bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood pressure in black, white and Asian factory workers in Birmingham
Authors: Cruickshank J K , Jackson S H D , Bannan L T , Beevers D G , Beevers M , Osbourne V L 
Published: December 2008

Summary
A screening survey was conducted among factory workers, aged 15-64 years, in Birmingham, England to investigate ethnic differences in blood pressure. One-thousand and forty-nine subjects (784 men, 265 women) were screened, representing 79% of the eligible population.
Mean systolic and diastolic blood pressures generally did not differ between men of black West Indian (n = 173), local white (n = 439) or Asian (n = 172) origin, when matched by 10-year age groups. Analysis of covariance using age as the covariate revealed that, overall, Asian men had significantly lower systolic but higher diastolic pressures than the other ethnic groups. The proportion of men arbitrarily defined as hypertensive (greater than or equal to 160 mmHg systolic or greater than or equal to 95 diastolic or blood pressures below this figure whilst receiving antihypertensive therapy) was 26% of West Indians, 22% of whites and 17% of Asians, but these were not significantly different when age was accounted for.
Black West Indian women (n = 101) did have higher diastolic pressure than white women (n = 164), but this difference was dependent on body mass index. Overall, systolic pressures in women were not significantly different.
These findings differ from those consistently reported from the United States.
A blood pressure clinic in a developing country
Authors: Ahmed M E K 
Published: December 2008

Summary
There are few studies of hypertension in Sudan. In this report, 124 patients attending a newly established hypertension clinic are studied, most of whom were taking irregular treatment initially. Seventy-three (59%) had a strong family history of hypertension. There was a very low incidence of cigarette smoking (13.7%), and alcohol consumption (4.8%).
As with blacks in the U.K. and the U.S.A., the commonest complications were cerebrovascular accidents and congestive cardiac failure. Most of the patients had moderately elevated blood pressures on the first visit, which fell significantly after 3 and 6 months of clinic attendance. Methyldopa and thiazides were the commonest drugs used, but a small pilot survey demonstrated that beta-blockers were effective. The high cost and poor availability of drugs contribute to poor compliance in these patients.
Does parasitic infestation protect the rural African from atheroma? (Abstract)
Authors: Howells D P M 
Published: December 2008

Summary
Parasitic infestation is associated with an increase in the mast cell population of tissues. Heparin is released from the mast cell to activate lipoprotein lipase and may influence fat metabolism. Depletion of the mast cell population may be a characteristic of a parasitic free, atheroma prone ‘Western’ population.
Anaemia in Asians in London
Authors: Britt R P , Hollis Yvonne , Keil J E , Weinrich M , Keil Barbara W 
Published: December 2008

Summary
Many Asian subjects were seen in London in the early 1970s with megaloblastic anaemia; in a majority of cases, this was dietary in origin. Pernicious anaemia occurs in Asians, but the incidence is probably lower than in Caucasians. Megaloblastic anaemia is now less common in this group, but a population survey in Punjabi females in the late 1970’s showed anaemia in 32%, and one or more features of iron deficiency in 76%.
Rheumatic diseases in blacks, whites and Asians—some comments
Authors: Bacon P A 
Published: December 2008

Summary
The aetiology of rheumatic diseases is unknown but in many of them it appears that there are one or more trigger factors which induce inflammatory rheumatic disease against the genetic background of the patient. Both trigger factors and genetic background may differ in different parts of the world. Ethnic differences can therefore modulate rheumatic diseases in many ways which will appear as differences in disease prevalence as well as in disease expression. This appears to be true of all rheumatic diseases which have been examined in detail, from the common ones to the rarer forms of connective tissue disease.
A comparison between a combination of ipratropium bromide plus fenoterol in a single metered dose inhaler (Duovent) and salbutamol in asthma
Authors: Flint K C , Hockley B , Johnson N McI 
Published: December 2008

Summary
The efficacy of a single metered dose inhaler containing a combination of fenoterol (100 micrograms/puff) and ipratropium bromide (40 micrograms/puff) has been assessed in 12 asthmatics. We conclude that the bronchodilator effect of 2 puffs of the combination inhaler was significantly greater than that achieved by 2 puffs of salbutamol (100 micrograms/puff).
Carcinoid tumour of ampulla of Vater associated with viscero-cutaneous neurofibromatosis
Authors: Kapur B M L , Sarin S K , Anand C S , Varma K 
Published: December 2008

