bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of myasthenia gravis treated with steroids: some suggestions for the mechanisms underlying their effect
Authors: Dandona P , Corkan E J , Sladen G E 
Published: December 2008

SummaryThis report deals with a patient with long standing myasthenia gravis treated with a small dose of corticosteroids. The response to treatment was prompt and the post-therapeutic deterioration in function was minimal and cholinergic in nature. It is suggested that the dose of anticholinesterases be reduced concomitantly with the institution of steroid treatment.
Active treatment of ganglia in children
Authors: MacKinnon A E , Azmy A 
Published: December 2008

Summary
One hundred and twenty-eight children, admitted for active treatment of ganglia around the wrist, hand, ankle or foot are reviewed. The methods of treatment are discussed. The most satisfactory results were obtained by excision (7-2% recurrence) and incision with a tenotome (11% recurrence). The overall recurrence rate was 19%. The ganglia around the wrist had the highest rate of recurrence.
Metaphyseal chondrodysplasia
Authors: Spranger J W 
Published: December 2008

SummaryAny review of the metaphyseal chondrodysplasias is complicated by their variety and mainly unknown pathogenesis. The more familiar types display considerable clinical and radiological diversity: even more so the rarer disorders which still require complete definition, but differences in their mode of inheritance make diagnostic precision mandatory. These dysplasias present in infancy or in childhood, when the patient, usually dwarfed, may be proportionate, so that some forms may be confused with rickets or other lesions. Mental retardation is unusual, but the skin, hair, nails and facies provide valuable diagnostic features. Radiological abnormalities mainly affect the metaphyses of the shortened limb bones, less often the skull, vertebrae, pelvis, ribs and extremities, and sometimes their distribution may indicate the specific type of dysplasia. In a further complex group multiple systems are involved, notably the pancreas, intestine and lympho-reticular, causing malabsorption and haematological or immunological disorders.
Echocardiographic diagnosis and evaluation of cardiomyopathies: idiopathic hypertrophic subaortic stenosis, Chagas' heart disease and endomyocardial fibrosis
Authors: Hernández-Pieretti O 
Published: December 2008

Summary
Echocardiographic investigations on patients with hypertrophic cardiomyopathy with obstruction have been detailed and compared with the changes found in sixty patients with chronic Chagas' 'cardiomyopathy'. These changes are similar to those encountered in congestive cardiomyopathy. Endomyocardial fibrosis is rare in Venezuela, but six patients have been found in that country and the echocardiographic changes in one of these patients has been included in this study.
Reversible lactic acidosis associated with repeated intravenous infusions of sorbitol and ethanol
Authors: Batstone G F , Alberti K G , Dewar A K 
Published: December 2008

Summary
Infusions of fructose or sorbitol are used commonly in parenteral nutrition and may cause lactic acidosis. A case is reported in whom blood lactate concentration was monitored frequently over a 5-day period during intravenous feeding with a sorbitol-ethanol-amino acid mixture. During the first five infusions blood lactate rose only moderately, but with the final infusion lactate rose to 11-1 mmol/l and the patient had a severe metabolic acidosis. In retrospect the patient had shown deterioration in renal and hepatic function tests during the preceding 24 hr. On terminating the infusions the blood lactate concentration fell rapidly. It is suggested that great care should be exercised when using such infusions in ill patients and acid base status and renal and hepatic function should be monitored frequently.
Granular cell myoblastoma of the biliary tree
Authors: Savage A , Devitt P 
Published: December 2008

Summary
A granular cell myoblastoma of the common bile duct is described which caused episodes of jaundice in a young woman. Histological examination demonstrated a close association of the tumour with nerve fibres, tending to support the theory of origin from Schwann cells. The lesion is benign and after excision carries an excellent prognosis.
Chlamydial, gonococcal, and herpes virus infections in neonates
Authors: Csonka G W , Coufalik E D 
Published: December 2008

