bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Depression by any other name...’
Authors: Bridges P K 
Published: December 2008

Summary
There is a popular conviction that psychological disturbance is invariably a reaction to environmental events. This approach is associated with total rejection of the so-called ‘medical model’. However, allowance must be made for the fact that contemporary knowledge of psychiatric illness is well behind what is now known about general medicine, and current ideas about psychiatric aetiology may be emotionally determined to give satisfying concepts which are often almost impossible to refute.
By tracing the progress of some hypotheses in general medicine, as they developed in the past, there are similarities with some current observations about the methods of action of physical treatments in psychiatry, treatments which have been discovered empirically.
There is a widespread assumption that psychological responses relate precisely to the degree of evoking stress or the patient's personal attitudes to the stress. However, emotional responsiveness may show an intrinsic individual variation so that many patients who over-respond to stress may do so because of enhanced responsiveness rather than necessarily because psychological events have brought about a state of vulnerability.
The exclusively dynamic approach to psychiatry has been perhaps unnecessarily encouraged by naming an illness ‘endogenous depression’ which could well be a primarily physical metabolic disturbance in the central nervous system but which happens to present with prominent depression, as well as other abnormalities. The emphasis on the component of depressed mood artificially delineates the illness and tends to impede consideration of its wider implications.
An account of the treatment of five chronic asthmatic patients
Authors: Kamburoff P L , Prime F J 
Published: December 2008

Summary
An account is given of the progress of five patients with intrinsic asthma who have received terbutaline continuously to control airways obstruction over a period of up to 2 years. One aim of this investigation was to find out whether there is any evidence of the development of tachyphylaxis to this drug. No such evidence was found. Two of the patients benefited from the administration of an α-blocking drug (indoramin).
Gout induced by L-dopa and decarboxylase inhibitors
Authors: Calne D B , Fermaglich J 
Published: December 2008

Summary
Two cases of clinical gout are reported in parkinsonian patients receiving L-dopa in combination with a decarboxylase inhibitor. Blockade of decarboxylation leads to major changes in the pattern of L-dopa metabolites. It is suggested that hyperuricaemia may result from accumulation of L-dopa itself or a transaminated product.
Sideroblastic and megaloblastic change
Authors: Bagnall W E , Fairman M J 
Published: December 2008

Summary
A case of primary sideroblastic anaemia is described in which megaloblastic changes in the bone marrow were found to be due to coincidental pernicious anaemia.
The importance is stressed of investigating all cases of macrocytic anaemia by iron staining of the marrow together with estimation of the serum B12 and folate levels.
A ‘bootstrap’ model of the renal medulla
Authors: Britton K E , Cage P E , Carson E R 
Published: December 2008

Summary
The ‘bootstrap’ model of the handling of salt, water and urea by the renal medulla is based on the concepts and data of Stephenson (1972), and Kokko and Rector (1972), and adds support to them. Revision of the traditional counter current hypothesis is necessary since active transport of salt and urea is absent from the inner medulla. This advanced model is structured appropriately and demonstrates how events in the medulla interact and vary with time as change from a diuretic to an antidiuretic state proceeds.
Combination antifungal therapy for cryptococcal meningitis
Authors: Tobias J S , Wrigley P F M , Shaw Elizabeth 
Published: December 2008

Summary
Two patients with Hodgkin's disease and cryptococcal meningitis are described. Both patients were treated with a combination of the two antifungal agents, amphotericin B and flucytosine. Nephrotoxicity was easily reversible in both patients and clinical improvement was seen with this combination therapy. Intrathecal therapy with amphotericin B was used in both patients. The optimal treatment of this disease may prove to be a combination of oral flucytosine, with amphotericin B given by intrathecal injection as well as rapid low dose intravenous injection.
An adsorbed surface-antigen influenza vaccine and its serological activity in volunteers
Authors: Brady M I , Furminger I G S , Stones P B 
Published: December 2008

Summary
A highly purified vaccine prepared from surface antigens of influenza virus adsorbed on to aluminium hydroxide has elicited good antibody results to both haemagglutinin and neuraminidase components, and has been shown to induce resistance to homotypic challenge at a satisfactorily high level.
Vaccination in the control of influenza
Authors: Smith J W G , Fletcher W B , Wherry P J 
Published: December 2008

