bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observations on the treatment of rheumatoid disease with penicillamine
Authors: Golding John R , Wilson J V , Day Albert T 
Published: December 2008

Summary
Forty-five patients with severe rheumatoid arthritis were given D-penicillamine hydrochloride according to a fixed regimen for up to 2 years. The effects of treatment were observed both clinically and by the use of laboratory parameters.
The results show that about 75% of patients exhibited objective improvement. Those with rheumatoid arthritis were found to do particularly well. The incidence, type and severity of side-effects are discussed.
The definition and evaluation of the skills required to obtain a patient’s history of illness: the use of videotape recordings
Authors: Anderson J , Dowling M A C , Day J L , Pettingale K W 
Published: December 2008

Summary
Videotape recording apparatus was used to make records of case histories obtained from patients by students and doctors. These records were studied in order to identify the skills required to obtain a patient’s history of illness. Each skill was defined. A questionnaire was developed in order to assess these skills and three independent observers watched the records of eighteen students and completed a questionnaire for each. The results of this were analysed for reliability and reproducibility between examiners. Moderate reliability and reproducibility were demonstrated. The questionnaire appeared to be a valid method of assessment and was capable of providing significant discrimination between students for each skill. A components analysis suggested that the marks for each skill depend on an overall impression obtained by each examiner and this overall impression is influenced by different skills for each examiner.
The hyperlipoproteinaemias
Authors: Levene D L 
Published: December 2008

Summary
Elevated plasma lipids have been associated with an increased risk of ischaemic heart disease. However, regimens which reduce plasma lipids may decrease the recurrence rate of myocardial infarction. Accurate diagnosis of patients with elevated lipids and their families may be important in both secondary and primary prevention of atherosclerosis.
Classification of hyperlipoproteinaemias, the methods of diagnosis and an approach to dietary and drug therapy are discussed.
Experimental approaches to the prophylaxis and treatment of ischaemic heart disease
Authors: Fitzgerald J D 
Published: December 2008

Summary
This paper describes some of the basic hypotheses on which our research in the cardiovascular field has been based. The difficulties and shortcomings of the experimental models used and our reliance on guidance from clinical science has been emphasized. The properties, effects and mode of action of the drugs resulting from our cardiovascular research have been described.
Hyperosmolar non-ketotic diabetes
Authors: Macaulay Michael B 
Published: December 2008

Summary
Hyperosmolar non-ketotic crises occur chiefly in mild, maturity-onset diabetics, yet present a medical emergency carrying a high mortality. This may in part be due to a lack of awareness of the clinical presentation, and of the principles of treatment. Five cases are described, in all of which excessive consumption of Lucozade, a proprietary ‘glucose’ drink, played an important part in the development of their hyperosmolar state.
Gastric ulcer and the anti-arthritic drugs
Authors: Emmanuel J H , Montgomery R D 
Published: December 2008

Summary
Sixteen cases are described of gastric ulcer in patients receiving anti-arthritic drugs. Half of the ulcers were in the antrum or on the greater curve. Ten patients were under treatment with indomethacin and/or prednisone, seven of them receiving both drugs.
The ulcers healed readily when the drugs were withdrawn, and in the case of prednisone a continued daily dose of 10 mg or less did not prevent healing.
All the patients with haemorrhage were taking aspirin, with or without other drugs.
The literature is reviewed, and it is suggested that the increased incidence of peptic ulcer in patients receiving anti-arthritic drugs is confined to gastric ulcer. There is suggestive evidence of an increased susceptibility to antral ulcer in severe rheumatoid disease, which may largely account for the ‘steroid ulcer’.
Indomethacin is potentially ulcerogenic, and its combined use with steroids may be inadvisable. Apart from its tendency to produce haemorrhagic erosions, the role of aspirin in the aetiology of chronic ulcer remains doubtful. No serious ill-effects have been reported in the use of ibuprofen or Distalgesic in ulcer subjects.
Osteomalacia following vagotomy and pyloroplasty
Authors: Mitchell A B S , Glass D , Gill A Morton 
Published: December 2008

