bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central circulatory responses in normotensive and hypertensive pregnancy
Authors: Lees M M 
Published: December 2008

Summary
Haemodynamic responses in normotensive pregnancy in the antenatal phase show that cardiac output is elevated by the end of the first trimester, and remains elevated throughout pregnancy, although it may fall very slightly at the end of the third trimester of pregnancy. Heart rate remains virtually static throughout pregnancy, although it may fall very slightly at the end of the third trimester of pregnancy. Arterial blood pressure remains virtually unaltered. During labour in patients with traditional anaesthesia, cardiac output is elevated by 40% overall at the end of the labour, and this rise may be as much as 60% in the immediate post-partum period. Patients with epidural analgesia show no overall rise in cardiac output throughout labour. Following Caesarean section there may be massive rises in cardiac output.
In patients who become hypertensive as a result of pregnancy, there are marked individual patterns. These different groups show patients with elevated levels of cardiac output, patients with a pure elevation of systemic vascular resistance, and a third group in which there is elevation of both resistance and output.
It seems certain that different syndromes are occurring, the theoretical explanations for which are discussed.
The respiratory response to pregnancy
Authors: Milne J A 
Published: December 2008

Summary
The respiratory response to pregnancy appears to be largely mediated by the action of progesterone and, perhaps to a lesser extent, oestrogens, at least in the first and second trimesters. The mechanical effects of the gravid uterus cause relatively little change in pulmonary mechanics, although finer changes in airways function require further investigation.
Dyspnoea during pregnancy is also probably hormone-mediated but the exact temporal relationship between hormone status, functional change and the development of symptoms is not yet clearly defined.
Acute renal failure due to non-traumatic rhabdomyolysis
Authors: Chugh K S , Nath I V S , Ubroi H S , Singhal P C , Pareek S K , Sarkar A K 
Published: December 2008

Summary
Seventeen patients with acute renal failure of diverse aetiology showed myoglobinuria and elevated levels of serum creatine phosphokinase (mean 119·2 Sigma u./ml) and adolase (mean 88·5 Sibley-Lehninger (SL)u./ml), indicating the presence of diffuse muscle cell injury. The primary conditions which led to rhabdomyolysis and acute renal failure were burns, eclampsia, prolonged labour, crush injury, epileptiform convulsions, status asthmaticus, viral myositis and intoxication with chemicals including copper sulphate, mercuric chloride and zinc phosphide. In 10 non-myoglobinuric patients with acute renal failure, serum creatine phosphokinase was normal (mean 8·9 Sigma u./ml) and serum aldolase was only slightly elevated (mean 11·2 SL u./ml). Although uric acid was elevated in both groups, the values were significantly higher in myoglobinuric (mean 0·728 ± 0·199 mmol/l) compared to non-myoglobinuric patients (mean 0·583 ± 0·093 mmol/l). During the oliguric phase, hypocalcaemia was observed in 82·2% of myoglobinuric patients and in 20% of non-myoglobinuric patients. Ten out of 15 patients with myoglobinuric renal failure developed hypercalcaemia during the diuretic phase whereas only 3 non-myoglobinuric patients showed a transient hypercalcaemia. Although the mean serum potassium was somewhat higher in the myoglobinuric patients, the difference between the 2 groups was not significant. It is concluded that acute renal failure associated with non-traumatic rhabdomyolysis is not infrequent and may occur in a variety of conditions where gross evidence of muscle injury is lacking.
Neutrophil function and diagnosis of pre-leukaemic states
Authors: Houghton J B 
Published: December 2008

Summary
Haemopoietic dysplasia is a condition which often precedes the development of acute non-lymphocytic leukaemia. Before this event, however, patients are at risk from severe infections even in the absence of neutropenia. This paper describes 3 patients with haemopoietic dysplasias in whom neutrophil microbicidal activity was deficient in vitro. The important abnormality appeared to be defective release of myeloperoxidase into the phagocytic vacuole. Two of these patients suffered from numerous baterial infections.
Feminizing adrenocortical carcinoma in a postmenopausal woman
Authors: Barcelo B , Abascal J , Ardaiz J , Gil P , Colas A , Menendez J , Inchausti J L 
Published: December 2008