Summary
Although killed influenza vaccine given by injection is protective, able to reduce sickness absence in industry and to control influenza in the armed forces, it has not so far been possible to demonstrate more than a small effect on the disease in otherwise healthy adults in industry and offices in the United Kingdom. The reasons are probably the poor rate of acceptance of vaccine, the relatively low incidence of clinical influenza in most years, and the incomplete protection given by the vaccine. Until major epidemics can be accurately forecast it is suggested that influenza vaccination may most usefully be used on a selective basis, namely for protecting those with illness predisposing to a severe effect from influenza; persons in institutions such as schools and homes for the elderly; key workers in the general population; and persons over the age of 65 years among whom considerable mortality occurs in winters when influenza is prevalent.
The common hyperlipidaemias
Authors: Lewis Barry 
Published: December 2008

Summary
The treatment of primary hyperlipidaemic states is reviewed. While several metabolically distinct forms of hyperlipidaemia exist, it is possible to classify patients into three groups for the purpose of therapy.
Group 1 is defined as hypercholesterolaemia (due to raised levels of β-lipoprotein). In Group 2 the level of endogenous triglyceride is increased, with or without hypercholesterolaemia. In the rare Group 3, there is exogenous hypertriglyceridaemia. A satisfactory response can be attained in at least 90% of cases, using dietary and drug treatment.
A study of the wound environment during total hip arthroplasty
Authors: McLauchlan J , Smylie H G , Logie J R C , Smith G 
Published: December 2008

Summary
Two hundred and seventeen total hip replacements were performed during a trial designed to assess the influence of a surgical isolator upon postoperative wound infection. The trial was controlled by performing 108 of the replacements in a standard plenum-ventilated theatre with twenty air changes/hr, which also housed the isolator procedures. Comparative postoperative wound infection rates were 6·4% for the isolator patients and 4·6% for those operated on in the plenum-ventilated theatre. There was intraoperative wound contamination in both groups of patients and, although the isolator reduced wound contamination at operation, this bore no relationship to eventual wound sepsis.
The effect of administered corticosteroids on the growth of children
Authors: Preece M A 
Published: December 2008

SummaryThe growth-inhibiting effect of exogenous corticosteroids has been reported in many papers. Most of them have concerned the clinical problems of asthma and rheumatoid arthritis but it is probable that the underlying disease is relatively unimportant in determining the effect on growth. Steroid therapy on alternate days seems to produce less undesirable effects than steroid treatment every day and corticotrophin may be preferable. Although the mechanisms are uncertain it seems likely that the action is peripheral and certainly exogenous growth hormone does not prevent the steroid effect. A minimal dosage of corticosteroids should always be used in replacement therapy for hypopituitarism.
Scleritis and temporal arteritis
Authors: Long R G , Friedmann A I , James D Geraint 
Published: December 2008

Summary
Thirty consecutive patients with severe scleritis or episcleritis were admitted as in-patients to the Medical Ophthalmology Unit and assessed for systemic disease. There were seventeen women and thirteen men. The mean age was 53 with a median of 57 (range 23-83). Eighteen of the patients had scleritis: eleven of these had evidence of connective tissue disease and three of them had temporal arteritis. Twelve patients had episcleritis: six of them had a collagen disease and one of them developed temporal arteritis. This high incidence of temporal arteritis in association with scleritis has not been previously reported. It is important to diagnose and treat overt temporal arteritis early with parenteral steroids so that ischaemic papillopathy can be avoided. A higher incidence of collagen diseases than previously described is reported in episcleritis. It is thought that this is secondary to selection since patients with the usual self-limiting episcleritis are not normally referred for further in-patient investigation. In no patient was more than one significant diagnosis made. There was no significant medical illness in only 11% of patients with scleritis and 33% of patients with episcleritis. The majority of the non-collagen diseases (e.g. hypertension) were not previously recognized. In none of the patients with temporal arteritis was the diagnosis made before admission. It is concluded that full examination and investigation for underlying disease is indicated in both scleritis and severe episcleritis.
Drug-induced hyponatraemia in psychogenic polydipsia
Authors: Gossain Ved V , Hagen Garrett A , Sugawara M 
Published: December 2008

