bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pacing after myocardial infarction
Authors: Harris Alan 
Published: December 2008

Summary
Experience of endocardial pacing in eighty-two patients with atrioventricular block after myocardial infarction is described. A unipolar pacing wire was passed into an antecubital fossa vein and passed into the right atrium and wedged into the apex of the right ventricle under radiological control using an image intensifier. All patients were attached to an external demand unit set at 60/min which will pace if there is asystole longer than 1 sec. The disadvantages of pacing are discussed.
A fall in mortality occurred from 71% of unpaced patients to 38% of thirty-seven patients where demand pacing was given. When suppressant drugs (lignocaine, procainamide and quinidine) were given in addition to pacing the mortality dropped to 11% of twenty-seven patients. The disadvantages of pacing are few and it is considered that suppressant drugs are only used with safety when a pacing system has been installed.
Haemocytic periodicity and periodic disorders: Periodic neutropenia, thrombocytopenia, lymphocytosis and anaemia
Authors: Reimann Hobart A 
Published: December 2008

SummaryEvidence has accumulated of rhythmic numerical oscillation of each of the blood cells either independently or in combinations.The cyclic changes originate in the marrow of some normal persons and animals without causing illness, and can be induced experimentally.In more than 100 reported instances, periodic oscillations of various cells were accompanied by respective episodes of the disorders named in the title. The disorders may be transitory but usually recur throughout life and occasionally are fatal. All resist therapy. Features in common suggest an interrelationship of the haemal disorders and other disparate heritable periodic diseases.Theoretically, the rhythms are regulated by ubiquitous, inherent, intracellular bioclocks controlled hypothalamically or neurohumorally in relation to a feedback mechanism. Reactions to long cycles are of greater clinical importance than disturbances arising from the circadian rhythm.
Psychiatric disturbance in chronic renal failure and its treatment by dialysis
Authors: Hailstone J Donovan 
Published: December 2008

Summary
The psychiatric disturbance in patients with chronic renal failure is described and some of the aetiological factors reviewed.
A number of psychiatric problems arise during the course of treatment by haemodialysis, both among patients, relations and members of dialysis teams. Their course, treatment and prognosis are discussed.
Inappropriate secretion of antidiuretic hormone in Guillain-Barré syndrome
Authors: Davies Aeron G 
Published: December 2008

Summary
Hyponatraemia occurred in five cases with severe Guillain-Barré syndrome who required assisted respiration.
In one, the syndrome of inappropriate secretion of ADH was demonstrated and probably accounted for the hyponatraemia in the other four. The water overload thus produced may have contributed to the neurological deterioration and the peripheral and pulmonary oedema seen in some of these cases.
General considerations in intermittent drug therapy of pulmonary tuberculosis
Authors: Fox Wallace 
Published: December 2008

Summary
The advantages of intermittent chemotherapy for pulmonary tuberculosis are discussed and the results of several controlled trials summarized. Once-weekly therapy now appears a definite prospect.
The most appropriate approach to therapy at both national and individual physician level now seems to be a combination of unsupervised daily and supervised intermittent regimens.
Potentially serious side-effects of high-dose twice-weekly rifampicin
Authors: Poole Graham , Stradling Peter , Worlledge Sheila 
Published: December 2008

Summary
Daily rifampicin in a single dose of 600 mg, combined with other drugs, usually streptomycin and isoniazid, was given to forty-nine patients for 3 months. It was planned to continue for another 15 months with twice-weekly rifampicin 1200 mg plus isoniazid 900 mg, but the high incidence of side effects led to cessation of the intermittent regimen when only two patients had completed 18 months.
Though there was no serious problem with daily treatment, eleven patients (22%) were unable to continue rifampicin on the intermittent regimen. In eight (16%) a pyrexial syndrome occurred. In one of these patients there was also temporary renal failure and in another, precipitous thrombocytopenia led to epistaxis and bleeding into the tongue and lips. Symptomless thrombocytopenia developed in two other patients, making three cases (6%) of thrombocytopenia in all.
In sixteen (33%) of the forty-nine patients antibodies to rifampicin were detected in the blood. Side-effects occurred in nine (56%) of these, including the three developing thrombocytopenia, but in only two (6%) of the thirty-three patients with no antibodies detected. This association of toxic reactions with antibodies is highly significant (P &lt; 0·001).
Problems of drug resistance in tuberculosis—the newer anti-tuberculosis drugs
Authors: Crofton John 
Published: December 2008

