World Trade, disease and Florida's animal populations. The changing dynamics.

One of Florida's three leading economic industries is agriculture. Agriculture feeds and enhances the lives of millions of people in Florida, the United States, and the entire world. Agriculture in Florida results in more than $6 billion in farm cash receipts, employment for more than 60,000 people a month, more than $18 billion in farm-related economic activity and stretches from the farm gate to the state's supermarkets with an impact of nearly $45 billion. The domestic and wild animal populations of Florida, our unique relationship to the Caribbean, Atlantic Ocean, Gulf of Mexico, Central and South America, as well as tourism, diverse human population growth and immigration, all add to the complexity of an environment capable of establishing many animals, animal pests and diseases not native to the United States. Never before have the dynamics of disease control involved as much challenge and diversity. Is the balance at risk, or is the risk over-balanced? Can science, economics and politics blend to maintain this balance? How will the balance affect world trade, disease control and the animal populations of Florida?

Fluoxetine in drug-dependent delinquents with major depression: an open trial.

Although fluoxetine might be more effective than placebo for treating adolescent depression without major comorbidity, little is known about the response of depressive symptoms to antidepressants in adolescents with comorbid conduct disorder (CD) and substance use disorders (SUD). Male adolescents, who remained or became depressed after > or = 1 month of abstinence from abused substances during residential treatment for SUD, were treated in an open trial for > or = 7 weeks with a fixed dose of 20 mg of fluoxetine. The eight adolescents (ages 14-18 years) with CD, SUD, and major depression were not in drug withdrawal or receiving other pharmacotherapy. A > or = 50% improvement was observed in mean scores on Ten Point Depression Scale rated by clinician (p < 0.01) and patients (p < 0.01), Carroll Self-Ratings for depression (p < 0.02), and Severity of Illness scores on the Clinical Global Impression (p < 0.01). Of the eight adolescents, seven showed marked improvement and wished to continue fluoxetine after the trial. Side effects were mild and transient. No subject required dosage reduction or discontinuation of medication because of side effects. Fluoxetine appeared useful in treating substance-dependent delinquents whose major depressions persisted or emerged after 4 weeks of abstinence. These preliminary findings justify a controlled trial in such youths.

Acute cholecystitis or metastatic renal cell carcinoma? a diagnostic dilemma.

Renal cell carcinoma is known to metastasize to many different organ systems. Lung and bone are clearly the most common sites of metastasis, but the symptoms at presentation may simulate those of other diseases of the organ system involved. The patient with metastatic renal cell carcinoma described here had symptoms of acute cholecystitis.

Twenty-year experience with the Mentor bladder pacemaker.

Twenty years after placement of a Mentor bladder pacemaker, a 38-year-old woman with spina bifida cystica still has controlled detrusor contraction and complete bladder emptying. The varied treatment modalities for this difficult group of patients has included electronic bladder stimulation. Although no longer commonly used, electronic bladder stimulation has shown long-term efficiency in this patient.