bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observations on the treatment of dissection of the aorta
Authors: Thenabadu P N , Steiner R E , Cleland W P , Goodwin J F 
Published: December 2008

Summary
The results are presented of treatment in twenty-three patients with dissection of the thoracic aorta, in four of whom it was acute (less than 14 days' duration), and in nineteen chronic (more than 14 days' duration). Sixteen patients had Type I and II dissection (involving the ascending aorta) and five Type III (descending aorta at or distal to the origin of the left subclavian artery); in two, dissection complicated coarctation of the aorta in the usual site. Thirteen patients had aortic regurgitation.
Three of the patients with acute dissection were treated medically; two, both with Type I dissection, died, and the third, with Type III, survived. The remaining acute patient was treated surgically and also died.
Of the patients with chronic dissection, eight were treated medically and eleven surgically. None of the medical group died in hospital; three died between 3 months and 1 year, and five have survived from periods of 12-72 months. Eleven patients with chronic dissection were treated surgically; four died in hospital at or shortly after operation; and the remaining seven lived for periods of 12-84 months.
The presentation, indications for surgical treatment and results are discussed. It is concluded that surgical treatment of chronic dissection may carry a higher initial mortality than medical, but that there may be slightly better overall long term results in the former. As this series was not selected randomly, because patients with complications were selected for surgery, and there are only a few patients in each group, the results do not permit firm conclusion regarding the relative merits of medical and surgical treatment.
It is suggested that all patients should initially be treated medically but that surgical treatment should be considered if the dissection continues, if aortic regurgitation is severe, if an aneurysm develops or enlarges, if cardiac tamponade develops or there is evidence of progressive involvement of the branches of the aorta. Attention is drawn to the important syndrome of chronic dissecting aneurysm of the ascending aorta with severe aortic regurgitation which requires definitive surgical treatment and aortic valve replacement. The importance of adequate visualization of the origin and extent of the dissection as a preliminary to surgical treatment is stressed.
Calculus disease of the urinary tract at a district hospital
Authors: Jeffery P J 
Published: December 2008

Summary
At a District General Hospital the organization of a clinic for the investigation and treatment of patients with calculus disease of the urinary tract is described. The way in which such a clinic may be orgainzed is discussed and the results presented. In patients with idiopathic hypercalciuria, sodium cellulose phosphate causes a significant reduction in urinary calcium levels when used in such a clinic.
Hereditary nephritis (with unusual renal histology): report of a first case from the West Indies
Authors: Hayes J S , Jankey N 
Published: December 2008

SummaryA 21-year-old Grenadian girl undergoing investigation in Trinidad for anaemia was diagnosed as a case of hereditary nephritis. She had the clinical features of a nephropathy, nerve deafness and an ocular defect. Renal histology was exceptional in that in addition to the typical findings of a hereditary nephritis, cystic areas generally associated with medullary cystic disease were noted. Several members of the patient's maternal family were afflicted with either deafness visual distrubances or renal disease.
Medical versus surgical treatment of stable angina pectoris: progress report of a large scale study
Authors: Hultgren Herbert N , Takaro Timothy , Detre Katherine 
Published: December 2008

Summary
A large scale, prospective, randomized study of surgical v. medical management of disabling angina pectoris is being conducted as a cooperative study among thirteen Veterans Administration hospitals in the U.S.A. A total of 1015 patients have been entered into the study and follow-up data are currently being evaluated. Patient entry into the study was concluded in December 1974. Patient compliance has been acceptable with only 7% of patients not adhering to their randomization category. Thirty-day operative mortality (1972-1974) in 309 patients was 5-3%. The patient population exhibited a severe degree of coronary disease. There was ECG evidence of prior myocardial infarction in 40%. There were significant obstructive lesions in three major coronary arteries in 51% and significant lesions of the left main coronary artery in 11%. Medical and surgical treatment groups demonstrated no significant differences in objective descriptive characteristics. Mortality in the medical group at 1 year was 8%. Mortality was influenced by several factors including the number of vessels involved, left ventricular function and the presence of left main coronary artery disease. The lowest mortality occurred in patients with single vessel disease and normal LV function who had a 1-year mortality of 3%. Patients with 3-vessel disease and abnormal LV function exhibited a 14% 1-year mortality. Patients with disease of the left main coronary artery and poor LV function had a 1-year mortality of 37%. Analyses of the results of treatment modalities in sub-groups is currently being performed and will be reported in future publications.
Congestive cardiomyopathy in a family of Becker's X-linked muscular dystrophy
Authors: Katiyar B C , Misra S , Somani P N , Chaterji A M 
Published: December 2008

