Search

A young female with cerebral and left arm symptoms from the congenital subclavian steal syndrome is presented. Surgical correction was performed using an axillary-axillary bypass. Pre-operative noninvasive vascular evaluation demonstrated reversal of flow in the left carotid artery which was corrected postoperatively. There was complete relief of symptoms and equal upper extremity blood pressure. This report represents the first instance in which this extremely rare congenital disorder was fully evaluated with noninvasive vascular techniques, and the first to be treated with an extra-anatomical surgical approach.

Ibuprofen is a nonsteroidal drug with analgesic, antipyretic, and anti-inflammatory properties that was recently introduced for use in antiarthritis therapy in the United States. In a year-long double-blind multiclinic trial in 885 patients with rheumatoid arthritis, ibuprofen was at least as satisfactory as aspirin, considering both efficacy and tolerance. In the majority of patients, daily doses ranged from 800 to 1,600 mg of ibuprofen and 3 to 6 gm of aspirin. The drugs did not differ greatly in providing relief from arthritis symptoms, but ibuprofen was definitely better tolerated, especially in regard to gastrointestinal complaints. Seven percent of the ibuprofen group dropped out of the study because of adverse reactions, as compared with 16% of the aspirin group; 17% of the ibuprofen group and 31% of the aspirin group had gastrointestinal symptoms.

Recent decades have seen important changes in the objectives, techniques and methodologies of economic history in Europe. Early modern history, the age of the modern state, has traditionally been for economic historians the age of the mercantilist state and economy. The concept of mercantilism, a complex of ideas and policies designed to achieve national power and, ostensibly, wealth, has long been a source of controversy amongst historians. In recent economic historiography it is the village, or region, or continent which has tended to become the 'sites' most appropriate to the techniques and objectives of historians trying to fit together the diverse elements in particular socio-economic historical situations. This chapter reviews new techniques that have been used to help explain the growth or decline of national economies, very successfully in the case of the Dutch Republic, the economic prodigy of Europe from the 1590s, and of seventeenth-century France; partially in the case of Spain.

SUPPURATIVE arthritis remains a relatively frequent form of joint disease despite the introduction of antibacterial agents. Chartier et al 1 of the Mayo Clinic covered the period from 1939 to 1957 and reported 77 cases of suppurative arthritis. Ward et al 2 from the Massachusetts General Hospital concentrated on the ten-year period from 1954 to 1964, reporting a total of 24 cases. Our interest in suppurative arthritis began in January 1960, and from then until 1964 we have observed 42 cases of infectious arthritis at the three universityaffiliated hospitals in the Buffalo area. Case Material Cases of infectious arthritis due to gonococcus, meningococcus, fungi, or tuberculosis were excluded on the basis that these represented specific diseases. Also, cases of pyogenic joint infection from osteomyelitis, penetrating wounds, or by extension were excluded. These were considered different problems from ordinary septic arthritis because of the nature of the cause. As a result