bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hormonal and blood pressure changes during converting enzyme inhibition by teprotide
Authors: VandenBurg M J , Sharman V L , Morton J J , Williams G H , Marsh F P 
Published: December 2008

SummaryChanges induced by i.v. and subcutaneous teprotide in plasma renin, angiotensin I, angiotensin II, aldosterone and bradykinin were studied in a renal transplant patient with severe high renin hypertension, before and after trinephrectomy. The immediate reduction in BP produced by teprotide was not solely attributable to the inhibition of conversion of angiotensin I to angiotensin II, because there was also a transient increase in serum bradykinin; however, the prolonged antihypertensive effect of teprotide appeared independent of bradykinin. After trinephrectomy, teprotide lowered systolic BP but had no significant effect on diastolic BP or plasma bradykinin. beta-Blockade prevented the secondary increase in plasma renin which followed teprotide, thereby potentiating its anti-hypertensive effect.
Pituitary apoplexy (spontaneous pituitary necrosis)
Authors: Sachdev Y , Gopal K , Garg V K , Mongia S S 
Published: December 2008

Summary
Pituitary apoplexy or spontaneous pituitary necrosis is an ill-understood clinical syndrome. It may occur as a neurological emergency requiring urgent interference in a patient with a known pituitary dysfunction or it may be responsible for drawing attention to an as yet unrecognized pituitary pathology. It has a bizarre clinical profile and an unpredictable neurological and endocrine course. Patients may die at once or may recover with or without endocrine/neurological deficit. Six cases of pituitary apoplexy with varied clinical presentation are cited.
Percutaneous transluminal dilatation of transplant renal artery stenosis
Authors: Rankin R N , Keown P A , Ulan R A , Stiller C R 
Published: December 2008

Summary
Percutaneous transluminal angioplasty has been applied to the treatment of transplant renal artery stenosis in 3 patients, 2 with severe hypertension resistant to medical therapy, and one with graft dysfunction related to the presence of the stenosis in the early post-transplant period. The clinical courses of the patients before and after angioplasty are illustrated and the usefulness of the technique in this difficult situation stressed.
Polycythaemia vera presenting as an acute abdomen
Authors: Isles Christopher , Strachan R W 
Published: December 2008

Summary
A patient who presented with severe abdominal pain was found to have an intrahepatic haematoma complicating previously undiagnosed polycythaemia vera (PV). Full recovery followed treatment with bed rest, control of hypertension, daily venesection and 32P. The hazards of surgery in uncontrolled PV are discussed and re-emphasized.
The evaluation of cefuroxime in the prevention of postoperative infection
Authors: Croton R S , Sykes D , Treanor J , Wake P , Green H T , Knowles M A , Eilon L A 
Published: December 2008

Summary
Patients undergoing biliary surgery received either 750 mg cefuroxime i.m. with the premedication and then 8 hourly for 3 days ((group A) or 1.5 g cefuroxime i.v. at the time of induction of anaesthesia (group B) or not treatment (group C). Wound infections occurred in 3 out of 35 patients in group A, 1 out of 40 patients in group B and 11 out of 39 patients in group C (group B significantly different than group C, P less than 0.05). Eight patients (23%) in group C had chest complications. Cefuroxime was effective in the reduction of wound sepsis following biliary surgery and 1.5 g i.v. administered during induction of anaesthesia is the dosage of choice. The incidence of chest infection tended to be lower in patients receiving cefuroxime but many more patients would have to be studied for a conclusive result.
Myocardial infarction in familial hyper-alpha and hypo-beta-lipoproteinaemia
Authors: Rabkin Simon W , Ledwich Rodney , Mymin D 
Published: December 2008

Summary
This is the documentation of an acute myocardial infarction in a 45-year-old woman with familial hyper-alpha- and hypo-beta-lipoproteinaemia. This dyslipoproteinaemia has been rarely associated with clinical evidence of ischaemic heart disease. Documentation of angiographically normal coronary arteries in this patient is consistent with the concept that increased alpha-lipoprotein (HDL) and low beta-lipoprotein (LDL) may prevent atherosclerosis. Thus, myocardial infarction in patients with this dys-lipoproteinaemia should be attributable to factors other than coronary atherosclerosis.
The diagnosis and management of patients admitted to hospital with acute breathlessness
Authors: Pearson S B , Pearson Elizabeth M , Mitchell J R A 
Published: December 2008