Summary
The value of ethambutol and rifampicin is now established but certain points about toxicity and effectiveness are still uncertain, in particular the failure rate if these two drugs are used together without a third.
Primary resistance to ethambutol has been described in the U.S.A. but seems rare in Britain. Acquired resistance to both drugs is now being seen in reference laboratories so that the drugs are already being wrongly used.
It is suggested that, if at all possible, a third drug should be added to the rifampicin-ethambutol combination. The pros and cons of different drugs are discussed.
In future an increasing number of relapsing cases will already have received the new drugs. The clinician will therefore have to work out for each patient the drugs to which his bacilli are probably sensitive. A reliable drug combination for that individual can then be devised.
The principles of such an analysis are outlined and examples given.
Gallstones and flatulent dyspepsia: cause or coincidence?
Authors: Johnson Alan G 
Published: December 2008

Summary
The pre-operative and postoperative incidence of flatulent dyspepsia was studied in 108 patients undergoing cholecystectomy. Ninety (83%) had pre-operative symptoms; of these forty-one (46%) were symptom-free after operation and twenty-two (24%) were improved but twenty-seven (30%) were no better. Patients with a well-functioning gallbladder, demonstrated radiologically, were relieved significantly more often than those with a poor or non-functioning gallbladder. Fatty food precipitated the symptoms in the majority of patients.
These figures suggest that there is neither a direct causal relationship between gallstones and flatulent dyspepsia nor is the relationship entirely coincidental. The implications of these findings for clinical practice are discussed.
Treatment of uncomplicated urinary tract infection in non-pregnant women
Authors: Mabeck C E 
Published: December 2008

Summary
A study of placebo treatment of acute symptomatic urinary tract infection in non-pregnant women showed that about 80% obtained sterile urine spontaneously within 5 months. About one-half of these had recurrent infection within a year.
Antimicrobials produced a high immediate cure rate, but only 45% maintained sterile urine for 2 years. The recurrence rate was highest during the first 2 months after treatment, and thereafter nearly constant during the subsequent 20 months. Twenty-nine percent of recurrences were recrudescences and 71% reinfections. About one-sixth of the patients had a very high recurrence rate, 2·6 infections/year, as compared with 0·32/year in the remainder. Nearly all of these patients had their first recurrence within 5 months of the initial treatment. The probability of recurrence increased with the number of previous infections. Some patients, however, after a period with many recurrences, showed a remarkable decrease in recurrence rate.
If the aim of treatment is to keep periods of bacteriuria to a minimum, it is necessary to do frequent urine cultures for at least 6 months after elimination of bacteriuria.
Foetal acid-base status in clinical foetal distress and high risk casesThe material in this paper has been taken from an M.D. Thesis submitted to the University of Hong Kong.
Authors: Lee K H 
Published: December 2008

Summary
The acid-base balance in 307 Chinese patients in labour was studied in Tsan Yuk Hospital, Hong Kong over a 15-month period. Fifty-six of these were normal cases, 200 cases exhibited clinical signs of foetal distress and the other fifty-one were high risk cases. The results showed that cases of clinical foetal distress had a significantly lower foetal pH than that in the normal control group. Of the different signs of clinical foetal distress, meconium was the least important and foetal tachycardia appeared to be more significant than the others. Cases of postmaturity and uterine inertia also gave a lower foetal pH than normal. It is concluded that foetal blood sampling is indicated in these types of cases.
The effect of methoxyflurane analgesia on renal function in burned patients: an investigation
Authors: Laird S M , Chrystal Kathleen M R 
Published: December 2008

Summary
This paper reports an investigation into evidence of renal dysfunction following methoxyflurane analgesia for burns dressings.
Twelve patients were studied and small increases in serum uric acid were observed in all of them. This increase may have been dose-related.
Four patients had small but consistent increases in blood urea nitrogen and serum creatinine on the third post-dressing day.
No definite conclusions can be adduced and further research is needed.
Ketamine anaesthesia for burns surgery
Authors: Sage M , Laird S M 
Published: December 2008

