bluuebunny/crossref_metadata_2025_split huggingface dataset:
Naevus striatus unguis
Authors: Liddell K , Catterall M D 
Published: December 2008

Summary
Three patients presented with an asymptomatic longitudinal pigmented band in a nail. A junctional melanocytic naevus in the nail matrix was suspected; this was confirmed by histological examination in each case. Differential diagnosis and management are discussed, together with a review of the literature. Local excision is considered to be the treatment of choice.
Prostaglandins and the lung
Authors: Morley J 
Published: December 2008

Summary
Evidence exists implicating prostaglandins as mediators of asthma and of chronic inflammation in the lung. In addition to their spasmogenic effects, PGs are also potent in vitro regulators of mediator secretion by basophils, mast cells, or lymphocytes. These regulatory effects of E-series PGs may have considerable significance in drug design and evaluation in both asthma and chronic inflammation.
Some clinical, social and psychological characteristics of migraine subjects in the general population
Authors: Crisp A H , McGuinness B , Kalucy R S , Ralph P C , Harris G 
Published: December 2008

Summary
A very careful enquiry within adequate sub-samples of the general population of a market town and its surrounding villages has revealed (a) no special relationship between so-called tension headaches and migraine as defined; (b) a two-year prevalence of migraine more or less similar to that reported elsewhere, i.e. approximately 10% of males and 25% of females being affected; (c) a greater prevalence of migraine amongst professional and managerial classes; (d) similar clinical features to those commonly described before; (e) that approximately 50% of the subjects had consulted their general practitioners and/or other doctors on account of the headache; (f) that actual migraine female subjects are significantly more anxious and depressed than normal subjects whilst at the same time reporting themselves as more sociable than others; they also complain more of other functional somatic disturbance; (g) that such differences were not always detected in the smaller male sample who showed similar tendencies only in respect of anxiety and other somatic complaint; (h) that subjects who described themselves on the questionnaire as having migraine but who were not on careful scrutiny always found to have it, showed as a population a higher degree of neurotic disability, including phobic avoidance patterns, than the population who actually have the condition.
This study supports the view that migraine is associated with certain psychological characteristics, especially amongst females. The profile is that of undefended dysphoria coupled with a definite tendency to be outgoing and engaging in the world. The price is migraine and other somatic complaint.
Severe meprobamate poisoning: successful treatment with haemoperfusion
Authors: Crome P , Higgenbottom T , Elliott J A 
Published: December 2008

Summary
Charcoal haemoperfusion used to treat a 56-year-old woman who had taken a very large overdose of meprobamate was followed by fully recovery. The plasma clearance of meprobamate was 153 ml/min and this compares favourably with values obtained for haemodialysis. The indications for haemoperfusion are reviewed.
Carcinoma of the lung presenting with a myeloproliferative disorder. A report of two patients
Authors: McIllmurray M B , Ryrie D R , Fletcher J 
Published: December 2008

Summary
A myeloproliferative disorder, similar to agonogenic myeloid metaplasia, has been described in patients with cancer. Two patients with carcinoma of the lung are described who presented with such a disorder but in whom there was no evidence of bone marrow fibrosis and in one of whom there was no evidence of bone marrow infiltration by tumor. The possible mechanism of this association is discussed.
Abdominal aortic aneurysms. Ultrasonic measurement of the transverse diameter and its prognostic significance in the light of pathological observations
Authors: McGregor J C 
Published: December 2008

Summary
The risk of rupture of an abdominal aortic aneurysm is related to size. Pathological observations suggest that there is usually an asymmetric formation of mural thrombus in the aneurysm sac and that rupture occurs more commonly through the lateral walls where there would be less. Ultrasonic estimation of the transverse diameter of an aneurysm offers a useful clinical method of monitoring size and likelihood of rupture.
Recovery of hypothalamic-pituitary-adrenal function after intermittent high-dose prednisolone and cytotoxic chemotherapy
Authors: Wilson K S , Gray C E , Lidgard G P , Parker A C 
Published: December 2008

