Atrial fibrillation precipitated by acute hypovolaemia.

Six patients with varying degrees of acute cardiorespiratory failure were seen. All patients deteriorated noticeably when rapid atrial fibrillation developed. In all patients intravenous digitalis failed to slow the ventricular response, and in three patients misguided attempts at electrical cardioversion failed. Haemodynamic monitoring showed a normal or low pulmonary artery occlusion pressure in all patients. Controlled expansion of plasma volume was associated with an immediate slowing of the heart rate in all patients, and the heart rate in all patients returned to sinus rhythm within 30 minutes of transfusion. It is suggested that hypovolaemia in critically ill patients may contribute to the development of atrial fibrillation.     

Epidemiology of bacillary dysentery in Algeria. II. The seasonality of dysentery

Morbidity rises during the period of summer and autumn are characteristic of bacterial dysentery in Algeria. During the last 18 years no essential changes in the seasonal character of bacterial dysentery were observed in the country taken as a whole. However, in different climatic and geographical zones of the country the seasonal character of dysentery greatly varies from one zone to another and essentially differs from the seasonal character of dysentery morbidity, typical of the country as a whole for many years. The most pronounced manifestations of seasonal rises are observed in the Sahara zone. The seasonal character of dysentery is formed mainly by morbidity among patients belonging to 3 age groups. The seasonal rises of dysentery can be probably explained by the complex of social and climatic factors, as well as by the biological features of the causative agents of this disease.     

Erectile impotence precipitated by organic factors and perpetuated by performance anxiety.

A survey of 72 men with erectile impotence showed that for 14 the onset had been concurrent with the start of a temporary physical disability (in 8), temporary exposure to a chemical agent in doses thought to be significant (in 4) or the return of sexual opportunity after a long period of celibacy or near-celibacy (in 2 older men). After elimination of that possible cause the impotence had persisted owing to anxiety about sexual performance. In another 6 of the 72 there were persistent nonpsychic causes for the impotence. Thus, in 28% of the men surveyed the precipitating cause of erectile impotence was organic. A large proportion of the cases of erectile impotence participated by a temporary nonpsychic factor could probably have been prevented with appropriate professional advice--for example, at the time an antihypertensive drug capable of causing the dysfunction was first prescribed.