Wound infections are common and serious complications of anesthesia and surgery. A wound infection can prolong hospitalization by 5 to 20 days and substantially increase medical costs.¹,² In patients undergoing colon surgery, the risk of such an infection ...

In the past few years, evidence has accumulated that atherosclerotic disease of the aortic arch may be a source of cerebral emboli.¹–¹⁰ We previously found that the prevalence of ulcerated plaques in the aortic arch at autopsy increased with age and was ...

The critical role of cellular activation in the initiation and propagation of infection with human immunodeficiency virus type 1 (HIV-1) has been well established.¹ A number of in vitro studies have demonstrated the importance of activation in the ...

The sensitivity and specificity of screening for Down's syndrome have improved in recent years with the identification of new biochemical markers of this disorder. Since the observation that serum levels of alpha-fetoprotein were reduced in women with ...

Figure 1. Abdominal ultrasonography in a 25-year-old man who reported pain in the right upper quadrant on exertion (Panel A) revealed communicating vessels between the right (RHV) and middle (MHV) hepatic veins and a membranous septum (arrow) at the ...

Lymphomas are the third most common group of cancers in children and adolescents in the United States, accounting for approximately 13 percent of newly diagnosed cancers in this age group.¹ Non-Hodgkin's lymphomas represent approximately 60 percent of ...

Patients with insulin-dependent diabetes mellitus (IDDM) face major changes in lifestyle and the possibility of debilitating and life-threatening complications. Treatment requires a knowledgeable health care team that includes a physician, a nurse ...

Presentation of Case

A 66-year-old woman was admitted to the hospital because of possible toxic epidermal necrolysis.

Her medical history included primary hypothyroidism, allergy to penicillin, long-standing hypertension, inflammatory arthritis with a ...

Mild perioperative hypothermia is common during major abdominal surgery. Its usual causes are anesthetic-induced impairment of thermoregulation, exposure to cold, and altered distribution of body heat. Measures to reduce heat loss include covering the ...

The ability of the human immunodeficiency virus (HIV) to replicate successfully in vitro appears inextricably linked to the state of activation of its cellular host. Indeed, an activated cellular environment is crucial for both the initial phase of the ...

To the Editor: Wilcox et al. (Dec. 7 issue)¹ reported that among 221 women who were attempting to become pregnant, conception occurred only during a six-day period that ended on the day of ovulation. This study provides excellent information for women ...

To the Editor: As reported by McGuire et al. (Jan. 4 issue),¹ the results of the Gynecologic Oncology Group's phase 3 trial comparing paclitaxel plus cisplatin with cyclophosphamide plus cisplatin in women with ovarian cancer are exciting and ...

To the Editor: We were intrigued by the editorial by Dr. Henderson entitled “Paradigmatic Shifts in the Management of Breast Cancer” (April 6, 1995, issue).¹ Of particular interest are the questions he asks about the effect of adjuvant therapy: “Are some ...

To the Editor: Case 37-1995 (Nov. 30 issue)¹ involves a patient with acute disseminated encephalomyelitis. In his discussion of the case, Dr. Hafler states, “The possibility of [eastern equine encephalitis] is strengthened by the patient's recent stay at ...

To the Editor: In patients with diabetic nephropathy, angiotensin-converting–enzyme (ACE) inhibitors reduce blood pressure and the progression of nephropathy,¹ but approximately 10 percent of patients have side effects that cause the discontinuation of ...

To the Editor: We had embarked on a trial of hepatitis B virus (HBV) immunization to clarify the meaning of isolated findings of seropositivity for antibodies against the core hepatitis antigen (anti-HBc) in persons infected with the human ...

To the Editor: The last place an 85-year-old patient with hypotension, severe abdominal pain, and a pulsatile abdominal mass should be is in the computed tomographic (CT) scanner (Images in Clinical Medicine, Jan. 4 issue).¹ Instead, this patient should ...

To many physicians, science in the courtroom means trouble. Science, it is claimed, deals with objective facts and theories whose validity can be judged only by those with lengthy training in scientific method. Law, in contrast, involves rules and ...

The current health care debate has focused on the classic triad of cost, access, and quality. Although there has been a substantial debate over cost and a growing debate over access, there has been minimal discourse on the question of quality. Central to ...

The history of medical education, as Theodor Puschmann observed in his classic account of the subject (A History of Medical Education from the Most Remote to the Most Recent Times. London, H.K. Lewis, 1891), is not only a key to the understanding of ...

Donald J. Murphy's book is a superb, lucid discussion of medical ethics and how patients and doctors can best use the health care system as the individual patient wants it used. Murphy discusses respect for the different points of view of patients and ...