Summary
A study was set up to investigate whether the theoretical advantages ketamine offered as an anaesthetic in burns patients were real.
Patients under 35 kg body weight were anaesthetized by an intermittent intramuscular technique and patients over this weight with an intravenous technique.
The study showed that ketamine had distinct advantages, giving cardiovascular stability and avoiding intubation. It was especially useful in the very ill patients. There were few complications during the study which we are now trying to minimize.
Bullous lesions of the skin and mucous membranes in primary amyloidosis
Authors: Northover J M A , Presbury D G C , Pickard J D , Haskell R , Murray-Lyon I M , Keith D A 
Published: December 2008

Summary
Four cases of primary amyloidosis are described in which bullous lesions of the skin or oral mucosa were a prominent clinical feature. Biopsy of such lesions and demonstration of amyloid by special staining may be of great diagnostic help.
The comparative value of amantadine and levodopa
Authors: Dallos Vera , Stone Patricia , Heathfield Kenneth , Allen Frank 
Published: December 2008

Summary
Sixty-nine patients with Parkinson's disease were randomly allocated in a trial to compare the therapeutic effects of levodopa and amantadine. The patients were assessed clinically and scored by occupational therapy tasks and degrees of disability. Both drugs were used for 2 months; in the first 4 weeks the doses were gradually increased to 400 mg of amantadine or 4 g of levodopa respectively, and in the second 4 weeks' period the maximum tolerated dose was maintained throughout. Fourteen patients withdrew and these were excluded from the series. Of the fifty-five patients who completed the trial, thirty-four were taking levodopa and twenty-one amantadine.
The results showed an average 33% improvement on levodopa and 23% on amantadine as regards tremor, rigidity and akinesia and their total scores improved 26% and 18% respectively. More cases showed substantial improvement on levodopa.
There was little difference in response between 200 and 400 mg amantadine daily, but side-effects with 400 mg amantadine daily were more frequent and severe. Side-effects with levodopa were similar to those reported in previous trials but we also noted brown body fluids in three patients. The average effective dose of levodopa was lower than in previous reports, and the largest number of patients received benefit from 1·5 g daily. The superior effect of levodopa was shown.
Diabetes and related variables among the five main racial groups in South Africa: Comparisons from population studies
Authors: Jackson W P U 
Published: December 2008

Summary
We have investigated the total prevalence of diabetes and related factors among representative, randomly chosen samples of the five ethnic groups living in Cape Town, and (East) Indians in Durban. Comparisons are hindered by differences in age distribution of the populations, while small, isolated groups were found to be unrepresentative. The variability of a single individual's blood sugar levels led us to require at least three abnormal values on 2 different days for a positive diagnosis. The use of different criteria for the diagnosis of diabetes varying from ‘lax’ to ‘stringent’ alters the discovered prevalence in our groups by the factor of approximately 2.
Mean blood glucose levels rose with middle age but never between childhood and early adulthood. Afternoon screening tests appeared valid, despite the agreed diurnal difference in glucose tolerance figures.
Both high screening blood glucose levels and diabetes itself were most common among Indians and coloured people and least among Whites and Bantu, each of the latter having a total diabetes prevalence of approximately 3·5% over age 15. It is noted that the Cape Coloured have more diabetes than any of the constituent races from which they originated.
The reasons for such racial differences are unclear—obesity cannot be the explanation here, since, to take one example, the fattest group of all, the Bantu women, have the lowest prevalence of diabetes. We found mild diabetes not uncommon among young people under 20 in the Indian, Malay and coloured population but none among White or Bantu. There was little difference between the sexes, and if anything the poorer people had more diabetes than the better-off.
Correlation between the foetal acid-base status and the Apgar scoreThe material in this paper has been taken from an M.D. Thesis submitted to the University of Hong Kong.
Authors: Lee K H 
Published: December 2008