Summary
Hypothalamic/pituitary and adrenal (HPA) function was assessed in ten patients who received intermittent high-dose prednisolone and cytotoxic chemotherapy for 5-40 months. Standard insulin hypoglycaemia (IHT), thyrotrophin-releasing hormone and tetracosactrin tests were performed 36 hr after the last dose of prednisolone and subsequently 10 days—52 weeks after completion of all chemotherapy. In the first tests there was evidence of impaired hypothalamic-pituitary function judged by peak adrenocorticotrophic hormone (ACTH), growth hormone (GH) and thyrotrophin (TSH) responses, and corresponding plasma corticosteroid responses were sub-normal in five patients. In the final IHTs, seven patients had persistently subnormal ACTH responses but all the corresponding plasma corticosteroid responses returned to normal. Mean peak corticosteroid responses to insulin and tetracosactrin and peak GH responses were significantly greater than in the first tests. Such chemotherapy regimens may have prolonged effects on hypothalamic/pituitary function but the demonstration of normal corticosteroid responses to hypoglycaemia and tetracosactrin indicates that these patients' stress responses will be normal as early as 10 days after treatment is stopped.
Pseudomonas pneumonia in status asthmaticus
Authors: Mungall I P F , Jackson E W , Dibble J B 
Published: December 2008

Summary
A case of Pseudomonas pneumonia developing in a patient on treatment for status asthmaticus is described. The use of broad spectrum antibiotics, high dose steroids and humidifiers or nebulizers may be of aetiological importance. Pseudomonas pneumonia is increasing in prevalence although it has not previously been described in association with status asthmaticus. It carries a high mortality and its prevention is, therefore, clearly important.
Left ventricular function in ischaemic heart disease. A review
Authors: Khattri H N , Raphael M J , Sharma B , Steiner R E , Goodwin J F 
Published: December 2008

Summary
The clinical significance of the abnormalities seen at left ventriculography in ischaemic heart disease is discussed. Aneurysms may be recognized when left ventriculography is combined with coronary arteriography to show the characteristic obliteration of the supplying artery. Localized areas of abnormal contraction seen at rest are almost certainly indicative of infarcts. Similar areas provoked by exercise or atrial pacing represent the site of acute ischaemia. The ischaemic ventricle may be recognized by abnormal response to exercise, even in the absence of angina. The abnormal response may be reversed by successful revascularization surgery.
Obsolete but dangerous antacid preparations
Authors: Robson R H , Heading R C 
Published: December 2008

Summary
One case of acute hypercalcaemia and two of recurrent nephrolithiasis are reported in patients who had regularly consumed large amounts of calcium carbon-ate-sodium bicarbonate powders for more than 20 years. The powders had been obtained from pharmacists unknown to the patients' medical practitioners. It is suggested that these preparations were responsible for the patient's problems, and that such powders should no longer be freely obtainable.
Phaeochromocytoma with nocturnal elevation of blood pressure
Authors: Yamamoto T , Jo T , Ishibashi T 
Published: December 2008

Summary
A 47-year-old woman with phaeochromocytoma showed blood pressure changes characterized by the regular appearance of hypertension at night. The urinary excretion of catecholamines and their metabolites showed augmentation roughly parallel with the elevation of the blood pressure. During normotensive periods, the urinary excretion of catecholamines and their metabolites was elevated. The findings suggested that the pressor effect of catecholamine hypersecretion was compromised to a certain degree and that the regular nocturnal appearances of hypertensive paroxysm conceivably resulted from a spontaneous cyclic augmentation of the catecholamine secretion from the tumour.
Rupture of the spleen in a patient with a perforated duodenal ulcer and infectious mononucleosis
Authors: Gray Robin 
Published: December 2008

