bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arteriosclerosis, amputation and peptic ulcer
Authors: Bouhoutsos J , Barabas A P , Martin Peter 
Published: December 2008

Summary
In a series of 400 consecutive patients with arteriosclerosis seen in two peripheral vascular clinics, we confirm the previously reported association with peptic ulcer. The incidence was almost 25% both in patients with occlusive disease (300) and with aneurysm (100). The accepted expectation of peptic ulcer in the same age-group is 6 or 7% (Jones, Kirk & Bloor, 1970; McManus, 1966).
Patients with peptic ulcer, or the history of one, had a significantly higher amputation rate than those without a peptic ulcer.
Successful resection of mycotic aneurysm of the superior mesenteric artery
Authors: Kumana C R , Foley R J E 
Published: December 2008

Summary
A patient with subacute bacterial endocarditis is presented in whom an intra-abdominal mycotic aneurysm was diagnosed prior to the development of cardiac signs. The patient was successfully treated for his endocarditis and the aneurysm which proved to be arising in a branch of the superior mesenteric artery was resected.
The lack of value of hepato-jugular reflux as a sign of heart failure
Authors: Singh S P , Haider R 
Published: December 2008

SummaryAn investigation was carried out of the diagnostic value of hepato-jugular reflux in patients with heart failure.The effect of abdominal compression on superior vena cava pressure was assessed in patients with and without heart failure. In four of the six patients without congestive cardiac failure, during compression, whether applied in the right hypochondrium or left iliac fossa, there was a significant rise in vena cava pressure. A similar response was also observed in three patients with congestive heart failure.Hepato-jugular reflex is not a reliable sign of incipient heart failure.
Colonic motility in man
Authors: Parks T G 
Published: December 2008

Summary
Studies of the motor activity of the large intestine have led to a better understanding of the normal physiology of this organ. The disturbed patterns which occur in functional and pathological states are easily recorded by modern technology. While of limited use as a diagnostic aid, investigation of the motor activity has contributed significantly to elucidate the aetiology of various disorders of colonic function.
The Cronkhite-Canada syndrome
Authors: Cotterill J A , Hughes J P , Day J L , Paulley J W , Turk E 
Published: December 2008

Summary
The eighteenth patient and seventh survivor with the Cronkhite-Canada syndrome is described. A remission of 9 years followed gastrectomy and steroid therapy. Findings on seventeen other patients described in the literature are reviewed.
The histological features are discussed in detail. The jejunum, though macroscopically normal, showed oedema, increased vascularity and mucous gland secreting activity. The possible importance of this increased vascularity in the aetiology of this syndrome is discussed.
Acute renal failure and lithium intoxication
Authors: Lavender S , Brown J N , Berrill W T 
Published: December 2008

Summary
A case of acute renal failure is reported in a patient with severe lithium intoxication. Renal biopsy showed damage in the proximal tubules with less marked changes in the glomeruli and interlobular arteries.
Lithium was withdrawn, and after treatment with peritoneal dialysis the patient regained normal renal function.
The accumulation of lithium is known to lead to acute renal failure in the rat and the dog, and this report provides further evidence that it may do so in man.
Accentuation of ichthyosis vulgaris due to associated leprosy
Authors: Shah A P , Shah S S , Doshi H V 
Published: December 2008

Summary
A case of ichthyosis vulgaris associated with tuberculoid leprosy is reported. Ichthyotic scales were markedly accentuated within the anaesthetic patches of leprosy.
The probable mechanism of the accentuation of ichthyosis by leprosy is discussed.
Abdominal trauma: a report of 129 cases
Authors: Bates T 
Published: December 2008

