bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exercise and altitude
Authors: Williams E S 
Published: December 2008

Summary
In studies concerned with the performance at high altitude it is often not possible to separate the effects which are due to hypoxia from those associated with the stress of ascent. Some of the basic observations concerning exercise at high altitude are reviewed and a study is described which was designed to simulate the physical exertion of high altitude mountaineering but performed at altitudes below 1000 m. Some of the changes observed including peripheral oedema might under other circumstances have been ascribed to altitude.
Terminal care: evaluation of in-patient service at St Christopher's Hospice. Part II. Self assessments of effects of the service on surviving spouses
Authors: Parkes C M 
Published: December 2008

Summary
Self-assessments of 34 spouses of patients who had died from cancer at St Christopher's Hospice were compared with self-assessments of a matched group of spouses of patients who had died in other hospitals in the vicinity.
The spouses of St Christopher's patients differed significantly from the comparison group in spending more time at the hospital, talking to more members of staff, other patients and visitors, reporting less anxiety and psychosomatic accompaniments of anxiety before (but not after) the patient's death and being less worried about pain, others hurting or harming the patient or about revealing their own fears to the patient.
The institutional ideals of the Hospice were characterized as: 'The hospital is like a family', ‘Nothing is too much trouble’ and ‘Don't worry’.
Prevention of amino acid losses during peritoneal dialysis
Authors: Jackson M A , Talbot S , Thomas D W , Lee H A 
Published: December 2008

Summary
The addition of amino acid supplements to peritoneal dialysis fluid has been studied in 8 patients with compromised renal function requiring peritoneal dialysis. By the addition of 10 ml of Vamin-glucose solution to each one litre of peritoneal dialysate, amino acid losses were curtailed, no significant alterations occurred in the plasma amino acid concentrations, there were no local complications and no infections were seen. This procedure is recommended as a safe, simple way of keeping a patient in positive amino acid balance during peritoneal dialysis.
Pre-operative intravenous feeding—a controlled trial
Authors: Heatley R V , Williams R H P , Lewis M H 
Published: December 2008

Summary
Seventy-four patients with a pre-operative diagnosis of stomach or oesophageal cancer were entered into a randomized, controlled clinical trial to assess the value of a short course of pre-operative intravenous nutrition. The effectiveness of this treatment was assessed by the clinical course and monitored by means of immune and biochemical profiles.
Pre-operative parenteral nutrition given over a 7–10-day period resulted in a significant reduction in the incidence of postoperative wound infections. Clinical benefit was confined to those patients who had a low serum albumin on admission to hospital. It is doubtful whether this limited benefit justifies the routine use of intravenous feeding, with its attendant hazards, in the pre-operative preparation of patients with upper gastrointestinal cancer.
Chromophobe adenoma of the pituitary with Cushing's syndrome and skin pigmentation
Authors: Sterling N , Hall M R P 
Published: December 2008

Summary
A 76-year-old man with pigmentation and Cushing's disease is described, who was found to have a large chromophobe adenoma of the pituitary. Despite normal skull X-rays the presence of bitemporal hemianopia led to the diagnosis which was later confirmed at post-mortem. Adrenalectomy performed in the treatment of Cushing's disease may be followed by skin pigmentation and an enlarging pituitary tumour (Nelson's syndrome), changes which are commonly attributed to the removal of the negative feed-back mechanism. The spontaneous occurrence of these changes in this patient who did not undergo adrenalectomy supports the view that a pituitary tumour pre-exists in cases of Nelson's syndrome and emphasizes the importance of directing initial treatment to the pituitary.
Adverse reaction to disopyramide
Authors: Dibble J B , Webster N R 
Published: December 2008

SummaryA case is reported where the use of i.v. disopyramide for a supraventricular tachycardia resulted in a more serious ventricular dysrhythmia giving hypotension and this probably contributed to the development of a myocardial infarction. Attention is drawn to the possible risk.
Antifungal therapy, 1978
Authors: Baum G L 
Published: December 2008

Summary
The past 40 years have brought great advances in the knowledge of morphology, immunology and epidemiology of fungal infections in man. Each general advance in the science of medicine has had its counterpart in man's improved facility to deal with these infections therapeutically. Although satisfactory control of fungal infections of man is still lacking, productive paths of investigation seem to have been found and the continued application of rigorous discipline to research efforts should provide even more efficient treatment in the future.
Chronic mucocutaneous candidiasis
Authors: Rosman N 
Published: December 2008

