bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Pediatric Sensorineural Hearing Loss: A Survey of Pediatric Otolaryngologists
Authors: Rutherford Kimberley D. , Lerer Trudy S. , Schoem Scott R. , Valdez Tulio A.
Published: January 2017

Objectives:

We sought to determine the trends in the evaluation of pediatric patients with sensorineural hearing loss (SNHL) and to determine evaluation patterns based on respondents' demographic data.

Methods:

All members of the American Society of Pediatric Otolaryngology were invited to voluntarily and anonymously complete an online survey. The survey was available from September 2009 to January 2010 and addressed demographic data and tests obtained in evaluating new pediatric patients with SNHL at different age points and with different degrees of hearing loss.

Results:

The response rate was 22.9% (79 of 345). For all ages and all types of SNHL, the most common consultations were genetics (26% to 76%) and ophthalmology (31% to 66%) consultations. Computed tomography of the temporal bones (49% to 66%), genetic testing (25% to 68%), and electrocardiography (13% to 43%) were the most commonly performed tests. Although there was no consistent difference in practice patterns by gender or years of practice, there were differences in the use of thyroid function tests, TORCH titers, and autoimmune studies by hospital affiliation.

Conclusions:

Type of SNHL and age are factors in the evaluation of pediatric patients with SNHL. Additionally, evaluation patterns differ according to region and hospital affiliation. The results of this study may provide guidance for otolaryngologists in making information-based and cost-effective evaluations.
The UN Conference on the Law of the Sea — The Basic Problems from a Norwegian Point of View
Authors: Vindenes Helge
Published: January 2017

The article gives a survey of the basic problems which will be before the forthcoming UN Conference on the Law of the Sea – as seen from a Norwegian point of view. In examining the interrelationship between these problems, the author arrives at the conclusion that the only feasible solution would be a ‘package deal’ covering all the main issues. The juxtaposition of priorities of the various interest groups at the Conference – a majority of coastal states for whom the rights to the resources in an area adjacent to the territorial sea is the most burning issue, and a minority of maritime powers for whom the question of freedom of navigation is more important – indicates the nature of the possible overall compromise solution. Such a solution would, it seems, have to consist of a package deal which must reconcile and accommodate, the interests of maritime freedom on the one hand with on the other hand, the increasing need for management powers, both for the coastal state and for international regulatory bodies. The main elements of such a package would probably have to be the following:

Firstly, a territorial sea limited to a maximum distance of twelve nautical miles from the baselines along the coast. There is already with the exception of a few Latin-American countries, broad agreement that a territorial sea limited to twelve nautical miles should constitute one of the main elements in the solution.

Secondly, guaranteed rights of passage inside the territorial sea, including a special right of free or unimpeded passage through straits used for international navigation. Thirdly, extensive resource management rights for the coastal state in an adjacent area outside the territorial sea. In this adjacent area, which would be called the economic zone and which would extend to a maximum of 200 nautical miles, the jurisdiction of the coastal state would be limited to matters pertaining to the exploitation of the area's natural resources – both its seabed resources and its fisheries resources. The coastal state would also have certain well-defined rights in the zone where measures to combat pollution are concerned, and the right to regulate scientific research. There would be freedom of navigation inside the zone.

In addition to an overall package solution along the lines mentioned above, the new convention will have to establish a legal regime for the exploitation of the natural resources on the seabed and ocean floor in areas outside national jurisdiction. It will also have to establish an international organization for the implementation of this legal regime. The author emphasizes the need for equipping the international organization with broad regulatory powers, in accordance with the basic approach taken by the UN General Assembly in 1970, when declaring the international seabed area as ‘the common heritage of mankind’.
Small States in International Politics: A Polar-Political Perspective
Authors: Skagestad Gunnar
Published: January 2017

The study of small states may be perceived, alternatively, as a distinctly separate discipline within the broader subject area of international politics, or, as one particular approach to the study of international politics in general. So may the study of the ‘new territories’. In this chapter, the two perspectives combine.

Presenting the ‘new territories studies’ as a novel approach to the traditional small states studies, the chapter discusses the practical/political possibilities and limitations inherent in the small states' situation and is also an attempt to contribute toward an improved theoretical basis for the study of small-state behavior. The empirical material is mainly the developments in inter-state relations which have taken place in the Antarctic (the ‘Antarctic Model’); the Arctic situation is also presented for comparative purposes.