SummaryThe incidence, type of lesions, portal of entry and treatment of chlamydial, gonococcal, and herpetic infections of neonates are briefly discussed. Herpes neonatorum is potentially the most serious of these conditions and major efforts in its prophylaxis are called for.
Neonatal streptococcal infections
Authors: Parker M T 
Published: December 2008

SummaryMost serious neonatal streptococcal infections are caused by group-B streptococci. The pattern of serious group-B neonatal disease in Britain resembles that described in other countries; both "early-onset" and "late-onset" forms are seen, but reliable incidence rates have not yet been determined. Serological-type III strains predominate in neonatal meningitis in Britain, but not so markedly as in some parts of the U.S.A. A deficiency of group-II strains in meningitis is, however, apparent in both countries. Present information about the carriage of group-B streptococci suggests that antibiotic prophylaxis administered to mothers or infants is unlikely to reduce greatly the frequency of "early-onset" disease. The continuous presence of a suitable chemical disinfectant in the vagina during labour might be more effective. Insufficient is known about the epidemiology of "late-onset" neonatal disease for rational preventive measures to be designed. More information is required about the postnatal acquisition of group-B streptococci by neonates and its sources, and about passive transfer of type-specific antibody from the mother to her child.
Neonatal meningitis
Authors: Goldacre M J 
Published: December 2008

Summary
Some of the main features of neonatal meningitis, studied in a defined population of infants, are reviewed. The incidence rate was twenty-six cases per 100 000 live-births. The case fatality rate was 43%. Gram-negative intestinal bacilli were the commonest infecting organisms. Streptococci accounted for an important minority of cases. It is stressed that neonatal meningitis usually presents as a non-specific illness, without the clinical signs of meningitis which are familiar in older patients. Twenty-three of the seventy-six infants in this study (30%) weighed 2500 g or less at birth. Another eight infants were born to mothers whose membranes had been ruptured for 24 hr or more.
The biochemistry of the basal ganglia and Parkinson's disease
Authors: Curzon G 
Published: December 2008

SummaryThe metabolic pathways for five transmitters in the basal ganglia are briefly described; the results of determinations of their concentrations, of their rate-limiting enzymes and of their degradation products are summarized. The changes found in Parkinson's disease are described. While dopamine synthesis in the basal ganglia is defective in this condition, abnormalities of other transmitters occur, and their possible significance is discussed.
Quadriceps myositis: an appraisal of the diagnostic criteria of quadriceps myopathy
Authors: Mohr P D , Knowlson T G 
Published: December 2008

Summary
A patient with the clinical picture of quadriceps myopathy was shown to have an underlying myositis. Review of the literature showed myositis to be a rare cause of the 'quadriceps syndrome' but it is important to identify this group because they are potentially treatable with corticosteroids.
Clinical and electroencephalographic data indicative of brain tumours in a seizure population
Authors: Vignaendra V , Ng K K , Lim C L , Loh T G 
Published: December 2008

Summary
One hundred and two patients suffering from seizures, with focal EEG signs (101 cases) and focal seizures but generalized EEG abnormalities (one case) were divided into tumour (twenty-one cases) and non-tumour (eighty-one cases) groups on the basis of contrast radiological studies. Retrospective analysis of various clinical data and EEG abnormalities, determined before the contrast radiological examinations, showed that the following were statistically significantly different between the two groups in favour of a tumoral aetiology for the seizures: age at onset of fits (&gt;20 years), presence of focal neurological signs and increased intracranial pressure, presence of focal unilateral delta waves without accompanying epileptic discharges, beta asymmetry between the cerebral hemispheres and hyperventilation-induced electrical seizures. A brain scan was a very useful screening test for the detection of a tumoral aetiology for seizures.
Assessment of casual blood pressure variations
Authors: Thulin Thomas , Bengtsson Bo , Scherstén Bengt 
Published: December 2008

