bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
The Role of Transient Hyperprolactinaemia in the Short Luteal Phase
Authors: Coutts J. R. T. , Fleming R. , Macnaughton M. C. 
Published: January 2017

Daily plasma analysis of complete menstrual cycles from infertile women (n = 32) revealed transient hyperprolactinaemia in a significant number in comparison with normally cycling women. The prolactin elevations occurred for variable durations at different stages of the cycle. Transient hyperprolactinaemia occurring at mid-cycle was associated with reduced late luteal phase steroid levels and short luteal phases. When the prolactin elevations occurred at other times they were unrelated to ovarian steroid levels. Treatment of patients with short luteal phases with bromocriptine (2.5 mg/day) normalised prolactin levels but also reduced gonadotrophins. The net result of these changes was a normalisation of the length of the luteal phase which was now deficient in steroid secretion. To alleviate these problems the treatments proposed for the short luteal phase are either bromocriptine (2.5 mg/day) for 7 days over the mid-cycle period only or bromocriptine for 7 days at mid-cycle in conjunction with a follicular stimulant in the early follicular phase.
Overview of Fibrinolysis
Authors: Chakrabarti R. 
Published: January 2017

The modern concepts of fibrinolytic activation and inhibition are discussed in this paper and the importance of the complex interlinkage with the kallikrein-kinin, coagulation, complement and immunity mechanisms is underlined. The importance of the fibrinolytic balance as a protective mechanism in prevention of thrombus formation, in inflammation and in cancer is postulated and in population studies the normal decline with age is standardised. The possibilities for long term fibrinolytic enhancement by use of a variety of drugs, such as the biguanides and anabolic steroids has been demonstrated.
The Effect of Ascorbic Acid on the Seasonal Variations in Serum Cholesterol Levels
Authors: Dobson Hilary M. , Muir Margaret M. , Hume R. 
Published: January 2017

One gram of ascorbic acid (Vitamin C) administered randomly to a group of healthy young people (aged 29 ± 5 years) produced a significant mean fall in serum cholesterol of 16 per cent within two months. A similar supplement to a group of healthy older people (aged 58 ± 3 years) produced a significant mean fall in serum cholesterol of 14 per cent but required six to 12 months' administration. Serial observations on a mixed age group of healthy people (aged 38 ± 12 years) over one calendar year revealed a seasonal fluctuation in serum cholesterol, the lowest levels being in summer (June 5.5 ± 0.7 mmols/l) and the highest levels in winter (January 6.4 ± 0.8 mmols/l), a significant rise of 16 per cent. These changes showed an inverse relationship with the leucocyte and serum ascorbic acid levels which also revealed a seasonal fluctuation, the months April/September being higher than the months October/March. The administration of 1g of ascorbic acid per day throughout the year abolished the winter rise in serum cholesterol levels. These results are discussed in the light of the relationship between cholesterol and vascular disease and the observations by Sir Richard Doll that lowering the cholesterol level, whether achieved by drugs or diet, results in a reduction in morbidity from myocardial infarction.
Pycnodysostosis in a Pakistani Family: Case Presentation and Review
Authors: Kerr Alison M. , Loudon Mary M. , Goel Krishna M. , Connor J. M. 
Published: January 2017

Pycnodysostosis is described for the first time in a Pakistani family. Two cases are presented and are contrasted with cases of osteopetrosis seen in this hospital over a twenty year period. The possibility of confusion with osteopetrosis is indicated and discussed.
Hormone Binding Globulins and Anticonvulsant Therapy
Authors: Beastall G. H. , Cowan R. A. , Gray J. M. B. , Fogelman I. 
Published: January 2017

