bluuebunny/crossref_metadata_2025_split huggingface dataset:
Some Observations on Temporary Drainage of the Kidney
Authors: Dix Victor W. 
Published: July 2019

Temporary drainage may be necessary for the success of an operation, as, e.g., a plastic operation on a hydronephrosis. It may, however, also be used as an aid to recovery of function by a damaged kidney; its use in these cases is not a necessity but is an optional point in technique. The method of drainage should be simple to adjust at the time of the operation, easy to control during the post-operative period, and one which causes no damage to the kidney when the drainage tube is removed. The technique of such a method is described. Some difficulties in operative technique, and in post-operative management, are considered, and the normal course of drainage in these cases is outlined. An additional point in favour of the method is that it can be used both in those cases in which drainage is necessary and in the others where it is not; and the experience gained by overcoming difficulties and complications in those cases where drainage is not of vital importance is of the greatest possible use in establishing a good technique for those cases in which failure of the drainage system would imperil the success of the operation.
Therapeutic Action of Injectio Ferri B.P
Authors: Burger G. N. , Witts L. J. 
Published: July 2019

The injection of iron, which was introduced into the British Pharmacopœia, 1932, has been carefully tested in ten cases of anæmia. The parenteral administration of iron is rarely desirable, because the therapeutic dose of iron by injection is so near to the toxic dose. Injectio Ferri B.P. has a very low therapeutic efficiency owing to its small content of iron; it is also painful, though this may be corrected by the addition of a local anæsthetic such as 3% procaine hydrochloride. Double the maximum official dose of Injectio Ferri B.P., i.e. 14 mgm. of metallic iron, can apparently be safely given at one injection, but it would be necessary to give this dose twice a day for about six weeks to equal the effects of large doses of iron by mouth. The treatment of anæmia by weekly or bi-weekly injections of small doses of iron is irrational and to be deplored.
The Bartonella and Related Parasites in Man and Animals (Oroya Fever and Verruga Peruviana)
Authors: Kikuth Walter 
Published: July 2019

Through the investigations of Noguchi on the one hand, and Mayer and Kikuth on the other, the unity of the ætiology of Oroya fever and verruga peruviana has been demonstrated experimentally. The Bartonella bacilliformis, the causal organism of Oroya fever, belongs to a group of micro-organisms, the parasitic nature of which has been definitely proved during the last few years. Tests with a view to transmitting the disease to monkeys, and the ætiology, clinical data, pathology, therapy and immunobiology are further explained with reference to personal experiments. Bartonella muris, which was first observed by Mayer in 1921, was confirmed by Mayer, Borchardt and Kikuth to be the causal organism of infectious rat anæmia following splenectomy. After splenectomy of the rat, the latent parasite becomes virulent and often causes a fatal anæmia. The clinical course of this infection is connected with an endothelial reaction which can be demonstrated histologically. The infection is transmitted by rat lice. Chemotherapeutic experiments led to the discovery of an effective arsenic-antimony compound with an index of 1: 3,500, which figure has never hitherto been reached in chemotherapy. The causal organism of dog anæmia following splenectomty is the Bartonella canis. Bartonella and bartonella-like structures as causal organisms and harmless blood parasites in various animals. On account of their peculiar behaviour the Grahamella, which were first described by Graham-Smith, should be kept strictly apart from the Bartonella and looked upon as a species by itself.
Some Medical and other Aspects of Bacterial Chemistry
Authors: Fildes Paul 
Published: July 2019

