive gains in survival among patients hospitalized for this condition. The notable ...

In 1955, Zollinger and Ellison described the clinical syndrome of virulent peptic ulcer disease associated with marked gastric hyperacidity and pancreatic islet-cell tumors.¹ A year earlier, Wermer had reported a familial disease characterized by ...

An apparent ethical dilemma arises when physicians consider enrolling their patients in randomized clinical trials. Suppose that a randomized clinical trial comparing two treatments is in progress, and a physician has an opinion about which treatment is ...

To the Editor: In the April 15 issue, Morris et al.¹ and Rose et al.² reported the results of randomized clinical trials comparing radiotherapy and concurrent cisplatin-containing chemotherapy with radiotherapy alone or radiotherapy combined with ...

To the Editor: In their meta-analysis of passive smoking, He et al. (March 25 issue)¹ analyzed 10 cohort and 8 case–control studies and concluded that nonsmokers exposed to environmental tobacco smoke had an overall relative risk of coronary heart ...

To the Editor: A 70-year-old man came to his physician with acute myocardial infarction after self-administration of sildenafil (Viagra) and nitrates, a case highlighting a new trigger for acute myocardial infarction. He had a history of hypertension and ...

To the Editor: Recently, the American College of Cardiology and the American Heart Association released an expert consensus document on the use of sildenafil (Viagra) in patients with cardiovascular disease.¹ The recommendations focused on patients with ...

To the Editor: Both in the report by de Lonlay-Debeney et al. (April 15 issue)¹ and in the editorial by Stanley and Baker,² diagnostic criteria for hypoglycemia in neonates were coupled with the therapeutic goal of maintaining the plasma glucose ...

To the Editor: Readers of Dr. Pérez-Stable's editorial on managed care in Latin America (April 8 issue)¹ who are not familiar with health care systems in Latin America may be left with the impression that the social-security systems in most countries ...

By conservative estimates, the influenza pandemic of 1918 killed 21 million to 40 million people around the world, 675,000 of them in the United States. After only 17 months, the mortality was half that attributed to the 4-year span of the Black Death in ...

Interferons have proved therapeutically effective for the control and sometimes cure of viral infections, cancer, chronic infections in immunodeficiency, and multiple sclerosis. Because they were the first previously unavailable proteins with clinical and ...

The treatment of patients with AIDS is a maturing specialty that is now moving into its third decade. For this reason, it is timely to note the appearance of a work dedicated exclusively to therapies for the suppression of viral replication and for the ...

This is a much-needed, complete and comprehensive reference book for all those who provide care for HIV-infected infants, children, adolescents, and pregnant women. This is the third edition of Pediatric AIDS, the first having been published in 1991 and ...

Concurrent Cisplatin-Based Radiotherapy and Chemotherapy for Locally Advanced Cervical Cancer Original Article, N Engl J Med 1999:340;1144-1153.. The legend to Figure 1, on page 1148, and the legend to Figure 2, on page 1149, should have noted that the ...

Cisplatin, Radiation, and Adjuvant Hysterectomy Compared with Radiation and Adjuvant Hysterectomy for Bulky Stage IB Cervical Carcinoma Original Article, N Engl J Med 1999:340;1154-1161.. On page 1158, the legend to Figure 1 should have read, “Tick marks ...