bluuebunny/crossref_metadata_2025_split huggingface dataset:
West Indian amblyopia
Authors: Fasler J J , Rose F C 
Published: December 2008

Abstract
A series of 21 patients admitted to St Thomas’ Hospital, Medical Ophthalmology Unit, with a diagnosis of West Indian or West African amblyopia is reported. Patients were investigated for haematological, biochemical, serological, and radiological abnormalities and particular attention was paid to dietary history. Patients admitted in recent years also underwent neurophysiological investigations. No definite correlation between visual loss and dietary or family history was found, and there was no evidence that the improvement in vision which occurred in just under half the patients on follow-up was related to treatment with hydroxocobalamin or multivitamins. Visual-evoked responses in 4 patients showed a prolonged latency suggesting optic nerve demyelination, while in only one case was the electro-oculogram definitely subnormal. These findings contrast with those in ‘toxic’ amblyopias and suggest that the syndrome of West Indian amblyopoa may be due to bilateral optic nerve demyelination of unknown aetiology rather than the effect of toxic substances or nutritional deficiency on the retina.
Acute epiglottitis in an adult
Authors: Barman S N , Bell H , Chazan B I 
Published: December 2008

Abstract
A 33-year old man developed acute epiglottitis of sudden onset which resulted in severe respiratory distress. A small endotracheal tube was passed as an emergency procedure. Respiratory arrest developed after he pulled it out 12 hr later. Subsequent progress was satisfactory following endotracheal intubation and treatment with ampicillin and hydrocortisone. Blood cultures grew Haemophilus influenzae.
Chronic eosinophilic pneumonia complicating long-standing rheumatoid arthritis
Authors: Payne C R , Connellan S J 
Published: December 2008

Abstract
A 54-year-old patient with long-standing rheumatoid arthritis developed chronic eosinophilic pneumonia in association with a relapse of his arthritic condition. There was a rapid and complete response to oral steroid therapy.
Coronary heart disease. The size and nature of the problem
Authors: Turner R W 
Published: December 2008

AbstractIn the U.K., coronary heart disease has reached epidemic proportions. It is the commonest cause of death after the age of 35 years and the fastest rate of increase is in early middle age. The epidemic is due mainly to our way of life. The most important factors are dietary, with smoking, physical inactivity and stress also contributing. Twenty independent working parties from different countries have reviewed the dietary evidence and reached a strong consensus on dietary recommendations. Little action has been taken in the U.K. The Coronary Prevention Group has been formed to consider the reasons for this inaction and also the implication for research, the government, the Ministry of Agriculture, Fisheries and Food, the Department of Health and Social Security, the food and agriculture industries, caterers, nutrition education and for individuals, of the dietary recommendations.
Prevention of coronary heart disease: the role of essential fatty acids
Authors: Sinclair H M 
Published: December 2008

Abstract
There are 2 classes of essential fatty acids (EFA), the linoleic (n-6) and linolenic (n-3). They are required for the glycerophosphatides (phospholipids) of cellular membranes; the transport and oxidation of cholesterol; the formation of prostaglandins. In deficiency of EFA, cellular membranes are imperfectly formed which causes increased susceptibility to various insults and increased permeability. Low-density lipoproteins (LDL) transport cholesterol mainly as cholesteryl linoleate and supply EFA to tissue. A relative deficiency of EFA (i.e. a high ratio in the body of non-EFA such as long-chain saturated fatty acids to EFA) causes an increase in plasma cholesterol. EFAs cause decreased aggregation of platelets. Atherosclerosis is not caused by increased aggregation of platelets, and can be prevalent in a population in which coronary thrombosis is rare.
Dietary prevention at home and abroad
Authors: Shaper A G 
Published: December 2008

Abstract
The main dietary recommendations towards the prevention/postponement of coronary heart disease (CHD) made in the U.K. in the last decade are reviewed. There is substantial agreement regarding the need for a reduction in the intake of saturated fats. It is suggested that only moderate changes in dietary polyunsaturated: saturated ratio may be sufficient to achieve changes in the incidence of CHD.
Control of hypertension in out-patients. Experience of the Glasgow Blood Pressure Clinic
Authors: Johnston J H , Lorimer A R , Rodger J C , Robertson W K , Thomas A , Lawrence W , Fife R 
Published: December 2008

