J. M. Kellett

Double Blind Trial of Yohimbine Hydrochloride in the Treatment of Erection Inadequacy

Abstract For many years yohimbine was a common treatment for disorders of potency and libido. However, yohimbine was withdrawn from use in the United Kingdom on account of inadequacy of the documentation confirming its efficiency. We report here the results of a double blind, cross over, placebo controlled trial of yohimbine hydrochloride 5.4 mg three times daily in the treatment of erectile inadequacy of mixed aetiology. Efficacy data are presented on 61 of 70 men recruited to the trial. Yohimbine was associated with a significant improvement in the quality of stimulated erections. The drug was generally well tolerated

The St. George's dementia bed investigation study: a comparison of clinical and pathological diagnosis

Sixty‐four elderly patients who had been admitted to the St. Georges Hospital Alzheimers disease evaluation project during 1981–1989 were followed up to postmortem examination. Comparison between clinical diagnoses and neuropathological diagnoses indicated positive predictive values for the antemortem diagnoses of 50–67%. Existing clinical criteria may not be accurate enough to permit firm antemortem diagnosis of older people for either research or clinical purposes.

The relationship between pre-operative anxiety and post-operative delirium

Forty five elderly patients undergoing total hip replacements were assessed one day before and two days after surgery in order to explore the relationship between pre-operative anxiety and post-operative delirium. Anxiety was measured by the State-Trait Anxiety Inventory and delirium was measured by a decrease in various measures of cognitive functioning. No relationship was found and this is discussed in the light of two theories which would have predicted one. Other secondary findings are reported and discussed.

Sexuality of the elderly

Abstract After considering various surveys of sexual activity with age it is concluded that the reduction in activity is more cultural than biological in origin. Additional factors include physical illness, drug treatment, psychological changes of ageing, and social factors relating to increasing frailty. Treatment involves education about the normal changes of ageing, and advice regarding the sexual taboos of earlier generations. The elderly must feel free to alter their sexual practice to suit themselves.

The St. George's dementia bed investigation study: cardiovascular, neurological and neuropsychological correlates

The results of the cardiovascular, neurological and neuropsychological examination of a series of patients admitted to the St. Georges dementia investigation bed and who later came to postmortem are compared in relation to their pathological diagnosis. Individual clinical signs were not found to differentiate between cases of dementia with vascular versus those with Alzheimers disease pathology, although multivariate analysis suggested that there was a pattern of signs associated with cerebrovascular disease. A vascularity index was constructed from these signs; it achieved a useful level of discrimination between vascular and nonvascular causes of dementia.

Sex and the elderly male

Abstract Despite a decline in sexual activity with age many couples continue coital contact until their nineties. The reasons for male dysfunction are discussed along with the nature and biology of ageing. Many problems are the result of a combination of factors both social and physical, so that effective treatment needs to use. all methods available. Many elderly men are taking drugs which impair their function and for which effective alternatives are available. The treatment of male dysfunction in old age is both challenging and satisfying.

Functions of a Sexual Dysfunction Clinic

The sexual dysfunction clinics set up on the model of Masters and Johnson have adapted to the NHS, and to the increase in organic treatments for erectile failure. In many senses the future of sexual counselling services led by the psychological sciences is in peril, as other disciplines move into this field. Doctors, in particular, need to establish their role by being able to unite the organic and psychological approaches. Above all we must avoid the sterile controversies which have bedeviled psychosomatic illness, and treat sexual dysfunction in the context of the whole person, involving psychology, pharmacology and physiology.

St George's hospital medical school course for the diploma in human sexuality

Abstract The St. Georges Hospital Medical School Course for the Diploma in Human Sexuality is described in terms of its development, content and examination pattern. Pass rates for the first three intakes are reported.