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Abstract Aims--To investigate the relation between social deprivation and causes of stillbirth and infant mortality. Methods--Stillbirths and infant deaths in 6347 enumeration districts in Wales were linked with the Townsend [...]

Summary Objective. To investigate differences in risk of categories and causes of death before 1 year of age between rural and urban areas. Methods. Population-based ecological study using Poisson regression analysis of data from all enumeration districts in Wales. Data included alt 243 223 registrable births to women resident in Wales, 809 therapeutic and spontaneous abortions, 1302 stillbirths and 1418 infant deaths occurring between 1993 and 1999. Main results. The relative risk of mortality in rural areas compared with urban areas for all deaths before 1 year of age was 0.89 (95% confidence interval 0.82, 0.98, P=0.02). The risk of mortality in rural areas was significantly Lower than in urban areas for all categories of deaths occurring after 7 days of life. The relative risk of death due to infection was significantly Lower in rural areas compared with urban areas (P=0.04), with similar results for deaths due to sudden infant death syndrome (P=0.03). After adjusting for social deprivation, there were no significant differences in the risk of death between rural and urban areas. Conclusions. While there were significant differences in crude risk between rural and urban enumeration districts for some causes and age groups before 1 year, after adjusting for social deprivation, these differences were not significant. The lack of significant interaction between rurality and deprivation indicated that the relationship between social deprivation and death before 1 year of age was not significantly different in rural areas compared with urban areas. Collaborative public health programmes to tackle deprivation are necessary in both rural and urban areas. [ABSTRACT FROM AUTHOR]

Recent studies suggest that the pylorus may play an important role in the regulation of the gastric emptying of nutrient liquids in man. Dextrose solutions in the range 5-25 g/dl have been reported to empty from the human stomach at a constant caloric rate of 2.1 kcal/min. This study examined, in 12 healthy volunteers, the effects of intraduodenal dextrose on pyloric motility. Dextrose solutions, 5, 10, 15, and 25 gde/dl and saline solutions, 0.9 and 2.7 g/dl were infused into the duodenum at 4 ml/min for 10 minutes. Antral, pyloric, and duodenal motility were monitored with sideholes and a sleeve sensor positioned across the pylorus. Significant increases in the rate of isolated pyloric pressure waves and in basal pyloric pressure were seen with 15 and 25 g/dl dextrose (p less than 0.02) and 2.7 g/dl saline (p less than 0.05). The intensity and duration of the phasic and tonic pyloric motor responses to intraduodenal dextrose were dose dependent and correlated directly with the rate of calorie delivery (p less than 0.005 for each parameter). Intraduodenal delivery of dextrose at a rate in excess of 2.1 kcal/min stimulates both phasic and tonic pyloric contraction. These changes in pyloric motility may contribute to the close regulation of the emptying of dextrose from the stomach. [ABSTRACT FROM PUBLISHER]

Two patients are described with chronic liver disease and portal hypertension in association with ulcerative colitis for which colectomy and ileostomy had been performed. Both patients developed bleeding from the varices situated around the ileostomy stoma and one also bled from the oesophageal varices. Each had a successful portacaval shunt performed because of this bleeding. The occurrence of such ileal varices is uncommon, but is important as a manifestation of portal hypertension. Although it can usually be easily controlled by local measures, portal-systemic shunt should always be considered, particularly as such patients are also very likely to bleed from oesophageal varices. [ABSTRACT FROM PUBLISHER]

The 20 patients described could be included in the group of patients diagnosed as `idiopathic steatorrhoea'. However, their histories were short and diarrhoea was not a major feature. Since megaloblastic anaemia due to folic acid deficiency was a common feature it is suggested that these patients may form a homogeneous group and the diagnostic label of temperate sprue is suggested. [ABSTRACT FROM PUBLISHER]

A clinical, biochemical, and pathological study is recorded of 50 patients in whom a diagnosis of idiopathic steatorrhea had been made and who had `flat' jejunal biopsies. It is suggested that there is an underlying constitutional defect, not yet clearly defined, and that possibly secondary intestinal infection allows the intestinal mucosa to become sensitized to substances in the diet. Of these gluten is the commonest; milk adversely affects others; and there may be other factors. [ABSTRACT FROM PUBLISHER]

A study of 33 patients with jejunal diverticula showed that all except four had symptoms or metabolic upsets attributable to the presence of the diverticula. A disturbance of vitamin B12 metabolism or absorption was found in 16 patients and neuropathy was found in 12 patients. It is considered that abnormal bacterial activity in the small intestine is an important factor in these patients. [ABSTRACT FROM PUBLISHER]

This paper demonstrates that the hepatic surface counting technique is a reliable and satisfactory method of estimating the absorption of radioactive vitamin B. It does not require the collection of faeces or urine and is therefore particularly useful in studying out-patients. [ABSTRACT FROM PUBLISHER]