The author arrives at certain guarded generalizations, where the need for international cooperation emerges as a major contingent factor regarding the validity of descriptive and normative hypothesizing on small state behavior.
The Effects of Letter Size, Case, and Generation Method on CRT Display Search Time
Authors: Vartabedian Allen G.
Published: January 2017

The effects of letter size, case, and generation method were studied in a task of searching for a common five-letter word in a CRT display. Symbol sizes of 0.12, 0.14, and 0.16 in. were evaluated. Words were composed of all uppercase or all lowercase letters. Two symbol generation methods-letters drawn by means of continuous strokes and by means of a seven-wide-by-nine-high pattern of dots in a fixed matrix-were investigated. The results indicated that for both methods of symbol generation, uppercase words were searched 13% faster than lowercase words. No significant differences were found due to symbol generation method or letter size.
The Effects of Headlight Glare on Vehicle Detection at Dusk and Dawn
Authors: Attwood Dennis A.
Published: January 2017

Ten experienced drivers performed a series of closed-course tests to determine whether a target vehicle, located between other oncoming vehicles in a single-lane convoy, could be detected under various levels of ambient illumination, with its low beam headlights on and off, and with different headlight configurations on the surrounding vehicles. Levels of ambient illumination varied from approximately 0.2 to 2100 lx during the experiment. Results indicated that low beam headlights on surrounding vehicles masked the unlit target vehicle. The degree of masking depended on the level of veiling luminance emitted by the surrounding vehicles and on the level of ambient illumination. It was also found that the target vehicle was more visible under all experimental conditions when its headlights were on than when they were off. Results are discussed in relation to subject and weather variations and in terms of current lights-on laws.
The Evaluation of a Complex Computer-Based Flight Procedures Trainer
Authors: Trollip Stanley R.
Published: January 2017

Skills such as flying holding patterns are taught in planes or simulators. An alternative method is to use computer-assisted instruction (CAI) which emphasizes training requirements rather than physical fidelity. Such a program was written and evaluated. Traditional ground school methods were compared with the CAI method. All subjects completed a training sequence in a ground trainer. Those taught by computer performed better and attained criterion quicker with significantly fewer critical errors. Results indicate that CAI offers an effective alternate to the costly trainers currently in use.
A Comparison of Kinesthetic-Tactual and Visual Displays via a Critical Tracking Task
Authors: Jagacinski Richard J. , Miller Dwight P. , Gilson Richard D.
Published: January 2017

The present study investigated the feasibility of using the critical tracking task to evaluate kinesthetic-tactual displays. Subjects attempted to control a first-order unstable system with a continuously decreasing time constant by using either visual or tactual unidimensional displays. In addition, display augmentation was introduced in both modalities in the form of velocity quickening. For these unoptimized displays, visual tracking performance was better than tactual tracking, and velocity quickening improved the critical tracking scores for visual and tactual tracking about equally. Comparing across modalities, tactually quickened tracking performance was approximately equal to visually unquickened tracking. The present results suggest that the critical task methodology holds considerable promise for evaluating kinesthetic-tactual displays and that tactual tracking performance under certain conditions may yield results comparable to those of visual tracking.
Global versus Local Consistency: Effects of Degree of Within-Category Consistency on Performance and Learning
Authors: Fisk Arthur D. , Jones Cerita D.
Published: January 2017

We examined the effects of varying degrees of global (higher-order) and local (stimulus specific) consistency on performance and learning in a visual search task. Participants performed a semantic-category, visual search task across 9792 trials of practice. Semantic categories were either completely consistent (all category exemplars served only as targets, never as distractors), completely inconsistent (across trials category exemplars served as both targets and distractors), or partially consistent (25%, 50%, or 75% of the category exemplars served only as targets while the remaining exemplars served as both targets and distractors). Following training, category learning was assessed by examining performance on untrained exemplars of the trained categories. Inconsistency at the category level did not affect detection performance of the consistent exemplars; however, only the completely consistent category-training resulted in statistically significant transfer.
The Resolution of Tuinal and other Barbiturate Mixtures
Authors: Stevens H. M.
Published: January 2017

A method is described for the resolution of barbiturate mixtures by preliminary oxidation with an acid solution of potassium permanganate. Barbiturates with saturated side chains are unaffected by this oxidative treatment and can be extracted from the acid solution by benzene. Those with unsaturated side groups are oxidised and their products are insoluble in benzene but soluble in n-butanol. The mixed products can be resolved, and also separated from unattacked barbiturates, by paper chromatography in n-butanol saturated with 6N ammonia. Suggestions are made as to the possible use of this method in the resolution of mixtures of barbiturates of unknown composition.
Fatal Agricultural Accidents
Authors: Albrektsen S B , Henriksen B M , Thomsen J L
Published: January 2017

During the period 1969–1988, 33 victims (30 males and 3 females) of agricultural accidents were autopsied at the University Institute of Forensic Medicine in Copenhagen. Five were under the age of 15 years. The median age was 51 years.

The most frequent types of accident were machinery accidents (45%), falling from a height (30%) and suffocation, including drowning, (12%). The place of the accident was meadow/field (36%), stable/barn (24%), farmyard (24%) and public road (12%).

Severe lesions in all body regions dominated the picture with a preponderance of skull/brain and chest lesions. Skull/brain lesions were found in 80% of the cases of falling from a height, while 87% of the machinery accident cases had severe chest lesions.

