Over the past 20 years, laboratory investigations have led to the belief that high ventilatory pressures result in barotrauma, or more appropriately, air leaks. Air leaks are defined as any extrusion of air outside the tracheobronchial tree, including ...

Mechanical ventilation can damage the lungs.¹,² Lesions at the alveolar–capillary interface,³ alterations in permeability,⁴ and edema⁵–⁷ have repeatedly been shown to occur in animals subjected to adverse patterns of mechanical ventilation.

In clinical ...

A strategy of mechanical ventilation that places limits on airway pressure and tidal volume has been recommended for patients with the acute respiratory distress syndrome.¹–⁴ This recommendation is based on the observation that mechanical ventilation, ...

Accurate, objective estimates of the probability of death from burn injuries would, as envisioned by Knaus et al.,¹ provide clinicians with an explicit basis for clinical decisions, help them understand the relative contributions of specific prognostic ...

Malaria most commonly presents as an acute systemic, febrile illness but may manifest more indolently as chronic anemia, glomerulonephritis, or tropical splenomegaly syndrome (or hyperreactive malarial splenomegaly) due to Plasmodium falciparum, P. vivax, ...

Figure 1. A 44-year-old woman was admitted to the medical intensive care unit with acute respiratory distress syndrome due to Streptococcus pneumoniae infection. A chest radiograph taken soon after admission revealed diffuse bilateral infiltrates (Panel A)...

Disasters, both natural and man-made, affect millions of people around the world every year. In the United States about 1.5 million households experience injury or suffer property damage each year as a result of floods, tornadoes, hurricanes, or ...

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A 51-year-old woman had had blurring of vision, polyuria, and anorexia for approximately six weeks. She had lost 9 kg (20 lb) in weight over the previous three months without the use of diet or exercise. Other symptoms included vaginal discharge and ...

Acute respiratory distress syndrome (ARDS) consists of the sudden development of diffuse lung injury in critically ill patients. Initial inflammation, edema, and atelectasis rapidly progress to fibrosis in many patients. The syndrome has been ...

The chances of survival after burn injury have increased steadily during the past 50 years. At the end of World War II, only 50 percent of patients survived burns involving 40 percent of their total body-surface area. Today, over 50 percent of all ...

To the Editor: The article by Mitler et al. on the sleep of long-haul truck drivers (Sept. 11 issue)¹ presents data on drowsiness. The authors state, “Of the total of 29,310 six-minute video recordings of the drivers' faces that we analyzed, 1989 of the ...

To the Editor: Khuroo et al. (Sept. 25 issue)¹ demonstrated that percutaneous drainage, combined with albendazole therapy, is a safe alternative to surgery for the treatment of uncomplicated hepatic hydatid cysts. A remarkable point in this study is that ...

To the Editor: The report by Tallman and colleagues (Oct. 9 issue)¹ concludes that “all-trans-retinoic acid as induction or maintenance treatment improves disease-free and overall survival as compared with chemotherapy alone and should be included in the ...

To the Editor: The Image in Clinical Medicine in the October 9 issue¹ shows a pathologic humerus through a focus of metastatic non-Hodgkin's lymphoma. The authors state that the arm was immobilized and that after four weeks the patient “had regained a ...

To the Editor: Bodenheimer's portrait of Oregon's Medicaid rationing scheme (Aug. 28 and Sept. 4 issues)¹ uses dubious data to argue that the program has reduced the number of uninsured Oregonians and too blithely dismisses matters of ethical concern. ...

To the Editor: Nevirapine (Viramune), manufactured by Roxane Laboratories, is a non-nucleoside inhibitor of human immunodeficiency virus type 1 (HIV-1) reverse transcriptase. Nelfinavir (Viracept), manufactured by Agouron Pharmaceuticals, inhibits the ...

With employers, advocacy groups, and publications of every stripe disseminating their own ratings of health maintenance organizations (HMOs) and advice for picking the best one, it was inevitable that doctors would soon contribute to the growing stack of ...

Trudy Karlson is an injury epidemiologist and Stephen Hargarten an emergency medicine physician, both public health professionals who have turned their attention to firearms in the belief that the science of injury control could be usefully applied to ...

The specialty of critical care medicine is, in large part, devoted to the care and treatment of patients with sepsis and the consequences of systemic infection. Tissue hypoperfusion and organ-system derangements are the hallmarks of severe sepsis and also ...

After 30 years of supporting graduate medical education through open-ended payment policies that rewarded academic medical centers for producing more physicians, the federal government last year curtailed Medicare's generous commitment to subsidize the ...