Summary
The foetal pH values of eighty-eight cases delivered within 30 min after foetal blood sampling were correlated with the 1-min Apgar score. With a pH of 7·20 or above the error of prediction was 1·3%. The error in cases with pH below 7·20 was 54·5%.
Significantly higher pH and lower δ base deficit were present in the low foetal pH group in vigorous, as opposed to depressed infants, suggesting that infusion acidosis was present in infants with a high Apgar score.
The degree of correlation between the foetal pH and the Apgar score was not significantly influenced by shortening the sampling-delivery interval to 15 min or lengthening it to 3 hr. The most significant factor affecting the degree of correlation in the present study was the setting of the critical pH. If the criterion of the critical pH was taken as 7·13 there would have been no false positive results and the error of prediction in cases delivered within 30 min of foetal blood sampling would be reduced to 1·1%.
Survival of candida septicaemia treated with amphotericin B
Authors: Mitchell A B S , Hosking G , Magrath I T , Farthing C P 
Published: December 2008

Summary
Candida albicans septicaemia occurred in an alcoholic woman who had severe hepatic dysfunction, and was further debilitated by multiple cardiac arrests, prolonged artificial ventilation, bronchopneumonia and Ps. aeruginosa septicaemia. She received broad spectrum antibiotics and corticosteroids, and needed prolonged intravenous cannulation. In vitro, a specific defect was demonstrated in her cell-mediated immune response to candida antigens. Examination of her serum showed normal immunoglobulins, and an adequate agglutination titre to these antigens.
Amphotericin B (800 mg intravenously over 19 days) was administered, and she survived. Hypokalaemia, anaemia, and peripheral neuropathy complicated therapy, and thrombophlebitis of a cannulated peripheral vein necessitated a vena caval catheter. There was no significant deterioration of renal function.
Toxic effects of other drugs were encountered—deafness following kanamycin, an encephalopathy when blood levels of carbenicillin were boosted by probenecid, and cardiac arrest when diazepam and phenobarbitone were administered to control an epileptic fit and delirium tremens. Prolonged intravenous cannulation was complicated by staphylococcal septicaemia.
A year later she died of peritonitis. Chronic pancreatitis was complicated by ascites, which became infected by E. coli. No residual C. albicans infection was found at necropsy.
Thyroid ‘hot’ nodules
Authors: Ramsay Ian , Richardson P J , Marsden Philip , McKerron C G 
Published: December 2008

Summary
A retrospective analysis of thyroid scintiscanning at one hospital over a 3-year period revealed nineteen patients in whom a solitary, hyperfunctioning thyroid nodule was producing thyrotoxicosis.
Most of the patients had clinical features referable to hyperthyroidism and in the majority a solitary nodule was palpable in the neck which was found to correlate well with the location of the ‘hot’ nodule on scanning. Cardiac failure was present in 21% and atrial fibrillation occurred in 37%.
The 131I uptake by the thyroid was of little value in deciding whether or not the patient was toxic, but there was good agreement between serum protein bound iodine determinations and measurement of serum thyroxine and resin uptake tests. There appeared to be no relationship between the size of the nodule and its degree of activity.
Thyrotoxicosis in Nigeria—a study of forty-six patients
Authors: Olurin E O 
Published: December 2008

Summary
In a review of 874 Nigerian patients with various types of thyroid gland disorders, forty-six patients were found to be thyrotoxic (5·3%), supporting the common observation of many authors that thyrotoxicosis is rarer in the African than in Europe and North America where thyrotoxicosis accounts for 20–50% of all thyroidectomies. The incidence of thyrotoxicosis is higher in the female than male though there is a higher proportion of males in this series than in the United Kingdom. There is a higher incidence of secondary thyrotoxicosis than has been reported elsewhere.
The clinical features of hyperthyroidism in the Nigerian are no different from those reported in other countries, though our patients tend to report rather late. Primary thyrotoxicosis occured a decade earlier in this series than in Britain. Two of the forty-six patients had adenocarcinoma of the thyroid although only in twenty-seven patients was thyroid tissue available for histological examination. Laboratory investigations were essential in borderline cases, especially estimation of the PBI in those with multinodular goitres.
The standard methods of treatment by antithyroid drugs, 131I and surgery were employed with immediately satisfactory results, though the follow-up was so poor that it is impossible to evaluate the late effects of treatment.
Calcification of the basal ganglia apparently presenting as a schizophreniform psychosis
Authors: Hall Peter 
Published: December 2008

