bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organization of controlled trials in paediatric liver disease
Authors: Gray O P 
Published: December 2008

Summary
There are very few controlled trials of treatment of liver disease in either adults or children. This is unfortunate because there are considerable uncertainties surrounding the effectiveness of the treatments in use. However, controlled trials present considerable difficulties to investigators in terms of organization and maintenance of enthusiasm. In order to gain the maximum information from trials it is imperative to categorize patients accurately. The planning of the trial requires an infinite attention to detail. The plan should be as simple as is possible to answer the questions. It is important that controlled trials should be restricted to 2 years, duration wherever possible. This allows the investigator’s interest to be maintained. In planning trials, it is important to remember that when the trial is mounted, the recruitment of patients is often considerably less than that which was expected. Because of the inadequacy of knowledge of effectiveness of treatment in liver disease it appears to be unethical to do anything other than controlled trials, henceforth.
Successful resuscitation in diabetic ketoacidosis: a strong case for the use of bicarbonate
Authors: Soler N G , FitzGerald M G , Bennett M A , Malins J M 
Published: December 2008

Summary
Although severe acidosis is a life-threatening condition owing to its cerebral and cardiac effects, correction of the acidosis with alkali remains a controversial issue in diabetic ketoacidosis. A 22-year-old female patient in diabetic ketoacidosis who was successfully resuscitated after cardiac arrest is presented and a strong case is made for the administration of bicarbonate in severe cases of diabetic ketoacidosis.
Megaloblastic anaemia associated with the oral contraceptive pill
Authors: Meguid Michael M , Loebl Walter Y 
Published: December 2008

Summary
A 27-year-old housewife suffered from severe headaches for a period of 2 years which developed after she started taking an oral contraceptive pill. During this time she gradually developed folic acid deficiency anaemia. This resulted from the inhibition by ‘the pill’ of the intestinal conjugase system required to deconjugate polyglutamic folate. The patient’s headache did not recur after stopping the pill and her anaemia improved with folic acid supplement. The relation between folic acid metabolism and ‘the pill’ is discussed.
Coma following treatment of very severe arterial hypertension, with improvement after dexamethasone therapy
Authors: Farrow L J , Wood J B 
Published: December 2008

Summary
We describe two patients with very severe arterial hypertension, who were treated vigorously and effectively with hypotensive drugs. Both promptly developed gross neurological abnormalities, yet recovered fully after treatment with dexamethasone. We have found no similar published reports. We believe that these cases illustrate an important risk of treatment of severe hypertension, and we suggest that cerebral oedema developed, and was then relieved by dexamethasone.
Clostridium welchii and Bacillus cereus infection and intoxication
Authors: Hobbs Betty C 
Published: December 2008

Summary
Clostridium welchii type A is a common agent of food poisoning when allowed to proliferate to large numbers in cooked foods, usually meat and poultry. The main factors of importance are survival of the spores, frequently found on raw products, through the cooking process, and possible contamination of cooked meats transferred to unclean containers; subsequent germination of spores and rapid multiplication of the vegetative cells during long slow cooling and non-refrigerated storage lead to heavy contamination. The toxin responsible is different from the soluble antigens, and its formation in the intestine is associated with sporulation.
Large numbers of Cl. welchii of the same serological types in food and faeces is the main diagnostic factor. Important preventive measures are rapid cooling and cold storage to prevent growth.
Bacillus cereus is an aerobic sporulating organism commonly found in cereals. Outbreaks described from Europe have a different aetiology with regard to food vehicles, incubation period and symptoms from those that have been reported recently in the U.K. from fried and boiled rice. The spores survive through cooking procedures and grow out to cells which sporulate readily in the cooked food and which are assumed to produce toxin in the food. Large numbers of B. cereus are found in foods causing illness and, as with Cl. welchii, the main preventive measure is inhibition of growth by quick cooling and cold storage of foods cooked ahead of requirements. A comparative table of the characteristics and clinical symptoms of Cl. welchii and B. cereus is given.
Staphylococcal food poisoning and botulism
Authors: Gilbert R J 
Published: December 2008

