Antisocial behaviour (conduct disorder) is the commonest psychiatric problem in childhood. An interview was developed to measure the direct and indirect costs arising from antisocial behaviour over a range of domains, including behaviours inside and outside the home. Data were collected for a pilot sample of 10 children aged 4-10 years who had been referred to child and adolescent mental health services. The average cost across the 10 families was £15,382 a year, ranging from £5411 to £40,896 per family. The greatest cost fell on the families themselves (average nearly £5000 per year) and the education authority (average nearly £5000 per year); and there were significant costs for the health service, social services and the Benefits Agency.
This was the first epidemiological investigation of HIV-associated brain pathology in the United Kingdom. HIV encephalitis appeared to occur more frequently in injecting drug users and those who died younger. Whereas the findings must be interpreted cautiously, one hypothesis was that differences in the route of transmission may have affected the manifestation of HIV-associated brain damage.
Between 1969 and 1991, 339 patients had an aortic valve replacement with their own living pulmonary valve at the National Heart Hospital, Guy's Hospital and the Harley Street Clinic, London. The longest follow-up is 24 years and cumulative follow-up is 3774 patient-years. No form of anticoagulation was used and there were no emboli. There were 25 hospital deaths (7.4%) but only 1 death since 1976. Late deaths occurred in 38 patients mainly from technical mal-insertion. Bacterial endocarditis occurred in 11 patients. Thirty-eight patients were re-operated upon and account for 15 of the late deaths. Freedom from re-operation was 85% and the actuarial patient survival was 80% at 20 years. There has been no evidence of primary tissue degeneration and explanted valves showed normal cusp cellularity. Accumulating evidence suggests that the cusps not only survive permanently but can grow with the patient making the operation ideal for children.
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