No abstract

Criteria for the classification of juvenile rheumatoid arthritis were analyzed in a detailed database of 250 children in order to assess the accuracy of diagnosis and validity of onset types and course subtypes. A number of conclusions have been derived from this study: 1) All definitions of the 1973 criteria for classification of juvenile rheumatoid arthritis should be retained. 2) The addition of onset types to the 1976 revision of the criteria has been validated. 3) The course of the disease after the onset period of 6 months is as important to the outcome of a group of children as is the onset type. 4) The current classification should be broadened to include the course subtypes.

After an earlier study into the practical aspects of the management of perinatal death, a counselling service was introduced for parents whose baby had died in the perinatal period. The service was monitored, and the parents who received the service were compared with a group that did not. Fifty families were allocated randomly either to the counselling (supported) group or to the contrast group, who received routine hospital care.

Six hundred sixty individuals from a music school were studied to determine the frequency of incidence and the nature of their hypermobility. They were interviewed and examined for the 5 recognized features of hypermobility (laxity of the thumbs, fingers, elbows, spine, and knees). The incidence of hypermobility, according to the number of joints involved, followed an empiric geometric law. Approximately 27 % of the individuals had 1 lax joint, whereas only 3% possessed all 5 features. Specific features were present at different frequencies in the 2 sexes. The ratio of the occurrence of 2 features in women compared with the occurrence in men was 2:l. Ratios for the Occurrence of 3,4, and 5 features were 4:1,8:1, and 3:1, respectively. Thus, hypermobility was a predominantly female characteristic. Joint laxity declined with age, although not to a statistically significant degree. In men, the decline started when they were in their mid-twenties; however, in women, joint laxity continued through the midforties.Joint laxity has fascinated people since time immemorial. However, it was not until the end of the nineteenth century that hypermobility was considered to be a problem in clinical practice. Kirk et a1 (1) were