AbstractFive hundred and sixty-two patients who had attended the Glasgow Blood Pressure Clinic regularly for 3 years between 1969 and 1978 were studied. The mean BPs for the group were 187/115 mmHg initially, 157/100 mmHg after 6 months, and 153/98 mmHg after 3 years. Twenty-eight per cent had ‘normal’ systolic pressure and 22% ‘normal’ diastolic pressure at 3 years. Thirty-seven per cent with mild, 83% with moderate, and 89% with severe systolic pressure elevation had moved into less severe categories by 3 years, as had 30% with mild, 60% with moderate and 84% with severe diastolic evaluation. Those patients with severe hypertension, who did not attain a less grade, had a statistically significant drop in pressure. Four per cent of all patients, however, had moved into a more severe severe grade of systolic pressure evaluation and 6% into a more more severe diastolic pressure grade at 3 years. These results suggest that the hospital Hypertension Clinic can play a useful part in the lowering of BP in out-patients. It is clear, however, that ‘normal’ BP levels are not achieved in a significant proportion of patients.
Portuguese-type amyloid neuropathy in an English family
Authors: Mahood J M 
Published: December 2008

Abstract
A 31-year-old woman thought to be suffering from a psychiatric illness was found to have peripheral and autonomic neuropathy, keratoconjunctivitis sicca and vitreous opacities. Her mother had died 10 years previously, aged 42 years from an undiagnosed illness with similar features. Histological proof of amyloidosis was obtained in both cases. This is the second report of familial amyloid neuropathy in an English family.
Acute renal failure complicating Legionnaires’ disease
Authors: Harvey M , Quirke P , Warren D 
Published: December 2008

Abstract
A 45-year-old man developed symptoms of pneumonia while on holiday in Spain. On his return home, a diagnosis of Legionnaires’ disease was confirmed, complicated by acute renal failure, He was treated with dialysis and spontaneous recovery of renal function began on day 19.
Terminal care: evaluation of an advisory domiciliary service at St Christopher’s Hospice
Authors: Parkes C M 
Published: December 2008

Abstract
In a matched, comparative study the provision of an advisory service to families who were nursing a patient with incurable cancer at home enabled the patient to stay at home longer than he otherwise would and helped the family and primary care team to cope with the added burden which resulted. Families seem to have been well satisfied with the help which was given and there were considerable savings in cost to the health service.
Plasma and salivary concentrations of erythromycin after administration of three different formulations
Authors: Henry J , Turner P , Garland M , Esmieu F 
Published: December 2008

Abstract
In a 6-volunteer cross-over study the pharmacokinetics of 3 erythromycin preparations were compared. A single oral dose of 500 mg of each preparation was administered at each occasion and the levels measured in timed samples of plasma and saliva. Markedly higher blood concentrations of the estolate and propionate were obtained compared to the stearate. Comparison of serum and plasma concentration of the drugs from each split sample showed no significant differences. Plasma concentrations always exceeded those in saliva but for any one preparation a similar ratio was obtained at different times. This may be useful to ascertain compliance and to measure concentration of the compounds where direct measurement in plasma is not practicable.
Low-dose vincristine in the treatment of corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) in non-splenectomized patients
Authors: Cervantes F , Montserrat E , Rozman C , Diumenjo C , Feliu E , Grañena A 
Published: December 2008

Abstract
Eight non-splenectomized patients with corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) were treated with low-dose vincristine (1 mg/week up to a total dose of 4 mg). Complete remission was achieved in 2 cases and partial remission in 3. Bleeding stopped in one patient who failed to remit. No statistical relationship was found between the response to vincristine and the duration of the disease or the corticosteroid-therapy. Side effects were only observed in one patient. By comparing these results with those reported in the literature, it can be inferred that low-dose vincristine may be useful in the management of corticosteroid-refractory ITP.
Retroperitoneal fibrosis and scleroderma
Authors: Mansell M A , Watts R W E 
Published: December 2008

