Traditionally thought of as an episodic, remitting illness, major depressive disorder often has a chronic course, with protracted episodes or incomplete remission between episodes.¹–³ At any given time, at least 3 percent of the U.S. population suffers ...

Critically ill patients who require mechanical ventilation are often given continuous intravenous infusions of sedative drugs to treat anxiety and agitation and to facilitate their care. Benzodiazepines are the agents most commonly given,¹,² but some ...

The life span of adults with end-stage renal disease is reduced, and cardiovascular disease accounts for approximately half the deaths among adults undergoing regular dialysis.¹,² Contributing factors include hypertension, glucose intolerance, ...

Although the antiparkinsonian effect of the dopamine precursor levodopa was first demonstrated 30 years ago,¹ and that of dopamine D2–receptor agonists more than 25 years ago,² the most appropriate time to begin these two treatments in patients with ...

Figure 1. A 22-year-old Marine underwent evaluation for a knee injury. He had no other symptoms, and the results of physical examination and routine laboratory tests were normal. A chest radiograph showed an anterior mediastinal mass protruding into the ...

The serum sodium concentration and thus serum osmolality are closely controlled by water homeostasis, which is mediated by thirst, arginine vasopressin, and the kidneys.¹ A disruption in the water balance is manifested as an abnormality in the serum ...

Preterm delivery is the chief problem in obstetrics today, accounting for 70 percent of perinatal mortality and nearly half of long-term neurologic morbidity.¹,² Approximately 10 percent of all births are preterm, but most of the serious illness and death ...

Presentation of Case

A 69-year-old man was admitted to the hospital because of worsening myasthenia gravis and an anterior mediastinal mass.

The anterior mediastinal mass had been detected on a computed tomographic (CT) scan four years earlier (Figure 1) ...

In 1984 the Journal became the first of the major medical journals to require authors of original research articles to disclose any financial ties with companies that make products discussed in papers submitted to us.¹ We were aware that such ties were ...

The majority of persons who have an acute episode of a major depressive disorder will have a response to the first or second treatment tried.¹ In patients with mild or moderately severe episodes, treatment with antidepressant drugs and brief ...

In few other areas of medicine is the saying “you can't get something for nothing” more true than in the intensive care unit. Modern advances in critical care have offered patients opportunities for survival that did not exist in earlier eras. The ...

To the Editor: The study of hepatic arterial infusion of chemotherapy after resection of hepatic metastases in patients with colorectal cancer, reported by Kemeny et al. (Dec. 30 issue),¹ represents a positive development in the management of colorectal ...

To the Editor: Edwards et al.¹ (Dec. 30 issue) compared the one-year survival at centers performing 20 or fewer liver transplantations per year with survival at centers performing more than 20 transplantations per year and found excess mortality in the ...

To the Editor: The article by Wintemute et al. (Nov. 18 issue)¹ and the accompanying editorial by Rosenberg et al.² add to the public health literature on firearms. Rosenberg et al. note that we need more information about the circumstances in which ...

To the Editor: Type 1 diabetes mellitus is an organ-specific T-cell–mediated autoimmune disease characterized by cellular infiltration of pancreatic islets (insulitis) and destruction of insulin-producing beta cells. Congenital diabetes is extremely rare,...

To the Editor: It is surprising that in the article by Hutchins et al. on the underrepresentation of patients 65 years of age or older in trials of cancer treatment (Dec. 30 issue),¹ Table 1 shows that only 42 percent of persons enrolled in the Southwest ...

To the Editor: In their analysis of the energy expended in chewing gum (Dec. 30 issue),¹ Levine et al. instructed subjects to chew gum “at a frequency of precisely 100 Hz (a value that approximates chewing frequency at our institution) with the aid of a ...

To the Editor: Athletes who abuse anabolic–androgenic steroids may go on to abuse opioid agonist–antagonists such as nalbuphine¹–³ or even classic opioids such as heroin.²,³ We studied this phenomenon among patients treated at Sunrise House, a private ...

Diabetes mellitus is becoming one of the most important health problems not only in developed countries but also in developing countries. Worldwide, more than 140 million people are estimated to have diabetes, and projections indicate that there will be ...

The stated purpose of this book is “to offer the latest clinical information in an easy-to-read-format, thereby aiding the busy practitioner to care for his or her patients.” The editors have tried to accomplish this by limiting “chapter content to the ...

It was not long ago that the combination of the words “therapeutics” and “multiple sclerosis” verged on the oxymoronic. If there are investigators who still have this point of view, they are not represented among the authors of the 40 chapters in this ...

“Medicines,” wrote Leonardo da Vinci, “will be well used when the doctor understands their nature, what man is, what life is, and what constitution and health are. Know these well and you will know their opposites; you will then know well how to devise a ...

Physicians' Experiences with the Oregon Death with Dignity Act Special Article, N Engl J Med 2000:342;557-563.. On page 560, in line 9 of the right-hand column, the statement should read, “physicians reported that 3 of the 28 changed their minds about ...

Cultivation of the Bacillus of Whipple's Disease Original Article, N Engl J Med 2000:342;620-625.. On page 620, on line 5 of the abstract and line 19 of the right-hand column, specimens from the aortic valve were obtained, not the mitral valve, as ...

Clinical practice is changing rapidly. New cardiovascular drugs, antiinflammatory drugs, cancer chemotherapy, and other pharmacologic weapons are being added to physicians' therapeutic armamentarium virtually daily. Most clinical studies that bring new ...