bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal Effects of Diazoxide and Frusemide and Interrelattonships
Authors: Pohl J. E. F. , Swales J. D. , Thurston H. 
Published: January 2017

The successful long-term control of diazoxide-induced Na retention in 52 hypertensive patients (mean creatinine clearance (Ccr) 38 ± 30.6 ml/min, range 1–123 ml/min) by the use of potent diuretics is reported. The mean duration of follow-up was 26.2± 14.4 months with a range of 3–52 months. The mean daily dose of frusemide was 344 mg (range 40–1000 mg). The mean daily dose of ethacrynic acid was 318 mg (range 100–800 mg). Rashes necessitating change of therapy were attributed to frusemide in seven patients. Diuretic dosage, corrected for patient Na intake, was independent of diazoxide serum levels (S.L.) below 100 mg/litre but was inversely correlated with CCI (rdiuretic, NaCCI(S.L. constant)= −0.33 2P<0.05). Concordant estimates of patient Na intake were obtained and the estimated mean daily Na intake of 121.2 ±62.1 mEq falls within the normal range. The eight patients with estimated mean Na intakes < 50 mEq/day (mean: 35 mEq/day) had a mean Ccr of 11.04 ± 5.98 ml/min whilst the 31 patients with estimated mean Na intakes > 100 mEqjday (mean: 158.9 mEqjday) had a mean Ccr of 48.92 ± 5.05 ml/min. This discrepancy was interpreted as due to a limitation in the ability to correct diazoxide-induced Na retention in patients with severe renal failure. In practice such patients are kept in balance by the use of more than one diuretic combined with a restricted Na intake.
The Treatment of Mycoplasma Pneumoniae Infections
Authors: Watson G. I. 
Published: January 2017

Apart from several family outbreaks (Watson, 1961), I have encountered two widespread epidemics, each involving about 100 patients in a rural general practice in Surrey, one lasting about 9 months in 1963/64 and the second about 7 months in 1974/75 (Watson, 1967). Twenty-five unselected families in 1963/64 and 31 comparable families in 1974/75 were studied in greater detail than the rest. This paper presents a comparison between the results of treatment in these two groups. Tetracycline or Oxytetracycline 250 mg. four times a day (q.d.s.) was the usual adult treatment in the first epidemic, with proportionately less of the Oxytetracycline 125 mg. syrup for children under 10 years. In the second epidemic adults were given erythromycin stearate 250 mg. q.d.s., while children received the ethyl succinate suspension q.d.s. in age-related doses. Treatment in both epidemics was usually continued as long as signs in the chest or coughing persisted. The conclusion was that an erythromycin rather than a tetracycline is the drug of choice for a patient with an acute febrile chest infection by M. pneumoniae because (a) fever and coughing were reduced more quickly, (b) relapses were less frequent, (c) lethargy and slow convalescence were prevented or cleared in a few days, and (d) infectiousness was apparently reduced by erythromycin treatment.
Andrew Moir: An Aberdeen Anatomist
Authors: Bayliss R. A. 
Published: January 2017

Andrew Moir was born in 1806, educated in King's College, Aberdeen and graduated M.A. in 1826. After becoming M.R.C.S., England, in 1828, he was a private anatomy teacher. He opened an anatomy theatre with a group of colleagues, but the hostile public feeling led to a riot in December 1831, and the building was destroyed. Three men were subsequently imprisoned, and there were complaints of official lack of concern. Moir was popular with medical students, and mentioned in two short-lived journals of 1831 and 1835. He continued to teach and later became lecturer at the revived medical school oj King's College. Moir died in 1844: he was hardworking, appreciative of past anatomists and enthusiastic about practical dissection, vigorously defending his science against detractors.
The Idiopathic Unstable Bladder and its Management
Authors: Taylor M. 
Published: January 2017

The two main types of idopathic bladder instability are described using pressure recordings and the relationship to incontinence defined. In combination with urodynamic studies, using a micturating cysto-urethrogram recorded on videotape for future analysis, it is possible to correlate bladder pressures with physiological events. Management of the unstable bladder is difficult and a variety of drug regimens have been attempted. Baclofen reduced detrusor-activity and produced a significant benefit in diurnal and nocturnal frequency and episodes of incontinence but not in enuresis. Seventy per cent of patients maintained this improvement three months after stopping treatment.
Defective Fibrinolysis in Venous Thrombosis
Authors: Davies J. A. , Crandon A. J. , McNicol G. P. 
Published: January 2017

