The recognition of psychological disturbance in a sexually transmitted diseases clinic.

This study examined the rate of psychological disturbance in a series of new patients attending a clinic for sexually transmitted diseases. Forty three per cent of patients were identified as probable psychiatric cases by the General Health Questionnaire. Medical staff in the clinic were asked to assess patients' level of psychological disturbance.

Problems in the conceptual framework of patient satisfaction research: an empirical exploration.

Survey research into patient satisfaction has been responsible for developing a number of related concepts concerning the ways in which patients evaluate the health care that they receive. Recently doubts have been expressed as to the adequacy of this approach for understanding how patients anticipate and respond to medical encounters. This paper reports a study of patients attending neurological outpatient clinics.

Effects of referral to a specialist for headache.

Patients consulting neurological outpatient clinics for headaches that were found not to be due to a serious structural lesion were followed up one year afterwards. Considerable improvement in symptoms was found in the sample. This was only partly attributable to any medical treatment received at the clinics or subsequently from a general practitioner.

Social dimensions of healing: a longitudinal study of outcomes of medical management of headaches.

The social sciences have made few direct empirical contributions to the understanding of 'non-specific' benefits of treatment and generally the symbolic healing of indigenous non-Western medicine has received most attention in this field. This paper reports some results of a wider study of neurological clinics in England in which it is shown that a sample attending for headaches experienced considerable improvement in symptoms when followed up 1 year after attendance. Most of this improvement appeared not to be due to any intended treatments received at the clinics but could be attributed to the quality of patients' immediate responses to clinic attendance as assessed from reach interviews conducted after their consultations.

Referrals to neurologists for headaches not due to structural disease.

Patients attending neurological clinics with headaches that proved not to be due to clearly defined structural disease were interviewed before and after the consultation and approximately one year later. Their expectations of the consultation were ill-formed. About two-thirds of the patients had fears about organic disease although few had psychiatric morbidity.

Psychogenic purpura (autoerythrocyte sensitization).

A 41-year-old woman has had a long history of repeated episodes of recurrent painful ecchymotic lesions. Results of coagulation tests were normal other than a slight decrease in antithrombin III. Skin tests were positive in response to the patient's own washed red cells.

Histiocytosis X.

A patient with histiocytosis X had nonhealing mouth lesions. Evaluation revealed diabetes insipidus and numerous bony lesions. Electron microscopy of the mouth lesions and lymph nodes did not indicate Langerhans cells, which have frequently been described as occurring in histiocytosis X.

The correlation of disease activity and antibody titers in pemphigus.

Twenty cases of pemphigus extracted from the literature and 19 patients from UCLA with pemphigus were studied in detail regarding the possible correlation of pemphigus titer and disease activity. A statistically significant relationship between titer and disease activity, as well as change in titer and change in disease activity, was found. However, in spite of this relationship, serial titers were not found to be consistent enough to be used reliably as a guide to therapy or prognosis in pemphigus.

Effect of racemic and S(+) alpha-chlorohydrin-1-phosphate on glyceraldehyde-3-phosphate dehydrogenase in relation to its contraceptive action.

The phosphate esters of racemic (+/-) alpha-chlorohydrin and its S(+)-optical isomer have been prepared as cyclohexylamine salts. In vitro both inhibited glyceraldehyde-3-phosphate dehydrogenase by a competitive mechanism, whereas (+/-) alpha-chlorohydrin did not. The S(+)-isomer was approximately four times as potent as the racemate.

Concentration of oestradiol, progesterone, luteinizing hormone and follicle-stimulating hormone in the jugular venous plasma of ewes during the oestrous cycle.

Changes in the concentrations of ovarian steroids and pituitary gonadotrophins were measured by radioimmunoassay in the jugular plasma of six Clun Forest ewes throughout the oestrous cycle. The concentration of oestradiol began to rise 12-14 h before the onset of oestrus from values of 11-2 +/- 0-36 (S.E.

Changes in cervical function at parturition.

In sheep and goats changes in the wall of the uterine cervix associated with parturition were studied in relation to the preparturient sequence of endocrine events. Evidence was obtained of separation of collagen fibrils, possibly due to changes in the electrostatic binding of the fibrils by glycosaminoglycans. The mechanical properties of the cervix were investigated quantitatively on isolated tissues by radial loading to destruction, and by progressive extension on a tensometer; the extension experiments revealed that at parturition (but not before) the cervical wall acts mechanically as if composed of two different tissues, one of which, the collagen layer, changes profoundly at parturition to facilitate dilatation.

Dilatation of the uterine cervix.

Dilatation of the cervix at parturition necessitates changes in the physical characteristics of cervical collagen and glycosaminoglycans which are probably hormone-dependent. The infusion of prostaglandin F2alpha (PGF2alpha) into the arterial blood supply to uterus and cervix of sheep pregnant for about 125 days resulted in cervical dilatation after 24 hours but this response was inconsistent; one factor affecting the response appeared to be the progesterone status, low circulating progesterone being associated with dilatation. Preliminary experiments in goats in which pregnancy is terminated by removal of the corpora lutea at day 125, subject to modification by the administration of progesterone, indomethacin or PGF2alpha, support the view that PGF2alpha evokes softening and dilatation of the cervix but that this is blocked by progesterone.

Concentration of steroids in bovine peripheral plasma during the oestrous cycle and the effect of betamethasone treatment.

Testosterone, oestradiol and progesterone were measured in peripheral plasma during the oestrous cycle of 6 heifers. Oestradiol and progesterone results confirmed earlier reports. Concentration of testosterone on the day of oestrus was 40+/-3 pg/ml (mean+/-S.

Parturition in the goat: plasma concentrations of prostaglandin F and steroid hormones and uterine activity during late pregnancy and parturition.

Changes in plasma concentrations of hormones and uterine activity associated with spontaneous parturition in the goat were examined. No change in oestradiol-17beta concentration was detected during the experimental period, but oestradiol-17alpha consistently increased in concentration 3-4 days before parturition. This was followed by an increase in prostaglandin F two days later, while a pre-partum decline in progesterone concentration occurred 18-20 h after the significant increase in prostaglandin F.