Summary
Osteomalacia, due to defective absorption of adequate dietary vitamin D, has been found in a 79-year-old woman, 5 years after an anterior selective vagotomy and pyloroplasty.
The evolution of the recognition of postgastrectomy osteomalacia is reviewed, and reasons are advanced why similar problems are to be expected following vagotomy and pyloroplasty.
Effect of diazepam (Valium) on dialysable thyroxine
Authors: Saldanha V F , Bird R , Havard C W H 
Published: December 2008

SummaryShort-term treatment with diazepam constantly reduced the level of protein-bound iodine, the percentage dialysable thyroxine and the ‘free’ thyroxine iodine in ten euthyroid individuals, but the serum levels remained within the normal range.The relevance of these findings to the effect of diazepam on thyroid function is discussed.
Viral hepatitis in drug addicts
Authors: Sullman Susan F , Zuckerman A J 
Published: December 2008

Summary
Viral hepatitis is an important and frequent complication of drug addiction. The discovery of the Australia antigen and its association with serum hepatitis has provided a number of specific serological tests which may be used for the diagnosis of at least a proportion of patients with hepatitis and also for the detection of carriers of the hepatitis virus. These tests might now be used to study in greater detail than has hitherto been possible the epidemiology of serum hepatitis among drug dependents, their contacts and the community at large.
The multiple aetiology of viral hepatitis
Authors: Zuckerman A J 
Published: December 2008

Summary
Infectious hepatitis is epidemiologically and immunologically distinct from serum hepatitis. The Australia antigen is related more specifically to serum hepatitis.
The possible role of coronavirus—and paramyxovirus-like particles in the aetiology of some infections of the liver in man and in marmosets inoculated with human infectious hepatitis material is discussed and the difficulties in the interpretation of the currently available data are emphasized.
The recent studies in Melbourne of a faecal antigen found in some patients with infectious hepatitis and the discovery of an antiserum in Milan which reacted with an antigen associated with epidemic hepatitis are discussed. Mention is made of the recent isolation in Detroit-6 cells of virus-like particles from patients with infectious hepatitis.
It is concluded that viral hepatitis is an infection of multiple aetiology and that the successful cultivation in vitro of the agent or agents of hepatitis remains the outstanding and most urgent problem.
The management of acute hepatic failure
Authors: Sherlock Sheila , Parbhoo S P 
Published: December 2008

Summary
Acute fulminant hepatitis leads to complex biochemical and circulatory disturbances including coma. These can be predicted to some extent by knowledge of the functions of the normal liver cells. Ineffective haemostasis, coma, hypoglycaemia, electrolyte abnormalities, hypotension and renal circulatory failure are particularly important.
Management should be governed by the abnormalities found in the individual patient. Fluid overload and sedation must be avoided. More complex methods of temporary hepatic support such as exchange transfusion or perfusion of the isolated pig’s liver should only be considered after simpler methods of correction have been attempted for a reasonable period of time and found wanting.
The prognosis of acute hepatocellular failure reaching the stage of deep coma is very poor, the mortality being about 80-90%.
The long-term treatment of hypertension with thiazide diuretics
Authors: Beevers D G , Hamilton M , Harpur J E 
Published: December 2008

Summary
Two hundred and twenty-seven cases of moderate to severe hypertension were treated with thiazide diuretics alone for periods of up to 12 years. In 80% the hypertension was adequately controlled without additional antihypertensive agents.
Hypokalaemic alkalosis was common despite potassium supplements—but caused no symptoms. The incidence of diabetes and gout was low.
It is concluded that thiazide diuretics provide excellent control of hypertension with very few side effects.
Tuberculosis in Brent
Authors: McNicol M W , Mikhail J R , Sutherland I 
Published: December 2008

Summary
An analysis has been made of the problem of tuberculosis in the Borough of Brent.
There have been changes in the population structure, the groups from which cases are drawn and the types of disease.
There has been an increase in the incidence of tuberculosis in immigrants of African and Asian origin, with more non-pulmonary disease.
Pulmonary disease in these groups has different clinical characteristics from those of disease in natives of the British Isles.
Mediastinoscopy: a diagnostic procedure in hilar and paratracheal lymphadenopathy
Authors: Mikhail J R , Mitchell D N 
Published: December 2008

