bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart size in thyrotoxicosis
Authors: Staffurth J S , Morrison N D W 
Published: December 2008

Summary
(1) Enlargement of the heart was found in 35% of a group of older patients with thyrotoxicosis who had no evidence of associated heart disease. Atrial fibrillation was present in 48% of patients with cardiac enlargement and in 10% with a normal sized heart. Both complications were more common when there was associated heart disease.
(2) In patients with an enlarged heart but no associated heart disease a reduction in heart-size after treatment of thyrotoxicosis was observed in five of twenty-three who had sinus rhythm throughout, and in three of eleven who had atrial fibrillation on presentation with subsequent reversion to sinus rhythm. There was no reduction in heart size in ten who had persistent atrial fibrillation after completion of treatment. Reduction in heart size was most marked in patients who had presented with frank cardiac failure.
(3) The incidence of cardiac enlargement and atrial fibrillation both increased with advancing age but whereas enlargement was common over 45 years atrial fibrillation was rarely seen under 55 years of age. Only one of thirteen patients with an enlarged heart under 55 years had atrial fibrillation.
(4) It is concluded that enlargement of the heart may be a manifestation of thyrotoxic heart disease, that it may precede the onset of atrial fibrillation in some instances, and consequently that atrial fibrillation is not necessarily the cause of an enlarged heart in thyrotoxicosis.
Penicillin encephalopathy
Authors: Conway N , Beck E , Somerville Jane 
Published: December 2008

Summary
Five patients who developed characteristic myoclonic twitching, drowsiness and convulsions due to intravenous penicillin and cloxacillin are described. Three had poor renal function. Twenty-three reported cases of penicillin encephalopathy are reviewed and the aetiology of the syndrome is discussed.
Bone sclerosis in infancy
Authors: MacCarthy Joan M T 
Published: December 2008

Summary
The significance of bone sclerosis in infants and children as seen on X-ray examination is discussed.
The recognition of increased bone density during the investigation of infants who fail to thrive may not establish the diagnosis but is important in instigating further tests.
This review draws attention to the practical value of recognizing a generalized increase of bone density, especially as an incidental finding. Since the immediate reaction of growing bone to metabolic insult is limited, there is considerable overlap in the radiographic features of different conditions, but clinical and biochemical measures can then be directed towards a correct assessment.
The management of acid-base balance in children with diabetic acidosis
Authors: Kuzemko J A , Fielding D W , Hudson F P 
Published: December 2008

Summary
Acid-base changes in eleven diabetic children admitted to hospital with keto-acidosis are described. Six children required intravenous sodium bicarbonate to correct the metabolic acidosis. It is concluded that immediate use of bicarbonate in these children was efficient, rapid and safe.
Acute intravascular haemolysis and renal failure due to arsine poisoning
Authors: Coles G A , Davies H J , Daley D , Mallick N P 
Published: December 2008

SummaryTwo men developed acute intravascular haemolysis after exposure to arsine gas in a metal smelting works. Both survived; one developed acute renal failure and required peritoneal dialysis. His renal function returned to near normal within 3 months. The probable mode of exposure has been investigated and is discussed. The toxic effects of arsine are briefly reviewed. The preventive action taken is detailed.
Degenerative diseases of the central nervous system transmissible to experimental animals
Authors: Beck Elisabeth , Daniel P M 
Published: December 2008

Summary
The clinical features and the pathological changes in the central nervous system of scrapie and kuru are described and attention is drawn to the similarities between these conditions. In both, inoculation of tissues into experimental animals reproduces a similar disease after a prolonged latent period.
The transmission of subacute presenile polioencephalopathy to a chimpanzee is noted.
The work which led to the discovery of the transmissibility of these conditions is mentioned.
The significance of central venous pressure and cardiac output measurements in shock
Authors: Riordan J F , McLay W D S , Walters G 
Published: December 2008