Summary
A retrospective study of 129 cases of abdominal trauma admitted to a district general hospital over the 8 years 1964–71 is reported. Road traffic accidents accounted for 60% of the cases and had a much higher mortality than domestic or industrial accidents.
Laparotomy was carried out in eighty-eight patients, but two patients with a ruptured abdominal viscus died without operation because the diagnosis was not recognized.
There were seventy-four cases of renal injury of which thirty-nine were treated conservatively and thirty-four were explored through a laparotomy incision. The indication for urgent operation in every case was the suspicion of an associated intraperitoneal injury and in all but three this was confirmed. Only one injured kidney was explored through the loin after an interval. Nephrectomy was carried out in eight cases (11%).
The commonest finding at laparotomy was rupture of the spleen, of which there were fifty-three cases. Major hepatic injuries and rupture of the duodenum carried a very high mortality. In all four cases of retroperitoneal rupture of the duodenum there was a delay in diagnosis of at least 24 hr due to the late onset of physical signs.
The overall mortality of patients with proved rupture of an abdominal viscus was 17% but in twenty patients (22%) there was a delay in diagnosis and this group carried a 30% mortality.
A diagnostic peritoneal tap was carried out in only fifteen cases, but in nine (60%) gave a false negative result.
The place of diagnostic peritoneal lavage in the management of abdominal trauma is discussed.
Stumbling blocks in the study of diamorphine
Authors: Twycross R G 
Published: December 2008

SummaryAlthough the centenary of the discovery of diamorphine is soon to be celebrated, much work remains to be done before its mode of action is thoroughly understood. The main stumbling blocks facing the would-be investigator can be summarized as follows: (1)Diamorphine in solution has a limited shalf-life.(2)The potency ratio of diamorphine to morphine is still a matter of dispute.(3)No basic studies appear to have been carried out on the fate of orally administered diamorphine.(4)Current methods of assay are not sensitive enough to detect diamorphine or its metabolites in serum after the administration of the drug when given in therapeutic amounts.(5)The undersirable side-effects of diamorphine may vary according to posture and mobility.(6)As the metabolic handling of the drug may be different in the two sexes, provision for a between-sex comparison should be included in the design of a clinical trial of diamorphine.
Sjögren's syndrome, dysimmunoglobulinaemia and malignant disease
Authors: Thomas Peter 
Published: December 2008

Summary
The occurrence of carcinoma in situ in the stomach and dysimmunoglobulinaemia in a patient who had Sjögren's syndrome is described. This is believed to be the first report of such a case to be found in the literature.
Although carcinoma has occasionally been described, in this syndrome its occurrence is probably coincidental and not part of the disease process. There is a greater incidence of lymphoid tumours in Sjögren's syndrome than in the general population. Corticosteroid therapy favourably influenced the immunoglobulin abnormalities and some of the clinical manifestations of the disease.
A brief review of the literature concerning Sjögren's syndrome, auto-immunity and malignant disease is included.
Hypogammaglobulinaemia with Whipple's disease
Authors: Cochran M , Gallagher J C , Cook M G , Peacock M 
Published: December 2008

Summary
The patient, a 54-year-old housewife, was well until the age of 40 years when she developed repeated infections. During the next 10 years recurrent attacks of diarrhoea also appeared and were associated with weight loss, increased skin pigmentation, and later the occurrence of arthralgia and polyserositis. She was found to have deficiencies of IgG and IgA. A malabsorption syndrome was established and shown to be due to Whipple's disease by jejunal biopsy. She also had hypocalcaemia and osteomalacia. Weekly injections of human gammaglobulin had no effect on either the diarrhoea or the arthralgia, although the severity of respiratory infections was reduced. Intramuscular injections of vitamin D failed to restore the serum calcium to normal. Continuous oral tetracycline was followed by marked symptomatic improvement, disappearance of the diarrhoea and some weight gain. Steatorrhoea however persisted and the jejunal histology showed only slight improvement. The serum calcium returned to normal possibly as a result of correction of a magnesium deficiency. The relevance of the hypogammaglobulinaemia to the Whipple's disease is discussed, and a search of the literature shows six other cases where both disorders were associated.
Pulmonary reaction to furoxone
Authors: Collins J V , Thomas A L 
Published: December 2008

Summary
A patient is reported in whom an acute pulmonary reaction resulted from the ingestion of Furoxone (furazolidine), a member of the nitrofurantoin group of drugs. A positive lymphocyte transformation test to Furoxone was found. This is thought to suggest that Type IV (Gell & Coombs, 1968) thymus dependent hypersensitivity may be implicated in such pulmonary reactions.
Epidemiological aspects of influenza in man and other animals
Authors: Hobson Derek 
Published: December 2008