More effective control of machinery and a data collection system for these accidents are proposed.
What Stops Effective Clinical Audit? Reports from the Front Line
Authors: Johnston G.N. , Crombie I.K. , Davies H.T.O.
Published: January 2017

Semi-structured interviews were conducted with 145 clinicians from a variety of clinical backgrounds in twelve Trusts across three Scottish health boards. Questions examined barriers to the audit process and obstacles that impeded the implementation of changes in response to the audit findings as well as the need for resources to facilitate the audit activity. The most difficult part of the audit process was reported as data collection (32%) but almost half of respondents would have changed the way the audit was done with hindsight. The biggest barrier to doing the audit was perceived as lack of time (33%). Colleagues' attitudes posed the biggest obstacles to making changes as a result of the audit (26%). Few perceived the need for more resources but preferred focused and proactive support from managers and audit support staff. Trusts need to work harder at creating cultures where clinical audit is supported and actively encouraged.
Which Acute Stroke Patients with Atrial Fibrillation are Prescribed Warfarin Therapy? Results from One-Year's Experience in Dundee
Authors: Craig J. , MacWalter R.S. , Goudie B.M.
Published: January 2017

The recommended treatment of ischaemic stroke patients with atrial fibrillation (AF) is anticoagulation therapy with warfarin sodium and if this is contraindicated then aspirin should be used. The management of patients on warfarin therapy can be complicated and there is a risk of intra-cranial haemorrhage in elderly patients. However, these are the patients who stand to gain the most benefit from this treatment and therefore increased use of warfarin for secondary prophylaxis is likely to lead to a lower rate of subsequent admissions and less morbidity. The recommended treatment for these patients has often not been fully instigated in practice. This study was carried out in order to determine whether a group of patients admitted to a teaching hospital with diagnosis of ischaemic stroke and atrial fibrillation received appropriate antithrombotic therapy. Details of patients admitted with acute stroke during 1997 were obtained from the Dundee Stroke Database and information was extracted from the relevant clinical notes. Twenty-five out of 42 patients (60%) were considered eligible for anticoagulation and 14 out of those 25 (56%) were found to be on warfarin either on admission or subsequently. Of patients aged less than 75 years, 8/10 (80%) were on warfarin, whereas only 6/15 (40%) of those aged 75 years and older were being anticoagulated.
Is Intranet Technology the Low Cost, Quick Fix Solution for Scotland's Clinical Information Technology Chaos? Results of a Pilot Study
Authors: Nixon S.J. , Munro M.M. , Sands I. , Dee E.G. , Smith J.A.
Published: January 2017

For health care professional staff immediate access to recent clinical documents is seen as the first priority for developments in Information Technology. Large amounts of clinical data are held on computer systems to which staff have little or no access. A pilot study has been undertaken to evaluate the use of Intranet technology, electronically extracting large volumes of data from various feeder systems in real time and allowing access via standard Internet browsers. Over 700,000 reports have been successfully transferred from three differing sources with more than 2000 new records added per week. Intranet technology would seem to be a low cost solution, capable of rapid implementation, that could overcome the most important bottleneck in clinical computing.
Primary Care or A&E? a Study of Patients Redirected from an Accident & Emergency Department
Authors: McGugan E.A. , Morrison W.
Published: January 2017

A departmental policy was introduced whereby patients with a complaint of over three days duration are assessed at triage by senior doctors as to whether they should be seen in A&E or redirected to primary care. This pilot study aimed to establish numbers, demographics, reasons for attending and outcome. A total of 179 patients were studied. Most were young men attending during working hours on week days. Most had symptoms for more than one week and had not seen their GP. Of 137 patients advised to see their GP — 67 did so. No adverse outcomes were reported. Twenty-three patients were seen in A&E: six had fractures, one required admission. Limited resources and increasing demands means that A&E must define its service. This system selects out those patients with prolonged symptoms who are likely to be able to be managed in the primary care setting.
The Prevalence of Obesity and Undernutrition in Scottish Children: Growth Monitoring within the Child Health Surveillance Programme
Authors: Armstrong J , Reilly J J ,   Child Health Information Team+
Published: January 2017

Objective: To assess whether anthropometric data, routinely collected as part of the Scottish Child Health Surveillance System (CHSP- PS, preschool children; CHSP-S, school age children) could provide a means of monitoring/surveillance for obesity and undernutrition at national and health board level.

Design: A survey of 15 health boards and both surveillance systems to identify the nature of data collected, format of data, and extent to which data were accessible (eg via Information and Statistics Division of the Common Services Agency). Measurements of weight and height collected as part of the CHSP-PS and CHSP-S were extracted from ISD. They were then audited and missing values or implausible values quantified, and degree of dispersion of values used as an index of quality of measurements.

Setting: Health Board Child Health Surveillance Systems and Information and Statistics Division, Edinburgh.

Results: Data on height and weight are currently available for 9 health boards for preschool children and 4 health boards for school age children. This represents coverage of around 80% of the preschool child population. Analysis of a data extract from the 39–42 month check in 1998/99, used as an example, revealed that 8% of weight and height data were missing, and approximately 1% were implausible measures. Population and health board level estimates of prevalence of obesity and undernutrition were possible and are presented. Data on height and weight are routinely collected in school age children in all health boards, however only four health boards have growth data electronically available via the school CHSP.

