bluuebunny/crossref_metadata_2025_split huggingface dataset:
A neonatal complication of maternal leukaemia treated with 6-mercaptopurine
Authors: McConnell J B , Bhoola R 
Published: December 2008

Summary
A 24-year-old African mother, who had received 6-mercaptopurine for acute leukaemia from before conception and throughout her pregnancy is described. The child, born prematurely, was anaemic at birth, with many features of a micro-angiopathic haemolytic anaemia. It is suggested that the mother's disease or treatment was involved in the aetiology of this anaemia.
The patient with angina; symptoms and disability
Authors: Mayou Richard 
Published: December 2008

Summary
Cardiac and mental states were assessed for forty men with angina pectoris, and relatives were interviewed as to symptoms and social disability.
Depression and anxiety together with irritability, fatigue and sleeplessness were common and minimization of such symptoms as well as of physical limitation was prominent. There were characteristic and major changes at work and in leisure and family life.
Disability was not closely related to physical handicap and it was evident that personality factors are of considerable significance in determining response and adaptation to angina.
Pregnancy and the skeletal complications of sickle cell disease
Authors: Akinla Oladele 
Published: December 2008

SummaryAn account is given of three patients with the skeletal complications of sickle cell disease in association with pregnancy. Avascular necrosis of bone and acute osteomyelitis are the usual forms of these complications.The associated high perinatal mortality is probably due to the constant hypoxia to which the foetus is exposed during both pregnancy and labour.
Minimal dose of a stimulus for maximal pepsin secretion
Authors: Desai H G , Zaveri M P , Antia F P 
Published: December 2008

Summary
Dose-response curves were obtained with subcutaneous histamine acid phosphate (HAP) in twenty-two subjects, intravenous HAP in fifteen subjects, subcutaneous pentagastrin in fourteen subjects and intravenous pentagastrin in twelve subjects in order to determine the minimal doses of these stimuli for maximal pepsin secretion.
The minimal doses for maximal pepsin secretion were 2·8 mg HAP on SHT, 1·2 mg/hr HAP on IHT, 300 μg pentagastrin on SPT and 100 μg/hr pentagastrin on IPT.
Hepatic manifestations during amoebic dysentery
Authors: Ramachandran S , Rajapakse C N A , de Saram R , Sivalingam S 
Published: December 2008

Summary
A variety of hepatic manifestations may occur during attacks of acute amoebic dysentery, conforming to clearly defined clinical groups.
The incidence of definite hepatic involvement presenting as cases of hepatic amoebiasis with or without demonstrable pus or with tender hepatomegaly was 57·5%.
While it is possible that the cases presenting with hepatic manifestations without demonstrable pus are due to small deep-seated abscesses, the non-specific nature of the histological lesions observed in the study and the inability to demonstrate the presence of amoebae in the lesions support the contention that these hepatic manifestations may represent a non-specific reaction in the liver to amoebic ulceration of the colon.
Chest radiology may be helpful in confirming the clinical evidence of hepatic involvement but the leucocyte count, ESR, and the serum enzymes are of limited value in indicating both its presence and type.
Patients manifesting hepatic involvement during attacks of amoebic dysentery should be adequately treated with tissue amoebicidals. This therapeutic approach would be useful in reducing the incidence of hepatic amoebiasis.
Changes in glucose tolerance, insulin, serum lipids and lipoproteins in patients with renal failure on intermittent haemodialysis
Authors: Arora K K , Trafford J A P , Atkinson M K , Sheldon J , Nunn R 
Published: December 2008

Summary
Fasting serum lipids and lipoprotein patterns, glucose tolerance and serum insulin response to glucose were investigated in eight patients with renal failure on intermittent haemodialysis and five normal controls. The mean 0·5, 1 and 2 hr blood glucose values were significantly higher in patients compared with controls but there was no significant difference between patients and controls in respect of fasting serum insulin levels or the insulin response to glucose. Six of the eight patients showed hypertriglyceridaemia (hyperprebetalipoproteinaemia).
Plasma lipids, blood coagulation and fibrinolysis in peripheral arterial disease
Authors: Newall R G , Bliss B P , Kirk C J C 
Published: December 2008