The evolution of bacterial chemistry as applied to medicine from bacterial chemistry as applied for economic purposes is traced. The outlook of the bacterial chemist is contrasted with that of the medical bacteriologist. The possible results of the study of bacterial nutrition from the medical aspect are noted. Difficulties arise from the fact that the nutrition of a single species varies. A variation in bacterial enzymes results from alteration in the substrate. The evolution of bacteria from primitive autotrophic types to the parasitic types of the present day may be explained on the basis of an evolution depending upon a gradual alteration in the substrate. The primitive bacteria in an evolutionary sense are endowed with great powers of synthesis, while the evolved bacteria are not. Thus, while the primitive bacteria can synthesize their protoplasm from simple nutrients, the parasitic bacteria cannot and must receive complex compounds pre-formed. In the case of parasitic bacteria this taking of nutrients from the tissue cells may have a bearing upon disease. An infective disease may in part be a deficiency disease. An essential cell nutrient may be taken from the cells by the bacteria, with a result that they cannot function properly in the “anti” sense.
Some Points in the Diagnosis of Stone by X-Rays
Authors: Wells C. A. 
Published: July 2019

The investigation of cases suspected of stone is concerned with (1) those in which a shadow is visible and (2) those in which X-rays throw no shadow. In the former group the nature of the shadow must be determined. If a stone, it must be accurately placed in the urinary tract and the anatomy and function of the affected and unaffected parts of the tract must be determined. A stone may be recognized by the characteristic shape to which it grows in the pelvis, in a calyx or in the ureter. In the earlier stages, or when the shape of the shadow is not characteristic, radiograms may be made on inspiration and expiration. In orthopædic and other cases immobilized for long periods interesting calculi may form and may subsequently be disintegrated and passed, or may require surgical treatment. For stones in the kidney and upper ureter pyelography by the descending route is ideal. For infected stones the retrograde route is preferable. For small ureteric stones an opaque catheter is best. Non-opaque stones are of real surgical significance. It is essential to make a positive diagnosis in a case of suspected stone, even if operation is not required. Furthermore, non-opaque stones are sometimes sufficiently large to demand operative removal. The presence of these stones can be inferred from descending pyelograms, and the stones themselves can be displayed by means of the opaque material they pick up in the course of a descending pyelography.
The Present and Future of Radium Teletherapy
Authors: Carling E. Rock , Allchin F. M. 
Published: July 2019

The problems before the radium teletherapist are those ordinarily dealt with by the deep-X-ray therapist. There is, unfortunately, only one method available for the solution of many of these problems, that of trial and error. This paper records errors and attempts to rectify them. The problems are:— (1) To construct apparatus that can safely be used by the workers. (2) To ascertain with precision the site and extent of the tumour. (3) To obtain a depth-intensity and dose of cancericidal order without damage to the skin or intervening and surrounding tissues. (4) To measure and record the dose received by the tumour. (5) To ascertain the best total duration and spacing of component parts of the total dose. (6) To find means for increasing differentially the sensitivity of malignant cells. (7) To safeguard the patient's general health. Unless there be any advantage in the use of short waves, there is no permanent field for teletherapy. The combination of long and short waves appears to us to offer advantages: (1) Permitting continuance of irradiation when one type ceases to be effective; (2) safeguarding the skin; (3) perhaps offering a biological superiority. The immediate future calls for:— (1) Improvements in apparatus. (2) Agreement as to the best unit applicable alike to gamma and X-irradiation. (3) Further exploration of means for measuring dose received. (4) Accumulation of data as to effective dose in relation to tumours of different organs and different histological type. (5) Better grouping of clinical classes. (6) More universal co-operation with physicists. (7) Concentration of control of both forms of treatment in the same hands.
The Uses and Limitations of Sterilization in Social Psychiatry
Authors: Blacker C. P. 
Published: July 2019

The uses and limitations of sterilization in psychiatry have become questions of considerable sociological importance since the publication of the Brock Report in January 1934. Compulsory and voluntary sterilization have quite different social implications—Psychiatric implications of the German law and of laws which have been proposed or passed in the U.S.A. Proposals of the Brock Committee; psychiatric aspects of the safeguards proposed; necessity for some general safeguards to prevent abuses. Genetic results attainable by a vigorously applied compulsory measure as against those to be expected from a voluntary measure.
Familial Hepatitis and Chronic Jaundice
Authors: Debré Robert 
Published: July 2019

