Infants with a first episode of wheezing diagnosed as bronchiolitis are often treated with oral dexamethasone. In this trial, children with bronchiolitis and no history of asthma received oral dexamethasone or placebo. There were no clinically significant differences in outcomes between the two groups.

This article summarizes the experience of a single institution in treating patients with metastatic testicular tumors that did not respond to cisplatin-based chemotherapy. High-dose chemotherapy with hematopoietic stem-cell rescue was potentially curative in such cases.

A cohort of 201 patients with type B acute aortic dissection was classified according to whether the false lumen of the aorta was patent, partially thrombosed, or completely thrombosed. Patients with partial thrombosis had a significantly higher mortality rate at 3 years.

In this clinical trial, rofecoxib (25 mg per day) was studied in the prevention of recurrent colorectal cancer. Although the median duration of study treatment was only 7.4 months, rofecoxib therapy was associated with an increased risk of cardiovascular adverse events (relative risk as compared with placebo, 2.66; P=0.04). The results indicate that even short-term treatment with rofecoxib may result in cardiovascular toxicity.

This article, which describes the person-to-person spread of obesity as a potential contributing factor in the U.S. obesity epidemic, analyzes a densely interconnected social network, using repeated assessments performed from 1971 to 2003 as part of the Framingham Heart Study. Social-network phenomena seem relevant to obesity, which appears to spread through social ties.

A 37-year-old man presents with localized swelling and tenderness of the left leg just below the knee; he suspects a spider bite. Examination shows a 5-by-7-cm area of erythema and warmth. A small area of necrotic skin covers a central, fluctuant 2-by-2-cm area. The temperature is 38.3°C, the pulse rate 115 beats per minute, and the blood pressure 116/78 mm Hg.

A 9-year-old boy with autism was admitted to the hospital because of pain in the hip, rash, and swelling of the gingiva. Three months earlier, pain in his right hip developed, and he eventually refused to walk. Physical examination disclosed no joint swelling, and radiographs of the pelvis and spine were normal. Indomethacin was prescribed; the pain improved, but a petechial rash on the legs and gingival swelling developed.

The Abigail Alliance for Better Access to Developmental Drugs sued the FDA, objecting to its policy prohibiting the sale of unapproved drugs and arguing that terminally ill patients with cancer should have access to experimental treatments after phase 1 studies. The author discusses this case and explains why he thinks a ruling in favor of the Abigail Alliance is unlikely.

Providing positive-pressure ventilation with a face mask and a bag-valve device can be a lifesaving maneuver. Although seemingly simple, the technique requires an understanding of the airway anatomy, the equipment, and the indications. This video demonstrates the equipment and technique used to provide positive-pressure ventilation with a face mask and a bag-valve device.