Ali patients presenting with acute upper gastrointestinal bleeding between November 1986 and April 1988 were admitted to a centralised joint medical/surgical unit, with a policy of early clinical and endoscopic assessment and rapid surgical intervention in those at high risk. Of the 430 patients admitted 69*5% were over the age of60 and 30% had significant additional medical conditions. 50 4% were bleeding from peptic ulcers and one third had been taking non-steroidal anti-inflammatory agents. Fifty five patients underwent surgery, which in two thirds was carried out within 24 hours of admission, usually for continued bleeding. In patients with peptic ulcer the operation rate was 21*6%. Overall mortality was 3*7%, and in those with bleeding gastric or duodenal ulcers 5-5%; surgical mortality in the later group was 15-2%. All patients who died had serious concomitant pathology and 87% were over 70 years of age. Adoption of a centralised approach to management ofhaematemasis and melaena is feasible in a District General Hospital and associated with an improved survival.
A double blind controlled trial has been made of clofibrate in the treatment of diabetic retinopathy. Fifty-six patients completed one year in the trial and form the basis for this paper. At the end of one year there was a significant reduction in the area of retina involved by hard exudation in the treated group. There were no significant effects on other retinal lesions. The improvement in retinal exudates was not associated with any significant improvement in visual acuity. DIABETES J8:285-91, May, 1969. The hard retinal exudation of diabetic retinopathy has been shown to regress after low fat and corn oil diets. 1 ' 2 A combination of clofibrate and androsterone (Atromid) which had previously been used as an agent to reduce serum lipids in patients with ischemic heart disease was also shown to cause a regression of the exudates of diabetic retinopathy. 3 Oliver 4 demonstrated that clofibrate alone (Atromid S) had the same lipid lowering effects as the combination of clofibrate and androsterone. It was important therefore to confirm that clofibrate alone had a favorable effect on diabetic retinal exudates, and if so to increase the evidence for its usefulness as a treatment for diabetic retinopathy. With this in mind a double blind controlled trial of clofibrate was undertaken in sixty-three patients with diabetic retinopathy. MATERIAL AND METHODSPatients with diabetic retinopathy were selected from two diabetic clinics in The Bristol Royal Infirmary with a bias for those with the most marked exudative retinal From the Department of Medicine, University of Bristol at Bristol Royal Infirmary (B. P. Harrold, K. R. Gough), and the Bristol Eye Hospital (V. J. Marmion), Bristol, England.
Tuberculous Meningitis-Asherson et al. MBRITCS 843Gas-chromatographic studies of the urinary androgenic steroids were performed and their significance has been considered.We should like to thank Dr. J. G. , 1965, 2, 843-848 Since the introduction of reliable techniques for the detection of deficiency of folic acid there has been a gradual recognition that certain patients develop nutritional deficiency of this substance, with resultant megaloblastic anaemia. Most observers had previously felt that folic-acid deficiency was not common in well-nourished communities such as ours, and that it was confined to patients who could not absorb folic acid, who showed increased metabolic demands for folic acid, or who were taking drugs which interfered with its action. Nutritional deficiency causing a megaloblastic anaemia has been recognized in this country in middle-aged women (Gough et al., 1963) and in other patients (Forshaw et al., 1964). It seemed reasonable to suppose that the elderly might be particularly prone to develop nutritional deficiency of this substance, because of diminished financial resources, reduced mobility interfering with shopping, and apathy over food consequent upon old age and loneliness. It was therefore decided to survey a group of elderly subjects entering an old people's home which was run by the Welfare Committee of Bristol Corporation. The survey was conducted during 1962-3, when 51 patients were seen. These were compared with a similar group of aged control subjects who were without apparent evidence of underlying disease. These patients were in the National Health practice of one of us (J. L. P.), and all volunteered for the study. Fifty-one consecutive patients were seen on arrival at the municipal home. Their ages ranged from 59 to 95, and 45 were 70 years and over. There were 17 men and 34 women. Two patients over 70 years old were uncertain of their exact age. A full clinical examination of the patients was performed, including a rectal examination. The weight was recorded and portable chest radiographs were also taken. An inquiry into each patient's financial, social, and nutritional background was made. If clinical and radiological examination showed no evidence of organic disease likely to cause folic-acid deficiency, the following tests were performed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.