Review of postperinatal mortality in a health district with a garrison town.

PIP: In order to determine the excess postperinatal mortality rate (PPMR) in the North East Essex health district, researchers examined 108 infant deaths. The PPMR of 10.2/1000 for army infants was significantly higher than the rate of 5.1/1000 for all the other infants (p=.02). Additionally, 8 of the 46 infants that died due to sudden infant death syndrome (SIDS) were children of army personnel. The SIDS rate of 5.8/1000 for army infants exceeded the SIDS rate of 2.1/1000 for all other infants by almost 3 times. Since the death rate for all other causes was 4.4/1000 for army infants and 3.1/1000 for all other infants, researchers concluded that SIDS was the leading cause of postneonatal mortality for army infants. Differences between Army mothers and all other mothers included that Army mothers tend to be younger (mean age 21 v. 26), more smoke (57.% v. 53.2%), and fewer intended to breast feed their infants (35.7% v. 53.2%). In addition, more army families experienced marital stress or violence, or both (p=.05) than did other families. The researchers speculate that for Army mothers, their young age, their isolation in the garrison, and the lack of family support probably all contributed to the high mortality of these infants. The government is considering studying infant deaths since 1984 to learn why they occurred and how to prevent them.^ieng

Obesity in boys: the distinction between fatness and heaviness.

An anthropometric survey of approximately 2350 boys aged 1-8 years was conducted as part of a study of pre-school child growth. It was shown that there was no close relationship between obesity measured as fatness from the triceps skinfold and the development of heaviness as judged by weight-for-height. It is suggested that the study of obesity in children should involve classification into sub-groups identifiable as the heavy but not fat, the fat but not heavy and those who are both heavy and fat. This may help in understanding the nature of obesity and its implications in future disease.

Social and psychological factors in the distribution of STD in male clinic attenders. I Demographic and social factors.

We describe three related studies of possible aetiological risk factors for sexually transmitted diseases (STDs) in men attending an STD clinic. In this paper we present the results for a variety of social and demographic variables traditionally associated with STD. In contrast to the results in the next two papers, these were largely negative. Occurrence rates of overall STD or of hepatitis, syphilis, gonorrhoea, or non-specific urethritis (NSU) had no aetiologically relevant association with age, nationality, marital status, social class, occupation, non-sexual social contact, drug abuse, or aggressive attitudes and behaviour. Gonorrhoea, however, was the only STD which correlated with alcohol abuse and with eating out rather than at home. We conclude that, with the possible exception of gonorrhoea, social factors contribute little to the distribution of STD risk within the study population.

Social and psychological factors in the distribution of STD in male clinic attenders. II Personality disorders, psychiatric illness, and abnormal sexual attitudes.

Using standardised questionnaires we examined the possible contributions of psychiatric illness, delinquent and other abnormal personality traits, and disturbed attitudes to sex to the risk of sexually transmitted disease (STD) infection in men attending an STD clinic. We found certain differences in personality and in attitudes between the clinic sample and control men. These differences, however, a) were not comparable with those found in groups of clinically abnormal subjects, b) were confined to homosexual and bisexual men, and c), with the possible exception of gonorrhoea, were not related to risk of STD infection.

Social and psychological factors in the distribution of STD in male clinic attenders. III Sexual activity.

We report on the relation between various aspects of sexual activity and risk of infection with sexually transmitted disease (STD) in two groups of men attending an STD clinic. Sexual promiscuity appeared to have little effect on the distribution of most STDs, showing a strong association only with gonorrhoea. This finding was contrary to expectation but consistent with the results reported in the first two papers in this series. In contrast to promiscuity, however, sexual orientation subgroups showed a sharp difference in incidence of the major STDs. Hepatitis and syphilis occurred equally commonly among bisexual and homosexual men, but much less commonly among heterosexuals; NSU occurred more commonly among heterosexual men; and gonorrhoea, though common in all three groups, occurred most commonly in bisexual men and least commonly among heterosexuals. For certain STDs the form of intercourse may be as important a risk factor as sexual promiscuity but the precise mechanisms by which sexual orientation influences risk of STD remain undefined.

Maximum leg force and power output during short-term dynamic exercise.

Force exerted and power generated were measured during short-term exercise performed on a bicycle ergometer that had been modified by the addition of an electric motor driving the cranks at a chosen constant velocity. Five subjects made a series of 20-s maximum efforts at different crank velocities (range 23--171 rev/min). The forces exerted were continuously monitored with strain gauges bonded to the cranks. Peak force was exerted at approximately 90 degrees past top dead center in each revolution. During the 20-s effort peak force declined from the maximum level (PFmax) attained near the start of exercise, the rate of decline being velocity dependent. PFmax was found to be inversely and linearly related to crank velocity and when standardized for upper leg muscle (plus bone) volume (ULV) was given by PFmax (kgf/l ULV) = 27.51--0.125 crank velocity (rev/min). Integration of the force records with pedal velocity enabled power output to be calculated. Maximum power output was a parabolic function of crank velocity, the apex of the relationship indicating that the velocity for greatest power output was 110 rev/min. At this velocity our subjects achieved a maximum mean power output, averaged over a complete revolution, of 840 +/- 153 W (85 +/- 5 W/l ULV). This was compared with the calculated value for maximum mechanical power output from aerobic sources, which was 272 +/- 49 W (30 +/- 1 W/l ULV).

Etomidate in electroconvulsive therapy. A within-patient comparison with alphaxalone/alphadalone.

In a group of 31 patients undergoing electroconvulsive therapy, there was no significant difference between the times of return of eyelash reflex, swallowing and respiration following a single induction dose of 0.2 mg/kg of etomidate as compared with an induction dose of 0.036 ml/kg of alphaxalone/alphadalone. The incidence of involuntary movements and increased muscle tone was significantly greater after etomidate than following alphaxalone/alphadalone; but the involuntary movements were never marked. The overall incidence of pain on injection was 15% after etomidate. There was a low incidence of venous sequelae following either drug.