A wealth of laboratory, nutritional, and epidemiologic evidence implicates dietary factors in the pathogenesis of colorectal cancer.¹ International variation in the incidence of and mortality due to large-bowel cancer,² rapid increases in the incidence of ...

The risks of colorectal cancer and adenoma, the precursor lesion, are believed to be influenced by diet.¹ Burkitt's proposal that a high-fiber diet protects against colon cancer was based on the low rates of colorectal cancer in Africa.² Insoluble fibers, ...

The failure to hospitalize patients with acute myocardial infarction or unstable angina who present to the emergency department is a serious public health issue. Previous studies have found that between 2 percent and 8 percent of patients with acute ...

Acromegaly is a chronic debilitating disorder resulting from excessive secretion of growth hormone and a resulting increase in the production of insulin-like growth factor I (IGF-I). It is usually caused by somatotroph adenomas of the pituitary gland. The ...

Figure 1. A six-year-old boy was hospitalized with a rash and fever. He had been well until two days before admission, when general pruritus developed. That evening, small water blisters developed at the base of his nose and face. During the next two days,...

Whiplash injury results from acceleration–deceleration forces applied to the neck, usually in motor vehicle collisions.¹ This type of injury is a common cause of chronic neck pain in industrialized countries. Symptoms of whiplash include pain in the neck, ...

The evaluation of acute chest pain remains challenging, despite many insights and innovations over the past two decades. The percentage of patients who present at the emergency department with acute chest pain and are admitted to the hospital may actually ...

Presentation of Case

A 60-year-old man was referred to the hospital because of a pituitary macroadenoma.

The patient had been well until three years earlier, when he became impotent and his libido decreased. Two months before his referral to this hospital,...

Because colorectal cancers usually arise from adenomatous polyps, it is believed that preventing the growth of adenomas in the colon and rectum or removing any that appear will prevent colorectal cancer.¹ Many have therefore awaited the results of the two ...

Patients with suspected acute coronary syndromes, or acute cardiac ischemia, account for nearly 1.7 million hospital admissions per year in the United States. Between 2 and 8 percent of patients with myocardial infarction are mistakenly released from the ...

Acromegaly is the clinical expression of chronic secretion of excessive amounts of growth hormone. Its cardinal clinical manifestation is thickening of the skin, soft tissue, and bones of the hands and feet. It also causes thickening of these tissues ...

Some physicians, patients, and policy makers conceive of illness in purely biologic terms. According to this view, social, economic, and legal forces are irrelevant to symptoms and behavior; only tissue injury and healing matter. However, in this issue of ...

To the Editor: In their report on treatment for prostate cancer after prostatectomy (Dec. 9 issue),¹ Messing et al. conclude that immediate hormonal therapy offers a survival advantage over delayed therapy. There are some basic issues that might call ...

To the Editor: My colleagues and I began evaluating children with autism and gastrointestinal problems in 1997 and reported our findings initially in 1998.¹ The main secretin-related observation was a significant increase in the volume of ...

To the Editor: Germ-line mutations in the RET proto-oncogene are associated with various disease phenotypes including familial medullary thyroid carcinoma and Hirschsprung's disease.¹ Studies have suggested an involvement of RET in the development of the ...

To the Editor: In their otherwise excellent review of endoscopy of the upper gastrointestinal tract, Drs. Van Dam and Brugge (Dec. 2 issue)¹ start with a discussion of the likely economic benefits of performing upper gastrointestinal endoscopy without ...

To the Editor: The course of human immunodeficiency virus (HIV) infection is usually more severe in elderly patients than in younger patients.¹ We have been following a 78-year-old man who, as a result of a test performed before cataract surgery in 1985, ...

To the Editor: In his comprehensive article (Dec. 9 issue),¹ Morens describes in great detail the last illness of George Washington, his suffering, the therapy rendered by his physicians, and the subsequent controversy surrounding the appropriateness of ...

The question of balance between work and home is much on my mind as I return to work from a second maternity leave. Attending medical school during the mid-1980s, I expected that my career would be challenging, meaningful, and the focus of my days. I ...

Menorrhagia is a comprehensive survey of the management of a commonplace gynecologic malady. According to this book, 25 to 30 percent of women have excessive menstrual bleeding at some time in their lives. I think most gynecologists would agree that ...

This scholarly book covers virtually all aspects of postmenopausal health. The discussions are clearly written, comprehensive, and concise, with basic aspects placed in a clinical context when possible. Often, a topic neglected in one chapter is addressed ...

The close developmental and spatial relation between bone and cartilage is self-evident, yet these two issues are often considered as separate entities. The approach taken in this book — to consider the structural, functional, metabolic, and pathologic ...