Most studies that describe the outcome of premature infants are based on birth weight and thus confound the effects of extremely preterm birth with those of intrauterine growth restriction.¹ However, physicians and parents contemplating the prognosis of ...

Patients with acute myocardial infarction benefit markedly from the restoration of coronary blood flow in the infarct-related vessel, and myocardial salvage is the principal mechanism of this benefit.¹ The unequivocal demonstration of the advantages of ...

Incisional hernia is a frequent complication of abdominal surgery. In prospective studies with sufficient follow-up, primary incisional hernia occurred in 11 to 20 percent of patients who had undergone laparotomy.¹–³ Such hernias can cause serious ...

There are two congenital anomalies specific to multifetal pregnancies: twin reversed-arterial-perfusion sequence and conjoined twinning. The twin reversed-arterial-perfusion sequence is a rare complication of monozygous twinning in which one fetus (the “...

Figure 1. A 74-year-old man presented with a one-week history of exertional angina and dizziness. Treadmill testing showed deep, prolonged depression of the ST segment and hypotension at a low level of exercise. During urgent cardiac catheterization, the ...

Organ transplantation has evolved rapidly from the first early successes¹ to the current widespread use of donated organs for the treatment of end-stage kidney, heart, and liver failure. With limited supplies of organs and an increasing demand for them, ...

Almost a century ago, in 1901, Eugene L. Opie described “hyaline degeneration of the islands of Langerhans” in the pancreas of patients with hyperglycemia (Figure 1).¹ A relation with diabetes mellitus was suggested, although at that time insulin had not ...

Presentation of Case

A 23-year-old man was admitted to the hospital because of complex partial seizures that had become generalized.

The patient, who was from El Salvador, had been well until the age of 15 years, when he had three seizures during a two-...

I had a kind of blind faith. I believed in the collaboration between the firm will of my one-pound-twelve-ounce daughter and the expertise of modern medicine. Of course, there was more than a bit of random luck involved, too.

— Wendy Wasserstein¹

Despite ...

The transplantation of organs is a triumph of modern medicine. Life expectancy and the quality of life are greater with kidney transplantation than with maintenance dialysis. Successful liver and heart transplantations are lifesaving. However, the gap ...

The transplantation of organs from living donors has always involved a balancing of the physical risks and psychological benefits to the donor against the benefits to the recipient. Early in the history of transplantation, the expectation was that the ...

To the Editor: The study by van Jaarsveld and colleagues (April 6 issue)¹ compared angioplasty with antihypertensive-drug therapy in patients with renal-artery stenosis and inadequately controlled hypertension. We are concerned about several aspects of ...

To the Editor: We are concerned about the definition of metastatic breast cancer used by Stadtmauer et al. (April 13 issue)¹ in their report on high-dose chemotherapy with autologous stem-cell transplantation in women with metastatic breast cancer. By ...

To the Editor: Thyroid dysgenesis (thyroid aplasia or an ectopic thyroid gland) is responsible for 85 percent of cases of congenital hypothyroidism. The pathogenesis of thyroid dysgenesis is not known. Although a few familial cases have been reported,¹,² ...

To the Editor: Morrison et al. (April 6 issue)¹ report that pharmacies in predominantly nonwhite neighborhoods in New York City are less likely than those in predominantly white neighborhoods to carry supplies of opioid analgesics adequate to treat ...

To the Editor: Many pregnant women have nausea and vomiting during the first trimester; these effects may be severe and in some women they continue beyond the first trimester.¹ The cause is likely to be multifactorial, and the disorder is a diagnosis of ...

Transplantation is one of the most complex and challenging enterprises of modern medicine. Despite recent progress in surgical techniques and immunosuppressive strategies, the wide-ranging societal, ethical, and psychological implications of transferring ...

Septic shock is difficult to define, difficult to investigate, and even more difficult to treat (mortality rates are greater than 50 percent). For these reasons, septic shock has become the bête noire of an entire generation of intensive care physicians. ...

At one time, antiplatelet therapy was limited to aspirin and dipyridamole as secondary or primary preventive agents. Today, however, we are facing a dramatic revolution in this field with the rapid development of receptor antagonists, inhibitors of ...