Summary
Mediastinoscopy, in the skilled hands of a thoracic surgeon, is a safe, cosmetically accepted procedure with negligible complications, less than that reported in many series of scalene node biopsies.
It has the advantage of yielding a much higher rate of diagnostic tissue, in all instances over 90%. In the cases of tuberculosis it enabled an organism to be isolated and sensitivities obtained.
It has also revealed a group of cases with findings, a further study of which may increase our understanding, assessment and management of patients presenting with hilar and/or paratracheal lymphadenopathy.
Diabetes mellitus and hypothyroidism
Authors: Bridgman J F 
Published: December 2008

Summary
It would appear from the literature that hypothyroidism is rare in male diabetics. Serologically, there is an established association between autoimmune thyroiditis and diabetes mellitus. However, very little clinical evidence has been produced to confirm these findings.
A series of four male insulin-dependent diabetics with hypothyroidism, including three who had latent pernicious anaemia, were studied. Their case histories and a review of the subject are presented
Cryptococcal meningitis as a complication of systemic lupus erythematosus treated with systemic corticosteroids
Authors: Collins J V , Tong D , Bucknall R G , Warin A P 
Published: December 2008

Summary
Cryptococcosis, a disease of world-wide distribution, is uncommon in the British Isles where it usually presents as meningitis affecting patients with malignant disease of the reticulo-endothelial system, diabetes mellitus or those receiving systemic treatment with corticosteroids. The clinical features and physical signs of the disease are often non-specific and resemble those of tuberculous meningitis. The diagnosis is made upon recognizing the encapsulated Cryptococcus neoformans on Indian Ink preparations of the cerebrospinal fluid, or by demonstrating precipitating antibodies to the organism in the patient's serum. The treatment is by intravenous administration of amphotericin B for a period of 6–12 weeks, supplemented in severe or relapsing cases by intrathecal therapy; alternatively, 5-fluorocytosine may be given by mouth. A case is reported of cryptococcal meningitis occurring in a 46-year-old woman with systemic lupus erythematosus treated with methylprednisolone. Treatment with amphotericin B was successful in suppressing the infection, but was accompanied by side-effects and some temporary impairment of renal function.
Mechanisms of renal tubular defects in old age
Authors: Dontas A S , Marketos S G , Papanayiotou P 
Published: December 2008

Summary
The mechanisms of renal tubular dysfunction in old age have been examined in twenty-eight clinically healthy elderly subjects without infection, and in fourteen subjects of similar age with laboratory evidence of intrarenal infection. The data were compared with those from thirteen clinically healthy young subjects. Studied were: proximal tubular (TmPAH) and distal tubular (CH2O) activity, minimal and maximal osmolal U/P ratios, maximal osmolal excretion in hydropenia, and GFR levels under standard hydration and under water-loading.
The reduction of GFR in old age is evident particularly in men under conditions of standard hydration: it is accentuated in the presence of renal infection. Proximal tubular activity is also significantly lower in elderly men, especially if they have chronic bacteriuria. The reduction is closely related to GFR levels, with identical TmPAH:Cin ratios in all groups. This supports the intact nephron hypothesis for this part of the nephron. Distal tubular activity is depressed in old age in both sexes proportionately more than proximal tubular activity or the GFR. The lower CH2O: GFR ratios imply a selective distal tubular damage.
Maximal osmolal U/P ratios in hydropenia are significantly higher in the young (mean 367) than in either the elderly non-infected (mean 279) or the elderly infected subjects (mean 212). Conversely, minimal U/P ratios in water-loading are lower in the young (mean 0.247) than in either elderly group (means 0.418 and 0.668). Osmolal excretion in hydropenia is not different between the groups, but urine flows in water-loading clearly separate them.
The data indicate that simple functions of the distal-collecting tubule (e.g. the CH2O), are less affected in old age than are functions involving several medullary structures (as is the maximal Uosm or U/P ratio). They suggest that the main impairment of the distal tubular cell involves the failure to achieve a proper osmotic gradient between tubular fluid and blood, rather than an inability to excrete or re-absorb an adequate amount of solute. Finally, it appears that renal infection aggravates the larger glomerular and proximal tubular deficits observed in non-infected men: it depresses distal tubular function equally in both sexes.
Results of patellectomy for osteoarthritis
Authors: Dinham J M , French P R 
Published: December 2008

