bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of a low-calorie diet with and without fenfluramine on the glucose tolerance and insulin secretion of obese maturity-onset diabetics
Authors: Dykes J Ranald W 
Published: December 2008

SummaryGlucose tolerance and insulin secretion have been measured in twenty-three obese maturity-onset diabetics (twelve high-insulin secretors and eleven lowor normal-insulin secretors) on first presentation and after 10 weeks on a low-calorie diet. There was a significant improvement in glucose tolerance alone, when the results were compared with those from diabetics not on any form of treatment.Thereafter nine of these subjects (five high-insulin secretors and four low- or normal-insulin secretors) continued on the dietary therapy alone, and eleven of the remaining fourteen subjects (six high-insulin secretors and five low- or normal-insulin secretors) continued on the low-calorie diet with the addition of fenfluramine, and their glucose tolerance and insulin secretion were measured again after a further 10 weeks. The remaining three subjects were no longer studied. The nine subjects continuing on the diet alone showed maintenance of the improvement in glucose tolerance achieved during the first 10-week period with no significant change in insulin secretion. The eleven subjects placed on fenfluramine in addition to the diet also showed maintenance of the improvement in glucose tolerance achieved during the first 10-week period with a significant decrease in insulin secretion in the six high-insulin secreting subjects and no significant change in insulin secretion in the five lowor normal-secretors.
Pleural effusions and yellow nails of late onset
Authors: Eastwood H D , Williams T J 
Published: December 2008

Summary
Recurrent pleural effusions have recently been described associated with a generalized deficiency of lymphatic drainage. A case is reported which is of interest as, though evidence of such a deficiency had been present as lymphoedema of the legs since childhood, further manifestations of this in the form of discoloured nails and recurrent pleural effusions developed in the eight and ninth decades.
The role of lung imaging in pulmonary embolism
Authors: Mishkin Fred S , Johnson Philip M 
Published: December 2008

Summary
The advantages of lung scanning in suspected pulmonary embolism are its diagnostic sensitivity, simplicity and safety. The ability to delineate regional pulmonary ischaemia, to quantitate its extent and to follow its response to therapy provides valuable clinical data available by no other simple means. The negative scan effectively excludes pulmonary embolism but, although certain of its features favour the diagnosis of embolism, the positive scan inherently lacks specificity and requires angiographic confirmation when embolectomy, caval plication or infusion of a thrombolytic agent are contemplated. The addition of simple ventilation imaging techniques with radioxenon overcomes this limitation by providing accurate analog estimation or digital quantitation of regional ventilation: perfusion (V/Q) ratios fundamental to understanding the pathophysiologic consequences of embolism and other diseases of the lung.
Ornithosis in Somerset. Experience in the South Somerset Clinical Area 1964–71
Authors: Anderson J P 
Published: December 2008

Summary
During an 8-year period, seventy patients were found, by complement fixation testing, to have had ornithosis. A clinical analysis was made of forty-seven who fulfilled strict diagnostic criteria; thirty-three had been referred to a chest clinic, fourteen had been hospitalized. A non-specific, febrile, myalgic illness with respiratory symptoms was the usual clinical syndrome; cough was a prominent, often dramatic, symptom. Pulmonary crepitations, variable radiographic changes, and a normal white blood cell count were found to be useful diagnostic features. Ornithosis sometimes masqueraded as major chest disease, and could be debilitating. Careful retrospective interrogation revealed significant bird contacts in the majority of patients. Treatment with a tetracycline was of possible clinical benefit.
Marburg virus disease
Authors: Martini G A 
Published: December 2008

Summary
In the late summer of 1967 an epidemic in thirty-one patients in Germany and Yugoslavia of a disease transmitted from African green monkeys occurred; seven patients died. The incubation period was from 4 to 7 days. The main clinical features were headache, high fever, diarrhoea, a very characteristic rash, severe bleeding tendency and involvement of the central nervous system. Nearly all organs were involved and showed severe cell necroses. The aetiological agent was identified as an RNS-virus and was named Marburg virus. It was detected in the blood, urine, throat-washing and seminal fluid.
Pseudo-pseudo-hypoparathyroidism with coarctation of the aorta—a clinical syndrome?
Authors: de Swiet J 
Published: December 2008