Summary
The pathogenesis of chronic mucocutaneous candidiasis is surveyed. Treatment comprises topical antifungal treatment which is insufficient, systemic antifungal treatment which is often followed by a rapid relapse, and specific immunotherapy with live tissue or transfer factor. Combination of systemic antifungal therapy and immunotherapy seems to be the most promising approach. However, no permanent cure has so far been achieved.
Aspergillus sinusitis
Authors: Grigoriu D , Bambule J , Delacretaz J 
Published: December 2008

Summary
Since 1969, 79 cases of fungal maxillary sinusitis have been diagnosed. Forty-nine were due to Aspergillus fumigatus. There were no underlying diseases which depressed cellular immunity and no patient was receiving immunosuppressive drugs or corticosteroids. Most patients had received antibacterial therapy before the appearance of FMS. Treatment was by surgery, nystatin and econazole.
The role of chemotherapy in the management of fungal endocaridits following homograft valve replacement
Authors: Wain W , Ahmed M , Thompson R , Yacoub M 
Published: December 2008

Summary
Initial intensive combined chemotherapy, with late re-operation when indicated, appears to give better results than immediate excision of the infected valve. The combination chemotherapy used in this series was amphotericin B (up to 100 mg/patient/day) and flucytosine (up to 12 g/patient/day). Serious side effects attributed to this chemotherapy were extremely rare. Candida infections were the most common and the Aspergillus infections were uniformly fatal. Embolectomies and excisions of large mycotic aneurysms were generally successful. Re-operation for late valve malfunction was common and yielded satisfactory results.
Problems in the laboratory assessment of antifungal activity
Authors: Odds F C 
Published: December 2008

Summary
The end points of tube dilution tests for minimal inhibitory concentrations of miconazole and flucytosine against Candida albicans were difficult to evaluate because partial inhibition was noted over a wide range of antifungal concentrations. This problem was not encountered with amphotericin B. Partial inhibition of Candida arose because of reductions in yeast growth rate and of cell yield. Different sizes of yeast inocula were differentially inhibited by the same concentration of antifungal agent.
An in vitro apparatus was described in which miconazole formulated as commercial creams, pessaries and medicated tampons for intravaginal application could be assessed for its inhibitory action in vitro.
Acute spinal epidural abscess. Observations from fourteen cases
Authors: Phillips G E , Jefferson A 
Published: December 2008

Summary
Fourteen cases of acute spinal epidural abscess are analysed. Postoperatively 6 recovered completely, 4 patients recovered enough to allow unaided walking, 2 died and 2 who were paraplegic pre-operatively remained so.
The purpose of this paper is to remind readers of the existence of this condition and to plead for early diagnosis and prompt surgical treatment.
Prolonged survival with adrenal cortical carcinoma
Authors: Shaw K M , Fisher C , Peters J L , Ross E J 
Published: December 2008

Summary
Recurrence of adrenal cortical carcinoma 22 years after first presentation is reported in a 54-year-old woman with Cushing's syndrome. This tumour is normally associated with poor prognosis and prolonged survival is rare. Although the patient had remained well with apparent ‘cure’ in the intervening years, it is suggested that hormonal changes related to the menopause and the development of primary hypoadrenalism stimulated recurrence of malignant activity and return of Cushingoid features.
The electrocardiographic diagnosis of apical infarction
Authors: Talbot Stephen , Kilpatrick David , Weeks Barbara 
Published: December 2008

Summary
Dyskinetic areas of the left ventriculograms of 151 patients were related to electrocardiographic signs of infarction. Apical dyskinesia alone or in combination with anterior or inferior dyskinesia could be associated with inferior and/or anterior infarction patterns. Appreciation of this fact prevents over-estimation of the severity of coronary artery disease from a resting electrocardiogram, showing both ‘anterior and inferior infarction’.
Aetiological factors in infection following open retrograde intramedullary nailing of the femur
Authors: Eid Abulfotooh M 
Published: December 2008