Summary
All residents in a suburban community in southern Sweden, 8 years of age and older, were invited to an ophthalmological examination. The examination included a blood pressure determination.
Of the 1917 persons invited 85·5% took part in the study. 3·5% of these were excluded because they were taking antihypertensive drugs. The investigations were conducted during 14 consecutive months and at different times of the day.
The systolic and diastolic blood pressure distribution curves exhibited a positive skewing. The blood pressures rose to a plateau with essentially unchanged pressures in the age groups 28–32 years up to 38–42 years. In these ages, the systolic blood pressure was significantly higher among the males than among the females. The relation was reversed in the age groups above 48 years. The diastolic blood pressure showed no significant sex differences in the various age groups.
A multiple linear regression analysis was used to determine whether there were diurnal and seasonal effects on the blood pressure independent of the age and sex. The systolic blood pressure during the winter months was 4·1 and 5·0 mmHg higher in the male and female subjects respectively, while the diastolic blood pressure during the winter months was 1·7 and 1·9 mmHg higher in the male and female subjects respectively. The time of day had no effect on the systolic blood pressure while the diastolic blood pressure increased by 0·24 and 0·27 mmHg/hr from 8 a.m. to 9 p.m. in the male and female subjects respectively.
It is concluded that the small genuine effects of the time of measurement of casual blood pressure lack practical importance in screening of hypertension.
The outcome of pregnancy in women suffering from migraine
Authors: Wainscott G , Sullivan F M , Volans G N , Wilkinson M 
Published: December 2008

Summary
The reproductive histories of 777 women suffering from migraine were compared with 182 non-migrainous women. The incidence of miscarriage, stillbirth and toxaemia of pregnancy was very similar in both groups and there was no increase in the number of congenital malformations in the children born to women who suffered from migraine compared with the control group or with the national average. It was concluded that women suffering from migraine did not have an increased risk of giving birth to children with deformity and it was unlikely that drugs most commonly used in the treatment of migraine were teratogenic.
Perspectives in coronary prevention
Authors: Turner R W D 
Published: December 2008

Summary
The seeds of premature coronary heart disease are often sown in childhood and it is the developing arteries of children which are the most susceptible. Paediatricians and all who work with them have the earliest and most promising opportunities for prevention.
Coronary protection can be added to the potential advantages of breast feeding and to ensure appropriate fatty acid balance throughout weaning.
It is reasonable to accept the strong consensus of opinion on diet reflected in the reports of the eighteen national committees. They are: to reduce total fat intake to 30–35% of the energy, to restrict consumption of saturated fat, cholesterol, sugar, and salt, to increase unrefined carbohydrate and polyunsaturated fat, and to maintain a P/S balance of 1.0–1.5:1.
Food is the fundamental coronary risk factor, but others may add insult to injury. Smoking, hypertension, obesity, lack of exercise, and stress, each of which is related to behaviour, may start in childhood. Smoking doubles the overall risk CHD and increases it ten times in males under 45 years old. Good habits, including food preferences and eating patterns learned early, are those most likely to be continued.
School meals require and should match revised nutritional education.
The co-operation of the food industry is essential and can be anticipated, but it requires a clear lead by paediatricians.
The nutritional advice should come from the medical profession.
Every contact with children and their parents provides an opportunity for enquiry and giving advice.
Influence of nutrition in childhood on the origins of coronary heart disease
Authors: Wolff Otto , Brook C G D 
Published: December 2008

SummaryBoth the quality and the quantity of food ingested are relevant to the genesis of risk factors for coronary heart disease and the two are inseparable. Nevertheless they have a major common pathway through hypertension, which may well be the most important consequence of a high-protein, high-carbohydrate, high-fat, high-energy and high-sodium diet.Because body fatness is a strongly genetically determined characteristic and because it evolves over the whole period of childhood a vigorous and sustained programme of health education is required at all levels. The aim of such a programme is to effect a small shift in the fatness of the whole population; such a shift would dramatically and disproportionately reduce the incidence of obesity. Since the morbidity and mortality which is found in obese subjects arises primarily from cardiovascular disease in general, and coronary heart disease in particular, nutritional influences have obvious relevance to the prevention of coronary heart disease.
Arterial changes in infants of smoking mothers
Authors: Asmussen I 
Published: December 2008

