Course of patients discharged early after myocardial infarction

Two hundred and seventy-one (76%) out of 358 survivors of infarction were discharged by the eighth hospital day, and 251 (93%) of them survived to six weeks after discharge. Six of the 20 patients who died between discharge and six weeks did so after readmission and 14 died as outpatients. All these patients who died at home had transmural infarction and four had diabetes. In inpatients successful resuscitation occurred mainly within the first 48 hours, with only three successful long-term results from all the patients who suffered arrest later. This suggests that more prolonged inpatient care would not have reduced the late mortality. These figures justify continuing with an early discharge policy for most patients, but coronary care should probably be more prolonged for patients with diabetes.

Peptic ulceration in men. Epidemiology and medical care

Estimates of the population prevalence of peptic and duodenal ulceration in men aged between 25 and 64 years were made in the London borough of Lambeth. The sampling frame for these estimates was a 20% private census. The lifetime prevalence rate of proved peptic ulcer (haematemesis, gastric and duodenal ulcers as validated by operation or barium meal), adjusted for age and social class, was estimated to be 6-7%, while the similarly adjusted lifetime prevalence for duodenal ulcer was 4-4%. The lifetime prevalences increased with age but not significantly so. A social class gradient was demonstrated with the highest prevalence in social class I and II. Previously described associations with blood group, secretor status, and serum pepsinogen were confirmed. Reported use of medical services increased with increasing severity of symptoms. A large number of respondents, however, who reported symptoms reported no medical care. It seemed unlikely that those men who reported symptoms and no medical care had demonstrable peptic ulcers.

Communications to an antenatal clinic

When referring pregnant women to an antenatal clinic many general practitioners and midwives presented details of their care in an incomplete and inconsistent manner. As a result, hospital staff often had insufficient basic data from which to work. We recommend that those providing care decide what information they need and make the rationale of collecting this information the subject of a well-evaluated local education programme.

Masturbatory guilt and sexual dysfunction

Anxiety arising from masturbatory guilt plays a major role in the production of frigidity and impotence. Reduction of this anxiety through greater community awareness of the normality of masturbation is therefore a fertile area for the principles of preventive medicine to be applied.

Occult gastrointestinal bleeding due to aspirin: comparison of two compounds

Occult gastrointestinal bleeding as measured by the faecal 51Cr-labelled red-cell loss was compared in eight healthy volunteers while on therapeutic doses of soluble aspirin and a new slow-release formulation of aspirin (Deskoval). While both preparations led to increased faecal blood loss, this was significantly less during administration of Deskoval than when soluble aspirin was taken.

The assessment and progress of long-stay and elderly psychiatric patients: the predictive validity of a ward behaviour questionnaire

This paper describes an attempt to validate a behaviour rating scale used to predict the likelihood of discharge among elderly and long-stay patients in a psychiatric hospital. The scale measured behaviour on the ward as rated by nursing staff. The scale was a sensitive predictor of discharge among those with a low score (indicating least disability), except for patients with organic psychoses. However, many patients with low scores were not discharged. In order to improve the scale's use as a screening technique additional information was considered. The significance of the findings is discussed.

Food choices of institutionalized vs. independent-living elderly

Data on food intake of ninety-nine nursing home residents and of ninety-eight independent-living elderly persons with respect to twenty-two food groups were obtained by questionnaire interview. Nutrient intake was calculated by computer and compared with the 1968 Recommended Dietary Allowances. Fewer than half of the respondents in both groups had intakes providing 67 per cent or more the allowances for eight nutrients, and 35 per cent fell below this level for two or more nutrients. There were no significant differences in nutrient intake due to type of living arrangement. However, the nursing home residents had made more changes in eating habits than the independent-living participants, and changes correlated negatively with nutritional scores. Nursing homes might improve residents' nutrient intakes by adjusting menus and food preparation to conform more closely with residents' food preferences.

Visualization of actin fibers associated with the cell membrane in amoebae of Dictyostelium discoideum

Amoebae of Dictyostelium discoideum were attached to a surface coated with polylysine, and the upper portion of the cells was sheared off with a stream of buffer. Scanning and transmission electron microscopy showed that the cytoplasmic surface of the exposed membrane was covered with fibers consisting of actin-containing filaments. The actin was identified by its solubility properties and its ability to interact with muscle myosin.

Descriptive studies of a psychiatric hospital population

These studies were carried out in Park Prewett Hospital (1,400 beds) which serves most of northern Hampshire, a population of just over 300,000 people. Our aim was to describe in some detail the gross features of this hospital population. Three descriptive techniques were employed.

Positional information and pattern regulation in hydra: the formation of boundary regions following axial grafts

A two-gradient model is proposed for regulation and regeneration of the head end of hydra in terms of positional information. One gradient is set up by a diffusible substance made at the head end, which may be regarded as a positional signal, and the other is a more stable cellular parameter which is the positional value. The rule for head end formation is that the concentration of the diffusible substance falls a threshold amount below the positional value. A variety of instantaneous axial grafts have been carried out which are discussed in terms of this model. Some simple computer simulations of diffusion are provided. There is some evidence that the source of the positional signal is localized at the head end. Some experiments on changes in polarity are given. It also seems that the positional signal from the head end inhibits foot end formation.

Premature ejaculation treated by the dual sex team method of Masters and Johnson

The treatment of premature ejaculation has always carried a poor prognosis and recovery in an established case is uncommon.

In 1970, in their book “Human Sexual Inadequacy”, Masters and Johnson reported the treatment of 186 cases of premature ejaculation with only four failures. Their technique is based on the use of a dual sex team comprising a male and a female therapist who treat the “marital unit”, not just the dysfunctional male.

The present authors report initial success in the treatment of two premature ejaculators using a shortened version of the Masters and Johnson programme, requiring only seven treatment sessions.

One case is described in detail to indicate the disturbed interpersonal dynamics which may undarly the development of premature ejaculation and to illustrate the manner in which the treatment principles are applied in its management.

The success of the technique seems to derive from a reduction of anxiety in the coital situation and a strengthening of trust and confidence in the relationship between the marital partners.