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We describe a typical case of apical ballooning syndrome in an octogenarian female patient with left ventricular wall motion abnormality on electrocardiography, whose ventricular function returned to normal. The patient has allergic rhinitis and had used nasal decongestant excessively a few hours prior to the episode of pain.

OBJECTIVE: To report a syndrome that is uncommon in childhood and call pediatricianśattention to the tubular diseases - just like Bartters syndrome - in differential diagnosis of failure to thrive and other diseases that can be usually found in children.METHODS: Two patients are presented. The first, a 3 years and 2 months old boy who was submitted for investigation of a failure to thrive detected when he was 9 months old. The second patient, a 3 months old girl, was admitted to the Intensive Care Unit due to severe electrolyte disturbances. She was supposed to have a pyloric hypertrophic stenosis.RESULTS: Both patients had failure to thrive, hypocloremic alkalosis, hypokalemia, and hypercalciuria. The first had a positive obstetric history for polihydramnios that is frequently found in the neonatal form of this syndrome. Treatment was done by blood potassium correction, together with indometacin and spironolactone administration. These drugs where well tolerated by the patients who have improved their growth rhythm only a short time after electrolytic disturbances had been corrected.CONCLUSIONS: The Bartter's syndrome is a tubular disease that is unusual in childhood. It must be considered as a possible cause of failure to thrive. The neonatal form is rare and can produce severe hydro-electrolytic disturbances, increasing the difficulties for diagnosis. The treatment is well tolerated, even by small children, and must begin early to reduce the troubles to thrive.

Summary and Conclusions In a field study in South Carolina, Anopheles quadrimaculatus mosquitoes were applied to native cases of malaria in Negroes to determine the infectivity of such malaria cases. Of 142 feedings upon Plasmodium falciparum patients, 21 showed infections. Of 12,606 mosquitoes dissected, 2.5 per cent were infected. These infections developed normally in the mosquito and in one out of two trials transmission was successful. The majority of the mosquito infections occurred during the months of October through January. Mosquitoes kept at outside temperatures during October and November became infected. One patient remained infective to mosquitoes over an 8-month period. Of the 25 patients showing gametocytes, 64 per cent infected mosquitoes. The gametocyte densities resulting in infections were relatively low, none being over 90 per cmm. Thirteen of the infections resulted when the gametocytes were fewer than 10 per cmm. Patients with asymptomatic parasitemias infected mosquitoes at about the same rate as did those who were symptomatic. As the asymptomatic group is considerably larger than the other, it is concluded that the former is mainly responsible for the transmission of malaria. There were 14 feedings upon P. malariae. Four cases showed gametocytes of a low density at feeding and three lots of mosquitoes were infected. Of 586 mosquitoes dissected, 1.7 per cent were infected. Of nine feedings upon P. vivax, none became infected nor were gametocytes present. It is concluded that the patient with an asymptomatic parasitemia, usually with a relatively low gametocyte density, is the important factor in the transmission and maintenance of P. falciparum and P. malariae malaria in the area studied.