JAMA

Wyngaarden, J. B.; Seevers, M. H.

doi: 10.1001/jama.1951.02920230001001pmid: 14794436

During recent years we have witnessed the development of an increasing number of effective antihistaminic agents, whose role in the therapy of allergic disease has now become well established. Recently a great mass experiment has begun in the treatment of the common cold with these compounds, and striking claims have been made for the efficacy of their early administration. An avid public has been eagerly supplied by various manufacturers until at present the consumption of these agents is enormous. Reliable estimates are that the total sale of these drugs will reach $100,000,000 in 1950.1 Fortunately, the antihistaminic compounds have proved to be relatively nontoxic in the usual doses, though they do frequently give rise to bothersome side effects. There are, however, certain serious potentialities embodied in these agents, and a small number of deaths have occurred. It is our purpose in this report to call attention to the toxicity

Womack, Nathan A.; Brintnall, E. S.; Ehrenhaft, J. L.

doi: 10.1001/jama.1951.02920230007002pmid: 14794437

This report has to do with a relatively recent series of patients with benign obstructions of the lower esophagus all fundamentally of motor origin. Most of the patients have had the disease for a long time and have had many types of nonsurgical care. Often, therefore, when they have presented themselves for surgical treatment secondary complications of a morphological nature have been present, such as inflammation, ulceration, dilatation, recent scar formation and severe malnutrition. As evidence of the frequency and the importance of this condition, we shall report our experience with 23 patients who have been referred to the State University of Iowa hospitals for surgical care in a period of slightly over two years. The fact that the patients have come from a relatively limited geographic area of more or less the same genetic stock with a relatively similar environmental situation lends homogeneity to the group. We shall not,

Engel, William J.

doi: 10.1001/jama.1951.02920230012003pmid: 14794438

The term nephrocalcinosis as used in this paper refers to bilateral diffuse calcifications in the renal parenchyma, generally in the pyramids and demonstrable by roentgen examination. In cases of nephrocalcinosis there is disturbed renal function associated usually with hyperchloremia and acidosis. There is also disturbed calcium metabolism; osteomalacia or rickets may eventually develop. Frequently there are few clinical symptoms in the early stages of the disease, but later weakness, anorexia, polyuria and polydipsia may be observed. Sometimes patients with nephrocalcinosis are referred to the urlogist because they have passed urinary calculi. This disorder was described by Butler, Wilson and Farber1 in 1936. In 1940 Albright and others2 reported a case of nephrocalcinosis in a 13 year old girl which was associated with rickets and dwarfism. Careful metabolic studies were carried out, resulting in an effective therapeutic regimen. These and two additional cases were described in the monograph

Flocks, R. H.

doi: 10.1001/jama.1951.02920230019004pmid: 14794439

Because of improvements in the technics of ureterointestinal anastomosis, cystectomy and partial cystectomy, there is need for a reevaluation of the indications and contraindications of the various types of treatment for patients with carcinoma of the bladder. A review of 540 patients with carcinoma of the bladder treated at the University Hospital from the years 1932 to 1942, a study of more recent patients treated more radically and a review of the recent literature emphasize the need for individual treatment of these patients. In order to adequately evaluate the various types of therapy, a basis of reference for classifying these tumors is necessary. This has been generally recognized. Jewett and Strong1 have shown that the microscopic anatomic structure or grade of malignancy of an infiltrating carcinoma of the bladder reveals only the potentiality of the tumor for rapid growth and metastasis but does not, in itself, indicate the presence

Huebner, Robert J.; Bell, Joseph A.

doi: 10.1001/jama.1951.02920230025005pmid: 14794440

For the past two and a half years representatives of the United States Public Health Service, the California State Department of Public Health and health departments of the county and city of Los Angeles, assisted by many local physicians, have been investigating the occurrence of Q fever in Southern California. These studies began in 1947 following Young's discovery of Q fever among patients in Artesia,1 a dairy community located in Los Angeles County. Shepard and Huebner found that 15 of 17 patients with Q fever in this area lived close to dairies or visited them and that serums of many local dairy cows contained antibodies for the disease.2 Huebner, Jellison and others recovered Coxiella burnetii, the causative agent of Q fever, from the milk of cows and showed that the pooled raw milk of two thirds of 63 dairies tested in the Los Angeles area contained the organism

Lennette, Edwin H.; Clark, William H.