SummaryStaphylococcal food poisoning and botulism are caused by the ingestion of food containing exotoxins. Outbreaks of both are still a problem in many countries. This paper attempts to summarize information relating to these illnesses, together with advice on how their incidence may be reduced, or better still prevented.
Bacterial challenges in food
Authors: Collee J G 
Published: December 2008

Summary
Qualitative and quantitative aspects of bacterial challenges that might be encountered in food are discussed with reference to recognized and relatively unrecognized hazards. Mechanisms of pathogenicity are reviewed and the populations at risk are noted. The bacterial content of food as it is served at table merits more study. The challenge of prevention by education is discussed. Indirect bacterial challenges in our food are considered. The real challenge of diagnosis depends upon an awareness of a complex range of conditions; the importance of effective communication with efficient laboratory and epidemiological services is stressed. There is an increasing need for care in the preparation and distribution of food.
Mites and house dust mite allergy in bronchial asthma in Northern Zambia
Authors: Buchanan D J , Jones I G 
Published: December 2008

Summary
Of 100 asthmatic patients prick tested for allergy to Dermatophagoides pteronyssinus, 88% were positive compared with only 14% of controls. A significantly greater proportion of dust samples from the houses of the asthmatics contained Dermatophagoides mites. The house-dust mite D. pteronyssinus, constituted 90% of the mites identified, other pyroglyphid mites, Cheyletus and Glycophagus making up most of the remainder. This study confirms that allergy to D. pteronyssinus is an important factor in the aetiology of asthma in Ndola. It is suggested that prevention of asthmatic attacks could be directed towards mite control and hyposensitization.
A study of the pharmacokinetics of clindamycin in normal subjects and patients with chronic renal failure
Authors: Eastwood J B , Gower P E 
Published: December 2008

Summary
A single dose of 150 mg clindamycin was given to nine patients with terminal renal failure being treated by maintenance haemodialysis and the blood levels were measured. Four of these patients were studied during haemodialysis and five between haemodialyses. Clindamycin (150 mg) was also given orally to four normal subjects.
The mean serum half-life in the normal subjects was 2·15 hr. For the dialysis patients the mean serum half-life off dialysis was 1·58 hr while that on dialysis was 1·85 hr.
There is evidence that clindamycin is excreted normally in chronic renal failure and that blood levels are not affected by haemodialysis. Normal adult doses, 150-300 mg four times a day, can be given safely in patients with chronic renal failure.
Traumatic aortic incompetence following road traffic accident
Authors: Irving J B 
Published: December 2008

Summary
This case report describes the presentation and treatment of a case of aortic incompetence, resulting from a road traffic accident. The relevant literature is briefly reviewed.
Aortic incompetence due to trauma has been described following non-penetrating chest injuries, such as kicks from horses (Barie, 1881), falls from heights and crushing accidents (Kissane, Koons and Clark, 1948; Levine, Roberts and Morrow, 1962). Despite the frequency of road traffic accidents, there have been no recent reports of traumatic aortic valve damage.
The effect of intravenous Aminoplex 5 on serum gastrin and gastric secretion
Authors: Chatamra K , Pigott H W S , MacNaughton J I , Wastell C 
Published: December 2008

Summary
Aminoplex 5 (Geistlich Ltd), which contains the essential amino-acids in laevo form plus sorbitol and 5% ethanol, may be infused intravenously for at least one hour in patients who are undergoing prolonged nasogastric suction without fear of great gastric hypersecretion of acid.
Pseudomonasosteomyelitis following puncture wounds
Authors: MacKinnon A E 
Published: December 2008

SummaryPuncture wounds of the foot are rarely followed by serious complications but in 1968 Johanson reported eleven cases of osteomyelitis, the infecting organism being Pseudomonas aeruginosa in each instance. He described the typical features of these infections which were confirmed by Minnefor, Olsen and Carver (1971) and Hagler (1971).This paper records a further case of Pseudomonas osteomyelitis and the previously recorded cases are reviewed. Attention is drawn to the importance of surgical as well as antibiotic treatment of these infections.
Atrial fibrillation and hyperthyroidism: a new look at their relationship and therapy with lidoflazine
Authors: Bruyneel K , Verhaegen H , De Vil Ch 
Published: December 2008