Summary
The central venous pressure changes which occur in shock syndromes vary with the aetiology and other factors.
Two methods of measuring CVP have given different results, and their advantages and disadvantages are discussed, together with an appraisal of the diagnostic and therapeutic value of such measurements.
The CVP changes produced by transfusion are related to changes in cardiac output and the value of the latter as a guide to treatment is discussed. The relationship of these measurements to clinical signs is emphasized.
The microcirculation in shock
Authors: Matheson N A 
Published: December 2008

Summary
Some aspects of blood fluidity in hypoperfusion with particular reference to the important role of the red cell are discussed. Changes in different organ beds and the internal fluidity of the red cell, which is of obvious importance in capillary flow are not considered.
It is not certain to what extent the phenomena discussed are critical factors in morbidity and mortality in shock because of paucity of objective data but there are good reasons for assuming them to be of importance and for directing treatment towards their correction.
The properties of Dextran 40 applicable to the therapy of disordered blood fluidity are described.
Volume expansion and flow promotion in shock
Authors: Gruber U F 
Published: December 2008

Summary
Volume replacement is the most important step in treating hypovolaemic shock.
Blood is needed when the oxygen carrying capacity threatens to fall below a critical level, but has the disadvantage of transmitting virus hepatitis. Anicteric hepatitis is about four times more frequent than the icteric form. Pasteurized plasma protein solution and albumin are free from the risk of transmitting hepatitis virus, and are good volume restorers.
Dextran 70 represents the best artificial colloid with additional anti-thrombotic properties. Dextran 40 is indicated in special situations to promote flow.
There is no proof that large amounts of Ringer solution are superior for treating hypovolaemic shock in man compared with colloids and electrolytes.
The effect of dietary sucrose on blood lipids, serum insulin, platelet adhesiveness and body weight in human volunteers
Authors: Szanto Stephen , Yudkin John 
Published: December 2008

Summary
A study was made of the effect of high or low intake of sucrose for periods of 14 days in a group of nineteen apparently healthy men.
The high sucrose diet produced no change in blood levels of cholesterol or phospholipids, or in glucose tolerance, but it produced a significant rise in triglycerides in all nineteen men. In six of them, there was in addition a rise in serum immunoreactive insulin, especially during the glucose tolerance test, and these same six subjects also showed a considerable increase in weight and a significant increase in platelet adhesiveness.
There was no difference between the six subjects and the remaining thirteen in any of the other measurements, or in the diets they consumed during the experiment. The changes produced by sucrose had disappeared, or nearly so, after 14 days of normal diet.
It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids. It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose, and that these may be identified as those that show ‘sucrose-induced hyperinsulinism’.
The radiological investigation of urinary infections in children
Authors: Starer F 
Published: December 2008

Summary
One hundred children with urinary tract infections were fully investigated radiologically. More than half showed abnormalities of the urinary tract.
It is concluded that full investigation of the urinary tract is justifiable at any age; it should be carried out in boys at the first infection, and in girls at the latest after the second infection, or if treatment did not produce the expected cure.
Vascular radiology in liver disease
Authors: Kreel Louis 
Published: December 2008

SummaryVascular radiology of the liver has increased in scope and function in recent years due mainly to the application of new techniques.It is now possible to examine not only the inferior vena cava and the portal venous system, but also the hepatic veins and the coeliac axis and superior mesenteric artery. Hepatic vein occlusion, portal vein patency and collateral veins, as well as space-occupying lesions, can now be diagnosed with a fair degree of accuracy.These techniques have also helped in the understanding of the altered haemodynamics of portal hypertension and can be used for treatment by intra-arterial perfusion of chemotherapeutic substances.
Obstetric radiology
Authors: Highman J H 
Published: December 2008

Summary
The uses of radiology in obstetrics are described. The dangers to the foetus are described. It is concluded that with care these can be reduced and the benefits from its use may often outweigh the dangers.
The indications for pelvimetry, the technique and its interpretation are discussed.
Placentography and the use of radiology in determining maturity are also described.
Acute carbon monoxide poisoning—3 years experience in a defined population
Authors: Smith J Sydney , Brandon S 
Published: December 2008

