bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levamisole treatment of a child with severe aphthous stomatitis and neutropenia
Authors: Verhaegen H , De Crée J , De Cock W , Brugmans J 
Published: December 2008

SummaryThe treatment of a 12-year-old girl with a lifelone history of recurrent infections and aphthous stomatitis is reported. A profound neutropenis, first noted at the age of 2 years, occurring at least every month was observed together with multiple mouth ulcers a sore throat and swelling of the jugular glands. Levamisole, originally described as an anthelmintic, has a beneficial effect on the symptoms of recurrent aphthous stomatitis. After levamisole treatment aphthous stomatitis was milder and in the 1-year follow-up period the patient was asymptomatic several times during a phase of obvious neutrophil depression. The child no longer complained of a sore throat with swelling of the jugular glands and the recurrent staphylococcal infections of the skin disappeared. After therapy a marked increase in monocytes at the moment of neutropenia was observed.
Isolation for high-risk patients
Authors: Emond Ronald T D 
Published: December 2008

Summary
Standard isolation accommodation provides adequate protection against the infectious diseases prevalent in the U.K. but higher standards are necessary for more dangerous infections imported from overseas. These may be provided reasonably cheaply by modifying existing wards but staff are still exposed to risk. By physically separating the patient from the attendants, the Trexler plastic isolator affords a greater degree of protection and is of particular value when dealing with a dangerous infection against which there is no form of immunization.
Chemoprophylaxis of respiratory infections
Authors: Batten John 
Published: December 2008

SummaryChemoprophylaxis of certain respiratory infections has been described. The benefit and cost of chemoprophylaxis of tuberculosis have been compared and indications outlined. While some protection against influenzal infection by drugs of the adamantane group has been demonstrated, chemoprophylaxis against respiratory virus infections is as yet unavailable or impractical. In diseases associated with impaired bronchial clearance the influence of long term chemoprophylaxis on the natural history of the disorders becomes less certain. Morbidity in chronic bronchitis and bronchiectasis may be reduced. In cystic fibrosis, however, although the prognosis has been undoubtedly improved by chemoprophylaxis, the effects of long term treatment of infection in the later stages are uncertain.
Phaeochromocytoma and hypercalcaemia
Authors: Ghose R R , Winsey H S , Jemmett J , Woodhead J S 
Published: December 2008

Summary
An example of possible pseudohyperparathyroidism associated with a non-endocrine benign tumour is reported. Some of the pertinent factors contributing to hypercalcaemia under these circumstances are reviewed, with particular reference to ectopic hyperparathyroidism and catecholamine-induced endogenous hyperparathyroidism.
Stricture of the descending colon due to schistosomiasis
Authors: Wright S G , Renton Peter , Swarbrick E T 
Published: December 2008

Summary
An example of a localized non-fibrous stricture of the colon due to Schistosoma mansoni infection is reported. The radiological and colonoscopic features are described. After treatment of the infection with niridazole, the stricture resolved completely. The pathogenesis of bowel lesions in schistosomiasis is briefly discussed.
The validity and significance of hormone levels in gynaecology
Authors: Sommerville Ian F 
Published: December 2008

Summary
The development of radioimmunoassay of steroid hormones in peripheral venous blood has led to a more direct index of gonadal production and concurrent monitoring of glandular function. While serial analyses of total urinary oestrogens can be correlated with luteinizing hormone (LH) excretion in treating amenorrhoea, radioimmunoassay of plasma oestrogens measures acute changes in ovarian responsiveness. For studies of androgens radioimmunoassay of plasma testosterone is the method of choice, but fractionation of urinary 17-oxosteroids may be useful and can be extended to include the pregnane series and corticoids. Urinary pregnanediol, however, may not reflect the endogenous secretion of progesterone and should be reserved for assessing induction of ovulation. Luteal function can be evaluated rapidly and specifically by radioimmunoassay of plasma progesterone. Although radioimmunoassay offers a new approach to ovarian physiology, its systematic application to disease is still in the future.
Steroids in the assessment of prenatal development
Authors: Chamberlain Geoffrey , Kitchin Yvonne 
Published: December 2008

