bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy (COCM)Supported in part by grant of Deutsche Forschungsgemeinschaft, SFB 30 Kardiologie Düsseldorf.
Authors: Kuhn H , Breithardt G , Knieriem H-J , Köhler E , Lösse B , Seipel L , Loogen F 
Published: December 2008

Summary
In order to find evidence of prognosis and of presymptomatic manifestation of congestive cardiomyopathy (COCM) in fifty-eight patients, the extent of morphological changes of endomyocardial catheter biopsy (EMCB), clinical and haemodynamic data were correlated to the clinical course. In addition, clinical, haemodynamic, angiographic, morphological and His-bundle electrographic studies were performed in patients with left bundle branch block (LBBB), normal left ventricular end-diastolic volume, and normal coronary arteries (n = 43).
Related to a 10-year mortality rate of 70% from the onset of symptoms, COCM is one of the most severe heart diseases. Endomyocardial catheter biopsy (EMCB) allowed clear prognostic separation in patients with COCM and seems to be of diagnostic value in patients with only slightly enlarged hearts and in patients with a short history of symptoms. The studies also revealed much evidence that at least some patients with LBBB, normal left ventricular end-diastolic volume (LVEDV) and normal coronary arteries exhibit an early stage of COCM. In these patients especially EMCB with severe changes of heart muscle cells and/or impaired left ventricular function may indicate subsequent COCM. So that there is now a new indication for performing EMCB.
Total exchangeable potassium in response to amiloride
Authors: Pearce V R , Antcliff A C , Beevers D G , Hamilton M 
Published: December 2008

Summary
The use of amiloride is described in twenty-four hypertensive patients who became hypokalaemic as a result of thiazide diuretic therapy in spite of oral potassium supplments. Amiloride caused a significant rise in exchangeable potassium, exchangeable potassium/kg body weight, and plasma potassium, together with a significant fall in plasma total carbon dioxide, body weight, systolic and diastolic blood pressures.
These results suggest that amiloride has a useful role in this type of patient.
Achalasia of the cardia in elderly patients
Authors: Lock M R , Ellis H 
Published: December 2008

Summary
Achalasia of the cardia frequently presents as dysphagia in middle age. In the elderly, dysphagia is usually due to a neoplasm of the oesophagus or cardia. The authors have been interested to see five patients over the age of 70 presenting with oesophageal symptoms due to achalasia which is uncommon in this age group and may be mistaken for neoplastic disease.
Cyclical release of vasoactive intestinal polypeptide (VIP) from a pancreatic islet cell apudoma
Authors: Devine B L , Carmichael H A , Russell R I , Joffe S N 
Published: December 2008

Summary
A patient is described who presented with the classical symptomatology and profound electrolyte disturbance of the Verner-Morrison syndrome due to a pancreatic apudoma secreting vasoactive intestinal polypeptide (VIP). Diagnosis was confirmed by plasma VIP as measured by a radio-immunoassay technique now available. It is suggested that the cyclical nature of the symptoms in this case was due to cyclical release of VIP from the tumour in response to an unknown stimulus. Perfusion studies confirmed the excess secretory state of water, sodium and chloride in the small intestine. Symptoms were completely abolished by surgery and the progress is being monitored by means of serial plasma VIP estimations to detect any early recurrence of metastatic disease.
General features of persistent virus infections
Authors: Mims C A 
Published: December 2008

Summary
Persistent virus infections are discussed from the virus point of view in terms of the bodily sites in which the infection persists. Glands and body surfaces are thought to be significant because they give the virus protection at the topographical level from immune forces, and because they are appropriate sites for the shedding of virus to the exterior. Germ cells are relevant sites because infection can thus be transmitted vertically from generation to generation in the host. The central nervous system, however, is generally a ‘dead end’ from which there is no shedding to the exterior. Persistance in blood may be relevant when continued arthropod transmission becomes possible. Most persistent viruses infect lymphoreticular tissues, and this is interpreted by suggesting that it results in an impaired immune response to the infecting virus, which in turn favours persistence.
It is suggested that the biological function of virus transformation and the integration of viral into host cell DNA is that it enables the infection to persist in the host and undergo reactivation. Papovaviruses, adenoviruses and oncornaviruses are considered from this point of view.
Polyarteritis presenting with thrombocytosis and palliated by plasma exchange
Authors: Hamblin T , Oscier D 
Published: December 2008