Summary
The successful surgical removal of a feminizing adrenal tumour in a postmenopausal woman is described. Most of these tumours are malignant and the pathological findings and the biological behaviour of the tumour frequently do not correlate, so that a careful follow-up is necessary. In the presence of vaginal bleeding in a postmenopausal woman endometrial carcinoma should be considered. If this has been ruled out and if oestrogens are elevated with low plasma gonadotrophins, a feminizing ovarian or adrenal tumour should be considered.
Neuroblastoma in adults
Authors: Rowe P H , Oram J J , Scott G W 
Published: December 2008

SummaryTwo cases of neuroblastoma are described in patients who were both more than 25 years old when their symptoms first appeared. The behaviour of this tumour appears less aggressive in adults than in children, but the cases presented illustrate its resistance to chemotherapy and radiotherapy, and surgery is suggested as the first line of treatment in adults, even if the growth cannot be removed completely.
Failure of treatment in chronic dermatophyte infections
Authors: Hay R J 
Published: December 2008

Summary
A proportion of dermatophyte infections fail to respond to normally adequate courses of griseofulvin and topical antifungal therapy. The organism Trichophyton rubrum was isolated from 96% of 50 patients studied, but no instances of in vitro resistance were seen. Of these patients, 57% had an underlying condition, commonly hay fever/asthma, atopic eczema, collagen disease or ichthyosis. Defective delayed type hypersensitivity responses and leucocyte migration inhibition to the specific antigen, trichophytin, were demonstrated. Immediate type hypersensitivity was seen in 58% and this was partially suppressible with chlorpheniramine and cimetidine. The relationship between these abnormalities and failure of treatment is discussed.
Aspergillus fumigatus and lung disease
Authors: Turner-Warwick M 
Published: December 2008

Summary
The range of clinical presentations of lung diseases associated with Aspergillus spp. is great. The conditions are very frequently misdiagnosed but errors should be avoided if the possibility of a fungal cause is considered and simple immunological tests undertaken. Often no more than skin-prick tests and serum precipitins need to be done. In many cases, fungus is not isolated from the sputum and negative results do not exclude the possibility of A. fumigatus as the causal agent. Treatment often results in marked clinical improvement and there is evidence that suppression of recurrent episodes of bronchopulmonary aspergillosis prevents progressive lung damage.
Ketoconazole, an oral antifungal: laboratory and clinical assessment of imidazole drugs
Authors: Borelli D , Bran J L , Fuentes J , Legendre R , Leiderman E , Levine H B , Restrepo-M A , Stevens D A 
Published: December 2008

Summary
Miconazole, a parenterally administered imidazole antifungal agent has been shown to produce responses in systemic fungal infections in man. Ketoconazole, an analogue, can be given by mouth. It is inhibitory in vitro at low concentrations to most fungi. Blood levels after oral administration to animals and man greatly exceed these inhibitory concentrations for several hours. The efficacy of this drug has been demonstrated in animal models. Initial clinical evaluation has produced responses to therapy with 200–400 mg/day in 13 of 16 evaluable patients with systemic and superficial fungal infections, involving 10 fungal pathogens. No toxicity has been noted to date in these human studies. Ketoconazole is a promising agent needing further extensive evaluation.
The influence of carbohydrases on the growth of fungal pathogens in vitro and in vivo
Authors: Pope A M S , Davies D A L 
Published: December 2008

Summary
Mixtures of mycolytic enzymes from various sources release protoplasts from living fungal tissue under suitable conditions. Such enzyme mixtures obtained from Coprinus comatus (mycolase I), Physarum polycephalum (mycolase II) and Lycoperdon pyriforme (mycolase III) are of low toxicity in mammals when given parenterally and are able to cure experimental systemic fungal infections in mice when administered alone or in conjunction with normally ineffective levels of conventional antimycotic drugs such as amphotericin B. The effect is believed to be due to enzymic degradation of the fungal cell wall either killing the fungus directly or enhancing activity of existing antifungal agents by increasing access to the cell interior.
Sensitivity of Candida albicans from patients with chronic oral candidiasis
Authors: Holbrook W P , Kippax R 
Published: December 2008

