Blood flow velocity of the anterior cerebral artery was investigated by Doppler ultrasonography in five time intervals up to 20 min after birth in 16 non-asphyxiated very immature infants (median birth weight 1,058 g, range 720-1,930 g; median gestational age 30 weeks, range 27-32 weeks) delivered by caesarean section and intubated after birth. Heart frequency, oscillometric mean arterial blood pressure and blood gases were recorded as well. There was a transitory increase in both systolic and end-diastolic velocities (from 29 to 35 and from 1 to 10 cm/s) during the first 5 min after birth which occurred together with an increase in heart frequency. The overall incidence of intracranial haemorrhage was low (3/16, 19%). This observation study shows a transitory increase in cerebral blood flow velocity with a peak at about 5 min after birth in preterm infants < 33 weeks of gestation undergoing standard resuscitation.

In 16 fo 20 patients with treatment-resistant hypertension endralazine, combined with beta-receptor blockers and diuretics, significantly lowered mean arterial blood pressure from 198/112 mmHg to 148/88 mmHg. The initial dose of endralazine was 2.5 mg three times daily. After this the dosage was increased, at the three to six-day intervals according to antihypertensive action and side effects, to a maximum of 50 mg daily in steps of 5.0--7.5 mg per dose. - In a second series of eleven additional patients with treatment-resistant renal hypertension the blood-pressure lowering effect of hydralazine and minoxidil was compared in an open cross-over trial. The result was in favour of hydralazine. Sodium and water retention was slightly less marked with endralazine. Sleep disorders, increased frequency of feeling cold, moderately severe flushing with red checks and feeling hot occurred but rarely with endralazine and regressed during the period of observation.

A 60-year-old stonemason, suffering for many years from joint pains and exertional dyspnoea, developed a high fever with weight loss. Physical examination revealed reddening of light-exposed skin areas, fine rales and overly warm and reddened hand and knee joints. Abnormal laboratory findings were increased erythrocyte sedimentation rate of 66 mm/h, C-reactive protein concentration of 1 mg/dl, haemoglobin of 9.4 g/dl and white cell count of 3300/microliters. Urine contained albumin (100 mg/dl) and cylinders. Titres of both antinuclear and anti-ds-DNA antibodies were elevated (1:2560 and > 97 U/ml, respectively). The chest radiography showed enlarged hili, as well as reticular and nodular shadows which histologically showed silicosis. Systemic lupus erythematodes was diagnosed and the patient was treated with prednisone (2 mg/kg daily), the dosage being reduced to 12 mg daily within 3 months. When the joint pains recurred, azathioprine (50 mg daily) was added for 24 months. At present he is receiving prednisone (12 mg daily) and there has been no recurrence for 4 years.

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In a 34-year-old patient asthma had developed as an allergy to infection. He died suddenly from cardiac and respiratory arrest following parenteral penicillin and sulphonamides. At autopsy necrotizing angiitis of the myocardial vessels as well as eosinophilic myocarditis were shown. These findings are probably the expression of a drug allergy.