

Am Fam Physician. 2006 Aug 1;74(3):420-6.
Lynchburg Family Medicine Residency, Virginia, USA. david.gregory@centrahealth.com
Comment in:
Bordetella pertussis is a highly contagious bacterium known to cause pertussis (whooping cough) and is transmitted via airborne droplets. Although childhood vaccination has dramatically reduced reported pertussis cases, the incidence of the disease has increased over the past 20 years, most notably in previously immunized adolescents and adults. Pertussis should be suspected in patients of all ages with cough who meet the clinical criteria for the disease. Diagnostic tests currently approved by the U.S. Food and Drug Administration for pertussis infection have low sensitivity. Regardless of test results, physicians should treat clinically suspected pertussis with antimicrobials and report cases to their state health department. A 14-day erythromycin regimen has been the treatment of choice; however, shorter-course macrolide antibiotics (e.g., azithromycin, clarithromycin) may be as effective with fewer adverse effects and better adherence to therapy. The recently recommended tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine for adolescents and adults may decrease the incidence of pertussis in infants--the group at the greatest risk of pertussis complications.
Curr Hypertens Rep. 2010 Jun;12(3):189-95.
Vascular Biology and Hypertension Program, Sleep/Wake Disorders Center, University of Alabama at Birmingham, 430 BMR2, 1530 3rd Avenue South, Birmingham, AL 35294-2180, USA. dcalhoun@uab.edu
Obstructive sleep apnea (OSA) and hypertension commonly coexist. Observational studies indicate that untreated OSA is associated with an increased risk of prevalent hypertension, whereas prospective studies of normotensive cohorts suggest that OSA may increase the risk of incident hypertension. Randomized evaluations of continuous positive airway pressure (CPAP) indicate an overall modest effect on blood pressure. However, these studies do indicate a wide variation in the blood pressure effects of CPAP, with some patients, on an individual basis, manifesting a large antihypertensive benefit. OSA is particularly common in patients with resistant hypertension. The reason for this high prevalence of OSA is not fully explained, but data from our laboratory suggest that it may be related to the high occurrence of hyperaldosteronism in patients with resistant hypertension. We hypothesize
Ameet Kishore had worked as an ear, nose and throat consultant in Glasgow Royal Infirmary for 12 years when he moved to the Apollo hospital in Delhi two years ago. Although reluctant to criticise the NHS, which had taught him so much, he said that the new Indian hospitals were cleaner and better resourced.
He contrasted the number of cochlear implant operations that he could perform: at Crosshouse hospital, Kilmarnock, the main ENT centre for the west of Scotland, he was limited to 40 a year; in Delhi he had done 70 in the past six months.