Summary
A case of carcinoid tumour of the ampulla of Vater with viscero-cutaneous neurofibromatosis is reported together with a review of the literature.
Adventures and excursions in bioassay—the stepping stones to prostacyclin
Authors: Vane J R 
Published: December 2008

SummaryPhysiology has spawned many biological sciences, amongst them my own field of pharmacology. No man has made a more important contribution to the fields of physiology and pharmacology than Sir Henry Dale (1875-1968, Nobel Laureate in Physiology and Medicine in 1936). Dale had a great influence not only on British pharmacology in general but also on my own scientific endeavours. Indeed, I can put forward a strong case for considering myself as one of Dale’s scientific grandchildren. My early days as a pharmacologist were influenced not only by Dale himself but also by his own school of colleagues, including Burn, Gaddum and von Euler. It was Burn who taught me the principles and practice of bioassay. Some of Gaddum’s first publications were on the development of specific and sensitive methods for biological assay and he maintained a deep interest in this subject for the rest of his life (1). In 1964 he said “the pharmacologist has been a ‘jack of all trades’ borrowing from physiology, biochemistry, pathology, microbiology and statistics—but he has developed one technique of his own, and that is the technique of bioassay” (2).
HLA antigens and necrobiosis lipoidica diabeticorum—a comparison between insulin-dependent diabetics with and without necrobiosis
Authors: Soler Norman G , McConnachie Peter R 
Published: December 2008

Summary
To investigate whether HLA-A, -B, -C, and -DR alloantigen frequencies are different in diabetic patients with and without necrobiosis lipoidica diabeticorum we studied 37 insulin-dependent (Type I) diabetics, 15 with and 22 without necrobiosis, and 96 normal control subjects. Compared to controls Type I diabetics had increased frequencies of B8, CW3, and DR4 and decreased frequencies of DR5 and DR7. Diabetics with necrobiosis differed from diabetics without necrobiosis only in that HLA-A2 was significantly less frequent in patients with necrobiosis. It is suggested that the lack of major differences between patients with and without necrobiosis argues in favour of the role of metabolic and/or vascular rather than genetic factors in the aetiology of necrobiosis.
Comparison of propranolol and propranolol LA in hypertension using 24-hr noninvasive blood pressure monitoring
Authors: Rustin M H A , Coomes E N 
Published: December 2008

Summary
The technique of non-invasive blood pressure monitoring was used to compare the 24-hr control of blood pressure in 10 patients with essential hypertension taking either twice daily propranolol or a once daily long-acting formulation of propranolol (propranolol LA). Both drug regimes produced smooth control of blood pressure and heart rate through the 24 hours and significantly reduced blood pressure and heart rate on bicycle ergometry tests. There was no significant difference between the two treatments. The non-invasive oscillometric method of measuring 24-hr control of blood pressure provides an alternative to ambulatory intra-arterial monitoring.
A case of congenital triple valve disease
Authors: van Besouw J P , Shepherd N A , Orr G , Jackson S H D 
Published: December 2008

Summary
We report a case of congenital triple valve stenosis with dominant pulmonary valve disease, sparing the aortic valve, presenting at the age of 51 years with progressive shortness of breath and central cyanosis. At post mortem, no intracardiac right to left communication could be demonstrated.
IgE myeloma associated with plasma cell leukaemia
Authors: West N C , Smith A M , Ward R 
Published: December 2008

Summary
A patient presented with plasma cell leukaemia and was found to have an IgE secreting multiple myeloma. IgE myeloma is very rare with only 18 cases recorded. However, this case is the fifth recorded of IgE myeloma associated with plasma cell leukaemia. Since plasma cell leukaemia only occurs in 1.6% of all cases of myeloma, it seems certain that this is a significant association.
Acute polyarthritis following the use of Corynebacterium parvum vaccine (Coparvax) for malignant pleural effusion
Authors: Lever A M L , Forsythe J , Oxford P 
Published: December 2008