Summary
Between 1 January 1965 and 31 December 1967, 206 episodes of carbon monoxide poisoning were known to the coroner or the city hospitals in Newcastle upon Tyne.
The mortality rates were: suicidal exposure 38·2%; accidental exposure 39·7%.
In 21·3% of suicidal and 18·9% of accidental exposures recovery was complicated by prolonged delirium suggesting that all degrees of functional or structural neurological damage may have occurred, yet oxygen therapy was given in only 43·8% of suicidal and 34·5% of accidental exposures.
In view of the risk of persistent neuropsychiatric sequelae it is suggested that current patterns of management should be revised.
Clinical associations of vitiligo
Authors: Dawber Rodney P R 
Published: December 2008

Summary
Vitiligo, a common skin condition, has been reported in association with thyroid disease, pernicious anaemia, carcinoma of the stomach, Addison’s disease and diabetes mellitus.
Some subjects with vitiligo can be shown to possess circulating antibodies to thyroid gland, thyroglobulin, gastric parietal cells and adrenal gland, even in the absence of disease.
Vitiligo is evidently another ‘skin-marker of internal disease’.
The aim and philosophy of patient monitoring
Authors: Stewart J S S 
Published: December 2008

Summary
The history of monitoring is traced from ancient times until the invention of transducers and computers. The relevance of progress in resuscitation is emphasized.
The more recent evolution of electromedical apparatus is considered from single signal detection, display and alarm to multiple signal processing, trend analysis and diagnosis.
The aim of patient monitoring is to give warning of early or dangerous deterioration and to achieve this by obtaining an optimal compromise involving many design factors, clinical, engineering and economic.
A new philosophy is illustrated by the specification and development of the Lifeline patient monitor. The translation of clinical diagnoses into electronic switching logic is of particular importance.
Principles of engineering design
Authors: Penny R K 
Published: December 2008

Summary
The paper sets out procedures used in engineering design by listing the various steps in a sequential pattern. This pattern is not universally applicable and the variants on it depend on the type of problem involved and the information available. Of critical importance is the way in which models—physical or mathematical—can be constructed and depending on these, three design methods are described. These types are illustrated by reference to a number of medical aids which have been designed.
Patient monitoring: on-line computing
Authors: Raison John C A 
Published: December 2008

Summary
On-line computing represents a further extension of the senses of attendant staff in intensive care situations.
Smaller computers will contribute as scientific processors, by extending the capability of instrumental systems or enabling new means of measurement and calculation.
The fullest use of computer-aid will provide systems of data acquisition from multiple sources, rapid processing correlation, analysis in mathematical and diagnostic forms, and resultant output in simply intelligible displays: later, some direct control of therapy may be applied.
Experimental studies with a clinical monitor and diagnostic computer
Authors: Levy L S , Guruswamy B A , Lee W R , Stewart J S S 
Published: December 2008

Summary
A clinical monitor and computer is described which uses input information about heart rate, blood pressure and oxygen saturation. The data are processed in a simple diagnostic computer, the circulatory failure analyser, to give a diagnosis of cardiac arrest, hypoxia and oligaemic shock and to give early warning of tachycardia, bradycardia, hypertension, hypotension and cyanosis. The analyser was tested on simulated signals and experimentally in animals. The validity of the logic utilized by the computer was confirmed and the sensitivity as a monitor was assessed.
User needs of patients and nurses in clinical monitoring
Authors: Crook J 
Published: December 2008

Summary
Monitoring equipment can be uncomfortable and even painful when connected to a patient and its mere presence can produce anxiety. It is possible to reduce these effects to some extent, and by adequate explanation and reassurance to persuade the patient to accept techniques which are used in his own interest.
The nursing staff will accept and use equipment, even though it is quite complex, if they are convinced primarily that it is necessary for the patient and reliable, and secondarily not too time consuming to look after. The equipment used for monitoring at the moment is too unreliable to be accepted confidently as a warning device. There is a need for much more reliable equipment in this field, but it is unlikely that the number of nurses required for an intensive care unit could be reduced.
It is generally agreed that there is a need for a technician experienced in electronics equipment to maintain and service these machines.
Monitoring requirements in patients with acute myocardial infarction
Authors: Adgey A A Jennifer , Pantridge J F 
Published: December 2008