Conclusions: Growth data routinely collected as part of child health surveillance for Scotland can be used to estimate population prevalence of undernutrition and obesity. These can in turn be used to monitor trends at local and national level, to monitor achievement in relation to public health targets, identify risk factors and high risk groups, and to follow cohorts over time. We describe a system of surveillance for undernutrition and obesity and identify its strengths and weaknesses.
Chronic Rhinosinusitis: A Comparative Study of Disease Occurrence in North of Scotland and Southern Caribbean Otolaryngology Outpatient Clinics over a Two Month Period
Authors: Ahsan S F , Jumans S , Nunez D A
Published: January 2017

A comparative study of the occurrence of chronic rhinosinusitis in clinics in the North of Scotland and Southern Caribbean was performed, to test the hypothesis that patients with chronic rhinosinusitis present more commonly in temperate climates than tropical climates. The data was collected prospectively over two month periods from outpatient clinics at both sites. A higher surgical trainee or consultant otolaryngologist made the diagnosis of chronic rhinosinusitis. Eight-hundred-and-seventy-two otolaryngology outpatients were studied 311 were from Trinidad and 561 from Aberdeen. The proportion of patients presenting with chronic rhinosinusitis in both samples is similar, 54(9.6%) patients in Aberdeen and 29(9.3%) in Trinidad. The proportion of chronic rhinosinusitis patients with a history of allergy is greater in Trinidad 79.3%(23) than in the Aberdeen sample 50%(27). Patients with chronic rhinosinusitis were seen as commonly in otolaryngology clinics in a tropical setting as in a temperate setting.
Factors Affecting the Results of Surgery for Prolapsed Lumbar Intervertebral Disc
Authors: Marshall W. J. S. , Schorstein J.
Published: January 2017

The clinical and operative findings in 320 patients with prolapsed lumbar intervertebral discs are described. The level of the lesion was correctly predicted on clinical grounds in 70 per cent of cases, but no single sign was found to be a reliable indication of the level. Prolapsed discs at 2 levels were found in 10 per cent of patients and it is suggested that both the L4/5 and the L5/S1 spaces should always be explored at operation. The long-term post-operative results are presented in 214 of the patients. Excellent results were obtained in 68 per cent of patients, good results in 14 per cent, poor results in 9 per cent and bad results in 8.5 per cent. Operation was less successful in patients over 40 years of age, in heavy manual workers, and in those with continuous sciatica for more than 1 year. It is suggested that a readiness to operate at an earlier stage in resistant cases would significantly improve the results of surgery.
The Incidence and Effects of Anaemia in a Young Industrial Population
Authors: Bryson D. D.
Published: January 2017

A survey of haemoglobin levels in 619 young people working at a Scottish factory showed that anaemia was prevalent. Anaemia was found to exist in 37 per cent of all females and in 19 per cent of all males between the ages of 15 and 19 years, different standards being used to define anaemia in each sex.

The incidence of anaemia varied significantly (P= 0.01) between groups of young people in different occupations being 39.9 per cent in female factory workers, 14.0 per cent in female clerical workers, 32.0 per cent in young male factory workers and 8.7 per cent in male apprentices.

The possible aetiology, particularly nutritional deficiency is discussed and the effect that anaemia may have on the industrial performance of the individual. The increased incidence of anaemia in semi-skilled workers suggested that social background may be an influencing factor in its occurance.

Comparisons with older groups showed that improvement in the mean haemoglobin level occurs spontaneously in boys but that this improvement did not occur in females.

The incidence of anaemia in females was not directly related to the number of years which had elapsed since menarche.

The fact that routine haemoglobin examination of the young worker is seldom undertaken at present is pointed out and the importance of such examinations especially in the female is stressed.
Emergency Psychiatric Referrals to the Casualty Department of a General Hospital
Authors: Le Poidevin D. , Reid A. H.
Published: January 2017

A survey of 100 consecutive cases referred as psychiatric emergencies to the casualty department of a general hospital is reported. Cases of self-poisoning recognised by the casualty officers were not included. Fifty-seven of the patients were self-referred.

Significant excesses were found in the sample of men in social classes IV and V, and men and women in 30 to 49 years age group. The commonest diagnoses were manic-depressive psychosis (38 per cent) and chronic alcoholism (27 per cent).

The risk of suicide was considered to be high.

Psychiatric referrals to the casualty department are increasing. Many patients claimed poor relationships with their general practitioners. The preventive function of a psychiatric unit in a general hospital is stressed. It is suggested a psychiatric casualty service may be needed in each big city.
A Simple Method of Estimating Plasma Salicylate Levels
Authors: Burston G. R.
Published: January 2017

A rapid, reliable, and simple method of estimating serum salicylate levels is described which makes this estimation available not only to units managing patients suffering from salicylate self-poisoning but also to departments using salicylates for medication and needing an easy method of checking the serum levels.
A Comparative Study of the Treatment of Urinary Infection
Authors: Kennedy A. C. , Allison M. E. M. , Briggs J. D. , McGeachie J.
Published: January 2017