Summary
In a study relating platelet stickiness, plasma fibrinogen and fibrinolysis to fasting plasma lipids in patients with atherosclerosis of the lower limbs, a significant correlation has been observed between platelet stickiness and plasma phospholipid levels. The possible mechanisms are discussed. No other correlation is observed. Fasting levels of plasma fibrinogen were raised, while levels of plasminogen, and the degree of platelet stickiness in many cases were normal.
Epidemiological features of subarachnoid and cerebral haemorrhages
Authors: Talbot S 
Published: December 2008

Summary
A study of coroner's necropsy statistics showed that subarachnoid and cerebral haemorrhage were important causes of sudden death in the community. There were more sudden deaths due to cerebral haemorrhage in women than in men but this was due to the increasing frequency of this condition with age and the sexes were equally affected if standardized mortality rates were calculated. Comparison with a study of hospital necropsy statistics showed that the latter was a selected group, elderly patients (predominantly women) being found less frequently. Deaths due to subarachnoid haemorrhage occurred as commonly in men as in women, but were rare over the age of 60 years. This fact probably accounted for the similar epidemiology of these fatal cases in the hospital and the community.
There was no significant seasonal variation in the death rate due to either cerebral or subarachnoid haemorrhage if surgically treated cases were excluded.
The mortality of both these conditions was highest at the onset and rapidly decreased. A secondary rise in mortality due to subarachnoid haemorrhage occurred between the sixth and eighth days after the onset in the hospital group. The length of survival before treatment is an important prognostic factor and must be known before the effect of treatment can be assessed.
Aetiology of postmenopausal bleeding
Authors: Keirse M J N C 
Published: December 2008

Summary
A retrospective analysis has been made of 160 cases of postmenopausal bleeding. The women were at least 45 years old and the time lapse from the last menstruation was at least 2 years.
The cause was a malignant neoplasm in 23·75%. The incidence of malignancy showed a definite rise with advancing age and with increasing duration of bleeding. It was nearly twice as high in women who stopped menstruation after the age of 55 years. Malignancy also seemed to be more frequent in patients with profuse bleeding and in those who had amenorrhoea lasting for 20 years or more.
The most usual malignant lesions were endometrial and cervical carcinoma, the ratio of these two conditions being 1·6: 1. Oestrogen administration was the most common cause in the non-malignant group: 12·5%. No cause for bleeding could be demonstrated in 8·8%.
The aetiology of postmenopausal bleeding is discussed.
The use of intra-arterial Urokinase in a case of recurrent arterial occlusion
Authors: Boucher B J , Connolly E M , Farrow S C 
Published: December 2008

Summary
The present case report describes the use of intraarterial Urokinase in an occlusive episode involving the right radial and ulnar arteries. Details of the case history are given and the choice of thrombolytic therapy, plus its route of administration are discussed.
Radioisotope scanning of brain, liver, lung and bone with a note on tumour localizing agents
Authors: Lavender J P 
Published: December 2008

SummaryRadioisotopic scanning of brain, liver, lungs and the skeleton is briefly reviewed with a survey of recent developments of clinical significance. In brain scanning neoplasm detection rates of greater than 90% are claimed. The true figure is probably 70–80%. Autopsy data shows a number of false negatives, particularly with vascular lesions. Attempts to make scanning more specific in differentiating neoplasm from vascular lesions by rapid sequence blood flow studies are reviewed.In liver scanning by means of colloids again high success rate is claimed but small metastases are frequently missed and the false negative scan rate is probably quite high.Lung scanning still has its main place in investigating pulmonary embolic disease. Ventilation studies using Xenon 133 are useful, particularly combined with perfusion studies.The various radiopharmaceuticals for use in bone scanning are reviewed. The appearance of technetium labelled phosphate compounds will probably allow much wider use of total skeletal scanning.Research into tumour localizing agents continues, the most recent and interesting being Gallium citrate and labelled bleomycin. Neither agent is predictable however although Gallium may have a place in Hodgkins disease and bronchogenic neoplasm and both may have a place in the detection of cerebral tumours.
The diagnosis of thyrotoxicosis
Authors: Greig William R , McDougall Iain R , Gray Henry W 
Published: December 2008

