bluuebunny/crossref_metadata_2025_split huggingface dataset:
Features of a successful therapeutic fast of 382 days' duration
Authors: Stewart W K , Fleming Laura W 
Published: December 2008

Summary
A 27-year-old male patient fasted under supervision for 382 days and has subsequently maintained his normal weight. Blood glucose concentrations around 30 mg/100 ml were recorded consistently during the last 8 months, although the patient was ambulant and attending as an out-patient. Responses to glucose and tolbutamide tolerance tests remained normal. The hyperglycaemic response to glucagon was reduced and latterly absent, but promptly returned to normal during carbohydrate refeeding. After an initial decrease was corrected, plasma potassium levels remained normal without supplementation. A temporary period of hypercalcaemia occurred towards the end of the fast. Decreased plasma magnesium concentrations were a consistent feature from the first month onwards. After 100 days of fasting there was a marked and persistent increase in the excretion of urinary cations and inorganic phosphate, which until then had been minimal. These increases may be due to dissolution of excessive soft tissue and skeletal mass. Prolonged fasting in this patient had no ill-effects.
Appendicitis, fibre intake and bowel behaviour in ethnic groups in South Africa
Authors: Walker Alexander R P , Richardson Barbara D , Walker B Faith , Woolford Atholie 
Published: December 2008

SummaryInformation on appendicectomy-prevalence was secured on 15,317 16–20-year-old South African pupils and students—Negroes, Coloureds (Eurafricans), Indians and Caucasians. Data were also obtained on crude fibre-intake, frequency of defaecation, and transit-time of digesta.Among students, 18–20 years, appendicectomy was very uncommon in rural Negroes (0·5%) and periurban Negroes (0·9%), slightly more common in urban Negroes (1·4%), but very common in Caucasians (16·5%); prevalences in Coloured and Indian groups were low (1·7 and 2·9%). Rural Negroes had a far larger fibre-intake, greater frequency of defaecation, and much shorter transit-time; yet, in the four ethnic groups in urban areas, despite wide differences in appendicectomy-prevalence, data on these variables were similar. Differences in other aspects of the bowel milieu intérieur must therefore be sought.Corresponding studies were made on 1325 Caucasian pupils in Homes; their diet is less sophisticated (in respect of fibre, sugar and fat-intakes) than that of the general population. Pupils had slightly greater defaecation-frequency, lesser transit-time, and an appendicectomy-incidence only 23% of that of an appropriate control-group.The conclusion is reached that the causes of appendicitis are wholly environmental.
Diabetes insipidus associated with an empty sella turcica
Authors: Matisonn R , Pimstone B 
Published: December 2008

Summary
A patient with severe diabetes insipidus for 14 years was found to have an enlarged and eroded sella turcica with greatly reduced pituitary tissue on pneumo-encephalography. It is suggested that the permanent diabetes insipidus may have resulted from growth of an intrasellar tumour, which subsequently infarcted spontaneously. Thyroid and pituitary-adrenal function nevertheless remained good, which accounts for persistence of the diabetes insipidus.
Haemolytic anaemia in myelomatosis
Authors: Pengelly C D R , Mondal B K , Barua A R 
Published: December 2008

Summary
A case of IgA myelomatosis with a haemolytic anaemia is described. No auto-antibodies could be found and the mechanism of the haemolysis was obscure.
Haemolytic anaemia is a rare complication but a search of the literature has revealed a few cases with a comparable shortening of red cell life-span, most without auto-antibodies but some with a positive Coombs' test.
Some veterinary aspects of the eradication of brucellosis
Authors: McDiarmid A 
Published: December 2008

Summary
An outline is given of some criteria which must be met for the eradication of brucellosis in this country. The incidence of this zoonosis and the financial loss it causes are considered, along with the ultimate benefits to be derived by the farming industry and public health from its eventual eradication.
Diagnostic tests, vaccination policy, financial incentives, educational methods, the question of notification, and the necessity for full collaboration between the medical and veterinary professions are discussed in relation to the problem as a whole.
The debates in the House of Commons and the House of Lords are mentioned as historic landmarks in the campaign against brucellosis in this country, and the progress of the present eradication scheme is summarized.
Veterinary aspects of rabies
Authors: Blamire R V 
Published: December 2008

