GASTROCAMERA STUDIES IN ROSACEA

SUMMARY.— Ten patients with rosacea were examined with the gastro-camera. No abnormality of the gastric mucosa was found. Gastric biopsy in 5 of the patients showed no histological abnormality and histochemically the succinic dehydrogenase content of the parietal cells was also normal.     

A multidisciplinary approach to the management of psychosocial admissions to a general paediatric ward

Abstract This study investigated the cheracteristics of all new in-patients with major psychological and/or social problems admitted to a medical ward over a 4-week period. Fifteen successive patients were studied prospectively. The professional time spent by the medical and paramedical personnel involved in the initial assessment and management was reviewed, and the children followed-up 6 months later.
The study found that the patients readily fell into two major groups. Group I were infants and children who had been maltreated or were at risk for child abuse. Group II were older children who presented with psychosomatic symptoms arising from disturbed family or environmental backgrounds. The medical, psychiatric and social work input was considerable for both groups (19 vs 27 h per patient respectively). Their hospital stay was prolonged (15 vs 21 days respectively; the hospital average was 4.4 days). The outcome differed in the two groups. Patients in Group I failed to attend follow-up appointments in most cases unless such attendance was legally mandatory. In contrast, Group II patients usually kept their follow-up appointments, the intervention generally being successful.     

Can Ultrasound and Computed Tomography Replace High-dose Urography in Patients with Impaired Renal Function?

Ninety-one patients with unexplained impaired renal functionwere investigated by high-dose urography, ultrasound and computedtomography (CT) without contrast. The aim was to evaluate therole of ultrasound and CT in renal failure, in particular theirability to define renal length and to show collecting systemdilatation. In the majority of patients, renal length could be measuredaccurately by ultrasound. Mea surements were less that thoseat urography because of the absence of magnification. Renalmeasurement by CT was not a sufficiently accurate indicatorof renal length to be of clinical use. Both ultrasound and CT were sensitive detectors of collectingsystem dilatation: neither technique missed any case diagnosedby urography. However, in the presence of staghorn cal culior multiple cysts, neither ultrasound nor CT could exclude collectingsystem dilatation. CT was the only technique which demonstrated retroperitonealnodes or fibrosis causing obstruction. It is proposed that the first investigation when renal functionis impaired should be ultrasound, with plain films and renaltomograms to show calculi. CT should be reserved for those patientsin whom ultrasound is not diagnostic or in whom ultrasound showscollecting system dilatation but does not demonstrate the cause.Using this scheme, ultrasound, plain radiography and CT wouldhave demonstrated collecting system dilatation and, where appropriate,shown the cause of obstruction in 84 per cent of patients inthis series. Only 16 per cent of patients would have requiredeither high-dose urography or retrograde ureterograms.