Summary
Two patients with psychogenic polydipsia developed hyponatraemia, one in association with administration of hydrochlorothiazide and the other with that of tolbutamide. It is suggested that the increased fluid intake in such patients may make them more susceptible to the development of hyponatraemia from thiazide or sulphonylurea compounds.
Acute renal failure following copper sulphate intoxication
Authors: Chugh K S , Sharma B K , Singhal P C , Das K C , Datta B N 
Published: December 2008

Summary
Eleven out of a series of twenty-nine patients (37-9%) with acute copper sulphate poisoning developed acute renal failure. Intravascular haemolysis appeared to be the chief factor responsible for renal lesions in these patients. Histological lesions observed in the kidney varied from those of mild shock to well established acute tubular necrosis. In one case, granulomatous lesions were seen in response to tubulorrhexis. Renal failure was the chief indication for dialysis in ten patients, whereas one patient was dialysed primarily for removal of copper. Notwithstanding the adequate control of uraemia by dialysis, only six of the eleven patients recovered. Septicaemia was responsible for death in three, hepatic failure in one and methaemoglobinaemia in another. It is postulated that release of copper from haemolysed red cells during acute haemolytic episodes may initiate, or contribute to, the development of renal damage.
Paget's disease of bone—a clinical and genetic study
Authors: Galbraith H J B , Evans E C , Lacey J 
Published: December 2008

Summary
An unselected series of 285 patients with Paget's disease of bone has been studied, of whom 54% were male and 46% female. The youngest was aged 25 years at diagnosis and the oldest 95. Of the patients 109 (38-2%) had never suffered serious symptoms. These diagnosed cases certainly represent only a small proportion, perhaps 10-15%, of all those with Paget's disease in the community from which they came. Few of the undiagnosed cases are likely to be suffering from serious symptoms or complications so it is apparent that the majority (probably over 80 or 90%) of those with the pathological state are relatively untroubled by their disease. The most common complication (8-8%) was pathological fracture. The fracture involved the shaft of the femur in 62% occurring in this section of the bone almost seven times more frequently in the patients with Paget's disease than in the general population. Because of the large number of undiagnosed cases in the community, the true incidence of pathological fracture and of sarcoma of bone in all patients with Paget's disease is probably only 1% and 0-1% respectively. Simultaneous estimates of the serum alkaline phosphatase and ESR were made in 128 of the patients. It was shown that the ESR is valueless as a measure of activity or extent of the disease. In many patients the level of the serum alkaline phosphatase changed very little over periods of several years. A history of the disease in one or more close relatives was found in three families, a lower incidence than was expected from previously recorded studies. The ABO blood groups were determined in 215 of the patients; 50% were of group A compared with 46% in a control group. The difference in distribution of blood groups in the two series of subjects is small and well within chance limits. The secretor status of 138 patients was investigated; 77% were secretors. This is similar to the proportion in control series. There is evidence to suggest that the degree of severity of Paget's disease does not vary, once it has developed in any particular individual, and that the more severe and extensive forms may have a stronger genetic basis.
Prognostic importance of ventricular extrasystoles in acute myocardial infarction
Authors: Talbot S 
Published: December 2008

Summary
Ventricular arrhythmias were recorded in 233 patients in a prospective study of patients with acute myocardial infarction. In over 95% of patients antiarrhythmic therapy was not given until the onset of ventricular tachycardia, ventricular fibrillation, or persistent idioventricular rhythm. There was a mortality of 18% during the patients' stay in hospital. The most important features of ventricular ectopic activity, which preceded these severe ventricular arrhythmias in the first 48 hr, were multiformity, variation of coupling intervals of larger or equal to 0-1 sec, the R-on-T phenomenon, double ventricular extrasystoles and ventricular bigeminy. The number of a single ventricular extrasystoles per minute was related to the probability of these severe ventricular arrhythmias but to a lesser degree. It was found that if all the patients with the first two prognostic features that if all the patients with the first two prognostic features were removed, the number of single ventricular extrasystoles was not of significant import and the other features were less important. Three-quarters of the severe arrhythmias occurred in the first 24 hr and during this period 60% were preceded by either multiform ventricular extrasystoles or extrasystoles with variable coupling. The importance of these findings in relation to prophylactic therapy is discussed.
Pseudo-obstruction and a sprue-like syndrome from stronglyloidiasis
Authors: Bartholomew C , Butler A K , Bhaskar A G , Jankey N 
Published: December 2008

