Temporary Pacing in Complete Heart Block due to Lyme Disease: A Case Report

The authors present the case of a 44-year-old man who was admitted with complete heart block and signs of severe bradycardia. After steroid administration and temporary pacemaker treatment the complete heart block resolved. During this therapy transient ST segment and T wave abnormalities occurred. The positive Borrelia burgdorferi antibody titer arrived only after therapy had been completed. This is regarded as the first case of Lyme carditis with complete heart block diagnosed in eastern Europe. Carditis resolved without antibiotic treatment and has not recurred.     

The Value of Undergraduate Electives for Recruitment in Psychiatric and Mental Health Nursing

The current nursing shortage has focused attention upon the need for the recruitment and retention of nursing students, as well as practitioners, to increase the available supply of nurses. Specialties such as psychiatric nursing which historically have not attracted a large percentage of graduates are at particular risk for nurse shortages. The nursing Literature of the past 15 years has demonstrated that undergraduate electives have served to interest students in particular areas of nursing. The experience of one baccalaureate nursing program which used a grant to institute electives for recruitment into employment and graduate study is described in this article.     

Choosing an Antibiotic

This article marks the beginning of a regular feature in the Journal. "Pharmacologic Highlights" will provide information an the latest in pharmacologic intervention, as well as stressing the importance of appropriate use of "tried and true" standard pharmacologic products. Reader input is most welcome. If you have suggestions for topics to be covered in this column or wish to contribute to this column, please contact Column Editor Margaret Fitzgerald (Simmons College, C-216, 300 The Fenway, Boston, MA 02115-5898).     

Research on infertility: definition makes a difference. The Cancer and Steroid Hormone Study Group

Although different definitions of infertility are used, research findings based on various definitions have not been systematically compared. To contrast the impact of five definitions of infertility on research findings, the authors analyzed data from the control group (randomly selected US women aged 20-54 years) of the Cancer and Steroid Hormone Study (1980-1983). For all definitions, an absence of recognized conception was the outcome of interest. Specifically, the authors examined the effect of various definitions of infertility on demographic characteristics of women classified as infertile, prevalence of a history of infertility, age at infertility classification, and cumulative incidence of conception after infertility classification. Results indicated that women classified as infertile by definitions based on unprotected intercourse for 12 months and unprotected intercourse for 24 months were more likely to be black, less educated, and classified as infertile at younger or older ages that women classified by alternative definitions. The prevalence of a history of infertility ranged from 6.1% (physician diagnosis) to 32.6% (unprotected intercourse for 12 months). For the definitions based on unprotected intercourse for 12/24 months and for physician diagnosis, the cumulative incidence of conception by greater than 120 months after infertility classification was 86.3%, 76.7%, and 75.4%, respectively. The authors conclude that the definition of infertility has an impact on research findings related to which and how many women are classified as infertile, the age at infertility classification, and the probability of future conception.