Summary
Ths dissociation of gross congestive cardiomyopathy and muscle disease in different members of a family affected with Becker's benign X-linked muscular dystrophy is described. The possibility that cardiomyopathy and muscular dystrophy may be the expressions of the same mutant gene has been suggested.
An investigation of renal function in chronic bronchitis
Authors: Daggett P 
Published: December 2008

Summary
An investigation has been made into various parameters of renal function in patients with chronic bronchitis and in a group of hypoxic controls. Abnormalities of glomerular filtration rate and of water handling have been demostrated in chronic bronchitic patients but not in hypoxic controls. The abnormalities are related to the arterial Pco2. A hypothesis is presented as to the role of CO2 in causing abnormalities of renal function in chronic bronchitis.
Simple techniques to treat medical phobias
Authors: Taylor C B , Ferguson J M , Wermuth B M 
Published: December 2008

Summary
Participant modelling, a behaviourally-orientated treatment technique, is an effect method of treating phobias associated with minor medical procedures or apparatus such as needles or intravenous catheters. The steps in this technique are described and two cases of severe needle phobias successfully treated with participant modelling are presented to illustrate further its application.
Histiocytic medullary reticulosis with hypogammaglobulinaemia and disseminated intravascular coagulation
Authors: Clarke P D , Amos R S , Edwards C W , Geddes A M 
Published: December 2008

Summary
A case of histiocytic medullary reticulosis in a 45-year-old man is described. The presentation with a swinging pyrexia is typical. Associated features were very low levels of all immunoglobulins and proved disseminated intravascular coagulation. Heparin therapy was given and the difficulties of controlling such treatment are demonstrated. It is concluded that an increased awareness of the condition as a cause of pyrexia might lead to an improvement in prognosis.
An approach to realistic evaluation of antihypertensive regimes
Authors: Carlisle R , Akinkugbe O O , Basile U , Solagbade M E 
Published: December 2008

Summary
Where practicable, all subjects found with onset-phase-four blood pressure of 90 mmHg or more after referral were allocated, on a random basis, to alternative antihypertensive regimes at a dosage related to response. Of those 110 receiving either guanethidine, methyldopa or debrisoquine, only the group on methyldopa had significantly reduced median blood pressure by two out of four criteria and after 6 months of therapy. It is nevertheless considered that by assessment of the total group more significant conclusions can be drawn for an eventual attempt to control hypertension on a community basis than by studies of highly selected groups treated under unusually favourable conditions.
Practolol-induced autoantibodies and their relation to oculo-cutaneous complications
Authors: Jachuck S J , Stephenson J , Bird T , Jackson F S , Clark F 
Published: December 2008

Summary
Tissue auto-antibodies were investigated in fifty-one patients (twenty-five female, twenty-six male) receiving practolol for ischaemic heart disease or dysrhythmias and compared with those found in 204 patients (fifty-eight female, 146 male) with ischaemic heart disease who did not receive practolol. Antinuclear factor (ANF) was found in 24% female and 16% male patients receiving practolol, but only in 5% of female and 4% of male patients who were not taking practolol. Thyroid cytoplasmic antibody (TCA) was detected in 16% female and 20% of male patients receiving practolol, compared to 10% of females and 6% of males in the control group. The incidence of ANF and TCA was significantly higher (P less than 0-05) in patients receiving practolol compared to the control group. The occurrence of gastric parietal cell antibody (PCA) and smooth muscle antibody (SMA) was not associated with practolol therapy (odds ratio of 2-4 and 1-9 respectively). The incidence of skin and eye complications was found to be 10% and the female to male ratio of this complication was 4 : 1. The correlation between autoantibody production and oculo-cutaneous complications could not be established in such a small group but three of the patients with the complications were found to have PCA, although PCA was found not to be associated with practolol therapy. Four of the five patients with the complications did not have circulating ANF.
A study of the effect of povidone-iodine on wound healing
Authors: Gilmore O J , Reid C , Strokon A 
Published: December 2008

