Between September 1998 and June 1999, there was an outbreak of febrile encephalitis in several pig-farming villages in Malaysia. More than 200 patients were admitted to hospitals nationwide, many of whom died.¹–³ The pig-farming industry was disrupted by ...

Listeria monocytogenes, a gram-positive bacterium that can grow at low temperatures, causes several illnesses in humans and animals. In immunocompromised persons, food contaminated with L. monocytogenes may cause severe invasive disease.¹–⁴ Few cases of ...

Of the estimated 1.4 million salmonella infections that occur each year in the United States, most are in children and the elderly and approximately 600 are fatal.¹ Septicemia complicates at least 7 percent of the 40,000 culture-confirmed infections that ...

Enteritis necroticans, an often fatal illness characterized by hemorrhagic, inflammatory, or ischemic necrosis of the jejunum, was first described in northern Germany and Denmark after World War II.¹,² Most patients had been starved for long periods and ...

Figure 1. The day after returning to Australia from a four-week trip to East Africa, a 30-year-old woman began to have fevers, rigors, and a severe headache. Routine hematologic and biochemical studies were normal, a urine culture was negative, and a ...

Myelofibrosis with myeloid metaplasia is classified broadly as a chronic myeloid disorder and, more specifically, as a chronic myeloproliferative disease¹ (Figure 1). The primary pathogenetic mechanism is a clonal stem-cell disorder that leads to ...

Now that routine laboratory testing is automated and is frequently part of an annual checkup, physicians are often faced with the problem of a patient with one abnormal result on measurement of serum aminotransferases or alkaline phosphatase but no ...

Presentation of Case

A 26-year-old woman was admitted to the hospital because of bouts of abdominal pain with vomiting, diarrhea, and hematochezia.

She had received a diagnosis of the irritable bowel syndrome several years earlier. Her disorder was ...

Almost 10 years ago, a group of distinguished scientists and policy makers began meeting at the offices of the Institute of Medicine in Washington, D.C., to consider the implications of the changing world of infectious diseases. Thought by some to be near ...

What accounts for the ability of cancer cells to proliferate in a manner that is out of control, whereas normal cells die after 40 to 60 cycles of replication? One mechanism that leads to the death of a normal cell is erosion of the structure that caps ...

There is considerable interest in reinvigorating medical professionalism.¹–⁶ This interest reflects a profound unease with the seeming primacy of economic factors among those currently affecting medical practice in the United States. There is general ...

To the Editor: The article by Wynia et al. (Nov. 18 issue)¹ is a praiseworthy attempt to describe comprehensively the emergence of medical professionalism, but it omits the important role of the government in defining and licensing the profession in a ...

To the Editor: Staszewski et al. (Dec. 16 issue)¹ report that “the combination of efavirenz, zidovudine, and lamivudine has greater antiviral activity . . . than the combination of indinavir, zidovudine, and lamivudine.” However, their conclusions may ...

To the Editor: Buxton et al. (Dec. 16 issue)¹ report that electrophysiologically guided antiarrhythmic therapy, primarily with implantable defibrillators, but not antiarrhythmic drugs, reduces the risk of sudden death in high-risk patients with coronary ...

To the Editor: Milgrom et al. (Dec. 23 issue)¹ report on the treatment of allergic asthma with monoclonal IgE antibody. It has generally been accepted that IgE has a central role in the pathogenesis of anaphylaxis, allergic rhinitis, and asthma. However, ...

To the Editor: In her review of iron metabolism (Dec. 23 issue),¹ Dr. Andrews omits one of the most common causes of iron deficiency, the functional iron deficiency seen in uremia. This form of iron deficiency is multifactorial and distinct from the ...

To the Editor: Hepatoerythropoietic porphyria is a rare autosomal recessive disorder of heme biosynthesis caused by a deficiency of uroporphyrinogen decarboxylase. Excessive accumulation of photoactive porphyrins in the skin, bone marrow, and peripheral ...

Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine, Jerome Groopman's second collection of clinical stories, illuminates the mysteries and uncertainties of serious illness and the fears it evokes in both patients and ...

Thyroid cancer, an uncommon disease, accounts for only about 1 percent of new cancers diagnosed each year. In contrast, benign thyroid nodules are common, with 5 to 10 percent of women having one or more palpable lumps in the thyroid. The challenge facing ...

The management of bladder cancer is a common and complex clinical challenge. In the United States, it is the fourth most common cancer in men and the eighth most common in women. Rates vary widely among North American men, however, from 28 cases per 100,...

Challenges in Breast Cancer is a welcome addition to the literature about this increasingly complex subject. A series of essays by experts from Europe and North America, it is not another textbook covering the entire field. The discussions of the biology, ...

A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery Disease Original Article, N Engl J Med 1999:341;1882-1890.. On page 1883, the sentence that begins four lines from the bottom of the left-hand column should have read, “...