Acute respiratory disease is the most common reason for outpatient visits and hospitalizations among children in the United States.¹ The majority of these illnesses are precipitated by viral infection. Influenza is a common disease of childhood; during ...

Annual vaccination against influenza is recommended for all persons six months of age or older who have chronic conditions that increase their risk of complications from influenza.¹–⁵ During past epidemics of influenza, hospitalization rates among high-...

Cerebral amyloid angiopathy, defined by the deposition of congophilic material in vessels of the cortex and leptomeninges, is a major cause of intracerebral hemorrhage in the elderly.¹,² Hemorrhages related to amyloid angiopathy generally occur in the ...

The risk of acquiring tuberculosis varies according to occupation and is high among funeral-home workers.¹ Embalmers are at particularly high risk for reactivity on tuberculin skin testing.² The increased risk may be due to exposure to Mycobacterium ...

Figure 1. A 30-year-old farmer was referred for evaluation of a bicuspid aortic valve. He had no history of hypertension. He had no symptoms other than mild dyspnea and aching calves on walking briskly. On examination he had a regular pulse (78 beats per ...

The National Institutes of Health (NIH) are the principal source of research support for medical schools in the United States. In 1997, the NIH awarded medical schools a total of 17,445 research grants and contracts, together worth $5 billion.¹ By ...

Over the past 20 to 30 years, major advances have been made in the diagnosis and treatment of congenital heart disease in children. As a result, many children with such disease now survive to adulthood. In the United States alone, the population of adults ...

Presentation of Case

A 66-year-old woman was admitted to the hospital because of the nephrotic syndrome.

For 30 years, she had had hypertension related to fibromuscular dysplasia of the right renal artery. A saphenous-vein bypass graft had failed, ...

Among the many respiratory viruses, influenza-virus has always stood out as different. Certainly, in adults, it is the most pathogenic. Not only did it cause in 1918–1919 one of the most deadly epidemics the world has ever seen, but also it routinely ...

Although intracerebral hemorrhage is a less frequent cause of stroke than cerebral infarction, it is more often fatal. It is usually attributed to hypertensive small-vessel disease, and the most common sites of hemorrhage are the basal ganglia, cerebellum,...

Five years ago, a jury in southern California awarded $89 million to the estate of Nelene Fox because her insurer, Health Net, did not approve treatment with autologous bone marrow transplantation and high-dose chemotherapy for breast cancer. Nearly 90 ...

To the Editor: In an analysis of the relation between body-mass index and mortality from the large and important Cancer Prevention Study II, sponsored by the American Cancer Society, Calle et al. (Oct. 7 issue)¹ concluded that obesity was a less ...

To the Editor: Contemporary pharmacotherapy for patients with advanced congestive heart failure (New York Heart Association functional class III or IV) typically involves the concomitant use of digoxin, loop diuretics, angiotensin-converting–enzyme ...

To the Editor: The report by Vogt et al. (Sept. 16 issue)¹ and the accompanying editorial² on hepatitis C infection in children highlight the fact that this infection is typically more indolent and slowly progressive in children than in adults. However, ...

To the Editor: In Dr. Shinobu's discussion of Creutzfeldt–Jakob disease in the September 16 Case Records,¹ he implies that cerebrospinal fluid markers have little diagnostic value. In fact, a positive test for 14-3-3 protein in cerebrospinal fluid has ...

To the Editor: The article by Javaheri (Sept. 23 issue)¹ expands our understanding of the key role of enhanced central chemoreflex sensitivity, including increased ventilatory responsiveness to hyperoxic hypercapnia while awake, in the pathophysiology of ...

To the Editor: Myxoma is the most common type of primary cardiac tumor, and approximately 86 percent of myxomas develop in the left atrium.¹ Right atrial myxomas are rare; patients usually present with dyspnea, fever, weight loss, right-sided heart ...

To the Editor: Metastatic tumors that invade the heart occur 20 to 40 times more frequently than primary tumors. Of the primary cardiac tumors, 75 percent are benign, and of these benign tumors, myxomas are the most common. The remaining primary cardiac ...

Over the past 25 years, widespread acceptance of pharmacologic therapies based on mechanistic concepts and remarkable advances in technology have substantially affected the natural history of coronary artery disease. The union of these diverse approaches ...

Death from cardiovascular disease in middle age is much less common now than it was 40 years ago. This change did not come about spontaneously. Concerted efforts to understand, treat, and prevent cardiovascular disease started in about 1950, when ...

Hormones (from the Greek word for messenger) . . . are among the most powerful substances known to man. In some instances their potency transcends credence. They govern such diverse and extraordinary phenomena as the rate of fuel utilization by the body, ...

Vitamin A Supplementation for Extremely-Low-Birth-Weight Infants Correspondence, N Engl J Med 1999:341;1697-1698.. On page 1697, 11 lines from the end of the letter by Dr. Boucher, the sentence should have read, “This report may also be contributing to ...