Vaginal fistulas in Crohn's disease.

Twenty-eight patients with vaginal fistulas complicating Crohn's disease, seen between 1970 and 1987, are described. Twelve required early operation; five of them had rectal excision. Conservative management was used in 16 patients but in none of these did the fistula close spontaneously.

Mortality in Crohn's disease--a clinical analysis.

We have examined the causes of death and the changing pattern of mortality over time among 769 patients with Crohn's disease under long-term review between 1944 and 1984. One hundred and fifty-six patients have died. The cause of death could not be classified in five.

Psychiatric screening for patients with faecal incontinence or chronic constipation referred for surgical treatment.

Fifty patients attending for surgical treatment of chronic constipation (n = 21) or faecal incontinence (n = 29) were studied using two psychiatric screening tests: the Hospital Anxiety and Depression (HAD) scale and the General Health Questionnaire (GHQ). Each patient was assessed preoperatively and 6-12 months postoperatively. Results were compared with age and sex-matched controls (n = 50).

Recurrence after strictureplasty or resection for Crohn's disease.

This study attempts to define whether there is an increased need for reoperation in patients with small bowel Crohn's disease treated by strictureplasty compared with those treated by small bowel resection. Previous studies of the rate of reoperation for small bowel Crohn's disease do not distinguish between reoperation performed because of a lesion at the original operation site and that undertaken because of a lesion at a distant site. This study analyses the need for reoperation only at the original site of operation and measures operation-free intervals.

Interhemispheric transfer in schizophrenics, depressives, and normals with schizoid tendencies.

Although several studies suggest that schizophrenics suffer from an impairment in the interhemispheric transfer (IHT) of information, methodological weaknesses in these studies preclude clear interpretation of their results. This study addresses these criticisms in order to provide a clearer test of the IHT theory. Schizophrenics, depressives, normal controls, and normals with schizoid tendencies were assessed on five measures of IHT (verbal and nonverbal dichotic listening, intermanual transfer, bimanual block design, finger sequence repetition) and two measures of unilateral hemispheric processing (lateral eye movements, auditory thresholds).

[3H]MK-801 binding sites in postmortem brain regions of schizophrenic patients.

[3H]MK-801 binding was used as a marker for the NMDA receptorion channel complex in postmortem brain samples from the frontal cortex, hippocampus, putamen, entorhinal region, and amygdala of schizophrenic patients and controls. In schizophrenia [3H]MK-801 binding levels were increased in all brain regions investigated reaching significance in the putamen.

Childhood disorder DRG: consideration for a predictive model.

The proposed Diagnosis Related Group (DRG) for prepaid child psychiatric hospitalizations is based on a mean length of stay of 6.6 days. This study examined data on 2,266 admissions to four state and four municipal hospitals providing child psychiatric care to residents of New York City.

Natural history and treatment of anorectal strictures complicating Crohn's disease.

Forty-four patients seen between 1975 and 1985 with anorectal strictures complicating Crohn's disease have been reviewed to determine the natural history and outcome of surgical treatment. Proctitis was present in 98 per cent, and 93 per cent of patients had sever perianal disease. The site of strictures was rectal in 22, anal in 15 and anorectal in 11 (4 patients had a stricture at 2 sites).

Fetal ovarian cysts: a report of five cases.

Large fetal ovarian cysts are rare; however, widespread use of antenatal ultrasound examination has led to an increased detection rate and surgical removal. A case presenting with bowel obstruction is described along with four other cases that presented in the last 24 years. Previously reported series are reviewed and compared.

Constraints on nest site selection: a comparison of predator and flood avoidance in four species of marsh-nesting birds (genera: Catoptrophorus, Larus, Rallus, and Sterna).

Nest site characteristics associated with flood and predator avoidance were compared for four nonpasserine species of marsh-nesting birds: clapper rails, willets, laughing gulls, and common terns. Species with short nests, willets and terns, minimized flood damage by nesting on higher ground than did gulls and rails that build tall nests. Species with dispersed, cryptic nests had taller surrounding grass than did open-nesting colonial species.

Prevalence of sexually transmitted disease among male patients presenting with proctitis.

Fifty male patients with proctitis were examined and the clinical, microbiological, serological and proctological features compared with 51 known male homosexuals attending the genitourinary (GU) clinic at the same hospital. The homosexuals had a short history of bowel symptoms, minor sigmoidoscopic and histological changes on rectal biopsy and many positive serological markers of sexually transmitted infection. There was some evidence of sexually transmitted disease in the IBD patients and three were homosexuals.

Geographically-based cancer control: methods for targeting and evaluating the impact of screening interventions on defined populations.

Successful implementation of cancer control programs depends on efficient targeting to those at highest risk of developing and dying from the disease. This study presents a methodology for targeting cancer screening on the basis of population and disease variation among small geographic areas. Techniques for quantifying the impact of targeting on the predictive value of a positive test are demonstrated, using 329 New York City health areas.

Life events and difficulties preceding the onset of functional dysphonia.

The Bedford College Life Events and Difficulties Schedule was used to determine the experiences of 56 women and 9 men who were interviewed about the 12 months before the onset of functional dysphonia. Thirty (54%) of the women had experienced a difficulty or event which involved conflict over speaking out (CSO), a dimension developed during the course of the study. Only 16% of a comparison group had such experiences.

Psychiatric illness in patients with inflammatory bowel disease.

One hundred and sixty two consecutive patients attending a clinic for inflammatory bowel disease (91 Crohn's, 71 ulcerative colitis) were assessed for the presence of anxiety and depression using a simple self-rating questionnaire (HAD scale) and a detailed evaluation (DSM-III). The overall prevalence of psychiatric illness (DSM-III) in ulcerative colitis and Crohn's disease was 34% and 33% respectively. There was no statistically significant association in ulcerative colitis patients between the presence of psychiatric illness and the present physical illness.

Results of proctocolectomy for Crohn's disease.

Seventy-four patients have had a one-stage proctocolectomy for the management of Crohn's disease. Indications for operation were: acute colitis 28 per cent, chronic colitis 39 per cent, perianal disease 13 per cent, proctitis and perianal disease 8 per cent, bleeding 5 per cent, coexisting colonic malignancy 7 per cent. There were two hospital deaths (2.

Low-density lipoproteins inhibit endothelium-dependent relaxation in rabbit aorta.

The vascular endothelium, in response to pulsatile flow and vasoactive agents including acetylcholine, secretes the endothelium-derived relaxing factor (EDRF), a substance which regulates vascular tone. Recent interest in EDRF has focused on its possible dysfunction in atherosclerosis. In animal models of the disease, endothelium-dependent relaxation is markedly reduced.

Intracellular mechanisms in the activation of human platelets by low-density lipoproteins.

Low-density lipoproteins (LDL) have been shown to cause aggregation of human blood platelets at concentrations above 2 g of protein/l. The secretion of the contents of platelet dense granules was detected, but not that of the lysosomes. LDL gave rise to a mobilization of [3H]arachidonic acid from phospholipids and the appearance of products of the cyclo-oxygenase pathway after only 10 s.

The psychiatric and social characteristics of patients with functional dysphonia.

Of 121 consecutive outpatients seen in an ENT clinic who received a diagnosis of functional dysphonia, 71 who were referred to the speech therapy department were interviewed. Sixty one (86%) were women, and the mean age of the group was 47.6 yr.