Although often lifesaving, mechanical ventilation causes numerous life-threatening complications,¹ making it important to discontinue ventilator support at the earliest possible time. More than 40 percent of the time that a patient receives mechanical ...

Acute low back pain is one of the most common reasons for consulting a primary care physician in the industrialized countries. The direct cost of medical care and the indirect costs to society of absenteeism from work due to backache are huge.¹ Physicians ...

Traumatic rupture of the thoracic aorta is a common and often fatal injury resulting from sudden deceleration in high-speed motor vehicle accidents.¹ Survival depends on early and accurate diagnosis and prompt surgical treatment.²–⁴ Although standard ...

Whipple's disease is a multisystem bacterial disease usually characterized by malabsorption, diarrhea, and polyarthritis. Ocular manifestations of Whipple's disease include blurred vision or visual loss with one or more of the following findings: vitritis,...

Several different kinds of thalassemia and hemoglobinopathy are prevalent in Southeast Asia.¹,² The frequency of the α-thalassemias reaches 30 to 40 percent in northern Thailand, whereas the β-thalassemias occur at a frequency of 3 to 9 percent. ...

Figure 1. The results of whole-body bone scintigraphy in a 58-year-old man who reported backache are shown. Plain bone films were unremarkable. Scintigraphy revealed numerous foci of increased uptake of tracer (“hot spots”), a finding consistent with ...

Nearly 500,000 patients in the United States were treated with radiation in 1990,¹ making radiotherapy one of the most widely used treatments for cancer. In this article we discuss advances that have occurred since the subject of radiation oncology was ...

Presentation of Case

A 26-year-old woman was readmitted to the hospital 8¹/2 weeks after a triple coronary-artery bypass procedure because of unstable angina.

First Admission

The patient had been well until five months before admission, when she began to ...

Weaning from mechanical ventilation — the process of preparing for and eventually carrying out the removal of external ventilatory support — may be a simple task in patients with readily reversible forms of respiratory failure. In such cases, the ...

The report in this issue of the Journal by Smith et al.¹ on the use of transesophageal echocardiography in the diagnosis of traumatic disruption of the thoracic aorta represents an important step forward in the evaluation of patients with major chest ...

Whipple's disease is both rare and enigmatic. It usually presents in middle-aged men, but in the 80 or so years since it was first described, fewer than 10 cases per year have been reported in the world's literature.¹ The most common clinical presentation ...

In the 1973 movie Sleeper, Woody Allen, about to die from complications of peptic ulcer surgery in a New York City hospital, is wrapped in aluminum foil and frozen. When it was defrosted, the body was healed as a result of two centuries' worth of medical ...

To the Editor: The article by Braveman et al. (Aug. 18 issue)¹ does not mention the number of emergency room visits or any admissions in the weeks before the admission for appendicitis. This is important information, because patients with no insurance ...

To the Editor: In associating the acute-phase reactants C-reactive protein and amyloid A protein with clinical outcome in unstable angina, Liuzzo et al. (Aug. 18 issue)¹ provide further evidence that coronary atherosclerosis is an inflammatory disease. ...

To the Editor: In their editorial (Aug. 4 issue),¹ Drs. Landau and Geelhoed state that with corticosteroid treatment “intubated children can be extubated earlier.” They refer to a report on a well-controlled study,² the senior author of which is Dr. ...

To the Editor: A number of immunologic disorders are known to be associated with chronic hepatitis C virus (HCV) infection.¹ We report a possible association between chronic HCV infection and Behçet's syndrome.

A previously healthy woman was infected ...

To the Editor: Many medications interfere with the assays for catecholamine metabolites in urine that are used to evaluate patients suspected of having a pheochromocytoma.¹,² We report the effect of buspirone, a commonly used anxiolytic agent, on these ...

To the Editor: We report the occurrence of acute pancreatitis in children being treated with recombinant growth hormone for short stature.

The index patient was a 12-year-old boy with pseudohypoparathyroidism who was receiving thyroxine and vitamin D. ...

As a clinician-scientist with a long-standing interest in coagulation disorders and thrombosis, I find it exciting that the molecular genetics of hemostasis now merits its own monograph. When i entered the field two decades ago, purification of even the ...

Hemoglobin S arose as a protection against malarial infection. However, it has also given rise to untold misery, pain, and suffering in hundreds of thousands of people who happen to be homozygous for the sickle-cell gene. The multiple causes of the ...

It is now more than 35 years since E.D. Thomas and coworkers reported in the Journal that large quantities of bone marrow could be safely infused into humans and that transient engraftment of hematopoietic cells was possible. That work germinated the seed ...

In an era in which technology seems to have overcome art in medicine, this book reminds us that “low-technology” procedures can still provide important insights into the causes of disease and the care of patients.

A Color Atlas of Urine Microscopy, an ...

Surgical Case-Histories from the Past, a compilation of historical case notes and narratives from a variety of sources with introductions by Harold Ellis, contains four parts, entitled “Major Advances,” “The Surgeon at War,” “Surgical Emergencies and ...

With the rapid growth of managed care and the demise of comprehensive health care reform, most academic medical centers now seem to recognize that they can no longer operate as specialty-driven institutions largely divorced from trends that favor lower ...