Summary
Many patients with oral candidiasis respond very slowly or not at all to therapy with amphotericin. Strains of Candida albicans were collected from 17 patients clinically resistant and from 15 who responded to a normal course of amphotericin treatment. Minimal inhibitory concentrations (MIC) determined on diagnostic sensitivity test agar plates gave values of: amphotericin 0·5 mg/l; nystatin 50 i.u./ml; chlorhexidine 12.5 mg/l. No clear MIC could be determined with plates containing miconazole. No difference was noted in MIC values between the 2 groups of patients. Tube-dilution tests in Sabouraud's broth gave MIC values of: amphotericin 0·25 mg/l; nystatin 12·5 i.u./ml; chlorhexidine 1·5 mg/l; miconazole 8–32 mg/l; ketonazole 64 mg/l. Persistence of oral candidiasis is not an indication of infection with resistant organisms. Despite difficulties in in vitro sensitivity testing of miconazole a clinical trial of the drug for treating oral candidiasis is indicated.
A comparative study of adverse factors in meningococcaemia and meningococcal meningitis
Authors: Ansari B M , Davies D B , Boyce J M H 
Published: December 2008

SummaryIn a retrospective study, a comparison was made of clinical and laboratory data in 14 patients with meningococcaemia and 40 patients with meningococcal meningitis. Significant differences were found in duration of symptoms, onset of purpura, presence of shock, initial WBC, ESR, and serum fibrin degradation products. The overall mortality rate in this series was 7%, 4 patients with meningococcaemia dying, but none with meningococcal meningitis. This study indicates the importance of clinical and pathological grading of patients with meningococcaemia. Death occurred only in patients presenting with 3 or more of the adverse factors detailed.
Clinical and epidemiological aspects of methylmercury poisoning
Authors: Bakir F , Rustam H , Tikriti S , Al-Damluji S F , Shihristani H 
Published: December 2008

SummaryAn opportunity to study the effects of methylmercury poisoning in humans was provided by the large outbreak in Iraq in 1971-2. In adults, poisoning resulted from the ingestion of home-made bread prepared from methylmercury-treated seed grain and there was a highly significant correlation between the amount of bread ingested and blood mercury levels. Poisoning in infants resulted either from prior exposure in utero or from suckling or both. Blood mercury levels were higher in infants and children than in adults.There was no increased incidence of congenital defects. Symptoms and signs of poisoning and histopathological changes were mainly confined to the CNS. Symptoms developed, on average, 1-2 months after exposure. In children there was mental retardation with delayed onset of speech and impaired motor, sensory and autonomic function. Severely affected children were blind and deaf. In adults, the clinical picture could be classified as 1, mild (mainly of sensory symptoms) 2, moderate (sensory symptoms accompanied by cerebellar signs) and 3, severe (gross ataxia with marked visual and hearing loss which, in some cases, progressed to akinetic mutism followed by coma). Grades 1 and 2 carried a better prognosis thant grade 3.Interference with transmission at the myoneural junction was found in 14% of patients studied. There was no evidence of peripheral nerve involvement per se and sensory symptoms may be of central origin.The clinical differences between the Iraqi and Japanese outbreaks may be a result, in part at least, of the severe, prolonged and continuous exposure which occurred in the latter outbreak. Improvement was observed among the mild and moderate group. Treatment with chelating agents, thiol resin, haemodialysis and exchange transfusion lowered blood mercury concentrations but produced no convincing clinical benefit. To be effective, treatment may need to be instituted soon after exposure.
Dermatitis herpetiformis and diabetes mellitus
Authors: Holt S , Blackwell J N 
Published: December 2008

Summary
Three out of 4 patients with coexistent diabetes mellitus and dermatitis herpetiformis (DH) developed severe renal failure which resulted in death in 2 of them. Diabetes mellitus and DH may coexist more frequently than would occur by chance, and such patients may run an increased risk from severe renal complications of diabetes.
The effect of oral cimetidine on the basal and stimulated values of prolactin, thyroid stimulating hormone, follicle stimulating hormone and luteinizing hormone
Authors: Nelis G F , Van de Meene J G C 
Published: December 2008

Summary
The effect of cimetidine on the basal values of PRL, TSH, FSH and LH and on the TRH/LHRH-stimulated values of these hormones was investigated in patients with peptic ulcer. No difference was found between the values before, during or after cimetidine maintenance treatment. To evaluate whether a rise in PRL occurs during the early phase of cimetidine treatment, daily estimations were made of basal PRL values during the first week of cimetidine adminstration in volunteers. No significant difference was found. It is concluded that oral cimetidine treatment has no influence on the basal and stimulated values of PRL, TSH, FSH and LH.
Multiple sclerosing haemangiomas of the lung
Authors: Joshi K , Shankar S K , Gopinath N , Kumar R , Chopra P 
Published: December 2008

