When patients receiving anticoagulation therapy undergo invasive procedures, management requires an individualized assessment of the risk of bleeding versus the risk of thrombosis. This review explains management, including bridging anticoagulation for patients receiving warfarin.

Injuries, whether intentional or unintentional, account for a substantial burden on the health care system. This article describes the magnitude of the problem worldwide, enumerates ongoing efforts to prevent injuries, and summarizes systems that need to be in place to care for the injured.

Accidental hypothermia (i.e., an involuntary drop in core body temperature to <35°C [95°F]) is a condition associated with significant morbidity and mortality.¹–⁴ Each year, approximately 1500 patients in the United States have hypothermia noted on their ...

No specialty shows better than obstetrics the tremendous progress that has been made in medicine in the past 200 years. This review describes the progress in the understanding, diagnosis, and management of pregnancy during the past two centuries.

Medical care in 2012 is unrecognizable as compared with what it was in 1812, and no 19th-century physician would be at home in a modern hospital. A 19th-century lawyer, however, would be completely at home in a contemporary courtroom, as would a present-...

This overview of 200 years of research and progress in the field of cancer provides support for the value of patience and investment in research.

Certification to perform catheter-based interventions for coronary artery disease was originally limited to hospitals that had the capability to perform cardiac surgery on site. However, there has been a progressive worldwide trend to allow percutaneous ...

Surgery is a profession defined by its authority to cure by means of bodily invasion. The brutality and risks of opening a living person's body have long been apparent, the benefits only slowly and haltingly worked out. Nonetheless, over the past two ...

The diaphragm is the dome-shaped structure that separates the thoracic and abdominal cavities. It is the principal muscle of respiration, is innervated by the phrenic nerves that arise from the nerve roots at C3 through C5, and is primarily composed of ...

For patients undergoing coronary-artery bypass grafting (CABG), adverse neurologic outcomes, including stroke and cognitive decline, are major concerns. Even mild cognitive deficits before surgery may be a marker for cerebrovascular disease and increased risk.

In this review of heart disease, Nabel and Braunwald focus on two themes — coronary artery disease and myocardial infarction — and explain how our understanding has evolved over the past two centuries. The authors consider therapies that have led to improved survival.

Ulcerative colitis is the most common form of inflammatory bowel disease. Its course is often mild, with few complications, and it can be cured by colectomy. Our current understanding of its pathophysiology, diagnosis, and treatment is reviewed.

Each year, more than half a million people worldwide receive a diagnosis of hepatocellular carcinoma, and hepatocellular carcinoma related to HCV is the fastest rising cause of U.S. cancer-related deaths. This review summarizes recent advances in prevention, surveillance, diagnosis, and treatment.

Nearly a quarter of patients with seizures have drug-resistant epilepsy. This review examines how this diagnosis should be established and how to recognize pseudoresistance. It explains possible mechanisms of drug-resistant epilepsy and presents treatment strategies.

Conventional wisdom is that chronic liver disease is an acquired bleeding disorder. However, the imbalance between procoagulant and anticoagulant activities can also lead to thrombosis. Studies are needed to assess the value of anticoagulants.

At least 5% of patients who undergo percutaneous coronary intervention have evidence of a periprocedural myocardial infarction. This review examines the clinical, diagnostic, and therapeutic implications of this diagnosis, as well as its implications for clinical trials.

Necrotizing enterocolitis, one of the most common and devastating diseases in neonates, typically manifests with feeding intolerance, abdominal distention, and bloody stools. This article discusses the current knowledge and treatment of this difficult-to-treat condition.

This review discusses the clinical and neurophysiological features of general anesthesia and their relationships to sleep and coma, focusing on the neural mechanisms of unconsciousness induced by selected intravenous anesthetic drugs.

Hospital-acquired infections are most commonly associated with mechanical ventilation, invasive medical devices, or surgical procedures. Gram-negative bacteria are responsible for more than 30% of hospital-acquired infections and predominate in hospital-acquired pneumonia. They are highly efficient at up-regulating or acquiring mechanisms of antibiotic drug resistance, especially in the presence of antibiotic selection pressure. This review updates what clinicians should know about these often life-threatening infections.

Gastroesophageal varices are present at diagnosis in almost half of patients with cirrhosis, and variceal hemorrhage continues to be a lethal complication of cirrhosis. This review explains the three main challenges in clinical management: primary prophylaxis to prevent a first episode of hemorrhage, the treatment of acute bleeding episodes, and secondary prophylaxis to prevent recurrence of variceal hemorrhage.