Summary
Symptomatic disease from Strongyloides stercoralis has been recognized for the first time in Trinidad. Five cases are reported, all showing clinical features suggestive of a sprue-like syndrome. Subtotal jejunal villous atrophy was seen in one case and partial villous atrophy in two. Three patients had laparotomies because of suspected partial intestinal obstruction. A sprue-like syndrome in certain Caribbean immigrants should arouse a suspicion of S. stercoralis.
Zinc metabolism and thyroid status
Authors: Bremner W F , Fell G S 
Published: December 2008

Summary
Urinary zinc excretion was found to be increased in patients with thyrotoxicosis when compared to euthyroid individuals. This increase did not appear to be due to an increase in creatinine clearance and was found to be strongly correlated with an index designed to assess the severity and acuteness of the metabolic response of the body to hyperthyroidism. The potential clinical significance of this finding is discussed.
Paravertebral and peripheral ligamentous ossification: an unusual association of hypoparathyroidism
Authors: Adams J E , Davies M 
Published: December 2008

Summary
A 62-year-old man with idiopathic hypoparathyroidism and extensive paravertebral and ligamentous ossification is reported. The clinical and radiological findings of this, and other reported cases, are discussed and compared with other causes of paravertebral ossification.
Necrotizing fasciitis
Authors: Tehrani M A , Ledingham I M 
Published: December 2008

Summary
The author's experience of fourteen patients with necrotizing fasciitis is reviewed. The pathognomonic feature of this condition is an extensive necrosis of subcutaneous tissue caused by a vicious cycle of infection, local ischaemia and reduced host defence mechanisms. The diagnosis can only be confirmed by immediate exploratory incision.
The reported mortality of 30-40% reflects the inadaquacy of conservative surgery in the treatment of this serious condition. Mortality can be reduced by early recognition followed by radical excision of the necrotic fascia and overlying skin. The preservation and subsequent use of the excised skin has the advantage of economy in the use of donor areas and reduction in morbidity. Hyperbaric oxygen therapy does not halt the spread of the necrotizing process and is not a substitute for radical surgery.
Treatment of acute hepatic encephalopathy with L-dopa
Authors: Chajek T , Berry E M , Friedman G , Abramsky O 
Published: December 2008

Summary
A clinical report of a 30-year-old woman who developed acute hepatic failure in the fifth month of pregnancy is presented. L-dopa administration resulted in a marked improvement in both level of consciousness and electroencephalogram. The literature dealing with L-dopa therapy in hepatic encephalopathy is reviewed.
Gynaecomastia associated with gonadotrophin-secreting carcinoma of the lung
Authors: Fairlamb D , Boesen E 
Published: December 2008

Summary
A 67-year-old man developed dermatomyositis. Investigation revealed an oat cell carcinoma of the lung. When he developed unilateral gynaecomastia this tumour was found to secrete gonadotrophins. The gynaecomastia disappeared after treatment with an anti-oestrogen—tamoxifen. This use of tamoxifen has not previously been described. Partial tumour regression was obtained with several cytotoxic drug regimes. His dermatomyositis responded to this treatment and remains in remission.
Polyradiculoneuritis and Mycoplasma pneumoniae infection
Authors: Holt S , Khan M M , Charles R G , Epstein E J 
Published: December 2008

SummaryA patient with severe Mycoplasma pneumonia developed polyradiculoneuritis and respiratory failure. The acute phase of the illness was complicated by a myocarditis, and recovery of neurological function was slow. Residual left hemidiaphragmatic paralysis was present 1 year after onset of the illness.
Catabolic disorders of complex carbohydrates
Authors: Spranger J W 
Published: December 2008