Summary
Methods for identifying the fetus at risk and monitoring fetal well-being as pregnancy progresses are now an established part of prenatal care in the Western World. In this short review the use of steroids in the assessment of prenatal development is discussed. The metabolism of oestrogens, progestogens, corticosteroids and androgens during pregnancy is outlined and the relative merits, in terms of usefulness and practicability, of urinary and plasma steroid assays are discussed.
Steroids and the eye—indications and complications
Authors: Dinning W J 
Published: December 2008

Summary
Corticosteroid therapy is of great value in many types of eye disease. The indications are briefly discussed, together with the choice of agent and mode of administration. The dangers of steroids are now widely recognized, and the complications are discussed, particularly cataract and glaucoma. Reference is also made to optic neuritis and thyroid ophthalmopathy, where the role of steroids is uncertain. Particular stress is laid on the need to keep steroid dosage as low as possible, so as to avoid systemic side effects. There are unfortunately many situations where treatment of doubtful efficacy has produced severe side effects. Despite the overall benefit of steroids in ophthalmology, there is a pressing need to find alternative treatment for a variety of blinding disorders.
The possibility of dietary protective factors in duodenal ulcer. II. An investigation into the effect of pre-feeding with different diets and of instillation of foodstuffs into the stomach on the incidence of ulcers in pylorus-ligated rats
Authors: Jayaraj A Paul , Tovey Frank I , Clark C G 
Published: December 2008

SummaryRats pre-fed on a South Indian diet show a much higher incidence of ulceration of the stomach after pyloric ligation than those on a North Indian diet. Removing vegetables and pulses from the North Indian diet deprives it of its protective effect. Staple foodstuffs with a high buffer content (unmilled rice, unrefined wheat and a millet [ragi]) placed in the stomach after pyloric ligation are also protective, but those with a low buffer content (milled rice, tapioca, sorghum and maize) are not protective. Refined wheat, however, gives protection despite its low buffer content. The significance of these findings in relationship to the distribution of duodenal ulcer in India and Africa is discussed.
The interrelationship between hypocomplementaemia, partial lipodystrophy and mesangiocapillary glomerulonephritis
Authors: Wakefield Marion A 
Published: December 2008

SummaryA further case of mesangiocapillary glomth reduced serum C3 levels is reported. The father of the patient was also found to have C3 deficiency. This lends support to the hypothesis that C3 deficiency may be the primary disorder relating these conditions and there is evidence in this case that the deficiency may be genetically determined. It is suggested that the complement state of close relatives, particularly younger siblings, of patients with these disorders should be investigated and, if abnormalities are found, they should be followed-up in order to elucidate the role of hypocomplementaemia in these uncommon disorders.
Systemic mastocytosis—central nervous system features and lymphographic demonstration of lymph node involvement
Authors: Hancock B W , Dandona P , Cumberland D C , Jarratt J A 
Published: December 2008

Summary
Systemic mastocytosis is uncommon. A patient is reported with many of the characteristic lesions of this disorder but with two features not before described—the occurrence of mixed pyramidal and neuromyopathic neurological signs and the demonstration of lymph nodes with abnormal architecture by lymphography.
The results of 100 small tissue biopsies of testis in male infertile patients
Authors: Scott R , Sinclair J , Rourke A , Chowdhury S , Yates A , Shaba J 
Published: December 2008

SummaryThe value of testicular biopsy in male infertility has recently been emphasized by Meinhard, McRae and Chisholm (1973), and the present authors agree with them that a biopsy is essential for the following reasons: (1) to establish a firm diagnosis; (2) to rationalize therapy on the basis of histological findings; (3) new developments in drug therapy and electronmicroscopic techniques will help to clarify many areas of doubt and uncertainty in this difficult field; (4) the diagnosis of 'sloughing' by itself may mask changes in germinal cell development which may be amenable to hormone therapy.
Penetration of digoxin into cerebrospinal fluid
Authors: Schott G D , Holt D W , Hayler A M 
Published: December 2008