Serum sex hormone binding globulin, thyroxine binding globulin, cortisol binding globulin and vitamin D binding globulin, together with total levels of the appropriate bound hormones, were determined in 21 epileptic subjects who had been stabilised by long-term anticonvulsant therapy. Serum sex hormone binding globulin capacity was higher in these patients than in appropriate control groups (men p<0.05; women p<0.01), and values correlated with serum phenytoin levels in the female subjects (p<0.01). Thyroxine binding globulin levels were unaffected by anticonvulsants, but significant reductions in serum thyroxine (men p<0.05; women p<0.001) and triiodothyronine (men p<0.05; women p<0.01) were observed. Cortisol binding globulin capacity was appreciably elevated in patients of either sex (p<0.001), and in the women this was accompanied by a reduction in serum cortisol (p<0.001) and a significant correlation with the serum phenytoin concentration (p<0.01). Neither vitamin D binding globulin capacity nor serum 25-hydroxycholecalciferol levels were influenced by anticonvulsants in this study. It is concluded that anticonvulsant drug therapy causes widespread alterations in the normal homeostasis between hormones and their serum binding globulins. Such alterations may well have clinical significance.
The Increasing Problem in Tayside of Cervical Cancer in Younger Women
Authors: Dodgson J. , Walker E.M. , Hussein K.A. , Robertson A.J. , Duncan I.D. 
Published: January 2017

The incidence of cervical carcinoma in younger women is increasing in Tayside despite a decrease in the overall incidence. However, stage for stage, we did not encounter a poorer survival in younger patients. A number of patients had been sterilised or had a pregnancy when cytological screening was available and not made use of. There were also some false negative smears which were reclassified for retrospective analysis. We would recommend cervical screening every three years and careful inspection of the cervix and a smear taken in cases of abnormal gynaecological symptoms such as post coital bleeding.
Risk Factors for Cardiorespiratory and All Cause Mortality in Men and Women in Urban Scotland: 15 Year Follow Up
Authors: Watt G.C.M. , Hart C.L. , Hole D.J. , Smith G.D. , Gillis C.R. , Hawthorne V.M. 
Published: January 2017

Study objective: To describe the relationship between risk factors, risk behaviours, symptoms and mortality from cardiorespiratory diseases in an urban area with high levels of socioeconomic deprivation. A cohort study of 15,411 men and women aged 45–64, comprising 80% of the general population of Paisley and Renfrew, Scotland. Outcomes: Mortality after 15 years from coronary heart disease(ICD 410–4), stroke(ICD 430–8), respiratory disease(ICD 460–519) and all causes. Main results: Mortality rates from all causes were 19% in men aged 45–49, 31% in men aged 50–54, 42% in men aged 55–59 and 57% in men aged 60–64. The rates are considerably higher than those reported in previous UK prospective studies. For women the rates were 12%, 18%, 25% and 38% respectively. In general men and women showed similar relationships between risk factor levels and mortality rates. People in manual occupations had higher mortality rates. Raised levels of systolic and diastolic blood pressure were associated with increased coronary, stroke and all cause mortality rates. Plasma cholesterol had no such association with all cause mortality rates. High and low levels of body mass index were associated with higher mortality rates than intermediate levels. A relationship between short stature and increased mortality rates was observed in men and women. FEV1 expressed as a percentage of the expected value showed the strongest relationship with mortality rates, particularly for respiratory disease, but also for deaths from coronary heart disease, stroke and all causes. Conclusions A similar pattern of relationship between risk factor levels and mortality rates exists in men and women in Renfrew and Paisley. Respiratory impairment as measured by FEV 1% predicted appears to be the most likely explanation of the observed high all cause mortality rates in this population.
SKI Injuries in Scotland a Review of Statistics from Cairngorm SKI Area Winter 1993/94
Authors: Langran M. , Jachacy G.B. , MacNeill A. 
Published: January 2017

Scottish skiing is a growth industry—nearly all acute ski injuries in Aviemore are managed initially by local general practitioners. This study set out to examine the nature and incidence of ski injuries in one Scottish ski resort, and to calculate the additional workload generated for the health centre, ambulance service and local hospital. During the study period, the winter ski season of 1993–94, a prospective study was made of the 486 acute ski injuries presenting to Aviemore Health Centre. Despite frequently poor weather conditions, the seasons injury rate for Cairngorm was 2.43 per 1000 skier days which compares favourably with statistics from other ski centres world-wide. The anatomical pattern of injuries for both downhill skiing and snowboarding was similar to that of other countries. Knee injuries constituted nearly one third of all cases. 8% of injuries involved the ski lift machinery. 31% of casualties underwent radiographic examination, 17% needed hospital referral and 7% required admission to hospital. The management of acute ski injuries can be performed effectively in the primary care setting. It has significant benefits in rural areas by rationalising the use of ambulance and hospital services.
Information about Antimalarial Chemoprophylaxis in Hospitalised Patients — Is it Adequate?
Authors: Nathwani D. , Spiteri J 
Published: January 2017