Summary
The effect of dry powder povidone-iodine (Disadine D.P.) on wound healing was assessed experimentally and clinically. It did not interfere with wound healing macroscopically, histologically or mechanically in Wistar rats. One hundred and one patients undergoing 'clean' elective surgery were included in the controlled clinical study and povidone-iodine did not affect wound healing in any way. In the control group 4% of patients developed infection compared with none of those sprayed with povidone-iodine. No adverse reaction to povidone-iodine was seen in either study. This antiseptic offers a safe alternative to antibiotics for use at operation whenever there is risk of wound infection from operative bacterial contamination.
Primary anorexia nervosa (weight phobia) in males
Authors: Hasan M K , Tibbetts R W 
Published: December 2008

Summary
Ten cases of primary anorexia nervosa (weight phobia) in males (as against 196 females) have been treated in the United Birmingham Hospitals over 19 years. A discrete syndromes appears to exist with much to support the view that it is the counterpart of primary anorexia nervosa in the female. Six illustrative case histories are described briefly. The heavy loading with consistent abnormalities of psychiatric interest makes it very probable that weight phobia is primarily a psychiatric disorder.
Primary unruptured ovarian pregnancy with intrauterine device
Authors: Saber R S 
Published: December 2008

Summary
A case of intrafollicular and unruptured ovarian pregnancy associated with intrauterine device which meets the rigid criteria of Spiegelberg (1878) is presented. Clinically, unruptured cases can be confused with ovarian cysts. Intrauterine devices are highly effective for protection against uterine gestation and to a lesser degree against tubal gestation, but they have no effect in preventing ovarian gestation.
Malabsorption in relation to abdominal irradiation and quadruple chemotherapy for lymphosarcoma
Authors: Scarpello J H , Sladen G E 
Published: December 2008

Summary
A case of severe diarrhoea and steatorrhoea following chemotherapy and abdominal irradiation for lymphosarcoma, is described. Investigations demonstrated bile acid malabsorption, and treatment with cholesytramine and a low fat diet was successful. A questionnaire was sent to thirty-two subjects who had undergone similar treatment for similar pathology and failed to demonstrate any sustained alteration of bowel function. Additionally, nine of these subjects underwent a 14C-glycocholic acid test and no evidence of interruption of the enterohepatic circulation of bile acids was found.
Early prediction of the outcome of a paracetamol overdose based on an analysis of 163 patients
Authors: Gazzard B G , Widdop B , Davis M , Hughes R D , Goulding R , Williams R 
Published: December 2008

SummaryClinical and biochemical data obtained from 163 patients who had taken an overdose of paracetamol were examined to determine which factors or measurements were of value in predicting the severity of ensuing liver damage early after ingestion of tablets. Although the overall severity of hepatic necrosis was found to increase with the dose of paracetamol ingested, correlation was not sufficiently close to provide an accurate prognostic index in individuals. Severe hepatic damage was less likely if the patient had vomited or had a stomach wash-out within 6 hr of overdose. The plasma concentrations of paracetamol, measured at known times after overdose, distinguished those who developed hepatic dysfunction from those who did not, but there was a poor correlation, particularly in the first 6 hr after ingestion of tablets, between these values and the severity of ensuing liver damage. Estimates of early plasma paracetamol half-lives from three or more samples taken within 4 hr of admission showed that all patients developing moderate or severe liver damage had half-lives greater than 4 hr, but this was also the case in nearly one-third of those with minimal liver lesions only.It is concluded that there is no completely reliable early prognostic test for individual patients with paracetamol overdose. If each patient is selected for treatment with cysteamine (mercaptamine) or other agents on the basis of plasma paracetamol levels, up to 30% may receive this agent who are at risk from trivial hepatic damage only.
Accidental ingestion of poisons and child personality
Authors: Sibert J R , Newcombe R G 
Published: December 2008