Summary
Rabies occurs in domestic animals and wildlife in most parts of the world. Affected mammals invariably die and the disease is greatly feared by man. Control measures can be effective in domestic animals but are difficult to apply in situations where wildlife is affected. Wildlife rabies is spreading southwards in Europe. New legislation has recently been introduced to strengthen the safeguards against importing the disease into Great Britain. Persons should be made aware of this legislation and the dangers of illegally introducing susceptible animals to this country.
A brief review of anthrax in domestic animals
Authors: Smith I M 
Published: December 2008

Summary
Although there exists in the U.K. a high degree of control of industrial and agricultural anthrax in man and anthrax in animals originating either from animal products or from materials contaminated by contact with them, total control of anthrax in this country seems unlikely to follow until the disease is eliminated from livestock in the enzootic areas abroad. This view rests on the probability that any contamination of agricultural land by anthrax spores is unlikely to be permanent in Britain.
Successful treatment of collagenous sprue with combination of prednisolone and gluten-free diet
Authors: Holdstock D J , Oleesky Samuel 
Published: December 2008

Summary
A case is described of adult coeliac disease with subepithelial collagen in a jejunal biopsy (‘collagenous sprue’) which responded well to treatment with prednisolone in addition to a gluten-free diet. The indications for corticosteroid treatment in adult coeliac disease are discussed in the light of the findings. It is suggested that collagenous sprue may represent the most severe form of adult coeliac disease, and the presence of sub-epithelial collagen in a jejunal biopsy may be the strongest indication for treatment with the combination of a gluten-free diet and corticosteroids.
The management of malignant pleural effusion
Authors: Sutton M L 
Published: December 2008

Summary
Several effective methods exist for the control of malignant pleural effusion: the most effective is iodized talc poudrage, but the relatively short survival times associated with malignant effusions from bronchogenic carcinomas make less elaborate methods more appropriate. 70–80% of malignant effusions can be controlled by intrapleural instillation of Mustine or the antimalarial drug quinactine. Preliminary removal of as much fluid as possible is an important contributory factor to success. Radioactive colloidal gold is obsolete in pleural effusions.
Respiratory syncytial virus infections
Authors: Gardner P S 
Published: December 2008

Summary
RS virus was isolated from 10·5% of the specimens examined in the MRC/PHLS hospital survey and from 0·9% of those in the general practice survey. The highest isolation rates were in infants with lower respiratory tract infections. Dyspnoea, wheezing and cough were the predominant clinical features. The differences in the rates between hospital and general practice and newer methods of diagnosis of RS virus infection are discussed.
Parainfluenza virus infections
Authors: Clarke Suzanne K R 
Published: December 2008

Summary
Parainfluenza viruses types 1, 2 and 3 were found in 2·5%, 0·8% and 1·6% respectively of patients examined in the MRC/PHLS general practice survey and in 2·2%, 0·7% and 2·7% of those in the hospital survey. Type 3 infections were found earlier in life than type 1, while type 2 infections tended to be detected in older children. These viruses were found most frequently in croup and laryngitis but were also common causes of coryza and lower respiratory infections, especially in general practice. The epidemiology and diagnosis of parainfluenza virus infections are discussed briefly.
Rhinovirus infections
Authors: Higgins P G 
Published: December 2008

Summary
One hundred and seventy-five rhinoviruses were isolated from 4·4% of patients in the general practice survey and 44 from 1·8% of children in the hospital survey. Isolations were made at all times of the year and although isolated most frequently from cases of common cold rhinoviruses were also found in association with other respiratory syndromes.
Influenza virus infections
Authors: Grist N R 
Published: December 2008