In previous studies a variety of attempts have been made to define laboratory tests which could predict patients who would develop deep vein thrombosis post-operatively. Such tests included the partial thromboplastin time, haematocrit and platelet adhesiveness. In this study patients undergoing gynaecological surgery were screened in advance with a panel of clinical measurements and laboratory tests and the development of DVT was noted using 125I-fibrinogen leg scanning. The values for the selected variables were analysed using logistic discrimination. The factors with the greatest prediction were the euglobulin lysis time, age, varicose veins, serum FR-antigen and percentage overweight for height. When this formula was applied to a further group of patients it allowed a ‘high risk’ group to be defined and these were given low-dose heparin with a significant reduction in the incidence of post-operative DVT. An unexpected finding was that patients who smoked cigarettes appeared to be protected from post-operative DVT.
Endothelial Fibrinolytic Activity in Hypercholesterolemic and Diabetic Rats; Effect of Stanozolol, Streptozotocin, Dexamethasone and Hypophysectomy
Authors: Smokovitis A. A. , Auerswald W. , Binder B. R. 
Published: January 2017

In genetically hypercholesterolaemic rats (RICO) the intimal plasminogen activator activity (PAA) at the nonbranching regions of the aorta, but not at the branching regions, was markedly lower than in controls. In alloxan-induced diabetes in rats, the pattern of changes in tissue PAA was different in different tissues. The anabolic steroid stanozolol induced in male rats a dose and time dependent increase in the tissue PAA; this increase was varying from one tissue to another. The antibiotic streptozotocin, at a diabetogenic dose, induced a 200% increase in the intimal PAA of the aorta in RICO rats and by 100% in controls ( normal rats) ten weeks after a single injection. Administration of dexamethasone in normal rates 24 hours and 3 hours before streptozotocin injection prevented the enhancement of PAA. However, administration of dexamethasone simultaneously with streptozotocin did not affect the enhancement of the intimal PAA. The hypophysectomy induced in rats significantly increased PAA in the intima of the aorta.
The Myasthenic (Eaton-Lambert) Syndrome Associated with Carcinoma. Enzyme Induction as a Possible Mechanism of Paraneoplastic Syndromes
Authors: Simpson J. A. 
Published: January 2017

A myasthenic syndrome associated with small-cell tumours of the bronchus and with autoimmune diseases (Eaton-Lambert syndrome) has been attributed to diminished probability that a nerve action potential will release acetylcholine (ACh) from terminals of cholinergic nerves (somatic motor and autonomic) This model derives from evidence for reduced quantal content of the transmitter released by a nerve impulse The test procedure implies certain constancies of postsynaptic response Abnormal responses to ACh-agonists indicate that receptor response is not normal It is suggested that all previously described neuromuscular responses are compatible with a new model: the subsynaptic apparatus produces excess acetylcholinesterase (AChE) which limits the endplate conductance changes produced by normal output of ACh This model is supported by earlier ultramicroscopic studies which cannot be accounted for by the contemporary model. It is proposed that enzyme induction by peptide or immunoglobulin may also be responsible for other paraneoplastic syndromes.
Treatment of Small Cell Carcinoma of the Bronchus by Combined Chemotherapy—Clinicopathological Correlation with Response
Authors: MacNee W. , Maloney D. , Lamb D. , Sudlow M. F. 
Published: January 2017

Thirty-seven consecutive patients, referred to a respiratory unit with a histological diagnosis of small cell carcinoma of the bronchus, were treated with a combined chemotherapy regime of adriamycin, vincristine and cyclophosphamide. Palliative radiotherapy was given for the control of symptoms. Thirty of 37 patients responded to treatment, 11/37 having a complete and 19/37 a partial response. The median survival of those patients with a complete response was 55 weeks, significantly higher (P<0.01) than either those with partial or no response to treatment. Those patients with limited disease survived longer. A high proportion of patients relapsed at the primary site of the tumour in the lungs. The relationship between the therapeutic response and the histological subtype of small cell carcinoma suffered from the limitations of the available pathological material. However, more of the patients with a complete response were of the lymphocytic-like pattern of small cell carcinoma. Useful survival in these patients with inoperable small cell carcinoma was achieved using this regime of chemotherapy, even in those patients with extensive disease, five of whom had survived for over one year.
Cognitive Functioning of Solvent Abusers
Authors: Mahmood Z. 
Published: January 2017

