Fifty-four acutely manic patients were allocated to treatment on a double-blind basis with either carbamazepine or lithium carbonate. The short-term effects of treatment were studied over a period of six weeks and the longer term, prophylactic, effects over a period of up to a year. Additional 'rescue' medication was allowed when clinically indicated. There was a high drop-out rate from the trial. Despite this, it appeared that valid comparisons between the two treatments could be made. No statistically significant differences were found, but carbamazepine appeared slightly less effective as a treatment for acute mania and more effective as a prophylactic treatment in this group of patients. Possible predictors of individual responsiveness to each treatment are discussed.

The initial benefit of primary angioplasty performed by experienced operators is maintained over a two-year follow-up period with improved infarct-free survival and reduced rate of reintervention.

An experiment is described which was designed to test the hypothesis that brief visual stimuli would not be perceived when they occurred during certain phases of the EEG alpha rhythm. The results agreed with the hypothesis. It was concluded that the alpha rhythm is a correlate of the activity of a ‘neuronic shutter' which periodically prevents the reception or processing of visual information by the brain. The procedure used was such that there was no necessity for the subjects to pay attention to the stimuli; indeed, efforts were made to avoid such attention. This methodology was thought to be of importance in obtaining a positive result.

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We report a case involving a 55-year-old man who had a recent resection of tracheal carcinoma and tracheal reanastomosis. He subsequently developed tracheomalacia and anastomotic dehiscence requiring airway stenting via an armored endotracheal tube (ETT). Placement of the armored ETT was technically difficult. It required insertion of an airway exchange catheter through the tracheal stoma to oxygenate, ventilate, and serve as a guide for ETT placement through the tracheotomy and across the dehiscence. During transtracheal jet ventilation our patient developed bilateral tension pneumothoraces requiring cardiopulmonary resuscitation and chest tube placement. The patient was quickly recovered, stabilized, and later discharged after a prolonged intensive care unit (ICU) course. We review the recommendations for jet ventilation via airway exchange catheters, common problems during this technique, and potential methods for avoiding these problems. The risk of barotrauma and pneumothoraces during jet ventilation via an airway exchange catheter should be kept in mind.

Since neither the unipolar nor the bipolar theories of manic-depressive psychosis explain all its features, an alternative model was tested. The hypotheses are that mixed affective psychoses represent a superimposition on hypomania of a second type of depression which can sometimes develop from the depressive phase of manic-depressive psychosis, and that schizophrenia occurring in the course of a manic-depressive illness is an alternative to mixed affective psychosis. From an examination of the clinical histories of a random sample of people with bipolar manic-depressive psychosis, evidence was found to support both ideas.

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