Examined the moderating effects of risk status on the impact of home intervention in a follow-up study of children with failure-to-thrive (FTT). Two types of risk (demographic and maternal negative affectivity) and two levels of intervention were examined. In this randomized clinical trial, all children received services in a multidisciplinary growth and nutrition clinic, and half the children also received home visits from a lay home visitor for 1 year. There were no effects of demographic risk, maternal negative affectivity, or intervention status on child outcome at the close of the home intervention. However, at age 4, more than 1 year after the home intervention ended, there were effects of the home intervention on motor development among all children and on cognitive development and behavior during play among children of mothers who reported low levels of negative affectivity. Results highlight the importance of conducting follow-up assessments in the evaluation of home intervention services, and suggest that among low-SES families of children with FTT, home intervention may be most useful among mothers with low negative affectivity.

PPC can be an effective treatment for refractory pemphigus but its adverse effects should be considered prior to therapy and closely monitored in patients on treatment.

Mefloquine is a relatively new antimalarial drug which has been associated with a wide variety of adverse effects, including skin reactions. In order to evaluate the range and frequency of mefloquine's dermatological effects, we searched the scientific literature for published case reports of such effects. We found 74 case reports, published between the years 1983 and 1997. Pruritus and maculopapular rash are the dermatological effects most commonly associated with mefloquine: their approximate frequency is 4-10% for pruritus, and up to 30% for nonspecific maculopapular rash. Adverse effects associated less commonly with mefloquine include urticaria, facial lesions and cutaneous vasculitis. One case of Stevens-Johnson syndrome and one fatal case of toxic epidermal necrolysis occurred. Appropriate primary studies of mefloquine use should be carried out to elucidate the epidemiology and aetiology of dermatological and other adverse effects of the drug.

Twelve cases of myocardial infarction as related to strenuous exertion are presented with the pathological findings in several of these cases. Three cases with coronary arteriography are also presented. The pathology of coronary arteriosclerotic plaques and the vulnerability to acute injury is reviewed and discussed. It is concluded that strenuous exertion can cause acute injury to coronary artery plaques due to the unusual stressful whip-like action to which coronary arteries are subject. These injuries may initiate as cracks in the plaques or subintimal hemorrhages and proceed to coronary occlusion and ultimate myocardial infarction. With this concept in mind we use the term of "crack in the plaque" (Black's Crack in the Plaque) to account for the sudden appearance of clinical coronary artery disease appearing during or shortly after exertion, or other stressful situations in patients without previous existing evidence of clinical coronary artery disease. This could also account for exacerbation of symptoms or death occurring after exertion in previously quiescent asymptomatic known coronary artery disease subjects. This concept may explain some of the puzzling features of coronary disease.

Summary This report gives an account of nine patients, all females, with the histological finding of eosinophilic spongiosis. Six of them had positive intercellular antibodies on direct immunofluorescence but only two had circulating pemphigus antibodies. The clinical presentations of those with proven pemphigus resembled bullous pemphigoid in one, dermatitis herpetiformis in another, whereas the remainder were more typical of pemphigus foliaceus or vulgaris. Three patients had negative immunofluorescence. They may still develop pemphigus or alternatively could have some unclassifiable bullous dermatosis.