Summary
The majority of deaths from myocardial infarction occur soon after the onset of symptoms. The mobile scheme described allows intensive care to commence in the patient’s own home or at the site of infarction and thus reduces the interval between the onset of symptoms and the initiation of intensive care. Monitoring is continued during transport and following admission to the hospital coronary care unit.
The major impact of therapy on the mortality from acute myocardial infarction will result from the detection and correction of rhythm disturbances.
Phenylketonuria: a review
Authors: Yu J S 
Published: December 2008

SummaryThe development of a practical screening procedure for phenylketonuria and the improvement in methods of chemical analysis have led to a realization that Folling’s (1934) disease of phenylketonuria is not a single entity.In this commentary, the current view on some aspects of phenylketonuria will be reviewed and the problems illustrated by experience gained in the Phenylketonuria Clinic at the Royal Alexandra Hospital for Children in Sydney, at present attended by fifty-six children. From April 1964, fifty-six infants and children were referred because of a positive screening test. Six were no longer abnormal at the time of retesting, forty-two had classical phenylketonuria and eight showed an atypical pattern. Subsequent family studies revealed five other classical phenylketonuric children, all of whom were retarded, and one other atypical phenylketonuric boy.
Ocular sarcoidosis
Authors: Jackson H 
Published: December 2008

Summary
In 5529 new patients attending eye clinics 0·8% of patients were found to have endogenous uveitis. None had radiographic evidence of sarcoidosis. Of thirty-four who had a Mantoux test 56% were negative. A Kveim test done on twenty-four of the cases revealed that 12·5% were positive, and in two of these histological evidence of sarcoidosis was found.
Eighty-two patients with multisystem sarcoidosis were similarly investigated and in addition their lachrymal secretion was measured. Of these twelve (14·6%) had an ocular lesion, six having bilateral uveitis, two unilateral uveitis and four lachrymal gland enlargement. 58% of these cases were found to have reduced lachrymal secretion. In addition fifty-seven of these patients without ocular abnormality had their lachrymal secretion measured and 49% of these were found to have reduced lachrymal secretion.
An attempt to demonstrate a transmissible agent from sarcoid material
Authors: Mitchell D N , Rees R J W 
Published: December 2008

Summary
The results of a controlled experiment in which an attempt was made to transmit sarcoidosis by inoculation of sarcoid and non-sarcoid lymph node homogenates into the footpads of normal and immunologically deficient mice, are reported.
The early and late changes in the footpads were assessed microscopically. A substantial proportion of the footpads of mice receiving sarcoid homogenate showed the histological characteristics typical of sarcoidosis in man and evolved fully only after a period of 6-8 months following inoculation. Moreover, positive Kveim tests were confined to a proportion of those mice given sarcoid homogenates and were all associated with a sarcoid granuloma in the footpad.
Conversely, the inflammatory lesions seen in the early histology of the footpads of mice inoculated with non-sarcoid homogenate were no longer apparent in the late histology and Kveim tests in all mice given non-sarcoid homogenate were negative.
Evaluation of the clinical and histological features of paratracheal and hilar gland enlargement
Authors: Mikhail J R , Drury R A B , Mitchell D N 
Published: December 2008

