Haematemesis

Abstract

National Health Service. By taking oxygen after temporary exertion beyond their real capacity, such as going upstairs, they can shorten the period of acute respiratory distress. The cylinder is also useful for operating the nebulizer for the relief of bronchospasm. Summary Coal-workers' pneumoconiosis has two forms: simple pneumoconiosis, which is rarely a cause of severe disability except in elderly men; and complicated pneumoconiosis, which may cause severe disability after the age of about 35 and is a modified form of tuberculosis. Under the present regulations men with either form are eligible for compensation. The number of new cases being certified annually in areas other than South Wales is increasing. The benefit paid is determined by the severity of disability and not by the degree of abnormality of the chest film. Miners receiving compensation may continue to work underground under dust-approved conditions if they wish. Advice on the nature of the disease, compensation, and re-employment is of special importance in the management of these cases, as misunderstandings are apt to arise. These are discussed in some detail. There is need for more exchange of information between the doctors with whom a miner with pneumoconiosis is likely to consult. Treatment of the acute pulmonary infections, bronchospasm, and cor pulmonale, and some of the principal symptoms in these cases, is briefly described. We wish to express our thanks to Dr. J. C. McVittie, of the Ministry of Pensions and National Insurance, for help in preparing the section on compensation. We are grateful to Dr. J. M. Rogan, of the National Coal Board, and to our colleagues in the Pneumoconiosis Research Unit for their helpful criticisms.

Surgery in Bleeding Peptic Ulcers

“…In our 98 emergency operations we found 13 patients without a chronic ulcer, six with acute lesions, two with gastritis, and five with no gross abnormality. A definite ulcer was found in all the cases of Fraenkel and Truelove (1955) and Gaunt (1960).…”

“…The increasing number of yearly admissions from bleeding peptic ulcer, and their increasing ages have been reported by Fraenkel and Truelove (1955), Avery Jones (1956), andLarge (1960). Our second series of patients were older, had more chronic ulcers, and more recurrent bleeding.…”

“…Avery Jones (1956) has emphasized the increase in whole series mortality that may occur in these circumstances. In spite of increasing numbers of older patients with more chronic ulcers, the mortality in Oxford fell from 19 % to 5.3 % (Fraenkel and Truelove, 1955) and in Reading from 7.4% to 5.9 % (Large, 1960), while it remained between 7 % and 8 % at the Central Middlesex Hospital, London (Avery Jones, 1956).…”

Gastro-duodenal Haemorrhage as a Surgical Emergency

“…This figure of 20% is still higher than that for other series. The following are corresponding figures from four recent papers: Avery Jones (1957) 10%, Ogilvie et al (1952 10%, Cates (1959) 13.5%, Fraenkel and Truelove (1955) 16.4%. In comparing these figures it is important to take into account the age factor.…”

“…This agrees with the findings in other series. Fraenkel and Truelove (1955) found the male: female mortality ratio for chronic ulcers to be 6.1% :4.3%. Cates (1959) found a ratio for all ulcers of 6.6% :3.2%.…”