To the Editor: As participants in the original exploratory study,¹ we did not find that treatment with anti–α₄ integrin antibody was of clinical benefit. Miller and colleagues ( Jan. 2 issue)² report that monthly natalizumab infusions in patients with ...

To the Editor: In the study by Ghosh et al. (Jan. 2 issue),¹ a regimen of two infusions of natalizumab at a dose of 6 mg per kilogram of body weight was associated with higher remission rates than was placebo at several intervals, except at week 6 (the ...

To the Editor: Hotchkiss and Karl (Jan. 9 issue)¹ rightly stress the complex nature of the interaction between circulating proinflammatory and antiinflammatory factors and emphasize the importance of the immunologic depression that ensues. However, in ...

To the Editor: Madden and coworkers (Dec. 19 issue)¹ provide data suggesting that mandating an increased length of stay for maternity care has had a limited effect on public health in terms of health outcomes in newborns. However, it is also important to ...

To the Editor: It comes as no surprise that a greater proportion of patients are being treated by nonphysician health care providers or that physicians are increasingly using physician assistants and other clinicians to extend care to patients, as ...

To the Editor: In their review article, Khoury et al. (Jan. 2 issue)¹ suggest that homocystinuria should be screened for by Guthrie bacterial inhibition assay and treated with vitamin B₁₂ and methionine restriction. Homocystinuria occurs in several ...

To the Editor: In his discussion of transient ischemic attacks (TIAs), Dr. Johnston (Nov. 21 issue)¹ did not discuss the role of echocardiography. It is estimated that at least 20 percent of acute neurologic ischemic events are cardioembolic in origin.²,^...

To the Editor: We welcome the initiative to redefine transient ischemic attack (TIA), undertaken by the TIA Working Group and described by Albers et al. (Nov. 21 issue).¹ However, the definition proposed is impractical. Clear definitions of disease are ...

To the Editor: The differential diagnosis of transient monocular blindness includes embolism, hypercoagulability, hemodynamic changes, papilledema, vasculitis, and vasospasm. Although it has been recognized for 150 years, only four clinicians have ...

The American Civil War (1861 to 1865) was the first major conflict of the industrial age, and the progressive industrialization of warfare that occurred over the subsequent 100 years led to unprecedented loss of life. The loss of over 600,000 men in that ...

Cardiovascular disease has been the leading cause of death among women for years, but a textbook on the unique characteristics of heart disease in women was virtually nonexistent just a decade ago. Fortunately, since Bernadine Healy, former director of ...

So be cheery my lads, let your hearts never fail

While the bold harpooner is striking the whale

— Nantucket Song from Moby Dick

It is not obvious why Moby Dick, a classic American novel, should be juxtaposed with a leading textbook of pediatric ...

Only over the past quarter-century have we come to appreciate the extreme, diverse, and persistent stresses associated with surgery. They can last from days to months and affect nearly every organ. The patients who are most susceptible to these stresses ...