Abstract
The association of retroperitoneal fibrosis and systemic sclerosis is reported from a patient positive for the HLA-B27 antigen. This appears to be the first report of such an association. Pathological features common to the 2 syndromes are discussed and the literature is reviewed.
Hyperemesis gravidarum due to thyrotoxicosis
Authors: Valentine B H , Jones C , Tyack A J 
Published: December 2008

Abstract
A case of hyperemesis gravidarum at 9 weeks’ gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pregnancy and its outcome is described. The need for practitioners to remember vomiting as a presenting sign of thyrotoxicosis is stressed.
Problems in home monitoring of blood glucose
Authors: Pantin C F , Bihari D , Brown E A , Bloom A 
Published: December 2008

Abstract
Two hundred and forty blood glucose readings were made on 5 Glucochek machines by 2 different operators. The results on all machines correlated poorly with equivalent results from an automatic glucose analyser with major discrepancies at all glucose concentrations. There was a wide gap in performance between the 2 operators. Analysis of variance suggested that errors were not only due to inter-operator and inter-machine differences. Possible sources of error were shown to include time of reaction and the amount of blood on Dextrostix. Dextrostix colour changes measured by eye were as accurate as those by Glucochek without the rogue values found at higher glucose concentrations with Glucochek.
Measurement of the effects of a single dose of prazosin on the cerebral blood flow in hypertensive patients
Authors: Rutland M D , Lee T Y , Nimmon C C , Granowska M , Britton K E 
Published: December 2008

Abstract
It was considered that the first dose reaction occurring with prazosin may have been due either to hypotension or to a specific reduction in cerebral blood flow. The development of a quantitative non-invasion nuclear medicine technique for cerebral flow has now made it possible to investigate the effects of prazosin on cerebral blood flow in hypertensive patients. This double-blind study showed a significant decrease in BP and a small just significant increase in cerebral blood flow following a single 1-mg dose of prazosin, when compared with a placebo. From these results, it is unlikely that the first dose reactions which occurred with prazosin were due to a specific reduction in cerebral blood flow.
Mucus-secreting ‘signet-ring’ cells in CSF revealing the site of primary cancer
Authors: Agnelli G , Gresele P 
Published: December 2008

Abstract
A case is reported of leptomeningeal carcinomatosis in which identification of mucus-secreting ‘signet-ring’ carcinoma cells in the CSF allowed diagnosis of an otherwise asymptomatic gastric cancer. When lumbar puncture is performed, careful cytological examination of the CSF should be carried out in any undiagnosed patient with neurological symptoms and signs.
Dual primary adenocarcinoma of the duodenum and jejunum in a patient with previous colonic cancers
Authors: Swift A C , Smith G T , Douglas D L 
Published: December 2008

Abstract
Primary adenocarcinoma of the small intestine is an uncommon tumour, the incidence being 40-60 times less frequent than carcinoma of the colon. Multiple primary neoplasia of the small bowel, although not infrequently seen with benign growths, is an extremely rare event with malignant lesions. A patient is described who had an adenocarcinoma of the duodenum and jejunum, with a previous history of colonic carcinomas. The case is discussed together with a brief review of the literature.
Streptococcal pharyngitis--rapid diagnosis by Gram stain
Authors: Sharma S C , Subbukrishnan P V 
Published: December 2008

Summary
Group A beta-haemolytic streptococci were isolated from 51 (9.8%) of 519 patients with pharyngitis. Throat culture results showed the mean sensitivity, specificity and predictive value of a positive Gram-stained smear of pharyngeal secretions as 70%, 89% and 69%. The data suggest that Gram staining of a smear directly from the swab is as accurate as and more speedy than a culture from the pharyngeal secretion for diagnosis of streptococcal pharyngitis.
Long-term treatment of trigeminal neuralgia with carbamazepine
Authors: Taylor J C , Brauer S , Espir M L E 
Published: December 2008

