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Two-year-olds were videotaped while engaged in free play and problem-solving play. The periods in which they were actively manipulating objects were analyzed as to level of engagement, distinguishing between periods of intense engagement, in which the children were concentrating on the nonverbal activity, and periods of casual engagement, in which they conducted the nonverbal activity in a more leisurely fashion. A micro-analysis of the children's spontaneous speech revealed that they spoke less at moments of intense engagement than at moments of casual engagement. These and other findings are taken as support for the hypothesis that when toddlers invest cognitive effort in nonverbal behavior, there is a reduction in mental resources available for speech.

The authors evaluated a new venous access port designed for peripheral venous insertion in the interventional radiology suite. Forty ports were placed in 40 patients in either the brachial, cephalic, or basilic vein under fluoroscopic guidance. These ports have been used for blood transfusion, blood sampling, parenteral nutrition, chemotherapy, and antibiotic therapy. The ports have been in use for 4,241 consecutive patients days. There have been no clinically apparent venous thrombotic complications and only one device-related infection. The cost and risk of complication are less than those for a surgically placed chest wall port, and the cosmetic result is excellent. This port has had excellent patient, nursing, and clinical acceptance.

A cost-benefit study for hepatitis B vaccination in Venezuelan hospital workers was performed through a decision tree analysis model, which includes the probabilities for the different outcomes of the hepatitis B virus infection (HBV). The current average cost of HBV infection to the Venezuelan Government was estimated at US$ 1,759 per patient. Implementation of selective vaccination or a mass vaccination campaign for the hospital workers would reduce the total cost of HBV infection to 51% or 28%, respectively, saving $17 to $26 million. This type of economic analysis may influence the distribution of the resources to be allocated for the control of HBV infection in Venezuela.

Cecal diverticulitis is a relatively rare disease, which closely mimics the picture of acute appendicitis. At times it is difficult to differentiate from carcinoma. Five cases of cecal diverticulitis are reported, with a discussion of some salient features of this condition. Although two cases were treated with a right hemicolectomy, a plea for conservatism in the treatment of this disease is made.

The effect of phenothiazine antipsychotic drugs on acid secretion was investigated in the isolated toad gastric mucosa. The acid secretory responses induced by maximal doses of histamine, carbachol and theophylline were all inhibited in a similar fashion by chlorpromazine. The ID50 was between 300 and 600 microM. Histamine-stimulated H+ secretion was also inhibited by trifluoperazine. Soluble cyclic AMP-dependent protein kinase activity was not significantly affected by 300 microM chlorpromazine. Microsomal (H+ + K+)-ATPase activity was significantly reduced by chlorpromazine. The results indicate that phenothiazines can inhibit acid secretion in the toad gastric mucosa and that inhibition of the gastric (H+ + K+)-ATPase may be involved in the mechanism of action.