Insulin-dependent diabetes mellitus (IDDM) is one of the most common chronic illnesses of childhood and adolescence in North America.¹ Although most young patients with IDDM are healthy, up to 40 percent eventually have diabetes-related microvascular ...

Hepatocellular carcinoma is closely associated with hepatitis virus infections, particularly infection with hepatitis B virus (HBV).¹–⁶ However, the cause-and-effect relation of HBV to hepatocellular carcinoma is as yet unproved. In Taiwan the association ...

Idiopathic giant-cell myocarditis is a frequently fatal type of myocarditis; only approximately 80 isolated cases and two small clinical series have been reported.¹,² The clinical course, unlike that of lymphocytic myocarditis,³ is usually characterized ...

Eastern equine encephalitis is a life-threatening mosquito-borne arboviral infection found principally along the east and Gulf coasts of the United States.¹ It was first recognized in humans in 1938.²–⁴ Cases have occurred sporadically and in small ...

A 77-year-old woman with a history of hypertension and an abdominal aortic aneurysm presented with acute upper back discomfort. The physical examination on admission was unremarkable, and a chest film revealed dilatation of a tortuous thoracic aorta. ...

The modern surgical treatment of disorders of the thoracic aorta began in the early 1950s when Gross, Swan, Lam, and DeBakey and their associates¹–⁴ reported successful treatment of coarctation and aneurysms of the descending thoracic aorta using ...

Over the past two decades, ultrasonography and computed tomography (CT) have emerged as the principal imaging methods for diagnostic examination of the liver and biliary tree. The other noninvasive imaging techniques, including magnetic resonance imaging (...

Presentation of Case

A 74-year-old man was admitted to the hospital because of increasing dyspnea and a cough.

The patient had been well until five months earlier, when dyspnea developed with a cough that produced minimal amounts of clear sputum. An ...

Poor metabolic control in adolescents with insulin-dependent diabetes mellitus (IDDM) is sometimes accepted as inevitable but likely to resolve when the patient's hormones, metabolism, and psyche finally come to terms with adult life. Unfortunately, such ...

The most common form of primary liver cancer is hepatocellular carcinoma. The other forms of primary liver cancer, including cholangiocarcinoma, angiosarcoma, and several others, are quite rare. Hepatocellular carcinoma is one of the 10 most common ...

An iatrogenic complication is an unfavorable response to medical treatment that is induced by the therapeutic effort itself.¹ Although some are minor, others are life-threatening. Serious or fatal iatrogenic complications occur in 4 to 9 percent of ...

To the Editor: The failure of the study by Adkinson et al. (Jan. 30 issue)¹ to demonstrate a significant benefit of immunotherapy with a few allergens to a particular group of children with asthma does not negate the positive benefit demonstrated in ...

To the Editor: Fine and colleagues (Jan. 23 issue)¹ present a detailed analysis of community-acquired pneumonia. An important complicating factor not specifically addressed in their prediction rule is pregnancy. Pneumonia is one of the most common and ...

To the Editor: Mortality from cardiovascular disease in Eastern Europe was low at the beginning of the 1960s, but a serious increase has occurred and in 1990 mortality was substantially higher than in Western Europe and the United States.¹ The political ...

To the Editor: The report by Loh et al. (Jan. 23 issue),¹ evaluating the association between left ventricular dysfunction and the risk of stroke in patients enrolled in the Survival and Ventricular Enlargement (SAVE) trial, raises important questions ...

To the Editor: We wish to raise some points of disagreement with the description of cardiac amyloidosis by Kushwaha et al. (Jan. 23 issue)¹ in their article on restrictive cardiomyopathy. The internationally accepted classification of the amyloidosis is ...

To the Editor: Multiple sclerosis, the most common neurologic disease in young adults, is accompanied by focal demyelinating plaques within the central nervous system, which can be quantified in vivo by using high-resolution magnetic resonance imaging (...

To the Editor: In the excellent review of the management of insomnia by Kupfer and Reynolds (Jan. 30 issue),¹ we read that “zolpidem may be less likely than benzodiazepines . . . to cause cognitive and psychomotor side effects (and may have fewer ...

Informed decision making is essential for high-quality intensive care medicine. The Critically Ill Cardiac Patient is a thoughtful and extensive review of what is known and what is important to help students, house staff, and fellows make informed ...

A wealth of epidemiologic, clinical, and basic research findings concerning or potentially relevant to the acute respiratory distress syndrome has emerged over the three decades since the original clinical description of the disorder. The editors of this ...

Multidisciplinary collaboration is the basis for many of the advances in pediatric pathology over the past 75 years. The contributions of Edith Potter span the early and middle years of this period of extraordinary progress. A true pioneer, she was among ...

Toward the goal of achieving what they call “the ultimate synthesis of the facts about the patient's situation with the clinician's practical experience and knowledge of the literature,” Robert Kliegman and his associates have produced a textbook that is ...