Summary
Sixty-nine patients with a chest radiograph showing enlargement of the hilar and/or paratracheal lymph nodes were analysed. Ten of these, mainly Asian, were found to be suffering from tuberculosis. Of the remaining fifty-nine, who had sarcoidosis, 12% were tuberculin-positive. All the cases diagnosed as sarcoidosis had either a positive Kveim test and/or mediastinal lymph node histology compatible with sarcoidosis. 10% of cases with sarcoidosis showed evidence of uveitis and 10% showed bone cysts and there was also a high proportion of other extrathoracic lesions.
From these studies we conclude that, whilst the currently accepted radiological staging of sarcoidosis serves as a convenient form of reference, these stages do not in any way relate to the clinical stage of disease, or to the histological appearance of affected lymph node tissue.
There is a correlation between a strongly positive Kveim test of three or more granulomas and mediastinal lymph nodes showing confluent granulomata (predominantly of the epithelioid cell-type) with fibrosis. The presence of intra- or peri-granulomatous fibrosis, or even gross diffuse fibrosis, does not seem in itself to be related to the nature of onset, clinical or accepted radiological staging of disease. However the mediastinal lymph nodes in patients with erythema nodosum were predominantly of giant cell-type; these patients were also Kveim-positive. Similar instances of giant cell predominance in the mediastinal lymph nodes were seen in each of the groups examined. Further studies are required to determine whether these cellular characteristics, or other histological features in the mediastinal lymph nodes, might be of prognostic significance.
Obesity and coronary heart disease
Authors: Baird I McLean 
Published: December 2008

Summary
Firstly, the incidence of obesity in the United Kingdom is not accurately known at the present time. Secondly, regional studies indicate that approximately half the population is overweight. The relationship of major degrees of obesity with sudden death and angina is established. The reversibility of the rise in coronary heart disease in obese subjects after weight reduction suggests that this is an important prophylactic measure particularly in middle-aged men. Thirdly, the prospective role of exercise in preventing coronary heart disease particularly in obese subjects deserves further investigation.
L-Dopa and amantadine hydrochloride in extra-pyramidal disorders
Authors: Parkes J D , Knill-Jones R P , Clements P J 
Published: December 2008

SummaryL-Dopa and amantadine hydrochloride were separately given to patients with diverse extra-pyramidal disorders including progressive supranuclear palsy; porto-systemic encephalopathy; oculogyric crises; drug-induced Parkinsonism; Huntington’s chorea, hemiballismus; spasmodic torticollis, familial tremor; and athetosis. Akinesia and rigidity were improved in the first two conditions and simultaneously there was improvement in disordered eye movement. Amantadine provoked an exacerbation in spasmodic torticollis and familial tremor. No other condition was influenced. Both amantadine and L-dopa will facilitate eye movement mechanisms: it seems probable that both drugs act on dopamine-sensitive areas within the CNS. Neither drug will give significant benefit in the above disorders.
The results of surgery for low back and leg pain due to presumptive prolapsed intervertebral disc
Authors: Dunkerley G E 
Published: December 2008

Summary
Fifty-six patients who had undergone fifty-seven operations for low back and leg pain thought to be associated with a prolapsed intervertebral disc have been reviewed. Forty-two had only mild residual signs and symptoms or none at all.
The patients selected for surgery were those with intractable signs and symptoms which had not improved with conservative treatment, and some were chronic low back invalids.
Myelography is a desirable adjunct in some patients when localization or diagnosis is in doubt.
In addition to the forty-two patients who had a successful outcome, five patients were improved and five who eventually had recurrences were successful at first. The figures therefore show that some measure of relief resulted from fifty-two out of fifty-seven operations performed.
The results of operation for carefully selected patients with presumptive prolapsed lumbar intervertebral disc are good. The operation is expected to relieve leg pain but more than half the patients will continue to have some discomfort or paraesthesiae. More relief from backache occurs than might be expected in view of the pathology and nature of the surgical procedure.
Most patients can return to their former occupation even though arduous.
Those accustomed to wear low back supports for years are able to stop doing so after surgery.
A small proportion of patients with initial successful results develop recurrence of back and leg symptoms. Most subside with conservative treatment and may arise from rupture of adhesions but re-exploration is sometimes necessary.
The results after the fenestration operation were not convincingly superior to those after laminectomy. Bearing in mind that the fenestration procedure was usually done on those with clear-cut signs and positive localization, it does not appear that there is anything to be gained by doing this rather more difficult operation.