Summary
A 77-year-old man with a malignant pleural effusion was treated by aspiration of fluid and injection of Corynebacterium parvum vaccine for pleurodesis. Within 24 hr he had developed a temperature and a neutropenia followed by an acute crippling polyarthritis of his hands and wrists which subsequently responded to oral steroids and non-steroidal antiinflammatory drugs.
Chlormethiazole in the treatment of neonatal status epilepticus
Authors: Miller P , Kovar I 
Published: December 2008

Summary
A pre-term neonate with status epilepticus resistant to conventional treatment but who responded to a chlormethiazole infusion is reported. Nineteen days of continuous infusion was required before treatment could be discontinued and oral phenytoin substituted. Chlormethiazole should be considered in the treatment of resistant convulsions in the newborn.
Lessons from falling coronary heart disease mortality in the United States
Authors: Epstein F. H. 
Published: December 2008

Summary
The marked decline in coronary heart disease mortality in the United States since the late 1960s is most likely due in large part to successful efforts at primary prevention, attributable in turn to improved eating habits, better control of blood pressure and a reduction in smoking. Another part of the decline can probably be explained by an improvement in prognosis. It remains to be established if there has been a reduction in morbidity as well as mortality. There are other countries which have experienced declines, though of a lesser degree, while several countries have recorded increases in coronary heart disease mortality. These downward and upward turns, in general, are likewise compatible with the theory that they are caused by corresponding favourable or unfavourable changes in life styles.
Trends in major risk factors. Cigarette smoking
Authors: Simpson D. 
Published: December 2008

Summary
The object of this paper is to examine the role of smoking as a risk factor in coronary heart disease, starting with a brief history of smoking in the U.K. and a reminder of the epidemiological evidence linking smoking and cardiovascular disease. This is followed by a more detailed look at the trends in consumption of tobacco and the major factors influencing those trends, together with an outline of the main components of a smoking control policy designed to combat our epidemic of smoking-induced disease.
Hypertension and the prevention of coronary heart death in general practice
Authors: Hart Julian Tudor 
Published: December 2008

Summary
A major attack on the main risk factors of coronary heart disease is essential in order to control it.
In general practice, there is a real opportunity to control high blood pressure and smoking; unfortunately coronary risk factors are closely related to social class and unemployment. Major new strategies will be needed both by government and the medical profession in order to achieve a reduction in the commonest single cause of death in the U.K.
Cardiac failure, hepatic congestion and increased level of serum carcinoembryonic antigen
Authors: Pönkä Antti , Forslund Terje 
Published: December 2008

Summary
A 65-year-old woman undergoing chronic haemodialysis for chronic nephritis had transiently elevated serum carcinoembryonic antigen levels, up to 26 ng/ml for nearly 3 months. This elevation was most probably due to cardiac failure with hepatic congestion and pulmonary oedema, because the antigen level returned to normal when the cardiac failure was properly treated, and comprehensive examinations revealed no other cause. During follow-up for 18 months, the carcinoembryonic antigen level has remained normal.
Benign Leydig cell tumour and germ cell carcinoma in situ in a young man with gynaecomastia
Authors: Fink R. S. , Mann M. S. , Hopewell J. P. , Ginsburg Jean 
Published: December 2008

Summary
A 21-year-old man presented with a 16-year history of recurrent pyrexial episodes and a 5-year history of gynaecomastia. Blood and urinary oestrogen levels were elevated and a mass was found in the upper pole of a retractile right testis.
After orchidectomy, oestrogen levels fell, gynaecomastia regressed and the pyrexial episodes ceased.
Histological examination of the right testis showed a benign Leydig cell tumour in the upper pole and a germinal cell carcinoma in situ in the remaining part of the testis. Thus a potentially lethal condition was detected at an early pre-malignant phase by virtue of a benign, endocrinologically active tumour. This would seem to be the first report of the co-existence of a Leydig cell tumour and germ cell carcinoma in the same testis.
Acute post-streptococcal glomerulonephritis following ear piercing
Authors: Ahmed-Jushuf I. H. , Selby P. L. , Brownjohn A. M. 
Published: December 2008

Summary
A case of post-streptococcal glomerulonephritis following ear-piercing is reported. It illustrates a rare but life-threatening complication of a cosmetic procedure carried out under unhygienic conditions.
Simultaneous presentation of two cerebral arterial aneurysms
Authors: Thomas A. M. 
Published: December 2008