Summary
Two cases of pseudo-pseudo-hypoparathyroidism are described, associated with coarctation of the aorta, suggesting a further common clinical link (besides those already recognized) between the former condition and Turner's syndrome. The need for a change of nomenclature of pseudo-pseudo-hypoparathyroidism is emphasized.
Oral antibiotic cure of staphylococcal endocarditis
Authors: Burman N D , Joffe H S , Watson C 
Published: December 2008

Summary
There are as yet few clinical reports of successful treatment of bacterial endocarditis with oral antibiotics, or of the use of the rifamycins in non-tuberculous infections. A case of refractory staphylococcal endocarditis successfully treated with oral rifampicin and erythromycin is presented. The availability of effective oral antibiotic therapy avoids the serious difficulties of long term parenteral antibiotics and offers a hopeful alternative to emergency cardiac surgery in this condition.
Treatment of active chronic hepatitis with cyclophosphamide
Authors: Naccarato R , Chiaramonte M , Farini R , Fagiolo U , Sturniolo G C 
Published: December 2008

SummaryTwenty patients with active chronic hepatitis, classified on the basis of the treatment into three groups, have been studied: (1) patients treated with cyclophosphamide (10 patients); (2) patients treated with cyclophosphamide after cycles of corticosteroid therapy (four patients); (3) patients treated with corticosteroid (six patients).In all patients we observed clinical, biochemical and immunological changes during and after treatment.Hepatic needle-biopsy was performed in all patients before treatment. The histological picture was rechecked after the first cycle of therapy in twelve patients.The results obtained in the three groups of patients have been statistically compared.Cyclophosphamide treatment produces an improvement of general conditions and a persistent normalization of several biochemical and immunological data, especially in those patients in which active chronic hepatitis was not in an advanced stage (type A aggressive form). The histological picture showed no changes after treatment.
Survival rate at middle age in developing and western populations
Authors: Walker Alexander R P 
Published: December 2008

Summary
Whereas expectation of life at birth invariably is greater in more privileged populations, the respective survival patterns at middle age can be entirely different. Comparisons have been made between South African and other populations, using, as a survival index, the number who are 70 years or more at present, as a percentage of the number who were 50 years or more 19 years earlier (data for the desired 20-year period were not available for all populations). Briefly (1) South African Negroes had the highest index; Indians both in India and South Africa the lowest; Caucasian populations in South Africa, United States, and England and Wales, were intermediate. (2) Indices for females were higher than for males; the disparity was least in Indians, but greatest for the population of England and Wales. Evidently, with progressive sophistication of diet and manner of life, the concomitant change from infections to degenerative diseases, as main causes of death at middle age and beyond, reduces rather than increases chances of survival.
How doctors prescribe and why
Authors: Teeling-Smith G 
Published: December 2008

Summary
Branded prescription medicines account for 95% of the total cost of the NHS pharmaceutical service, and 74% of all prescriptions written by general practitioners employ the brand name. This predominance of branded preparations reflects the fact that 96% of the leading medicines prescribed in 1969 had been first introduced since 1949. These are the products of modern pharmaceutical research, typically introduced under their brand name.
Potential savings, if generic names were used instead of brand names in prescribing, are very small because it is only in exceptional cases that cheaper alternatives exist with the same active ingredients as the original branded preparation.
The paper suggests that since general practitioners appear so overwhelmingly to favour the use of brand names it would be logical to introduce their use into medical teaching.
Europe
Authors: Grainger H S 
Published: December 2008

Summary
At the present time, pharmacopoeias concentrate on defining the active principle of a product, limits of impurities and certain in vitro tests such as disintegration and dissolution rate which have been thought, incorrectly in many instances, to predict absorption characteristics.
In future, tests must be developed which will more adequately predict bio-availability and these, with information comparing the blood levels and clinical effects of different preparations of drugs, must be available to the prescriber in a pharmacopoeia or other officially recognized compendium.
The association between webs, iron and post-cricoid carcinoma
Authors: Chisholm Morag 
Published: December 2008

