Prognosis in giant-cell arteritis

In a study to assess the natural history of giant-cell arteritis, 90 patients with proved disease were followed up from the time of diagnosis. Early mortality was low and most commonly due to vertebral arteritis, but cerebral infarction did not appear to be a late complication. High maintenance dose steroids and visual loss were associated significantly with a shortened life span (p=0.0003 and p=0.0024). One-third of the patients developed chronic relapsing disease, but serious late complications were not encountered. After the initial attack has been controlled steroid dosage should be reduced to the minimum needed to alleviate symptoms.

Respiratory failure revisited: acute exacerbations of chronic bronchitis between 1961-68 and 1970-76

Factors determining survival have been analysed retrospectively in 157 admissions of 135 patients with an acute exacerbation of chronic bronchitis and emphysema causing hypoxaemia and carbon dioxide retention. All were treated with controlled oxygen therapy. The death-rate increased with the age of the patient, but was not correlated with the age of the patient, but was not correlated with the severity of hypoxaemia on admission, when the patient was breathing air. The death-rate was significantly higher in those patients in whom arterial [H+] rose above 55 nmol/1 (pH = 7.26) during controlled oxygen therapy. The absence of a rise in the arterial PCO2 during controlled oxygen therapy was not necessarily indicative of a good prognosis, since 5 out of 18 patients showing this response subsequently died in that admission. Only 28% of the 111 patients who left hospital alive survived for five years.

The influence of obstetric procedures and social and cultural factors on breast-feeding rates at discharge from hospital

The influence of obstetric factors on breast-feeding rates at discharge from St. Thomas's Hospital in 1969 and 1970 has been examined in 1356 primiparous mothers delivering healthy babies. Induction of labour and assisted delivery were significantly associated with lower breast-feeding rates. The association could not be explained by differences in social class, country of origin, birthweight, anaesthesia in labour, or medical reasons for induction and assisted delivery. The most likely explanation is that induction and assisted delivery are associated with delay in starting breast-feeding. However, trends in obstetric management of labour and delivery are unlikely to have a large influence on the incidence of breast-feeding compared with the influence of social and cultural factors.