Summary
Ninety-six strains of influenza A and 113 influenza B were found in the two MRC/PHLS surveys. In the general practitioner survey the majority of strains were isolated from cases diagnosed as influenza but in hospital most came from cases diagnosed as having other respiratory infections. In the latter survey isolation rates were higher in upper respiratory tract infection than in lower ones but in the general practice survey this trend was reversed. Influenza-like symptoms tended to increase with age, while coryza and vomiting was commoner in the younger age groups. The frequency of influenza virus infections found in the survey is compared with those found in Glasgow over the last decade and their effect on the incidence of lower respiratory tract infection discussed.
The management and outcome in children admitted to hospital
Authors: Court S D M 
Published: December 2008

Summary
2418 children aged 0–14 years were admitted to hospital with respiratory infections; 2396 recovered and 22 (0·9%) died.
Previous respiratory illness had been experienced by 5·6%; 2·6% had congenital heart disease and 0·6% cystic fibrosis.
Antibiotics were given in every category of illness; the frequency varied from 68% in colds to 97% in pneumonia. Oxygen was given to 14% of children with croup, 29% with bronchiolitis and 13% with pneumonia. No child with upper respiratory infection or croup died. The case mortality in the 1295 children with lower respiratory infections was 1·7%: 0·6% in bronchitis, 0·7% in bronchiolitis, and 3·1% in pneumonia.
Pathogenic infective agents were isolated in half the deaths; and in 36% predisposing malformations or disease were present.
With a limited study of management and outcome deductions must be made with caution. It suggests, however, that therapy based on understanding of the infective agents and the respiratory dysfunction to which they give rise is not as yet generally applied.
Further observations from an experience of 660 cases of stereotactic tractotomy
Authors: Knight Geoffrey 
Published: December 2008

Summary
A study of the results of some 660 cases of stereotactic tractotomy shows that these have been consistent through a 12-year period, more than 50% of cases of resistant depression can be set free of medical care and another 25% at least can be improved. Comparable results are also obtained in obsessional illness and anxiety states, particularly those in which there is a depressive component.
The original localization of the target site described in 1964 has not required modification but pathological studies and anatomical research has revealed new features concerning the anatomical connections affected by this operation.
The lesion beneath the head of the caudate nucleus does not extend quite so far as the substantia innominata and should therefore be called subcaudate tractotomy. Connections from the anterior cingulate region and posterior orbital cortex are severed at this site but amygdalo-hypothalamic fibres are not interrupted directly, however; the projection from the amygdala to the dorsal median nucleus sends a radiation to the posterior orbital cortex which is divided here. In addition, important projections from frontal cortex to hypothalamus which bring the external milieu into association with the limbic system pass downwards through the target area beneath the head of the caudate nucleus and are also divided at this point, the localized lesion, therefore, produces a marked effect upon fibres which are concerned in emotional activity. The wellnigh specific effect in cases of depression raises the question whether the operation acts by modifying the intensity of emotional reactivity through limbic connections or has a more specific effect upon the cause of abnormal reactivity through fronto-hypothalamic connections exerting an influence on monoamine production in the hypothalamus.
Stereotactic limbic leucotomy—a follow-up study of thirty patients
Authors: Kelly Desmond , Mitchell-Heggs Nita 
Published: December 2008

SummaryThis prospective study reports the results of stereotactic limbic leucotomy at a mean of 17 months following surgery. Clinical improvement had occurred in twenty-four (80%) of the patients, fifteen (50%) of them being symptom free or much improved. Fourteen of sixteen patients suffering from obsessional neurosis were improved, as were five of seven with chronic anxiety and the degree of improvement at 17 months was superior to that at 6 weeks. Psychometric scores of anxiety, obsessions and neuroticism were all significantly reduced at 17 months. The mean depression scores were also significantly reduced and this result was superior to that reported in a previous study of ‘free-hand’ operations.Adverse effects were not a problem following limbic leucotomy. Emotional blunting, disinhibition, post-operative epilepsy and excessive weight gain were not encountered, and intelligence was unaffected by the operation. Limbic leucotomy is a much more limited and precise procedure than older ‘free-hand’ operations which we have studied, but its therapeutic effects are comparable and in obsessional neurosis, superior.
Blood volume studies in chronic obstructive non-specific lung disease: a comparison of the bronchitic and emphysematous patients
Authors: Cocking J B , Darke C S 
Published: December 2008