Summary
The recurrent problem in human influenza is the pandemic increase in mortality and social dislocation which occurs every 10–15 years whenever a new subtype of type A virus emerges, with antigens which cannot be neutralized by antibodies induced in the population by infection or vaccination with any of the foregoing epidemic strains.
There is an urgent need to interpret these past antigenic shifts so that the constitution of the next pandemic strain can be predicted, allowing effective specific vaccines to be made in advance.
The pandemic viruses are unlikely to be direct mutants from one to another. Epidemiological evidence of their cyclic recurrence in mankind at 70 year intervals suggests the role of animal reservoirs of influenza viruses. Man may be infected directly, or after genetic recombination between an animal virus with novel antigens and a human strain with the necessary virulence for man.
Clinical aspects of ‘Q’ fever
Authors: Brown G Laing 
Published: December 2008

Summary
‘Q’ fever is an acute febrile illness seen mainly among members of the farming community. The infection is contracted from sheep and cows mainly by inhalation of infected dust, but can be spread by raw milk.
The symptoms bear a marked resemblance to influenza and in the majority of cases the illness clears up spontaneously. A firm diagnosis can best be made by demonstrating a rise in complement fixing antibodies. Patchy consolidation of the lungs is seen on X-ray in about one-third of the cases and occasionally the infection becomes implanted on previously damaged heart valves and gives rise to subacute bacterial endocarditis. Treatment with tetracycline or trimethoprim sulphamethoxazole is indicated.
Antimalarial drugs and their actions
Authors: Peters W 
Published: December 2008

SummaryNew antimalarial drugs are required, partly because of the emergence of drug resistant strains of malaria parasites and partly because better compounds are needed to cure relapsing tertian malaria. In reviewing the diverse modes of action of currently used antimalarials, against a background of the pathogenesis of malaria, attention is drawn to deficiencies in our knowledge. Even less do we understand how the malaria parasite becomes resistant to certain drugs, in particular chloroquine. New approaches to the problem include the application of combinations of existing antimalarials, and the search for new drugs on an unprecedentedly vast scale. Out of over a quarter million compounds that have recently been screened, a handful are now in clinical trial and are showing great promise for the treatment of multiple resistant falciparum malaria. The paper concludes by summarizing current recommendations for the prophylaxis and therapy of malaria due to drug resistant parasites.
Toxicity of co-trimoxazole in nutritional haematinic deficiency
Authors: Hill A V L , Kerr D N S 
Published: December 2008

Summary
A woman of 47 habituated to analgesics and living on an inadequate diet was deficient in iron, folate and vitamin B12. Treatment of pyelonephritis with co-trimoxazole precipitated pancytopenia with a megaloblastic bone marrow. She recovered following withdrawal of the drug and administration of iron, folate and vitamin B12.
Intravascular haemolysis complicating treated non-ketotic hyperglycaemic diabetic coma
Authors: Blackwell S W , Burns-Cox C J 
Published: December 2008

Summary
A patient with non-ketotic hyperglycaemic diabetic coma is reported with the complications of cerebral oedema, oliguric renal failure, transient cataracts, possible acute pancreatitis and intravascular haemolysis. The last association has not been reported before, and it may have been due to rapid infusion of hypotonic saline producing haemolysis locally at the infusion site.
The treatment of carcinoma of the lung by radiotherapy
Authors: Deeley Thomas J 
Published: December 2008

Summary
Where the diagnosis of cancer of the lung is made by bronchoscopy the preferred treatment is surgery for squamous lesions and radiotherapy for anaplastic and oat-cell lesions. In inoperable tumours 8% of patients survive for more than 3 years after a radical course of radiotherapy; some clinical trials aimed at improving this survival rate are described. This lecture deals with the established disease, earlier diagnosis, before spread, would make radical treatment with a possibility of cure possible in more patients but this disease can be prevented to a large degree and this is the obvious method of attack.
The terminal care of patients with lung cancer
Authors: Twycross R G 
Published: December 2008