Summary
A 66-year-old patient with polyarteritis nodosa presented with thrombocytosis and was found to have circulating immune complexes. Treatment by plasma exchange produced symptomatic improvement and lowered both the platelet count and the level of immune complexes. While plasma exchange is a useful technique in investigating the pathogenesis of the disease, predisolone is a more convenient way of treating it.
The treatment of lupus nephritis by methyl prednisolone pulse therapy
Authors: Dosa S , Cairns S A , Lawler W , Mallick N P , Slotki I N 
Published: December 2008

Summary
Four patients with proliferative glomerulonephritis due to systemic lupus erythematosus were treated with intravenous methyl prednisolone ‘pulse’ therapy. In all, eight courses of therapy were given, three for acute oliguric renal failure; and on each occasion there was a good response to the treatment. Clinical, histological and immunological details of the patients are presented. The diagnosis, treatment, and monitoring of disease activity in lupus nephritis are discussed in the light of this experience.
Coronary artery surgery: indications and recent experience
Authors: Robinson P S , Coltart D J , Jenkins B S , Webb-Peploe M M , Braimbridge M V , Williams B T 
Published: December 2008

Summary
The comprehensive experience of coronary artery surgery in a Cardiothoracic Unit over a 31-month period is reviewed. Hospital mortality for elective bypass grafting was 3·9% overall and 2·5% in those with good pre-operative left ventricular function. Major influences on hospital mortality were pre-operative left ventricular function, extent of coronary artery disease and extent of the surgical procedure undertaken in terms of number of aortocoronary grafts inserted, coronary endarterectomy and particularly concomitant valve surgery or aneurysm resection.
Follow-up experience shows 74% of grafted patients to be symptom-free and 85% symptomatically improved one year after surgery with 70% symptom-free and 80% improved at two years. Early post-operative deaths appear related to early graft closure and recurrence of symptoms postoperatively to late graft closure or progression of coronary disease in the native circulation. The study provides a guide to the relative risks of coronary artery surgery for symptomatic coronary artery disease and expected symptomatic results in the early follow-up period.
Axial volvulus of Meckel's diverticulum
Authors: Osborne M P , Hamilton G , Shalley M 
Published: December 2008

Summary
Two cases of axial volvulus of a Meckel's diverticulum associated with a diverticular band are described. In both cases, the pre-operative diagnosis was of acute appendicitis. The importance of further exploration if the appendix is insufficiently inflamed to acount for the symptoms and signs is emphasized.
Epidemiological approaches to ‘epidemic neuromyasthenia’: syndromes of unknown aetiology (epidemic myalgic encephalopathies)
Authors: Thomas M 
Published: December 2008

Summary
The study of future outbreaks of ‘epidemic neuromyasthenia’ syndromes would be easier if there were a standing advisory arrangement for the co-ordination of basic standart studies, diagnostic tests and long term survey of patients. It is proposed that this might be achieved by establishing an ‘EN Outbreaks Panel’ at Colindale which, in addition to epidemiologists and virologists might include specialists in infectious diseases, neurology and psychiatry and other fields. The approach to such a panel would be through the Communicable Diseases Surveillance Centre (CDSC) when outbreak is suspected. Arrangements could then be made by the CDSC with the Epidemiological Research Laboratory and the Virus Reference Laboratory to assist immediate investigations and for a follow-up to ascertain the incidence of sequelae, as well as for long storage of sera and other specimens.
A prospective study of the factors affecting anticoagulant control in a hospital out-patient clinic
Authors: Shepherd A M M , Christopher L J , Stevenson I H , Henney C R , Brown Y 
Published: December 2008

Summary
Anticoagulant control (as indicated by the percentage of Thrombotest values outside a defined range) was determined in out-patients attending a hospital anticoagulant clinic and the influence of patients' age and sex, indication for anticoagulation, concurrent drug therapy and duration of anticoagulant treatment studied. Of these factors, duration of treatment was most important, control being particularly poor in the first 6 months (40% of Thrombotest values outside the 5–15% range, compared with 17% in patients treated with anticoagulants for more than 2 years). Control was also influenced by patients' age and the data supported previous evidence of an increased sensitivity to anticoagulants in the elderly.
The immunological evaluation of levamisole treatment in cancer patients
Authors: Verhaegen H , de Cree J , de Beukelaar A , de Cock W , Verbruggen F , Krug F 
Published: December 2008