Summary
Thyrotoxicosis is a clinical syndrome due to excessive amounts of thyroid hormone in the circulation and tissues. Graves' disease, goitre and exophthalmos, is the commonest variety, but in some parts of the world thyrotoxicosis supervenes on the background of a long standing nodular goitre. Other varieties such as ectopic TSH syndromes are very rare.
The diagnostic sequence in practice starts with clinical suspicion and a decision can often be made on the symptoms and signs alone. It is, however, always advisable to confirm the presence or absence of thyrotoxicosis. There has been re-orientation in the simple test procedure used in this respect. Measurements such as serum TSH and serum TSH response to TRH and measurements of serum LATS levels are available only in a few centres and are not discussed in detail.
Tests based on the carriage of thyroid hormones in the blood are preferable to in vivo radionuclide studies, particularly when the patient is thought to be euthyroid. We advise a serum PB127I and serum total thyroxine estimation in all patients. If the data are abnormal we add a serum T3 resin estimation to check whether the values are due, for example, to iodine contamination or altered binding.
We advise radionuclide studies in all doubtful cases and measurements such as the 4 hr or 24 hr 131I uptake and the 48 hr serum PB131I are very helpful. A thyroid uptake suppression test may be required if there is still doubt. In general those patients going for thyroidectomy or 131I therapy should have a scan performed. With improved technology much safer radionuclides, such as 123I or 99mTc, may be usable when thyrotoxicosis is suspected in children or during pregnancy.
The use of total-body counters for the study of iron metabolism and iron loss
Authors: Warner G T 
Published: December 2008

Summary
Total-body counters designed for clinical use have considerable advantage and application over other methods for the measurement of iron metabolism. An investigation may be performed on an out-patient basis and the need for faecal collections avoided.
Although the initial cost of their installation is high, this can be off-set by the saving of in-patient costs in 2 or 3 years of operation.
The investigation of renal disease using radionuclides
Authors: Atkins Harold L , Freeman Leonard M 
Published: December 2008

Summary
The use of radioactive labels for tracers is an important part of the investigation of renal disease. These techniques seldom replace, but often complement radiographic techniques. Generally, the radionuclide methods provide functional and dynamic information in a non-invasive, non-traumatic type of examination. The examinations usually are relatively simple to perform and carry a very low risk of untoward reaction.
The past decade has seen significant advances in radiopharmaceutical design and instrumentation. It is expected that the next decade will produce an even greater advance in this field.
The renal excretion of nutrients in pregnancy
Authors: Hytten F E 
Published: December 2008

Summary
A feature of normal pregnancy is a huge increase in the excretion of nutrients in urine. Glycosuria is commonplace, and about half of all healthy pregnant women excrete more than when not pregnant. Amounts in excess of 1 g/24 hr are common, and excretion is characteristically intermittent with little apparent relation to plasma levels. Amino acid excretion is also raised four or five times by late pregnancy, with a characteristic pattern for different amino acids, and folate and other water soluble vitamins are similarly squandered. The mechanisms are not understood.
Agranulocytosis associated with sulphasalazine therapy
Authors: Cochrane P , Atkins P , Ehsanullah S 
Published: December 2008

Summary
A case report of a patient with agranulocytosis associated with sulphasalazine therapy is described. Recovery followed supportive therapy and withdrawal of the drug. Investigations including tests for leucocyte antibodies, the presence of which might have suggested an immunological cause for the drug reaction, were negative; an acetylation study, however, characterized the patient as a ‘slow’ acetylator phenotype, suggesting that the drug reaction was more likely to have been toxic in nature. It is suggested that acetylation studies be performed in patients who have previously shown serious side effects to sulphasalazine to assess the incidence of ‘slow’ acetylators.
Passive smoking: Absorption by non-smokers of carbon monoxide from room-air polluted by tobacco smokeThis article is reproduced from the Lancet (1973) i, 576, by kind permission of the Editor.
Authors: Russell M A H , Cole P V , Brown E 
Published: December 2008