Summary
Thirty-three patients with chronic osteomyelitis of the femur following open retrograde Küntscher intramedullary nailing of the femur were studied to determine possible reasons for the development of infection. In 32 patients the indication for the operation was a closed fracture of the shaft of the femur (recent or malunited) and in one it was to shorten the femur. In 6 patients (18·2%) there was evidence of skin, urinary and upper respiratory tract infection. In 14 patients (42·4%) it was felt that potential infection was present in poor skin overlying the fracture and unhealed laparotomy wounds. Four patients were under the age of 15 years. The operating theatres lacked facilities for room-air exchange, for provision of filtered air or for modern body-exhaust systems. Twenty-two (66·7%) operations were performed by surgeons under training.
Focal fits during chlorambucil therapy
Authors: Naysmith A , Robson R H 
Published: December 2008

Summary
An elderly man receiving chlorambucil for chronic lymphatic leukaemia developed focal fits. The onset and frequency were dose related. There was no evidence of metabolic disturbance or of meningeal leukaemia. Although reported in children and well recognized in animals, chlorambucil-induced fits in an adult have not been previously recorded.
Choreo-athetosis with severe thyrotoxicosis
Authors: Marks Peter , Anderson John , Vincent Richard 
Published: December 2008

Summary
Two cases of severe thyrotoxicosis are described. They both exhibited choreo-athetoid movements which were abolished by successful treatment of the thyrotoxicosis. It is suggested that the tremor of mild thyrotoxicosis is one end of a spectrum at which choreo-athetosis is at the most severe end. A tentative explanation of this hypothesis is given in the discussion.
Extensive alimentary and genital ulceration, mesenteric cysts, malabsorption, T-lymphocyte depletion and subsequent anaplastic bladder carcinoma
Authors: Bateson M C , Beck J S , Clark J , Baxby K , Bouchier Ian A D 
Published: December 2008

Summary
The occurrence of several unusual disorders in a single patient prompted the question as to whether these may all have been part of a single syndrome, and the possible differential diagnosis is discussed in detail.
The case was thought to be an instance of acquired T-lymphocyte depletion leading to the development of premature malignant disease.
Testicular feminization syndrome: a report of three Ethiopian patients and a brief review
Authors: Tsega E , Damtew B 
Published: December 2008

Summary
The clinical features of 3 Ethiopian patients presenting with the complete syndrome of testicular feminization are described. All 3 were seen because of primary amenorrhoea. At laparotomy, one patient had testes located intra-abdominally, a second lodged in the inguinal canals and a third as masses in the labia majora. Also, one of these patients had bilateral inguinal herniae, a usual feature of this syndrome. Since the incidence of malignancy is high among individuals with undescended testes, they were removed in 2 patients. In the third patient, however, the testes were not removed because of delay in development of secondary sex characteristics. The literature on testicular feminization is also briefly reviewed.
Low salt diet and frusemide in the treatment of hypertension
Authors: George C R P , Burke A M 
Published: December 2008

Summary
The BPs of 86 of 100 severely hypertensive patients were controlled by measures designed to reduce total body sodium, namely a low salt diet plus the addition of incrementally increased frusemide treatment if diet alone was inadequate. Control of hypertension was maintained over prolonged periods of time in 70 of the patients. Among the 14 who failed to respond adequately, mean plasma renin level was higher (when tested) than in those who did respond adequately, and renal artery stenosis was discovered in 2. Supplementary propranolol controlled the hypertension in 8 of the inadequate responders.
Galactorrhoea following surgical procedures to the chest wall: the role of prolactin
Authors: MacFarlane I A , Rosin M D 
Published: December 2008

Summary
Normal prolactin levels were found in two cases of galactorrhoea following surgical procedures to the chest wall and one was treated successfully with bromocriptine. Studies were then carried out to test the claim that chest-wall injury is one of the common causes of hyperprolactinaemia. Serum prolactin levels were measured before and after thoracotomy in 7 patients, following traumatic rib fractures in 8 patients and after burns to the chest in one patient. No evidence was found to suggest that sustained hyperprolactinaemia follows chest wall surgery or injury, and the role of prolactin in the condition ‘chest wall injury’ galactorrhoea is discussed.
Haemorrhoids--objective measurement of proctoscopic appearances
Authors: Mosley J G , Galland R B , Saunders J H , Spencer J 
Published: December 2008