Summary
A 72-year-old patient presented as a sealed perforated duodenal ulcer. This was later confirmed at operation when in addition a haemoperitoneum due to a lacerated friable spleen was discovered. The patient denied antecedent injury. The peripheral blood film was normal but a subsequent differential slide test for infectious mononucleosis was positive. Histology of the spleen showed hyperplasia of the red pulp in addition to capsular and trabecular infiltration with lymphocytes and atypical mononuclear cells confirming the diagnosis. Infectious mononucleosis in the elderly is rare and a complicating rupture of the spleen at this stage has not been reported previously. The diagnosis may depend on the histology alone because the peripheral blood film and serology can be negative. The possible role of the perforated duodenal ulcer is discussed.
Cytomegalovirus infection and the Guillain-Barré syndrome
Authors: Arnold A G , Lawrence D S , Corbitt G 
Published: December 2008

SummaryA fatal case is described of the Guillain-Barré syndrome due to cytomegalovirus infection, which was associated with hepatitis, myocarditis and viral pneumonia.Previous cases, which have usually run a benign course, are reviewed. Attention is drawn to the possible adverse effect of steroid therapy.
The use of dilute hydrochloric acid and cimetidine to reverse severe metabolic alkalosis
Authors: Rowlands B J , Tindall S F , Elliott D J 
Published: December 2008

Summary
Two cases of severe metabolic alkalosis associated with gastric hypersecretion were successfully treated with dilute hydrochloric acid and a histamine H2-receptor antagonist given by intravenous infusion. This combined therapy with electrolyte replacement and suppression of gastric secretion is valuable in the control of this serious metabolic abnormality when conventional treatment is unsuccessful or contraindicated.
Gout without crystals on initial synovial fluid analysis
Authors: Romanoff N R , Canoso J J , Rubinow A , Spark E C 
Published: December 2008

Summary
In five patients with acute arthritis in whom gout was eventually documented, an initial synovial fluid analysis failed to reveal urate crystals. Four of the patients were seen in one hospital during a period of 30 months in which 103 cases of gout were documented on initial aspiration. While this is an uncommon event, the importance of being able to make a definitive diagnosis of gout is such that re-aspiration of the same or other joints may be justified under certain circumstances.
The origins of atherosclerosis
Authors: Woolf N 
Published: December 2008

SummaryThe presence of atherosclerotic lesions in young adults suggests that early stages of atherogenesis occur during childhood. The relationship of intimal lesions in childhood to fully developed atherosclerosis is briefly discussed. Factors likely to promote lipid accumulation within the arterial wall and proliferation of connective tissue elements are reviewed with particular emphasis on endothelial cell injury and the possible consequences of this for intimal smooth muscle cell proliferation.
Coronary artery disease in children
Authors: Neufeld H N , Blieden L C 
Published: December 2008

Summary
In this paper an attempt has been made to correlate the morphologicla aspects of childhood atherosclerosis. Some of the features described are directly related to atherosclerosis. Some of the other conditions described may be related to the subsequent development of atherosclerosis by damaging the vessel wall and thus stimulating the production of atherosclerosis. In other instances, as in the description of the ultrastructural features of the coronary arteries, the exact role of the changes described still remains to be elucidated.
Risk factors of CHD in children—a retrospective view of the Westland study
Authors: de Hass J H 
Published: December 2008

Summary
Routine medical examinations have been carried out in children for many years, but more recently paediatricians have broadened their outlook to consider not only the health of the child until the age of 14 or 16 years but also his future health as an adult. Screening for risk factors for coronary heart disease (CHD) in children raises problems of normal values by sex and age, especially for serum cholesterol and blood pressure.
The results of a study of CHD risk factors in school children in Westland, Holland, are described. Although further information is needed it is concluded that in future paediatricians should accept a greater responsibility for preventive cardiology.
Smoking in childhood
Authors: Bewley B R 
Published: December 2008

Summary
A longitudinal study of smoking in a cohort of 6000 children aged 11–12 years is being carried out in Derbyshire. One of the main objectives is to discover the factors which influence children to take up smoking. Once such factors are determined intervention methods can be developed to discourage children from smoking which, it is hoped, will result in a reduction in mortality and morbidity from cigarette smoking.
Blood pressure and its significance in childhood
Authors: Lauer R M , Rames L K , Clarke W R 
Published: December 2008

