Patients with suspected dissection of the thoracic aorta require immediate diagnostic evaluation so that urgent therapeutic interventions can begin. Detailed information on associated findings, such as the extent of the dissection, the location of the ...

There is strong evidence that non-insulin-dependent diabetes mellitus (NIDDM) is a genetic disorder¹,². The concordance in identical monozygotic twins approaches 90 percent,³ and the lifetime risk of NIDDM is about 40 percent in children with one diabetic ...

Leukoplakia is a premalignant lesion of the epithelium of the oral cavity; it is related to and can become oral cancer¹,². This lesion is closely linked etiologically to tobacco use, and its natural history is variable. The rate of transformation of ...

Few studies of bacterial meningitis have focused on the clinical and pathologic features of the illness in adults¹–⁵. Most large series have included both children and adults, with children accounting for 45 to 87 percent of cases⁶–¹⁶. Results have rarely ...

The Lennox-Gastaut syndrome is a severe epileptic encephalopathy that affects children and constitutes approximately 5 percent of childhood epilepsies¹. The syndrome is characterized by the onset of multiple types of seizures during childhood, including ...

Figure 1. Meningococcal Purpura.

Massive intracutaneous hemorrhages are apparent in a patient with meningococcemia. The bleeding is related in part to thrombocytopenia, which is often part of the syndrome of disseminated intravascular coagulation, and in ...

Acute aortic dissection is a life-threatening condition, and its prompt diagnosis remains essential for successful management. Although early mortality may be as high as 1 percent per hour¹ among untreated patients, survival can be improved by the rapid ...

Stage

An 87-year-old woman who had suffered from chronic constipation came to the emergency room and reported having had abdominal pain for two days. It had begun in the lower abdomen while she was straining with a bowel movement. The pain was constant ...

Presentation of Case

A seven-year-old girl was admitted to the hospital because of a fourth episode of sore throat, dyspnea, and fever.

The child had been born after 35 weeks of gestation to a mother 36 years old (her third pregnancy). The pregnancy was ...

Despite decades of investigation, the pathogenesis of non-insulin-dependent diabetes mellitus (NIDDM) remains one of the great mysteries of medicine. During the 1970s and 1980s there was substantial progress toward unraveling one part of the puzzle, the ...

An oncologist beginning the study of squamous-cell carcinoma of the upper aerodigestive tract is often overwhelmed by the differences in presentation, staging, biologic behavior, and treatment depending on the precise site in the head and neck. In ...

To the Editor: In the August 6 issue, two articles describe a patient with Munchausen's syndrome¹,². Patient 3 in the article by Ifudu et al. is described as a 30-year-old white man “admitted to the hospital because of hematuria and hemoptysis associated ...

To the Editor: We were puzzled by the recent report by Relman et al. (July 30 issue)¹ confirming the identification of the Whipple's disease bacillus. A year ago in The Lancet we also reported that the Whipple bacillus was a gram-positive bacterium rich ...

To the Editor: Colombo et al. showed (Sept. 5, 1991, issue)¹ that yearly screening for hepatocellular carcinoma with an alpha-fetoprotein assay and real-time ultrasonography failed to improve the rate of detection of small and potentially operable tumors ...

To the Editor: The article by Riggs and Melton on the prevention and treatment of osteoporosis (Aug. 27 issue)¹ is likely to become a much cited reference. Therefore, the error in the legend for their Figure 2 is important. Figure 2 is said to show ...

To the Editor: Maternal cigarette smoking during pregnancy is associated with fetal risks in the short and long term¹,². Any attempt to understand the effects of maternal smoking on the fetus should include an estimate of the degree of fetal exposure to ...

Doctors are inherently powerful. In The Healer's Power, family physician-philosopher Howard Brody argues that medical ethicists should avoid using the principle of autonomy to whittle away at physicians' power. Instead, those in the field of ethics should ...

This is an excellent, comprehensive little book written by one author and divided into five parts followed by a glossary. The five parts cover the nature and causes of cancer, cancer at the cellular and molecular levels, cancer prevention and treatment, ...

Without question this is an ambitious, well-organized, comprehensive, but surprisingly slim book in which a multidisciplinary group of experts covers the wide-ranging field of musculoskeletal oncology. Under the editorship of Dr. Michael Lewis of New York'...

This multiauthored work describes an approach to the differential diagnosis of 71 clinical problems or symptoms encountered in a primary care practice. An earlier volume, Difficult Diagnosis (Philadelphia: W.B. Saunders, 1985), presented an entirely ...

This remarkable book represents an attempt to follow the interrelations of art and anatomy, as depicted in publications and private works, from the medieval period to the present day. It is not an encyclopedia of anatomical illustrations, but a book based ...

Recalling that Paul Beeson, a former editor of Cecil, became incensed at reviewers who thought the weight of the book was important, I shall refrain from mentioning the 19th edition's hefty 8.75 pounds. Yet size may eventually spell the end of the ...

A Comparison of Electrophysiologically Guided Antiarrhythmic Drug Therapy with Beta-Blocker Therapy in Patients with Symptomatic, Sustained Ventricular Tachyarrhythmias. On page 991, in Figure 2, the numbers of patients at risk, listed under panels A and ...