This is a rare, but potentially very troublesome disorder. We have been able to carry out detailed radiological, histological and biochemical investigations on 51 patients and the results of these investigations are presented. Considerable evidence of abnormal platelet activity has been found. The histological evidence has come from both biopsy and nephrectomy specimens and has shown aggressive atherosis leading to microembolic lesions and in some cases showing microaneurysm formation. In some instances this has led to areas of infarction both small and large. Most of the cases studied have been fully followed up and it has been found that despite the histological changes, the blood pressure remains normal and no demonstrable deterioration in renal function occurs. Attempts at treatment are described and discussed.

No abstract

No abstract

It is generally recognized that in many patients the ureteric obstruction and other manifestations of non-malignant retroperitoneal fibrosis will respond to treatment with corticosteroids. However, most surgeons are reluctant to use steroids as the primary treatment for patients with this condition, mainly because of the risk of mismanagement of malignant retroperitoneal fibrosis. Our experience in the care of 17 patients with non-malignant retroperitoneal fibrosis has led us to believe that an initial non-surgical approach is both safe and preferable.

This paper describes a method of teaching communication skills to pre-clinical medical students in the setting of general practice. By focusing on the nature of the patient's problem this teaching tries to place interviewing and diagnostic procedures in their proper context in the doctor-patient relationship.