Summary
The results of treating 143 patients with trigeminal neuralgia with carbamazepine (CBZ) over a 16-year period have been reviewed. The drug was effective initially with few mild side effects in 99 patients (69%). Of these, 19 developed resistance later, i.e. between 2 months and 10 years after commencing treatment, and required alternative measures. Of the remaining 80 (56%), the drug was effective in 49 for 1-4 years and in 31 for 5-16 years. Thirty-six patients (25%) failed to respond to CBZ initially and required alternative measures, as did 8 (6%) who were intolerant of the drug. One patient developed CBZ-induced water intoxication with hyponatraemia. Subsequently hyponatraemia was excluded in 17 patients who had been taking CBZ for between 4 months and 7 years. This study has thus confirmed the efficacy of CBZ in the treatment of trigeminal neuralgia and shown that it may continue to be effective for many years.
Treatment of adult lymphoblastic leukaemia using cyclical chemotherapy with three combinations of four drugs (COAP, POMP, TRAP schedule)
Authors: Proctor S J , Finney R , Walker W , Thompson R B 
Published: December 2008

Summary
Seventeen adult patients with previously untreated acute lymphoblastic leukaemia (ALL) were entered into a schedule of chemotherapy in which 3 combinations, each of 4 drugs, were administered in a predetermined cyclical rotation in combination with cranial irradiation and intrathecal injections of methotrexate. Of the 17 patients, 16 completed induction therapy and 15 (94%) entered remission. The only patient with T-ALL died before receiving any therapy. The median survival for all patients (17) was 22 months. Meningeal leukaemia did not occur during the haematological remission phase although 3 patients developed this complication following relapse. The authors conclude that the addition of cyclophosphamide and cytosine arabinoside to vincristine/prednisone provides excellent remission induction but the aggressive maintenance schedule employed has not led to significant long-term survival.
Audit of an inner city coronary unit
Authors: Pedoe H T , Besterman E , Kidner P H 
Published: December 2008

Summary
The performance of the St Mary’s Hospital London W2 coronary care unit was studied in each of 2 years, 1969 and 1975, results of which could be compared with each other and with national figures from the annual reports of the Hospital In-patient Enquiry. In 1975 the admissions were 42% more than in 1969; the increase was confined to mild cases over 45 years of age, and was out of proportion to national trends. The hospital fatality rate was unchanged and when age-standardized was 69% and 78% of contemporaneous national rates. In both years, 50% of the patients admitted came from outside the health district and 10% of local admissions were visitors from abroad. In 1975 there was an increased proportion of ex-smokers among the patients and more gave a history of previous myocardial infarction. The value and limitations of this kind of surveillance of a clinical unit are argued.
Arthropathy in Dressler’s syndrome
Authors: Davidson C 
Published: December 2008

SummaryThree patients developed a polyarthritis in association with Dressler’s (post-myocardial infarction) syndrome. Joint involvement was more pronounced in the upper limbs and persisted many months after other features of Dressler’s syndrome had settled. In 2 cases the findings in the joints were slight and might have been overlooked but for the persistently raised ESR. There was a prompt symptomatic response to prednisone.
Hyperlipidaemia diagnosed at lumbar puncture
Authors: Burke B J , McKee J I , Hargreaves T 
Published: December 2008

Summary
A patient presenting with subarachnoid haemorrhage and high lipid concentrations in the cerebrospinal fluid (taken at lumbar puncture), who has later shown to have type V hyperlipidaemia is described. This case, so far as can be ascertained by the authors, is the first report of hyperlipidaemia being diagnosed from CSF examination.
Effects of captopril (SQ 14,225) in a patient with primary pulmonary hypertension
Authors: Horowitz J D , Brennan J B , Oliver L E , Harding D , Goble A J , Louis W J 
Published: December 2008

Summary
In a 33-year-old patient with severe primary pulmonary hypertension, the acute administration of the angiotensin-converting-enzyme inhibitor captopril (SQ 14,225) induced a rise in cardiac output, and a fall in both pulmonary and systemic vascular resistance. Subsequent chronic oral administration of captopril induced only transient clinical improvement, and the patient died. Captopril may nevertheless be useful in the treatment of less advanced cases of this disease.
Benign chondrolipomatous tumour of the breast
Authors: Dharkar D D , Kraft J R 
Published: December 2008

