Rapidly progressive renal failure resulting in end-stage renal disease has been reported to occur in women who have taken weight-reducing pills containing the Chinese herbs Stephania tetrandra and Magnolia officinalis.¹ This so-called Chinese-herb ...

Whether to perform carotid endarterectomy in asymptomatic patients is an important public health issue. On the basis of Medicare records, the number of carotid endarterectomies in the United States rose from 46,571 in 1989 to 108,275 in 1996.¹ The ...

Refractory or recurrent ascites is a clinical challenge frequently encountered in patients with cirrhosis.¹–³ The treatment options are repeated large-volume paracentesis, creation of a peritoneovenous shunt, creation of a portosystemic shunt, and liver ...

Because of the limited efficacy of medical treatment for Parkinson's disease and because of advances in technology and in our understanding of the function of the basal ganglia,¹ certain patients with advanced Parkinson's disease are being treated ...

Figure 1. Fever and diarrhea developed in a 34-year-old Swiss man two weeks after his return from Madagascar. Before his visit he had not taken any prophylactic antimalarial drugs. Despite self-treatment with ciprofloxacin and metronidazole, he remained ...

Each year, 1 billion passengers travel by air, and over 50 million people from industrialized countries visit the developing world.¹,² Travelers may be exposed to a variety of pathogens and risks, and 20 to 70 percent of people report some health problems ...

Childhood Cancer

Cancer is a leading cause of death in children, second only to accidental injury, and is responsible for approximately 10 percent of deaths in children. More than 10,000 new cases of childhood cancer are diagnosed each year in the United ...

Presentation of Case

A 21-week-old girl was admitted to the hospital because of fever.

The infant had been born by normal spontaneous vaginal delivery to a 37-year-old nulliparous woman after a full-term, uncomplicated pregnancy. The mother had ...

Bestselling books perpetuate the myth that natural products such as herbs and other “dietary supplements” tend to be safer than conventional medicines.¹ Once relegated to health food stores, these products now fill pharmacy and supermarket shelves. So-...

The importance of understanding the pathophysiologic basis of transient cerebral ischemia or ischemic stroke became clear with Fisher's original description of stroke in patients with atherothrombotic “occlusion of the internal carotid artery” in 1951.¹ ...

Ascites is one of the most important complications of cirrhosis. It predisposes patients to several additional complications, including spontaneous bacterial peritonitis, the hepatorenal syndrome, and hepatic hydrothorax, and it is one of the most common ...

An estimated 120,000 to 160,000 women in the United States are currently living with human immunodeficiency virus (HIV) infection.¹ The majority of these women are of reproductive age, and many of the risk factors that are linked to HIV infection (e.g., ...

To the Editor: The quantitation of mortality and morbidity caused by influenzavirus infections has traditionally relied on estimates of the number of infections that occur in excess of the number expected for the season. The sharp seasonality of the ...

To the Editor: As department chairs at a medical school that falls in the bottom half of the list of National Institutes of Health (NIH) beneficiaries, we wish to comment on the article by Moy et al. (Jan. 27 issue).¹ This study of the distribution of ...

To the Editor: Gillick (Jan. 20 issue)¹ suggests changing the standard of care of using gastrostomy tubes in patients with advanced dementia. She argues that tube feeding in these patients seldom achieves its intended medical aims and that it does not ...

To the Editor: Studdert and Brennan (Jan. 27 issue)¹ raise the possibility that subjecting managed-care organizations to tort liability and punitive damages might cause litigation to become widespread and disrupt “the economics of managed care for the ...

To the Editor: The number of patients with human immunodeficiency virus type 2 (HIV-2) infection in western Europe is increasing; at our hospital we currently follow 630 patients seropositive for human immunodeficiency virus type 1 (HIV-1), 14 ...

Since the advent of the Human Genome Project in 1990, ethicists, geneticists, physicians, and commentators have explored the implications of this government-sponsored effort to map and sequence the human genome. The past decade has also witnessed an ...

Cancer is often portrayed as a Darwinian struggle in which a progenitor cell evolves or progresses over a series of hurdles. A recent Medline search returned more than 7000 items on cancer and evolution and more than 27,000 on cancer and progression. ...

Over the past few years, genetic research has produced rudimentary data on a possible direct connection between genetic makeup and major psychiatric illnesses (or traits such as impulsivity). These early findings may eventually have implications for ...

We have come a long way since the public confrontation in 1860 between Bishop Samuel Wilberforce and Thomas Huxley, one of Charles Darwin's chief advocates. When the bishop asked him whether apes were on his grandmother's or grandfather's side, Huxley ...