Campylobacter jejuni is the most commonly recognized cause of bacterial gastroenteritis in the United States.¹,² When antibiotics are indicated for the treatment of campylobacter gastroenteritis, erythromycin or a fluoroquinolone such as ciprofloxacin is ...

Calcific tendinitis of the shoulder is characterized by a reactive calcification that affects the rotator-cuff tendons.¹ Frequently, such calcifications are incidental radiographic findings in asymptomatic patients. In most cases, they are located 1 to 2 ...

Management of thoracic aortic dissection depends on the patient's prognosis. Whereas patients with proximal dissections clearly benefit from surgical repair, the therapeutic strategy for dissections of the aortic arch and descending thoracic aorta is far ...

Acute aortic dissection is one of the most catastrophic diseases that can affect the aorta. There are 10 to 20 cases per million population per year,¹,² and if the condition is left untreated, 36 to 72 percent of patients die within 48 hours of diagnosis, ...

Figure 1. A 68-year-old woman was admitted to the emergency room with sudden left hemiparesis. A computed tomographic scan of the brain showed an image consistent with infarction of the right frontal lobe. A transthoracic echocardiogram suggested that ...

Figure 1. A 56-year-old woman has had discolored skin since the age of 14 (Panel A, left, and Panel B). At the age of 11 the patient was given nose drops of unknown composition for “allergies,” and three years later her skin turned gray. The pigmentation ...

Hemostasis is a physiologic mechanism that maintains blood in a fluid state within the circulation. The coagulation of blood is mediated by cellular components and soluble plasma proteins. In response to vascular injury, circulating platelets adhere, ...

In the United States, epilepsy affects approximately 0.6 percent of the population (1.6 million persons) and has a lifetime prevalence of approximately 3 percent (and will thus affect 7.2 million persons).¹ For the majority of patients, epileptic seizures ...

Presentation of Case

A 77-year-old man was admitted to the hospital because of syncope and hemoptysis.

The patient had a long history of type 2 diabetes mellitus, hypertension, coronary artery disease, congestive heart failure, paroxysmal atrial ...

In June 1998, the World Health Organization convened a meeting to discuss the use of quinolones in animals used for food and its potential effect on human health. Participants included experts from a wide range of disciplines.¹ They concluded that major ...

Calcific tendinitis of the shoulder is a self-limiting calcification of the rotator cuff (Figure 1). Radiologically evident calcification has been reported in 7.5 to 20 percent of adults with no symptoms¹,² and in 6.8 percent of those with shoulder pain.² ...

Two reports in this issue of the Journal, by Dake et al.¹ and by Nienaber et al.,² represent the collective experience of four institutions on three continents with a new treatment for aortic dissection. These reports detail preliminary findings in 31 ...

I am standing at a bank of phones, desperately punching in codes and numbers. Each time, the line goes dead. “Why can't I get through to anyone?” I think. “I must be doing something wrong.”

I wake up. This time it's only a dream. But the dream originated ...

To the Editor: In their article on mutations of the cystic fibrosis gene in patients with chronic pancreatitis, Sharer et al. (Sept. 3 issue)¹ concluded that the frequency of carriers of the 5T allele was significantly higher in these patients than in ...

To the Editor: Berlowitz et al. (Dec. 31 issue)¹ reported inadequate control of blood pressure in a selected population of older men followed in outpatient clinics at five hospitals and concluded that physicians must accept some responsibility for the ...

To the Editor: Achenbach et al. (Dec. 31 issue)¹ reported that electron-beam computed tomography (CT) may be a useful test to detect high-grade coronary-artery stenoses or occlusions. The authors stated that 25 percent of the 500 coronary arteries ...

To the Editor: Farkouh et al. (Dec. 24 issue)¹ have shown that patients who present to the emergency room with chest pain and who have an “intermediate risk” of cardiovascular events can be “safely” cared for with the use of a chest-pain observation unit ...

To the Editor: The medical mystery in the April 1 issue¹ involved a 79-year-old woman, shown here in Figure 1, who had had discoloration of her face and eyes for several months. Examination revealed bluish pigmentation of her sclerae and skin. For five ...

To the Editor: In their analysis of the attributes of excellent attending-physician role models, Wright et al. (Dec. 31 issue)¹ provided only a snapshot and did not analyze what happens to role models over time. If teaching were highly valued, one might ...

To the Editor: Hemenway's review of my book More Guns, Less Crime (Dec. 31 issue)¹ makes false and misleading claims. My book analyzed Federal Bureau of Investigation data on crimes in all American counties from 1977 to 1994, as well as similar data on ...

To the Editor: Clinicians give pharmaceutical samples provided to clinics by industry sales representatives to patients who are unable to afford medicines or use them as starter packs for patients initiating a new treatment. These samples are usually ...

Educators at recently established rural medical schools throughout the world share various challenges and satisfactions. Serving on faculties that tend to be small, they must often be versatile teachers. Medical-library holdings are limited, students ...

Debates are taking place in medical schools and on the pages of medical journals about the extent to which medical students need to learn about molecular medicine and about how the subject should be taught. Indeed, the rapid proliferation of modern ...

Childbirth, at least in the developed world, has become very safe over the past several decades, mainly because of advances in the understanding of the effects of maternal disease on the progress of pregnancy and on maternal and fetal outcomes. This ...