Elevated blood pressure is a common problem in the United States. Recent survey data indicate that 24 percent of U.S. adults — approximately 43 million people — have hypertension and only 47 percent have optimal blood pressure (systolic blood pressure, <...

The BRCA1 gene, which is located on chromosome 17q12–21, encodes a protein containing 1863 amino acids.¹ Germ-line mutations of the gene confer a lifetime risk of 85 percent for breast cancer and about 45 percent for ovarian cancer in families with ...

Cardiomyopathy of either ischemic or nonischemic origin is characterized by a progressive loss of myocytes.¹–³ Defects in coronary blood flow develop in the overloaded myocardium,⁴,⁵ resulting in myocyte death and fibrosis at multiple sites in the ...

The principal causes of fulminant liver failure are viral infections and drugs.¹ Food poisoning is rarely implicated, and most documented cases arise from the consumption of toxic mushrooms such as amanita, lepiota, and gyromitra species.¹–⁵ Foodborne ...

Figure 1. Abdominal computed tomography, with the administration of oral and intravenous contrast material, was performed in a 40-year-old woman with long-standing pain in the right lower quadrant and a three-day history of nausea, vomiting, and right-...

There should be “no teaching without a patient for a text, and the best teaching is that taught by the patient himself.”¹ This principle of William Osler reflects the traditional practice of using the bedside as the primary site for clinical teaching. ...

Acne vulgaris, or acne, as it is generally called, is the most common skin disease, affecting nearly 80 percent of persons at some time between the ages of 11 and 30 years.¹ It can persist for years and result in disfigurement and permanent scarring, and ...

Presentation of Case

A 50-year-old right-handed woman with multiple sclerosis was admitted to the hospital because of an enlarging intracranial mass.

The patient had been well until 15 years earlier, when she began to have bifrontal headaches with reduced ...

The literature on fulminant hepatic failure is studded with exotica. Hepatic failure has been caused by mushrooms, overheated hot tubs, and the infamous unripe ackee fruit that is associated with Jamaican vomiting illness. The report by Mahler and ...

Nearly 40 years after William Osler advocated “radical reform” at Johns Hopkins to bring medical education to the bedside,¹ Romano reported the observations of 100 patients at Peter Bent Brigham Hospital whose physicians had made case presentations during ...

Attacks on health researchers are not new. Pierre Louis, for example, was vilified nearly two centuries ago for suggesting that bloodletting was an ineffectual therapy.¹ In an open society such as ours, controversy is common and often socially useful. The ...

“Let the jury consider their verdict,” the King said, for about the twentieth time that day. “No, no!” said the Queen. “Sentence first — verdict afterwards.” “Stuff and nonsense!” said Alice loudly. “The idea of having the sentence first!” “Hold your ...

To the Editor: With respect to your editorial on the medicinal use of marijuana (Jan. 30 issue),¹ I made it a priority, as the first director of the National Institute on Drug Abuse (1973 to 1978), to investigate the health effects of smoking marijuana ...

To the Editor: Gill et al. (Oct. 24 issue)¹ reported that they induced apoptosis of two nodular cutaneous Kaposi's sarcoma lesions in each of 36 patients by administering human chorionic gonadotropin (hCG) intralesionally three times a week for two weeks;...

To the Editor: Postpartum depression occurs in approximately 10 percent of women who give birth and is associated with substantial morbidity in mothers and their children. For some women, treatment with an antidepressant drug may be necessary but ...

To the Editor: The post–lumbar puncture syndrome may be due to prolonged leakage of cerebrospinal fluid because of delayed closure of a dural defect, which causes low cerebrospinal fluid pressure. The reported frequency of the syndrome ranges from less ...

To the Editor: I find no fault with the report by Hansen et al. on ganciclovir-induced psychosis (Oct. 31 issue) ¹ or with their conclusions, but I do take exception to their terminology. In their case report, they clearly describe all the characteristic ...

To the Editor: I must congratulate you on the wonderful reproduction of the magnetic resonance imaging (MRI) scan of traumatic carotid-artery dissection (Image in Clinical Medicine, Oct. 31 issue)¹ (Figure 1). Perhaps you could market it as a mask for ...

Progress in molecular and cellular biology increasingly influences research on cancer medicine. Advances in recent years have produced powerful new methods of diagnosing and treating malignant diseases. New techniques, such as in situ hybridization and ...

By far the most important disease of the breast is cancer, and because the greatest opportunity for reducing mortality from this disease is through mammography, it is quite fitting that the emphasis of Diagnosis of Diseases of the Breast is on the ...

There are public discussions about breast health and breast disease almost everywhere, from national television specials to local fund-raising events. I have been involved in radio talk shows, discussion groups, and even foot races, all focusing attention ...

Uncertainty dogs our efforts to practice scientifically sound medicine in any field, and vascular surgery is no exception. How refreshing it is that two thoughtful and well-known scholars have been willing not only to admit this fact in print but also to ...

Cost-effectiveness analysis has created excitement as a possible way of meeting health care's most pressing challenge, the rationing of scarce resources. This book is by a panel of 16 nongovernment scholars, including four physicians, who were convened by ...