Summary
A case of mulitple sclerosing haemangiomas of the lung is described from a 40-year-old woman, who presented with haemoptysis. A chest X-ray revealed multiple circumscribed coin lesions in both lungs. A right upper lobectomy was done for diagnosis. The patient has remained well for 2 years after surgery. Multiplicity of tumour masses of pulmonary sclerosing haemangiomas is extremely rare and, although benign, may pose a great diagnostic problem.
Demeclocycline therapy for resistant oedema in advanced cardiac failure
Authors: Bonser R S A , Ghose R R 
Published: December 2008

Summary
A patient with long-standing ischaemic heart disease and severe low output congestive cardiac failure received numerous diuretics, which gradually became ineffective. Resistant oedema was treated by adding demeclocycline to the current diuretic regime of frusemide and metolazone. Diuresis resulted, oedema disappeared and body weight fell. This drug combination was continued without complication for a further 6 months until his death.
Para-aminosalicylic acid-induced hypoglycaemia in a patient with diabetic nephropathy
Authors: Dandona P , Greenbury E , Beckett A G 
Published: December 2008

Summary
A 62-year-old Indian with diabetic nephropathy controlled with metformin, developed miliary tuberculosis for which he was treated with rifampicin, isoniazid and ethambutol. Soon afterwards he developed cholestatic hepatitis and visual disturbance. Rifampicin and ethambutol were stopped. Streptomycin caused vertigo and had to be stopped. The introduction of para-aminosalicylic acid (PAS) led to hypoglycaemic coma. Metformin was stopped. Hypoglycaemic coma recurred. PAS was stopped and the patient’s blood glucose concentrations became normal. Treatment with isoniazid and ethambutol led to total recovery from pulmonary tuberculosis. The induction of hypoglycaemia with PAS in this patient suggests a potential role for PAS in the treatment of diabetes mellitus.
Gentamicin extraction from an anuric patient by combined haemodialysis and charcoal haemoperfusion
Authors: Wright N , Bhamjee A 
Published: December 2008

Summary
A 39-year-old woman who developed acute renal failure following intra-abdominal sepsis was treated with gentamicin. Her serum concentrations reached potentially toxic levels. Combined haemoperfusion and haemodialysis removed approximately 70% of the given drug and the patient made a complete recovery.
Campylobacter enteritis in Chelmsford
Authors: Bradshaw M J , Brown R , Swallow J H , Rycroft J A 
Published: December 2008

Summary
During one year, out of 1829 faecal specimens examined at the Chelmsford Public Health Laboratory, campylobacters were isolated from 109 (6%), 21 of the positive cultures were from hospital in-patients and 3 were from hospital staff. The remaining 85 isolates were from specimens sent in by general practitioners.
The authors’ figures show a marked season variation with most of the infections occurring from June to September. The highest incidence (36%) was in the 20 to 30 age group, 99% of patients had diarrhoea, usually watery, occasionally explosive, and 9% had visible blood in their stools. Eighteen per cent. of patients had abdominal pain, 5 of the 21 hospital in-patients underwent abdominal surgery. Fifty-nine faecal specimens were examined microscopically and 30 of these had blood and pus cells or pus cells alone. Three patients had rectal biopsies showing a nonspecific colitis, 11 patients had recently been abroad.
Unusual variants in the presentation of temporal arteritis
Authors: Cherry J E , Pearce J M S 
Published: December 2008

Summary
A retrospective study was made of 96 patients diagnosed as cranial arteritis of whom 32 were accepted using strict clinical criteria or a positive temporal artery biopsy. Unusual presentations of fever, psychiatric illness, headache-free patients and a ‘normal’ ESR are described. The recognition of these variations is important in the early diagnosis of temporal arteritis.
The treatment of ‘shooting’ pain
Authors: Swerdlow M 
Published: December 2008

SummaryAnticonvulsant drugs were given to 70 patients suffering from lancinating pains of various clinical aetiologies. Serum drug estimations were used to ensure that an effective dose level was achieved. In about 66% of the cases, treatment produced some diminution in the intensity and/or frequency of the "flashes" of pain. The neurophysiological and pharmacological rationales are briefly explained. It is concluded that this use of anticonvulsant agents merits further study.
Small cell carcinoma of the lung
Authors: Morgan P G M 
Published: December 2008

