Current estimates of the risk of breast cancer in a woman who carries a BRCA1 or BRCA2 mutation and is from a kindred with multiple cases of breast or ovarian cancer, or both, range from 76 to 87 percent.¹–⁴ Estimates of the risk of ovarian cancer in a ...

Family history is a significant risk factor for the development of breast cancer. The relative lifetime risk of breast cancer ranges from 1.4 for a woman whose mother was given a diagnosis of breast cancer after the age of 60 to 15.0 for a woman with an ...

Studies of large families many of whose members have cancer have led to the identification of two genes, BRCA1 and BRCA2, that, when mutated, predispose family members to breast cancer.¹–⁴ Members of such kindreds who are heterozygous carriers of a germ-...

The estimated incidence of pulmonary embolism in the United States exceeds 600,000 cases per year.¹ If untreated, pulmonary embolism has an estimated mortality of 30 percent,² which is more than 10 times the mortality at one year for treated pulmonary ...

Figure 1. A previously healthy 52-year-old man presented with right-sided pleurisy, fever, and shaking chills for three days. On examination he was febrile and had marked tenderness to percussion over the right lower rib cage. A chest radiograph showed an ...

Atrial tachyarrhythmias early in the recovery period after cardiothoracic surgery are common; they develop in 11 to 40 percent of patients after coronary-artery bypass grafting¹–³ and in over 50 percent of patients after valvular surgery.² Technical ...

Stage

A 65-year-old man had persistent weakness and limitation of activity three months after coronary-artery bypass surgery. He had been well until two weeks before surgery, when he was admitted to the hospital with generalized weakness and diaphoresis ...

Presentation of Case

A newborn boy was admitted to an intensive care unit because of respiratory depression.

The infant was born to a 28-year-old woman (gravida 2) at 38 weeks' gestation, after an uneventful pregnancy. The parents were from the Cape Verde ...

The world cheered the discovery of the BRCA1 cancer-susceptibility gene in 1994¹ and was chilled by its implications. A woman with a strong family history of breast or ovarian cancer, or both, who carries a germ-line mutation of BRCA1 faces roughly an 85 ...

Pulmonary angiography and contrast venography are nearly 100 percent sensitive and specific in making the diagnoses of pulmonary embolism and deep-vein thrombosis. Nevertheless, these conditions frequently go undetected, often with serious consequences. ...

To the Editor: Dr. Mangano and other investigators in the Multicenter Study of Perioperative Ischemia Research Group (Dec. 5 issue)¹ have failed to report directly the outcome of the eight patients in the placebo group who were taking beta-blockers ...

To the Editor: The term “minimally invasive surgery” is currently used for several procedures in cardiac surgery.¹–³ Coronary-artery bypass surgery on the beating heart without extracorporeal circulation, using a small lateral approach through the fourth ...

To the Editor: Percutaneous transluminal coronary angioplasty (PTCA) and coronary-artery bypass grafting (CABG) are both known to be highly effective in the treatment of coronary disease.¹,² Many recent trials have compared PTCA with CABG in single-...

To the Editor: The recommendation by Hennekens et al. (Nov. 28 issue)¹ that beta-adrenergic–antagonist drugs be routinely administered to patients during acute myocardial infarction is supported by convincing findings from clinical trials. The evidence ...

To the Editor: In their study of immunohistochemical staining of the DCC protein and its association with the prognosis of colorectal cancer (Dec. 5 issue),¹ Shibata et al. report that the absence of stainable DCC is predictive of mortality. Absence of ...

To the Editor: Drappa et al. (Nov. 28 issue)¹ discussed four patients with Fas gene mutations and associated findings that we and others have described as autoimmune lymphoproliferative syndrome,²–⁴ a more informative name than the eponymous Canale–...

To the Editor: The Clinical Problem-Solving article “When Too Much Is Too Little” by Morrison et al. (Dec. 5 issue)¹ should be required reading for every physician who cares for dying patients — and for every physician in training. It is a sobering ...

Today, one rarely thinks of the microscope as an important instrument of high technology. Yet, even in this age of computed tomographic scans and gene sequences, the humble microscope is arguably the medical device used most often. Soon after its ...

I picked up this book with keen anticipation. Although multiple myeloma is a rare tumor, it is apparently becoming more common, and it is a fascinating paradigm for all cancers. Multiple myeloma introduced us to monoclonality before cloning became ...

This textbook joins a growing list of excellent books on one of the frontiers of modern surgery: surgery of the skull base. An anatomical domain that is the province of neither otolaryngologists nor neurosurgeons, the skull base is a complex and ...

Recent years have seen a proliferation of atlases of the head and neck. Most of these atlases are geared toward specialties of the head and neck, such as facial plastic surgery, oncology, reconstruction, and trauma. Only a few authors have attempted to ...

Genetic tests are now available for the detection of mutations in the BRCA1 and BRCA2 genes. Among women who carry germ-line mutations in these genes, the cumulative risk of breast cancer is estimated to range from 40 percent to 85 percent, and for ...