The author reports the history of a family of six children, of whom two, the eldest and the fifth, are normal; three died, a boy when 6 months old and two girls when 9 and 10 years old, from the same familial disease that also attacked another boy now 7 years old. The essential features of this disease are hypertrophy of both liver and spleen, chronic icterus with evidence of salts and bile-pigments in the blood and urine, retardation of physical, mental, and sexual development, slight deafness in one case and clubbing of the fingers in another. This condition is a good example of biliary cirrhosis of the liver. After reviewing recent French observations, the author recalls the large contribution of English authors on the subject. He then distinguishes three types of familial cirrhosis: Laennec's type with enlarged liver, the type of splenomegalic anascitic and anicteric cirrhosis, resembling Banti's syndrome, and the commonest type or biliary cirrhosis. The author describes particular histological lesions, and when dealing with differential diagnoses, excludes dyslipoidic, polycoric, and other acquired cirrhosis in children. He then summarizes the relationships between this disease and the obstructive cirrhosis to a congenital defect of the bile-ducts, the cirrhosis in young Indians, the syndrome of hepatic lenticular degeneration, and the syndrome of cirrhosis of the liver combined with hæmangiomatosis. Finally, after recalling the close analogy of the condition with renal dwarfism, the author shows how the interpretation of these relationships may throw light on the pathogenesis of various progressive congenital diseases.
Discussion on Active Immunization—Some Present-Day Problems
Authors: Parish H.J. 
Published: July 2019

Diphtheria.—Immunization is safe and effective. Compulsory measures are indicated, especially for the younger age-groups. The Schick test may be reserved for selected groups and to control modified methods. Proper spacing of doses of prophylactics and periodic reinoculation will ensure a high level of immunity. It is important to beware of “one-shot” methods. Indiscriminate swabbing is to be discouraged; high carrier rates are an indication for widespread diphtheria prophylaxis. Enteric fever.—Mass immunization is desirable in many areas, although there is no justification for compulsion except for people exposed to special risks. In deciding upon dosage of vaccine, more attention should be paid to physical state and body-weight. After the primary course, very small periodic doses (for example o.i.c.c) are worthy of trial. Vaccine can be given during an epidemic without increasing the chances of infection. Tetanus.—Two doses of toxoid spaced by six weeks give useful immunity. Women give significantly higher titres than men. A third dose of i.o.c.c. after a long interval—seven to nine months—often produces a dramatic rise in circulating antitoxin, and counteracts any tendency to waning immunity. Smallpox.—As vaccination has not been made compulsory in this country, infection by virulent strains from the continent may tax the resources of the public health services. Whooping-cough.—The large number of injections of vaccine usually recommended is a deterrent to mass immunization. Research into the possibility of fewer doses and wider spacing is indicated. Other diseases are considered briefly. Combined immunization.—It may be useful to combine diphtheria T.A.F. and tetanus toxoid, also tetanus toxoid and T.A.B. vaccine. T.A.F. plus T.A.B. is probably contra-indicated for adults on account of severe reactions. Diphtheria A.P.T. should not be mixed with tetanus toxoid as it may go into solution and become ineffective. Sterilization of syringes and needles.—An intensive inoculation campaign is no excuse for slip-shod methods.
Drug Interaction in the Field of Analgesic Drugs
Authors: Lasagna Louis 
Published: July 2019

The evidence for believing that mixtures of aspirin, phenacetin, and caffeine provide advantages over the individual components of these mixtures is reviewed, and doubt expressed as to the rationale for the use of these mixtures in ordinary medical practice. The syndrome of ‘analgesic nephropathy’ is also reviewed, and on the basis of experiments in healthy volunteers it is suggested that individual ingredients of analgesic mixtures be scrutinized more carefully in an attempt to track down the agents responsible for toxic effects. The use of phenothiazine compounds, alone or in mixture with narcotics, is reviewed, and the opinion expressed that methotrimeprazine has special analgesic attributes. The narcotic antagonists represent an extremely interesting group of drugs which possess analgesic activity as well as the ability to antagonize certain effects of morphine and other narcotic agents. The patterns of respiratory effect, psychotomimesis, and abstinence phenomena seen with these antagonists illustrate the possibility of dissociating certain effects usually assumed to be linked inseparably in drugs possessing the analgesic power of morphine.
Physiological and Pharmacological Interactions of Antihypertensive Drugs
Authors: Dollery C T 
Published: July 2019

