PROSTAGLANDIN E₁ infusion is widely used to maintain patency of the ductus arteriosus in neonates with congenital heart disease, and also to treat persistent fetal circulation and pulmonary hypertension in newborns.^{1 , 2} An infusion rate of 0.05 μg per ...

HYPERTROPHIC pyloric stenosis classically occurs within a few weeks after birth. Typically, affected infants present with bile-free vomitus, metabolic alkalosis, and dehydration. The identification of an enlarged pylorus (the pyloric "olive") by palpation,...

THE treatment of metastatic malignant melanoma with chemotherapy is largely palliative, and new therapeutic approaches would be highly desirable. Dacarbazine as a single agent is still the chemotherapy of choice, with a response rate of about 15 to 18 ...

NEUROMUSCULAR-BLOCKING drugs (muscle relaxants) are often administered to critically ill patients to facilitate mechanical ventilation.¹ Although pancuronium is the most frequently used muscle relaxant in medical intensive care units,² some patients are ...

PRIMARY immunodeficiency diseases are a heterogeneous group of disorders resulting from intrinsic defects of the immune system.¹ They are frequently associated with repeated bacterial, fungal, or viral infections and may be caused by defects in organs (...

LYME disease is a multisystem disorder caused by the spirochete Borrelia burgdorferi. Spread to humans by infected ticks, it is the most common vector-borne illness in the United States.¹ The primary vectors are Ixodes dammini in the northeast and ...

The deer ticks (Ixodes dammini) that transmit the Lyme disease spirochete (Borrelia burgdorferi) in the northeastern United States are members of a morphologically similar group of "black-legged ticks" that includes the wood tick (I. ricinus) of Europe ...

A REASONABLE definition of refractory hypertension might comprise these features: the blood pressure remains above 140/90 mm Hg (160/90 mm Hg for patients over 60 years of age), the routine evaluation does not suggest secondary hypertension, treatment ...

Presentation of Case

A 14 1/2-year-old boy was admitted to the hospital because of progressive muscle weakness. The child was born of a full-term, normal pregnancy by cesarean section. His early development was believed to be normal. He was able to run at ...

Gastric-outlet obstruction in infants causes vomiting of such persistence that the loss of fluid and electrolytes may be life-threatening. The causes of gastric-outlet obstruction include relatively common disorders, such as hypertrophic pyloric stenosis, ...

Melanoma presents formidable problems at both ends of the clinical spectrum — from prevention and early detection to treatment of metastatic disease. In white populations, the worldwide incidence of invasive primary cutaneous melanoma has been rising for ...

The risk of Lyme disease frightens many people who are bitten by ticks. Is their anxiety justified? What should we do when one of our patients is bitten but we do not know whether the offending tick is a carrier of Borrelia burgdorferi? Internists, ...

To the Editor: The report by Simonds et al. (March 12 issue)¹ that several but not all people became seropositive for the human immunodeficiency virus (HIV) type 1 after receiving organs or tissues from a single HIV-seronegative donor brings into focus ...

To the Editor: In the valuable study by Powderly et al. (March 19 issue)¹ comparing fluconazole with amphotericin B as suppressive therapy for cryptococcal meningitis in patients with the acquired immunodeficiency syndrome (AIDS), the authors state that ...

To the Editor: The recent review of the surgical management of spastic diplegia and cerebral palsy by Park and Owen (March 12 issue)¹ appears to be an authoritative and objective opinion on the beneficial effects of dorsal rhizotomy for these conditions. ...

To the Editor: In their recent study (March 12 issue),¹ Broderick et al. found that the risk of subarachnoid and intracerebral hemorrhage among adult blacks under 75 years of age was 2.3 times that among whites. No causal factors were identified for the ...

To the Editor: The report of Comenzo et al. (March 26 issue)¹ claimed that endo-β-N-acetylglucosaminidase D from Streptococcus (Diplococcus) pneumoniae destroyed the anomalously expressed blood-group A—like substance on erythrocytes from their patient. ...

To the Editor: Increases in the production of fetal hemoglobin can ameliorate the severity of both sickle cell disease and β-thalassemia. Three groups of agents are known to increase the production of fetal hemoglobin in humans: cytotoxic drugs,^{1 , 2} ...

To the Editor: Dysmorphic hematuria is defined as the presence of >8000 erythrocytes with irregular membranes, variations in size and shape, and vesicle-shaped protrusions per milliliter of urine and is considered to be a specific indicator of glomerular ...

To the Editor: The preliminary report by Hubbard et al. (March 19 issue)¹ on the use of aerosolized recombinant human deoxyribonuclease I (rhDNase) in the treatment of cystic fibrosis is intriguing, but the authors appear to have concluded that rhDNase ...

To the Editor: Weiss et al. (March 26 issue)* convincingly show that both lives and money will be saved by improving the home treatment of patients with asthma. Practically, this involves education about asthma, nebulization in the home, and telephone ...

To the Editor: Women in central Zaire insert substances into the vagina to enhance sexual stimulation for themselves and their partners. These substances, they say, "dry" and "tighten" the vagina and thus make sexual intercourse more pleasurable. Focus-...

In the preface to this book, the author points out that successful vascular surgery demands technical excellence but also depends heavily on proper judgment and case selection. His observation is particularly applicable to reconstruction due to ...

In the past few years, several encyclopedic textbooks on critical care medicine have been published. Although comprehensive, they are unfortunately large and expensive and suffer from the need to cover all aspects of what has become a far-reaching ...

This textbook was written with the intent to review current knowledge of cardiac arrhythmias for a wide medical audience ranging from general practitioners to clinical cardiologists. The initial chapters review the fundamentals of electrocardiography, ...

This book is an integrative attempt to use various behavioral, genetic, and cultural influences to explain why people smoke. It draws many parallels with other substance-abuse problems involving heroin, cocaine, and alcohol.

Krogh is strongly in favor of ...

Essentials of Nuclear Medicine Imaging is an excellent example of how information can be effectively presented in a concise manner. It is designed to provide core information to readers looking for basic information on nuclear medicine.

The book is ...

Interventional radiology is a new discipline that is progressing at such a rapid pace that textbooks become outmoded within two or three years of publication. Laser angioplasty was a hot subject three to five years ago and was widely discussed in books on ...

This book is delightful reading. For anyone who has spent time and effort studying the entry into the world made by each of us, this short book will provide insights. In his preface, Al-Azzawi sets himself the task of remaining pragmatic and practical. He ...

These five books represent the spectrum of new books available in the field of obstetrics and gynecology. They vary in their country of origin, targeted readers, depth of material, and type of presentation.

Obstetrics: Normal and Problem Pregnancies is ...

This second edition of a successful textbook of urologic diseases follows the format of the first edition. It was edited by four distinguished urologists, who invited leaders in various subspecialties to contribute chapters. In most cases, the authors ...

Education, History, Biography, and Public Press

The Colonial Disease: A social history of sleeping sickness in northern Zaire, 1900–1940. (Cambridge History of Medicine.) By Maryinez Lyons. 335 pp., illustrated. New York, Cambridge University Press, 1992. ...

UNIVERSITY OF IOWA

The following conferences will be held in Iowa City, unless otherwise noted: "Midwestern Conference on Health Care in the Elderly" (Sept. 11 and 12); "8th Annual Iowa Symposium on the Management of Cardiovascular Disease" (Sept. 17 and ...