Transient atrioventricular standstill. Etiology and management

Four patients with different clinical conditions had transient cardiac standstill for periods of up to 22.5 seconds. All patients showed signs of cerebral ischemia and required cardiac resuscitation. In one patient, the standstill was thought to be the result of a transient increase in the vagal tone, and no long-term therapy was required. In the second patient, cardiac standstill occurred during hospitalization for impending myocardial infarction. Coronary arteriography followed by coronary artery surgery was performed, and there was no further episodes of standstill. In the third patient, standstill was probably related to long-term ingestion of propranolol hydrochloride, and was not observed after this medication was discontinued. In the fourth patient, standstill was the result of the sick sinus syndrome, and a permanent pacemaker was inserted. Standstill of both atria and ventricles may occur under different clinical settings, and management of arrhythmia should be guided by thf etiology of the arrhythmia.

A two-year review of court examinations

This paper reports on a review of 518 Psychiatric Court Examination conducted at the Ottawa Court House in 1972-1973. Characteristics of the sample are described, and an attempt is made to relate the effects of some of these characteristics to decisions resulting from the psychiatric examination. It was concluded that those examinations help to identify obviously mentally distubed persons, advise the Court about the mental condition of people first appearing in Court, and do not unduly alter the legal process.

A rapid radioimmunoassay method for plasma luteinizing hormone

1. A rapid double antibody radioummunoassay method for the determination of plasma luteinizing hormone (hLH) is described. 2. The method involves preincubation of the anti-LH serum with the precipitating second antibody and incubation of this mixture with unknows and standards at room temperature overnight. The incubation tubes are then centrifuged, supernatants decanted and the precipitates counted. 3. A total of two working days is required to complete the assay and report the results. 4. This method is more rapid than the conventional ones currently used for the estimation of LH in blood.

W.H.O. sponsored collaborative studies on nutritional anaemia in India. 1. The effects of supplemental oral iron administration to pregnant women

A W.H.O. sponsored collaborative study of the effects of iron supplementation to pregnant women was carried out in Delhi (northern India) and Vellore (southern India). Supplementation was given under supervision from the 26th to the 36th or 38th week of pregnancy. A control group received only placebo; one group received vitamin B12 and folic acid alone; four groups received vitamin B12, folate and a daily iron supplement ranging from 30 to 240 mg of elemental iron as ferrous fumerate, and one further group received 120 mg of iron without B12 or folate. Groups receiving no iron showed a fall in mean stet concentration. Those receiving iron showed a rise in haemoglobin, the best results being in the groups receiving 120 and 240 mg of iron together with vitamin B12 and folate. Even in these groups however there was still a high prevalence of anaemia and iron deficiency at the end of the trial period. Iron alone did not produce as good results as iron plus vitamin B12 and folate. The supplementation had no detectable effect on the birth weight of the children, nor on the haemoglobin concentration of the infants at three months of age. The daily absorption of iron in the pregnant women, as judged from the increase in haemoglobin mass, was not as satisfactory as expected. Possible reasons for this are discussed. It is concluded that to provide these women with adequate iron a daily oral supplementation of 120 mg of elemental iron or more is needed. This can only be achieved by medicinal means. Before supplementation can be recommended on a public health scale, further information regarding the cost and expected benefits of such measures must be obtained.