Most women with metastatic breast cancer have a response to various combinations of conventional-dose chemotherapy, but less than 5 percent of them are alive 10 years after the detection of metastatic spread.¹ Several phase 2 trials performed in the late ...

Despite advances in drug therapy, the prognosis of patients with heart failure remains poor.¹ The accurate assessment of prognosis in patients with this disorder is critical, to ensure that patients with the most severe disease receive appropriate ...

The identification of effective strategies to prevent opportunistic infections has been an important advance in the care of patients with human immunodeficiency virus (HIV) infection.¹ Primary prophylaxis is instituted on the basis of CD4+ cell thresholds ...

Figure 1. A 49-year-old woman with progressive metastatic breast cancer despite aggressive chemotherapy was hospitalized with slurred speech, clumsiness of the right hand, and increasing lethargy. Examination revealed that the patient was somnolent but ...

Every year, more than 1 million patients in the United States have acute myocardial infarction, and almost half these patients have myocardial infarction with ST-segment elevation. Guidelines on myocardial infarction issued by the American College of ...

Hearing loss is the most common sensory defect in humans, affecting normal communication in 10 percent of people aged 65 years or older. In most cases, hearing loss is a multifactorial disorder caused by both genetic and environmental factors. However, ...

Presentation of Case

A 74-year-old man was referred to the Memory and Movement Disorders Unit of this hospital because of progressive memory loss and personality changes.

The patient had been well until three years earlier, when his wife observed that he ...

In this issue of the Journal, Stadtmauer et al. present the results of a clinical trial in which conventional-dose chemotherapy was compared with high-dose chemotherapy plus autologous bone marrow transplantation (hematopoietic stem-cell rescue) in ...

Heart failure is a major health problem in the United States. It is estimated that 4.6 million Americans are currently treated for heart failure and that approximately 550,000 new cases are diagnosed each year.¹ Despite advances in therapy, including the ...

The recent Institute of Medicine (IOM) report on the quality of care, entitled “To Err Is Human,” has awakened much of the health care system to the challenge of reducing the number of adverse events in hospitals.¹ The Agency for Healthcare Research and ...

Eugene O'Neill, the only native-born American playwright awarded a Nobel prize for literature, winner of four Pulitzer prizes, and widely regarded as the nation's first and most distinguished dramatist, suffered from an ultimately lethal neurodegenerative ...

To the Editor: Botto et al. (Nov. 11 issue)¹ fail to represent fairly the work of Smithells and associates² and the subsequent delayed response by public health authorities to the important discovery that folic acid supplementation prevents a substantial ...

To the Editor: Berger and coworkers (Nov. 18 issue)¹ report that light-to-moderate consumption of alcohol results in a slight reduction in the risk of stroke. It is difficult to believe that consuming only one drink per week could have a measurable ...

To the Editor: Lipscomb et al. (Dec. 23 issue)¹ report on predictors of the success of methotrexate treatment in women with tubal ectopic pregnancies. In their study, ectopic pregnancy was diagnosed with the use of an algorithm incorporating measurements ...

To the Editor: Autologous bone marrow transplantation has been a controversial treatment for metastatic breast cancer. Proponents of the procedure have pointed to studies indicating an increase in disease-free survival with this approach, whereas others ...

To the Editor: The Image in Clinical Medicine by Matuchansky and Lenormand (Dec. 2 issue)¹ is excellent, but why was it labeled Taenia saginata? The two species of intestinal taenia that are commonly found in humans are T. saginata and T. solium, which ...

To the Editor: Much as I admire Robert Kuttner's work, his history of medical education and academic health centers (Sept. 30 issue)¹ is misleading in ways that take them off the hook for their current plight. After World War II, the American Medical ...

To the Editor: A 10 percent increase in body weight during the first year after organ transplantation is common, and many patients become obese (body-mass index [the weight in kilograms divided by the square of the height in meters], >30) within two ...

It is remarkable that more of us do not have immunologic diseases related to foods, considering the large amounts of foreign substances we are exposed to daily through our gastrointestinal tracts. Moreover, it is far from surprising that food is ...

Rheumatic Diseases and the Environment reviews a number of topics with a common theme: the effect of environmental agents on the development of rheumatic disease. Most rheumatic disorders are thought to result from interactions between genetic and ...

Occupational accidents and diseases are ancient problems. Occupational asthma was known to Hippocrates and Paracelsus (1493–1541), and in his book De Morbis Artificium Diatriba, published in 1700, Ramazzini (1633–1714) described occupational asthma in ...

This book is targeted to residents who need an introduction to the pediatric intensive care unit and to generalists who may have to care for an ill or injured child. The 21 chapters cover the essentials of critical care and, in general, are well written ...