Many insurance companies offer standard life policies to people born with coarctation of the aorta that has been successfully repaired. In reality, surgical repair does not promise a healthy life span—the mean age at death in patients who have had successful surgery is only 38 years (Heart 2002;88:113-4). The causes of premature death range from rearctation of the aorta, hypertension, and coronary heart disease to late formation of an aneurysm at the repair site. The message is clear: continuing surveillance for a lifetime, using transthoracic echocardiography

Positron emission tomography (PET scanning) was used to study seven adults with Tourette's syndrome. It showed an increased rate of presynaptic release of dopamine from the striatum (American Journal of Psychiatry2002;159:1329-36). These findings fit in with clinical studies which have shown stress induced increases in dopamine. The work holds out a long term prospect of pharmacotherapy for Tourette's syndrome.

Now that most children are immunised against measles, what should the medical reaction be to an episode of morbilliform rash with fever? Determine the cause, says a report in Archives of Disease in Childhood (2002;87:202-6). If no diagnosis is made, parents may suspect measles and confidence in the vaccine will be eroded. Tests on 93 children in East …