SummaryVarious kinds of dysrhythmias are found in association with hyperthyroidism but especially atrial fibrillation. The causal relationship of chronic atrial fibrillation and the endocrine disorder is controversial, as is its therapeutic management. Six patients with this particular combination of disorders were treated with lidoflazine: a new anti-anginal drug with anti-arrhythmic activity. All six patients returned to sinus rhythm on lidoflazine treatment although still hyperthyroid and remained in sinus rhythm during the follow up period ranging from 5 to 14 months. This occurred independently of antithyroid treatment. Some evidence is put forward that dysrhythmias and most commonly chronic atrial fibrillation are triggered off by hyperthyroidism or other disorders but that they are maintained by permanent cardiac damage due to arteriosclerosis, hypertension, coronary heart disease or rheumatic valve disease.Successful chemical cardioversions and maintenance of sinus rhythm can be obtained independent of the thyroid function. Our results confirm the anti-arrhythmic activity of lidoflazine.
Renal failure and suprarenal calcification after secondary haemorrhagic disease in a newborn baby
Authors: Moncrieff M W , Hargreaves H 
Published: December 2008

Summary
A newborn baby who was severely asphyxiated at birth developed secondary haemorrhagic disease which was treated successfully with intravenous heparin. However, she was later found to have supra-renal calcification, chronic renal insufficiency and hypertension. It is felt that prompt treatment of conditions that predispose to secondary haemorrhagic disease is very important as, once this has occurred, treatment may not prevent permanent damage to vital organs.
Polymeric IgA myeloma, hyperlipidaemia and xanthomatosis: a further case and review
Authors: Roberts-Thomson P J , Onitiri A C , Venables G S , Lewis B 
Published: December 2008

Summary
A patient is described who had myeloma of the polymeric IgA variety, together with a striking hyperlipidaemia and xanthomatosis. Investigations into the protein and lipid abnormality failed to demonstrate any mechanism for the hyperlipidaemia. A review of the literature, however, validates this clinical entity and some of the suggested explanations are discussed.
Methoxy-9-ellipticine lactate in refractory acute myeloid leukaemia
Authors: Ansari B M , Thompson E N 
Published: December 2008

Summary
Two cases of refractory acute myeloid leukaemia were treated with methoxy-9-ellipticine lactate alone and in combination with other chemotherapeutic agents. In the first patient a successful complete second and third remission was achieved lasting 2 and 3 months respectively. However, a partial remission was obtained in the second patient as treatment with methoxy-9-ellipticine was only started in the terminal phase of the illness. In view of the resistance of this form of leukaemia to present chemotherapeutic drugs both initally and at the time of relapse, the response of these two cases to methoxy-9-ellipticine is worth reporting.
Intravenous trimethoprim/sulphadimidine in the treatment of Bacteroides septicaemia
Authors: Hanson Gillian C , Woods R L 
Published: December 2008

Summary
The name Bacteroides is used to describe a group of Gram-negative bacilli which are non-sporing obligate anaerobes (Wilson and Miles, 1964). Their natural habitat is the large intestine, mouth, and vagina.
Bacteroides septicaemia is becoming increasingly well recognized as a complication of gastrointestinal and gynaecological surgery. Patients with underlying malignancy or prior antibiotic therapy are predisposed to this condition (Bodner, Koenig and Goodman, 1970). In a survey by Okubadejo, Green and Payne (1973), twenty-nine strains of B. fragilis were tested against co-trimoxazole—all were found to be sensitive. One of the disadvantages of co-trimoxazole has been the absence of a parenteral form for use in seriously ill patients in whom oral administration is not practicable. We report the use of intravenous trimethoprim/sulphadimidine in two cases of septicaemia due to Bacteroides infection.
The association of syphilis with cirrhosis: the role of alcohol and serum hepatitis
Authors: Sadikali F 
Published: December 2008