Summary
Seventy-three knees which had undergone patellectomy for patello-femoral osteoarthritis are reviewed.
A possible mechanism of involvement of the tibiofemoral joint is described.
Patellectomy, when the disease is confined to the patello-femoral articulation, appears to be beneficial over a 5-year period. When arthritic changes are present in the tibio-femoral joint, patellectomy may be beneficial in about half the patients.
Pseudohypoparathyroidism with paradoxical increase in hypocalcaemic seizures due to long-term anticonvulsant therapy
Authors: Glynne Alan , Hunter Iain P , Thomson John A 
Published: December 2008

Summary
A case of pseudohypoparathyroidism is described. Unusual features included the apparent absence of a familial history and the long delay in clinical diagnosis. Dental evidence is presented which dates the metabolic abnormality back to at least the age of 2, yet symptoms did not appear until the age of 12 and the correct diagnosis was not made until she was 32. The role of long-term anticonvulsant therapy in the paradoxical exacerbation of the patient's hypocalcaemic seizures is discussed.
Some chemical indices of diabetic vascular disease
Authors: Wardle E N , Piercy D A , Anderson J 
Published: December 2008

SummarySome chemical indices which could be related to diabetic complications have been assessed in 105 diabetics.In juvenile (insulin-dependent) diabetics with retinopathy, cardiovascular disease or nephropathy, levels of fibrinogen, fibrin monomer, beta-lipoprotein, cholesterol and alpha-2-macroglobulin were raised. Only in part is the explanation due to a rise of fibrinogen and cholesterol with age. Among twenty-six patients with a plasma fibrinogen over 400 mg/100 ml, eleven sustained a major cardiovascular catastrophe within the next 2 years. Alpha-1-acid-glycoprotein was raised in these eleven and beta-2-glycoprotein generally in juveniles with cardiovascular disease. Triglycerides were elevated in all groups, but notably in patients with Grade I retinopathy with venous dilation. There was a suggestion that triglycerides were related inversely to dietary carbohydrate in mature onset diabetics, and serum cholesterol in juveniles was related to insulin dosage. The part of lipids in vascular disease is then discussed. An interesting positive correlation was found between fibrin monomer, itself an indication of in vivo thrombin formation, and beta-lipoprotein.Although alpha-2-macroglobulin was elevated in juveniles, especially with complications, this did not apply to maturity onset cases and therefore no direct relation to diabetic vascular disease can be suggested. Moreover, alpha-2-macroglobulin levels were normal in acromegaly.
Foetus acardius amorphus
Authors: Alderman Brian 
Published: December 2008

Summary
A case of acardius amorphus is reported. The rarity of foetal monsters without a functioning heart is emphasized and the method of classification reviewed. The theories of teratogenesis are discussed. Evidence is presented in support of the theory that there is a primary failure of the organ to develop. The possibility of anoxia and nutritional deficiency of the foetus being solely responsible for the malformation seems unlikely.
Steatorrhoea and jejunal reticulum cell sarcoma occurring in a patient on long-term colchicine therapy for gout
Authors: Boucher B J , Wright J T 
Published: December 2008

Summary
A second case is described where steatorrhoea developed following long-term colchicine therapy for gout; the relationship of therapy to the development of a reticulum cell sarcoma of the jejunum is discussed.
A tale of two cities: a comparison of sarcoidosis in London and Paris
Authors: James D Geraint , Turiaf J , Walker A N , Battesti J P 
Published: December 2008