Summary
The concentration of digoxin in the cerebrospinal fluid (CSF) of ten patients receiving conventional oral doses of this cardiac glycoside has been measured by a radioimmunoassay technique. Digoxin was undetected in eight patients and barely detectable in two, suggesting the presence of a significant blood-CSF barrier for digoxin. The implication of these findings is discussed.
Obstructive cholecystitis due to metastatic melanoma
Authors: Ostick D G , Haqqani M T 
Published: December 2008

Summary
A patient with isolated metastases from cutaneous melanoma to the gall-bladder is reported. The patient presented clinically with obstructive cholecystitis. The course of melanoma is unpredictable and the possibility that an apparently unassociated condition is due to metastases should always be considered. Isolated metastases may respond well to radical surgery and reward the surgeon's efforts.
Technical possibilities for coronary artery bypass surgery and the outlook for graft patency
Authors: Yacoub M H 
Published: December 2008

Summary
In an attempt to analyse the results of saphenous bypass grafting 213 patients were re-investigated by repeat coronary, graft and left ventricular angiography. In this series, the presence of diffuse arterial disease was not considered as a contra-indication to operation. Instead, additional endarterectomy was performed.
The overall patency rate was 88% and was not significantly altered by the passage of time, although the patency rate during the first 6 months was 94%. The patency rate did not appear to be influenced by the age of the patient, the severity of the lesion pre-operatively, the artery grafted nor additional endarterectomy. The run-off was judged to be good in 82% of grafts investigated before 6 months, compared to 70% of those investigated later. Progress of the disease in the native vessels appeared to be slightly accelerated in the segment proximal to the graft.
Correlation between anti-DNA antibody titre and psychiatric manifestations in systemic lupus erythematosus
Authors: Levo Y , Kalaci J , Pick A I , Golomb M 
Published: December 2008

Summary
A patient with systemic lupus erythematosus with predominant psychiatric involvement was followed during two psychotic exacerbations of her disease. A high correlation was found between disease activity and the titre of anti-DNA antibodies. Disease activity was preceded and accompanied by a high titre, while remission was associated with low titre. The significance of this correlation for the pathogenesis, diagnosis and managment of the psychiatric symptoms of systemic lupus erythematosus are discussed.
Corrugation of the skull in Paget's disease of bone
Authors: Chakravorty N K , Das S K , Kataria M S 
Published: December 2008

Summary
Paget's disease of bone has been known for about 100 years and the usual deformities of bone, e.g. bowed tibia, large head, are well described in medical text books. However, there does not appear to have been a description of corrugation of the skull as a recognized deformity in Paget's disease. Three cases are now described to illustrate this deformity as an unusual but valuable sign in this disease.
The simultaneous presentation of Hodgkin's disease of myeloma
Authors: Ibbotson R M , Revell P A , Molland E A , Minton M J 
Published: December 2008

Summary
The simultaneous presentation of Hodgkin's disease and multiple myeloma is described. This is rare as only one previous case appears to have been documented. Speculations as to the aetiology are discussed as well as the significance of the presentation.
Survival and death from subdural haematoma on medical wards
Authors: Dronfield M W , Mead G M , Langman M J 
Published: December 2008

SummaryAll patients with subdural haematoma presenting to medical wards in Nottingham over a 5-year period have been reviewed. Of twenty-one such patients eight were first diagnosed at post-mortem, whilst all of the remaining thirteen patients in whom the diagnosis was made in life survived following neurosurgical evacuation of the haematoma. Diagnostic failure was caused mainly by failure to consider the possibility of subdural haematoma or misinterpretation of negative investigations. An attempt has been made to characterize the clinical patterns that may suggest the presence of a subdural haematoma, and recommendations are made on the investigation of such patients.
Pathological validation of auscultation of the elderly heart
Authors: Denham M J , Pomerance A , Hodkinson H M 
Published: December 2008

Summary
Systolic murmurs present in 129 geriatric patients followed to post-mortem were assessed as mitral or aortic in origin by simple clinical assessment alone. Post-mortem examination contradicted clinical findings in only 2% of cases. Mitral valve pathology, mostly post-inflammatory scarring or mucoid degeneration, was present in 50% of the cases with murmurs. There was a significant correlation between the presence of murmurs, particularly mitral murmurs, and congestive cardiac failure, and there was also a significant correlation with age. A tendency for aortic systolic murmurs to be associated with a higher mean systolic blood pressure was not significant and there was no significant association between systolic murmurs and ischaemic heart disease.
Polyarteritis nodosa of the liver: a report of two cases
Authors: Cowan R E , Mallinson C N , Thomas G E , Thomson A D 
Published: December 2008