Summary
The effect of levamisole on different immunological parameters was studied in patients with various malignant diseases.
Levamisole restored tuberculin-negative delayed hypersensitivity reactions and increased the sensitivity to 1-nitro-2,4-dichlorobenzene challenges. It also increased low E-rosette formation of T-lymphocytes and enhanced the clearance of a lipid emulsion by the reticulo-endothelial system.
Levamisole had no effect on serum immunoglobulin levels but increased serum haemolytic complement activity.
Intraperitoneal noxythiolin and povidone-iodine in experimental peritonitisBased on a paper presented to the Surgical Research Society, January 1977.
Authors: Gilmore O J A , Houang Elizabeth T , Reid Claire , Shaw Elizabeth J 
Published: December 2008

Summary
The efficacy of intraperitoneal noxythiolin and povidone-iodine was compared in mice and rats with induced Gram-negative peritonitis. Noxythiolin 1% solution reduced the mortality of mice from 65 to 41% (P &lt; 0·1) but was ineffective in rats. Povidone-iodine (6·0–7·5 mg available iodine/kg body weight) significantly reduced the mortality of both mice (P &lt; 0·001) and rats (P &lt; 0.01) in treated animals compared to matched controls. The mortality rate of rats treated with povidone-iodine was significantly less than those treated with noxythiolin (P &lt; 0·01).
The syndrome of diabetes insipidus, diabetes mellitus and optic atrophy (DIDMOA) with diabetic cheiroarthropathy
Authors: FitzGerald G A , Greally J F , Drury M I 
Published: December 2008

Summary
Two sisters with diabetes mellitus and optic atrophy are described. One of them also has vasopressin responsive diabetes insipidus. Both have diabetic cheiroarthropathy, an unusual deformity of the hands.
Myxoedema coma. A report on five successfully treated cases
Authors: Khaleeli A A 
Published: December 2008

Summary
Five consecutive cases of myxoedema coma treated successfully with intravenous triiodothyronine and later oral thyroxine are described. All were hypothermic and had biochemical evidence of advanced myxoedema. Co-existent disease, notably diabetes and anaemia, was common.
Rectal bleeding in the first month of life
Authors: Levene M I 
Published: December 2008

Summary
Sixty-nine infants were examined who presented with rectal bleeding in the first month of life. In 64% of these children no cause was found. Infantile diarrhoea, haemorrhagic disease of the newborn and anal fissure were the most common diagnoses made. The mortality in the entire group was &lt;3%. It is concluded that rectal bleeding in this age group is a relatively benign condition and in certain cases hospital admission may not be required.
Some aspects of the role of viruses in cancer
Authors: Potter C W 
Published: December 2008

Summary
The cells of tumours induced by many oncogenic DNA viruses, or cells transformed in vitro, contain virus-specific T and transplantation antigens; these have been described for SV40 virus, polyoma virus and adenoviruses. The investigation of viruses as causes of malignant disease in man has sought to establish whether tumour cells possess these virus-specific proteins; however, to date and with the limitations of present techniques, this enquiry has not demonstrated the above viruses as causal of human cancer. More recent studies with herpesvirus type 2 (HSV-2) have shown this virus to transform animal and human cells in culture, and induce cancer in experimental animals: for these reasons, many researchers have suggested that this agent may be an agent of some forms of cancer, in particular carcinoma of the cervix. The possible association of HSV-2 with human malignant disease is discussed.
Severe bronchial asthma requiring ventilation. A review of 20 cases and advice on management
Authors: Webb A K , Bilton A H , Hanson G C 
Published: December 2008

Summary
The natural history and outcome of 20 asthmatics who required mechanical ventilation is reviewed. Seven of these patients died. The majority of the deaths could have been prevented if: (1)The patient had been followed-up in an asthma clinic and had been fully informed of the danger of an asthmatic attack.(2)The medical staff had been trained more fully in the evaluation and management of a severe asthma attack.
Careful sequential assessment will enable timely transfer of patients with severe bronchial asthma to a unit experienced in their management.
Leptospirosis and acute renal failure—clinical experiences and a review of the literature
Authors: Kennedy N D , Pusey C D , Rainford D J , Higginson A 
Published: December 2008