doi: 10.1001/jama.1951.02920230030006pmid: 14794441

Q fever was described as a new clinical entity by Derrick1 in 1937. The original description was based on febrile illnesses observed among abattoir workers in Queensland, Australia,2 and for some years the disease was recognized only in that area. Since 1944, however, the disease has been identified in Mediterranean Europe and Africa, in France, Germany, Switzerland, Rumania and England; in the Western Hemisphere, Q fever has been reported from Panama and several parts of the United States. Prior to 1946 the only authenticated instance of naturally acquired Q fever in the United States was that reported by Hesdorffer and Duffalo3 in 1941. In 1946 there occurred two large outbreaks of Q fever among workers in meat-packing houses; one outbreak, involving 55 persons, occurred in Amarillo, Texas,4 the other, involving 33 persons, occurred in Chicago.5 In May 1947, Q fever was identified in California in

Falk, Abraham; Ebert, Richard V.

doi: 10.1001/jama.1951.02920230034007pmid: 14794442

The use of streptomycin in all forms of tuberculosis has been the subject of a clinical study by the Veterans Administration since 1946. During that period streptomycin was used in all clinically recognized cases of tuberculous pericarditis at the hospitals engaged in this study, but results have not been published. Analysis of the clinical data forms the basis of this report. The onset of pericarditis in many of these patients occurred during hospitalization for pulmonary tuberculosis, and in the others hospital admission was secured soon after onset. CRITERIA FOR SELECTION OF CASES Twenty-five cases of proved or presumptive tuberculous pericarditis treated with streptomycin were reviewed. Criteria adequate for the diagnosis of pericarditis and proof of its tuberculous etiology were established, in order that cases of uncertain causation might be eliminated. The diagnosis of pericarditis in this study was not made unless fluid was obtained by pericardial aspiration or histological proof

Siddall, A. C.

doi: 10.1001/jama.1951.02920230038008pmid: 14794443

This report presents the results of a program of cancer detection in rural practice. Sixteen hundred and fifty examinations have been carried out on 950 presumably well women over a period of six years, and 13 malignant growths have been found. The first cancer detection clinic in this country was established in 1937,1 and today approximately 240 detection centers are in operation.2 The Lorain County Medical Society of Ohio fell in line with this movement and opened a detection center in Elyria in 1946 along with a diagnostic clinic in Lorain. For various reasons the county medical society discontinued the Elyria detection center one year ago and, instead, sponsored a program to make every physician's office a cancer detection center. The local cancer committee was to continue with its program of education and publicity. To date 42 members of the county society have signified their willingness to cooperate

Dagradi, Angelo E.; Sollod, Norman; Friedlander, Jackson H.

doi: 10.1001/jama.1951.72920230001009pmid: 14794444

Cooley and Lee in 19251 called attention to a blood dyscrasia occurring in children and characterized by anemia, splenomegaly and the occurrence of peculiar, roentgenologically demonstrable bone changes. It was originally believed that this disease was almost uniformly fatal before the age of 12 years,2 but the gradual accumulation of knowledge on the subject brought with it a realization that various degrees of severity of the condition existed,3 ranging from the mild and asymptomatic to the severe and fatal. A "minor" and a "major"4 form of the disease were therefore recognized, and it was further demonstrated that the "minor" form was much more prevalent than the more familiar, severe, form.5 Persons with the "minor" form of the malady were shown to constitute the reservoir of genetic carriers who perpetuated the serious form of the disease,6 and the term "trait" became synonymous with the "minor"

Godfrey, Lincoln

doi: 10.1001/jama.1951.72920230002009apmid: 14794445

The remarkable results that Hench and his colleagues1 and subsequently others have obtained in rheumatoid arthritis using cortisone and pituitary adrenocorticotropic hormone (ACTH) have led to the search for other compounds which are more readily available and could produce comparable results. Carlström and Lövgren2 reported good results in rheumatoid arthritis with the administration of adenosinetriphosphate. Favorable responses occurred within five to 10 days after therapy was begun in the majority of their patients. This rapidity of response with adenosinetriphosphate, in comparison with the slow response of patients treated with gold compounds or other conventional methods, suggested that adenosinetriphosphate influenced the disease in a manner comparable to that of cortisone and pituitary adrenocorticotropic hormone. Adenosinetriphosphate is a high energy phosphate compound occurring naturally in the body, of great importance in the intermediary metabolism of dextrose. There have been a few scattered reports in the literature of its use in