Three separate episodes of acute pulmonary edema are described that developed in two otherwise healthy individuals during heavy exertion at high altitudes. Detailed physical examination and laboratory studies failed to demonstrate pulmonary infection or cardiac disease. Data obtained by cardiac catheterization during one of these episodes revealed elevation of the pulmonary artery pressure and a normal left atrial pressure. This syndrome appears to be the consequence of pulmonary vascular obstruction distal to the capillary bed, presumably in the pulmonary veins. It is brought about by exposure of susceptible individuals to high altitudes, and is completely reversed by oxygen administration.

No abstract

Twenty-four percent of bed-days were occupied by patients whose discharge from hospital was delayed for social or geriatric reasons in a bed-usage survey carried out on surgical patients during a three-month period of 1973. By early social assessment with the regular help of a medical social worker it was possible to reduce such delays to 16% in a similar study during the same period of 1974. The at-risk patients were the elderly admitted as an emergency and the present policy contributed particularly to the overall care of this group.

No abstract

Phenylbutazone (Butazolidin®), introduced into clinical usage in 1952 as an antirheumatic agent in gout, rheumatoid arthritis and other periarticular diseases, has gained widespread usage among adults, and a report of its accidental ingestion by a 2-year-old infant may therefore be of interest. On March 8, 1955, during a period of parental strife, a 24-month-old female infant was left alone at home with a 39-month-old sibling. At 9:30 A.M. she was discovered to have ingested 2 or 3 tablets of aspirin and phenacetin, and a small bottle of cough syrup, containing no potentially toxic or systemically active ingredients.