Thoracic aortic aneurysms are potentially life-threatening. The majority are caused by atherosclerosis,¹ most commonly of the descending aorta; clinical manifestations are due to the compression of adjacent structures, dissection, or rupture.² Rupture of ...

Several million subclavian-vein catheters are placed in patients each year in the United States to enable care givers to administer chemotherapy, total parenteral nutrition, or long-term antibiotics or to manage perioperative fluids. Subclavian ...

Severe endemic iodine deficiency causes endemic cretinism, characterized by deaf-mutism, intellectual deficiency, rigid-spastic motor disorder, and sometimes hypothyroidism.¹–⁵ Cretinism occurs in as many as 2 to 10 percent of the population of isolated ...

Nevus of Ota is typically a bluish or gray-brown lesion of the eye and the surrounding skin innervated by the first and second branches of the trigeminal nerve.¹ Histologically, it is a benign dendritic melanocytosis of the papillary and upper reticular ...

Figure 1. Transfemoral Repair of Abdominal Aortic Aneurysm.

A Dacron prosthetic graft was sutured to a balloon-expandable metallic stent and inserted under local anesthesia through a right femoral-artery cutdown in a 70-year-old woman with an enlarging, ...

Clinicians have known for many years that some patients with psychiatric disorders move continually from state to state.¹,² We have reported a wandering style associated with factitious post-traumatic stress disorder,³ drug seeking,⁴ Munchausen's syndrome,...

Accidental hypothermia is defined as an unintentional decline in the core temperature below 35 °C. At this temperature, the coordinated systems responsible for thermoregulation begin to fail, since the compensatory physiologic responses to minimize heat ...

Presentation of Case

A 35-year-old man was admitted to the hospital because of increasing exertional dyspnea, recent arthralgia and digital clubbing, and a questionable fungus ball in the right lung.

The patient had been well until five years earlier, ...

Infusion of blood products, medications, and fluids and removal of blood for testing are essential in treating many critically ill patients. Central venous catheterization through the subclavian vein¹ has facilitated such potentially life-saving ...

Iodine deficiency is by far the most common preventable cause of mental deficits in the world. The evidence for this statement has emerged from a variety of disciplines, including epidemiology, endocrinology, and neurology.¹

The most severe effect of ...

A report in this issue of the Journal documents that some men are admitted to multiple Veterans Affairs (VA) hospitals with remarkable regularity.¹ Using a central data base, Pankratz and Jackson found that in 1991, for example, 810 patients were admitted ...

To the Editor: O'Connor and his colleagues (Aug. 18 issue)¹ describe the devastating array of medical problems presented by injection-drug users infected with the human immunodeficiency virus (HIV). The authors recognize that, “To care for HIV-positive ...

To the Editor: In their timely review of the management of infections caused by antibiotic-resistant Streptococcus pneumoniae (Aug. 11 issue),¹ Friedland and McCracken omit mention of erythromycin and clindamycin as alternative therapy for penicillin-...

To the Editor: In the review of insect stings by Reisman (Aug. 25 issue),¹ I wonder why there was no reference to H₂-receptor antagonists such as cimetidine and ranitidine in the discussion of prophylactic treatment and treatment of local and systemic ...

To the Editor: With respect to the case report regarding a 74-year-old woman with diarrhea, dehydration, and weight loss (Aug. 11 issue),¹ we believe the discussants left us tantalizingly short of important clinical and laboratory information that would ...

To the Editor: The report by Lee et al. (Aug. 18 issue)¹ leaves me curious. Partial holoprosencephaly was discovered on magnetic resonance imaging (MRI) in an 18-month-old girl who was severely dehydrated and “lethargic but otherwise normal.” Was this ...

To the Editor: Burke et al. (Aug. 11 issue)¹ concluded from their retrospective study that cyclosporine does not cause progressive toxic nephropathy in renal-transplant recipients. Their analysis of 1663 recipients revealed remarkable stability in serum ...

To the Editor: Diet is known to affect serum creatinine and urea nitrogen,¹ but dietary variations are not usually considered in the differential diagnosis of elevated serum creatinine and urea nitrogen concentrations. I report an instance in which an ...

The father of one of us ran a hospital as a sideline to his full-time job as a radiologist (and single parent of four). Now whole legions daven over hospital management, academic departments analyze the analysts, and health policy books are reckoned up by ...

Except for AIDS, there is perhaps no more appropriate focus for epidemiologic study than violent death among the young. Homicide and suicide among adolescents have reached or remain near their highest levels since modern records have been kept and, when ...

As the world's population ages, the interdisciplinary field of geriatric medicine has begun to expand. With the recognition that aging brings with it changes in neurobiologic, psychosocial, and physical functioning, geriatric psychiatry has become an ...

Physicians caring for patients with substance abuse or dependence have to overcome the obstacle of the underemphasis on addictions in the curriculum at most medical schools. Given the high prevalence and often devastating nature of these syndromes, too ...

In the crowded field of textbooks of geriatrics, this work is intended to occupy a new niche by covering the care of the elderly patient from the perspective of an interdisciplinary team. The result is a rich compendium of material, much of which is not ...