Summary
Hypertension is an important accelerator of the atherosclerotic process. Detection in childhood may be important although longitudinal data are lacking of the prognosis of blood pressure measurement in childhood through adult life. The blood pressure of children should be measured.
In populations where salt intake is high, values for blood pressure increase with age. Populations who eat small quantities of salt are relatively free from hypertension. There is an epidemiological argument for limiting salt intake in children.
There are few data to indicate the level of blood pressure in children which should be treated. Children's blood pressures are labile and elevated levels are sustained only in a small minority. In these secondary causes, advice should be sought. In subjects with extreme persistent hypertension drug therapy should be considered; in subjects with values of blood pressure not so extremely raised surveillance should be maintained to prevent the development of sustained hypertension.
A basis for migraine therapy — the autonomic theory reappraised
Authors: Johnson E S 
Published: December 2008

Summary
The concept that migraine results from an initial vasoconstriction due to increased release of noradrenaline from the sympathetic nerves to cranial blood vessels has been reappraised in the light of recently acquired knowledge of the mechanisms of action of drugs used in the treatment of migraine, physiological and pharmacological evidence implicating noradrenaline, and the observations by others that several migraine variants may be associated with some degree of sympathetic overactivity. If the theory is correct, it suggests that both prophylaxis and management of the acute condition should be possible by means of selective alpha-adrenoceptor antagonism. The use of drugs with potentially dangerous vasoconstrictor properties appears to be unnecessary. The suggestion is made that the increased adrenergic activity might result from changes within the hypothalamus.
Calcium requirements in man: a critical review
Authors: Paterson C R 
Published: December 2008

Summary
Many official bodies give advice on desirable intakes of calcium but no clear evidence of a calcium deficiency disease in otherwise normal people has ever been given. In Western countries the usual calcium intake is of the order of 800–1000 mg/day; in many developing countries figures of 300–500 mg/day are found. There is no evidence that people with such a low intake have any problems with bones or teeth. It seems likely that normal people can adapt to have a normal calcium balance on calcium intakes as low as 150–200 mg/day and that this adaptation is sufficient even in pregnancy and lactation. Inappropriate concern about calcium intake may divert attention and resources from more important nutritional problems.
Hospital phobia: a rapid desensitization technique
Authors: Waxman D 
Published: December 2008

Summary
The less disabling phobias do not normally present a problem in that the stimulus may be avoided. This would also apply to hospital phobia until an acute medical or surgical problem might arise, when avoidance could constitute a direct threat to life.
Although phobic illness is a common problem the small number of cases of hospital phobia recorded may represent the tip of the iceberg beneath which could be many phobic patients who deny their symptoms and risk their health because of their irrational fear.
A case of hopsital phobia in a pregnant patient with suspected disproportion was treated by a rapid desensitization technique using hypnosis. After five sessions of 30 min each, the patient was symptom free.
This simple method of desensitization, if more widely known would considerably minimize the risk caused by concealment of the phobic problem.
Guillain-Barré syndrome after rubella
Authors: Saeed A A , Lange L S 
Published: December 2008

Summary
A case of polyneuropathy (Guillain—Barré syndrome) developing only 6 days after rubella infection in a 26-year-old woman is described. Serological confirmation of the viral infection by detecting the specific IgM antibody has not been previously reported in any of the rubella cases associated with the syndrome.
Hostile interaction in a general hospital ward leading to disturbed behaviour and bulimia in anorexia nervosa: its successful management
Authors: Cohen S I 
Published: December 2008

Summary
A girl of 17 years with severe anorexia nervosa, treated on a medical ward in a teaching hospital, developed bulimia, stole food, was sometimes doubly incontinent, behaved angrily, and aroused the hostility of patients and staff. The growth of a vicious circle of hostility is described and it was hypothesized that the hostility had aggravated the bulimia. On the basis of this hypothesis the situation was clarified with the patient and staff, attitudes changed, the patient's appetite dropped within a day from about six times to one-and-a-half times the normal and her behaviour became normal. The significance of these events is briefly discussed.
An investigation of the immune response of patients suffering from anorexia nervosa
Authors: Armstrong-Esther C A , Lacey J H , Crisp A H , Bryant T N 
Published: December 2008

