Changes in health care delivery and efforts to curb medical costs have resulted in increased emphasis on reducing hospital stays after acute myocardial infarction. Although the potential reduction in cost achieved by a shorter stay in the hospital is ...

Allergic bronchopulmonary aspergillosis is a hypersensitivity disease of the lungs that is almost always caused by Aspergillus fumigatus (Table 1). Several sets of diagnostic criteria have been proposed,²–⁴ incorporating the clinical, immunologic, and ...

Juvenile rheumatoid arthritis is the most common rheumatic condition in children.¹,² In approximately one third of patients, the disease is controlled with nonsteroidal antiinflammatory drugs and an appropriate program of physical and occupational ...

Myofibrillar or desmin-related myopathies are a heterogeneous group of severe, dominantly inherited, skeletal myopathies, often accompanied by cardiomyopathy, that result in syncopal episodes or sudden death due to conduction defects.¹–⁵ They can be ...

The relation between silicone breast implants and autoimmune or connective-tissue diseases has been the focus of considerable medical and legal discussion throughout the past decade.¹–⁴ Concern was aroused by early case reports of connective-tissue ...

Figure 1. A 45-year-old man with asymptomatic human immunodeficiency virus infection presented with abdominal distention. Examination revealed an enlarged, soft liver extending 20 cm below the costal margin in the right midclavicular line, with a width of ...

Carcinoma of the anal canal accounts for 1.5 percent of digestive-system cancers in the United States, with an estimated 3400 new cases in 2000.¹ Thirty years ago, anal cancer was believed to be caused by chronic, local inflammation of the perianal area²,^...

Presentation of Case

An 8 1/2-year-old girl was admitted to the hospital because of an abdominal mass and pain.

The child had had recurrent abdominal pain during the preceding two years. Her mother believed that the symptoms had begun at about the time ...

“Doctor, how much damage was there to my heart?” “When can I go home?” Any physician who has worked in a coronary care unit will recognize these two questions as the most common ones asked by patients recovering from myocardial infarction. Until the 1950s,...

For patients with rheumatoid arthritis, a new era in treatment has begun. This optimistic view, shared widely by rheumatologists, reflects the introduction in the past two years of novel agents to treat this painful and debilitating condition. These ...

Scientific methods for determining truth differ from judicial methods. Scientists confer, develop theories, and then test their theories by performing data-based research. If important findings appear to be inconsistent with the prevailing theory, the ...

To the Editor: In comparing osteopathic spinal manipulation with standard care for patients with low back pain, Andersson et al. (Nov. 4 issue)¹ fail to recognize that many patients may have improvement with minimal or no treatment. This might have been ...

To the Editor: In their study of the economic implications of HLA matching in cadaveric renal transplantation (Nov. 4 issue),¹ Schnitzler and colleagues probably overstate the economic benefits of a strictly local organ-allocation system. They ...

To the Editor: In their article on the treatment of Alzheimer's disease (Nov. 25 issue),¹ Mayeux and Sano failed to mention AIT-082 (leteprinim potassium, Neotrofin), galantamine, or lazabemide but included such dubious treatments as Gingko biloba and ...

To the Editor: One morning, my wife motioned to me that she felt her throat tightening and was suddenly having difficulty breathing. With progressively worsening epiglottitis, she now had severe respiratory stridor due to laryngospasm. During the next ...

To the Editor: In their review of recent evidence indicating that gelsolin limits excitotoxic necrosis while probably enhancing ischemia-induced apoptosis in cerebral ischemia, Zipfel et al. (Nov. 11 issue)¹ suggest that “the concurrent administration of ...

To the Editor: Bodenheimer's article on long-term care for the frail elderly (Oct. 21 issue)¹ extols the Program of All-Inclusive Care for the Elderly (PACE) for its cost effectiveness, for its excellence as a model of care for the frail elderly, and as ...

To the Editor: A variety of vibrio species can cause gastroenteritis, wound infections, and primary septicemia as well as illness among marine organisms.¹,² Photobacterium damsela (formerly Vibrio damsela) is similar to other species of the genus vibrio, ...

Since his death in 1919, William Osler has been the subject of intense biographical interest. Although Harvey Cushing's Pulitzer prize–winning Life of Sir William Osler (London: Oxford University Press, 1925), which is more than 1400 pages long, remains ...

In Huyler's story “The Virgin,” 15-year-old Anna has a problem “down there.” “She was so beautiful she caught me. I entered the room looking down at her chart, so that when I raised my eyes I had no warning, no time to prepare myself. She was fifteen and ...

Knowledge of liver disease has increased enormously in the past few years and has changed both the diagnosis and the treatment of hepatic disorders. Medical treatments of viral hepatitis and portal hypertension are among the important advances of the past ...

The identification of Helicobacter pylori as the cause of peptic ulcer in the early 1980s resulted in a major reappraisal of chronic gastritis. In recent years many books have been published on H. pylori and gastroduodenal disease, yet few have focused ...