Escherichia coli O157:H7 causes sporadic and epidemic gastrointestinal infections worldwide. In approximately 15 percent of the children in North America who are infected with E. coli O157:H7, the hemolytic–uremic syndrome develops soon after the onset of ...

Mortality from cardiovascular disease continues to decline, but patients with coronary artery disease, left ventricular dysfunction, and asymptomatic ventricular arrhythmias remain at high risk for sudden or nonsudden death.¹–⁵ Although myocardial ...

Human colon cancer develops in a stepwise fashion from normal mucosa to adenomatous polyps to carcinoma. Mutation in the adenomatous polyposis coli (APC) gene commonly occurs early in the development of sporadic adenomas.¹ Patients with familial ...

The incidence of cancer is increased during the first year after the diagnosis of venous thromboembolism and may also be increased, to a lesser extent, for at least the next 10 years, as shown in large cohort studies of data from registries.¹,² A ...

Figure 1. A previously healthy 16-year-old girl presented with a three-day history of progressive pain on the left side of her chest. A chest x-ray film showed a large left-sided pneumothorax with bilateral cystic radiolucencies, and a chest tube was ...

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. It is estimated that this cancer will develop in 130,000 people in the United States in 2000 and that 56,000 will die from the disease.¹ Surgical resection ...

Pulmonary Langerhans'-cell histiocytosis forms part of a spectrum of diseases characterized by monoclonal proliferation and infiltration of organs by Langerhans' cells (Table 1).¹ Several organ systems may be involved in Langerhans'-cell histiocytosis, ...

Presentation of Case

A 61-year-old man was admitted to the hospital because of a wide-complex tachycardia and dyspnea.

The patient had been well until one month earlier, when he was assaulted and sustained an orbital fracture, associated with blurred ...

At the end of this month, I will be leaving the Journal after 21 years as an editor. I began in 1979 as assistant deputy editor, became executive editor in 1988, and became editor-in-chief last year. It has been an extraordinary experience.

I have had the ...

Marcia Angell, a superb editor, has an instinct for the best in medical writing and an exceptional talent for quickly grasping the core of a manuscript, whatever its topic. In judging a submitted article, she consistently stresses rigor of experimental ...

The hemolytic–uremic syndrome is characterized by hemolytic anemia, thrombocytopenia, and acute renal insufficiency. There are at least four major causes of the syndrome: bacterial and viral infections, which are responsible for the epidemic form; ...

Recently reported large series have provided clear evidence of an association between idiopathic thromboembolism and the development of cancer. The standardized incidence ratio for all cancers is as high as 6.7 within the first year after a thromboembolic ...

To the Editor: Ramakrishna et al. (Feb. 3 issue)¹ report that the inclusion of amylase-resistant starch in an oral rehydration solution improved the treatment of cholera by reducing stool output and the duration of diarrhea. The comparison groups ...

To the Editor: In clinical practice, we see women with pregnancy-associated venous thromboembolic events who have had several previous pregnancies without thromboembolism. It is not clear why some pregnancies in such women are complicated by venous ...

To the Editor: Wolfe et al. (Feb. 3 issue)¹ provide a compelling and long-overdue assessment of deficiencies in the care of terminally ill children. Though long on evidence, their report is short on practical suggestions for meaningful intervention and ...

To the Editor: Spontaneous rupture of splenic lesions is a well-described complication of infectious, hematologic, and neoplastic diseases.¹ Intrasplenic aneurysms are uncommon and have been found most frequently in patients with portal hypertension.

We ...

To the Editor: In their review, Muth and Shank (Feb. 17 issue)¹ discussed the pathophysiology, diagnosis, and treatment of gas embolism, a potentially fatal complication of various medical and surgical procedures. Although we found the review to be ...

To the Editor: Armstrong et al. (Feb. 24 issue)¹ discuss many of the potential benefits of using risk-prediction models to assess the risk of breast cancer for individual women and to guide care. However, there are also some risks associated with risk ...

To the Editor: A 66-year-old woman with a two-year history of right-sided trigeminal neuralgia (involving the second trigeminal division) presented with severe exacerbation of her typical sharp pain after a root-canal procedure in a right upper incisor. ...

If there had been a Nobel prize for cardiac surgery, it would have been awarded to half a dozen surgeons, starting with Gross and Gibbon and extending to Starr or Favaloro. In the middle of this list would have been C. Walton Lillehei (Figure 1). This ...

The boundary between generalist and specialist is not only changing but also unstable. It shifts, depending on the specific discipline, insurance regulations, the patient's needs, and the physician's training. This book is an example of a new genre of ...

Heart failure is one of the most frequent reasons patients are admitted to the hospital. The incidence of heart failure is rising sharply in countries throughout the world, including developing countries. Despite advances in its treatment, heart failure ...

The field of vascular disease is rapidly eroding the artificial barriers that previously confined its practitioners to a rather narrow field of endeavor. To remain up to date, clinicians, teachers, and researchers in the field of vascular disease now must ...

The provincial health insurance plans of Canada, still prized by a population that relies on universal coverage of hospital care and physicians' services, nevertheless suffered a dramatic loss of public confidence in the 1990s as a result of sharp ...