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SEATTLE -- Newborn hearing tests may provide a marker for infants at risk for sudden infant death syndrome (SIDS), researchers found.

A 77-year-old man complains of deep, aching pain of several months' duration in his left thigh that is exacerbated by both standing and walking.

Drugs may confer serious risks along with substantial therapeutic benefits. The aging of the population and the trend toward increased outpatient drug use-and hence the likely rise in adverse events-underscore the need for ongoing surveillance of outpatient drug safety.

When you palpate for inguinal hernias, ask the patient to take a deep breath and then bear down in a moderately strenuous Valsalva maneuver--rather than cough--after you have placed your finger in the inguinal ring.

ABSTRACT: Angiotensin-converting enzyme inhibitors and ß-blockers are the cornerstone of heart failure medical therapy; unless contraindicated, start these agents as soon as possible after volume status has been optimized. Aldosterone receptor antagonists, angiotensin-receptor blockers, and a fixed-dose combination of hydralazine and isosorbide dinitrate (the last recommended especially for African Americans) can be used as add-on therapy. Prophylactic implantable cardioverter defibrillators reduce long-term mortality in symptomatic patients with a left ventricular ejection fraction (LVEF) of 35% or less. Cardiac resynchronization therapy improves symptoms and ventricular remodeling in some patients; indications include wide (more than 20 milliseconds) QRS complex on ECG, impaired LVEF (35% or less), and advanced heart failure symptoms (NYHA classes III and IV) despite optimal drug therapy. Measurement of natriuretic peptides and impedance cardiography both show promise for monitoring patients with heart failure and for guiding therapy, but definitive data to justify their routine use are still lacking.

Oral Histoplasmosis

A 39-year-old woman complained of excruciating pain that radiated from a chronic lesion on the left upper lip to the entire left side of the face. She had AIDS but was not receiving antiretroviral therapy.

In the late 1980s, "club drugs" were typically limited to the so-called rave/techno subculture.1 More recently, studies have shown the growing appeal of 3,4-methylenedioxymethamphetamine (MDMA), or ecstasy to middle-aged and older adults.

One day after he had been hit in the left eye with a drinking glass, a 48-year-old man sought medical attention. He could see only light and shadows with the eye.

A large right adrenal mass was noted incidentally on an MRI scan of the lumbar spine, which had been performed for other reasons in a 55-year-old non-obese woman. The bright heterogeneous mass (T2-weighted image) measured 6.2 3 6.2 3 4.1 cm and sat like the head of a serpent on the superior pole of the right kidney. Its margins were smooth, but signal intensity was increased on T2 weighting because of high water content. The left adrenal gland was normal.

RESEARCH TRIANGLE PARK, N.C. -- Things may not be all quiet on the home front. When soldiers deploy for combat, child abuse and neglect increase as does stress for the spouses left behind, researchers here said.