Cognitive dysfunction and solvent abuse have been found to be closely related, but the precise nature of this relationship remains obscure. Twenty eight non-active solvent abusing and 20 non-abusing adolescents were given tests of non-verbal and verbal intelligence, arithmetic, literacy level and learning ability. In addition, they were asked three standard questions about their spare time activities and future orientation. The results clearly indicated that, while the two groups did not significantly differ in potential abilities, the abusers performed significantly poorly on all but one test of acquired abilities. The abusers were found to be less future orientated, were ‘bored’ with themselves. The aetiological implications of the study are discussed.
A Single-Blind Study of Naproxen Sodium and Mefenamic Acid in Minor Trauma
Authors: Macintyre I. M. C. , Fink P. , McGrouther R. , Spence A. , Zarifa Z. 
Published: January 2017

In a single-blind, parallel, randomised trial the efficacies of naproxen sodium and mefenamic acid were compared in the treatment of musculoskeletal injuries. The daily dosages used were 1100 mg naproxen sodium and 1500 mg mefenamic acid. Patients were assessed before, during and after four days' treatment, with respect to pain, tenderness, swelling and limitation of function of the injured part. Two hundred and eighty-one patients entered the study and 217 were included in the analysis, 106 in the mefenamic acid group and 111 given naproxen sodium. Both groups showed an improvement in symptoms under treatment but there was no significant difference between the two groups in terms of any of the measurements of efficacy. There was no significant difference between the numbers of side-effects reported in each group, although more were seen in the naproxen sodium patients. In this study, both drugs were equally effective in relieving the symptoms of musculoskeletal injuries.
A Comparison of Atenolol and Long-Acting Trimazosin in Mild to Moderate Essential Hypertension
Authors: Webb D. J. , Hutcheson M. J. , Robertson M. P. , Murray G. D. , Lorimer A. R. , Robertson J. I. S. 
Published: January 2017

In a 12-week double-blind randomised study the efficacy of atenolol and a new longer-acting formulation of trimazosin were compared when given once daily in patients with mild to moderate hypertension. Two parallel groups, each consisting of 18 patients, were studied. At randomisation the two groups were well matched for age and sex distribution. They were also well matched for blood pressure, pulse rate and body weight; these latter measurements were recorded at regular intervals during the 12 weeks of study. Atenolol produced substantial reduction in both systolic and diastolic blood pressure, and in heart rate, during 12 weeks of treatment. This therapeutic effect was maintained until the next dose after 24 hours. Trimazosin, by comparison, failed to reduce either systolic or diastolic pressure, or to alter heart rate. Side effects were minor with both agents and compliance with treatment was good. Atenolol caused significant elevation of plasma concentration of triglyceride, with reduction in high density lipoprotein concentration when compared with trimazosin. In conclusion, atenolol was confirmed as an effective agent for the treatment of mild to moderate hypertension. By comparison trimazosin in the longer-acting formulation was ineffective in this study. However, trimazosin may still find a place in treatment if used at higher dose.
Use of Nifedipine as the Drug of Third Choice in Management of Hypertension
Authors: Roulston J.E. , Wathen C.G. , Muir A.L. 
Published: January 2017

Nifedipine has been used in the management of hypertension in 36 consecutive patients who could not tolerate, or were not controlled by, atenolol and thiazide diuretics. Mean supine blood pressure was reduced from 193/110 ± 5/2 (SEM) mmHg to 162/91 ± 5/2 mmHg at eight weeks and remained at that level for the six months of follow-up. Blood pressure reduction at four weeks was not always a predictor of final BP level. Eight patients could not tolerate atenolol, nine patients could not tolerate thiazide diuretics and four patients could not tolerate nifedipine. No significant changes in plasma urea, creatinine, sodium, potassium urate, ‘total CO2’ or glucose were observed. We conclude that nifedipine is a well-tolerated drug and may be useful after beta-blockers and thiazide have been tried in the management of hypertension.
The Basic and Advanced Cardiopulmonary Resuscitation Skills of Trained Hospital Nursing Staff
Authors: Seidelin P.H. , McMurray J.J.V. , Stolarek I.H. , Robertson C.E. 
Published: January 2017

