Modern information technologies and worldwide communication through the Internet promise both universal access to information and the globalization of the medico-social network's modes of communication between doctors, laboratories, patients, and other players. The authors, specialists in public health and members of an association that aims to create opportunities for access to training in public health in developing countries, warn that the use of the term "globalization" ignores the reality of the "digital divide," that is, the fact that social inequalities may preclude the realization of this promise on a truly global scale.

PoCUS examination appears to be a feasible technique for a rib fracture diagnosis in the ED.

A short cut review was carried to examine the evidence for the use of ultrasound in diagnosing pneumonia in paediatric patients. A literature search was performed that found one systematic review and meta-analysis based on eight papers and a further five relevant papers. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that lung ultrasound appears to have an acceptable sensitivity and specificity for the diagnosis of pneumonia in children when performed by an experienced sonographer.

Several fluoroquinolones currently under investigation or on the market potentially interact with theophylline. In this study, meta-analysis methodology was used to evaluate the significance of findings from quinolone-theophylline interaction studies. Two major databases were searched: Index Medicus (from 1986 to March 1990) and Current Content/Clinical Medicine (from 1985 to March 1990). A total of 32 studies were retrieved; 20 of these met the inclusion criteria. With a large effect size (ES) value of 2.26, enoxacin is the strongest inhibitor of theophylline metabolism of this family. The fail-safe N value was 135, indicating that 135 studies enrolling an average of 8 patients and showing no interaction (i.e., ES = 0) would be required to lower the ES to the threshold value of 0.1, which we considered a priori to render the results nonsignificant. Other fluoroquinolones showed a degree of interaction that can be considered significant: Ciprofloxacin (ES = 0.50, fail-safe N = 26), norfloxacin (ES = 0.31, fail-safe N = 10). Ofloxacin (ES = 0.13, fail-safe N = 4), lomefloxacin (ES = 0.12, fail-safe N = 2), and fleroxacin (ES = 0.06, fail-safe N = 2) provided the weakest evidence of interaction based on effect size and power. Among the fluoroquinolones studied, ofloxacin, lomefloxacin, and fleroxacin, when available, should be the fluoroquinolones of choice when the patient also is receiving theophylline.

Culex (subgenus Mochthogenes). (figs. 1, 2).In the subgenus Mochthogenes, only the pupa of Culex (M.) inconspicuosus, Theo., has been described.Since one of us (M.P.) has obtained the immature stages of all the known species, including C. (M.) castor, De M., we take advantage of this opportunity to give a key to the pupae. The pelts were all obtained from specimens bred in isolation at Yangambi, Belgian Congo, and the resulting adults identified by means of the male terminalia.The terminal hairs of the paddle appear to be absent in the pelt of C. (M.) castor, but this may be due to accident, although no scars are to be seen.KEY TO THE PUPAE.