Inguinal hernias are common, and although the results of surgical repair are often satisfactory, postoperative recovery may be slow, and the hernia may recur. The period of recovery after repair of inguinal hernia in patients with paid recovery time is ...

Cyclospora cayetanensis, previously called cyanobacterium-like body, was recently established to be a coccidian parasite.¹,² Cyclospora oocysts do not multiply outside the host. After fecal excretion they do not sporulate and become infectious for days to ...

Aluminum toxicity occurs in adults and children with renal insufficiency who are treated by dialysis with aluminum-contaminated solutions or oral phosphate-binding agents that contain aluminum.¹–⁷ The clinical manifestations of aluminum toxicity include ...

In 1957, Jervell and Lange-Nielsen reported a syndrome of congenital sensory deafness associated with a prolonged QT interval in four children of a Norwegian family.¹ The affected children had multiple syncopal episodes, and three died suddenly at the ...

Figure 1. A 25-year-old woman who had had a single syncopal episode two years earlier was hospitalized after a two-minute episode of syncope during an argument with a police officer over a traffic ticket. A 12-lead electrocardiogram obtained on admission ...

In 1986, when one of us reported on trends in the incidence of cancer in the United States from 1950 through 1982,¹ it was clear that some 40 years of cancer research, centered primarily on treatment, had failed to reverse a long, slow increase in ...

Ion channels constitute a class of proteins that is ultimately responsible for generating and orchestrating the electrical signals passing through the thinking brain, the beating heart, and the contracting muscle. Using the methods of molecular biology ...

Presentation of Case

A 67-year-old woman was admitted to the hospital because of azotemia with nausea, vomiting, and bloody diarrhea.

The patient had been in excellent health until one week earlier, when she began to have nausea, vomiting, and diarrhea, ...

Inguinal hernias have been a problem since prehistory, and through recorded time, surgeons have attempted to repair them. A coherent anatomical basis for repair awaited Bassini's classic description in 1889: suture of the conjoined tendon (internal ...

One hundred years ago, Osler observed that to know syphilis was to know clinical medicine. Today, to know and appreciate the many clinical, microbiologic, and public health aspects of the outbreak of cyclosporiasis associated with raspberries that ...

Two interesting papers on ion channels appear in this issue of the Journal. In the first, Splawski et al.¹ describe the clinical manifestations of a mutation in an ion-channel gene in an extended family. A young girl with congenital hearing loss and ...

The looming surplus of physicians in the United States has given new life to the long-standing national debate about the training of physicians, subsidies for such training, and the large numbers of graduates of foreign medical schools in residency ...

To the Editor: In their prospective, multi-institutional study of adverse cerebral outcomes after coronary-artery bypass surgery, Roach et al. (Dec. 19 issue)¹ have documented the frequency of such outcomes (6.1 percent) and their costs in terms of ...

To the Editor: Jollis and colleagues (Dec. 19 issue)¹ report the results of their study on the outcome of acute myocardial infarction in relation to the admitting physician's specialty. Research that compares the quality of care provided by generalists ...

To the Editor: I am disturbed by the design of the trial reported by Hortobagyi et al. (Dec. 12 issue).¹ The standard of care for painful lytic metastases is radiation therapy or surgery, especially for lesions involving a risk of pathologic fracture.² ...

To the Editor: Ely et al. (Dec. 19 issue)¹ advanced our understanding of the process of weaning patients from mechanical ventilation. How did the daily screening protocol influence decisions about weaning and extubation in the control group? The extent ...

To the Editor: Chronic fibrotic liver disease accounts for virtually all nonpulmonary causes of mortality in patients with cystic fibrosis. Therefore, along with lung disease and nutritional status, liver fibrosis is an important predictor of the outcome ...

To the Editor: Dysphagia has many causes, including mechanical obstruction and neurologic disorders. Foreign bodies occasionally cause dysphagia, especially in the elderly and in children.¹ Usually, however, dysphagia does not improve without treatment ...

To the Editor: The Image in Clinical Medicine by Doerfler and Naidich (Dec. 19 issue)¹ reminded me of the surgical repair of three cases of tracheal stenosis I reported in 1970.² The technique my colleagues and I used, approaching the lesion from the ...

To the Editor: In addition to malaria, leptospirosis, typhoid fever, amebiasis, and viral infections, the rickettsial diseases are an important consideration in the differential diagnosis of febrile infection in travelers returning from tropical Asia. ...

The recent increase in the proportion of medical school graduates choosing primary care is an encouraging response to market signals and educational reforms. But having more graduates in family medicine, general pediatrics, and general internal medicine ...

Around 1980, the results of three studies with important implications for public health were published. The discovery that myocardial infarction was caused by a clot almost instantly led to a new clinical-services industry. The positive relation between ...

Educating Doctors is a somewhat deceptive title, because in the end, this book presents Stewart Wolf's philosophy of life and his critique of the ills of the present medical system and rehashes his years of research on a variety of issues.

As someone ...

As part of the centennial celebration of the American Academy of Ophthalmology (1896 to 1996), Daniel M. Albert and Diane D. Edwards were commissioned to write The History of Ophthalmology. Their book celebrates the advances that have been made in the ...

There are several reasons why medical students are only marginally exposed to information about diseases of the eye. Among them are the fact that the ophthalmology rotation usually lasts only two to three weeks at the most and the difficulty of mastering ...