Summary
A case of subarachnoid haemorrhage due to rupture of a middle cerebral artery aneurysm followed by immediate enlargement of a carotid intra-cavernous aneurysm is described. The enlargement of the second aneurysm was due to a rise in blood pressure caused by the subarachnoid haemorrhage. Although multiple aneurysms are common, this phenomenon is very rare and the reasons for this are discussed.
Bi-atrial myxomas presenting as recurrent pulmonary emboli in a girl
Authors: Hanly John , de Buitleir Michael , Shaw Keith , Maurer Brian , FitzGerald M. X. 
Published: December 2008

Summary
A 14-year-old girl whose sole presenting features were symptoms of pulmonary embolism, was found to have bi-atrial myxomas. The diagnosis was made preoperatively, and the patient had a successful outcome following elective surgery. The absence of other features such as systemic embolism, atrioventricular valvular obstruction, fever and constitutional symptoms makes this a most unusual case. Right atrial myxoma should be considered in any patient presenting with pulmonary embolism for which there is no obvious source.
Hypocalcaemic cataract as a presenting symptom of renal insufficiency
Authors: Kazi G. Q. , Phillips C. I. , Lambie A. T. , Winney R. J. 
Published: December 2008

Summary
A young man of 17 years presented with bilateral reduced vision because of cataracts. Investigations showed a low level of serum calcium along with other evidence of renal failure. The cataracts were mainly in the posterior pole (cupulliform); faint peripheral cortical opacities were also present—in the form of about a dozen half-loops straddling the equator and extending about half way towards the axial centre of the lens.
Occult ruptured spleen—two unusual clinical presentations
Authors: Moore P. G. , Gillies J. G. , James O. F. , Saltos N. 
Published: December 2008

Summary
Case reports of two patients with occult rupture of the spleen are presented. In one, blunt trauma appeared to involve only the neck and upper chest, resulting in two distinct tracheal injuries and no clinical indication of abdominal injury. On the 5th day after injury this patient strangulated an indirect inguinal hernia. At subsequent surgery, a ruptured spleen was also found. The second patient gave no history of trauma and presented in cardiac and respiratory failure after a 2-month illness characterized by abdominal pain. On clinical and biochemical assessments, he was considered to have pancreatitis complicated by pseudocyst formation. Laparotomy revealed intra-abdominal haemorrhage and a ruptured spleen. The diagnosis and complications of occult ruptured spleen are discussed.
Neuroenteric cyst of the cerebellum
Authors: Mehta V. S. , Chowdhury Chitra , Bhatia R. 
Published: December 2008

SummaryIntracranial neuroenteric cysts are rarely encountered and no more than 13 cases have been reported in the literature. This paper reports another case located in the cerebellum. These occur mostly in adults and there is no typical clinical presentation. The computed tomographic scan shows them as low attenuating lesions with no peripheral contrast enhancement. These cysts are believed to be developmental in origin.
High serum thyroxine-binding globulin—an important cause of hyperthyroxinaemia
Authors: Leahy Bernard C. , Davies Derek , Laing Ian , Walton Leslie 
Published: December 2008

Summary
Four patients are described who had a significant elevation of serum thyroxine-binding globulin (TBG). Review of these patients indicated that inappropriate therapy for thyrotoxicosis had been given in three cases. A study of our laboratory records revealed that significant TBG elevation was a relatively common phenomenon which occurred in approximately 0.45% of our hospital population. Patients with this abnormality have serum thyroxine levels which are comparable to those with clinical thyrotoxicosis. Tri-iodothyronine is frequently elevated though less so than in patients with clinical thyrotoxicosis. Measurement of TBG is indicated in all cases of hyperthyroxinaemia in which the clinical features of thyrotoxicosis are doubtful. The TRH test was found to be most useful in evaluating the thyroid status of these patients.
Does hyperthyroidism predispose to thioridazine-induced hyperpyrexia and cardiac arrhythmias?
Authors: Murphy Michael B. , FitzGerald Muiris X. 
Published: December 2008

