Characteristics of infant mortality in the RSA 1929-1983. Part I. Components of the white and coloured infant mortality rate

Secular trends in white and coloured neonatal, post-neonatal and infant mortality rates are presented for the period 1929-1983. More detailed information is given for deaths in the first month of life. During this 54-year period the infant mortality rate for whites has declined from 64.2/1,000 to 13.5/1,000, whereas the rate for coloureds fell from 158.8 (1938) to 55.0/1,000. The greater part of the latter decline occurred after 1970. Since 1945 the neonatal mortality rate (NMR) for whites has exceeded the post-neonatal mortality rate (PNMR) but among coloureds the PNMR still exceeds the NMR.     

Mediastinal-width/chest-width ratio in blunt chest trauma: a reappraisal

The chest radiographs of 54 patients with blunt chest trauma and suspected aortic rupture were reviewed retrospectively. A mediastinal-width/chest-width ratio was calculated at the level of the aortic arch. There were 44 patients without evidence of aortic rupture on aortography or surgical exploration and 10 patients with surgically confirmed aortic rupture. There was no identifiable ratio of significance in distinguishing those with aortic rupture and those without rupture. The mediastinal-width/chest-width ratio is of insufficient sensitivity and specificity in confirming or excluding aortic rupture to be clinically useful.     

MMPI F-K index among hospitalized Vietnam veterans

The F-K index of the MMPI has been used as a marker of symptom overreporting. One population for which previous research has shown this pattern is Vietnam in-country veterans with PTSD. This study assessed the F-K index on 515 inpatients: 329 Vietnam in-country and 186 Vietnam-era patients. Normative data on psychiatric inpatients were presented. Also, a special MMPI subscale (MMPI-PTSD), a measure to identify PTSD among these veterans, was used. Results showed that all Vietnam veterans, especially in-country veterans, overreport symptoms to a high degree. The overall mean for in-country vets was 7.3. Also, when the special MMPI-PTSD subscale was used, a vast majority of in-country veterans who were in the PTSD range had high F-K index scores. Dissimulation as a symptom of PTSD was discussed.     

Use of the bipedicle flap in radical neck dissection for head and neck cancer

Many advantages of the bipedicle flap have become obvious in our large volume of head and neck surgery, especially in patients who have received radiation therapy. Not once has carotid blowout occurred after utilization of this type of incision.     

The detection, pharmacokinetics and behavioral effects of diisopropylamine dichloroacetate (DADA) in the horse: a preliminary report

1. Drug administration studies using diisopropylamine dichloroacetate (DADA) and diisopropylamine (DIPA) were conducted in Thoroughbred and Standardbred horses to assess physiological effects and develop detection methods. 2. Four horses received 0.08 mg DADA/kg body wt and showed no changes in heart and respiratory rates or body temperature as measured over a 1-hr period after administration. A transient diuretic effect was found to occur in 2 mares dosed with 0.80 mg DADA/kg body wt. 3. A qualitative detection method using thin-layer chromatography was developed to detect DIPA, the major metabolite of DADA in equine urine. A quantitative detection method (lower limit of detection 0.5 micrograms/ml urine) for this metabolite was also developed using gas chromatography. 4. Neither DADA or the free base, DIPA, were detectable in equine blood samples using the above-mentioned methodologies.     

Treatment of advanced squamous-cell carcinoma of the head and neck with a combination of cisplatin, vinblastine, and bleomycin

Fifty patients with advanced, measurable, squamous-cell cancers of the head and neck received treatment with a combination of cisplatin, vinblastine, and bleomycin (PVB). The tumours in 25 patients (50%) responded to treatment (partially in 17 and completely in eight). The median duration of response was 18 weeks, and that of survival was 31 weeks. Toxicity was moderately severe; myelotoxicity occurred in 13 patients, and nausea and vomiting in 22 patients.     

Restructuring health care: the social geography of public and private health care under the British Conservative Government

The 1979 election of the Conservative Government in Britain was not followed by the demolition of the welfare state. However, a variety of policy initiatives were introduced both to restructure National Health Service (NHS) expenditure, and to facilitate private provision of health services. This article considers the effects of such policies on the existing and future distribution of health care resources. A historical introduction discusses the main thrusts of conservative welfare policy. This is followed by an examination of the current financial situation of NHS authorities, at the regional and sub-regional scales; the political response to the 1983 manpower reductions is also considered. Events in the NHS are then contrasted with the deregulation of the private sector. The emergence and distribution of commercial acute hospitals are examined, as are other initiatives designed to transfer some of the financial burden of welfare provision away from the state. A concluding section compares and contrasts these developments and considers prospects for the future form of health care provision in Britain.     

The spatial variation of mortality among children under 5 years of age in South Africa

Childhood mortality rates between 1 and 4 years and under 5 years of age were systematically calculated according to the statistical regions of South Africa for the white and coloured populations. The geographical variation is wide and the statistical significance in these mortality rates is presented in map form. Mortality rates are particularly high in rural areas. For the coloured group, the correlation between the spatial distribution of infant mortality rates under 1 year of age and the 1-4 year mortality rate pattern was high.     

A randomized study of adjuvant immunotherapy with levamisole and corynebacterium parvum in operable non-small cell lung cancer

The effects of a combination of levamisole (pre- and post-operative) and post-operative corynebacterium parvum (intrapleural and intravenous) have been compared to no adjuvant therapy in 38 patients with operable non-small cell lung cancer. This immunotherapy program was well tolerated and early results suggest it may delay recurrence.