The complex mechanisms that maintain the blood pressure can be interfered with at many points by drugs. A drug acting at one point may be potentiated by another which blocks a compensatory reflex minimizing the effect of the first. Many therapeutically useful drug combinations have a nonspecific mechanism of this kind although drugs that act upon different points in the sympathetic efferent vasomotor pathway have not been proved to have a useful additive effect. It is not easy to prove a synergistic action of two drugs unless it is large. The best supported examples are combinations of either a diuretic or a vasodilator with a sympathetic blocking drug. These combinations are the ones most widely used in treatment of hypertension. They allow the dose of each active substance to be reduced so that unwanted side-effects are decreased without losing the desired action on the blood pressure. Drug combinations have special risks besides their obvious advantages. Patients are more likely to become confused and take the wrong doses if their treatment regime is complicated. Two drugs which are individually nontoxic may have dangers when used together. Oliguria and a mounting blood urea may follow combined use of powerful modern diuretics. Toxic effects may be entirely unrelated to the main therapeutic action of the drug, as with the enhanced diabetogenic effect of diazoxide used with hydrochlorothiazide. Several potent cardiovascular drugs modify the response to drugs which might be given to raise the blood pressure in an emergency. No drug in common therapeutic use seriously reduces the response to injected noradrenaline but some, such as sympathetic blockers and monoamine oxidase inhibitors, greatly increase sensitivity. Pressor amines that act indirectly by noradrenaline release may be ineffective in the presence of drugs which deplete or insulate the stores of the transmitter in adrenergic nerve endings. The advantages and disadvantages of drug interactions deserve more thought and study than they usually receive.
Drug Combinations in Antibacterial Chemotherapy
Authors: Barber Mary 
Published: July 2019

Double chemotherapy for the treatment of bacterial infections has been recommended for many reasons, of which the most important are the following: (1) To achieve a synergic effect. (2) To delay the emergence of resistant strains. (3) To prevent superinfection. (4) To treat relatively inaccessible bacteria. (5) To treat mixed infections. (6) To treat undiagnosed infections.Combinations which have a truly synergic effect in vivo are those which show bacteri cidal synergy in vitro. Bacteri cidal therapy is of great practical importance in conditions which are inaccessible to the natural defences of the body, or where they are deficient. If in such cases the infecting bacterium is not readily killed by a single drug, then combinations should be tried. There are no absolute rules and double bactericidal sensitivity tests should always be carried out on the infecting strain, but the most likely combination to show this type of synergy is a penicillin and streptomycin.If a bactericidal drug is combined with an agent which is only bacteristatic, the killing effect may be antagonized, since many bactericidal drugs only kill rapidly multiplying cells. Again there are no absolute rules, but antagonism is particularly liable to occur when the bactericidal agent is one of the penicillins and is very unlikely to occur when it is a polymyxin, since this kills resting bacteria.Drug combinations to delay the emergence of drug-resistant strains should be considered for infections due to staphylococci and coliform bacilli, particularly in hospitals, and when it is desired to use drugs to which these bacteria readily develop resistance.Drug combinations may also be the most efficient treatment for mixed infections and may be necessary for the treatment of fulminating infections pending bacteriological diagnosis. The combination of nystatin with a tetracycline may be necessary to prevent candidiasis if tetracycline therapy has to be prolonged.
Radiologists as co-authors in case reports: does their involvement make a difference?
Authors: Bosmans Jan ML , Luyckx Elisa , Broeckx Bart JG , Ceyssens Sarah , Parizel Paul M , Snoeckx Annemie 
Published: July 2019

