A noninvasive method for recording the electrical activity of the human uterus in vivo.

Development of an electrohysterograph (EHG) for recording the electrical activity of the uterus in vivo has been blocked for 60 years by problems with artifacts and extraneous/reactive electrical activity. This study reevaluates a method of cervical recording that does not appear to have these limitations. A set of cervical electrode cups was used to record uterine activity of 33 normal subjects and patients who had dysmenorrhea, endometriosis, or chronic pelvic pain. The electrode cups were atraumatic, able to be fitted to all subjects, and showed exceptional positional stability. Unipolar and bipolar recordings from the cervix showed the same infrequent spikes and spike bursts reported from other studies along with continuous, mildly irregular, undulating slow-wave activity, which was present throughout the recordings. The frequencies and amplitudes of these slow waves changed in relation to exogenous estrogen, diagnosis, intrauterine catheters, and the intensity of the subject's pain. Spikes and spike bursts were common only during menses and at midcycle. The cervical electrode cups proved easy to use and were well accepted by the subjects. The findings indicated that the spikes and slow waves were probably uterine in origin and not artifact or extraneous/reactive activity. There were also direct and indirect indications that the slow waves may represent the ionic propagation of uterine electrophysiologic activity through a network of uterine intercellular ionic channels (gap junctions). The limited but fairly consistent evidence from a number of perspectives indicates that recording spike and slow-wave activity from the cervix is a viable and practical EHG method.

Treatment outcome in a private-sector residential care program.

The treatment outcomes of 60 chronic mentally ill patients who received services at Community Care, a private-sector residential care program, were analyzed. In addition to psychiatric services, the program offers instruction in living skills and vocational preparation, helps patients find jobs and housing, and operates an outpatient support network. Forty-two percent of the patients discharged during the study period achieved independence or near independence in the program and functioned at that level during a three-year follow-up period. Patients' level of education, degree of participation in the program, levels of residential and vocational achievement at discharge, and discharge status were significantly related to outcome. Patients with good participation in the program who stayed with the outpatient support network at discharge had at least a 95 percent probability of good outcome.

A behavioral program for the treatment of chronic patients.

The authors report the development of a short-term behavioral therapy program for chronically hospitalized schizophrenic patients who had responded only minimally in a therapeutic community. The basic program was a token economy, which concentrated on personal care activities, productive activities, and leisure activities, combined with drug treatment. During the first 9 months of the program 105 patients were admitted and 79 were discharged--24 to nursing or group homes and 47 to their own home or family. At 1-year follow-up 62 patients were still in the community without any readmissions. The findings that a token economy can be effective with chronic patients at comparatively little additional expense has broad implications for custodial care facilities with limited resources.