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BETHESDA, Md. -- In children with bipolar disorder or severe mood dysregulation, extreme irritability sparked by frustration triggers distinctly different brain activity patterns, suggesting different psychophysiological mechanisms.

COLUMBUS, Ohio -- The soccer boom among America's children has taken its toll in a steady stream of injuries, yet the rate may haae actually dipped, found a retrospective 13-year survey.

BALTIMORE -- Eighteen million American men ages 20 or older have erectile dysfunction, generally attributed to the effects of diabetes, hypertension, or physical inactivity, researchers here reported.

A 49-year-old white man, in whom HIV infection had been newly diagnosed (CD4+ cell count, 25/µL; HIV-1 RNA level, 274,000 copies/mL), was transferred to our hospital for further workup and treatment of multiple neurologic deficits. He had presented to another hospital with a 4-day history of left-sided weakness and numbness, left-sided facial droop, dysphonia, and dysphagia that led to the initial diagnosis of an acute stroke.

A 75-year-old woman had undergone a total thyroidectomy, with histologic evidence of poorly differentiated follicular thyroid cancer. She subsequently received an ablative dose of iodine-131. After a disease-free interval of about 2 years, she presented with evidence of recurrence in the thyroid bed. She had enlarged cervical lymph nodes and complained of dyspnea on exertion.

In the treatment of chronic rhinosinusitis, antibiotics are often given for 3 to 6 weeks, but the optimal regimen has not been established. Dubin and coworkers conducted a study to assess the effectiveness of a 3-week course. They found that for some patients, significant radiographic improvement occurs when antibiotics are given for more than 3 weeks.

A 26-year-old woman presented with a1-week history of pleuritic chest painand abdominal pain, which was associatedwith nausea but unrelated tofood intake or bowel movements. Shehad also had gross hematuria for thepast 10 days and swelling around hereyes and ankles as well as fatigue andarthralgias for 2 weeks.

In his recent editorial Putting Guidelines for Chronic Kidney Disease IntoPractice (CONSULTANT, October 2006, page 1295), Dr Gregory Ruteckidiscussed the results of a study that shows many clinicians fail to follow evidence-based guidelines for the management of chronic kidney disease(CKD), such as when to consult a nephrologist.1 A sampling of the feedbackwe received appears below, along with Dr Rutecki's responses.

Medical technology is a double-edged sword. CT scans help detect early disease, but with the addition of contrast, they may cause renal failure. Pacemakers save countless lives, but they can become infected and lead to serious complications.

A 59-year-old woman was evaluated for epigastric discomfort and iron deficiency anemia of 2 months' duration. Two years earlier, she had undergone left upper lung lobectomy and adjuvant radiation for T2 N0 M0 poorly differentiated adenocarcinoma of the lung.

WASHINGTON -- Gender testing of an embryo at the blastocyst stage simply for "family balancing" is ethically untenable, determined a panel of the American College of Obstetricians and Gynecologists.

CHICAGO -- There is more evidence that nonsmokers exposed to wafting second-hand smoke at work have an increased risk of developing lung cancer.

SAN DIEGO -- Tight glucose control following cardiac surgery may not be as important in protecting infants' brains as it is for adults postoperatively, researchers said here.

LOS ANGELES -- Magnetic resonance angiography is highly effective in identifying stenotic supra-aortic arteries, according to researchers here.

SAN DIEGO -- Academic medical centers, despite the training responsibilities that frighten many patients away, have lung cancer surgery outcomes that equal or exceed those of non-academic hospitals, researchers said here.

SAN DIEGO -- Real-world revascularization outcomes pan out better with coronary artery bypass graft (CABG) than with percutaneous coronary intervention (PCI), even when drug-eluting stents are used, investigators reported here.

DALLAS -- Serious symptoms of sickle cell disease in childhood don't imply a greater risk of premature stroke or death for patients as they grow up, according to researchers here.

ORLANDO -- Adding Eloxatin (oxaliplatin) to the neoadjuvant chemotherapy mix for rectal cancer did not affect radiation dosing nor limit the ability to perform surgery, researchers here reported.