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Violence among adolescent boys in impoverished urban areas is a major public health problem. We assessed violence-related attitudes and beliefs and exposures among 29 delinquent, 22 truant and 12 dependent of the state adolescent boys who attended an urban publicly funded extended day program. One purpose of this study was to assess violence related factors among truant boys as much is unknown about violence in this population. Another objective was to compare truant and dependent boys with delinquent boys to identify violence-related factors distinguishing aggressive/destructive boys from boys with social adjustment problems but who are not aggressive/destructive. All three groups of boys had high exposure to community violence, delinquent friends and anti-social attitudes and beliefs about violence with the highest levels found among delinquents. Absence of a caring adult was pervasive among all groups and highest among delinquents (91% vs. 83%, p = .04), and urgently needs to be addressed. KEYWORDS Adolescent boys, attachment, attitudes/beliefs about violence, caring, delinquency, dependent of the state boys, exposure to violence, truancy, violence

The drug alprazolam appears to be more effective than oral progesterone in reducing premenstrual syndrome (PMS) symptoms. PMS symptoms include mood swings, irritability, mental confusion, depression, breast tenderness and cramps. In a three month treatment study, 170 women received either oral progesterone, alprazolam or placebo on the 18th day of the menstrual cycle extending to day two of the cycle. Thirty-seven percent of the women treated with alprazolam showed a 50% improvement in daily symptom reports. Alprazolam was most effective in improving pain, mood and mental functioning. Progesterone was no more effective than placebo in treating PMS., Objective. - To determine the effectiveness of oral micronized progesterone, alprazolam, and placebo in premenstrual syndrome (PMS) treatment and the effect of clinical contact on treatment responses. Design. - Randomized, double-blind, placebo-controlled 3-month parallel treatment arms with flexible dosage and with the length of clinical contact randomized within each treatment group. Setting. - University hospItal PMS medical treatment outpatient program in obstetrics/gynecology department. Subjects. - Among volunteers for PMS treatment, 444 were evaluated and 185 meeting defined PMS criteria were randomized to treatment; treatment data are available for 170. There were no medical withdrawals for adverse events. Intervention. - A double-blinded protocol in which 300 mg of oral micronized progesterone, 0.25 mg of alprazolam, or placebo was administered four times a day from day 18 of the menstrual cycle through day 2 of the next cycle, including taper. The mean daily dose at the third treatment was 1760 mg of progesterone or 1.5 mg of alprazolam. Subjects were randomized to brief (< 20 minutes) or extended (50 minutes) visits. Main Outcome Measures. - Daily symptom report (DSR) scored for total DSR symptoms, four DSR factors. Results. - Alprazolam was significantly better than placebo or progesterone for total premenstrual symptoms and DSR factors of mental function, pain, and mood. Thirty-seven percent of the alprazolam group experienced a 50% reduction in total DSR scores. There were no clinically significant withdrawal symptoms when alprazolam administration was restricted to the luteal phase. Oral micronized progesterone therapy was no better than placebo. Brief vs extended visits had no effect on treatment outcome. Treatment response was associated with severity of premenstrual symptoms at baseline but with no other diagnostic variables. Conclusions. - Alprazolam has a role in PMS treatment and offers a therapy limited to the luteal phase. Oral micronized progesterone is ineffective for PMS. (JAMA. 1995;274:51-57)

Asthma patients who live in impoverished urban areas may be more likely to die of asthma than persons living in rural areas or persons of other socioeconomic groups. A study of death rates due to asthma in Philadelphia during the years 1969 to 1991 found that the death rates have risen since 1978 even though the levels of air pollution have decreased. Outdoor allergens may not be the only factors that make asthma worse. Indoor conditions such as overcrowding, which may promote respiratory tract illnesses, may create asthmatic conditions among poor, urban residents. Census tract areas with greater numbers of blacks and Hispanics had higher rates of death from asthma than did areas with mostly white residents. Blacks and Hispanics typically receive less regular medical care than whites, and regular medical care may be necessary to control asthma. The average age of persons who died of asthma in Philadelphia from 1985 to 1991 was 54.

A canine model is employed to assess the differential participation of the left and right vagus nerves. The sinus node (SN) and atrioventricular (AV) nodes reveal negative chronotropic and dromotropic movements, which are influenced by the vagus nerves. The automaticity of SN and the nodal conduction of AV are controlled by ATP. The reactions are influenced by aminophylline. The negative chronotropic reaction of ATP in SN is prevented by the right vagus nerve.

Premenstrual syndrome (PMS) is a constellation of emotional, behavioral, and physical symptoms that intensify prior to the onset of menstruation, reaching a level that interferes with a woman's normal functioning. Many of the approximately seven million women with PMS receive progesterone (a hormone), but the effectiveness of progesterone vaginal suppositories has not been evaluated in a large, randomized, controlled trial. To this end, 121 carefully screened women with PMS received both progesterone and an inert placebo in suppository form, according to a study design in which each woman used placebo and progesterone, each for two consecutive menstrual cycles. During the second cycle for each treatment, two suppositories were used, doubling the dose of progesterone. The suppositories were used between days 16 and 28 of a standard cycle. Treatment effectiveness was evaluated by daily symptom reports (DSRs) maintained by the subjects, in addition to several other clinical and patient-reported measures. The DSR included 17 symptoms associated with PMS. The average duration of PMS symptoms was 7.9 years, and 73 percent of the patients had a history of mental illness. No differences in DSR scores, or any other measure used, were found between the placebo and progesterone treatments. These results are consistent with those in other published reports, and the larger sample size further enhances their credibility. There appears to be insufficient therapeutic effect to justify use of progesterone vaginal suppositories for treating PMS. (Consumer Summary produced by Reliance Medical Information, Inc.)