Summary
Over a 5-year period 230 cases of small cell carcinoma presented to Brompton Hospital, London. The male to female ratio was 2.5:1 and 39% had evidence of extrathoracic disease. Forty-five patients were untreated and had a median survival of 70 days. The 5-year survival for surgery and radiotherapy was 6.6% and 4.2% respectively. Of 13 patients treated with chemotherapy the median survival was 285 days. The factors which influence survival are described.
Acute poisoning due to Wright’s vaporizing fluid
Authors: Wiseman H M , Turner W M L , Volans G N 
Published: December 2008

Summary
A 3-year survey is reported of acute poisoning by Wright’s Vaporizing Fluid which covered a change in formulation from 90% cresol to 10% chlorocresol. Of 160 children (average age 2.5 years) and 12 adults, 21.5% had moderate symptoms, 7.5% had severe symptoms and one child died. Where incidents involved the old formulation very few patients escaped without symptoms and over 50% of thm had skin burns or moderate systemic symptoms. With the new formulation over 50% of the patients were asymptomatic and skin burns were uncommon. However there was no significant difference in the incidence of severe systemic symptoms between the formulations. The new formulation appears safer when small amounts of the fluid are ingested, but when larger amounts are involved it is potentially lethal. The case history of the fatal poisoning is presented.
Cimetidine treatment for the prevention of recurrence of duodenal ulcer: an international collaborative study
Authors: Burland W L , Hawkins B W , Beresford J 
Published: December 2008

Summary
Comparison of cimetidine and placebo in the prevention of recurrence of ulceration was carried out in the study of 696 patients with recently healed duodenal ulcers. Treatment with cimetidine 400 mg at bedtime or twice daily for up to 12 months very significantly reduced recurrence of symptomatic ulceration. Asymtomatic ulceration occurred in treated and untreated patients but was found significantly less often in cimetidine-treated patients. There were no serious untoward effects of cimetidine treatment. Only 3 patients (0.8%) were withdrawn for possible drug-related reasons. Evidence from other studies suggests that the natural history of duodenal ulcer remains unaltered when cimetidine treatment is stopped after one year. Investigations have been planned to study the efficacy and safety of longer periods of treatment.
Unusual presentation of cholangiocarcinoma
Authors: Marigold J H , Horton L W L , Thompson R P H 
Published: December 2008

Summary
A patient who presented with dysphagia was found to have a cholangiocarcinoma, with metastases in the para-oesophageal lymph nodes. Although dysphagia has been described as a presenting feature of some metastatic carcinomas, to the authors’ knowledge, there have been no reports of it as a presenting symptom of a cholangiocarcinoma.
Thrombophlebitis migrans: a further systemic complication of ulcerative colitis
Authors: Elliott H L 
Published: December 2008

Summary
Thrombophlebitis migrans complicating ulcerative colitis has been reported only once previously when it occurred in a patient with chronic and extensive bowel disease. This report describes the occurrence of thrombophlebitis before any bowel upset in a patient who proved to have only a mild colitis, and no laboratory evidence of hypercoagulability. It seems that thrombophlebitis migrans is a further systemic complication of ulcerative colitis, and that its occurrence may precede overt bowel disease.
Pernicious anaemia and hypogammaglobulinaemia in a patient with severe infantile kyphoscoliosis
Authors: Lee F I , Norfolk D R 
Published: December 2008

Summary
A 27-year-old man with severe infantile kyphoscoliosis suffered from recurrent respiratory tract infections during childhood and early adult life. He deteriorated and was found to have pernicious anaemia and common variable immunodeficiency with hypogammaglobulinaemia and impairment of cell-mediated immunity. Marked clinical improvement has followed the institution of effective gamma-globulin replacement.
Hypersensitivity and jaundice due to azathioprine
Authors: Davis M , Eddleston A L W F , Williams R 
Published: December 2008

Summary
A patient is described who suffered hypersenitivity reactions (anorexia, nausea and vomiting) as well as cholestatic jaundice from therapy with azathioprine. Evidence is given that the 2 reactions were mediated by different portions of the azathioprine molecule.
Partial nodular transformation of the caudate lobe of the liver presenting with ascites
Authors: Fletcher M S , Wight D G D 
Published: December 2008

Summary
Partial nodular transformation is a rare condition which effects the perihilar portion of the liver and may cause chronic portal hypertension. This case report describes an elderly women in whom the condition was confined to the caudate lobe, which had become greatly enlarged and, by external compression of th portal vein at the hilum of the liver, had caused portal vein thrombosis and subsequent acute ascites.