Summary
Lung cancer is the commonest form of malignant disease seen at St Christopher's Hospice. More than 35% of the male and about 8% of the female cancer patients are admitted with this diagnosis. This means that each year approximately 100 patients with lung cancer are amitted and cared for at the hospice. The more common symptoms experienced by 185 consecutive terminal lung cancer patients admitted to St Christopher's Hospice are listed in Table 1.
Collaborative studies of acute respiratory disease in patients seen in general practice and in children admitted to hospital. Aims, field methods and morbidity rates
Authors: Miller D L 
Published: December 2008

Summary
Two collaborative studies of acute respiratory disease were organized, one in patients seen in general practice and the other in children admitted to hospital. The main aims were to study the epidemiology and clinical presentation of these diseases and of the viruses associated with them. The field methods used are described and analyses of the consultation rates in general practice and of hospital admissions in children are presented. Both consultations and admissions were most frequent by far in very young children, especially those under the age of 1 year, but the pattern of incidence for the various clinical categories differed with age. Lower respiratory illnesses were relatively much more frequent in infants and in adults over 65 than in intermediate age groups. Seasonal variations were slight for most upper respiratory tract conditions but pronounced for lower respiratory illnesses, especially bronchiolitis of infants which was epidemic each winter, and for influenza. Changes in the initial diagnosis in patients seen in general practice did not greatly influence the total morbidity pattern but the final diagnoses showed a substantial proportional increase in the number of cases of lower respiratory illness. The shortcomings of the field methods and clinical records available for use in the study and the reliability of the results are discussed.
Viral and epidemiological findings in MRC/PHLS surveys of respiratory disease in hospital and general practice
Authors: Poole Pauline M , Tobin J O'H 
Published: December 2008

Summary
The results found and the laboratory methods used for the isolation of viruses and β haemolytic streptococci in two MRC/PHLS surveys of respiratory disease in patients in hospital and general practice are described. 717 viruses and 82 β haemolytic streptococci were isolated from 2418 children in hospital and 835 viruses and 435 strains of β haemolytic streptococci from patients seen in general practice. Virus isolation rates in the two surveys were 28·9% and 21·0% respectively. Rates by age, sex, time and by clinical categories are given and discussed in relation to isolations from control subjects, the cause of deaths in twenty-two of the children tested, and the incidence of convulsions and meningism found in those examined in these surveys.
Adenovirus infections
Authors: Pereira Marguerite S 
Published: December 2008

Summary
Ninety-three adenoviruses were found in the MRC/PHLS survey of patients in general practice and eighty-eight in those admitted to hospital, types 1, 2, 3, 5 and 7 being the most frequent ones isolated. The adenoviruses accounted for 11% and 12% of all viruses and were present in 2% and 4% of patients examined in these surveys. These agents were present at all times with slightly increased frequency in the first part of each year. Fever, pharyngitis and tonsillitis were the most frequent symptoms encountered.
Psychosurgery and the limbic system
Authors: Kelly Desmond 
Published: December 2008

SummaryThe limbic system can be considered to consist of a central ‘core’ from which three well-defined circuits emerge. These are the Papez or medial circuit, the basolateral circuit and the defence reaction circuit. The functions of the primitive limbic brain are modulated by a higher order control—the frontal lobe. Emotional responses and physiological changes have been obtained by stimulation of fronto-limbic pathways and limbic circuits and these have been used for location of target sites in psychosurgery. For the relief of intractable depression and anxiety, lesions are generally made in the lower medial quadrant or posteroorbital part of the frontal lobe, where there is a concentration of fronto-limbic connections. In primary obsessional neurosis lesions at this site produce less satisfactory results, but these illnesses may be helped by lesions in the cingulate gyrus, which is part of the Papez circuit. Patients with epilepsy and aggressive outbursts may respond to temporal lobotomy, or to operations, such as amygdalotomy, where lesions are placed in the defence reaction circuit.
Custom psychosurgery
Authors: Turner Eric 
Published: December 2008