Fifty-five female patients aged 12 to 76 years were found to have a significant urinary tract infection on culture of 2 or more consecutive mid-stream specimens of urine (i.e. over 100,000 organisms/ml.). Ninety per cent were due to Escherichia coli and 50 per cent were asymptomatic. A comparative study of the value of 4 regimes (alkali alone, sulphonamide plus alkali, streptomycin plus alkali, nitrofurantoin) in eradicating the initial infection and on the recurrence rate was carried out. Alkali alone had no effect on bacteriuria, nitrofurantoin had a 100 per cent 5-day sterility rate, while sulphonamide and streptomycin had 85 and 88 per cent 5-day sterility rates respectively, differences which are not statistically significant. All of the failures had E. coli infections, none had pyelographic evidence of pyelonephritis or had an elevated blood urea, and only 2 had an antibody titre against the infecting organism over 1/320. There was an overall recurrence rate, mainly due to re-infection, of 53 per cent within the first 6 months. Sulphonamide therapy seemed associated with a lower recurrence rate than nitrofurantoin or streptomycin but the numbers involved are too small to allow statistical evaluation.
Management of Urinary Tract Infection in General Practice
Authors: Milne J. S. , Irons A. W. , Kennedy G. , Wallace Edith T.
Published: January 2017

In a general practice an attempt was made to determine the relative merits of cycloserine, sulphadimidine or nitrofurantoin in the treatment of urinary tract infection. Bacteriological follow-up continued for 2 years. The incidence of patients with symptoms and with significant bacteriuria before treatment was 13 per 1,000 females at risk.

With a follow-up of 50 days nitrofurantoin and cycloserine had an apparent cure rate of 78 and 79 per cent respectively. Sulphadimidine had a cure rate of only 43 per cent due largely to a higher incidence of organisms resistant in vitro. Results after 2 years show that apparent cures are much fewer (nitrofurantoin 46%, cycloserine 36%, sulphadimidine 29%) and there is much less difference in the effectiveness of the various drugs. Only 4 patients stopped treatment because of drug toxicity.

The results of intravenous pyelography in 155 patients suggest that rather than X-ray all patients with urinary-tract symptoms, prolonged bacteriological follow-up will reveal those in whom X-rays may be helpful.
Serum Transaminase Levels following Cross-Clamping of the Aorta in Open Heart Surgery without Coronary Artery Perfusion
Authors: Reid J. M.
Published: January 2017

A study was carried out on 25 patients who underwent open heart surgery, with cross-clamping of the aorta but without perfusion of the coronary arteries to ascertain whether this produced any adverse effect on the myocardium. Serum enzyme levels (glutamic oxalacetic transaminase and glutamic pyruvic transaminase) were estimated on the first, third, seventh, and twenty-first postoperative days, these results being compared with two groups of controls; the first, 19 patients who had lung resection, and the second, 20 patients who underwent closed mitral valvotomy. The mean levels remained normal in the two control groups, but were markedly elevated on the first and third days after operation in the open heart patients, in whom they had returned to normal by the twenty-first day. No correlation was found between the transaminase levels and the duration of either the perfusion or the coronary occlusion. Four deaths occurred in the 25 patients, in only one of which could death be attributed to the technique. The survivors have shown no evidence of impaired myocardial function, and the technique appears effective and safe when limited to a maximum of 60 minutes of continuous aortic occlusion.
The Management of Ovarian Carcinoma—A Review of 420 Cases
Authors: Barr W. , Cowell M. A. C. , Chatfield W. R.
Published: January 2017

Four hundred and twenty cases of ovarian carcinoma, treated over an 8-year period, are reviewed.

Except for 26, they were treated initially by surgery. Two hundred and fourteen cases had further treatment by irradiation and 68 by chemotherapy. It appears that in Stage 2 and Stage 3 cases, the 5-year survival rate is improved by post operative irradiation.

The difficulties of staging the disease are discussed and simplification recommended.
The Folate Status of Alcoholics
Authors: Williams I. R. , Girdwood R. H.
Published: January 2017

Plasma and erythrocyte folate levels and plasma vitamin B12 levels have been studied in a group of 50 well motivated alcholics admitted to a psychiatric unit for the treatment of alcoholism. Sixty-six per cent of the patients had abnormal liver function tests and 12 per cent had neurological complications. The folate status of the alcoholics did not differ significantly from that of 40 healthy blood donors, and was unrelated to the degree of impairment of liver function.
ECG Reporting by Computer
Authors: Macfarlane P. W. , Lorimer A. R. , Lawrie T. D. V.
Published: January 2017

This paper reviews the methods used in the interpretation and monitoring of ECGs by computer. The use of digital and analogue/hybrid computer systems is described and the problems associated with the technique are discussed. The reasons why a small dedicated computer is thought preferable to a large multi-purpose machine are also mentioned.
The Early Diagnosis of Chronic Crohn's Disease
Authors: Kyle James
Published: January 2017

Crohn's disease is increasing in frequency, mainly in urban areas. Small bowel disease is 4 times more common than transmural inflammation of the large bowel. A history of colicky abdominal pain, diarrhoea and weight loss should always arouse the suspicion of Crohn's disease, especially when the patient is a young woman. In more than half the patients no mass can be felt. Large bowel disease is relatively commoner in older patients. Crohn's disease must be considered in the differential diagnosis of gynaecological complaints, and may cause symptoms referrable to the spine and hip joints. Barium enema is the most useful confirmatory investigation provided reflux into the terminal ileum is obtained.
Long-Term Trimethoprim-Sulphamethoxazole in the Management of Recurrent Urinary Infection
Authors: Dargie H. J. , Allison M. E. M. , McGeachie J. , Macdonald G. A. , Kennedy A. C.
Published: January 2017

