Local facial cutaneous vasoconstriction: an unusual complication of inhaled racemic epinephrine in a neonate.

A term infant treated for post-extubation stridor with nebulized racemic epinephrine developed localized facial blanching due to cutaneous absorption of the aerosolized vasoconstrictor. Local application of heat restored circulation to the afflicted area. This complication of a commonly used medication is not previously reported in the medical literature and has the potential for severe sequelae.

Founding physicks: the lives and times of the physician signers of the Charters of Freedom.

The Declaration of Independence had 56 signers, four of whom were physicians. The constitutional convention in 1787 had 55 delegates and 39 of them signed the Constitution. Three of these delegates were physicians and two signed the document. The Bill of Rights was a product of the first Federal Congress and three of its members were physicians. This paper presents a biographic outline of these physicians and their contributions to society, within a context of contemporary medicine during the first 25 years of the USA.

Indomethacin-associated neutropenia with subsequent Gram-negative sepsis in a preterm infant. Cause or coincidence?

A preterm male infant with a patent ductus arteriosus developed neutropenia during treatment with indomethacin. Afterward, the mother described her own history of indomethacin-associated neutropenia. During the recovery from the neutropenia, the infant became septic with bacteremia caused by Enterobacter cloacae. Although indomethacin-related neutropenia has been described in adults, no case in a neonate has been reported. If neutropenia occurs after indomethacin therapy in a neonate, a familial history of indomethacin-associated neutropenia should be sought and the increased risk of infection should be considered.

Urinary effects of morphine in preterm infants.

AIM: To describe the association between morphine administration in preterm infants, hydronephrosis, and renal dysfunction. METHODS: The findings were based on serial ultrasound examinations and blood studies. RESULTS: Two preterm infants had bladder distension and hydronephrosis after they received intravenous morphine for analgesia. Morphine was used at a low dose. Each patient had a normal urine output and normal serum creatinine before the signs and symptoms of urinary retention were observed. Within 24 h of morphine administration, each infant concurrently developed oliguria and elevation of the serum creatinine. Cessation of morphine and urinary drainage resulted in rapid and complete resolution of the hydronephrosis and the elevated creatinine. CONCLUSION: Morphine, even at low dosages, can be associated with hydronephrosis in hospitalized preterm infants.