Since the first successful transplantation of hematopoietic stem cells from umbilical-cord blood 11 years ago,¹ banks have been established worldwide to supply cord blood as an alternative to bone marrow for transplantation. Globally, about 200 ...

The acute chest syndrome is the leading cause of death and hospitalization among patients with sickle cell disease.¹–³ The optimal treatment has not been established because the cause remains largely unknown. Both infectious and noninfectious causes have ...

Several studies have shown that continuous intravenous epoprostenol (prostacyclin) improves exercise tolerance, hemodynamic variables, and survival in patients with primary pulmonary hypertension.¹–⁷ This treatment, however, has two substantial drawbacks. ...

Acromegaly is a systemic disorder caused by sustained hypersecretion of growth hormone. The typical features include thickening of the skin, enlargement of the hands, feet, and mandible, and visceromegaly.¹,² Active disease is indicated by the presence of ...

Figure 1. A four-year-old boy was seen by the pediatrician because of difficulty sleeping and intense pruritus in the anal region, with a three-day history of local redness in the anal region. His mother had attempted to relieve the itching by washing the ...

Observational studies have several advantages over randomized, controlled trials, including lower cost, greater timeliness, and a broader range of patients.¹ Concern about inherent bias in these studies, however, has limited their use in comparing ...

Randomized, controlled trials were introduced into clinical medicine when streptomycin was evaluated in the treatment of tuberculosis¹ and have become the gold standard for assessing the effectiveness of therapeutic agents.²–⁴ The ascendancy of randomized,...

Presentation of Case

A 17-year-old boy was admitted to the hospital because of obstructive jaundice and weight loss.

The patient had been well until two months earlier, when he consulted a physician because of pruritus. Topical antibiotic preparations ...

The pharmaceutical industry is under mounting scrutiny because of rapidly increasing expenditures for drugs in the United States. Drug expenditures are now the fastest-growing component of health care costs, increasing at the rate of about 15 percent per ...

It has become a cliché to say that sickle cell anemia is the first “molecular disease.”¹ The substitution of valine for glycine in β-globin has been known as the cause of sickle cell anemia since 1957.² That this specific knowledge has not resulted in a ...

The role of observational studies in the evaluation of treatments is a long-standing and contentious topic.¹ In this issue of the Journal, Concato et al.² and Benson and Hartz³ report that observational studies give results similar to those of randomized, ...

Red cells that contain sickle hemoglobin tend to acquire an abnormal, sickled shape when their mutant hemoglobin polymerizes as a result of low oxygen tension. In the classic view of sickle cell disease pathophysiology, it is this deoxygenation-induced ...

There is increasing interest among the general public and the medical community in the role of religion in medicine. Polls indicate that the U.S. population is highly religious; most people believe in heaven and hell,¹ the healing power of prayer,² and ...

To the Editor: We would like to comment on the design and interpretation of the recent study by the Heart Outcomes Prevention Evaluation (HOPE) investigators on vitamin E supplementation and cardiovascular events (Jan. 20 issue).¹ Although this study was ...

To the Editor: In an informative report, Curtis et al. describe extensive transmission of tuberculosis by an adopted nine-year-old child (Nov. 11 issue).¹ However, I think the authors of the paper and the author of the accompanying editorial² overlooked ...

To the Editor: Studies in animals and humans have shown that cryopreserved ovarian tissue can be transplanted successfully.¹–⁴ We report the successful transplantation of frozen, banked autologous ovarian tissue according to a protocol approved by the ...

To the Editor: Both Dr. Yacht and Dr. Cohen (Feb. 10 issue)¹,² present excellent arguments for and against collective bargaining by residents, respectively.

Dr. Cohen asks residents first to try other means of being heard, not unions. Physicians for ...

To the Editor: The complex ethical and emotional aspects of withdrawing ventilatory support from critically ill patients were well presented by Truog et al. (Feb. 17 issue)¹ in their Sounding Board article on the role of neuromuscular blockade in this ...

To the Editor: Coronary-artery rupture is a rare but well-recognized complication during percutaneous revascularization¹ that usually requires urgent surgical intervention and often has a poor or fatal outcome. The management of coronary-artery rupture ...

To the Editor: Malaria often presents as an acute febrile illness with fever, headache, rigors, anemia, and splenomegaly. The only malaria parasite associated with cerebral complications, Plasmodium falciparum usually blocks cerebral capillaries because ...

In the course of preparing a scholarly documentation of needlework in the late 1800s and early 1900s, Rachel P. Maines, the author of this small and surprising book, noticed a variety of advertisements for vibrators. After graduate school, as an assistant ...

Men die several years earlier than women. They have more health-risk behaviors and see physicians less often than women. Yet there are few medical books about men's health, whereas those about women's health abound. I was able to find only one other book ...

There has been considerable scientific interest in the contribution of lifestyle to health since recorded history began. However, the idea that the study of lifestyle's contribution to health is a discipline in itself seems to be relatively new. The ...