Nineteen patients with recurring urinary infections were treated with trimethoprim-sulphamethoxazole in full dosage for 6 months. In 14 (Group I) the upper urinary tract was structurally abnormal and in 5 (group II), the I.V.P. showed no abnormality. In Group I the response rate was initially 70 per cent but had fallen to 30 per cent by the end of the treatment period. In group II all patients responded initially and 4 out of the 5 maintained sterile cultures over the period of treatment. Side effects were not serious and in particular, no haematological anomalies were noted in any patient throughout the 6 months of treatment.
Extended Therapy with a Trimethoprim-Sulphonamide for the Treatment of Established Urinary Tract Infection
Authors: Gavras H. , Lawson D. H. , Linton A. L.
Published: January 2017

Thirty patients with recurrent urinary tract infections who had failed to respond to previous extended treatment with Sulphadimidine and/or Ampicillin were treated with a Trimethoprim-sulphamethoxazole combination ‘Septrin’. Twenty six per cent developed allergic reactions.

In those who completed a 3-months' course there was a 59 per cent success rate in eradicating bacteriuria at a 6-months follow-up.
Acute Septic Parotitis: Incidence, Aetiology and Management
Authors: Speirs C. F. , Mason D. K.
Published: January 2017

The clinical details, management and bacteriology of acute septic parotitis in 36 patients occurring during the period 1956–67 are reviewed.

The incidence of acute septic parotitis increased from 0.009 per cent of hospital admissions during 1956–61 to 0.016 per cent in the period 1962–67.

In the period 1956–61, the organism most commonly isolated was Streptococcus viridans; during the period 1962–67 it was Staphylococcus aureus and more than 50 per cent of the latter were penicillin-resistant. During the period 1962–67, 4 patients with acute septic parotitis died during the course of their hospitalisation. All had acute renal failure as well as the clinical features of bacteraemic shock.

The factors influencing the incidence and mortality of acute septic parotitis during the 20th century are considered.

A regime for the future management of this condition, based upon an analysis of the present survey is suggested.
Increased Thyroxine Secretion following Surgical Operation
Authors: Harland W. A. , Orr J. S. , Richards J. R.
Published: January 2017

Radiothyroxine turnover measurements were made in 10 male patients before and after relatively minor surgery. Thyroxine secretion rate rose significantly from 110±15 μg. per day (mean±SD) pre-operatively to 137±33 soon after surgery, although plasma protein bound iodine concentrations remained unaltered. Plasma activity, following a dose of radiothroxine given prior to surgery, diminished at a single exponential rate, which continued through surgery. A second dose of radiothyroxine, differently labelled and given post-operatively also disappeared exponentially, but in every case the slope was steeper than for the pre-operative dose. The daily fractional disappearance rate rose significantly from 0.11±60.029 pre-operatively to 0.163±0.028 post-operatively.
The Use of Polyglycolic Acid Suture in Gastro-Intestinal Anastomosis
Authors: Miln D. C. , O'Connor J. , Dalling R.
Published: January 2017

One hundred and thirty four cases are presented in which polyglycolic acid (P.G.A.) sutures were used. In 34 cases the suture was inserted into the various layers of the abdominal wall and in 100 it was used in a variety of anastomoses involving the gastro-intestinal tract. In the light of our experience we feel that this suture is highly satisfactory in these situations, in addition to possessing physical properties which make it superior to catgut.
High Incidence of Myelomatosis in North-East Scotland
Authors: Dawson Audrey A. , Ogston Derek
Published: January 2017

One hundred and fifty-three patients with myelomatosis were diagnosed in the decade 1960–69 in the North Eastern Region of Scotland (excluding Kincardine County). This incidence is higher than the incidence in Scotland as a whole. It is also higher than expected from mortality figures for the region, for Scotland and for England. The possible reason for this latter finding is discussed.
The Use of Frusemide and Propranolol in the Treatment of the Hypertension of Chronic Renal Disease
Authors: Wilkinson R. , Pickering Mary , Robson Valerie , Elliott R. W. , Kerr D. N. S.
Published: January 2017

Nine patients with renal disease, hypertension and impairment of renal function of varying degree have been studied before and during treatment with frusemide. In three patients observations were repeated following the addition of propranolol. In most cases frusemide resulted in a reduction of both lying and standing blood pressure but for the group the fall was not significant (P>0.05). In all patients a reduction in exchangeable sodium was achieved and the fall was significant for the group (P<0.05); this was accompanied by a significant increase in serum creatinine (P < 0.05). Plasma renin activity was increased in all patients during treatment with frusemide and the change for the group was significant (P<0.05). The addition of propranolol resulted in a marked reduction in renin in the three patients treated but in two blood pressure actually rose; in these two sodium retention had occurred following the introduction of propranolol.
Elevation of Serum Gamma-Glutamyl Transpeptidase in End-Stage Chronic Renal Failure
Authors: Fine A. , McIntosh W. B.
Published: January 2017

