bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal lesions in leprosy amongst north Indian patients
Authors: Chugh K S , Damle P B , Kaur S , Sharma B K , Kumar B , Sakhuja V , Nath I V S , Datta B N 
Published: December 2008

Summary
Sixty consecutive patients with leprosy were investigated for renal involvement. Clinically overt renal disease was present in 4 patients; 3 presented with a nephrotic state and one patient with progressive renal failure. Urinalysis showed daily protein loss ranging from 0.4 to 8.9 g in 8 patients and microscopic haematuria in 4 cases. Elevated levels of blood urea and creatinine were seen only in one patient with diffuse proliferative glomerulonephritis. Of the 36 patients in whom distal tubular functions were evaluated, concentration and/or acidification defects were detected in 9 patients (25%). Renal histology revealed no abnormality in any of these patients. Serum C3 levels were decreased in 5 patients with lepromatous leprosy and 3 patients with borderline leprosy.
Histological evidence of renal involvement was detected in 9 patients (15%). Amyloid deposits were seen in 3 (5%) patients of whom 2 had lepromatous leprosy and one had tuberculoid leprosy with chronic trophic ulcers. Mesangial proliferative lesions were seen in 5 (8.3%) and diffuse proliferative lesions (with crescents in more than 70% of glomeruli) in one patient. All of them had lepromatous leprosy. Three of the 5 patients with mesangial proliferative glomerulonephritis had erythema nodosum leprosum at the time of biopsy. Immunofluorescence studies revealed granular deposits of IgA, IgM and C3 in one patient with mesangial proliferation and IgA/IgM with or without C3 in 3 more patients in whom renal histology was normal. Glomerulonephritis associated with leprosy appears to be immune mediated but confirmation requires identification of lepra antigen in the glomerular immune complex deposits.
‘Hospice’ versus ‘hospital’ care—re-evaluation after 10 years as seen by surviving spouses
Authors: Parkes C. Murray , Parkes Jenny 
Published: December 2008

Summary
This study compares terminal cancer care in 1967–69 with care in 1977–79 as evaluated by surviving spouses of patients who died in St Christopher’s Hospice and other local hospitals.
Patients and their surviving spouses reported less personal distress in both settings in 1977–79 than in 1967–69 and the patients were also thought to have suffered less pain. These differences were found before, during and, in surviving spouses, after the period of terminal care. They were confirmed in subsamples of 30-34 patients matched for age, sex, socio-economic status and duration of terminal period.
Improvements may be attributable to the training in terminal care provided by staff of the Hospice since 1967 and augmented in its Study Centre which was opened in 1973.
Although pain and distress in the patient is no longer a major problem in either setting, spouses in 1977–79 remain less anxious at St Christopher’s Hospice than at other hospitals; they play a larger part in the care of the patient and are in closer contact with staff before and after bereavement.
Captopril in hypertension after renal transplantation
Authors: Chan M. K. , Sweny P. , El Nahas A. M. , Farrington K. , Fernando O. N. , Moorhead J. F. 
Published: December 2008

Summary
Eight hypertensive renal allograft recipients who had received captopril are presented. Captopril in a maximal daily dose of 250 mg enabled the withdrawal of large doses of beta-blocking agents and vasodilators. Blood pressure was satisfactorily controlled in all except one. No adverse side effects were observed other than the 'first dose' effect which resulted in transient anuria in one patient. Captopril appears to be a useful agent in the management of severe hypertension after renal transplantation.
Dermatobia hominis infestation
Authors: Nunzi E. , Rongioletti F. , Rebora A. 
Published: December 2008

Summary
A patient is reported who, after leaving Venezuela, developed some boils on the left upper limb inhabited by Dermatobia hominis larvae. The curious life-cycle of this tropical fly is described with some considerations about the diagnostic problem. A simple unreported way of larvae extraction is suggested.
Oral disopyramide after admission to hospital with suspected acute myocardial infarction. U. K. Rythmodan Multicentre Study Group
Authors: Rythmodan U. K. 
Published: December 2008

