Central venous oxygen saturation (CVSO2) was measured in 31 patients with myocardial infarction. CVSO2 correlated well with the patients' clinical course. In those patients not in heart failure, mean + SEM for CVSO2 was 70 + 1%. When heart failure was present, CVSO2 averaged 56 + 1%. When both heart failure and shock were present, CVSO2 averaged 43 + 1%. In nine patients, serial determinations of arterial oxygen saturation and CVSO2 were made. In 22 of 26 instances, either a fall in CVSO2, was accompanied by an increase in the arteriovenous oxygen saturation difference or an increase in CVSO2 was accompanied by a decrease in arteriovenous oxygen saturation difference. Serial measurements of CVSO2 appear to be a useful method of monitoring changes in myocardial function in patients with myocardial infarction.Additional Indexing Words: Mixed venous oxygen saturation Central venous pressure MEASUREMENT of cardiac output and intracardiac pressures is used to assess myocardial function in the catheterization laboratory.

Objective. To determine the efficacy of simethicone in the treatment of infant colic. Design. Randomized, double blind, placebo-controlled. Setting. Three general pediatric practices in distinct geographic regions. Patients. Eighty-three infants between 2 and 8 weeks of age with infant colic. Interventions. Treatment with simethicone and placebo in double blind crossover fashion. Results. A total of 166 treatment periods, ranging from 3 to 10 days, were evaluated in the 83 infants. Compared to baseline, improvement in symptoms was reported for 54% of the treatment periods, worsening was reported for 22%, and, for 24%, there was no change. The likelihood of the treatment period being rated as showing improvement, worsening, or no change was the same whether the infant was receiving placebo or simethicone. Twenty-eight percent of he infants responded only to simethicone, 37% only to placebo, and 20% responded to both. No statistically significant differences were noted among these three groups of responders. No difference could be shown even when infants with "gas-related symptoms" (by parental report) were separated out as a group. Conclusion. Although both produced perceived improvements in symptoms, simethicone is no more effective than placebo in the treatment of infantile colic.

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The purpose of this study was to investigate the current incidence of circumcision, the reasons governing parental decisions regarding circumcision, the immediate and later complications from the procedure, as well as genital problems occurring in uncircumcised boys. The incidence of circumcision was found not to have changed over the past five years despite the recommendations of the American Academy of Pediatrics Task Force on Circumcision. The reasons given for circumcision reflected mostly the strength of tradition, rather than a medical approach. Four per cent of newborns experienced early complications from the procedure, whereas 13 per cent experienced later, minor complications. Problems reported in uncircumcised infants were probably variants of normal. While the results of this study and evidence for discontinuing neonatal circumcision, we strongly recommend that, if physicians dissuade parents from having their infants circumcised, they must give adequate information concerning hygiene and the slow, natural separation of the foreskin from the glans.

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