Summary
The proctoscopic diagnosis of haemorrhoids may be influenced by the surgeon’s knowledge of the presence or absence of associated symptoms. In this study, an observer with no knowledge of the history, was used to check the surgeon’s proctoscopic findings in 12 asymptomatic controls, and 24 symptomatic patients on 2 occasions, the latter group undergoing McGivney rubber band ligation.
There was very good correlation between the findings of the surgeon and the observer, indicating a lack of ‘historical bias’. The documentation method designed to allow this comparison proved sufficiently accurate and reproducible to enable a correlation between haemorrhoidal mass and symptoms. Relief of symptoms after treatment correlated well with an objective reduction in haemorrhoidal mass.
Hypercalcaemia in malignant lymphoma
Authors: Greaves M , Hancock B W 
Published: December 2008

Summary
Three patients with malignant lymphoma complicated by hypercalaemia without radiological bone abnormality are described. The medical literature has been reviewed and the possible underlying mechansims discussed. The early diagnosis of this potentially fatal complication is important since this may respond (together with the underlying disease) to appropriate chemotherapy.
Recurrent insulin resistance
Authors: Leatherdale B A , Ingram D A , Dixon K 
Published: December 2008

Summary
The patient described developed 2 separate episodes of insulin resistance and on each occassion daily administration of soluble insulin in a daily dose of 980 units failed to achieve satisfactory control. Both episodes responded to steroid therapy. The maximum binding capacity of the serum for insulin was measured on each occasion; in the first episode it was grossly elevated whereas the second time the level was unremarkable. She is currently free of diabetic complications and satisfactorily controlled on a sulphonylurea and diet.
Primary hyperparathyroidism in a patient with Conn’s syndrome
Authors: Fertig A , Webley M , Lynn J A 
Published: December 2008

Summary
A 61-year-old patient with treated Conn’s syndrome due to multiple bilateral adrenocortical adenomata developed primary hyperparathyroidism. At operation, a parathyroid adenoma and a thyroid colloid nodule were found. Although adrenocortical adenomata and hyperplasia are common findings in multiple endocrine adenopathy type I, they are only rarely functional. Hypertension is often associated with primary hyperparathyroidism, but the relationship is usually unexplained.
Recurrent oculomotor palsy due to haemorrhage in pituitary adenoma
Authors: Mohanty S 
Published: December 2008

Summary
Haemorrhage in pituitary adenoma is an unusual cause of recurrent oculomotor palsy. Three episodes of right oculomotor palsy are reported from a patient having haemorrhage in pituitary adenoma. Early operation and decompression of haemorrhagic pituitary adenoma should be performed so that vision may be preserved and recovery of oculomotor palsy be assured.
Clostridium difficile isolated from the stool of a patient with pseudomembranous colits following ampicillin plus flucloxacillin (Magnapen) therapy
Authors: Morgan R J , Gemmell C G , Lee F D , Lang W , Russell R I 
Published: December 2008

Summary
A case is reported of the isolation of Clostridium difficile from the stool of a patient with antibiotic-related pseudomembranous colitis.
Abdominal aortic aneurysm--the forgotten diagnosis?
Authors: Contini S , McMaster P 
Published: December 2008

Summary
A review of all cases of abdominal aortic aneurysm presenting to Addenbrooke’s Hospital, Cambridge, in a 4-year period revealed that there were 118 such patients and confirmed the relatively low operative mortality for elective aneurysmal surgery (6.6%) compared with the high mortality (66.6%) for ruptured or leaking abdominal aneurysm. In only 50% of the cases was the correct diagnosis made during the lifetime of the patient; nor was the correct diagnosis always made after admission to hospital.
The need for an early and accurate diagnosis of abdominal aneurysms is stressed and an increased awareness of this condition, based on well established clinical features, would undoubtedly reduce the overall mortality.
A common source outbreak of Acinetobacter pulmonary infections traced to Wright respirometers
Authors: Cunha B A , Klimek J J , Gracewski J , McLaughlin J C , Quintiliani R 
Published: December 2008