Summary
A multi-centre double-blind randomized study is reported in which the effect on mortality of oral disopyramide (300 mg loading dose, then 100 mg qds) was compared with placebo in 1985 patients entering hospital with suspected acute myocardial infarction. Treatment was commenced with 24 hr of onset of symptoms (mean time to first dose 9 hr) and continued until discharge from hospital or 14 days, whichever came first. Nine-hundred and ninety-five patients were allocated to disopyramide and 990 to placebo. The overall mortality, calculated on an intention-to-treat basis, was 7.2% for the disopyramide and 5.6% for the placebo patients. Among those patients with proven infarction mortality was 9.5% of 687 on disopyramide and 7.4% of 716 on placebo. These differences are not statistically significant. Patients with cardiac failure or hypotension at entry did not fare worse on disopyramide, but those with a conduction defect did. Reinfarction was not significantly influenced by disopyramide. The prophylactic use of disopyramide in patients with suspected acute myocardial infarction does not reduce mortality or the incidence of early reinfarction.
Hypnosis in the treatment of acute pain in the emergency department setting
Authors: Deltito Joseph A. 
Published: December 2008

Summary
Emergency ward physicians are presented daily with patients in pain. Provisions of safe, quick pain control remains one of their major duties. Hypnosis can be used as an effective adjunct or substitute for analgesic medications when these drugs prove to be ineffective or contraindicated. Four such illustrative cases of attempted pain control are presented. The psychological foundations of pain and its assessment are discussed.
The emergency ward physician can obtain facility in hypnotic techniques with only modest training. Hypnosis may then become a valuable tool in helping him provide safe and effective pain management.
Chest pain—indigestion or impending heart attack?
Authors: Simpson F. G. , Kay Janet , Aber Clive P. 
Published: December 2008

Summary
A high proportion (40%) of patients with definite myocardial ischaemia who were questioned on admission to a Cardiac Monitoring Unit had experienced preceding chest pain which had been misinterpreted by both the patients themselves and doctors as ‘indigestion’ and which had often been inappropriately treated. ‘Indigestion’ in the chest in previously non-dyspeptic subjects over 40 years of age should be regarded as myocardial ischaemia until proved otherwise.
Cricoid webs—incidence and follow-up study in Indian patients
Authors: Khosla S. N. 
Published: December 2008

SummaryA study was conducted to investigate the association of anaemia with dysphagia and cricoid webs in an adult Indian hospital population of 2,840 patients (1,200 males and 1,640 females).There were 150 cases (5.2%) of anaemia in the total population studied. One hundred and seventeen patients suffered from iron deficiency anaemia and only 33 from non-iron deficiency anaemia. Dysphagia was present in 15 patients (13%) of those with iron deficiency. Six (40%) of these cases of iron deficiency with dysphagia had cricoid webs.None of the cases with non-iron deficiency anaemia or the control population had either dysphagia or cricoid webs.Iron therapy improved four out of the six patients of iron deficiency with cricoid webs both subjectively and objectively.
Clinical comparison of elastic supports for venous diseases of the lower limb
Authors: Gandhi D. B. , Palmar J. R. , Lewis B. , Schraibman I. G. 
Published: December 2008

Summary
Compression garments for the lower limb were tested in two groups—general support garments and anti-embolism supports. A total of 98 patients was examined. The method used was by the interposition of partly fluid-filled pressure sensors between garment and skin. A combination of roller bandage with shaped tubigrip (SBB—Seton) and Sigvaris stockings afforded effective pressure in the general support group but only the roller bandage plus pressure garment (Seton) did so in the anti-embolism group, both in the acute and prolonged studies.
A comparison of beclomethasone dipropionate aqueous nasal spray and beclomethasone dipropionate pressurized nasal spray in the management of seasonal rhinitis
Authors: Dunn A. M. , Wilson R. S. E. , Baggott P. J. 
Published: December 2008

Summary
Forty patients with seasonal rhinitis and a proven sensitivity to pollens were studied for 2 weeks during the pollen season of 1982. The study was carried out according to a double-blind, double-dummy design. All patients received 100 micrograms beclomethasone dipropionate (BDP) into each nostril twice daily (400 micrograms/day) on a randomized basis, from either the aqueous nasal spray or the pressurized nasal spray (Beconase Nasal Spray). Analysis of patients’ symptom scores, additional symptomatic medication and physicians’ assessment indicated that both treatments were equally effective in controlling the symptoms of seasonal rhinitis. Any adverse events reported were considered to be clinically insignificant.
BDP aqueous nasal spray was therefore found to be an effective and acceptable therapy in the management of seasonal rhinitis.
Human infestation by Taenia saginata lasting over 20 years
Authors: Wright E. P. , Jain S. 
Published: December 2008

