Alcohol abuse and gallstones account for approximately 80 percent of cases of acute pancreatitis.¹,² The pathogenesis of acute biliary pancreatitis is not fully understood and may be multifactorial.³–⁸ It is uncertain whether gallstones merely initiate or ...

Community-acquired pneumonia is diagnosed in approximately 4 million adults each year in the United States, and more than 600,000 of these are hospitalized.¹,² The site of care — home or hospital — often determines the extensiveness of the diagnostic ...

Current estimates of the incidence of stroke among patients with coronary artery disease are as low as 3.4 percent per 1000 patient-years of follow-up.¹ Stroke is also a known but infrequent early complication of myocardial infarction. In the two-week ...

An estimated 8 to 20 percent of women have depression at some time in their lives, most commonly during childbearing years and often requiring drug therapy.¹,² The decision to continue or initiate pharmacotherapy for depression during pregnancy is ...

Thymomas are rare epithelial neoplasms frequently associated with myasthenia gravis, hypogammaglobulinemia, and pure red-cell aplasia.¹–¹¹ In pure red-cell aplasia, autoantibodies against early and late erythroid-cell progenitors or erythropoietin, as ...

Figure 1. A 69-year-old man with no prior biliary surgery had intermittent, self-limited episodes of fever and chills for three months and a cholestatic pattern of liver-enzyme elevations. A diagnosis of recurrent cholangitis due to cholelithiasis was ...

Restrictive cardiomyopathy is defined as heart-muscle disease that results in impaired ventricular filling, with normal or decreased diastolic volume of either or both ventricles. Systolic function usually remains normal, at least early in the disease, ...

Presentation of Case

A 39-year-old man was admitted to the hospital because of acute leukemia.

The patient had been well until four weeks earlier, when he began to have progressive malaise, fever, and lymphadenopathy. Epistaxis occurred and required ...

Almost 100 years ago, Opie postulated that a gallstone transiently obstructing the ampulla of Vater — the channel where the bile duct and pancreatic duct meet — could precipitate pancreatitis.¹ At least half of all cases of pancreatitis are due to the ...

At the turn of the century, Sir William Osler described pneumonia as “the captain of the men of death.” Pneumonia remains a major cause of death worldwide, accounting for an estimated 5 million deaths per year. In developed countries, the antimicrobial ...

To the Editor: With regard to the articles on alternative techniques of hysterectomy by Dorsey et al. and Weber and Lee and the accompanying editorial by Stovall and Summitt (Aug. 15 issue),¹–³ the terms “laparoscopic hysterectomy” and “laparoscopically ...

To the Editor: The study by Lepor et al. (Aug. 22 issue)¹ confirms the efficacy of α₁-adrenergic antagonists in the management of benign prostatic hyperplasia. It also underscores the importance of focusing on the patients' symptoms, rather than relying ...

To the Editor: In the Images in Clinical Medicine series (Aug. 15 issue),¹ Wong and Van Dam described a case in which an expandable metallic esophageal prosthesis spared their patient considerable discomfort and expense. Expandable metal stents, ...

To the Editor: In his discussion of diuretic therapy in his excellent review of congestive heart failure (Aug. 15 issue),¹ Dr. Cohn did not mention that resistance to diuretics frequently develops in patients with severe refractory heart failure. The ...

To the Editor: The cutaneous T-cell lymphomas include mycosis fungoides, the Sézary syndrome, and other sporadic primary T-cell proliferations in the skin.¹,² The human T-cell lymphotropic virus type I (HTLV-I) is a retrovirus that causes adult T-cell ...

To the Editor: In his discussion of Case 25-1996 (Aug. 15 issue),¹ Dr. Drapkin seems to doubt that measurement of the levels of adenosine deaminase in pleural fluid is useful for the diagnosis of pleural tuberculosis. It is true that other conditions can ...

This book contains a wealth of information on addiction. The topics range from psychoanalytic theory and public health policy to biochemistry. Substance dependence is broadly defined, and separate sections deal with stimulants, smoking, and alcohol and ...

Drug policy in America appears to have originated from two competing conceptions of addiction. The “criminal model,” which originated many generations ago, views addiction as one of the many deviant types of behavior exhibited by the large and worrisome “...

The Panel on Research on Violence against Women was established by the National Research Council in 1995 to fulfill a congressional request for a research agenda to increase understanding of violence against women. The multidisciplinary panel restricted ...

During the past 25 years, opposing forces have been waging a battle over the validity of science and the scientific method. This culture war, sometimes pursued with fierce polemics, began in the 1960s with growing resistance to the view that the ...

Tobacco companies have come to personify the devil, and strategies to exorcise tobacco smoking from the United States proliferate. Tobacco's demonic status is even reflected in popular fiction. John Grisham's latest bestseller, The Runaway Jury, for ...

A small group of editors of general medical journals met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements ...

Insulin-like Growth Factor I — An Important Intrauterine Growth Factor Editorial, N Engl J Med 1996:335;1389-1391.. On page 1390, the sentence that begins 23 lines from the bottom of the left-hand column should have read, “Serum concentrations of growth ...