Vitamin K is routinely administered to newborns to prevent hemorrhagic disease. However, intramuscularly administered vitamin K has recently been found to be associated with a twofold increase in the risk of cancer during childhood¹,². If this association ...

The molecular analysis of recurring structural abnormalities of chromosomes in human neoplasia has led to the identification of a number of genes involved in these rearrangements. Alterations in these genes are implicated in the development of malignant ...

Duchenne's muscular dystrophy, one of the most common and most severe hereditary diseases of muscle, is transmitted as an X-linked trait and is usually fatal before the third decade of life. Becker's muscular dystrophy is a less common and more benign ...

Several forms of hereditary dilated cardiomyopathy have been identified; with the exception of those resulting from mutations of mitochondrial DNA,¹,² no pathological finding can be used to differentiate the conditions, so their distinction depends on the ...

The post-traumatic fat embolism syndrome is a multisystem disorder characterized by pulmonary and neurologic dysfunction, pyrexia, and a petechial rash¹–⁴. More than a century after the first descriptions of the fat embolism syndrome, the cause of fat ...

Figure 1. Paradoxical Embolus.

A paradoxical embolus was identified in a 64-year-old woman who presented with sudden chest pain and marked dyspnea. Pulmonary embolism was suspected. Soon after admission, she had a massive stroke and died. At autopsy ...

When it enacted the Tax Equity and Fiscal Responsibility Act of 1982, Congress modified the system by which hospitals are reimbursed for the care of Medicare patients¹. The prospective payment system instituted was based on diagnosis-related groups (DRGs)...

In the United States, more vector-borne diseases are transmitted by ticks than by any other agent¹. During the past 20 years, tick-borne diseases have taken on increased importance as humans have moved into rural areas and increased their recreational ...

Presentation of Case

A 70-year-old man was admitted to the hospital for further management of a myocardial infarct.

The patient had been well until three days earlier, when substernal pain developed and was accompanied by mild dyspnea, without nausea, ...

Once again the most appropriate method of administering vitamin K to newborns is under discussion. This fat-soluble naphthoquinone is essential for the gamma-carboxylation of the prothrombin-complex proteins into their active forms, which bind calcium in ...

Acute leukemias result from acquired genetic lesions that activate cellular proto-oncogenes or inactivate tumor-suppressor genes, leading to the loss of growth control in blood-forming cells. In these leukemias, exchanges of genetic information between ...

Dilated cardiomyopathy can result from numerous underlying diseases, both intrinsic to the heart (such as coronary atherosclerosis) and extrinsic to the heart (such as catecholamine excess)¹. However, there remain many patients with dilated cardiomyopathy ...

The fat embolism syndrome is a source of considerable morbidity after blunt trauma and is associated with a mortality of 10 to 20 percent. It has been recognized since the latter part of the 19th century¹,². Nonetheless, the pathophysiology of this ...

To the Editor: Two Special Articles in the March 18 issue¹,² provide detailed information on differences in health care between Canada and the United States. The authors of these articles fail to comment on two important issues, however. In “Hospital ...

To the Editor: The report by Hauser et al. (April 8 issue)¹ suggests that “attention deficit-hyperactivity disorder is strongly associated with generalized resistance to thyroid hormone.” In this study, the diagnoses of attention deficit-hyperactivity ...

To the Editor: In their review of the management of chronic obstructive pulmonary disease (April 8 issue),¹ Ferguson and Cherniack state, “All persons who are at risk [for the disease] should be evaluated for airflow limitation with the use of ...

To the Editor: For persistent mucocutaneous infections due to herpes simplex virus (HSV) in immunosuppressed patients, acyclovir is the drug of choice¹. Foscarnet is an alternative agent,²,³ but it too may lead to resistance. A new approach to the ...

To the Editor: Sra et al. (April 15 issue)¹ found that in patients with neurocardiogenic syncope associated with bradycardia or asystole, drug therapy is often effective in preventing syncope, whereas artificial pacing is not. This study raises important ...

To the Editor: After a 53-year-old man was admitted to the hospital in October 1990 with mild exertional dyspnea, a chest film showed a foreign body about 40 cm long. The foreign body was obviously a guide wire. One end was coiled in the left and right ...

In 1948 the General Assembly of the United Nations adopted the Universal Declaration of Human Rights. Article 5 of this declaration reads: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” Since then, many ...

Ouch! A textbook devoted entirely to the diagnosis of pain? Weiner's is just such a textbook, and it is a stunning, welcome addition to the library of medicine.

Dr. Wiener defines acute pain as pain that is “new and never experienced before,” “so severe ...

We have seen a boom in the subspecialty of pain management over the past several years, and now great interest has developed in the area of acute pain. There is a tremendous need for a reference work that specifically addresses the needs of patients with ...

The field of postoperative pain management is rapidly developing a body of specialized knowledge for practitioners to use in improving the quality of patient care. This textbook is an excellent guide to the new advances in postoperative pain management. ...

This surgical atlas is a testament to the progress made in microvascular surgery since its inception two decades ago. Appropriately, the book was coauthored by surgeons in the United States and China, where much of the pioneering and refinement in the ...

Over the past decade, tremendous advances have been made in the field of oral and maxillofacial surgery, in the form of improved surgical techniques, application of rigid fixation principles, and use of three-dimensional radiographic anatomical displays. ...