Summary
A case of a 61-year-old woman with a history of infestation by Taenia saginata lasting over 20 years is described. The patients repeatedly denied eating raw or inadequately cooked beef. Despite many attempts using different taenicides during those years, the patient continued to pass tapeworm segments until niclosamide was administered. Eighteen months after treatment with niclosamide the patient remains symptom-free.
Ipratropium bromide in patients with nocturnal asthma
Authors: Cox I. D. , Hughes D. T. D. , McDonnell K. A. 
Published: December 2008

Summary
Fourteen patients with nocturnal asthma were recruited to a two period crossover trial which compared a run-in period on nightly salbutamol (200 micrograms) with a period on nightly ipratropium bromide (160 micrograms) and a period on nightly salbutamol plus ipratropium at night.
Morning dipping, as assessed by the fall in peak flow overnight, was significantly reduced in the periods when ipratropium bromide was taken. Peak flow in the morning and also at night was improved when taking ipratropium bromide. Ipratropium bromide in adequate dosage appears to be effective in reducing morning dipping in asthma.
Comparison of nifedipine (retard formulation) and mefruside in the treatment of mild to moderate hypertension—a prospective randomized double-blind crossover study in general practice
Authors: Douglas-Jones A. P. , Mitchell A. D. 
Published: December 2008

SummaryTwenty-two patients under general practice care, suffering mild to moderate hypertension and receiving no active treatment had three baseline blood pressure measurements taken during a single blind 4-week placebo run-in period. One patient was secondarily excluded at this stage because of a placebo response and one patient dropped out for personal reasons. The remaining 20 patients were randomized to receive either nifedipine 20 mg twice a day or mefruside 25 mg once a day in a classical two-period crossover design with 8-week treatment periods separated by a 4-week single-blind placebo washout. During 8 weeks nifedipine therapy the mean supine blood pressure was reduced from 173 (s.d. = 15.4)/107(s.d. = 6.4) mmHg to 150(s.d. = 16.7)/93(s.d. = 10.8) mmHg whereas the corresponding reduction for mefruside was from 174(s.d. = 15.9)/107(s.d. = 9.4) mmHg to 153(s.d. = 19.1)/94(s.d. = 9.7) mmHg. Neither drug affected postural changes in blood pressure. Standing blood pressure measurements under 8 weeks nifedipine therapy fell from 172(s.d. = 12.3)/103(s.d. = 5.6) mmHg to 150(s.d. = 17.9)/94(s.d. = 10.0) mmHg with corresponding changes for mefruside being 174(s.d. = 14.7)/106(s.d. = 9.0) mmHg to 150(s.d. = 20.2)/95(s.d. = 9.4) mmHg. Since blood pressures returned to within 4% of baseline values by the end of the placebo washout period it can be inferred that each therapy was a significant (P less than 0.05 for all blood pressure variables) antihypertensive treatment in its own right.
A case of recurrent salmonella septicaemia in an infant
Authors: Mitchell-Jones P. J. , Sankey R. J. 
Published: December 2008

Summary
A 6-month-old girl was admitted with a febrile illness. Salmonella eastbourne was isolated from the stool and blood cultures. Septicaemia was treated with antibiotics but recurred twice on cessation of therapy. The only focus of infection found was the gut itself. Septicaemia did not recur following loss of the pathogen from the gut.
A hole in a primigravid uterus—an unusual finding at elective caesarean section
Authors: Olobo-Lalobo J. H. 
Published: December 2008

SummaryThe spontaneous rupture of the primigravid uterus before the onset of labour is an obstetric rarity. Invariably there is a history of antecedent scarring. A case of uterine rupture, an unusual finding at Caesarean section, is reported. The only antecedent history was partial salpingectomy and oophorectomy. The probable mechanism of rupture is discussed. Admission at 32 weeks and Caesarean section at 36 weeks is recommended in the next pregnancy.
Measurement of plasma group I pepsinogens
Authors: Levine D. F. , Beer M. 
Published: December 2008

