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Although pregnant women with hypertension are usually given magnesium sulfate to prevent seizures, it is possible that other anticonvulsants, such as phenytoin, would also be effective. To investigate this further, a prospective, controlled study was carried out with 47 hypertensive patients who are at 36 weeks or more gestation (70 percent were only mildly hypertensive). The subjects were randomly assigned to receive either magnesium sulfate (24 patients) or phenytoin (23 patients) intravenously; blood levels of the drugs were monitored. After delivery, patients and nurses completed questionnaires concerning the side effects of the drugs. The neonatal outcome was also evaluated. Results showed that both drugs were safe and tolerated well by the women. No seizures occurred and no negative neonatal outcomes were noted. The blood levels of free phenytoin (not bound to albumin) were within the therapeutic range in 22 cases, while the total phenytoin levels (free plus bound) were higher than the usual levels in nonpregnant patients. The results show that both phenytoin and magnesium sulfate are safe and effective for seizure prophylaxis. Because less patient monitoring is needed with phenytoin than magnesium sulfate, patients with mild pregnancy-induced hypertension and low risk of seizures may be better suited for phenytoin treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Objective. To assess the effects of payment methods on the costs of care in medical group practices. Data Sources. Eighty-six clinics providing services for a Blue Cross managed care program [...]

A heat‐stable, glycoprotein‐like material, osteopoietin, produced during bone marrow regeneration, has been shown to induce bone formation when implanted in the rat eye. The material was separated by ultrasonic treatment or by acid buffer (pH 3–5) from sponges implanted in the marrow. The extracted material free of bone or cell solids, induced bone formation in the anterior eye chamber of the rat, whereas the cell solids and control sponges similarly implanted did not.

Several letters to the editor are presented in response to articles in previous issues, including "Rip-off Software You Must Never Use," a review of the Cubot X17 phone, and another on the demand by the British government for rural areas to request broadband.

Several letters to the editor are presented in response to articles published in previous issues including "Rip-off software you must never use"; one relate to review of the Cubot X17 smartphone; and another related to extension of deadline for getting Windows 10 operating system.