Summary
Examination of umbilical arteries and veins, and vessels in placental villi was carried out by electronmicroscopy in smoking and non-smoking mothers. Severe vascular changes were found in the smoking group. These findings suggest that similar changes may be present in the vessels of the newborn child. Stopping pregnant women from smoking may help to prevent CHD in their children in later life.
The paediatrician's responsibility for the prevention of coronary heart disease
Authors: Wolfe O H 
Published: December 2008

Summary
A strong case exists in favour of encouraging children not to smoke, to be reasonably physically active and to eat in moderation to avoid obesity. The principal role of the paediatrician is in the education of health personnel who are in a position to influence children and their families to adopt these measures. Paediatricians will also be involved with children at special risk of ischaemic heart disease. They have a responsibility to promote reasearch to determine the efficacy of these measures in the prevention of coronary heart disease.
Upper gastro-intestinal endoscopy and radiology in the elderly
Authors: Stanley T V , Cocking J B 
Published: December 2008

Summary
The results of oesophago-gastro-duodenoscopy (OGD) and radiology in one hundred consecutive elderly patients were reviewed to assess the efficacy, safety and acceptability of endoscopy in this age group. False positive radiological features occurred in two of nine patients with normal endoscopic examinations. The remaining ninety-one patients had 138 lesions, sixty-four of which were diagnosed by both techniques. Endoscopy missed fourteen lesions partly because of unsuccessful intubation (one patient) or incomplete examinations due to obstructive lesions (eight patients). Radiology misdiagnosed or did not demonstrate sixty-one lesions. OGD proved to be safe and relatively well tolerated; it was invaluable at confirming or refuting the diagnosis of malignancy, at detecting multiple pathology and identifying bleeding lesions, but it gave inferior results with hiatus herniae. Thus it can usefully be undertaken in the elderly as a complementary examination to radiology.
Splenic cysts: a report of six cases and a brief review
Authors: Shousha S 
Published: December 2008

Summary
Six cases of splenic cysts, removed surgically in the Royal Free Hospital during the last 10 years, are presented. These include a hydatid cyst, two primary, epithelium lined, and three secondary, non-epithelium lined cysts.
The histology, aetiology, symptomatology, diagnosis, treatment and complications of splenic cysts are discussed.
Partial lipodystrophy with nephrotic syndrome
Authors: Hunter A M , Lawson A A H , Thomson D 
Published: December 2008

SummaryA patient with nephrotic syndrome in association with partial lipodystrophy is reported. The features of partial lipodystrophy are well recognized and the renal lesion is a mesangiocapillary glomerulo-nephritis of a dense deposit type with an associated depression of C3. This type of kidney involvement is becoming increasingly recognized as common in the syndrome of partial lipodystrophy.
The assessment of glomerular function: creatinine clearance or plasma creatinine?
Authors: Morgan D B , Dillon S , Payne R B 
Published: December 2008

Summary
Plasma creatinine concentration is superior to creatinine clearance for the detection of abnormal glomerular function, of changes of glomerular function in patients with chronic renal disease. Creatinine clearance should be abandoned as the routine assessment of glomerular function.
Plasma renin activity following renal transplantation
Authors: Snow M H , Jachuck S J , Robson V , Wilkinson R 
Published: December 2008