Summary
Plasma group I pepsinogen (PG I) concentration is now a readily available non-invasive marker of gastric secretory function, with several potentially useful applications.
Ninety-eight percent of control subjects had a plasma PG I below 115 ng/ml while values above this level were seen in 43% of duodenal ulcer patients. Plasma PG I levels below the observed normal lower limit of 30 ng/ml were seen consistently in patients with documented achlorhydria or pernicious anaemia.
In 48 patients with a variety of upper gastrointestinal disorders there was a significant correlation between PG I pepsinogens and pentagastrin-stimulated maximal acid output.
Changes in plasma PG I promise to be useful in evaluating both operations on the vagus and newer anticholinergic drugs, whilst in epidemiological and family studies these measurements seem well suited to explore duodenal ulcer heterogeneity.
Comparative study of four antacids
Authors: Jacyna M. R. , Boyd E. J. S. , Wormsley K. G. 
Published: December 2008

Summary
Four antacid preparations have been studied in a stratified, randomized, double-blind trial to evaluate criteria which determine patients' acceptance of this type of therapy. There was a considerable range of judgements about palatability, but preference was determined not only by factors such as the smell, taste, texture and after-taste of the preparation, but also by the order in which the antacids were tested and by the age and sex of the patient. The preparations also differed considerably in acid-neutralizing capacity and ability to bind bile salts, as well as cost. We conclude that individuals requiring antacid therapy should be allowed to chose from among a range of preparations, in order to maximize compliance.
Relapse of lymphoma in the heart after a 10-year remission
Authors: Bell A. J. , Mufti G. J. , Hamblin T. J. 
Published: December 2008

SummaryA 71-year-old woman presented with intractable cardiac failure 10 years after receiving treatment for lymphoma.Extensive investigations failed to demonstrate a recurrence of her disease, but resolution of her cardiac failure following a trial of chemotherapy and subsequently a cross-sectional echocardiogram suggested intracardiac relapse. This was later confirmed at autopsy. Cardiac metastases should be suspected in patients with malignant disease who develop signs or symptoms related to the heart.
Renal amyloidosis and non-specific aorto-arteritis—a hitherto undescribed association
Authors: Dash S. C. , Sharma R. K. , Malhotra K. K. , Bhuyan U. N. 
Published: December 2008

Summary
Two patients presented with the nephrotic syndrome complicating non-specific aorto-arteritis (Takayasu’s arteritis). Histologically both had renal amyloidosis. On investigation there was no evidence of chronic infection or any immuno-inflammatory disease known to be associated with amyloidosis. These cases raise the possibility of a significant association between aorto-arteritis of the Takayasu type and systemic amyloidosis.
Disulfiram-induced hepatitis—report of a case and review of the literature
Authors: Nässberger Lennart 
Published: December 2008

Summary
Disulfiram has been used as an adjunct to the treatment of chronic alcoholism since 1948. We report a young woman who developed clinical, biochemical and histopathological signs of a liver hypersensitivity reaction. A review of the literature is also presented.
Exocrine pancreatic insufficiency and idiopathic haemochromatosis
Authors: Jansen P. L. M. , Thien T. , Lamers C. B. , Yap S. H. , Reekers P. , Strijk S. 
Published: December 2008

SummaryThe case history of a 34-year-old patient with precirrhotic idiopathic haemochromatosis and severe chronic steatorrhoea is presented. The pancreas had a normal appearance on ultrasonography and endoscopic retrograde pancreaticography. However, pancreatic function tests revealed significant abnormalities. The pancreatic output of trypsin, amylase, lipase and bicarbonate was deficient and basal and stimulated serum pancreatic polypeptide levels were subnormal. In contrast, the oral glucose tolerance test was unimpaired. The pancreatic insufficiency had started suddenly during a summer vacation and may have had a viral aetiology. The hypothesis is advanced that in haemochromatosis the iron-laden pancreatic acinar and PP-producing cells are more susceptible to damage by viruses than normal pancreatic cells.
Crohn’s disease and pericarditis
Authors: Manomohan V. , Subbuswamy S. G. , Willoughby C. P. 
Published: December 2008