Summary
About 50 cases of leptospirosis are diagnosed each year in the United Kingdom, with an overall mortality of 5%. Renal failure, in association with jaundice, is commonly held responsible for this figure. Over a period of 18 years, 6 cases of leptospirosis complicated by renal failure were treated at the Royal Air Force Renal Unit; there were 4 survivors. The 2 deaths occurred before the unit policy of daily haemodialysis and total parenteral nutrition, and were both from haemorrhagic complications.
The authors believe that patients with leptospirosis and progressive renal impairment should be managed in renal units experienced in the management of the hypercatabolic patient, and that this should improve their prognosis.
Influenza in a geriatric unit
Authors: Gowda H T 
Published: December 2008

Summary
An outbreak of influenza A (resembling A/Victoria/3/75) occurred in 2 geriatric wards in February 1976 and, out of 19 patients, 3 died. Of the patients who were at risk, 30% were affected.
Immunization for influenza in the elderly just before the winter is suggested. The procedure is simple and inexpensive. The recommendations of the DHSS (U.K.) for the use of influenza vaccine to practising doctors is, therefore, welcome.
The suitable treatment appears to be that of repeated immunization with inactivated vaccine. Amantadine in the elderly population may also be effective, and is worthy of trial.
Liver and gastrointestinal function in pregnancy
Authors: Seymour C A , Chadwick V S 
Published: December 2008

Summary
Difficulties arise in the interpretation of liver tests in the pregnant subject, since some values increase (alkaline phosphatase) whilst others remain unchanged (transaminases) or fall during pregnancy. The diagnosis and management of some causes of jaundice in pregnancy, such as viral hepatitis, gall stones, benign intrahepatic cholestasis and acute fatty liver of pregnancy are discussed.
Little is known about the commonest symptoms of pregnancy (nausea, vomiting and constipation) other than that they might be due to hormonally induced alteration of sphincter tone. However, pre-existing bowel disease has a greater effect on pregnancy. Fertility is reduced in poor nutritional states (e.g. coeliac and Crohn's diseases) and an increased occurrence of spontaneous abortion has been noted. For inflammatory bowel diseases, the time of onset is important in determining the outcome of pregnancy. Relapse in the disease is commonest in the first trimester and in the puerperium. Treatment of these conditions is essentially as in the non-pregnant subject. The controversial subject of sulphasalazine and steroid usage in pregnancy is discussed.
Metabolic changes in pregnancy relevant to diabetes mellitus
Authors: Lind T 
Published: December 2008

Summary
The alterations in carbohydrate metabolism during pregnancy are discussed and possible mechanisms for these changes are put forward. It is stressed that the raised levels of plasma glucose, the enhanced response to insulin and the decreased tissue sensitivity to insulin are all features of normal pregnancy. It may be difficult to distinguish this from very early forms of diabetes mellitus during pregnancy, the detection of which is briefly considered.
Neoplastic autovagotomy causing gastric stasis
Authors: Thomas W E G , Fletcher M S 
Published: December 2008

Summary
Neoplastic autovagotomy causing atonic gastric stasis is extremely rare. Two cases are reported in which marked gastric stasis was complicated by a bezoar and a gastric volvulus respectively. Both cases were associated with a left hilar bronchial carcinoma, and malignant invasion of the vagus nerve may have been the underlying cause.
Severe orthostatic hypotension associated with carcinoma of the bronchus
Authors: Green C J , Breckenridge A M , Wright F K 
Published: December 2008

Summary
A patient is described who had severe orthostatic hypotension. An account is given of his treatment with a monoamine oxidase inhibitor and tyramine. At post-mortem, 8 months after the illness began, a small oat cell carcinoma of the bronchus was found. It is suggested that the orthostatic hypotension was a nonmetastatic manifestation of the underlying carcinoma.
Carcinoid tumour as a complication of ulcerative colitis
Authors: Hay D J , Curt J R N 
Published: December 2008

Summary
Patients with long-standing ulcerative colitis have an increased chance of developing a carcinoma of the colon, especially when the inflammatory process involves the entire colon, but no case of a carcinoid tumour of the colon occurring in a patient with ulcerative colitis has been reported.
Birmingham Medical Research Expeditionary Society 1977 Expediton: thyroid function and acute mountain sickenss
Authors: Wright A D 
Published: December 2008

