A validated postal questionnaire has been used to establish the prevalence of dyspeptic symptoms in five geographical locations from the south coast ofEngland to the north ofScotland. The six month period prevalence of dyspepsia in the 7428 respondents to the questionnaire is 41% and equal between the sexes, with similar prevalence rates in the centres studied. There is considerable overlap between upper abdominal symptoms and symptoms of heartburn; 56% of patients with dyspepsia experience both groups of symptoms. Symptom frequency fails progressively with age in men and women, but the proportion of people seeking medical advice for dyspepsia rises with age. One quarter of the dyspeptic patients studied have consulted a general practitioner about their symptoms. This study suggests that the prevalence of dyspepsia in the community has changed little over the last 30 years, despite evidence that the frequency of peptic ulcer disease is failing. Symptom prevalence is unrelated to social class, but this factor is associated with consultation behaviour, the consultation rate rising from 17% in social class 1 to 29% in social class 4. Results RESPONSE RATEA total of 9936 questionnaires were sent out and 7428 evaluable questionnaires were returned, giving an overall response rate of 75%. There was variation in the response rate between centres (51% to 81%), and also between age groups with response rates within the 10 year age bands ranging 65% (20-29 yrs) to 88% (60-69 yrs). NON-RESPONDERSNon-responders were found to be low users of medical care (mean annual consultation rate of 1 5 consultations per annum); no patients with peptic ulcer disease were identified in this group, in which only 4% had consulted in the preceding six months because of dyspeptic symptoms. There was a similarly low consultation rate in the preceding six months for other physical or psychological problems. DEMOGRAPHIC CHARACTERISTICSThere was a slight excess of women in the final sample (women 53%, men 47%). The social class distribution of the respondents within each centre varied markedly, as shown in Figure 1( (Fig 1(b)). Over half the positive responders to these questions experienced both of these symptoms, as shown in the Venn diagram (Fig 2).Of patients experiencing these symptoms in the last six months, the proportion consulting their general practitioner about them varied from 18% in suburban Birmingham to 35% in Southampton (mean=25%). These results are summarised in Figure 1(c).The prevalence of recently experienced dyspeptic symptoms by age and sex is illustrated in Figure 3, showing a progressive fall in symptom frequency with age, particularly in men, but with the proportion ofdyspeptic patients seeking medical advice gradually increasing with age. The six month period prevalence of dyspeptic symptoms was identical in male and female respondents (41%) although there was a slight excess of women over men (27% v 23%) in patients who consulted a doctor about the symptoms. The six month period prevalence of dyspeptic sympt...

We found only limited evidence to support parecoxib as an analgesic after craniotomy.

Serum glutathione levels were assessed in a patient with genetically proven Unverricht-Lundborg disease (ULD) before and during treatment with the antioxidant N-acetylcysteine (NAC). Glutathione levels were low before treatment, and increased during treatment. This increase was mirrored by an improvement in seizures, but not in myoclonus or ataxia. Three other patients with clinically determined ULD showed a variable response and some notable side effects during treatment with NAC.

In 15 patients who underwent open exploration of the brachial plexus, the somatosensory evoked potentials and nerve action potentials recorded at the time of operation were useful as guides to the most appropriate surgical procedure, and also in predicting the outcome in certain lesions. In three patients the apparent normality of the upper trunk of the plexus was concealing a more proximal lesion which was irrecoverable. The presence of a somatosensory evoked potential showed functional continuity in three patients in whom the C7 root was clinically involved and who recovered after operation. In five patients proximal stumps ofruptured CS roots showed functional central continuity; this indicated their sultabifity for grafting. These patients recovered except one who suffered from co-existing disease.

An electrophysiological system for monitoring the spinal cord during operations for scoliosis is described. During the development of the technique the recording of cortical somatosensory evoked potentials from the scalp and spinal somatosensory evoked potentials from the laminae or spines was superseded by the positioning of recording electrodes in the epidural space cephalad to the area to be fused. All recordings were made in response to stimulation of the posterior tibial nerve at the knee. Results in 138 patients are presented and the findings in three patients who exhibited neurological deficits after operation are described. It is concluded that spinal somatosensory evoked potentials are sensitive to minor spinal cord impairment, possible due to ischaemia, and that these changes may be reversed when the cause is quickly remedied. The monitoring system interferes minimally with anaesthetic and surgical procedures and is now performed as a routine.