Drug therapy for Graves' disease in blacks--very low rates of remission.

The rates of remission after a course of antithyroid drugs in 71 black and 45 white patients with Graves' disease were compared. One year after stopping therapy 27% of blacks and 47% of whites were in remission (P less than 0.01); at 2 years the proportions were 7% and 27% respectively (P less than 0.

Effects of citrus molasses distillers solubles and molasses on rumen parameters and lactation.

Effects of dietary citrus molasses distillers solubles (0, 6, 12, and 18% of DM) on diet digestibility and ruminal parameters were studied with four fistulated Holstein cows fed each diet in Latin square sequence. Diets were 25% cottonseed hulls with solubles substituted for corn. Dry matter and organic matter digestibilities were increased curvilinearly with peak at 6%.

Coronary heart disease and urinary albumin excretion rate in type 2 (non-insulin-dependent) diabetic patients.

Associations between overnight urinary albumin excretion rate and prevalent coronary heart disease and its major risk factors were examined in a cross-sectional study of 141 Type 2 (non-insulin-dependent) diabetic patients. Mean albumin excretion rate was higher in men (geometric mean 13.5 micrograms/min; 95% confidence interval 10.

Comments on the long-term outcome of schizophrenia.

Among the many technical issues dealt with in this symposium, two clinical problems are preeminent--how is schizophrenia defined and what is meant by outcome? Each problem is highly complex. Even given adequate designs, sampling, and analysis, the generalizability of the results depends on the extent to which the diagnostic and outcome criteria are independent of each other and reproducible. The authors amply demonstrate how far we are from achieving such comparability.

Principles and practice of measuring needs in the long-term mentally ill: the MRC needs for care assessment.

We report the development of a new procedure for assessing the needs for treatment and care of the long-term mentally ill. This procedure covers 21 areas of clinical and social functioning, and in each of these specifies appropriate interventions. Decision rules are described which permit problems in functioning to be primarily classified as a met need, an unmet need, or as involving no need, and which allow the identification of various secondary needs.

The effect of kallikrein on spermatozoal ATP and other semen parameters.

Kallikrein promotes the release of kinins, which have been shown in in vitro studies to improve motility, viability and metabolism in human spermatozoa. The effects of kallikrein therapy on 25 males attending an infertility clinic was assessed, regarding endogenous spermatozoal ATP content, as well as other semen parameters. Thirteen of the 25 patients showed an improvement in either count, morphology, motility, viability, or a combination of these, after 3 months Kallikrein therapy.

A haven for the severely disabled within the context of a comprehensive psychiatric community service.

The priorities accorded severely disabled or disturbed long-stay patients in Regional and District planning strategies vary enormously. A scheme to cater for the needs of this group is described. The scheme includes: non-stigmatising housing; a domestic regime, daytime occupation and leisure activities offering forms of enabling and caring that foster the highest possible levels of functioning; a secure home; private and peaceful outdoor space; and graduated steps towards independence that allow for the possibility of relapse.

Parathyroid hypertension. A reversible disorder.

A retrospective study of 75 patients who were surgically cured of primary hyperparathyroidism from 1976 to 1984 was performed to evaluate the blood pressure and metabolic responses to parathyroid surgery. Published data on the population prevalence of hypertension (HT) in South Africa were used for comparison. The overall prevalence of HT before surgery was 47%, compared with 23% in the general population.

Use and misuse of the PSE.

The principles underlying the development of the Present State Examination and the instruments and computer programmes associated with it are discussed in the light of comments made in three recent papers by psychiatrists trained in the German tradition of clinical phenomenology. Many of their comments are cogent and highly relevant to the future development of the system. Some common misunderstandings are also considered; in particular, those that lead to results being interpreted outside the limits of the specifications laid down.

High radio-isotope uptakes in patients with hypothyroidism.

Hypothyroidism is usually associated with a low radio-isotope uptake by the thyroid gland. We report 8 cases of Hashimoto's thyroiditis with clinical and biochemical hypothyroidism and with borderline high or overtly increased technetium-99m pertechnetate and/or iodine-131 uptakes.

Severe airway obstruction associated with rheumatoid arthritis and Sjögren's syndrome. A case report.

Numerous pulmonary complications associated with rheumatoid arthritis (RA) and Sjögren's syndrome (SS) have been described. Mild airway obstruction has recently been recognized in these disorders, severe obstruction occurring in only a few patients with RA. We report a patient with RA and SS who developed severe irreversible airway obstruction, an association not hitherto described.

A ward in a house: accommodation for "new' long-stay patients.

A proportion of psychiatric patients still remain in hospital for more than a year who would not be acceptable in community accommodation because of their severe handicaps. This group has been caLled the "new' long-stay. Studies have suggested that this group could be accommodated in high dependency hostels set up in association with a hospital.

Epidemiology of mental disorders in Camberwell.

A two-stage psychiatric survey of a random samples of adults aged 18-64 from Camberwell is described. Agency interviewers carried out the first stage (N = 800), using the shorter form of the Present State Examination (PSE). MRC interviewers, using the full PSE, saw a stratified sample of these (N = 310) in the second stage.

The adult respiratory distress syndrome. A review, some thoughts and a few new ideas.

Adult respiratory distress syndrome is being recognized more frequently as a complication of a number of conditions. The causes, pathophysiology, pathology, clinical manifestations and management are reviewed in this article. The use of positive end-expiratory pressure (PEEP) and super-PEEP is discussed.