Summary
Twenty subjects spent a mean of 78 min seated in an unventilated smoke-filled room of approximately 43 m3 (15 × 12 × 8 ft). The smoke was produced by burning and smoking eighty cigarettes and two cigars. The average ambient carbon monoxide (CO) concentration was 38 ppm. Blood samples taken before and after the exposure showed an increase in carboxyhaemoglobin (COHb) in all subjects without exception (P &lt; 0·001). The COHb of the twelve non-smokers increased from a mean of 1·6% to 2·6% (P &lt; 0·001), while the six cigarette smokers, all inhalers, besides having significantly higher initial levels (P &lt; 0·001) also showed a greater increase from a mean of 5·9% to 9·6% (P &lt; 0·001). The two cigar smokers, one an inhaler, the other a non-inhaler, showed respective COHb changes similar to the cigarette smokers and non-smokers. The mean increase of 1% COHb among the non-smokers was similar to the mean increase for the smokers of 0·7% for each cigarette smoked, suggesting that the amount of CO which the non-smokers absorbed by passive smoking was about the same as would be expected if they had actively smoked and inhaled one cigarette.
Turner's syndrome with coeliac disease, thin bones and abnormal liver function tests
Authors: Thatcher N , Stephens A D , Besser G M 
Published: December 2008

SummaryA patient is described with 45 XO Turner's syndrome and thin bones. It transpired that the patient had osteomalacia due to gluten sensitive enteropathy rather than the osteroporosis usually expected with Turner's syndrome. In addition, she had unexplained liver dysfunction. Causes for thin bones other than the osteoporosis associated with ovarian agenesis should be considered in patients with Turner's syndrome.
The work of a psychosurgical unit
Authors: Bridges P K , Bartlett J R 
Published: December 2008

Summary
The widespread use of standard leucotomy terminated in the early 1950's with the advent of the phenothiazine group of drugs. But since then, psychosurgical techniques have been considerably refined and the indications for the newer operations are becoming increasingly precise. Knight's (1969) stereotactic tractotomy is probably the most frequently performed contemporary operation for the relief of some psychiatric illnesses, and the number of patients now referred for this treatment have justified the organization of a specific unit for the purpose.
The value of such a special unit, involving close co-operation between neurosurgeon and psychiatrist is emphasized. It provides a supportive environment for patients who are sharing a highly specialized treatment, and offers opportunities for studying outcome after operation with resulting improvement in selection. It also facilitates research possibilities in general. The clinical work of the Geoffrey Knight Psychosurgical Unit, probably in its way unique, is described and questions often encountered from doctors and from patients are considered. The importance of rehabilitation after operation is stressed and some aspects of the longer term post-operative psychiatric care involved are dealt with.
Chronic liver disease associated with childhood ulcerative colitis
Authors: Toghill P J , Benton K P E , Smith P G 
Published: December 2008

SummaryIn a series of 301 patients with ulcerative colitis forty-eight developed the disease before the age of 20. In this group of forty-eight patients there were four cases of serious chronic liver disease as compared with a total of seven cases of chronic liver disease in the whole series. The hepatic lesions in the patients developing colitis in childhood were unrelated to the extent, duration or severity of the colitis but colitis in very early life appeared to predispose to liver disease subsequently.
Drugs for rare diseases
Authors: Lyle W H 
Published: December 2008

Summary
Pharmaceutical houses alone are equipped to market new medicines. The cost is very high, much of this arising from the preliminary toxicological and pharmacological work which is required in order to satisfy licensing authorities.
The introduction of a drug, even for a rare and lethal disease without such data, even if permitted by the authorities, would leave its manufacturer exposed to adverse publicity and litigation in the event of a mishap.
These considerations have had the effect of stifling original work in the drug treatment of rare diseases, the position having worsened in recent years.
This trend is illustrated by the history of the introductions of penicillamine and triethylene tetramine for Wilson’s disease.
How should we prescribe?
Authors: Vere D W 
Published: December 2008