Summary
In a study of 17 subjects plasma-thyroxine-binding globulin and plasma thyroxine concentrations rose during a high altitude trek. An early and sustained rise in plasma reverse triiodothyronine occurred independently of changes in plasma thyroxine and was probably related to physical exertion. Similar changes in thyroid function were found in subjects most affected and least affected by acute mountain sickness.
Birmingham Medical Research Expeditionary Society 1977 Expedition: cardiopulmonary function before, during and after a twenty-one-day Himalayan trek
Authors: Stockley R A , Green I D 
Published: December 2008

Summary
The heart rate response to exercise was studied in 17 normal subjects before, during and after a 21-day Himalayan trek to 5490 m. The group were fitter before the trek when compared to normal subjects of a similar age (P &lt; 0.001) having a lower heart rate response to exercise for their lean body mass. The trek significantly increased the 'fitness' of the group as a whole (P &lt; 0.025) but this was not seen in the 5 members of the group who had severe acute mountain sickness. Similar changes were noted within the first 8 days of the trek before symptoms of mountain sickness occurred.
The group had normal pulmonary function before the trek but peak expiratory flow rate and vital capacity decreased with altitude. The effect was more marked in the subjects with acute mountain sickness.
Dose response for blood pressure and degree of cardiac beta-blockade with atenolol
Authors: Marshall A J , Barritt D W , Heaton S , Harry J D 
Published: December 2008

Summary
The hypotensive effect of 25 mg, 50 mg, 75 mg, 100 mg and 0 mg of atenolol daily were compared in a double-blind within-patient study. The fall in blood pressure with 25 mg daily was not significantly different than with 100 mg. The dose response curve lies between 0 and 25 mg daily. Cardiac beta-blockade (measured by suppression of exercise tachycardia) was not maximal with 25 mg of atenolol daily. The dose response curves for beta-blockade and the hypotensive effect are not parallel.
Fatal intestinal amoebiasis
Authors: Thuse M G 
Published: December 2008

Summary
The clinical presentation of amoebic colitis are diverse. Amoebiasis is comparatively rare in the U.K. and, unless the clinician is aware of the condition, wrong diagnosis often leads to delay in appropriate treatment resulting in high mortality. Diagnosis rests on clinical suspicion, stool examination, sigmoidoscopy with rectal biopsy and serological tests. Amoebiasis is readily treatable and death from it should be very rare.
Quality of specimens and sputum culture results: a retrospective study
Authors: Rahman M 
Published: December 2008

Summary
A retrospective study of laboratory reports of sputums examined in the first 3 months of 1977 and of 1978 showed some interesting findings, which were similar in these 2 years. Analysis of the findings demonstrated that information from a proportion of sputum cultures were not helpful to the clinicians. Probable causes of such unhelpful results and some ways to overcome these problems were discussed, along with reviews of relevant literature. A conclusion drawn at the end of the discussion was that, under present circumstances, it was not expected that sputum cultures would produce totally reliable aetiological agents, unless attempts were made to obtain a better quality of specimen, e.g. those obtained by transtracheal or bronchoscopic aspirations.
Ectopic ACTH syndrome from bronchogenic carcinoma in association with chronic lymphocytic leukaemia
Authors: Forfar J C 
Published: December 2008

Summary
A patient under treatment for chronic lymphocytic leukaemia developed lobar pneumonia after 8 months. When antileukaemic therapy was discontinued, features of an ectopic ACTH syndrome developed, secondary to bronchogenic carcinoma. Exogenous steroid therapy for leukaemia seemed to suppress the clinical manifestations of the ectopic ACTH syndrome while subsequent endogenous steroid production controlled the peripheral lymphocyte count.
Lithium neurotoxicity
Authors: Newman P K , Saunders M 
Published: December 2008

Summary
The peripheral and central neurotoxic effects of lithium carbonate are illustrated by 4 case histories. Lithium neurotoxicity is likely to be more common than the literature suggests. Neurological sequelae may be irreversible and may be associated with therapeutic serum levels. Prevention may be facilitated by more stringent case selection, EEG and clinical monitoring and the development of improved methods of drug level assessment.