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health sciences library UNIVERSITY OF MARYLAND BALTIMORE NOT TO CfRCULAti ^l.timore WOT TO CIRCULAll Digitized by the Internet Archive 2015 in https://archive.org/detaiis/deiawaremedicaij6511medi S DELAWARE MEDICAL JOURNAL Official Publication of the Medical Society of Delaware VOLUME 65 JANUARY 1993 NUMBER 1 HEALTH SCIENCES LIBRARY UNIVERSITY OF MARYLAND BALTIMORE FEB 10 1993 NOT IN CIRC. §r ^ - IIVI\ \ K / ”’ 1/ V-. V V TOPICS INCLUDE: Treatment of Ventricular Arrkytlimias Pkysical Inactivity - Tke Least Appreciated Cardiac Risk Factor Tkromkolytic Tkerapy Use in Acute Myocardial Infarction TkeC ontemporary Treatment of Hypertension Expanding Indications for Transesopkageal Eckocardiograpky Altering Cardiac Risk Factors FOR MORE INFORMATION, OR TO REGISTER, CALL 366-1929 (302) ^ MEDICAL CENTER OFDCLAWARE ^ CDNSULTANTSP.A. ISSN0011-7781 DELAWARE VOLUME 65 JANUARY 1993 NUMBER 1 MEDICAL JOURNAL CONTENTS Official Publication oftheMedical Societyof Delaware 13 PRESIDENT’S PAGE Health Care Reform - What Can/Should We Expect/Do? 1925LoveringAvenue Wilmington, Delaware 19806*2166 Stephen R. Permut, M.D. 17 SCIENTIFIC ARTICLE Editor E. Wayne Martz, M.D. Anaphylaxis to Protamine Masquerading as an Insulin Allergy AssociateEditor VirginiaU. Collier, M.D. RichardKim, M.D. ManagingEditor LaurelA. Haring 25 EMERGENCY MEDICINE FORUM Noncardiogenic Pulmonary Edema: A Certain Etiology? AssistantEditor Sharon M. Swayne AndyBilotti, M.D. GrandRoundsEditor VirginiaU. Collier, M.D. 29 BOARD OFMEDICAL PRACTICE ' Publicationand E. Wayne Martz, M.D. EditorialCommittee ! ' William J. Boyd, M.D. HEALTH LAW ' Kim L. Carpenter, M.D. 31 I JohnJ. Chabalko, M.D. The National PractitionerData Bank in Operation VirginiaU. Collier, M.D. I Steven L. Edell, D.O. PeterJ. Shanley, Esq. i JeromeGroll, M.D. WilliamJ. Holloway, M.D. RobertC. Knowles, M.D. EDITORIALS I' JamesF. Lally, M.D. 35 Fees and Health Care Costs Allan Levy, D.O. Harold G. Marks, M.D. E. Wayne Martz, M.D. E. Wayne Martz, M.D. James H. Newman, M.D. 36 Noninvasive Ventilatory Support > RobertE. O'Connor, M.D. John J. Chabolko, M.D. LeoW. Raisis, M.D. Bernhard Singsen, M.D. CarolA. Tavani, M.D. 39 LEXTER TO THE EDITOR FrederickK. Toy, M.D. RobertJ. Varipapa, M.D. InformedConsent for Transfusion Dennis R. Witmer, M.D. Leslie W. Whitney, M.D. BusinessManager Dean L. Winslow, M.D. MarkA. Meister Enteredasaecond-claesmatterJune26,1929,atthePoetOfficeatWilmington,Delaware,undertheactofMarch3,1879.laauedmonthly.Second-claaapostage paidatWilmington,Delaware.Copyright1993bytheMedicalSocietyofDelaware.Indexedin"HospitalLiteratureIndex"and"IndexMedicua."Availablethrough UniversityMicrofilms.TheDelawareMedicalJournaldoesnotholditselfresponsibleforstatementsmadebyanycontributororadvertiser.POSTMASTER:Send addresschangestoDelawareMedicalJournal,1925LoveringAvenue,WilmingtonDE19606-2166.Annualsubscriptionratesare$20fordomesticand$25for overseas.Singlecopiesare$2.50.Advertisingcopyisaccepted,subjecttotheapprovaltothePublicationCommitteeoftheMedicalSocietyofDelaware.For informationaboutadvertising,calltheJournaloti\ceat302/656-3957. CONTENTS, continued 41 BOOK REVIEWS Medicine's New Vision DavidPlatt, M.D. YourMedical Rights! How to Become an EmpoweredConsumer Carl T. Opderbeck,M.D. NEW MEMBERS 43 49 PROCEEDINGS OFTHE MEDICAL SOCIETY OF DELAWARE HOUSE OF DELEGATES, 1992 71 IN BRIEF 74 INDEX TO ADVERTISERS BANCROFT PARKWAY WOODDALE Here is an authentic reproduction of colonial A gracious three-story stucco manor house on architecture by George F. Bennett. This elegant eight-plus acres. The home dates back to 1789 home has been designed for both entertaining andwastotally restored in 1983. Featuresare a and family living. A few of the many library with cherry paneling, sumptu- features included in this home are a GllPlN ous master suite, front and rear stair- sunroom,breakfastroom,qualitycon- case to all three floors, wine cellar, struction with stone, slate and hard- VANTRUMP&MONTGOMERY'NC heated Sylvan pool, four-car garage woodfloors.Aspaciousinterior.Priced Realtors andmuchmore.Offeredat$1,575,000. at $399,000. Call FredZell at478-4165. Call Carole Shepherd at 478-4165. 8 Del Med Jrl, January 1993, Vol 65, No 1