CALL FOR PAPERS
OCCUPATIONAL MEDICINE: HAVE YOU EVER CONSIDERED IT?
The Metropolitan Washington, D.C. Medical Genetics Residency and Fellowship Program at the National Human Genome Research Institute offers a three-year program in Medical Genetics which is designed to train physicians to diagnose, manage, and counsel patients with genetic disorders. The RRC and/or ABMG accredit this program in Clinical Genetics, Biochemical Genetics, Clinical Molecular Genetics, Clinical Cytogenetics, and Ph.D. Medical Genetics. Training sites include: The Clinical Center at the NIH, ChildrenŐs National Medical Center and Research Institute, Georgetown University Medical Center, and Walter Reed Army Medical Center. Starting in July 2000 four positions are available to M.D.s or M.D./Ph.D.s who have completed two years of residency training in the U.S. Interested individuals should send a letter of interest, a curriculum vitae, and three letters of reference to Maximilian Muenke, M.D., Director of Residency and Fellowship Training, Office of the Clinical Director, National Human Genome Research Institute, National Insti-tutes of Health, Building 10, Room 10C101, 10 Center Drive, MSC 1852, Bethesda, Maryland 20892-1852, Email: [email protected], Phone: 301/402-8167, or 301/402-1159 (secretary), or Fax 301/496-7157. The NIH is an Equal Opportunity Employer
WPW Syndrome Advice for Runners
I have Wolff-Parkinson-White syndrome, and when running I have frequent bouts of sustained supraventricular tachycardia (SVT). I have used the combination of squatting, Valsalva's maneuver, and carotid sinus massage to break my bouts, but when I'm hot and vasodilated I've had trouble keeping my blood pressure high enough for carotid sinus massage to be effective. In a hypotensive state, carotid sinus massage can increase the heart rate.
Recently, I have developed a technique that I call "Mac's maneuver." I lie on my back on the floor or ground with my legs straight up a wall or tree at a 90° angle. Then I massage my carotid sinus. This is a good position if you get lightheaded, and it opposes the effects of postexercise vasodilation, increasing the efficacy of carotid sinus massage.
- James McComb Larson, MD, San Diego
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This page was updated September 30, 1999 by Ann Harste.
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