Summary
The association of iron deficiency anaemia, post-cricoid webs and carcinoma is controversial. The main findings in a recent study which re-examined this problem are presented here. It was shown that the majority of patients with a post-cricoid web have evidence of iron deficiency but that only about 10% of patients with iron deficiency develop post-cricoid webs. Factors which might be important in the pathogenesis of a post-cricoid web have been looked for and a few significant points noted. The main findings were an increased frequency of angular stomatitis and edentia, thyroid disease and thyroid cytoplasmic antibodies in patients with webs compared with patients with iron deficiency anaemia without a web.
Follow-up studies in patients with a post-cricoid web or Paterson-Kelly syndrome show an increased frequency of post-cricoid carcinoma ranging from 4 to 16% in different series and the association is even more striking in patients presenting with post-cricoid carcinoma. It is concluded that the available evidence confirms the association between iron deficiency, postcricoid webs and carcinoma but the mechanism of the production of these changes is not yet understood.
Transient erythroid hypoplasia in a patient on long-term co-trimoxazole therapy
Authors: Stephens M Elizabeth M 
Published: December 2008

Summary
The occurrence of isolated erythroid hypoplasia in a patient on long-term treatment with co-trimoxazole is described. It is suggested that this haematological complication, which has not been previously reported, was due to hypersensitivity to the sulphonamide component.
Female genital self-mutilation as a cause of vaginal bleeding
Authors: Simpson M A , Anstee B H 
Published: December 2008

Summary
While self-mutilation in the form of wrist and arm cutting is relatively common and genital self-mutilation in men is well recognized, female genital self-mutilation seems to be strikingly rare. With the exception of injuries secondary to frank self-induced abortion or the insertions of foreign bodies in children, only three cases of female genital self-mutilation have been reported in the literature so far. It is suggested that the phenomenon may not be as rare as hitherto supposed and therefore a further case is reported.
Viral hepatitis and hepatitis B antigen: recent advances
Authors: Krugman Saul 
Published: December 2008

SummaryRecent advances in hepatitis research have shed new light on the etiology, pathogenesis, epidemiology and prevention of type B hepatitis infection. The so-called ‘Dane’ particle is probably the complete hepatitis B virion; its outer coat is the hepatitis B (Australia) antigen (HB Ag) and its inner core is an immunologically distinct particle. Subtypes of HB Ag (a, d, y, w and r) are useful indices for epidemiological surveys. Concepts of epidemiology have changed: type B hepatitis is transmissible by contact as well as by inoculation. The presence of HB Ag in blood is indicative of the presence of hepatitis B virus. Tests to detect antigen and use of voluntary blood donors have played a major role in the decreased incidence of post transfusion hepatitis. A special hepatitis B gammaglobulin preparation and a heat-inactivated hepatitis B vaccine have proved to be effective in preliminary studies.
The role of immunological mechanisms in acute and chronic hepatitis
Authors: Eddleston A L W F 
Published: December 2008

Summary
Studies of asymptomatic carriers of hepatitis B antigen (HB Ag) have suggested that the hepatitis B virus may not be directly damaging to liver cells and it is possible that the hepatocellular necrosis which accompanies acute hepatitis may be induced by immunological reactions directed at viral antigenic determinants on the surface of infected cells.
Immunological reactions may also be implicated in the pathogenesis of active chronic hepatitis. Although antibodies which are commonly present in the serum are probably not of primary importance in the immunopathology, recent studies have demonstrated liver-specific immune responses, both humoral and cellular, which may be more directly related to the pathogenesis.
Treatment of chronic active hepatitis in children
Authors: Dubois Reuben S , Silverman Arnold 
Published: December 2008