SummaryThe role of syphilis and alcohol was investigated in a prospective study of patients with cirrhosis of liver in Uganda, and results were correlated with the histological type of cirrhosis, and serological tests for hepatitis B antigen (HB Ag). Eighteen out of eighty (22·5%) patients with histologically-proven cirrhosis had positive serology for syphilis (VDRL and TPI). A high incidence of alcoholism (80%) and syphilis (60%) was found in patients with micronodular cirrhosis who were all negative for HB Ag. By contrast, HB Ag was detected in 37% of patients with macronodular cirrhosis who had a much smaller incidence of syphilis and alcoholism. Although chronic infection with hepatitis B virus related to HB Ag appears to be an important factor in the pathogenesis of cirrhosis in at least 30% of cases, infection acquired during past treatment for syphilis is not an important cause of the association of syphilis with cirrhosis in this population. Subdivision of patients with cirrhosis into those with and those without a history of severe alcohol abuse showed that the difference between the incidence of syphilis in the two groups is significant statistically. However, evidence of syphilis in association with non-alcoholic as well as alcoholic cirrhosis in this and other previously reported series suggests that the association between the two diseases cannot be entirely explained through the common factor of alcoholism, and other factors may also be responsible.
Neonatal listeriosis
Authors: Variend S , Blumenthal I 
Published: December 2008

SummaryThree cases of neonatal listeriosis are reported. This local incidence in a busy neonatal unit over a 10-year period would agree with other reports that the condition is rare in the United Kingdom. Two cases had septicaemia and one developed septicaemia and meningitis, contrasting with the previous view that the commonest presentation is with meningitis, and could be due to the greater use of blood cultures in babies suspected of having infection. The mode of delivery differed in each case which allowed certain conclusions to be made regarding pathogenesis of the condition. Thus evidence is presented against fetal infection through an ascending route or while passing through an infected birth canal. Maternal bacteraemia with a transplacental spread of infection would seem more likely. The possible use of Gentamicin in the treatment of this condition is discussed and the better prognosis with septicaemia, compared with meningitis, is emphasized.
Review of general surgery 1974
Authors: Ellis Harold 
Published: December 2008

Introduction
In this year’s review, the author, once again, has selected those subjects which he has found of personal interest and appeal during the year. Cholecystectomy is one of the commonest major general surgical operations and, therefore, its post-operative complications are extremely important in the hospital community. Acute pancreatitis continues to be a somewhat mysterious condition which remains a clinical, diagnostic, and therapeutic challenge. There is evidence that renal calculi are being seen with ever increasing frequency in the Western World and there is naturally considerable interest in their diagnosis and management. New methods of investigation continue to make the study of deep vein thrombosis and pulmonary embolism an important and exciting topic. Realizing his surgical limitations, the surgeon is anxious to learn about new concepts of prophylaxis, early diagnosis and treatment in malignant disease; a number of interesting papers are discussed in this area. Surgeons are paying increasing attention to the local and systemic factors which are of importance in the healing of their gastro-intestinal anastomoses and much work of interest has been reported in this field. We report new studies in the management of patients with extensive burns and we conclude with one or two eye-catching papers which have been published during the year.
Hormonal mechanisms in the onset of puberty
Authors: Swerdloff Ronald S , Odell William D 
Published: December 2008

SummarySexual maturation is associated with increasing levels of sex steroids. These steroidal events are the result of complex changes that occur at several functional levels including the hypothalamus, pituitary, gonad and adrenal gland. These changes, as outlined in Table 3, are often interrelated.While considerable progress has been made in our understanding of the hormonal events associated with sexual maturation, many important questions remain unanswered. Further intensive investigation will be required before we have a lucid understanding of the physiological basis of the sequence of hormonal events which occur during the pubertal process.
Endocrine aspects of anovulation
Authors: Jacobs H S 
Published: December 2008

