“Appalled and astounded” at the consequences that [immigration to Boston] had already produced, [Lemuel] Shattuck concluded [in 1850] that it was the immigrants — the poor and unwanted from England and Ireland — who were primarily responsible for bringing ...

Abdominal aortic aneurysms arise through a chronic degenerative process that produces localized weakening of the aortic wall. They have a natural history characterized by progressive expansion and eventual rupture.¹ Population-based screening studies ...

Medical students often learn axioms in order to remember the key features of a disorder. The “rule of 10” used to describe pheochromocytomas is a good example: 10 percent are extraadrenal, and of those, 10 percent are extraabdominal; 10 percent are ...

Many patients do not have formal plans about who should make end-of-life decisions for them if they become unable to make such decisions themselves. This Sounding Board article reviews the case of a man who had informal conversations with his wife and children about end-of-life care, but who had not made a formal statement about either his wishes or who should act in his interest if he were unable to do so. Head trauma received in an automobile accident resulted in substantial but not life-threatening neurologic impairment. In an important decision, the Supreme Court of California sided with the patient's mother, who wished to keep him alive, rather than with his wife and daughter, who wished not to replace a feeding tube. The authors review the case and its implications for end-of-life decisions.

To the Editor: After the September 11 terrorist attacks, many people in the United States had substantial symptoms of stress.¹–³ However, little information is available from other countries.

Between October 6 and October 13, 2001, we conducted a survey ...

To the Editor: Schiller and colleagues (Jan. 10 issue)¹ report equivalent overall survival and response rates for four third-generation chemotherapy regimens in advanced non–small-cell lung cancer. The median survival in the four groups was 7.4 to 8.1 ...

To the Editor: The letter from Powers et al. (Jan. 24 issue)¹ challenged our use of the unstratified analysis in evaluating the overall response to empirical antifungal therapy and stated that a Bonferroni correction for multiple testing is required for ...

To the Editor: Bell and Redelmeier (Aug. 30 issue)¹ have quantified something that clinicians have long suspected: it gets tough in hospitals over the weekend. Their study has enormous implications for hospital staffing and therefore deserves careful ...

To the Editor: Although the estimated rate of cancer during pregnancy is 1 case per 1000 live births,¹ and placental metastases are not uncommon, transplacental transmission of maternal tumors is rare. We report a case of small-cell carcinoma of the lung ...

To the Editor: An invasive approach is still the gold standard for prenatal diagnosis of genetic disorders. Chorionic-villus sampling, the current procedure of choice, allows an early diagnosis, but the miscarriage rate after chorionic-villus sampling is ...

Major advances in the management of stroke in the past 15 years have substantially altered clinical practice and have lowered the morbidity and mortality associated with cerebrovascular diseases. These advances have involved diagnostic and interventional ...

Vasculitis is often a clinical conundrum. It is uncommon, many of its signs and symptoms are nonspecific, and it can mimic many other diseases. Some forms of vasculitis are innocuous, whereas others can lead to the rapid development of irreversible organ ...