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BACKGROUND: The news media are an important source of information about new medical treatments, but there is concern that some coverage may be inaccurate and overly enthusiastic. METHODS: We studied coverage by U.S. news media of the benefits and risks of three medications that are used to prevent major diseases. The medications were pravastatin, a cholesterol-lowering drug for the prevention of cardiovascular disease; alendronate, a bisphosphonate for the treatment and prevention of osteoporosis; and aspirin, which is used for the prevention of cardiovascular disease. We analyzed a systematic probability sample of 180 newspaper articles (60 for each drug) and 27 television reports that appeared between 1994 and 1998. RESULTS: Of the 207 stories, 83 (40 percent) did not report benefits quantitatively. Of the 124 that did, 103 (83 percent) reported relative benefits only, 3 (2 percent) absolute benefits only, and 18 (15 percent) both absolute and relative benefits. Of the 207 stories, 98 (47 percent) mentioned potential harm to patients, and only 63 (30 percent) mentioned costs. Of the 170 stories citing an expert or a scientific study, 85 (50 percent) cited at least one expert or study with a financial tie to a manufacturer of the drug that had been disclosed in the scientific literature. These ties were disclosed in only 33 (39 percent) of the 85 stories. CONCLUSIONS: News-media stories about medications may include inadequate or incomplete information about the benefits, risks, and costs of the drugs as well as the financial ties between study groups or experts and pharmaceutical manufacturers.

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Emerging evidence suggests that media coverage of medicine is increasingly promotional in nature. Recent Australian examples include misleading newspaper articles on an experimental cancer vaccine and a high profile television current affairs segment on a new influenza drug, which failed to disclose the industry ties of a key expert featured in the report. There are widening concerns that this problem in medical journalism may be exacerbated by the growing commercialisation of medical and scientific research, and the increasing ties between researchers, doctors and pharmaceutical or biotechnology companies. Closer links between industry and medicine are being explicitly encouraged both in academia and the health care sector for the mutual benefits they bring. However, these partnerships are the cause of growing unease within medicine. In the United States, rigorous legislation governing research protocols is being proposed, and in Australia new ethical guidelines covering industry-profession relationships are being promulgated. If one of the media's roles is informing the community about the business of health and medicine in a fair and accurate way, a cultural change in medical journalism is required.

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Thirty term infants undergoing general anesthesia and pyloromyotomy had pre- and postoperative sleep studies to determine whether these infants were at risk for postoperative apnea. Sleep studies showed an improved respiratory disturbance index (RDI) after surgery. Postoperatively, apnea indices were lower and lowest oxygen saturation values were increased compared to the infants' preoperative status. We conclude that pyloromyotomy does not elicit postoperative apnea in term infants.

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BACKGROUND: The use of cricoid pressure for the possible prevention of regurgitation of gastric contents during induction of anesthesia in both adults and children has been recommended. However, equally important is the technique in possibly preventing insufflation of gas into the stomach. This study was designed to determine the efficacy of cricoid pressure application in preventing gastric gas insufflation in pediatric patients and to determine the airway pressure at which gas entered the stomach (pop-off point). METHODS: Fifty-nine patients, 2 weeks to 8 yr of age, physical status 1-4, scheduled for elective surgery, received an inhalational induction of anesthesia with halothane, N2O, and O2. A single observer used a stethoscope to auscultate over the upper abdomen for any air entry. In study I (without paralysis), the proximal airway pressure was slowly increased by gradually closing the pop-off valve on the anesthesia machine until gas was heard entering the stomach (pop-off point) or until the peak inspiratory pressure (PIP) reached 40 cm H2O. Thereafter, the pressurization procedure was repeated three times, altering the application and removal of cricoid pressure. The same patients were then paralyzed (study II), and the stomach evacuated before commencing an identical pressurization sequence with and without cricoid pressure. RESULTS: Appropriately applied cricoid pressure was 100% effective in preventing gas insufflation into the stomach of all children up to 40 cm H2O PIP with and without paralysis. In addition, paralysis significantly decreased the median pop-off point in any given patient. CONCLUSIONS: Appropriate application of cricoid pressure prevents gastric gas insufflation during airway management via mask up to 40 cm H2O PIP in infants and children. An additional benefit of cricoid pressure occurs in paralyzed patients in whom gastric insufflation occurs at lower inflation pressures.

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Clinical data on all non-hemophiliac adult cases of transfusion-induced HIV infection (TI-HIV) referred for treatment to the Infectious Disease Service at Memorial Sloan-Kettering Cancer Center between 1987 to 1989 (N = 20) provided an opportunity to investigate the social and psychological impact of transfusion-induced HIV-infection. The specific psychosocial issues presented by this population which relate to the circumstances of their infection (i.e., blood transfusions) include: coping with personal feelings of victimization, sadness, anger, and isolation; decision-making concerning medical treatment; and re-building trust in relationships with medical care professionals. Counseling interventions with this population are described.

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Although a substantial number of children experience serious parental illness and death, the adjustment problems attendant to the stress of having a fatally ill parent have not been examined systematically. This paper compares the psychosocial adjustment of 62 school-aged children with a terminally ill parent (study sample) with that of children in a community sample, using several standard rating scales. Study children had significantly higher levels of self-reported depression (Children's Depression Inventory) and anxiety (State-Trait Anxiety Inventory) and lower self-esteem (Self-Esteem Inventory). Parents also reported study children's significantly higher behavior problems and lower social competence (Child Behavior Checklist). Increased professional attention to this vulnerable population is encouraged.

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The authors discuss the specific social and psychological tasks that confront individuals who are dying with AIDS. The young age of the patient, the nature of the disease process, and the social context in which the death occurs profoundly affect the patients' experience.

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