Summary
A patient with gross basal ganglia calcification is described, whose condition was associated with severe psychotic symptoms and in whom the clinical picture was not typical of hypoparathyroidism, pseudohypoparathyroidism or pseudo-pseudohypoparathyroidism.
Calcification of the basal ganglia may occur in a variety of infections, toxic and metabolic disorders, particularly hypoparathyroidism, pseudohypoparathyroidism, toxoplasmosis and some anoxic conditions (Moskowitz, Winickoff & Heinz, 1971).
Though there is doubt as to the precise diagnosis in the present case, familial calcification appears to be the most probable.
Implanted-pacemaker-induced dysrhythmia and its management
Authors: Jachuck S J 
Published: December 2008

Summary
Five cases of implanted-pacemaker-induced dysrhythmia are described and factors precipitating such dysrhythmias are discussed.
The efficacy of practolol in the treatment of such dysrhythmias is shown and its use as a prophylactic antidysrhythmic agent has been suggested.
Comparison of propranolol and Ro 3-3528 in hyperthyroid tachycardia and dysrhythmias
Authors: Phillips Eileen M , Turner Paul , Houghton Joan , Ferriman D G 
Published: December 2008

Summary
Ro 3-3528, a non-selective β-adrenoceptor blocking drug which lacks intrinsic activity, produces a dose-response effect in hyperthyroid tachycardia, and shows no dysrhythmic properties. In hyperthyroid patients, β-blocking drugs of this nature are preferable to those possessing intrinsic sympathomimetic activity, which may have dysrhythmic properties in this condition.
Thiazides and hypokalaemia in diabetic ketoacidosis
Authors: Alberti K G M M , Hockaday T D R 
Published: December 2008

SummaryIn a series of forty-one episodes of diabetic coma or pre-coma, three patients had plasma potassium values of less than 3.0 mEq/l. All three had been taking thiazide diuretics with only one receiving oral potassium supplements. None was previously known to be diabetic, representing 18% of the new diabetics in the series. The mean plasma potassium for the other new diabetics was 4·7 ± 0·2 mEq/l. These findings emphasize that adequate potassium supplements should be given with thiazide diuretics to diabetic subjects and to those with an increased risk of developing the disease.
Megaloblastic anaemia due to trimethoprim-sulphamethoxazole therapy in uraemia
Authors: Yuill G M 
Published: December 2008

Summary
A patient is described in whom malignant hypertension led to oliguric renal failure. A course of trimethoprim and sulphamethoxazole (co-trimoxazole) was prescribed for an intercurrent urinary tract infection and appeared to precipitate a megaloblastic anaemia which responded satisfactorily to folic acid.
Monozygous twins with hypothyroidism and diabetes mellitus
Authors: Mitchell I , Lawson A A H 
Published: December 2008

Summary
Monozygous twins with diabetes mellitus and autoimmune hypothyroidism are described. The onset of the hypothyroidism was simultaneous, but one twin had had insulin-dependent diabetes mellitus for 9 years while the other twin developed insulin-independent diabetes concurrently with the hypothyroidism. Two other siblings had diabetes mellitus and one of them had a goitre, possibly lymphadenoid. The aetiology of autoimmune hypothyroidism is discussed, and evidence is presented which supports suggestions that diabetes mellitus may be an autoimmune disease.
Fractionation of the influenza virus with the object of producing subunit vaccine
Authors: Hoyle L , Barker Sheila M 
Published: December 2008

Summary
Attempts have been made to produce a subunit influenza vaccine containing haemagglutinin and neuraminidase but free of lipid and nucleic acid.
Disintegration of virus with Nonidet P40 followed by selective dialysis was only partially successful, but by disintegration with sodium dodecyl sulphate followed by ether extraction and precipitation with ammonium sulphate a product was obtained in which the content of ribonucleic acid was reduced to 1% and the lipid content to less than 5% of the amounts present in the original virus.
When A1 strains of virus and some strains of virus A were shaken with n-butanol only the ribonucleoprotein (S antigen) was found in the aqueous phase and the procedure affords a very simple method of producing pure S antigen for use in serological diagnosis.