Summary
Thirty-eight children with chronic active hepatitis are reported. Their mode of presentation was usually indistinguishable from acute viral hepatitis (63%). Extra hepatic manifestations were more common in those patients with an insidious onset. The twenty-eight patients tested for hepatitis B antigen (HB Ag) were all negative and SGOT values were higher (mean 1000 i.u./l) than those reported in adult patients with chronic active hepatitis. Thirty-three patients had marked elevation of serum gammaglobulin (mean 3·78 g/100 ml) and 34% had positive LE cells. All patients had histologic features of ‘aggressive’ hepatitis; in addition five biopsies also showed areas of submassive hepatic necrosis. The initial response to corticosteroid was excellent in all but three patients. To date drug therapy has been suspended in fifteen patients for periods of 3 months to 4 years and 7 months. There have been eight deaths. Three with hepatic insufficiency and two with sepsis. Three others have subsequently died following orthotopic liver transplantation.
Controlled trials of immunosuppressive therapy in hepatitis
Authors: Stern R B , Williams Roger 
Published: December 2008

SummaryThree types of hepatitis are seen in children—acute viral hepatitis, active chronic hepatitis and the neonatal hepatitis syndrome. Few adequate controlled clinical trials of immunosuppressive therapy have been performed in these conditions, and none specifically in children.Many trials in the 1950s using corticosteroids were performed in acute viral hepatitis. Some showed that steroids were superior to controls and some showed no difference. Later trials confirmed that steroids were of no benefit in uncomplicated viral hepatitis, and further trials are now unjustifiable.Active chronic hepatitis is seen in all age groups, and there is little clear-cut evidence that the disease differs significantly in children from adults. Three well controlled clinical trials using immunosuppressive agents have been performed in this condition, but all were predominantly in adults. The conclusions were that steroids are the treatment of choice, although azathioprine may have a steroid-sparing effect.No prospective controlled trials of immunosuppressives have been carried out in the neonatal hepatitis syndrome, and in view of the variable prognosis there is an urgent need for one to be carried out. Large numbers, and a long follow-up period would be necessary and the trial need not be performed doubleblind.
Verapamil and the myocardium
Authors: Nayler Winifred G , Krikler Dennis 
Published: December 2008

SummaryAlthough many of the drugs which recently have been developed for use in relieving angina pectoris display β-adrenoceptor blocking activity this property cannot be essential, because verapamil relieves angina pectoris without blocking the cardiac β-adrenoceptors. Like propranolol, verapamil slows the heart and reduces both the peak tension developed during systole and the rate at which that tension is developed. Verapamil further resembles propranolol in that it improves cardiac efficiency, reduces the oxygen requirement of the heart and abolishes certain arrhythmias. Verapamil differs from propranolol, however, in that it does not antagonize the cardiac β-adrenoceptors and it dilates the coronary vessels. Verapamil probably owes its activity to its ability to interfere with the inwards displacement of calcium ions across cardiac cell membranes.
Prevalence and site of bacteriuria in diabetes mellitus
Authors: Ooi Boon Seng , Chen Beatrice T M , Yu Moses 
Published: December 2008

Summary
Twenty-four of 152 female diabetic patients (15·8%) were found to have significant bacteriuria as compared to a prevalence rate of only 4·6% of 152 matched non-diabetic controls. The difference in prevalence rates is statistically significant. However, if the prevalence rates are analysed according to age, bacteriuria was significantly more common only in diabetic females above the age of 50. Localization of site of infection was performed in all diabetic female subjects with bacteriuria. The kidney was affected in 62·5% of patients. The pathogenetic considerations relating to these results are discussed. There was no difference in prevalence rate of bacteriuria between male diabetics and their controls.
Food contaminants
Authors: Kazantzis G 
Published: December 2008

Summary
With the increasing use of a large variety of chemicals, opportunities for contamination of food are becoming greater. Food may be involved following some accidental occurrence or from more general environmental contamination. Three examples are given: an outbreak of paralysis in Morocco involved 10,000 people who had ingested food adulterated with triorthocresyl phosphate; an epidemic of jaundice in London followed the contamination of flour with an epoxy resin hardener; organic mercury poisoning in an Arab country involved more than 6000 people who had eaten bread made from grain treated with a methyl mercury fungicide. The hazard which may arise from heavy metal accumulation in the body is discussed.
Blood lipids and the treatment of essential hypertension with methyldopa and bendrofluazide
Authors: Libman L J , Dormandy T L , Arrowsmith D E , Heal Joanna , Hoffbrand B I 
Published: December 2008

