Cognitive decline has increasingly been recognized as a complication after cardiac surgery. Although important advances in techniques for perioperative anesthesia, surgery, and the protection of organs have resulted in substantial reductions in age-...

Acute otitis media in children accounts for 20 million office visits per year in the United States, and 18 percent of ambulatory care visits among preschool children.¹,² Impaired hearing and delayed speech development are the most frequent long-term ...

The use of Doppler ultrasonography in patients with hypertension has led to an increase in the diagnosis of renal-artery stenosis. Patients with stenosis of more than 50 percent of the luminal diameter of a renal artery are usually treated with ...

Chronic obstruction of the common bile duct may cause hepatic fibrosis and secondary biliary cirrhosis.¹,² Hepatic fibrosis is usually considered an irreversible process, even when the underlying cause is treated or removed.³ However, the fibrosis can be ...

Methanol poisoning may cause severe illness or death.¹,² Although methanol itself is not highly toxic, it is metabolized by alcohol dehydrogenase to formaldehyde and subsequently to formic acid (Figure 1); these metabolites cause the metabolic acidosis, ...

Figure 1. A 22-year-old woman had had hypertension for one year. Her only symptom was an occasional headache. Examination revealed a blood pressure of 148/110 mm Hg, a vascular bruit on the left-hand side of the upper abdomen, and no cardiomegaly. The ...

Primary diseases of the renal arteries often involve the large renal arteries, whereas secondary diseases are frequently characterized by small-vessel and intrarenal vascular disease. In this article, we will concentrate on the two most common primary ...

Presentation of Case

A 26-year-old man was admitted to the hospital because of pain, erythema, and swelling of the legs.

The patient had been well until two weeks earlier, when he had had occasional cramps in his thighs while walking. Four days before ...

Coronary-artery bypass grafting (CABG) is a very effective procedure for reducing angina and stabilizing ventricular function. It is not surprising, therefore, that more than 500,000 bypass procedures are performed in the United States each year. As ...

Cirrhosis represents a late stage of progressive scarring in chronic liver disease. It begins with subendothelial or pericentral fibrosis (hepatic fibrosis) and progresses to panlobular fibrosis with nodule formation (cirrhosis). Once established, ...

To the Editor: In the Clinical Problem-Solving article by Lurie et al. (Sept. 7 issue),¹ the authors describe an 80-year-old man with unexplained back pain, an elevated erythrocyte sedimentation rate, plain films that showed only degenerative changes, ...

To the Editor: Van Overmeire et al. compared ibuprofen with indomethacin for closure of patent ductus arteriosus in premature neonates (Sept. 7 issue).¹ They found that the rates of ductal closure were similar in the two treatment groups but that ...

To the Editor: In their article, Lipshultz and colleagues (Sept. 14 issue)¹ conclude that perinatal exposure to zidovudine does not result in echocardiographic evidence of acute or chronic cardiac abnormalities. The importance of perinatal treatment with ...

To the Editor: Girelli et al. (Sept. 14 issue)¹ found that polymorphic alleles of the factor VII gene that are associated with low plasma levels of the coagulation factor confer protection against myocardial infarction in patients with coronary ...

To the Editor: In her review of my book, Expecting Trouble: The Myth of Prenatal Care in America (Oct. 12 issue),¹ Dr. Klerman correctly asserts that one benefit of tocolysis is that it may delay premature delivery until corticosteroids have been ...

To the Editor: Between 1982 and May 2000, the Food and Drug Administration (FDA) received reports of 431 cases of depression, suicidal ideation, suicide attempts, or suicide in U.S. patients treated with isotretinoin (Accutane, Hoffmann–LaRoche), which ...

To the Editor: Informed consent is essential for research involving human subjects. However, little is known about whether researchers manage to communicate to potential study participants the required information as outlined in the Helsinki Declaration.^...

In PC, M.D., Satel deplores the “political correctness” (the PC of her title) advocated by some physicians, academics in the fields of nursing and public health, psychologists, social workers, and health lawyers. She defines political correctness as the ...

Recent developments are revolutionizing our understanding of the potential therapeutic role of what used to be called bone marrow transplantation but is now called hematopoietic stem-cell therapy. Over the past three decades, much empirical knowledge has ...

Hematopoietic stem-cell transplantation was undoubtedly one of the most important medical advances in the second half of the 20th century. The 1990 Nobel prize in physiology or medicine was awarded to Joseph E. Murray and E. Donnall Thomas for their ...

Validity of a Set of Clinical Criteria to Rule Out Injury to the Cervical Spine in Patients with Blunt Trauma Original Article, N Engl J Med 2000:343;94-99.. On page 95, the sentence that begins 12 lines from the bottom of the right-hand column should ...

Does VA Health Care Measure Up? Editorial, N Engl J Med 2000:343;1963-1965.. On page 1964, the sentence that begins on line 24 of the left-hand column should have read, “In addition, between 1995 and 1999, the VHA provided treatment for 22 percent more ...