The cardiopulmonary resuscitation skills of 105 trained hospital nurses were tested. Both basic and, for the first time in the UK, advanced skills were examined; basic skills were assessed by practical evaluation with a standard manikin and advanced knowledge by multiple choice questionnaire. No nurse adequately performed all four practical skills tested. Knowledge of the ventilatory aspects of resuscitation, defibrillation and advanced technique and drug management were also found to be poor. The findings add further support to adequate training of nurses in resuscitation skills. We describe a solution to overcome the heavy demands of such teaching and suggest that the same model be applied to the training of medical staff in resuscitation skills.
Review of 18 Years' Experience of a Diagnostic Geriatric Neurology Referral Service
Authors: Duncan G. , Caird F.I. 
Published: January 2017

From 1971 to 1989, 1446 cases were referred from Glasgow and the West of Scotland to the University Department of Geriatric Medicine for neurological diagnosis. In that time, the number increased from one per week to more than two per week, and the proportion from outside Glasgow from 2% to 24%. Eighty-seven per cent had CT scans and 8% electrophysiological studies. One third of patients stayed three days or less, and one third over a week. Cerebrovascular disease was diagnosed in 637 cases (44%), subdural haematoma or hygroma in 59 (4%), and intracranial tumour in 228 (16%), of which 26 (11%) were benign. In 104 cases (7%) no definite diagnosis was made. Management was changed in 402 of the 1446 cases (28%). In the 635 (44%) in whom a referring diagnosis was documented, this was not confirmed in 63%; diagnosis and/or management was changed in 80%. The proportions of referring diagnoses of subdural haematoma and intracranial tumour that were confirmed rose with time. The value of the service lay in the speed and ease of access to it, and the opportunities for teaching and learning it provided. The problems it posed were those of the transfer of ill patients, the distances sometimes necessary, and the need for high standards of communication.
Malaria in Aberdeen: An Audit of 110 Patients Admitted between 1980–1991
Authors: Nathwani D. , Badial R. , Khaund R.R. , Douglas J.G. , Smith C.C. 
Published: January 2017

All 110 patients seen in North East Scotland after contracting malaria from foreign travel were treated in the Regional Infection Unit in Aberdeen. Those patients managed there from January 1980 to March 1991 are described. There were 54 episodes of Plasmodium falciparum malaria (49%) and 26 episodes (23%) of Plasmodium vivax malaria. The remainder had either mixed infection or were diagnosed as malaria on high clinical probability. The majority of the patients were male (80%) and under 40 years of age (84%). Most patients were either Caucasians born in the UK (69%) or native Africans (23%) who were students recently arrived for further education or who had returned from visiting their country of origin for summer holidays. The British residents acquired infection either while on oil related business in West or Central Africa (46%) or after travelling on holiday (30%). The peak incidence of presentation was August and September. 93.5% of patients with falciparum malaria had returned or originated from Africa. 42% with vivax malaria had visited Africa and 27% Papua New Guinea. 70% had been prescribed antimalarial prophylaxis but less than half of these took their medication correctly. The majority of patients with falciparum malaria presented within two weeks of arrival in Britain while patients with vivax malaria presented at varying (but generally longer) intervals, 42% being diagnosed more than three months after exposure. Falciparum infection was more severe although there have been no deaths in the unit from malaria. Our experience seemed of interest and worth reporting because of the number of patients whose infection reflected travel related to the offshore oil industry, which is centred in Aberdeen.
“A Beloved Physician” John Abercrombie MD (EDIN) FRCSE, FRCPE, MD (OXON) 1780–1844
Authors: Baxter P. A. 
Published: January 2017