SummaryThe authors have studied 352 emergency medical admissions during a summer period and 355 during the winter months to identify 177 patients who had been treated for breathlessness. Multiple and rapidly changing treatments have been taken to indicate diagnostic uncertainty. Using this model, the authors have shown that there is much more uncertainty in winter than in summer and that the working diagnosis of chest infection or asthma is particularly likely to be associated with multiple treatment. It is questionable whether the stereotyped descriptions of diseases in standard text books provide an adequate basis for emergency treatment decisions and it is considered that the diagnostic value of investigations such as chest radiography needs further careful scrutiny.
Plasma sex hormone concentrations in men with hypertension treated with methyldopa and/or propranolol
Authors: Taylor R G , Crisp A J , Hoffbrand B I , Maguire A , Jacobs H S 
Published: December 2008

Summary
Serum concentrations of LH, FSH, testosterone and prolactin were measured in patients with hypertension treated with propranolol (34 cases), methyldopa (13 cases), and methyldopa + propranolol (11 cases). The results were compared with those obtained in 18 controls (hospital out-patients). There were no differences in these hormone concentrations in the various groups, and no difference between those complaining of impotence (13 cases) and those with normal sexual function.
Impotence in hypertensive men on treatment with methyldopa cannot be explained by abnormalities in secretion of the reproductive hormones.
A double-blind controlled trial of the effect of sodium cromoglycate in preventing relapse in ulcerative colitis
Authors: Whorwell P J , Whorwell G M , Bamforth J , Colin Jones D , Down P , Edwards A , Gent A E , Golding P , Gough K R , Hellier M D , Isaacson P , Loehry C A , Milton-Thompson G J , Smith C L , Waldram R P , Wright R 
Published: December 2008

Summary
A double-blind controlled trial of the effect of sodium cromoglycate (SCG) in preventing relapse in ulcerative colitis has been completed in 100 subjects. In patients already taking sulphasalazine, SCG did not prove to be of any additional benefit. However, in patients not on any other maintenance therapy, the relapse rate was 40% for SCG as compared with 75% for placebo. A large study of the effect of SCG in patients intolerant of sulphasalazine is indicated.
A practical approach to the investigation of the hyperprolactinaemic patient
Authors: Shalet S M , Chapman A J , Whitehead E , Beardwell C G 
Published: December 2008

Summary
Pituitary function was assessed in 39 patients with previously untreated hyperprolactinaemia. Primary hypothyroidism, drug-induced hyperprolactinaemia and chronic renal failure were excluded in all patients. All of the 22 patients (group 1), who had either a normal pituitary fossa or a minor radiological change on lateral skull X-ray, had completely normal pituitary function with the exception of 2 who were partially growth hormone-deficient. However, 9 of the 17 patients with macroadenomas (group 2) had a deficit of one or more anterior pituitary hormones. After the lateral skull X-ray 13 patients in group 1 had further neuroradiological investigations. In only one was a minor abnormality noted which had not been observed on the plain film and this was not of practical significance.
In centres where hyperprolactinaemic patients with a normal pituitary fossa or a minor radiological change on lateral skull X-ray are treated with bromocriptine, further neuroradiological investigations and dynamic tests of pituitary function are not required.
Lupus nephritis and lupus band test
Authors: Adam B A , Wang F , Looi L M , Prathap K 
Published: December 2008

Summary
Twenty-seven patients with histologically confirmed lupus nephritis were studied to identify the incidence of lupus band and its significance to histological patterns of nephritis and complement levels. It was found that the kidney involvement is 2.5 times more frequent in lupus band positive patients. The association of a positive lupus and low C3 level signifies the presence of diffuse proliferative glomerulonephritis rather than membranous glomerulonephritis. The results, together with earlier reports, are discussed.
Septicaemia in the elderly
Authors: Madden J W , Croker J R , Beynon G P 
Published: December 2008