Summary
It seems fundamentally improbable that different mental symptoms and personality disorders should be relieved by one single form of operation on the brain. The present paper describes five operations which can be performed with benefit to different types of psychiatric abnormality; namely, unilateral temporal lobectomy, unilateral or bilateral temporal lobotomy, inferior quadrant pre-frontal leucotomy, paramedian frontal leucotomy and posterior cingulectomy.
The symptoms that represent an indication for these various operations and the results of the operations on the symptom complexes are described. The proposition is put forward that only operations suitable for the precise psychiatric diagnosis should be used. A new form of analysis of sphenoidal lead examinations is described which is of primary importance in conjunction with psychiatric examination in deciding which operation a particular patient would or would not benefit from. A concept of diencephalic instability is introduced in connection with this EEG analysis to supplement the usual concept of centrencephalic epilepsy. Diencephalic instability as defined here seems to respond specifically to paramedian lobotomy, provided of course the clinical condition justifies such a step.
Amygdalotomy
Authors: Hitchcock Edward , Cairns Valerie 
Published: December 2008

Summary
The results of a multi-disciplinary research project into the management and assessment of patients with epilepsy and behaviour disturbances are reported in eighteen patients who have undergone amygdalotomy over the past 5 years. The psychological and neuro-surgical assessments are detailed and the effects of stimulation and coagulation of the amygdala nucleus are described in six patients.
It is concluded that certain cases benefit by amygdalotomy, but that changes are not limited to a decrease in abnormal aggressive behaviour but also lead to a decrease in other areas of maladaptive behaviour. The aim of the operation is to enable the patient to respond more appropriately in a range of situations which in turn would lead to an increase in general effectiveness.
The influence of antihypertensive treatment over the incidence of cerebral vascular disease
Authors: Beevers D G , Hamilton M , Fairman M J , Harpur J E 
Published: December 2008

Summary
The incidence of stroke in a group of 499 treated hypertensive patients was closely related to the adequacy of control of hypertension. This trend was independent of the level of diastolic blood pressure at presentation, and differed markedly from the incidence of myocardial infarction and angina pectoris which did not vary with adequacy of control.
Treatment of severe hypertension and hypertensive emergencies with intravenous clonidine hydrochloride
Authors: Niarchos Andreas P , Baksi Arun K 
Published: December 2008

Summary
Eleven severely hypertensive patients, median age 54 years, were treated with intravenous (i.v.) clonidine hydrochloride (Catapres). In nine there were life-threatening complications: severe left ventricular failure (LVF), hypertensive encephalopathy, cerebral haemorrhage, dissecting aortic aneurysm, renal failure, and severe epistaxis. In two patients there was pronounced, but uncomplicated, elevation of blood pressure. 0·15 mg or 0·3 mg clonidine was given every 40 min with electrocardiographic (ECG) monitoring. The mean systolic and diastolic blood pressures in the eleven patients were respectively 266 and 165 mmHg before treatment falling to 165 and 109 mmHg after treatment (P &lt; 0·001). The mean decrease in heart rate was 26 beats/min (P &lt; 0·001). Doses of clonidine required for control ranged from 0·15 mg (one ampoule) to 0·9 mg (mean 0·56 mg), although one patient received a total of 0·9 mg without an adequate response. The presenting condition caused the eventual death of two patients. There were no serious side effects, except for one transient episode of sino-atrial heart block. It is concluded that clonidine is effective and safe in the treatment of hypertensive emergencies.
Anomalous responses to stimulation and suppression tests in Cushing's syndrome due to a calcified adrenal adenoma
Authors: Epstein S , McLaren E H , Goldin A R 
Published: December 2008

Summary
A case of Cushing's syndrome, due to an adrenal adenoma, which responded to dexamethasone with a rise in plasma urinary steroids is described. Further unusual features were radiologically visible calcification and a response to ACTH stimulation.
Lipomatous pseudohypertrophy of the pancreas associated with chronic pulmonary suppuration in an adult
Authors: Siegler D I M 
Published: December 2008

Summary
This report describes a man who died at the age of 43 of overwhelming pulmonary suppuration in association with pancreatic steatorrhoea. Autopsy revealed lipomatous pseudohypertrophy of the pancreas. The patient is the longest documented survivor with pulmonary complications of lipomatous pseudohypertrophy of the pancreas. The literature on this rare condition is reviewed.