SummaryThe personality of 105 children under 5 years of age admitted to Cardiff Hospital was compared with 105 control children by means of a semantic differential test. Poisoning-children were significantly more anxious (P less than 0-008), harder (P less than 0-01), and more active (P less than 0-04) than controls. They also caused more worry (P less than 0-04) and put other than food more ofter in their mouths (P less than 0-002). There were no significant differences in the age of walking, and the ages of becoming clean and dry between cases and controls. However, poisoning-children had significantly more accidents and hospital admissions than did controls. The relevance of these findings, particularly in relation to the important role of family stress, to the aetiology of accidental poisoning in childhood is discussed.
Chlorpromazine-induced haemolytic anaemia in anorexia nervosa
Authors: How J , Davidson R J 
Published: December 2008

Summary
Two patients with anorexia nervosa who developed progressive haemolytic anaemia during chlorpromazine therapy are presented. In each case, withdrawal of the drug alone led to a prompt haematological response. Drug-induced oxidant damage is proposed as being the underlying haemolytic mechanism.
Successful treatment of Pseudomonas aeruginosa septicaemia and meningitis with neutropenia—the presenting feature of hypogammaglobulinaemia
Authors: Johnston P G , Speller D C 
Published: December 2008

Summary
A neutropenic child of 20 months suffered generalized infection with Pseudomonas aeruginosa, involving the bloodstream and the meninges. This was successfully treated with intravenous and intrathecal antibiotics and granulocyte transfusions before granulopoiesis recovered spontaneously. No immunoglobulin replacement was given during the acute episode, as the diagnosis of X-linked hypogammaglobulinaemia was made subsequently.
Perioperative antibiotic prophylaxis and prosthetic valve endocarditis
Authors: Ward C , Jephcott A E , Hardisty C A 
Published: December 2008

Summary
A study of twenty-five cases of prosthetic valve endocarditis suggests that the antibiotics used for perioperative prophylaxis may alter the type and antibiotic sensitivity of organisms which subsequently infect the artificial valves. Based on the results of this study, the authors have been able to modify their prophylactic regime to encompass these organisms and to predict the antibiotics most likely to be effective in the treatment of prosthetic valve endocarditis in their unit. No single prophylactic or therapeutic regime will be equally effective in all centres, but by examining the different types and sensitivities of bacteria which cause prosthetic valve endocarditis in a locality, antibiotic regimes can be chosen which best suit the local situation.
The cellular structure of bronchial carcinoids
Authors: Marks C , Lamberty J 
Published: December 2008

Summary
A histological and electronmicroscopic study of bronchial carcinoids indicated that these tumours are argyrophilic in keeping with their occurrence in tissue of embryologically foregut origin. Normal bronchi contain cells that resemble, in their electronmicroscopic content, intestinal Kultschitzky-type cells. Characteristic of the carcinoid cell is the presence of intracellular neurosecretory granules seen on electronmicroscopy despite the apparent absence of argentaffin granules under light microscopy.
Osteoporosis in childhood
Authors: Dent C E 
Published: December 2008

Summary
Osteoporosis is defined as 'too little normal bone', the disorder being rarer in children than adults. The varied forms in childhood can be classified as those secondary to some other disease and primary forms of the disorder which include the genetically determined osteogenesis imperfecta types and idiopathic forms of osteoporosis. A plea is made for greater clinical application in attempting to discriminate differing forms of these primary disorders. Osteogenesis imperfecta it is argued is a heterogeneous condition with the evidence favouring both dominantly and recessively transmitted forms in different kindreds. Another possible osteogenesis imperfecta variant is characterized by dwarfing, scoliosis and peculiar cystic lesions of the proximal humeri. Idiopathic juvenile osteoporosis is a term reserved for the acute osteoporosis beginning in the immediate prepubertal years and may differ in its cause from idiopathic osteoporosis beginning rather earlier in childhood. It is emphasized that immobilization osteoporosis is of very great importance and may become superimposed upon other osseous dysplasias. A complete understanding of these conditions will be helped by elucidation of the basic underlying defects in collagen and other constituents of bone matrix.
Perthes' disease and multiple epiphyseal dysplasia
Authors: Griffiths H E , Witherow P J 
Published: December 2008

