Immediate effects of improved hospital environment on behaviour patterns of mentally handicapped patients

In 1972 three old hospitals were closed and patients transferred to a new hospital for the mentally handicapped. Four to six weeks before transfer, disturbed and a sample of non-disturbed patients were rated on a selected scale; they were again rated four to six weeks after transfer. The disturbed patients numbered 39 per cent of the total and both men and women shared a significant improvement, though the men did not improve to the same extent as the women. There was also a significant improvement among the non-disturbed patients, though this did not apply to the epileptic patients.

The influence of antihypertensive treatment over the incidence of cerebral vascular disease

The incidence of stroke in a group of 499 treated hypertensive patients was closely related to the adequacy of control of hypertension. This trend was independent of the level of diastolic blood pressure at presentation, and differed markedly from the incidence of myocardial infarction and angina pectoris which did not vary with adequacy of control.

Ventricular tachycardia in a patient with toxoplasmosis

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The use of amiloride hydrochloride in the correction of hypokalaemic alkalosis induced by diuretics

Amiloride hydrochloride is a very potent drug for correcting the profound hypokalaemia and metabolic alkalosis that is induced by thiazide and other diuretics. No potassium supplements are necessary.

The long-term treatment of hypertension with thiazide diuretics

Two hundred and twenty-seven cases of moderate to severe hypertension were treated with thiazide diuretics alone for periods of up to 12 years. In 80% the hypertension was adequately controlled without additional antihypertensive agents.

Hypokalaemic alkalosis was common despite potassium supplements—but caused no symptoms. The incidence of diabetes and gout was low.

It is concluded that thiazide diuretics provide excellent control of hypertension with very few side effects.

Axenic production of ova by Enchytraeus fragmentosus (Bell)

The microannelid Enchytraeus fragmentosus was found to be capable of sexual reproduction under axenic culture methods described. Axenic clones of this annelid reproducing by sexual and asexual methods are now available.

Assessment of the severity of primary depressive illness. Wakefield self-assessment depression inventory

A self-assessment inventory for measuring severity of depressive illness is described, Its chief merits are brevity and simplicity. The correlation with the Hamilton Rating Scale is +0·87. At a cut-off level of 14–15 points 3% of patients and 7·5% of ‘Normals’ are misclassified. The mean scores for male and female patients do not differ significantly and the small positive correlation of score with age is of little practical significance. The limitations in this inventory are discussed but, despite them, it has practical value and merits further development.

The treatment of benign hypertension with clonidine

Clonidine (Catapres) is a new drug for the treatment of hypertension which has an uncertain mode of action. Sixty-one patients have been treated with Clonidine for up to 21 months. Side-effects of treatment have been troublesome and in 20 per cent of patients have necessitated discontinuing therapy. Sedation was the most frequent and troublesome side-effect. Dryness of the mouth was a less troublesome symptom. In only 48 per cent of patients continuing Clonidine was good blood pressure control achieved and maintained.

In a comparable group of patients treated with Methyl Dopa only 7 per cent had to discontinue therapy because of side-effects of the drug, and effective control was achieved in 70 per cent of the remainder.

Clonidine is strikingly devoid of postural and exercise hypotensive effects, and produces a uniform control of blood pressure throughout the day. It has been successfully combined with Methyl Dopa and Bethanidine. Despite its troublesome side-effects, these attributes may make it a satisfactory drug for the treatment of patients in whom uniform control is difficult.