According to data from the Coronary Artery Surgery Study, more than half of all women with chest pain who are referred for coronary angiography do not have angiographically significant coronary stenosis, as compared with only 17 percent of men.¹ Data from ...

Half of all myocardial infarctions occur in persons in whom plasma lipid levels are normal.¹ In an effort to better identify patients at high risk for cardiovascular events, several markers of risk have been proposed for use in screening, including ...

Serologic surveys indicate that the prevalence of infection with herpes simplex vi-rus (HSV) type 2 (HSV-2) among adults approaches 25 percent in the United States and ranges from 4 to 18 percent in western Europe.¹–⁵ In most studies, only 10 to 25 ...

Glucocorticoids are administered to patients with cystic fibrosis for acute indications, such as bronchiolitis,¹ bronchial hyperreactivity,² and allergic bronchopulmonary aspergillosis,³ as well as for long-term treatment of mild-to-moderate obstructive ...

Figure 1. A 36-year-old woman who had been a vegan for many years presented with a one-week history of decreased visual acuity. She had had megaloblastic anemia six years earlier (hemoglobin, 7.5 g per deciliter) that was found to be due to folic acid ...

Overweight and obesity affect approximately one half of the U.S. adult population,¹,² and the proportion of those with obesity, defined as a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or more, has ...

Pneumothorax is classified as spontaneous (not caused by trauma or any obvious precipitating factor), traumatic, or iatrogenic (Table 1). Primary spontaneous pneumothorax occurs in persons without clinically apparent lung disease; secondary spontaneous ...

Presentation of Case

A 41-year-old man was admitted to the hospital because of pain in multiple bones.

The patient had been well until eight years earlier, when he had a mandibular abscess that resulted in the loss of his lower central incisors. He had an ...

In 1991, two articles in the Journal noted that women evaluated for chest pain were less likely than men to undergo coronary angiography.¹,² These studies and others generated concern that the symptom of chest pain was taken less seriously by physicians ...

In patients with cystic fibrosis, the inflammatory response in the airways to bacterial infection is excessive and deleterious. Thus, interrupting the inflammatory response is a goal of therapy. In a clinical trial of prednisone, given on alternate days ...

To the Editor: In the November 4 issue, Zijlstra et al.¹ report a better long-term outcome after primary angioplasty than after thrombolysis in patients with acute myocardial infarction. Should the debate about the relative merits of angioplasty and ...

To the Editor: Towner et al. (Dec. 2 issue)¹ report that vacuum extraction, use of forceps, and cesarean section during labor are all associated with an increased rate of subdural or cerebral hemorrhage in neonates. They suggest that an abnormality of ...

To the Editor: The analysis by Wolfe et al. (Dec. 2 issue)¹ purports to demonstrate a survival benefit of cadaveric renal transplantation as compared with hemodialysis for patients with end-stage renal disease. We agree that these data lend strong ...

To the Editor: The results reported by Jha et al. (Dec. 9 issue)¹ on the use of miltefosine, the long-awaited therapy for visceral leishmaniasis, are convincing and possibly open a new avenue for the treatment of protozoan diseases.

My colleagues and I ...

To the Editor: In their review article, Joshi et al. (Dec. 16 issue)¹ do not mention an extremely common infection seen in patients with diabetes: chronic periodontitis. Periodontitis is associated with substantial morbidity in the form of tooth loss, ...

To the Editor: Screening for and treatment of gestational diabetes mellitus remain matters of considerable debate, yet Kjos and Buchanan convey no sense of this controversy in their recent review (Dec. 2 issue).¹ That some pregnancies involve more marked ...

To the Editor: Vegetarians are at risk for nutritional deficiency if they do not receive vitamin supplementation. We report a case of severe bilateral optic neuropathy in a patient who had been a vegan for many years and who did not take vitamin ...

The 100th anniversary of Freud's The Interpretation of Dreams saw the publication of a new translation by Joyce Crick and a “neurophilosophical” treatise on the subject by Owen Flanagan, professor of philosophy, experimental psychology, and neurobiology ...

As the new millennium begins, the identification of cardinal historical events has become standard. In the field of psychiatry, a good case can be made for choosing the development of psychotherapeutic drugs as the key advance of the past century. What ...

In the introduction to this book, editors Malcolm Lader and Dieter Naber note that, intricate though our psychiatric nosology has become, it does not offer the kinds of sharp demarcations that would make decisions about treatment easy. Illnesses overlap ...

The study of twins is a fundamental tool of genetic epidemiology and thus is important to all medical and behavioral sciences. Even in this era of study of the human genome, the definition of phenotypic boundaries in many fields still requires refinement, ...