Summary
Blood volume measurements were made on forty-five patients with chronic obstructive non-specific lung disease. Thirty patients were considered to have the features of predominant emphysema, and fifteen had more bronchitic characteristics. Mean red cell volume was 100·8% of the predicted normal volume in the emphysematous group, whereas that of the bronchitic patients was 121·8% predicted. The emphysematous patients were not on average polycythaemic, because they were both less hypoxic and also had a subnormal polycythaemic response to hypoxia; in constrast a quantitatively normal response occurred in the more bronchitic subjects. The pathogenesis of the subnormal response occurring in the emphysema group is discussed. Mean plasma volume was similar but slightly reduced in both groups, being 92·1% predicted in the emphysema patients and 95·7% predicted in the remainder.
Retroperitoneal haemorrhage and neuropathy complicating anticoagulant therapy
Authors: Curry P V L , Bacon P A 
Published: December 2008

Summary
Nine cases of retroperitoneal haemorrhage complicating anticoagulant therapy are reported. Six cases were receiving heparin for myocardial infarction: an incidence of 4·3% of patients on such treatment. All the cases presented with pain, six had neurological involvement and one patient died.
The incidence of this complication is higher than previously noted. Retroperitoneal haemorrhage requires a high index of clinical suspicion for early diagnosis and treatment if serious sequaelae are to be prevented.
Solitary cyst of the liver presenting as an abdominal emergency
Authors: Sood S C , Watson A 
Published: December 2008

Summary
A case of torsion of a solitary non-parasitic cyst of the liver presenting as an acute abdominal emergency is described. Reference is made to the pathogenesis of such cysts, which occur infrequently and only rarely present with complications. A review of previous reports of complications in such cysts is presented.
Use of the 198Au liver scan in assessing the therapeutic effect of penicillamine in Wilson’s disease
Authors: Chajek T 
Published: December 2008

SummaryIn a 14-year-old girl Wilson’s disease was found to be the etiologic basis of an active liver cirrhosis diagnosed months previously. Specific therapy with D-penicillamine caused remarkable clinical and biochemical improvement. Repeated liver scans using 198Au revealed increased liver uptake of the 198Au while the size of the spleen decreased. It is proposed that repeated liver scintiscanning may provide another easily performed and safe test for evaluation of the effect of therapy in these patients.
The retail pharmacist
Authors: Haberfield G R 
Published: December 2008

Summary
Though the exclusive use of approved names would simplify dispensing by a retail pharmacist, present standards of equivalence are not adequate to ensure that in these circumstances the patient would always receive the preparation best suited to his need. In the present situation, the decision about brands cannot be left to the retail pharmacist and doctors should therefore identify a particular product in their prescriptions by using the trade name.
Serum cholesterol and serum triglycerides in mental retardation
Authors: Lawlor T , O’Hara F , Birtwistle D T 
Published: December 2008

Summary
Two hundred and thirty-four mentally retarded adult patients, 116 female and 118 male, whose ages ranged from 16 to 81 years had their fasting cholesterol and triglyceride concentrations determined whilst their blood was being taken for routine investigations during a seven week period. These values were compared with those of a healthy adult population who were being screened for these values at the same laboratory. The values of both cholesterol and triglyceride concentrations were found to be significantly lower in the hospital population. A survey of the diet of the hospital patients failed to account for these low values. No significant difference was found between epileptics and non-epileptics, mongols and non-mongols.
Parkinsonism and transient bilateral ptosis in systemic lupus erythematosus
Authors: Teoh P C , Richard A T Ng , Wong P K 
Published: December 2008