Summary
Five atypical cases were observed amongst ninety children with Perthes' disease, ten of whom had bilateral hip joint involvement. All five were boys, four being under 4 years of age. Four had bilateral hip joint disease, four presented with hip pain, three showing some degree of retardation of bone growth. In one case the hip disorder was familial, and in four there were bony abnormalities elsewhere. Despite the absence of the classic signs of multiple epiphyseal dysplasia, a mild form of this condition is a possible alternative diagnosis for these children. Racial and familial differences are known in the prevalence of Perthes' disease which itself may represent a dysplasia. The pathogenesis of Perthes' disease is still uncertain, although some abnormality of the blood supply to the proximal femoral epiphysis is postulated. That such a vascular defect may be engrafted on to multiple epiphyseal dysplasia is possible, with subsequent joint degeneration which may come to resemble Perthes' disease either clinically or radiologically. A plea is made for the closer study of young children presenting with what may seem to be atypical Perthes' disease.
Skeletal abnormalities in homocystinuria
Authors: Brenton D P 
Published: December 2008

Summary
The skeletal changes of thirty-four patients with the biochemical and clinical features of cystathionine synthase deficiency are described. It is emphasized that there is clinical evidence of excessive bone growth and the formation for bone which is structurally weaker than normal. The similarities and differences between this condition and Marfan's syndrome are stressed and the possible nature of the connective tissue defect leading to the skeletal changes discussed. The most characteristic skeletal changes in homocystinuria are the skeletal disproportion (pubis-heel length greater than crown-pubis length), the abnormal vertebrae, sternal deformities, genu valgum and large metaphyses and epiphyses.
A review of the osteopetroses
Authors: Beighton P , Horan F , Hamersma H 
Published: December 2008

Summary
The osteopetroses are a group of conditions which are characterized by varying combinations of bony sclerosis and modelling defects. Classical osteopetrosis may be inherited as an autosomal dominant or autosomal recessive: the former variety is benign, heterogeneous and comparatively common, while the latter is precocious, potentially lethal and rare. Many other craniotubular dysplasias and hyperostoses are loosely grouped with the osteopetroses. The commonest of these is the autosomal dominant form of craniometaphyseal dysplasia, while the others which are well known include Pyle disease, and van Buchem disease. Sclerosteosis is a progressive condition in which massive cranial thickening is associated with syndactyly and gigantism. Each of these disorders has specific clinical and radiographic features, which permit recognition. Diagnostic accuracy is crucial for treatment, prognostication and effective genetic management.
Tumoral calcinosis: a manifestation of extreme metastatic calcification occurring with 1, alpha-hydroxycholecalciferol therapy
Authors: Walker G S , Davison A M , Peacock M , McLachlan M S F 
Published: December 2008

Summary
Two cases are reviewed, both of which developed tumoral calcinosis whilst receiving 1, alpha-hydroxy-cholecalciferol therapy. Tumoral calcinosis is an extreme form of peri-articular calcification, and its occurrence in patients with chronic renal failure is unusual. These peri-articular masses developed around the shoulders in both patients, and the action of 1, alpha-hydroxycholecalciferol as a possible factor promoting this form of metastatic calcification is discussed.
Cytomegalovirus infection in the neonate and its prevention
Authors: Stern H 
Published: December 2008

SummaryAbout 0.5% of infants are infected in utero with cytomegalovirus (CMV). As many as 20% become mentally retarded and a further substantial proportion suffer lesser degrees of brain damage. The need for a vaccine is greater than in the case of rubella. A live, tissue culture-adapted strain of CMV has been shown to produce neutralizing antibody in volunteers without significant side effects or detectable virus excretion. The problems of developing such a vaccine for use in man, namely, attenuation, antigenic differences among virus strains, reactivation of latent infection and oncogenicity, are briefly discussed.