Self referral to an accident and emergency department for another opinion.

Objective: To determine whether patients referring themselves to an accident and emergency department for another opinion after consulting their general practitioner present with serious illness, show any risk factors for being admitted, or are more likely to be patients of particular practitioners.

Design: Six month prospective survey.

Setting: District general hospital's accident and emergency department, receiving 42,000 new patients a year.

Polyethylene glycol in the production of blood grouping reagents: some further advantages.

The use of various water-soluble non-ionic polymers, including polyethylene glycol (PEG) 8000, has been described in the preparation of diagnostic blood grouping reagents. The major advantages of using PEG in this way are ease of preparation and the ability to concentrate antibodies. We describe here two previously unreported advantages of using PEG: (i) substantial reductions in the volume of red cells required for adsorption of isoagglutinins; and (ii) the ability to store PEG precipitates in a 'dry' form substantially reduces storage requirements.

Stability of murine monoclonal anti-A, anti-B and anti-A,B ABO grouping reagents and a multi-centre evaluation of their performance in routine use.

We have previously reported the production of 3 murine monoclonal reagents for ABO typing (designated ES-9, ES-4 and ES-15). This study presents results of tests of stability of these 3 reagents, together with a fourth murine monoclonal antibody (LM103/107). In addition, data are also presented from a multi-centre evaluation of the performance of the murine monoclonal reagents in routine ABO typing of both donors and patients using a wide variety of techniques, both manual and automated.

DIOGENES.

This paper describes the DIOGENES database available though BRS Information Technologies. The database focuses on drug and medical device regulatory information from the Food and Drug Administration. The specific strengths of DIOGENES are mentioned as well as some plans for further development of the database.

A comparison of the Milch and Kocher techniques for acute anterior dislocation of the shoulder.

Two methods of reduction for anterior dislocation of the shoulder were compared in 111 patients. Milch's technique was found to be atraumatic and relatively painless. Greater success with Milch's technique was experienced in patients under 40 years of age in whom the dislocation had been present for less than 4 hours.

Familial Hodgkins disease.

Three cases of Hodgkins Disease in one family are described. The index case presented with pyrexia of unknown origin and the diagnosis of Hodgkins Disease was made at post mortem. Two other members of the family had died of a similar cause many years previously.

Effect of whole herd anthelmintic treatment on milk production of dairy cows.

Fifteen of 29 commercial dairy herds were given a series of anthelmintic treatments. The remaining herds were untreated to provide a measure of seasonal variation. In the treated herds all milking cows were treated once in the summer and the autumn and three times at monthly intervals in late winter and early spring.

Effect of anthelmintic treatment immediately after calving on milk production.

The effects of anthelmintic treatment on the milk production of cows subjected to contrasting nutritional conditions before and after calving were determined. Half of the cows in each of 2 management treatments were treated with 3.75 grams of fenbendazole on the second day after calving and twice more at weekly intervals.

The fat and water content of the dead infants skinfold.

Precentages of total fat and water in skinfold tissue from the suprailiac site were estimated in 46 newborn infants of varying gestations. No significant correlation between fat content and gestation was present and no marked difference existed between the sexes at term (the mean fat value in males being 44.6% and that in females 41.

Pyloric diaphragm, antral web, congenital antral membrane--a surgery rarity?

Three cases of pyloric diaphragm in elderly patients are reported. The finding of these patients within a 2-year period (1976-8) suggests that the condition is not as rare as previously thought. Diagnosis was achieved endoscopically and the condition managed surgically.

The importance of prolactin and the milking stimulus in the artificial induction of lactation in cows.

Lactations were successfully induced in 15 out of 18 non-pregnant cows treated with oestradiol-17beta (0.1 mg/kg body weight) and progesterone (0.25 mg/kg body weight) on days 1-7 (where day 1 is the first day of treatment).

Squamous cell carcinoma of the renal pelvis presenting with hypercalcemia.

A case of hypercalcemia associated with documented squamous cell carcinoma of the renal pelvis without bony metastasis is reported. Pseudohyperparathyroidism was suspected strongly because of the radioimmunoassay values of parathormone. This was confirmed by the prompt decrease of serum calcium after removal of the neoplasm.