Summary
Two patients with liver disease due to polyarteritis nodosa are described. They presented in a similar manner, with a swinging fever, a polymorphonuclear leucocytosis and high alkaline phosphatase levels, but the natural history of the illness was different, with revocery in one and death in the other.
The different effects of sodium bicarbonate and aluminium hydroxide on the absorption of indomethacin in man
Authors: Garnham J C , Kaspi T , Kaye C M , Oh V M 
Published: December 2008

SummaryThe influence of oral sodium bicarbonate and aluminium hydroxide on the absorption of indomethacin has been studied in normal volunteers. While sodium bicarbonate appeared to increase indomethacin absorption, aluminium hydroxide markedly reduced both the rate and extent of absorption. The buccal absorption of indomethacin over the pH range 5-9 was also studied in normal volunteers, and showed that the percentage absorption increased markedly as the pH was reduced. The clinical importance both of pH-partition and of adsorption are discussed in the context of antacid interactions. It is concluded that caution must be exercised when prescribing an antacid with other orally-administered drugs.
Coeliac disease with mild mucosal abnormalities: a report of four patients
Authors: Scott B B , Losowsky M S 
Published: December 2008

Summary
In a routine adult gastroenterological practice, seventeen (15%) of 123 patients had small-intestinal biopsies which were neither normal nor were completely flat as found in classical coeliac disease. Some of these had a possible cause for the mild mucosal abnormality, but in six there was no other apparent cause and all four of these who were treated with a gluten-free diet responded morphologically and symptomatically. It is concluded that at least these four patients have coeliac disease in a mild form and that the classical flat biopsy is not a prerequisite for the diagnosis of coeliac disease.
Management of prolonged hypoglycaemia in Beckwith's syndrome
Authors: Moncrieff M W , Lacey K A , Malleson P N 
Published: December 2008

SummaryA new-born baby with Beckwith's syndrome had severe hypoglycaemia, and was treated with glucagon and prednisone. Treatment was stopped at 1 month of age and his blood glucose levels were satisfactory for the ensuing 6 weeks. However, at 10 weeks of age, he had a hypoglycaemic convulsion and required large doses of diazoxide and prednisone for the next 2 months to maintain the blood glucose above 40 mg/100 ml. Insulin excretion was raised until he was 4 months old. Cases of Beckwith's syndrome which develop hypoglycaemia, should be treated with diazoxide and corticosteroids until insulin excretion is normal.
Pulmonary alveolar microlithiasis
Authors: Onadeko B O , Abioye A A , Beetlestone C A , Adetuyibi A , Cooke A R , Sofowora E O 
Published: December 2008

Summary
A case of pulmonary avleolar microlithiasis is reported. This is of especial interest as it is the first case to be reported from Africa South of the Sahara. The clinical presentation of the patient follows a similar pattern as that of cases already described by other workers. The diagnosis in this case was made in life by a combination of radiological examination and a lung biopsy. The clinical presentat on and aetiology of the condition are briefly discussed.
A new look at erythromycin
Authors: Lacey R W 
Published: December 2008

Summary
This article reviews the current place of erythromycin in antibiotic therapy. Overall, erythromycin is thought to be underused because: (1) the fear of resistance has been exaggerated; (2) significant toxicity has been associated with only one derivative (the estolate); (3) newer antibiotics have very rarely been demonstrated to be superior to erythromycin. Erythromycin has an important place in treating acute upper and lower respiratory tract infections, acute otitis media, sinusitis, skin and soft tissue, osteomyelitis, prostatitis, infections due to Mycoplasma spp. and Chlamydia organisms, and infections due to anaerobes.
Streptococcus agalactiae in urinary tract infections
Authors: Mhalu F S 
Published: December 2008