Summary
A retrospective study was made of 44 elderly patients with bacteraemia treated in the period 1974-1980. Positive blood cultures in 5 cases were considered clinically insignificant. Twenty-six of the remaining 39 patients were found to have a Gram-negative bacteraemia, mainly associated with urinary tract infection. Abnormalities of liver function were common but 5 jaundiced patients with Gram-negative infection were shown to have stones in the common bile duct. The value of blood cultures as a diagnostic aid in the non-specifically ill elderly patient is emphasized.
Clinical toxicology of ‘magic mushroom’ ingestion
Authors: Peden N R , Macaulay K E C , Bissett Ann F , Crooks J , Pelosi A J 
Published: December 2008

Summary
The clinical features are reported in 27 cases of ‘magic mushroom’ ingestion. Mydriasis and hyperreflexia were common as were disorders of perception and affect. Psilocybe semilanceata appears to have been the species of fungus involved.
The diagnosis of Ménétrier’s disease
Authors: Ward M W N , Sarner Martin , Whittaker M G , Clark C G 
Published: December 2008

Summary
Two cases of Ménétrier’s disease are reported to illustrate the clinical presentation and diagnosis of this unusual condition. The literature has been reviewed of all the reported cases to establish the relative importance of the individual symptomatology, the value of the diagnostic methods, and to highlight the diagnostic pitfalls. Recognition of the barium meal appearances and snare biopsy at gastroscopy may avoid the necessity of diagnostic laparotomy.
Atropine treatment for baclofen overdose
Authors: Ferner R E 
Published: December 2008

Summary
A healthy 17-year-old girl took a single large dose (420 mg) of baclofen. She was conscious on admission to hospital, but within 3.5 hr of overdose showed signs of marked cerebral, cardiac and respiratory depression, flaccidity and hypothermia. Eight hours after overdose, atropine administered i.v. produced a worth-while increase in cardiac output, ventilation and temperature, lasting for about 90 min. This is of therapeutic and theoretical interest, and supports the veiw that baclofen leads to cholinergic dominance.
The effect of folate analogues on thymidine utilization by human and rat marrow cells and the effect on the deoxyuridine suppression test
Authors: Deacon Rosemary , Perry Janet , Chanarin I , Lumb M 
Published: December 2008

Summary
The deoxyuridine (dU) suppression test assesses the capacity of marrow cells or activated lymphocytes to convert exogenous dU into thymidine. In addition, the effect of the added cobalamin or folate on the result is used to determine the nature of the deficiency in megaloblastic marrows. This study shows that folates have a considerable effect on the uptake of labelled thymidine by marrows from patients with megaloblastic anaemia in the absence of added dU. Less thymidine was taken up by megaloblastic marrow cells if they were first incubated with 5-formyltetrahydrofolate, 10-formyltetrahydrofolate or tetrahydrofolate. 5-Methyltetrahydrofolate increased thymidine uptake in cobalamin-deficient marrows and reduced thymidine uptake in folate-deficient marrows. These results could be explained if added folates facilitated utilization of endogenous dU. However, the addition of folates or cobalamin did not affect the validity of a dU suppression test with human marrow. More marked changes were present on the addition of folates to rat marrow cells both from control and nitrous oxidetreated animals.
Mortality in acute upper gastrointestinal haemorrhage: a six-year survey from the University Hospital of Wales
Authors: Mayberry J F , Counsell B R , Penny W J , Rhodes J 
Published: December 2008

Summary
In a retrospective survey of normal hospital practice, 583 patients were admitted between March 1972 and 1978 because of haematemesis or melaena. Sixty (10·3%) of these patients died; most deaths occurred in elderly patients (mean age 75 years) 75% of whom had a serious medical problem which complicated the situation. Malignancy, cardiovascular disease and respiratory problems were the most commonly associated factors. The attitude towards both emergency investigation and surgical intervention was very conservative and any reduction in mortality would require a concerted effort to deal with the special problems in elderly patients who are at particular risk.
Complete recovery of spinal cord compression following parathyroidectomy
Authors: Ganesh Alka , Kurian Susy , John Lily 
Published: December 2008

Summary
A case is reported of spinal cord compression at T2 level caused by a brown tumour of primary hyperparathyroidism involving the posterior arch of the vertebra. The spontaneous regression of cord compression following parathyroidectomy is documented clinically and radiologically.
Continuous infusion of papaveretum for relief of postoperative pain
Authors: Saha S K 
Published: December 2008