Malaria remains a huge public health problem worldwide, with over 100 million new cases annually, causing one to two million deaths.1 This global problem spills over into the UK, with around 2000 cases of reported annually.2 The proportion of infections due to Plasmodium falciparum (PF) continues to increase and worse still accounts for five to 12 deaths per year. In 1992, Nathwani et al reported the 10 year experience of malaria cases admitted to the Regional Infection Unit, in Aberdeen, Scotland-the “Oil Capital”.3 This study was of interest in that 46% of those British residents who acquired infection had travelled to West or Central Africa on oil related business. The Oil boom of the 1980‘ s appeared to very much centred around Aberdeen and the neighbouring hinterland but did not appear to extend to Dundee which was only 60 miles further down the North-East coast. We, therefore, carried out a retrospective study of patients with malaria admitted to the Regional Infectious Diseases Unit in Dundee over a fifteen year period between 1980 and 1994.
On Being a Medical Student in the 1930s
Authors: Girdwood R. H. 
Published: January 2017

From a Minute Book which has survived the years, an account is given of matters discussed by the Clinical Medicine Board of the Royal Infirmary of Edinburgh in the 1930s. This Board consisted of the senior physicians in the hospital and the records give an indication of the excessively large number of students who were all having their clinical experience in the wards of the one hospital. In addition to the University students there were others studying for the Triple Qualification of the Royal Colleges. The pressure of this teaching on staff and patients was considerable. It was decided to transfer some of the tuition to Craigleith Hospital which became the Western General. In 1939 the male house doctors were awaiting their call-up. The administrators had to consider arrangements for the continuation of teaching if bombing took place. In March 1941 the Polish Medical School was organised in Edinburgh
Use of Antenatal Cards for Literate Health Personnel and Illiterate Traditional Birth Attendants: An Overview
Authors: Chabot H T J , Rutten A M 
Published: January 2017

A review of the existing literature on various risk-oriented antenatal cards developed during the last 15 years, makes apparent a multitude of action-oriented cards available for trained health personnel (obstetric nurses, midwives and doctors). Few antenatal cards, however, have been developed for use by illiterate traditional birth attendants (TBAs). A revised version of an illiterate antenatal card is presented, that has been developed over the past 3 years in Mali. It contains some important improvements, notably its use at the various levels of the health care pyramid both by illiterate TBAs and by trained midwives. It also includes specific ‘standing orders’, based on generally accepted ‘at-risk’ criteria. Suggestions for its adaptation elsewhere in Africa as part of current Safe Motherhood policies are discussed.
Telangiectases in Venous Insufficiency: Point of Reflux and Treatment Strategy
Authors: Mariani F. , Bianchi V. , Mancini S. , Mancini S. 
Published: January 2017

Objective: To verify the role of sources of non-saphenous reflux in the appearance of reticular varices and telangiectases in areas other than the lateral venous system of Albanese. Setting: Institute of General Surgery and Surgical Specialisations, Interdepartmental Centre of Research, Treatment and Phlebolymphological Rehabilitation, University of Siena. Patients and methods: The study was carried out on 106 women aged 18–65 years who were affected by chronic venous insufficiency (CVI) at the Cla-s Ep Asl stage, according to the CEAP classification. The patients had telangiectases (200 telangiectactic areas) and reticular varices of the lower limbs of type II and III of the classification of Weiss, with competent saphenous trunks and a normal deep venous system. Sclerotherapy was therefore performed, after clinical and duplex ultrasound examination. The records of 185 telangiectactic area treated 3 years earlier were reviewed. Results: In all cases reticular varices was found together with the telangiectases. In 73.5% (147/200 areas) one or more incompetent perforating veins was found (average diameter 1.6 mm) and in 83.6% (123/147 areas) it was possible to establish that the main source of reflux was in the base of the telangiectasia. Complete elimination of microvarices was achieved in 88% of cases (176/200 areas; average sessions: 3.5). The complications were haemosiderin pigmentation (1.5%, 3/200 areas) and matting (1%, 2/200 areas). In 24 areas resistant to the therapy it was not possible to demonstrate the presence of reflux, while in 24.5% of cases (49/200 areas, average surface 15.4 cm2) two sessions of sclerotherapy were sufficient eventually to obtain (about 4 weeks later) the disappearance of the micro-varices. Follow-up after 3 years revealed the appearance of new telangiectases in 58.9% of cases (109/185 check-ups). Of these 95.4% (104/109) arose in areas other than those treated and therefore only 4.6% (5/109) recurred in the area where the sclerosing treatment had been carried out. Conclusion: In CVI all telangiectases are accompanied by reticular varices, even when not visible on clinical examination; in most cases the sources of reflux are distinguishable as incompetent perforating veins and are situated beneath telangiectactic efflorescences.
Prevalence of Venous Insufficiency in French Adults of the SUVIMAX Cohort
Authors: Preziosi P. , Galan P. , Aissa M. , Hercberg S. , Boccalon H. , Berard H. 
Published: January 2017