Summary
Treatment with thioridazine resulted in hyperpyrexia and ventricular tachycardia in a young woman who was later shown to have thyrotoxicosis. The reasons why hyperthyroidism may enhance thioridazine toxicity are reviewed.
Effect of introduction of colposcopy into a district general hospital
Authors: Pill C. F. , Letchworth A. T. , Noble A. D. 
Published: December 2008

Summary
Management of cervical intra-epithelial neoplasia, in a district general hospital, was examined for two 22-month periods before and after the introduction of colposcopy. This technique enables the clinician to evaluate the extent and severity of pre-malignant change, and makes treatment, using less radical destructive techniques, possible. The method of conservative treatment in this hospital was diathermy, and the cure rate of cases so treated was 97%. The use of diathermy treatment resulted in a 75% reduction in the incidence of cone biopsy in women below the age of 40 years.
A further advantage of colposcopy has been recognized, which is that some women with "mild or moderate changes" are discovered to have more severe lesions, and receive appropriate treatment without delay. It follows that all patients with an abnormal smear should be referred for colposcopy, unless there is an obvious local cause of the abnormality, such as easily treatable infection, and that the post-treatment smear reverts to normal.
In this hospital the cost of establishing a colposcopic service was low, and the cost benefits, as well as the improved management of cervical intraepithelial neoplasia suggests that the service should be introduced in all district general hospitals.
Cholecystitis associated with myelomatosis
Authors: Sherlock D. , Jones B. 
Published: December 2008

SummaryA case of myeloma presenting as acute cholecystitis unresponsive to conventional management is reported. The impairment of the immunological response is a well-known aspect of myeloma, although this usually takes the form of recurrent respiratory infections. It is unusual for acute on chronic cholecystitis, a predominantly Gram-negative infection, to present in this way.
Transient electrocardiographic changes during two episodes of relapsing brucellosis
Authors: Gur Hanan , Gefel Dov , Tur-Kaspa Ran 
Published: December 2008

Summary
Cardiac involvement in the course of acute brucellosis is rare and, when present, is usually manifested by endocarditis. Myocarditis is very infrequent and in the few reported cases, the course of the disease was fulminant. A patient with recurrent brucellosis who presented transient electrocardiographic T wave changes during two episodes of acute illness is reported. It is suggested that the patient had minor asymptomatic myocarditis in the course of recurrent brucellosis.
Acquired hypogammaglobulinaemia and sarcoidosis
Authors: Lee Christine A. 
Published: December 2008

Summary
A syndrome has been described in which hypogammaglobulinaemia is associated with splenomegaly and haemolytic anaemia and also non-caseating granulomata in lymph nodes, liver, spleen and skin. This report describes a patient with this syndrome who in addition had a positive Kveim and elevated serum angiotensin converting enzyme (SACE), suggesting the diagnosis of sarcoidosis.
Neurological aspects of insulinomas
Authors: Daggett Peter , Nabarro Sir John 
Published: December 2008

Summary
Neurological involvement occurred in every one of a series of 30 patients with an insulinoma. The episodic nature of the hypoglycaemia caused symptoms and signs to fluctuate and often led to delay in diagnosis (mean length of history was 3 years). The commonest feature at first presentation was confusion (20 instances), but as the illness evolved, coma (16 instances) and convulsions (8 instances) became more frequent. Objective weakness was found in 7 patients, with 3 examples of hemiparesis and 2 each of paraparesis and monoparesis; in all, the weakness resolved over a period of 1 hr to 3 days when normoglycaemia was maintained. Other neurological features included subjective visual disturbances, headache, dysarthria and ataxia.
220 patients with an insulinoma from 7 series in the literature were reviewed. The high incidence of neurological features was confirmed, with confusion (152 cases), coma (82 cases) and convulsions (58 cases) predominating. Visual disturbances were common, though not accurately quantified in some series. Objective evidence of weakness on the other hand was reported in only 6 of the 222 patients. Other less common symptoms included headache (18 instances) and peripheral paraesthesiae (14 instances). In the 7 series reviewed, as in our own, it was found that in any one patient, each episode of hypoglycaemia was accompanied by the same symptom complex.
The presence of an insulinoma should be considered in any patient with unusual, or inexplicable neurological features, particularly when they are intermittent. The diagnosis can be confirmed by demonstrating an inappropriately high circulating insulin level, for the ambient blood glucose concentration.