A series of 489 consecutive patients with definite or classical rheumatoid arthritis was followed for a mean of 11.2 years. Cohort-analysis of the series showed a three-fold increase in mortality overall in comparison with age- and sex-specific rates in the general population. In patients first seen in hospital early in the course of the disease (less than 5 years from onset), the excess of deaths from circulatory, respiratory and musculoskeletal disorders was highly significant. Malignant disease and digestive system disorders accounted for a small excess of borderline significance. Patients who were referred later (greater than 5 years from onset) experienced, in addition, a highly significant excess of deaths from infections and disorders of the digestive and genito-urinary system but not from malignant neoplasms.

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Calcium and Serum Lipids-Yacozoitz et al. M BRILTSH Substitution of gluconate for carbonate as the anion in the calcium salt resulted in no significant difference in metabolic effect, as was anticipated from the results of Patton and Sutton (1952). The change from carbonate to gluconate was attempted because carbonate caused a degree of constipation and abdominal distress which was absent when gluconate was employed. The gluconate, however, because of the higher molecular weight, requires considerably more of the salt to achieve the same calcium level, presenting the problem of larger numbers of tablets to be ingested..The lowering of serum cholesterol and triglycerides by calcium is interesting from two points of view. First, Wells and Cooper (1958) reported that calcium inhibited cholesterol absorption in rats in the presence of dietary fat. Calcium was also reported to be hypocholesterolaemic in rabbits (Iacono et al., 1960). This might in part explain some of the hypocholesterolaemic activity of calcium in that absorption of exogenous cholesterol may have been inhibited. The second reason for interest in the hypolipaemic action of calcium was the repeated reports of a negative relation between mortality from cardiovascular disease and the hardness of drinking-water (Schroeder, 1960a(Schroeder, , 1960bMorris et al., 1961). Since calcium is the major cation associated with water hardness, it was not unexpected that a similar negative correlation was found between water calcium-ion concentration and cardiovascular disease mortality.Studies are being conducted into the mechanism of the hypolipaemic effect of calcium and upon the effects of calcium ingestion upon tissue lipids. It is anticipated that this preliminary study will be expanded to examine the effects of dietary calcium on larger numbers of people, particularly young males with electrocardiographically proved myocardial infarctions, in order to ascertain whether a significant decrease in morbidity and mortality could be attained in this way. SummaryIncreased calcium ingestion by subjects of both sexes who were free of clinical coronary heart disease caused a significant decrease in both serum cholesterol and serum triglyceride levels. Both faecal dry matter and total faecal lipids were increased. The exact mechanism of the hypolipaemic action of calcium still requires clarification. , 1965, 1, 1354-1356 Indomethacin, a new drug for treating arthritic disorders, was introduced for clinical trial in 1962. It is chemically unrelated to either corticosteroids or other anti-inflammatory compounds, and has an indole structure within its formula [ 1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-acetic acid]. Although anti-inflammatory activity can be demonstrated in animals (Winter, Risley, and Nuss, 1963), this effect has not been conclusively shown in man, though measurable reduction in the finger-swellings of patients with rheumatoid arthritis, as measured by jeweller's rings, occurs (Hart and Boardman, 1963). Other parameters of inflammation such a...