Summary
Postoperative analgesia, once established initially by the titration method, is sustained with a flexible regime of papaveretum, infused continuously with a portable syringe pump. The initial analgesic requirement (IAR) for titrating the pain threshold level, was between 4 and 10 mg of papaveretum and the maintenance dose between 1 and 1·66 mg/hr for the first 24 hr and between 0·83 and 1 mg/hr for the second 24 hr. There was no significant association between IAR and the maintenance dose (P&lt;0·2) nor was there any correlation between the maintenance dose, body weight, age, sex or nature of operations. The results in 70 patients are encouraging.
Bordetella bronchiseptica infection in stage IV Hodgkin’s disease
Authors: Stoll David B , Murphey Shelia A , Ballas Samir K 
Published: December 2008

Summary
It is well known that patients with lymphoproliferative disorders have an altered immune status and are susceptible to opportunistic and non-opportunistic infections. The authors report the first case of a patient with advanced Hodgkin’s disease who developed pneumonia caused by the animal pathogen Bordetella bronchiseptica. The most likely source of this organism was the patient’s dog. While B. bronchiseptica is often responsible for outbreaks of pneumonia and septicaemia in wild and domestic animals, its role and incidence in human infections is not known. It is felt that patients with underlying lymphoproliferative diseases and pneumonia should be questioned about any contact with animals.
The ‘tumour overkill syndrome’. A potentially lethal complication of cancer chemotherapy
Authors: Slevin M L , Cotterill A M , Bell R , Lister T A 
Published: December 2008

Summary
Two cases of acute leukaemia of Burkitt type in whom chemotherapy was associated with the ‘tumour overkill syndrome’ are described. One patient died with severe metabolic derangement which followed chemotherapy. In the other, an intensive programme of allopurinol administration, alkalinization of the urine and forced diuresis was instituted before chemotherapy, thus correcting the initial biochemical abnormalities and modifying those which occurred after chemotherapy. This approach prevented a fatal outcome, allowing the patient to survive to achieve bone marrow remission.
Cardiovascular mortality among immigrants to England and Wales
Authors: Marmot M G , Adelstein A M , Bulusu L 
Published: December 2008

Summary
The Office of Population Censuses and Surveys (OPCS) is analysing mortality of immigrants to England and Wales. On average, immigrants are healthier and have a lower mortality then people who remained in the country of origin—demonstrating the ‘selection’ effect of migration. For cardiovascular diseases, the mortality of immigrants reflects the pattern in the country from which they came. Thus, immigrants to England and Wales from France, Spain and Italy (low-rate countries) have a low standardized mortality ratio from ischaemic heart disease. Immigrants from the West Indies and Africa have a high mortality from hypertension and cerebrovascular disease. It is noted that the mortality from ischaemic heart disease is high among immigrants from India and Pakistan.
Pneumatosis cystoides intestinalis associated with pyloric stenosis
Authors: Padwell A , Kopelman C 
Published: December 2008

Summary
Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas-filled cysts in the bowel wall. A case is reported which was associated with peptic ulcer and in which there was involvement of the ileum and pre-pyloric region of the stomach. Stomach involvement is a rare occurrence. Chronic pneumoperitoneum was also present. The mechanism of its occurrence is discussed.
Assessment of chronic aortic valve disease in adults
Authors: Harries A D , Griffiths B E 
Published: December 2008

Abstract
Chronic aortic valve disease is often tolerated for a long period of time with little in the way of symptoms, but once symptoms develop, the downhill course is often rapid. Medical therapy may alleviate symptoms of congestive heart failure and angina, but does not alter the natural history of the disease. The recent advances of cardiac surgery have, however, considerably improved the prognosis of most patients. Some patients with aortic regurgitation, though, will develop progressive congestive heart failure despite aortic valve replacement. Others with severe aortic stenosis will die suddenly while awaiting surgery as will a small number who previously had been asymptomatic. The information that comes from cardiac catheterization as well as the non-invasive investigation of cardiological disease, greatly enhanced by the introduction of the echocardiogram, has provided the physician with a better understanding of the particular problems in question and, therefore, the potential to solve them. This article aims to review the means by which high-risk groups can be identified, in order that their outlook may be improved especially with respect to the timing of surgical intervention.
Delayed halitosis-a rare cause
Authors: Lawson R A , Carroll K 
Published: December 2008