Summary
Plasma renin activity (PRA) was studied serially for up to 21 days following transplantation in thirteen patients receiving renal allografts. PRA was measured during fasting and recumvency and its relationship to renal function, diuretic administration, plasma sodium, allograft rejection and blood pressure was examined.
PRA fell steadily as renal function improved and plasma sodium rose following transplantation and when rejection episodes were excluded an inverse relationship between PRA and renal function could be seen. It is not possible to say whether the changes in PRA and function are causally related or whether changes in plasma sodium alone account for the observed changes in PRA. Some rejection episodes were accompanied by an increase in PRA, but this was not sufficiently consistent to be of value in the diagnosis of rejection. PRA also increased in relation to frusemide-induced fluid loss. There was no relationship in these patients between PRA and blood pressure.
The problems of massive small bowel resection and difficulties encountered in management
Authors: Barros D'Sa A A B , Parks T G , Roy A D 
Published: December 2008

Summary
Massive small bowel resection is imperative in the management of several pathological conditions and is accompanied by high operative mortality. In those that survive, serious nutritional disturbances are inevitable. Intestinal adaptation is said to occur but cannot be relied upon. Long-term parenteral nutrition is problematical and often unsuccessful. Many surgical procedures have been adopted in an effort to improve prognosis and have been found wanting. Controlled experimental studies in the use of reversed segments and a limited number of reported clinical cases using the method after massive resection suggest that this technique may improve the function of the residual intestine to such an extent that other supportive measures are unnecessary.
Study by vaginal cytology of ovarian function in pre-menopausal womenPaper presented at the VIth International Congress of Cytology, Tokyo, Japan, May 2–5, 1977.
Authors: Mehta P V 
Published: December 2008

Summary
In the pre-menopausal years, the ovarian secretion waxes and wanes until its cessation. In this study of women in the pre-menopausal period neither did the menstrual pattern prove to be a reliable criterion by which to judge the extent of oestrogen effect or deficiency nor was there correlation between serial colpocytology and endometrial histology, Hyperplasia of the endometrium was seen with different degrees of oestrogen status and in the menopause. Maximum cases of hyperplasia were seen in the irregularly menstruating group of women. It is therefore emphasized that before beginning oestrogen therapy, both colpocytology and endometrial histology should concur to establish oestrogen deficiency. A close watch should be kept on cases showing an endometrial hyperplasia.
Avascular necrosis of the femoral head in patients receiving intermittent cytotoxic and corticosteroid therapy for Hodgkin's disease
Authors: Hancock B W , Huck P , Ross B 
Published: December 2008

Summary
Two patients with stage IIIB Hodgkin's disease are reported, in whom treatment with cytotoxic and corticosteroid therapy was followed by avascular necrosis of the femoral head.
Immunoglobulin profiles of the chronic antibody response: discussion in relation to brucellosis infections
Authors: White R G 
Published: December 2008

SummaryThe use of a sensitive and quantitative radioimmunoassay has enabled much finer dissection of the immunoglobulin-antibody profiles for an individual immune response. The kinetics of the response are considered in relation to the switch from IgM to IgG antibody production. In the domestic fowl, the kinetics of this switch varied with different antigens: whereas the response to a thymus-dependent antigen proceeded through a brief 19S response to a declining 7S response, the response to a thymus-independent antigen failed to switch from 19S to 7S for several weeks and consisted of repeated excursions of 19S antibodies. When injected intravenously and simultaneously, Salmonella adelaide O (killed) organisms (thymus-independent) and sheep red cells (thymus-dependent) interact so that the response to the latter fails to switch from 19S to 7S and consists of repeated excursions of 19S antibody. The changed character of the sheep red cell response is interpreted as being due to lack of 7S antibody. Passive antibody to either sheep red cells or to S. adelaide produced an inhibition of the sheep red rell response so that only one excursion of 19S antibody was observed.The use of the radio-immunoassay enables an independent measurement of all IgM, IgG and IgA antibody to the surface antigen of Brucella obortus. The test, when applied to forty-six sera from individuals with various types of brucellosis, successfully detected antibody in many instances in which conventional serological tests were negative, and such antibody (if IgM) was associated with acute or (if IgG or IgA) with chronic cases of brucellosis. The radioassay test should prove highly valuable effectively to eliminate, in individual patients, the diagnosis of brucellosis based on the inability of conventional tests to detect significant antibody levels.