We studied the effect of asymptomatic bacteriuria on survival in 342 healthy residents of a home for the aged. At entry into the study 76 subjects (22 per cent) had bacteriuria on two consecutive urine cultures. There were no differences in age distribution, blood pressure, hematocrit, smoking habits, cholesterol, or myocardial changes between bacteriuric and nonbacteriuric subjects. Median survival was 53 and 75 months in nonbacteriuric men and women 70 to 79 years old, and 45 months in all nonbacteriuric subjects over 79; median survival of bacteriuric men and women aged 70 to 79 was 33 and 34 months, and that of those older was 31 and 29.5 months; the shorter survival of bacteriuric subjects was significant (P less than 0.003). These differences in mortality among subjects living under identical conditions and with equal prevalence of risk factors indicate that bacteriuria in old age is associated with a reduction in survival of 30 to 50 per cent.

Hippocrates' treatise On Wounds in the Head represents an excellent source of information regarding the extent of experience with head injuries in classical antiquity. On the basis of clinical observation, the great physician gives an accurate description of the external appearance and consistency of the cranium. Fractures of the cranium are divided into six main categories, each of which is discussed separately, regarding its mechanism, clinical assessment, and treatment. The medical history and clinical evaluation are considered the most important factors when dealing with cranial trauma. Trepanation, a neurosurgical procedure still in practice today, is presented in detail. As a whole, the treatise, the first written work in medical history dealing exclusively with cranial trauma, reveals that Hippocrates was a pioneer in treating head injuries.

SummaryThe mechanisms of renal tubular dysfunction in old age have been examined in twenty-eight clinically healthy elderly subjects without infection, and in fourteen subjects of similar age with laboratory evidence of intrarenal infection. The data were compared with those from thirteen clinically healthy young subjects. Introduction.