Summary
A patient is described who developed acute pericarditis during a severe first attack of Crohn’s disease. The opportunity was taken to measure levels of circulating immune complexes, both during the acute phase of the illness and during convalescence; no significant change in these levels from normal values was found. The Crohn’s disease and the associated pericarditis responded to systemic corticosteroid therapy, and no relapse has occurred during 14 months of follow-up.
Formic acid poisoning with suicidal intent: a report of 53 cases
Authors: Rajan N , Rahim R , Krishna Kumar S 
Published: December 2008

Summary
A report of 53 cases of formic acid ingestion with suicidal intention is presented. The patients were seen in one hospital in Kerala State over a 3 year period. Fifteen patients died and 38 patients survived. The pattern of clinical features seen is presented.
Thyrotoxicosis, myasthenia gravis and periodic paralysis in a Chinese man
Authors: Lee K O , Guan R , Ee B , Cheah J S 
Published: December 2008

Summary
The association of myasthenia gravis and periodic paralysis in thyrotoxicosis has not been reported before. We describe a Chinese man with thyrotoxicosis and myasthenia gravis, who subsequently developed periodic paralysis. The possible aetiological links are discussed.
Listeria monocytogenes endocarditis
Authors: Sheinman B D , Evans T , Sage R 
Published: December 2008

Summary
A fatal case of endocarditis due to Listeria monocytogenes is reported. Case reports of endocarditis due to this organism are rare but indicate a higher mortality than with many other causes of bacterial endocarditis. The size of the problem may be underestimated because the organism has a ‘diphtheroid’ appearance and may be incorrectly dismissed as a contaminant.
Patterns of drug taking in patients with chronic airflow obstruction
Authors: James P N E , Anderson J B , Prior J G , White J P , Henry J A , Cochrane G M 
Published: December 2008

Summary
A questionnaire on the pattern of drug taking was completed by 185 patients with chronic airflow obstruction. Of these, 49% admitted to taking their prescribed therapy regularly and 33% could be regarded as being fully compliant. The use of increasing numbers of drugs was not accompanied by a fall in compliance. Regular drug taking was better in patients (particularly females) with asthma than in patients with chronic bronchitis and emphysema. During acute exacerbations of airflow obstruction, excessive use of bronchodilators beyond the recommended increase in medication was rare; indeed, underuse of therapy in this situation was commoner. These conclusions must be regarded as tentative since the questionnaire was not validated by repeat interviewing or measurement of drug usage.
Use of amiodarone during pregnancy
Authors: Robson D J , Jeeva Raj M V , Storey G C A , Holt D W 
Published: December 2008

Summary
Two cases are reported in which amiodarone was administered during pregnancy for longer periods than has been reported previously. Limited placental transfer of amiodarone and its desethyl metabolite was observed in both cases. A normal child resulted from each pregnancy despite, in one case, amiodarone therapy throughout the entire pregnancy. However, caution is urged in the use of amiodarone during pregnancy in view of the limited data available.
A case of herpes zoster associated encephalitis with rapid response to acyclovir
Authors: Cheesbrough J S , Finch R G , Ward M J 
Published: December 2008

Summary
A case of herpes zoster encephalitis which responded very rapidly to acyclovir is presented. The differential serum: cerebrospinal fluid antibody response was followed and its value in making the diagnosis is discussed. The penetration of acyclovir into the cerebrospinal fluid was measured, and found to be in agreement with predicted values.
Raynaud's syndrome and carpal tunnel syndrome
Authors: Waller D G , Dathan J R 
Published: December 2008

Summary
We report three cases of Raynaud's syndrome with digital ischaemic ulceration, in association with carpal tunnel syndrome. In all cases, the aetiology of the Raynaud's syndrome was probably unrelated to the nerve compression. However, symptoms were worse on the side of the median nerve lesion in two patients and worse on the side with the most severe nerve dysfunction in the third; symptoms were relieved by carpal tunnel decompression in two patients. We suggest that carpal tunnel syndrome may exacerbate Raynaud's syndrome and should be considered particularly in patients with asymmetrical digital lesions.
Torsion of a wandering spleen
Authors: Witz M , Witz L , Reina A , Shenkman L , Dinbar A 
Published: December 2008

Summary
We present an unusual case of torsion of a wandering spleen in a 14 year old boy. Wandering spleen is an entity which has rarely been reported in infants and children. Although patients may be asymptomatic, some may present as an acute surgical emergency if trauma or torsion of the vascular pedicle occurs, as in our case. The treatment of this condition is splenectomy.