Summary
Over a 30-day period, Acinetobacter calcoaceticus var. antiratus was the responsible pathogen for hospital-acquired pneumonia in 10 patients, and resulted in the colonization of the upper respiratory tract in an additional 9 patients. Wright respirometers contaminated by this organism were shown to be the common source for the outbreak as indicated by the recovery of a single serotype (8J), the inability to recover Acinetobacter from any other environmental source, and the demonstration that moisturized Wright respirometers are capable of "aerosolizing" fluids containing Acinetobacter.
Alveolar hydatid disease of the liver with Budd-Chiari syndrome
Authors: Khuroo M S , Datta D V , Khoshy A , Mitra S K , Chhuttani P N 
Published: December 2008

Summary
Alveolar hydatid disease in man is the intermediate stage in the life cycle of the tapeworm Echinococcus multilocularis. This is a rare disease restricted to very few areas of the world. The occurrence of this disease in India is now described for (so far as the authors are aware) the first time. Some unusual features of the disease are highlighted in this patient. The hepatic lesion had infiltrated into the right atrial wall resembling an atrial tumour. The ostium of the inferior vena cava was occluded, causing Budd-Chiari syndrome. The radiological and haemodynamic study of the hepatic outflow tract in this disease are documented.
The use of cross-sectional echocardiography in a general hospital
Authors: Brown A K , Anderson V 
Published: December 2008

Summary
Three hundred and five patients routinely referred to a general hospital were surveyed to assess the advantages of cross-sectional echocardiography (CSE) over the conventional M mode method. CSE provided a dynamic display of the movement of the heart, particularly left ventricular function, and facilitated the location of cardiac structures. It was valuable in assessing the degree of mitral stenosis and the type of left ventricular outflow obstruction. Mitral valve prolapse, pericardial effusion, intracardiac tumours and congential heart disease were more easily diagnosed than by M mode techniques, but the origin of the basal systolic murmur still remained a problem. It was concluded that the 2 systems were complementary, and that CSE provided important additional information which improved the diagnostic capability of echocardiography.
Survial from acute renal failure with and without multiple organ dysfunction
Authors: Routh G S , Briggs J D , Mone J G , Ledingham I McA 
Published: December 2008

Summary
A 10-year retrospective analysis has been carried out of 114 patients dialysed for acute renal failure. Fifty-eight patients, predominantly suffering from multiple organ failure, required treatment in an Intensive Therapy Unit (ITU); 56 less severely ill patients were treated in a Renal Unit. Overall survival in the former group was 36% and in the latter group 63%.
In the first 5 years of the study, survival in the ITU patients was 31% and in the second 5 years, was 38% in spite of a trend towards increased severity of illness. These results challenge the view that haemodialysis is rarely worth-while in patients with multiple organ failure, and suggest that current management techniques have improved prognosis. The most important adverse factors continue to be old age, sepsis and gastrointestinal disease.
Acute leukaemia in siblings
Authors: Harrison J F , Lilleyman J S 
Published: December 2008

Summary
Unequivocal lymphoblastic leukaemia in a 4-year-old boy was followed 3 years later by equally unequivocal myeloblastic leukaemia in his 20-year-old brother. The boy achieved complete remission and remains well more than 6 years later whereas his brother failed to respond to treatment and died after 5 months. The parents and 3 remaining siblings showed no recognized features suggesting a constitutional predisposition to leukaemia despite thorough investigation.
LSD ‘flashback’ as a cause of diagnostic error
Authors: Smith J A , Walters G , Johnston D 
Published: December 2008

Abstract
An emaciated, but otherwise physically normal young man presented with an acute psychosis resembling hallucinogenic drug abuse. His behaviour was so strange that the underlying pathology of severe pyloric stenosis was only detected when a chance measurement of urea and electrolytes was made, revealing gross biochemical abnormalities. His abnormal mental state persisted for more than one week and an LSD ‘flashback’ was postulated as the cause of the prolonged psychosis
Angioneurotic oedema and urticaria following hydrocortisone--a further case
Authors: Ashford R F , Bailey A 
Published: December 2008

Abstract
It is still not commonly realized that immediate hypersensitivity reactions to hydrocortisone can occur. A rare case is reported which illustrates the need for caution when using this drug in atopic subjects. Ideally, parenteral hydrocortisone should only be used where facilities for resuscitation are available.