Summary
Two large series of patients with sarcoidosis in London and Paris have been analysed and compared for differences in ethnic background, clinical features, mode of onset and duration, chest radiographic resolution, laboratory investigation and treatment.
It is found that in both capitals, sarcoidosis is a multisystem disorder. Most organ-systems of the body are invaded, emphasizing the fact that sarcoidosis transcends boundaries of various specialties, making it a disorder of general medical interest.
The diagnosis was confirmed by various histological techniques and the Kveim-Siltzbach test was found to be positive in three-quarters of patients in both series.
Depression of delayed type hypersensitivity, abnormal serum globulins and hypercalcaemia were observed in a significant proportion of both series.
Corticosteroids were administered to one-third of the London and to two-thirds of the Paris patients. The patient has the same chance of survival whether he lives in London or Paris, for the overall mortality is about 5% in both countries.
Inactivated vaccines. 2. Laboratory indices of protectionPresented by the senior author before the symposium on Influenza Vaccines, London, 27 April 1972.
Authors: Dowdle W R , Coleman M T , Mostow S R , Kaye H S , Schoenbaum S C 
Published: December 2008

Summary
The data from our 1968–69 influenza vaccine field trials are anlaysed and pre-challenge haemagglutinin and neuraminidase serum antibodies are evaluated as indices of protection. Prevention of flu-like disease, fever, confinement to bed, and/or seroconversion to Hong Kong was significantly related to post-vaccine A/Hong Kong/68(H3N2) haemagglutination-inhibition (HI) titres. Prevention of disease was also related, although not significantly statistically in every category, to pre-challenge A/Hong Kong/68 neuraminidase inhibition (NI) titres. The trend was the same regardless of whether the origin of the NI antibody was through A/Aichi/68 or A/Japan/62 vaccines or through pre-Hong Kong influenza infections. In summarizing the data using fever as an index of disease, the attack rate (AR) among volunteers without Hong Kong NI or HI antibody was 45%. Presence of NI antibody, in the absence of HI antibody, significantly reduced the AR to 24%. Those with both NI and HI titres experienced a still lower AR of 14%. Those with HI and NI titres both &gt; 1: 160 ran little risk of disease, with an AR of 7%.
Age-related response to 1000 CCA unit zonally purified, inactivated influenza vaccines in volunteers in the U.S.A.
Authors: Marine William M , Thomas James E 
Published: December 2008

SummaryResponse to 1000 CCA unit Aichi/68 and Japan/57 influenza vaccines was studied in 687 volunteers from ages 6–101 in the summer of 1971. The vaccines, prepared by zonal ultracentrifugation, were well tolerated in all age-groups. Antibody responses were comparable with each vaccine and were strongly influenced by age of the volunteer. Persons born since 1940 (age 31 and under) had a much more impressive response as determined by both overall geometric mean titre rise and% with ≥ four-fold increase in titre than persons born before 1940. The most reasonable explanation for this phenomenon seems to be the greater prior exposure of the younger age-groups to the strains in the vaccines. It is concluded that more attention needs to be given in the future to assessing vaccine potency in the age-groups for which the maximum protection is desired, namely, the elderly.
Nasal and circulating antibody responses to influenza vaccination and their importance in resistance to infection
Authors: Tyrrell D A J , Buckland R A , Schild G C , Freestone D S , Chinn S , Slepushkin A N 
Published: December 2008

Summary
Small groups of volunteers were inoculated intranasally with live-attenuated, and parenterally with detergent-split-saline or with whole-virus-oil-adjuvant influenza A2/HK (H3N2) vaccines after the prevalence of Hong Kong strains. Antibody titres in nasal secretions and serum were measured by HI, antineuraminidase and neutralization tests. The oil adjuvant vaccine produced large rises in antibodies and the other two vaccines produced small rises. The volunteers given oil adjuvant and live vaccine were both well protected against challenge with a partly attenuated strain. Statistical analysis showed that resistance to infection was predicted best by high titres of antibody in the serum, but the presence of antibody did not seem to explain completely resistance to infection.