Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States.¹ COPD results mainly from cigarette smoking by susceptible persons and develops over years, with a progressive decline in lung function. Smoking ...

B-cell chronic lymphocytic leukemia is the most common leukemia in adults. It has a highly variable clinical course; some patients die from the disease within a few months of the diagnosis, whereas others live for 20 years or more.¹ The clinical staging ...

In the United States, Streptococcus pneumoniae is the most commonly identified bacterial cause of meningitis,¹ otitis media,²,³ and community-acquired pneumonia,⁴ and it is a frequent cause of bacteremia. In the past, approximately 80 percent of patients ...

In case–control studies, colonization and infection with vancomycin-resistant enterococci have been associated with exposure to vancomycin,¹–⁶ third-generation cephalosporins,³–⁶ antibiotics that are active against anaerobes,³,⁶–⁸ ciprofloxacin,¹ and ...

Figure 1. A 77-year-old woman with cirrhosis was admitted with a one-week history of altered sensorium. A prior evaluation of her liver disease disclosed only a serum alpha₁-antitrypsin level of 30 mg per deciliter (reference range, 93 to 224). The ...

In the United States, eligible veterans 65 years of age or older may receive health care funded either by the Veterans Health Administration (VHA) or by the Health Care Financing Administration (HCFA) under Medicare. The VHA is the largest integrated ...

Depression is second only to hypertension as the most common chronic condition encountered in general medical practice.¹ At least 1 in 10 outpatients has major depression, but most cases are unrecognized or inappropriately treated,²–⁴ leading to loss of ...

Presentation of Case

A 38-year-old woman was admitted to the hospital because of a tumor at the gastroesophageal junction.

The patient had been in excellent health until six and a half weeks earlier, when she began to have a fever with a cough productive ...

Chronic obstructive pulmonary disease (COPD) is a group of disorders characterized by a poorly reversible limitation of airflow that is usually progressive and associated with a persistent inflammatory response of the lungs. It is caused by at least three ...

One hundred years ago, the three major causes of death in the United States were tuberculosis, pneumonia, and gastrointestinal infections. Subsequently, the advent of antibiotics resulted in a major decline in the incidence of life-threatening infections ...

Nearly 25 years ago, a congressionally mandated study found that many components of the health care system of the Veterans Administration (now the Department of Veterans Affairs, or VA) were inefficient and often poor in quality.¹ A blue-ribbon panel ...

To the Editor: Ball et al. (Aug. 24 issue)¹ found that a young child's exposure to other children protects against the development of asthma and frequent wheezing later in childhood. However, there are no data in their report on exposure to the most ...

To the Editor: In their study of plasma levels of factor VIII in relation to recurrent venous thrombosis, Kyrle et al. (Aug. 17 issue)¹ demonstrate the value of measuring factor VIII for predicting the risk of recurrence of thrombosis. However, some ...

To the Editor: In 1998 we presented data from the Appropriate Blood Pressure Control in Diabetes (ABCD) trial on the effect of nisoldipine as compared with enalapril on cardiovascular outcomes after five years of follow-up in 470 patients with ...

To the Editor: In his otherwise excellent review (July 27 issue),¹ Dr. Barnes did not adequately address the role of bacterial infection in the pathogenesis and clinical course of chronic obstructive pulmonary disease (COPD). Four studies have ...

To the Editor: It has been suggested that toxicologic screening rarely leads to changes in medical management in the emergency department.¹ We present a case of an overdose that was misdiagnosed because of the nonspecific nature of an immunoassay.

A 17-...

To the Editor: The report by Harris and Douglas (Aug. 17 issue)¹ on the enrollment of women in cardiovascular clinical trials funded by the National Heart, Lung, and Blood Institute is predicated on the assumption that the proportions of men and women ...

To the Editor: In their letter on the use of heparin during cardiopulmonary bypass in patients with a history of heparin-induced thrombocytopenia, Pötzsch et al. (Aug. 17 issue)¹ do not mention whether they obtained informed consent from the subjects in ...

To the Editor: Rapid pharmacologic control of severe hiccups is a difficult problem.¹ The preferred drugs for treating hiccups are dopaminergic blockers or antagonists. Nefopam (3,4,5,6-tetrahydro-5-methyl-1-phenyl-1H-2,5-benzoxazocine hydrochloride) is ...

Principles and Practice of Sleep Medicine encompasses the pathophysiology, diagnosis, and treatment of disorders resulting from disruptions of the sleep–wake cycle and circadian rhythm. This is a relatively new area for medical practice. Some 50 years ago,...

This handbook is the most comprehensive book I know of on the subject of occupational dermatology. Its 1300 pages are divided into four parts. The first part encompasses the epidemiology, treatment, and prognosis of occupational skin diseases, and the ...

It is axiomatic that a thorough understanding of the biology and physiology of a given condition or disease is a prerequisite for wise clinical practice and for designing the next round of basic and clinical investigations. Comprehensive knowledge is even ...

Low-Dose Inhaled Corticosteroids and the Prevention of Death from Asthma Original Article, N Engl J Med 2000:343;332-336.. On page 335, in Figure 1, the curve should have started at 1, not at 0.