Summary
Approved names, though often bulky, are preferable on balance to brand names because they identify drugs precisely by compound, often revealing derivation and class of action as well. Brand names at present have the advantage of identifying a preparation. This affirms bio-availability, if that is known, and safeguards the consumer’s legal position. But both advantages are against drug defects. It should therefore be hoped that they will become obsolete through pharmaceutical progress, and so do not constitute a lasting reason to confound prescribing accuracy with financial expediency.
Prescribing and the regulation of formulation
Authors: Beckett A H 
Published: December 2008

Summary
Unless the equivalence of different products has been established, the prescriber must define the product he requires by using the trade name. Present pharmacopoeial standards based on in vitro methods are inadequate to predict equivalence in man. There are many ways in which differences in formulation may influence absorption of drugs, and only comparable absorption profiles can be taken as evidence of equivalence.
Is this a world-wide problem?
Authors: Stevens C C B 
Published: December 2008

Summary
Substitution is a worldwide problem arising from professional pride and status and pressure of economics. Substitution, legal or otherwise, is encouraged by governments, international agencies, professional and quasi-official bodies.
Some faults lie in industry and the developing use of marks but generally it is economic pressures at a time of restricted resources and increasing demand that make for economy in all sections. It is thought that the use of generic names aids economy and that is why restrictions are placed on marks in all parts of the world.
Road traffic accident fatalities (review of 142 post mortem reports)
Authors: Kamdar B A , Arden G P 
Published: December 2008

Summary
One hundred and forty-two post mortem reports of road accident deaths in the Windsor accident area have been reviewed. Although head and chest injuries accounted for the deaths of most of these victims, twelve died of inhalation asphyxia and another eighteen died of hypovolaemia due to haemorrhage from otherwise minor injuries. Some of these cases would perhaps have survived if they had received skilled medical attention at the most critical time.
Analgesics in cancer pain: results of a questionnaire
Authors: Robbie D S , Mennie A T 
Published: December 2008

Summary
A questionnaire was sent to seventy-five doctors in a London cancer hospital enquiring about their use of analgesics in cancer pain.
In the 37 replies which were returned a wide range of analgesics was prescribed.
In the most painful and distressing conditions, opiates were always used with a strong bias towards diamorphine. However, it was claimed that mild non-narcotic analgesics given regularly often gave better and longer lasting reliefs than narcotics which were prescribed on a pro re nata basis.
Experiences with cutaneous ureterostomies in adults
Authors: Lien W M 
Published: December 2008

Summary
Between 1963 and 1971, twenty-five adult patients underwent cutaneous ureterostomies. The operation was performed for neurogenic bladder in sixteen cases, malignant diseases in eight cases and congenital bladder neck obstruction in one case. Sixteen patients were alive and well at the time of writing. The follow-up period ranged between 5 days and 7 years. The results were analysed and advantages of this type of urinary diversion discussed.
The treatment of malignant ventricular tachycardia by aorto-coronary saphenous vein bypass graft
Authors: Ikram H , Jeffery R M , Parkins R A , Makey A R , Emery E R J , Stone D L 
Published: December 2008

Summary
A 61-year-old man with a previous cardiac infarction had at least fifteen attacks of ventricular tachycardia which finally did not respond to either drug or electrical therapy. Angiography showed a blocked right coronary artery and a non-contractile portion of postero-inferior left ventricular wall.
An aorto to right coronary saphenous vein bypass graft was inserted, and although attacks of tachycardia occurred following the operation these were of short duration and reverted spontaneously.
He has been free of tachycardia for 5 weeks, with a greatly improved effort tolerance.
Infantile nephrotic syndrome
Authors: Nagi N A , Nouri L 
Published: December 2008

SummaryFour infants, two boys and two girls, with congenital nephrotic syndrome are reported in a single family. The disease process began during the first year of life. The disorder did not respond to corticosteroid therapy. One infant received cyclophosphamide therapy as well without avail. All four children died from intercurrent infection. The family tree is suggestive of an autosomal recessive inheritance.