Summary
The various disorders caused by heritable defects in complex carbohydrate catabolism comprise two groups: (A) The mucopolysaccharidoses, six main and several subtypes are described. (B) The mucolipidoses (oligosaccharidoses), at least nine types being recognized. Whilst most of these are now well defined by clinical and biochemical studies, much of the sequence of events from the intrinsic metabolic error to their clinical features remains obscure. Most are transmitted as autosomal recessive conditions, a mode of inheritance often, as with these disorders, associated with enzymic deficiencies. All patients display the Hurler phenotype, but this, as also the characteristic bone changes, varies widely in severity both within and between the specified types of disease. The radiological abnormalities—dysostosis multiplex—indicate the broad disease complex and are rarely type-specific; diagnostic precision needing knowledge of both clinical and biochemical examinations. In several types mental development is normal and bone changes are mild, so permitting confusion with other forms of bone dysplasia or disease.
Diagnosis of Chagas' cardiomyopathy. Non-invasive techniques
Authors: Puigbó J J , Valecillos R , Hirschhaut E , Giordano H , Boccalandro I , Suárez C , Aparicio J M 
Published: December 2008

Summary
The natural history of Chagas' disease and its manifestations when the heart is involved are detailed clinically and pathologically. Three phases are recognized: the acute phase, lasting from 1-3 months, the latent phase, which may last from 10-20 years, and the chronic phase, which has the most serious manifestations. This phase is subdivided into three clinical stages. An analysis of the varied cardiac manifestations on 235 patients is included.
Maternal genital chlamydial infection as a cause of neonatal conjunctivitis
Authors: Hobson D , Rees E 
Published: December 2008

Summary
Infections of the cervix with Chlamydia trachomatis are common, at least in those groups of sexually active women of child-bearing age who are seen in STD (sexually-transmitted diseases) clinics. Persistent untreated infection presents a hazard to the women themselves during pregnancy and to their infants who may develop chlamydial conjunctivitis. The clinical and laboratory findings in 1009 women and in 103 infants with conjunctivitis are presented. Practical problems of diagnosis and control of neonatal chlaymdial conjunctivitis are described. A possible association between prematurity and chlamydial infection is discussed.
Toxoplasmosis in the perinatal period
Authors: Williams H 
Published: December 2008

Summary
Although many of the fundamental biological features of toxoplasmosis are today well appreciated, the practical problem of prevention of its most serious consequence—disabling congenital disease, remains unsolved. The reasons vary in different communities, but are concerned with detection of the chief mode of spread, assessment of incidence, delineation of vulnerable antenatal women in latently infected populations, and assessment of the risks of therapeutics. The results of some of the approaches to these problems in Scotland are reported and discussed.
The coagulopathy associated with aortic aneurysms
Authors: Gétaz E P , Louw J H 
Published: December 2008

Summary
The authors in this article record their experience with eight-four patients with abdominal aortic aneurysms. Twenty-seven patients (32%) presented with ruptured aneurysms with an overall mortality of 56%. Of the unruptured aneurysms, 67% were operable with a mortality of 5.3%. The highest mortality amongst the patients with ruptured aneurysms was in the group who was shocked. In the group with ruptured aneurysms, of those in whom platelet counts were performed, 50% were abnormally low, and 56% had evidence of abnormal coagulation. Seventy per cent of those with coagulation abnormalities died. In the unruptured group 28.2% had thrombocytopenia but no other abnormalities of coagulation. All patients undergoint aneurysm resection should have a platelet count and a full clotting screen. Therapy should be directed to normalization of the coagulation system.
Perianal Paget's disease
Authors: Lock M R , Katz D R , Parks A , Thomson J P 
Published: December 2008

Summary
Paget's disease involves the ducts of apocrine glands and the overlying epidermis and is considered to be locally neoplastic. It is capable of developing into invasive carcinoma and in this event the prognosis is poor.
The perianal skin may be affected by Paget's disease. This is a rare disorder and the four patients who have been seen with this disease at St Mark's Hospital since 1930 are described.