The serum gamma-glutamyl transpeptidase (GGT) was measured on 32 randomly selected patients about to commence or already on chronic haemodialysis. Raised values were found in 12 patients (37%). None of these patients had received drugs known to affect hepatic microsomes and all had normal liver function tests. The possible significance of this surprising finding is discussed.
Subpopulations of Lymphocytes: A Review
Authors: Russell J. M. , Sandilands G. P. , Cochran A. J.
Published: January 2017

Human lymphocytes comprise a heterologous population of cells which can be sub-divided on functional criteria or on the basis of surface membrane markers. Although it is widely accepted that human lymphocytes are broadly divisible into thymus dependent (T) and thymus independent (B) cells, recent evidence suggests that at least in humans this distinction may not be as clear cut as previously thought. An assessment of the relative numbers of T and B cells in human peripheral blood and lymphoid tissues can be made utilizing these marker systems. This has led to a reclassification of human lymphoid diseases according to the T and B cell concept, which might be of value in characterising the immunological status in health and disease, and may allow a more rational approach to the therapy of immune deficiency states and lymphoid malignancies.
The Role of Intravenous Clomipramine in the Treatment of Obsessional and Phobic Disorders
Authors: Marshall W. K. , Micev V.
Published: January 2017

The results of intravenous clomipramine therapy in 118 patients suffering from obsessional syndromes and phobic anxiety states are reviewed. A remarkable consistency of improvement was observed especially in those patients suffering from obsessional symptoms. Better results were obtained in patients lacking hysterical personality traits. A brief reference is made to a pilot study involving the use of the 16PF personality test in assessing the effect of clomipramine.
Erythromycin in Respiratory Tract Infection
Authors: Gould J. C.
Published: January 2017

One of the main uses of erythromycin in respiratory tract infection has been in the treatment of acute streptococcal tonsillitis as an alternative to penicillin.

Studies on the quantitative bacteriology of tonsils obtained at tonsillectomy have shown large numbers of both haemolytic streptococci and Haemophilus species in most samples and these organisms can be effectively reduced in number by preoperative treatment with antibiotics such as erythromycin. Such investigations suggest that erythromycin might have wider use in the treatment of respiratory tract infections, particularly where Haemophilus influenzae and other Haemophilus species are involved.

Apart from specific infections such as those due to Mycoplasma pneumoniae, erythromycin is effective in the treatment of acute pneumonia due to organisms such as the pneumococcus, and this paper reports the further use of erythromycin in the treatment of acute exacerbations of chronic bronchitis where the clinical and bacteriological effects of treatment with this antibiotic are compared with those of ampicillin.
Comparison of Erythromycin Stearate and Oxytetracycline in the Treatment of Nongonococcal Urethritis: Their Efficacy against Chlamydia Trachomatis
Authors: Oriel J. D. , Ridgway G. L. , Tchamouroff S.
Published: January 2017

The effectiveness of Oxytetracycline 250 mg. 6 hourly for 2 weeks and erythromycin stearate 500 mg. 12 hourly for 2 weeks in the treatment of non-gonococcal urethritis (NGU) have been compared; cell culture for Chlamydia trachomatis was performed before and after treatment. There was no significant difference between the results obtained with the two antimicrobials. Both were clinically effective in the treatment of Chlamydia-positive NGU. Response to therapy was rapid; 2 weeks after treatment began, only 5 (14%) of 35 men treated with Oxytetracycline and 4 (13%) of 30 men treated with erythromycin stearate still had urethritis. Clinical improvement was accompanied in the majority of cases by failure to re-isolate C. trachomatis, but a small number of men who had not been exposed to the risk of reinfection yielded chlamydiae after therapy with Oxytetracycline or erythromycin stearate.

The results of treatment of men with NGU from whom C. trachomatis had not been isolated were similar to those obtained in isolation-positive patients; again, there was no significant difference in the efficacy of the two antimicrobials. It is concluded that erythromycin stearate is a useful alternative to tetracyclines in the treatment of NGU.
Erythromycin and Anaerobic Infection
Authors: Lambert H. P.
Published: January 2017

The theoretical basis of the use of erythromycin in peri-operative prophylaxis after bowel surgery will be discussed and the results of the use of erythromycin in such patients and the sensitivity to the antibiotic of isolates from human peritonitis described. This work will be related to results obtained in a rabbit experimental model for the study of peritonitis.
Debrisan: An Effective New Wound Cleanser
Authors: Morrison J. D.
Published: January 2017

Debrisan (Pharmacia GB), an insoluble hydrophilic powder of polymerised dextran, has recently become available in Britain as a wound cleansing agent. So far it has proved to be an effective, if costly, agent for the initial cleaning of moist varicose ulcers, but once the slough has been removed, it has no advantage over more traditional methods in promoting ulcer healing.
Giant Trichobezoar—An Unusual Case
Authors: Grant J. A. , Murray W. R. , Patel A. R.
Published: January 2017

