In 1969, Paris et al.¹ described two siblings who had the autosomal recessive disease cystic fibrosis and whose father and paternal uncle and grandfather had chronic calcific pancreatitis. Not only did this report hint at a shared molecular basis for ...

Chronic pancreatitis is a potentially life-threatening disease¹; the most common types are alcohol related and idiopathic. Susceptibility to pancreatitis varies widely.² Even though pancreatitis rarely results from recognized genetic defects,³,⁴ it is ...

Atrial fibrillation is the most common of all sustained cardiac arrhythmias, with the prevalence increasing with age to up to 5 percent in persons more than 65 years of age, and it is a major cause of stroke.¹–³ Experimental studies and human surgical ...

From 1 to 5 percent of pregnant women have chronic hypertension, defined as sustained hypertension that is present before conception or during the first 20 weeks of gestation.¹ The rates are higher in older women, obese women, and black women.²–⁴ Chronic ...

Figure 1. A 39-year-old man with a 22-year history of smoking one to two packs of cigarettes per day was referred to our hyperbaric facility because of an ulcer on the tip of the third finger of his right hand that had been present for six months (Panel A)...

Although cigarette smoking is a leading cause of premature morbidity and mortality in the United States, insurance coverage for smoking-cessation services is uncommon.¹ Lack of information about the effect of insurance coverage on the demand for and use ...

Rapid, unilateral injury to either peripheral or central vestibular structures produces the acute vestibular syndrome, which consists of severe vertigo, nausea and vomiting, spontaneous nystagmus, and postural instability. When this syndrome evolves over ...

In patients with cystic fibrosis, the inability to maintain the luminal hydration of ducts that contain or secrete large molecules may affect multiple organs. The protein product of the gene that causes the disease — the cystic fibrosis transmembrane ...

There is a growing crisis of confidence in managed care. Because of its success in controlling costs to employers, managed care has triggered fears that necessary health services are being withheld and that decisions about health care are being driven by ...

Remarkable advances have been made recently in our understanding of the molecular and genetic bases of disease. The potential therapeutic opportunities offered by these scientific findings, combined with the expanding needs of an aging population, have ...

To the Editor: In their study of sildenafil in men with erectile dysfunction, Goldstein et al. (May 14 issue)¹ found that the drug had few major side effects. I would like to bring to your attention two cases of ventricular tachycardia that occurred ...

To the Editor: X-linked adrenoleukodystrophy is an inherited recessive disorder characterized by a defect in peroxisomal β-oxidation of very-long-chain fatty acids (those with more than 22 carbon atoms) and secondary neuroinflammatory damage.¹,² Even ...

To the Editor: In their article on cancer and venous thromboembolism, Sørensen et al. (April 23 issue)1 reported an increased incidence of the diagnosis of cancer in the first six months of follow-up after the diagnosis of primary deep venous thrombosis ...

To the Editor: Simons et al. (Dec. 4 issue)¹ report that inhaled beclomethasone is somewhat more effective than salmeterol in controlling symptoms of asthma in children and that beclomethasone retards children's growth, whereas salmeterol does not. ...

To the Editor: Werzberger et al. (April 16 issue)¹ report that on the basis of six years of follow-up after the Monroe efficacy trial, vaccination against hepatitis A is protective. However, it still remains to be determined how long the vaccine will be ...

To the Editor: Tucker (April 23 issue)¹ discusses the treatment of pain in dying patients. This has been a concern to all physicians, and the use of large doses of pain medications, as needed, to control unremitting cancer-associated pain has ceased to ...

To the Editor: A 58-year-old avid rower was profoundly frustrated by his poor performance in the Grand Masters Singles race during Boston's 1997 Head of the Charles Regatta. While putting his scull up on the rack, he appeared ashen and morose to a fellow ...

In most North American academic medical centers, the departments of gastroenterology and hepatology coexist in an uneasy relationship somewhat akin to a dysfunctional marriage. In previous editions this voluminous textbook was limited to the subject of ...

The tools for the clinical diagnosis of tumors of the gastrointestinal tract are no longer limited to a physical examination, rigid endoscopy, and barium contrast radiography but also include fiberoptic endoscopy, ultrasonography, endoscopic ...

Colorectal cancer is the fourth most common type of cancer worldwide and accounts for considerable mortality. Refinements in surgical technique and reductions in perioperative mortality have improved outcomes substantially in recent years, and little ...