{'fraction_non_alphanumeric': 0.017676767676767676, 'fraction_numerical': 0.018037518037518036, 'mean_word_length': 4.937901498929336, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Urgent surgery in ulcerative colitis.

colleagues have found that the death rate at five years was lower in patients referred between 1960 and 1967 than between 1952 and 1959.15 Indeed, up to a level of diastolic pressure before treatment of 140 mm. Hg the survival rate remained constant between 80 and 9000 in 1960-7. Not only was it 10-20% higher than in the previous period but it contrasts strongly with the close relationship between diastolic pressure and the five-year mortality in the untreated patient. Accelerated hypertension continued to have a poor prognosis, especially when kidney damage was present. Possibly the control of blood pressure was poorer in patients who died during 1952-9, but throughout the study patients who died of uraemia and stroke were no more likely to have been in poor control than those dying of myocardial infarction. Of the deaths 7% from the earlier group and 27% from the later group occurred as a result of myocardial infarction. In this study, as in others, the prognosis at all levels of diastolic pressure before treatment was better in women. The need for treatment in the individual patient with hypertension is dictated by the prognosis without treatment, the effect of treatment on prognosis, and the inconvenience and hazard of treatment. A clear case can now be made for treatment in men and women under 65 years who have sustained diastolic hypertension with retinal changes or with complications, and in any patient with accelerated hypertension. The difficult area is in mild hypertension (diastolic pressure not above 95 mm. Hg) in patients without retinal changes-especially in men under 50, in whom the prognosis is poorer. Conclusive evidence is still lacking to support the view that treatment in such cases improves the prognosis. Nevertheless, as treatment of more severe hypertension has failed to reduce the mortality from myocardial infarction, many hope that the effective reduction of mild diastolic hypertension at an earlier age will delay the onset of degenerative vascular disease and increase the expectation of life. Obvious problems arise in identifying the young, mild, symptomless hypertensive. The place of health screening programmes is still debatable, but no doctor should miss an opportunity to record the blood pressure of a young or middleaged patient who is a rare visitor to the surgery. Once hypertension has been discovered, the further difficulty arises of how best to enlist the patient's co-operation without arousing his fears. The greatest difficulty of all is to record the real pressure, increasingly difficult as anxiety grows, and often possible only on brief admission to hospital. It is no longer consistent with good medical practice to run away from these difficulties.