It has been known for several thousand years that concretions of animal and vegetable matter form in the stomachs and intestines of certain animals. These objects are known as bezoars. The finding of such curiosities in man is also recognised but is rare. A short history of bezoars is given and a case of a giant trichobezoar reported. The medical, surgical and psychiatric aspects are discussed.
Campylobacter Enteritis—An In-Patient Study
Authors: Pentland B.
Published: January 2017

During the first eight months of 1978, 26 patients were admitted to the Communicable Diseases Unit at King's Cross Hospital, Dundee with a diagnosis of campylobacter enteritis. The variety of clinical features encountered is described. Although diarrhoea occurred in all cases, it was preceded or accompanied by abdominal pain in the majority of cases and by fever in over half of the patients. The article emphasises the need to consider campylobacter infection in patients presenting with bloody diarrhoea, acute abdominal pain or pyrexias of unknown origin.
Intestinal Parasites in Homosexual Men
Authors: McMillan A.
Published: January 2017

A study on the prevalence of intestinal parasites in a group of homosexual men, attending a sexually-transmitted diseases clinic in Glasgow, was undertaken. Of 118 men examined over an eight-month period, four, one of whom had symptoms of dysentery, were found to be infected with Entamoeba histolytica. Cysts of lodamoeba buetschlii were also found in the stool of one of these men. A further two patients had giardiasis, and 11 men had enterobiasis. The importance of an awareness of these conditions is discussed.
Coronary Heart Disease in North-East Scotland: A Study of Genetic and Environmental Variation in Serum Lipoproteins and other Variables
Authors: Robertson F. W. , Cumming A. M. , Douglas A. S. , Smith Elspeth B. , Kenmure A. C. F.
Published: January 2017

Serum lipoprotein concentrations and other variables such as relative weight, skinfold thickness, blood pressure, serum glucose, uric acid, fibrinogen, smoking habits, etc. have been recorded on about 700 persons, including about 200 survivors of myocardial infarction under age 50 years, 250 of their relatives and 250 unrelated controls. Elevated levels of VLDL and LDL are several times more frequent in survivors of infarction than in controls. Cigarette smoking is associated with 20 to 30 per cent increase in VLDL. Relative weight and skinfold thickness together account for a quarter of the variance of VLDL in men, 9 per cent in women. LDL and HDL are uncorrelated; there is a low, consistently negative correlation between HDL and VLDL and IDL. Parent-offspring regression and sib correlations indicate high, intermediate and low heritability for respectively HDL, LDL and VLDL. First degree relatives of survivors of infarction have higher levels of VLDL, IDL and LDL but not HDL.
Melanoma in the South-East of Scotland: A Review
Authors: Stilwell J. H. , Crucioli V.
Published: January 2017

A review was carried out of 129 patients with extraocular melanoma of the skin who were treated at Bangour General Hospital during the period 1968 to 1978 in order to compare our findings with those of earlier studies in the United Kingdom. The clinical features of our series were very similar to those of earlier studies but the impression is that the incidence since the war has been rising. This was confirmed with a sub-group of our patients in which the incidence in West Lothian increased by 52 per cent from the first to the second five-year period; this was statistically significant. One disturbing fact was that only 25 per cent of patients presented for treatment in less than six months from the onset of symptoms, suggesting that the potential danger of a pigmented lesion is not appreciated by the public. A health education programme is long overdue.
The use and Abuse of Topical Corticosteroids in Dermatology
Authors: Hallam N. F.
Published: January 2017

Since their introduction almost 30 years ago, topical corticosteroids have made a dramatic contribution to the management of a wide range of noninfective skin disorders. Their principal mode ofaction is anti-inflammatory and a variety of potencies and vehicles is available. Several important side effects have been described, of which skin atrophy is the most common, but with careful usage the risks are not great.

Topical corticosteroids are contraindicated in certain conditions.
Chlorhexidine in Methanol for the Preoperative Cleansing of Surgeons' Hands: A Clinical Trial
Authors: Murie J. A. , Macpherson S. G.
Published: January 2017

A clinical trial has shown that a technique of preoperative hand disinfection using a methanolic solution of chlorhexidine is faster, cheaper and more acceptable to users than the conventional aqueous detergent chlorhexidine preoperative scrub regime. The wound infection rate in general surgical patients was not influenced by the method used.
Microangiopathic Haemolytic Anaemia before and after Renal Transplantation
Authors: Williams Catriona , Anderton J. L. , Yates P. A.
Published: January 2017

A patient who developed chronic renal failure secondary to the haemolytic uraemic syndrome subsequently developed life threatening microangiopathic haemolytic anaemia following renal transplantation. Transplant nephrectomy was necessary to prevent the progression ofthrombocytopenia and associated pulmonary haemorrhage.
Baclofen: A Team Approach to Drug Evaluation of Spasticity in Childhood
Authors: McKinlay Ian , Hyde Elizabeth , Gordon Neil
Published: January 2017

A double blind crossover trial of baclofen against placebo was carried out in 20 children with spasticity in a day school for physically handicapped children. No significant benefit from baclofen in functional activities was observed and an unacceptable incidence of side-effects was recorded. However, interesting differences between the observations during formal testing and during everyday activities were noted and these may have implications for future trials. A longer study using a lower dose (e.g. 1 mg/kg) might achieve different results.