This son of an Aberdeen minister, graduating MD in Edinburgh in 1803, established a leading practice in that city, attracting apprentices to study medicine and patients of all classes of society from throughout Scotland. Sir Walter Scott in his later years was one who relied on his medical expertise. Dr Abercrombie, a Fellow of both the Royal College of Surgeons and Royal College of Physicians, Edinburgh, was in the forefront of Edinburgh medicine. An extensive author, primarily on medical subjects and laterally turning to metaphysical, moral and religious works, he gained a reputation among intellectuals world-wide. A philanthropist, he gave large amounts of financial aid to Missionary Societies, both at home and overseas. A founder member of first President of the Edinburgh Association for Sending Medical Aid to Foreign Countries (two years later renamed the Edinburgh Medical Missionary Society).
Motor Neuron Disease: A Disease of Old Age
Authors: Chancellor A.M. , Hendry A , Caird F. I. , Warlow C.P. , Weir A.I. 
Published: January 2017

There is little information dealing specifically with motor neuron disease (MND) in the elderly. Given current epidemiological trends, geriatricians will be increasingly called upon to diagnose and manage this condition. We report four patients who presented within a six month period to a geriatric medical unit, and place this experience in the perspective of 229 patients from a population-based study of adult-onset MND in Scotland in 1989 and 1990. In 1990 Scotland had a crude annual incidence of MND of 2.25/100,000; the figure for those over 65 is four times greater. MND is more common in men, but the sex ratio was nearly equal over the age of 65. The risk of presenting with bulbar palsy was greater in women, and even higher in elderly women. This, together with increasing age, is the most important negative prognostic factor in MND. Problems with the diagnosis and management of MND in the elderly are highlighted.
Cholesterol Testing by General Practitioners in Grampian: Patterns and Outcomes
Authors: Smith B.H. , Vranjkovic V. , McEwan S.R. , Ritchie L.D. 
Published: January 2017

Initiation, distribution, concomitants and follow-up of cholesterol testing were studied in Grampian. Data were examined for 4979 patients, representing all patients in one year from those general practices who made exclusive use of the clinical chemistry laboratory for cholesterol testing. A random sample of 215 patients was studied in further detail. Age and sex distribution, results of cholesterol tests and their follow-up, nature and results of associated biochemical tests, test initiation, testing rates by practice, and prescription rates of lipid lowering agents by practice were measured. Cholesterol testing was mostly in line with current knowledge of cardiovascular risk, and associated with further cardiovascular and biochemical assessment. There was a 90-fold range in practice cholesterol testing rates, and a similarly wide range in prescription rates of lipid lowering agents; there was a significant correlation between these. Rates and results of follow-up testing suggests a “rule of halves” for cholesterol testing.
Integrating Clinical Pharmacists into the Primary Health Care Team: A Framework for Rational and Cost-Effective Prescribing
Authors: Hamley J.H. , MacGregor S.H. , Dunbar J.A. , Cromarty J.A. 
Published: January 2017

A recent Audit Commission report into general practice prescribing identifies areas where general practitioner and pharmacist collaboration could be beneficial. Two such areas are formulary development and repeat prescribing review. Increased generic prescribing is encouraged in the report and in central priorities for Scottish Health Boards. This study was designed to develop and assess the effects on prescribing, of a practice formulary and a procedure for change to generic name prescribing. A practice formulary, standards for generic name prescribing and an approach to prescribing review were agreed, developed and implemented. Formulary compliance and the extent of prescribing generically and of changes to generic prescriptions were assessed by prospective prescription monitoring. Consultations resulting in a prescription reduced from 69% to 59% and 80% of acute prescribing events were met from 144 formulary medicines. Rapid change to generic name prescriptions was achieved without patient complaints and the overall generic prescribing level increased from 57% to 68%. Eighty percent of all new prescriptions were generic.
Listeria Endocarditis Causing Aortic Root Abscess and a Fistula to the Left Atrium
Authors: Hood S. , Baxter R. H. 
Published: January 2017

We report the case of a 74 -year-old man who presented with endocarditis on a porcine aortic valve replacement. Five of six blood cultures grew listeria monocytogenes. Transoesophageal echocardiography demonstrated the presence of a cavity posterior to the aortic annulus, apparently communicating with the left atrium. The patient underwent successful aortic valve re-replacement. Listeria endocarditis is rare with only 58 reported cases in the literature and is associated with high mortality.