Summary
Many neurological abnormalities have been described in systemic lupus erythematosus (SLE), but transient bilateral ptosis and parkinsonism are rarely encountered. This paper describes a young Malay girl with SLE who develops psychosis, bilateral ptosis and parkinsonism during an exacerbation of her illness. These neurological features disappeared after adequate treatment with cyclophosphamide. Though the pathogenesis of these neurological abnormalities is not clearly known, it is likely that transient bilateral ptosis is due to myoneural dysfunction not unlike that of myasthenia gravis. As for parkinsonism, it can probably be explained on the basis of ‘vasculitis’ of the basal ganglia leading to microinfarcts and encephalomalacia.
Endoscopy in achalasia
Authors: Roesch W 
Published: December 2008

Summary
In achalasia oesophagoscopy should be used to rule out definitely carcinoma of the cardia involving the myenteric plexus of the lower oesophageal sphincter. An easy passage of the instrument through the narrow terminal segment is characteristic but not always possible due to extreme distortion. Syncopal attacks are rarely encountered.
Cardiac involvement in idiopathic haemochromatosis and the effect of venesection
Authors: Jachuck S J , Rai G S , Fossard C 
Published: December 2008

Summary
Eight patients with idiopathetic haemochromatosis have been followed up for 2-15 years to study their cardiac state and the effect of repeated venesection in treating their disability. Five of these patients had no clinical cardiac disability. Serial electrocardiographs were done in five patients and significant abnormality was seen in three of them at the time of admission. After removal of excess iron the cardiac disability progressed in two patients and regressed in one other. One of these presented with palpitations and was found to have Wolff-Parkinson-White syndrome. Not one of our patients developed cardiac failure and the two deaths which occurred were the result of hepatic failure. At autopsy one of them was found to have metastases in the myocardium from a hepatoma, a complication we have not encountered in previous reports.
Primary acquired hypogammaglobulinaemia and auto-immune thyroiditis
Authors: Hilton Angela M , Doyle L 
Published: December 2008

SummaryA patient with primary acquired hypogammaglobulinaemia and auto-immune thyroiditis is presented, an association which has not been described previously. The role of disturbances of cell-mediated immunity in the pathogenesis of the thyroid lesion is discussed.
Survival in renal cortical necrosis due to snake bite
Authors: Ramachandran S , Perera M V F 
Published: December 2008

Summary
A case of acute renal cortical necrosis following snake bite is reported. The case illustrates that survival is possible in renal cortical necrosis following snake bite and that even in the presence of anuria or prolonged oliguria active treatment of the acute renal failure following snake bite is indicated.
Viral infections of the liver in childhood
Authors: Zuckerman A J 
Published: December 2008

Summary
Hepatitis A and hepatitis B viruses and yellow fever virus are the most important causes of acute inflammation of the liver. Hepatitis is also frequently associated with other common viral infections such as cytomegalovirus (human herpesvirus 5) and EB virus (human herpesvirus 4). In addition, there are a number of viruses which occasionally display increased hepatotropism producing a clinical picture which is similar to classical hepatitis.
Genetic aspects of the Pi system
Authors: Cook P J L 
Published: December 2008

Summary
α1-Antitrypsin can be shown to be polymorphic by starch gel electrophoresis. At present 19 different alleles are known which are inherited in an autosomal pattern and constitute the Pi system. In one phenotype called Pi type ZZ there is a virtual deficiency of plasma α1-antitrypsin and about 230 such babies are expected in England and Wales every year.
Neonatal hepatitis syndrome and alpha-1-antitrypsin deficiency: an epidemiological study in South-East England
Authors: Cottrall K , Cook P J L , Mowat A P 
Published: December 2008

Summary
A prospective epidemiological study of the Neonatal Hepatitis Syndrome in S.E. England showed Alpha-1-Antitrypsin Deficiency (Pi ZZ) to be present in seven out of fifty-two patients. Data are considered from these seven patients, and from a further six cases from outside this area. The nature of acute illness, pathological changes on early liver biopsy, and short-term prognosis show considerable variability, but in general the hepatitis is more severe in patients with Alpha-1-A.T. deficiency than in those in whom no aetiological factor was found.