Audit of maternal serum screening: strategies to augment counselling in response to women's views.

Women's opinion on the maternal serum screening programme offered at one maternity unit in East Northumberland (1991-1992) was evaluated. The responses from 1,774/2,633 women showed a general acceptance of the test but 722/1,774 (40%) wanted more information and a third, more explanation. Recommendations, which included a 'gold standard' protocol, a video to complement revised patient information literature and a coordinator to facilitate interdisciplinary communication and training with support for midwives, were introduced.

Eosinophilic endomyocardial disease due to high grade chest wall sarcoma.

Eosinophilic endomyocardial disease is characterised by persisting blood eosinophilia and acute endocardial lesions which progress to endomyocardial fibrosis. In most cases the cause is unknown but it has been described in association with malignant tumours. A fatal case is presented of a 64 year old woman with this disease due to a high grade sarcoma of the chest wall, an association not previously reported.

Medical therapy of Ménétrier's disease with omeprazole.

Medical therapy of Ménétrier's disease is often unsatisfactory and may lead to surgical treatment. Two cases, previously unresponsive to H2 antagonists, are presented showing a marked response to omeprazole.

Transient hyperphosphatasaemia in association with acute infection in adults.

The causes of raised serum alkaline phosphatase were determined prospectively in a consecutive series of 2884 acute medical admissions. Diagnoses were established by pre-defined clinico-pathological criteria. Two hundred and four patients had hyperphosphatasaemia.

Five-year vascular audit from a district hospital.

Vascular patients under the care of one surgeon over a 5-year period have been reviewed, from computer-based discharge records, with regard to in-hospital measures of outcome to determine whether or not surgery was being performed to an acceptable standard. Out of 466 procedures, 30 per cent of patients had at least one complication, 14 per cent had further surgery and 9 per cent died. Outcome was examined within the following treatment groups: aorto/iliac aneurysm, aortofemoral bypass, femoroproximal popliteal bypass, femorodistal popliteal bypass, femorocrural bypass, embolectomy and percutaneous transluminal angioplasty.

Inter-specialty rotation in anaesthetics.

It has never been easy to attract junior doctors to training posts in anaesthetics in small District General Hospitals. This paper discusses the benefits of introducing an internal hospital rotation within general medicine.

Emergency resection of phaeochromocytoma presenting with hyperamylasaemia and pulmonary oedema after abdominal trauma.

Phaeochromocytoma may present as an acute emergency with a perplexing variety of symptoms. We report a case in which a tumour of the organ of Zuckerkandl was removed after its unexpected discovery during laparotomy for abdominal trauma. A patient is described in whom a history of abdominal trauma coupled with collapse, pulmonary oedema, raised serum amylase and a positive peritoneal tap for blood, led to laparotomy at which an extramedullary phaeochromocytoma was found unexpectedly.

Parotid tumours: a review of parotid tumour surgery in the Northern Regional Health Authority of the United Kingdom 1978-1982.

A review of inpatients treated for parotid tumours during the 5-year period 1978 to 1982 in the Northern Regional Health Authority of the United Kingdom revealed 376 new parotid tumours and 28 recurrent tumours. The incidence of new parotid tumours was 2.4 per 100,000 and of pleomorphic adenomas 1.

Prediction of remission after antithyroid drug treatment in Graves' disease.

A prospective study was carried out to determine the factors which influence response to antithyroid drug treatment in Graves' disease and to assess their predictive value. Eleven variables were included in the assessment and were subjected to discriminant analysis, log rank test and "survival" analysis. The patients were observed for a considerable period (mean duration 51 months).

Fluoroscopic peroperative cholangiography: technique and associated radiation hazards.

The techniques specific to peroperative fluorocholangiography are discussed based on an experience of 632 cholangiograms and an estimation has been made of the associated radiation doses to staff and patients. Rapid and accurate information can be obtained during fluorocholangiography using appropriate techniques with acceptably low radiation hazards.

Reversed rotation of the midgut in an adult. Case report.

Management of a patient with a congenital anomaly of the midgut can be difficult for a surgeon since these abnormalities are extremely rare particularly in adults. However a thorough knowledge of embryology and anatomy will allow the complexity of a rotational anomaly to be resolved. A case of reversed rotation of the midgut is presented and the literature on this subject reviewed.