Summary
Endocrine features of anovulation are reviewed, with particular emphasis on methods of investigation. The value of, and indications for, measurements of serum gonadotrophin concentrations are discussed: it appears that FSH measurements allow better discrimination than LH measurements in diagnosing patients with primary ovarian failure. The results of stimulation tests with the synthetic form of gonadotrophin-releasing hormone are described and the relationship of tests with exogenous progestogens and clomiphene is discussed.
Excavating pulmonary metastases in carcinoma of the cervix
Authors: Kirubakaran M G , Pulimood B M , Ray D 
Published: December 2008

Summary
A case of excavating pulmonary metastases from carcinoma of the cervix is described. The secondary tumour had appeared nearly 4 years after apparent ‘cure’ of the primary lesion by radiotherapy. The diagnosis is discussed.
The significance of Escherichia coli in the upper respiratory tract of children under 2 years of age
Authors: Barrie John D , Gallacher James B 
Published: December 2008

Summary
Colonization of the upper respiratory tract of neonates by Gram-negative bacilli (especially Escherichia coli) is not rare, and the incidence declines after 1 year of age. It is believed that the likelihood of colonization increases with the length of stay in hospital at the time of birth, and that such colonization does not reflect any pathological process. Evidence has not been found to support the view that the use of antibiotics is the reason for colonization in neonates (the situation in adults or children over 2 years of age is not considered here). The authors believe that the birth canal is not an important source of Gram-negative bacillary flora but that perineal contact at birth and maternal handling after birth more probably are, especially in the hospital environment where Gram-positive organisms have been suppressed by hexachlorophane.
With the limited range of E. coli typing sera available, a relatively high proportion of non-typeable strains was found. Among those which did type, the incidence of various strains corresponded fairly closely to those which are known to occur in the normal bowel and to cause urinary infections. No evidence for type-specific respiratory pathogenic strains was found.
Autoimmune haemolytic anaemia and ulcerative colitis
Authors: Gorst D W , Leyland M J , Delamore I W 
Published: December 2008

Summary
Two cases of ulcerative colitis are described in which there was associated severe auto-immune haemolytic anaemia. The colitis in both patients responded to conventional therapy and one patient underwent splenectomy for her anaemia. Possible aetiological links are discussed.
Consequences of acute renal failure relevant to hepatic failure
Authors: Weston M J , Wilkinson S P 
Published: December 2008

Summary
The onset of renal failure in patients with liver failure complicates an already deranged metabolic picture and may increase the retention of many potentially toxic substances. The risk to the patient of haemorrhage and infection is aggravated. Dialysis may correct the features of uraemia and, in acute liver failure at least, provide time for kidney as well as liver regeneration.
Functional renal failure (FRF) in cirrhosis of the liver and liver carcinoma
Authors: Vesin P , Traverso H 
Published: December 2008

Summary
The term ‘functional renal failure’ has been used to describe the renal failure developing in advanced cirrhosis in which tubular function and structure remain intact. It may develop spontaneously, in which case prognosis is poor, but may be secondary to gastro-intestinal haemorrhage or excessive use of diuretics, in which case correction of the precipitating factor leads to improvement in renal function. It is suggested that the renal failure is due to a reduction in effective circulating plasma volume.
The role of renin in renal failure associated with hepatic failure
Authors: Smith I K 
Published: December 2008

Summary
A review of the literature has shown that the role of renin in renal failure is not resolved. It has been invoked as an aggravating factor: decreased renal perfusion releasing large quantities of renin sufficient to cause further renal vasoconstriction. If so, then angiotensin generation and action must occur entirely intrarenally since the vasoconstriction appears to be confined entirely to this vascular bed. It may prove necessary to evaluate the renin-angiotensin system within the kidney rather than peripherally. Elevated renin levels in peripheral plasma are at least as likely to be a consequence of reduced renal perfusion as a cause of it.
The few studies so far undertaken of the renin-angiotensin system in renal failure associated with liver disease are inconclusive. If further studies should ascribe a role to renin in the pathology of renal failure, then it may be possible to treat the condition by pharmacological manipulation of the renin-angiotensin system and thereby prevent some of the more serious consequences of renal failure.