Summary
The blood lipids of eight patients with previously untreated essential hypertension have been studied before and after treatment with methyldopa and bendrofluazide. No significant change was found in any of the measurements over a mean treatment period of 5·25 months. These results are believed to provide evidence that hypotensive therapy does not predispose to the development of ischaemic heart disease.
Incidence of Meckel’s diverticulum in 100 cadavers
Authors: Rojhan M S , Hejazi R 
Published: December 2008

Summary
The literature concerning the embryology, histology, clinical significance and preoperative diagnosis of Meckel’s diverticulum has been reviewed.
Meckel’s diverticulum was found in about 6% of subjects from the Tehran region, suggesting that it occurs more frequently in Iran than previously supposed.
A case of primary cerebral venous thrombosis
Authors: Brookfield D S K 
Published: December 2008

Summary
A case of primary cerebral thrombophlebitis is described in a young man, who had a thrombotic diathesis. The patient initially presented with a right phlegmasia alba dolens which was treated with anticoagulants, surgery and thrombolytic therapy. Over 2 years later he developed a further phlegmasia and what was clinically thought to be a meningitis. Despite anti-coagulation he died from a progressive cerebral venous thrombosis.
Microbial ecology of the female lower genital tract during pregnancy
Authors: de Louvois John , Hurley Rosalinde , Stanley Valerie C , Jones J B , Foulkes J E B 
Published: December 2008

Summary
The posterior fornices of the vagina of 280 unselected pregnant women were sampled, using a sponge swab, squeezed out into Stuart’s Transport Medium. Other specimens were also taken. Eleven primary media were inoculated, wet swabs were examined, and Gramstained smears were also made. Nineteen groups or species of microbes were identified.
Nearly 80% of women harbour pathogenic, or potentially pathogenic microbes; 52% harbour streptococci of various sorts. The incidence of the various groups, and species of microbes is tabulated. There is a statistically significant correlation between the presence of polymorphonuclear leucocytes in excess of one per high power field, and the presence of lesions of the cervix.
The effects of adrenergic β-blockade with oxprenolol on peripheral metabolism
Authors: Asmal A C , Coleman A J , Leary W P 
Published: December 2008

SummaryPeripheral metabolism was studied with the forearm technique in six fasting normal subjects before and after oxprenolol administration. With the forearm technique the product of blood flow and arteriovenous differences is a measure of substrate uptake or release, and, therefore, an index of metabolism. Blood flow was measured with venous occlusion plethysmography, and arterial and venous samples obtained through indwelling catheters in the radial artery and deep forearm vein.Oxprenolol administration influenced both peripheral flow and the basal pattern of substrate exchange. Before oxprenolol blockade a net uptake of glucose, triglycerides, and FFA, and a net release of glycerol were recorded across the forearm. After oxprenolol blockade there was a marked reduction in triglyceride uptake, with augmentation of glucose uptake and inhibition of lipolysis.
Hodgkin’s disease of the duodenum presenting with haemorrhage and perforation
Authors: Bardhan K D , McArthur Peter , Rigby Christopher 
Published: December 2008

Summary
A case of Hodgkin’s lymphoma confined to the duodenum, draining lymph nodes and spleen, presenting with haematemesis and perforation, thus mimicking a peptic ulcer, is recorded. Such a case is not known to have been previously reported.
Self-induced colitis
Authors: Byrne Jane S , Carney M W P , Harry D S , Lee F I 
Published: December 2008

Summary
The case is reported of a young ex-nurse with severe inflammation in the distal colon, extending 15 cm proximally from the anus, due to the self-instillation of a noxious substance, namely, caustic soda. She escaped detection over a period of months. The result was extensive inflammatory change in the terminal 15 cm of the large bowel, with gross macroscopic, histological and radiological abnormalities.