Politics, medical education and the control of contagious diseases: Sydenham Hospital of Baltimore.
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Mean birth weights were evaluated in infants with D-transposition of the great arteries, tetralogy of Fallot, endocardial cushion defect, hypoplastic left heart syndrome, pulmonary stenosis, aortic stenosis, coarctation of the aorta, ventricular septal defect, and atrial septal defect in a population-based case-control study of congenital cardiovascular malformations in residents of Maryland, Washington, D.C., and northern Virginia (1981-1987). Study subjects were liveborn singletons without extracardiac anomalies. After adjustment for potentially confounding maternal, gestational, and infant factors, significant birth weight deficits were found for infants with tetralogy of Fallot, endocardial cushion defect, hypoplastic left heart syndrome, pulmonary stenosis, coarctation of the aorta, ventricular septal defect, and atrial septal defect. After adjustment, infants with these malformations (except coarctation of the aorta and atrial septal defect) were also significantly more likely than were controls to have low birth weight for gestational age. These findings strengthen previous evidence that certain cardiovascular malformations and low birth weight may be causally related.
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A supine technique for reducing posterior dislocations of the hip is presented. We believe this technique provides more controlled traction than do other maneuvers and have found it to be a safe and effective method to reduce the posteriorly dislocated hip.
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Advanced cases of malnutrition are rare in the United States. Since it is rarely suspected, a correct diagnosis of malnutrition, even in extreme form, may easily be missed. We present a recent case of the kwashiorkor form of the syndrome of protein-energy malnutrition to emphasize its diagnostic features and to enhance early recognition and initiation of proper therapy. The misunderstanding of a physician's recommendations by a teen-aged mother may have initiated this illness.
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A group of 479 fire fighters were investigated for routine exposure to hydrogen cyanide in the fire atmosphere using measurements of serum thiocyanate (SCN-). Our findings indicate that fire fighters were exposed to levels of hydrogen cyanide sufficient to raise their mean serum thiocyanate (SCN-) levels above that of controls. This elevation of serum SCN- occurred independently of smoking habits. Exposure to cyanide occurred much less frequently than previously studied exposures to carbon monoxide. Difficulties of correlating acute symptoms and the effectiveness of mask use with serum thiocyanate are discussed.
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