SummaryPatients suffering from anorexia nervosa rarely appear to develop the common cold or influenza. This study examines the immunological response of fifteen female anorexia nervosa patients of both the vomiting and carbohydrate-abstaining type and compares them with a control population matched for age and occupation. Both anorectics and control populations received the admune influenza vaccine. Initially both groups had similar haemagglutination inhibition titres against the three different viral antigens: A/HK; A/PC; A/Eng. However, the anorectics showed over a 2-month period a higher titre of antibody especially to the Hong Kong virus: this was sigignificant. Cellular immune responses were measured using a tuberculin and a macrophage inhibition test, no significant difference between the two groups was obderved. These results which support the clinical findings are discussed.
The spectrum of paracetamol (acetaminophen) overdose: clinical and epidemiological studies
Authors: Hamlyn A N , Douglas A P , James O 
Published: December 2008

Summary
In a regional survey of paracetamol overdose, 201 patients were admitted to hospital over 12 months. Chronic alcoholism was present in 10% of cases. Over 25% of patients were females aged 20 years or less. Initial blood paracetamol levels were in the toxic range in 16% and histologically severe liver damage eventually found in 20% of those biopsied. This finding corresponded to a serum aspartate aminotransferase of 600 i.u./l or more. Renal failure severe enough to require peritoneal dialysis developed in 1%. Elevated serum amylase was recorded in 22% of a 108-patient subset. Evidence of myocardial damage was found in 11.6% of an eighty-six patient subset. An unfavourable prognosis was indicated by a prothrombin ratio of 20% or less and hepatic coma, the overall mortality being 3.5%.
The apparent safety of this useful analgesic is compromized by its widespread employment in parasuicide. This, the insidious and delayed onset of toxicity in overdose and ineffectiveness of late treatment argues for controlling availability to the general public.
Granulomatous sarcoid nephropathy
Authors: Ford M J , Anderton J L , MacLean N 
Published: December 2008

Summary
When sarcoidosis of the renal parenchyma occurs it is rarely of major clinical significance. The clinical features and post-mortem findings of a case of subacute uraemic syndrome due to severe granulomatous involvement of the kidney by sarcoidosis are described. The case is unusual in that granulomatous sarcoid nephropathy resulted in death from renal failure within 4 months of onset of symptoms in the absence of clinically apparent sarcoidosis.
Gastro-cutaneous fistula following anterior gastropexy
Authors: Mackie D B , Whitaker M J F , Gent A E 
Published: December 2008

Summary
Two patients are described who developed a gastric fistula to the anterior abdominal wall following anterior gastropexy. Both fistulae closed spontaneously without any specific treatment. It is suggested that the fixation of the stomach to the anterior abdominal wall allows the fistula to discharge externally thus preventing peritoneal contamination with its serious consequences.
Diagnosis and natural history of congested (dilated) cardiomyopathies
Authors: Oakley C 
Published: December 2008

Summary
The diagnosis of primary dilated cardiomyopathy depends on the recognition of a dilated poorly contracting left ventricle with increased end-diastolic and end-systolic volumes in the absence of a detectable cause. The diagnosis is made only after exclusion both of structural heart disease and of known causes of secondary heart muscle disorder.
The natural history is still largely unknown and is probably as variable as the likely causes. The left ventricular disorder does not cause symptoms until heart failure supervenes except for occasional patients who develop an early atrial or ventricular dysrhythmia, conduction defect, chest pain or murmur of mitral regurgitation. This period of latency may be short, prolonged or even permanent since it is unlikely that all cases progess to the point of failure. A few patients recover normal or near-normal cardiac function. The interplay between high blood pressure, hypertensive heart failure and dilated cardiomyopathy is illustrated by patients who recover from heart failure to become hypertensive and vice versa and in current treatment with vasodilators and diuretics for patients at either end of the spectrum.