Abstract
A 38-year-old tuberculous male Pakistani presented with halitosis and a cough especially marked when lying on his left side. Barium swallow demonstrated a fistula between oesophagus and left main bronchus. Anti-tuberculous therapy and repeated cauterization failed to close the fistula. Thoracotomy confirmed a congenital oesophago-bronchial fistula. Division and suture resulted in cure.
Normotensive cardiomyopathy and malignant hypertension in phaeochromocytoma
Authors: Shapiro L M , Trethowan N , Singh S P 
Published: December 2008

Abstract
A patient with two different presentations of phaeochromocytoma is described. She initially presented with normal blood pressure and heart failure following a prolonged feverish prodrome. A provisional diagnosis of myocarditis or early congestive cardiomyopathy was made and she improved with digoxin and diuretics. Eighteen months later, after a period of normotension free from heart failure, she developed malignant hypertension with recurrence of heart failure. A phaeochromocytoma was surgically removed, with return to normal of blood pressure and cardiac status. It would seem that the initial presentation of the phaeochromocytoma was a catecholamine-induced myocarditis without hypertension and this resolved with the subsequent development of malignant hypertension. The possible mechanisms responsible for this are discussed and it is concluded that phaeochromocytoma should be considered in patients who have heart failure and persistent features of myocarditis.
Malign effects of splenectomy—the place of conservative treatment
Authors: Werbin Nahum , Lodha Kiran 
Published: December 2008

AbstractIn this review article the incidence is discussed of overwhelming post-splenectomy infection (OPSI), which is especially likely to occur in children and when splenectomy is carried out for haematological disorders. Long-term broad spectrum antibiotics or the use of polyvalent pneumococcal vaccine are often advocated as prophylactic measures under these circumstances.After mild splenic trauma, conservative surgery or partial splenectomy may be indicated in some cases. Where trauma is more severe and the spleen cannot safely be preserved there may be a place for autotransplantation of splenic slices, for example into a pocket of omentum, and there is some experimental support for this technique.
Livedo reticularis and cerebro-vascular disease
Authors: Stephens W P , Ferguson I T 
Published: December 2008

Abstract
Three cases are described in which extensive livedo reticularis was associated with premature cerebrovascular disease. The patients presented with transient cerebral ischaemic attacks and gradually developed permanent neurological damage with intellectual impairment. The value of detailed neuropsychological testing to identify bilateral cortical abnormalities is demonstrated. CAT scanning may reveal multifocal cerebral infarction. The nature of this condition is not understood.
Altered quinidine disposition in a patient with chronic active hepatitis
Authors: Powell J Robert , Conrad Kenneth A , Okada Robert , Guentert Theodor W , Riegelman Sidney 
Published: December 2008

Abstract
A 49-year-old female with chronic active hepatitis and ventricular ectopic activity was given i.v. 600 mg quindine gluconate (4·4 mg/kg). Quinidine plasma concentrations were analysed by high pressure liquid chromatography and plasma protein binding by equilibrium dialysis. The pharmacokinetic values were total body clearance 0·11 l/kg/hr, elimination half-life 41·5 hr, volume of the central compartment 2·26 l/kg, volume of distribution from the area under the curve 6·5 l/kg, and 19% unbound in plasma. Based on the limited information available, quinidine dosing should be markedly decreased in patients with severe liver dysfunction.
Leucoplakia of the oral cavity, smoking and arylhydrocarbon-hydroxylase inducibility
Authors: Andréasson Lars , Korsgaard Rolf , Trell Erik , Björlin Gunnar , Mattiasson Ingrid , Trell Lena 
Published: December 2008

Abstract
In a consecutive series of 53 cases of oral leucoplakia, smoking history, oro-dental status and arylhydrocarbon-hydroxylase (AHH) inducibility were assessed. There was an increased association of leucoplakia with smoking, particularly in the male cases, but no remarkable findings as to dental status. Overall, there was a slightly higher frequency of cases with high AHH inducibility than expected from a normal control population. This difference was confined to the smokers, where there was a statistically highly significant over-representation of high AHH inducibility and under-representation of low AHH inducibility. The figures in the non-smoking patients were close to the expected.