Background: The symptoms of venous insufficiency of the lower limbs (VILL) include a feeling of heaviness in the legs, pain, and nocturnal cramps, which may be combined with organic disorder (varicose veins). The objective of this study was to determine the prevalence of VTLL in terms of both varicose veins and functional symptoms in the participants of the SUVIMAX cohort, which is representative of the French population for the age range under consideration (women: 35–60; men: 45–60). Methods: Information on the venous status of 3065 subjects in SUVIMAX cohort were collected from three different sources: yearly systematic clinical (1994-1996), monthly follow-up by a telematic network (1994–1998) and non-specific questionnaire (1997). Two mutually exclusive populations were thus denned on medically diagnosed varicose and venous insufficiency. Results: Venous insufficiency was medically diagnosed in 192 men (14.6%) and 584 women (33.6%), and varicose veins were diagnosed in 143 men (74.5%) and 317 women (54.2%) from this group. Prevalence reported symptoms of venous insufficiency and of varicose veins was 13.6% and 7.4% respectively in men and 28.2% and 12.4% in women. Sex, age, body mass index and number of pregnancies were found to be correlated with the risk of venous insufficiency. Conclusions: VILL is a very common disease in French adults both as varicose veins and as functional symptoms. Venotonics were the main type of treatment but not enough use is made of elastic compression stockings. [Int Angiol 1999;18.171–5]
The Epidemilogy of Chronic Venous Ulcer: Some Unanswered Questions
Authors: Ruckley C. V. 
Published: January 2017

Objective: To highlight gaps in knowledge concerning the epidemiology of chronic venous insufficiency and to indicate what future studies are required. Methods: Existing classifications are compared. Limitations of epidemiological studies are defined. Data from published series and from the Edinburgh Vein Study are presented. Synthesis: The Basle 1978 classification of chronic venous insufficiency (CVI) is a purely clinical classification in which the earliest grade is corona phlebectatica. The Porter 1988 classification of CVI attempted to correlate clinical grades with sites of venous incompe-tence. However, a consistent relationship does not exist. The CEAP classification separates the clinical grades (which do not include corona phlebectasia) from the anatomical segments. The CEAP clinical classification covers a range of venous manifestations but is not consistent. There is a need for further consideration of classifications. Published selected series of patients show that the frequency of incompetence in both deep and superficial systems increases in proportion to the severity of the clinical manifestations of venous disease. To understand the significance of these data we need to know the patterns of venous incompetence in the general population. Data from 1566 subjects between the ages of 18 and 64 years in the Edinburgh Vein Study, a randomly selected cross-section of members of the Edinburgh population, showed that the prevalence of CVI was age-related and was present in 9.2% of men and 6.6% of women. Men had a significantly higher frequency of reflux in the deep system than women. In order to direct therapeutic interventions where they are most appropriate we need to know which patients with the early stages of varicose veins progress to CVI and which patients with early CVI progress to the serious skin complications. Conclusions: Key information concerning the natural history of venous disease and its evolution in relation to haemodynamic abnormalities awaits the findings of longitudinal-cohort epidemiological studies which include the duplex scanning of large populations.