Ulcerative Colitis is a chronic inflammatory bowel disease with evidence of immune activation¹. Approximately 15 percent of patients with ulcerative colitis have a severe attack requiring hospitalization for intravenous corticosteroid therapy at some time ...

Treatments for Crohn's disease are empirical and designed to reduce inflammation. Although corticosteroids are an effective treatment,¹,² long-term steroid therapy is associated with important problems, such as osteoporosis³. The antimetabolite ...

Unexpected findings from the Multiple Risk Factor Intervention Trial, a trial of the primary prevention of coronary heart disease, suggested that treating hypertension with high doses of thiazide diuretic drugs might increase the risk of sudden death from ...

Congenital toxoplasmosis is a protozoan infection that can result in blindness and mental retardation. In the United States, its incidence is estimated to range from 1 in 1000 births to 1 in 10,000¹. Most infected newborns have no symptoms at birth, but ...

It is uncertain whether patients with proximal deep-vein thrombosis are better treated with streptokinase plus intravenous heparin or with heparin alone¹–¹⁰. One review article⁴ citing no increased risk of major bleeding and one meta-analysis⁶ citing ...

Figure 1. Uric Acid Stones in Crohn's Disease.

An intravenous urogram was obtained in a 37-year-old woman with persistent watery diarrhea. She had had Crohn's disease for 11 years, and most of her colon and part of her ileum had been removed 4 years ...

Figure 1. Extraintestinal Manifestations of Crohn's Disease.

Multiple oral and perianal ulcerations were found at presentation in a 48-year-old man with Crohn's disease. The patient had had no diarrhea before the diagnosis but reported having oral and ...

Systemic Lupus Erythematosus (SLE) is defined by its clinical features and by the almost invariable presence in the blood of antibodies directed against one or more components of cell nuclei. Certain manifestations seem to be associated with the presence ...

Fever is a complex, coordinated autonomic, neuroendocrine, and behavioral response that is adaptive and is used by nearly all vertebrates as part of the acute-phase reaction to immune challenge. Although the febrile response can be elicited by a wide ...

Presentation of Case

A 20-year-old woman was admitted to the hospital because of a soft-tissue mass in her forearm.

The patient had been well until six months earlier, when she observed the development “overnight” of a firm mass in the left forearm, ...

As our medical decisions become more and more standardized and codified, we should take care to ensure that critical therapeutic choices are not based exclusively on formal guidelines. Many decisions need to be individualized, especially when they involve ...

Currently, patients with ulcerative colitis or Crohn's disease are treated sequentially with 5-aminosalicylic acid preparations, corticosteroids, and mercaptopurine or azathioprine; metronidazole is beneficial in patients with colonic or perianal Crohn's ...

In this issue of the Journal, Siscovick et al. report a case-control study that evaluated the risk of cardiac arrest associated with diuretic treatment of hypertension¹. The authors are aware of the pitfalls of a case-control study and have taken ...

To the Editor: Wolraich et al. (Feb. 3 issue)¹ concluded that neither dietary sucrose nor aspartame affects children's behavior or cognitive function, even when intake exceeds typical dietary levels. This conclusion is not justified.

The dependent ...

To the Editor: The use of Lorenzo's oil in patients with adrenomyeloneuropathy, the form of adrenoleukodystrophy that occurs in adults, has recently been reported by Aubourg et al. (Sept. 9 issue),¹ with an editorial by Rizzo². In contrast to rapidly ...

To the Editor: The study by Blanche et al. (Feb. 3 issue)¹ confirms the bimodal pattern of AIDS in newborns and shows a clear correlation between the survival of the infant and the severity of disease in the mother. The authors hypothesize that advanced ...

To the Editor: In the clinical image of porcelain gallbladder (Feb. 10 issue),¹ Lo and Okada state, “The entire wall of the gallbladder is calcified. . . .” This statement is not entirely correct. The calcifications in porcelain gallbladder are seen ...

To the Editor: Acute thrombotic obstruction of an aortic bioprosthetic valve is an uncommon yet life-threatening condition¹–³. A 72-year-old man came to our hospital because of four days of chest pain and dyspnea. Seven months earlier, he had undergone ...

To the Editor: The acetaminophen treatment nomogram is widely used as a guideline for acetylcysteine therapy in patients with an acetaminophen overdose¹. However, the potential toxicity of acetaminophen may be underestimated by the nomogram in patients ...

To the Editor: Several fast-food chains now advertise food cooked in “100 percent vegetable oil” or “100 percent cholesterol-free vegetable oil.” The advertisements are often prominently displayed on the menu or directly on the food packaging. A consumer ...

Does it interest you, dear reader, that the human use of salt began with the start of agriculture on the banks of the Tigris and the Euphrates in the seventh or eighth millennium B.C.; that before that the human need for salt was met by eating fish, birds,...

No two electrolyte disorders engender more controversy or provoke more intense anxiety on the part of medical students, house officers, and practicing physicians than hyponatremia and hypernatremia. These disorders are no longer of interest only to the ...

Cardiac Mapping is a lengthy textbook of cardiac electrophysiology, with 41 individual chapters contributed by a variety of authors. It is divided into seven parts and covers a broad range of topics, including the theoretical basis of cardiac mapping, ...

Congestive heart failure due to various forms of cardiomyopathy is a leading cause of cardiac morbidity and mortality. Despite recent clinical advances in the detection and treatment of cardiomyopathies, many fundamental questions remain unanswered. ...

The field of sleep-disorders medicine has expanded rapidly since the discovery of rapid-eye-movement sleep in the mid-1950s. With a base of fewer than two dozen sleep-research centers, the first program focusing on the clinical aspects of sleep was ...

I might as well admit that my first thought when I started to examine Dr. English's book was that it might represent a rather entrepreneurial approach to bioethics. Then I noticed that in addition to his M.D. degree and to his having served as a professor ...