Background Due to their crucial role in many diagnostic processes, a considerable number of papers in non-radiological medical journals contain images. We noticed that radiologists are seldom mentioned as co-authors. Purpose To investigate how often radiologists are involved as co-authors and to measure the influence of their involvement on the choice and quality of the illustrations and captions. Material and Methods We queried PubMed for papers in English with the search string “case report” in the title, examined them for the presence of radiological images, and excluded those published in radiological journals. We developed a scoring system, containing objective and subjective qualification criteria. In addition, we checked if a radiologist was involved as co-author, or mentioned in the Acknowledgments section. We performed a statistical analysis to check if the involvement of a radiologist had a significant effect on the overall quality of the case report. Results In 21% (45/218) of the papers, a radiologist was mentioned as co-author and in 3% (7/218) a radiologist was mentioned in the acknowledgments. In 76% (166/218), radiologists were neither involved as co-authors, nor mentioned in acknowledgments. We found statistically significant quality differences between these three groups ( P < 0.001). Conclusion This study indicated that the quality of case reports can be improved when radiologists are involved in the preparation and publication of papers containing imaging studies.
Probable Interaction Between Warfarin and Inhaled and Oral Administration of Cannabis
Authors: Hsu Amy , Painter Nathan A. 
Published: July 2019

Objective: To report a probable interaction between warfarin and edible cannabis that resulted in an elevated international normalized ratio (INR) without bleeding complications. Case Summary: A 35-year-old Middle Eastern male on warfarin long term with an INR goal of 2.5 (accepted range: 2.0-3.0). The patient has generally been stable on warfarin 10 mg daily from 2010 to 2018, until INR suddenly increased to 7.2 following 1 month of edible cannabis ingestion and cannabis smoking. Patient denied any signs and symptoms of bleeding. No other reasonable causes of the elevation in INR were apparent. The patient was advised to hold 2 doses of warfarin and discontinue cannabis use. The INR dropped below 4 upon discontinuation of cannabis with dose adjustments to warfarin. Discussion: The elevation in INR can be explained by the inhibition of CYP2C9 by cannabis use causing decreased metabolism of warfarin. The interaction between warfarin and cannabis was determined to be probable using the Horn Drug Interaction Probability Scale. Conclusions: There are no previous reports of interactions between edible cannabis and warfarin, with very few case reports describing the interaction with other forms of cannabis. Close monitoring of INR in patients with concomitant cannabis is recommended for proper warfarin management.
What Prophylactic Antibiotic (Type, Dose and Route of Administration) Should Be Administered Perioperatively for Patients Undergoing Total Ankle Arthroplasty (TAA)?
Authors: Sanchez Marisa , Losada Cecilia 
Published: July 2019

Recommendation: The administration of prophylactic antibiotics before total ankle arthroplasty (TAA) potentially reduces the incidence of surgical site infection (SSI) and/or periprosthetic joint infection (PJI). Weight-based (of at least 2 g) cefazolin administered intravenously within 60 minutes before the procedure can be an adequate choice for antibiotic prophylaxis. If the patient has a beta-lactam anaphylaxis, we recommend an appropriate alternative antibiotic effective against Staphylococcus. It is unclear whether prophylaxis should be given as a single dose or as multiple doses. Level of Evidence: Strong. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Is There a Role for the Use of Dilute Povidone-Iodine (Betadine) Irrigation or Other Antiseptic Irrigation Solutions During Total Ankle Arthroplasty (TAA) or Other Foot and Ankle Procedures?
Authors: Englund Kristin , Heidari Nima 
Published: July 2019

Recommendation: With regard to total ankle arthroplasty (TAA), there is a lack of evidence to recommend for or against the use of betadine solution. Level of Evidence: Consensus. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Does Deep Chronic Infection After Total Ankle Arthroplasty (TAA) Require Implant Removal?
Authors: Kaplan Jonathan , Raikin Steven 
Published: July 2019

Recommendation: Yes. Deep chronic infection after total ankle arthroplasty (TAA) requires implant removal unless otherwise contraindicated. Level of Evidence: Strong. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).