Summary
Cartilage associated with malignant neoplasms of breast has been known and documented for over 200 years. Benign breast tumours containing cartilage are rare. A case of such a tumour was encountered. Histologically it comprised multiple foci of mature benign cartilage in benign fibrous and adipose stroma. Other cases of similar tumours in the literature are reviewed.
Caverno-saphenous shunt in the treatment of priapism
Authors: Ihekwaba F N , Lawani J 
Published: December 2008

Summary
The painful pathological condition of the penis, priapism, is usually associated with serious destructive changes which lead to impotence if treatment is with-held or delayed. Conservative therapy is slow, uncertain and usually ineffective. Early surgical decompression of the corpora cavernosa, repeated if necessary, is essential if impotence is to be averted. Two unusual cases of this condition recently seen at the University College Hospital, Ibadan, in which treatment had been delayed for periods previously thought to be too long for recovery are herein presented and the management described. It is advised that failure of the initial surgical operation calls for early re-operation to establish a new shunt.
Lysozyme and hypokalaemia
Authors: Mir M A , Lodha S C 
Published: December 2008

Summary
Serum potassium, lysozyme and urinary lysozyme measurements were made in 98 patients with tuberculosis, 18 with sarcoidosis and 30 with acute myeloid leukaemia. Serum K concentration fell below 3·5 mmol/l in 17 of the 30 leukaemic patients and only 7 of these had raised serum lysozyme concentrations. None of the patients in the tuberculosis-sarcoidosis group with lysozymaemia or lysozymuria developed hypokalaemia. This study suggests that raised lysozyme concentrations are not causally related to hypokalaemia.
Endocrine abnormalities in primary hyperparathyroidism
Authors: Hamilton D V , Pryor J S 
Published: December 2008

SummaryEndocrine abnormalities in 73 patients with primary hyperparathyroidism were studied: 8 patients were diabetic, 3 were thyrotoxic, 2 were hypothyroid, and one had a gastrinoma and carcinoid tumour. In 9 of these patients, carbohydrate metabolism and thyroid function were studied in detail pre- and 3 months postoperatively. In 6 patients following a glucose load, insulin concentrations were markedly elevated pre-operatively when compared with those found postoperatively. Likewise, in 7 patients, serum thyroxine was greater pre- than postoperatively. The aetiology of these changes and their relevance to the management of patients with primary hyperparathyroidism is discussed.
Lymphoma presenting as mononeuritis multiplex
Authors: Reid Alison C , Bone I 
Published: December 2008

Summary
A case is reported of mononeuritis multiplex, the peripheral nerve lesions being caused by metastatic deposits of lymphoma in muscle. The patient also had a past history of a facial nerve palsy and the Guillain-Barré syndrome. This case portrays an interesting spectrum of unusual manifestations of neoplastic disease - both with regard to metastatic spread and peripheral neurological involvement.
Rapid development of neurosyphilis in a long-standing diabetic
Authors: Gorsuch A N , Thin R N , Simmons P D , Cudworth A G 
Published: December 2008

Summary
At the age of 50 years, a known diabetic presented with clinical features of diabetic neuropathy which on investigations proved to be taboparesis. The case is described as a reminder that tabes dorsalis, although rare in the United Kingdom at present, must be included in the differential diagnosis of diabetic neuropathy. In addition, the tabo paresis developed over a 5-year period, in contrast to the slow development classically described in this condition.
SLE syndrome, probably induced by labetalol
Authors: Brown R C , Cooke J , Losowsky M S 
Published: December 2008

Summary
A 45-year-old woman developed polyarthralgia and muscle tenderness after 6 months’ therapy with labetalol 1800 mg daily. A raised ANF titre but normal DNA binding levels suggested a drug-induced SLE syndrome. Both symptoms and ANF titre improved when therapy was changed from labetalol to propranolol.
Periodic paralysis complicating malaria
Authors: Senanayake Nimal , Wimalawansa Sunil J 
Published: December 2008

Summary
Episodic muscular weakness, commonly associated with alterations of serum potassium, is the cardinal feature of periodic paralysis. The combination of transient hyperkalaemia and rigors occurring during febrile episodes of malaria is suggested as the underlying cause which precipitated the muscular paralysis. Three patients with malaria who developed a similar paralysis during the paroxysms of fever are described to illustrate this.