Modifications of the urethral rest and stress profiles after different types of surgery for urinary stress incontinence

Summary. Full urodynamic assessment, including urethral profiles at rest and under stress, using microtransducers, was made before and at least 6 months after surgery for urinary stress incontinence in 86 patients. Cure was assessed objectively. Procedures compared were Burch colposus-pension, Pereyra urethrovesical suspension and anterior colporrhaphy. The Burch colposuspension increased the pressure transmission ratio more efficiently than the vaginal operations and the cure rate was 91%. Only 50% of Pereyra operations were successful and success was related to an increase in the functional urethral length and in the pressure transmission ratio. The success rate for anterior colporrhaphy was 57% and was associated with a significant decrease in the maximal urethral closure pressure and the continence area. The prognostic value of the urethral profiles at rest and under stress and the therapeutic implications are discussed.     

Medication compliance in children with asthma

A questionnaire to assess compliance with prescribed therapy was completed by 200 children with asthma. The validity of the questionnaire was assessed objectively by measuring plasma theophylline concentrations in 37 subjects and by weighing metered dose aerosol canisters before and after use in 19 subjects. The average compliance was 67.9%. The close agreement between answers to the questionnaire and the objective measurements of compliance indicated that most participants recalled the drug regimens accurately. Good compliance was related to whether Australia was the parents' country of origin, to knowledge of the disorder and to comprehension of medication but was not related to perception of the severity of the illness. This study demonstrates that compliance is relatively poor even in a clinic population which attends regularly and appears well-motivated.     

Tinnitus in pregnancy

The presence of tinnitus in pregnancy was investigated by a postal questionnaire survey. A group of pregnant women attending the ante-natal clinic and a control group of non-pregnant members of the nursing staff at the Royal United Hospital in Bath were studied. The prevalence of tinnitus in the pregnant and non-pregnant women was compared. Both groups were similar in age, previous noise exposure and the presence of ear disease or operations. Twenty-five per cent of the pregnant women reported tinnitus compared with 11% of the control group. Chi-square analysis of this data gives a value of χ²= 4.07, d.f. = 1, P < 0.05. The result of our survey shows that there is a significantly increased prevalence of tinnitus in pregnant women compared with a similar non-pregnant control group. This association has not been previously reported.     

A communications seminar series for general practice residents

This article describes a seminar series for general practice residents dealing with communication, interpersonal relations, self-image, and patient-dentist interactions. Objectives, content, and methods of evaluation are presented.     

Maudsley Hospital Survey: prevalence of alcohol problems and other psychiatric disorders in a hospital population

This study, the first of its kind in the United Kingdom, reports on the prevalence of alcohol problems and other psychiatric disorders in the Joint Maudsley and Bethlem Royal Hospital population over a 12 year period. The steady 9–11% of the total number of diagnoses that are alcoholic, forces home the realization of the significant contribution of drinking problems to the work load of the hospital. The consistency of the percentage of alcoholics who receive an additional diagnosis, 30–40%, has considerable implications for treatment, treatment service planning and the understanding of aetiological factors.     

Optimal digital filters for long-latency components of the event-related brain potential

A fundamentally important problem for cognitive psychophysiologists is selection of the appropriate off-line digital filter to extract signal from noise in the event-related brain potential (ERP) recorded at the scalp. Investigators in the field typically use a type of finite impulse response (FIR) filter known as moving average or boxcar filter to achieve this end. However, this type of filter can produce significant amplitude diminution and distortion of the shape of the ERP waveform. Thus, there is a need to identify more appropriate filters. In this paper, we compare the performance of another type of FIR filter that, unlike the boxcar filler, is designed with an optimizing algorithm that reduces signal distortion and maximizes signal extraction (referred to here as an optimal FIR filter). We applied several different filters of both types to ERP data containing the P300 component. This comparison revealed that boxcar filters reduced the contribution of high-frequency noise to the ERP but in so doing produced a substantial attenuation of P300 amplitude and, in some cases, substantial distortions of the shape of the waveform, resulting in significant errors in latency estimation. In contrast, the optimal FIR filters preserved P300 amplitude, morphology, and latency and also eliminated high-frequency noise more effectively than did the boxcar filters. The implications of these results for data acquisition and analysis are discussed.     

Case report: A patient with primary biliary cirrhosis and autoimmune haemolytic anaemia

Diseases of an autoimmune nature are well recognized in association with primary biliary cirrhosis. Although autoimmune thyroiditis and many rheumatological conditions are well described in primary biliary cirrhosis, autoimmune haematological diseases have been less well reported. We report on a 66 year old North American Indian man with coincident primary biliary cirrhosis and warm antibody haemolytic anaemia. This case report supports the suggestion of an association between autoimmune haemolytic anaemia and primary biliary cirrhosis.     

Characterization of a Precocious New Lesion Distal to a Stent Site by Atherectomy

A 58-year-old woman presented with a new rapidly progressive lesion distal to a stent. This lesion was treated with atherectomy through the stem in order to characterize it pathologically. The aggressive proliferative response discovered suggested that this unusually distal lesion was produced by the trauma of her previous angioplasty .     

The crime of passion and the changing cultural construction of jealousy

Killings motivated by jealousy are, on occasion, glorified by the term ‘crime of passion’. The response to such crimes depends on the prevailing attitudes to jealousy and the legal practices current at the time. The cultural construction of jealousy has undergone radical changes in emphasis over the history of Western society, and legal systems have altered in response to changing cultural and social contexts. It is argued that the generosity accorded to the jealous killer has survived these changes. In our current emotionology jealousy is increasingly regarded as psychopathological and as such ceases to be the responsibility of the jealous individual. Although pathological jealousies do exist, the vast majority of jealous reactions are not usefully regarded as pathological. If jealousy is to be translated from a vengeful cry of rage into a disappointed hope, it is essential to recognise that most jealous reactions fall within the scope of normal human experience. When violence emerges from such jealousy, appeals by mental health professionals to psychopathology to explain and mitigate are misguided.     

Impact of childhood cancer on religious life of Korean families

This paper reports on the social and personal relevance of religious faith entering into the situation of family stress due to the illness of a child with cancer. The expectations of religious faith may include, objectively, the actual physical healing of the child or the determination of the child's fate; it may include, subjectively, the hope for emotional support, the provision of moral guidance in time of difficulty, or an overarching life-view. There were major religious changes in 20% of the families. While all the major religious faiths in South Korea were represented in the study, 61% of the sample identified Christianity as their primary religious response.