Summary
Streptococcus agalactiae was found to be the cause of approximately 1% of urinary tract infections in a London teaching hospital in the 2 years studied. Of the forty-eight patients with this infection, forty-three were female. In nine patients the infection followed renal transplantation while in nine others it occurred in the presence of chronic renal failure. The rest, who included seven females who developed the infection following hysterectomies, had other clinical conditions which could have predisposed to such infections. The rarity of urinary tract infection by S. agalactiae is in contrast to the high frequency with which the organism colonizes the normal urethra. Serotypes III and II were the predominant isolates in these patients with urinary tract infections; this corresponds to the distribution of the different serotypes in the genito-urinary tract of normal individuals.
Perforation of the right ventricle and cardiac tamponade caused by a venous catheter
Authors: Iglesias A , Rufilanchas J J , Maronas J M , Figuera D 
Published: December 2008

Summary
A case is reported in which a venous catheter perforated the right ventricle and caused cardiac tamponade. Methods recommended to avoid such complications include limiting the length of the radio-opaque catheter, and modifications to the catheter tip.
Acute appendicitis in association with non-obstructive carcinoma of the caecum
Authors: Waller D G , Glasgow M 
Published: December 2008

Summary
A case of carcinoma of the caecum is reported, which presented as acute appendicitis, although the carcinoma did not obstruct either the lumen of the appendix or the colon. The prognosis for caecal or proximal colonic neoplasm presenting as appendicitis is poor. This is in part due to the association being missed at the initial laparotomy. It is suggested that a more aggessive attitude should be taken in the pre- and post-operative management of any patient over 50 years of age who presents with appendicitis. The difficulties of identifying a small tumour at laparotomy even if the mucosa can be palpated are emphasized.
Epistaxis and hypertension
Authors: Charles R , Corrigan E 
Published: December 2008

Summary
The status of nose bleeding as a symptom of high blood pressure has been studied in patients admitted because of epistaxis. Twenty-six patients with a factor predisposing to nasal bleeding had age- and sex-adjusted systolic and diastolic scores similar to those of the general population. One hundred and sixty-eight patients with no such factor formed a different population with significantly higher age- and sex-adjusted systolic and diastolic scores. It is concluded that epistaxis is a true symptom of hypertension.
Leiomyosarcomatosis of probable uterine origin with long survival—a case report
Authors: Young R A 
Published: December 2008

SummaryA case of leiomyosarcomatosis is presented. Over a period of 15 years the patient underwent seven operations to remove eleven tumours, the largest as big as a football, before dying of widespread metastases: between operations the patient was remarkably well. The disease was almost certainly of uterine origin from apparently benign fibroids, and photomicrographs are provided as supportive evidence. The various modes of presentation of abdominal leiomyosarcoma—mass, pain, obstruction, fistula, anaemia—are illustrated in the case report. The value of repeated palliative surgery in such cases is emphasized.
Antibacterial therapy in general medical wards
Authors: Lawson D H , MacDonald S 
Published: December 2008

Summary
Information from a comprehensive drug surveillance programme is analysed to provide details of antibacterial drug use in medical wards. Some 28% of patients received antibacterial therapy, usually for the treatment of respiratory or urinary tract infections. The agents most frequently prescribed were ampicillin, co-trimoxazole and tetracyclines. Overall, 11% of recipients experienced one or more adverse effect of therapy. No significant bacterial growth was obtained from some 40% of specimens of sputum sent from patients. A plea is made for more rational use both of sputum culture in the investigation of patients with respiratory infection and of antibiotics in their treatment.
Haematological abnormalities in acute pancreatitis. A prospective study
Authors: Murphy D , Imrie C W , Davidson J F 
Published: December 2008

Summary
Twenty-five patients with acute pancreatitis were studied prospectively in the first week of their admission using haematological and coagulation tests. Platelet counts initially fell and later returned to admission levels. Rising levels of plasma fibrinogen were recorded. The kaolin cephalin clotting time was shorter than its control in twenty-one patients. Eighteen patients had elevated fibrinogen degradation products and fourteen had a positive ethanol gelation test. It is suggested that by taking into account the results in series of individual patients a degree of intravascular coagulation may be a common feature of acute pancreatitis. In one patient (presented in detail) strong evidence for disseminated intravascular coagulation was found