bluuebunny/crossref_metadata_2025_split huggingface dataset:
Birmingham Medical Research Expeditionary Society 1977 Expedition: signs and symptoms
Authors: Fletcher R F 
Published: December 2008

Summary
The BMRES group of 17 persons is described and details are given of the trek to 5400 m. The research programme is outlined. Moderately severe acute mountain sickness (AMS) was observed in 5 subjects. All subjects were rated according to their symptoms related to AMS by interview, peer review and self-assessment, and the results compared.
Terminal care: evaluation of in-patient service at St Christopher's Hospice. Part I. Views of surviving spouse on effects of the service on the patient
Authors: Parkes C M 
Published: December 2008

Summary
The surviving spouses of 34 patients who died of cancer at St Christopher's Hospice have been interviewed about 13 months after the patient's death. The information given is compared with that obtained from 34 spouses of patients dying from cancer in other hospitals and matched with the St Christopher's group.
Patients at St Christopher's were less often thought to have suffered severe pain and other distress than at other hospitals, but pain relief was not bought at the cost of drug-induced confusion and patients at St Christopher's remained more mobile than at other hospitals.
Hospice patients were more aware of chapel services and prayers than at other hospitals. None was said to have been upset by these and 66% were glad of them.
Despite the frequency of deaths in the Hospice, patients at St Christopher's were no more likely to be thought to have been 'upset' by such events than patients elsewhere or to have found their interactions with other patients anything but helpful.
The problem of tricyclic antidepressant poisoning
Authors: Crome P , Newman B 
Published: December 2008

SummaryIn the year May 1976 to April 1977, 489 enquiries about the management of tricyclic antidepressant poisoning received at the London Centre of the National Poisons Information Service were followed-up. One hundred and sixty-four patients (33.5%) were unconscious, convulsions occurred in 62 (12.7%), hypotension in 31 (6.3%), respiratory depression in 28 (5.7%), tachydysrhythmias in 17 (3.5%) and cardiac arrest in 12 patients (2.5%). Sixteen patients died (3.3%). No statistically significant differences were found between individual antidepressants although poisoning with amitriptyline-like drugs resulted in a significantly higher proportion of unconscious patients than poisoning with imipramine-like drugs (P &lt; 0.01). There were more asymptomatic children than adults and more unconscious adults than children. Tricyclic antidepressant poisoning is a major clinical problem in general medical and paediatric practice.
Propranolol in acute intermittent porphyria
Authors: Menawat A S , Panwar R B , Kochar D K , Joshi C K 
Published: December 2008

Summary
Twenty cases of acute intermittent porphyria were studied during the acute phase. Cardiovascular manifestations were noted in all the cases, with tachycardia in 20 and with hypertension in 17. Propranolol in doses ranging from 20–200 mg was given to all the cases and produced adequate control of tachycardia and hypertension. At follow-up, smaller doses of propranolol were found to maintain the pulse rate and BP within normal limits and also to prevent acute attacks.
Hypocalcaemic chorea secondary to malabsorption
Authors: Howdle P D , Bone I , Losowsky M S 
Published: December 2008

Summary
A patient presented with chorea and a recent history of Crohn's disease. Investigation revealed the cause of the chorea to be hypocalcaemia secondary to malabsorption. So far as is known there has been no previous report of hypocalcaemic chorea due to malabsorption.
Recognition and chemotherapy of oculomycosis
Authors: Jones Barrie R , Clayton Yvonne M , Oji Erasmus O 
Published: December 2008

Summary
Oculomycosis may be divided into the orbital infections of phycomycosis of Aspergillus and other species and the infections of the globe. The latter comprise endogenous, post-surgical or traumatic intra-ocular infections and direct infections of the cornea: these are the commonest form of oculomycosis. They are not easy to differentiate from other, more common causes of septic infection of the eye. The early recognition of fungal infections of the eye thus rests on maintaining an efficient service for all septic infections of the eye.
Candida albicans and other dimorphic fungal infections are best treated with flucytosine combined with either polyenes such as amphotericin B and natamycin or combined with imidazoles such as clotrimazole or miconazole.
Aspergillus spp. account for about 50% of the cases of filamentous fungal infection of the cornea but more than 100 species of varying pathogenicity and drug sensitivity have been implicated. Econazole, clotrimazole or miconazole combined with thiabendazole are recommended for Aspergillus spp. Econazole, thiabendazole or miconazole combined with flucytosine for Cladosporium sp. For Fusarium solani and other species econazole is the best drug but some isolates are sensitive to thiabendazole or other imidazoles.
Alternatively, filamentous fungal infections may be treated with natamycin which has a broad spectrum of activity; but does not penetrate well and, like other polyenes, should not be combined with imidazole antifungal chemotherapy because of antagonistic drug interaction.
Overall, econazole emerges as the most widely acting drug; but successful results are dependent on rather complex investigation with intensive and protracted care that can best be provided in a few centres of referral.
Fungal endocarditis: patients at risk and their treatment
Authors: Seelig M S , Goldberg P , Kozinn P J , Berger A R 
Published: December 2008

SummaryFungal endocarditis is not rare. It usually develops in patients with abnormal or surgically traumatized hearts, to whose blood fungi have gained access, perhaps during temporary (often iatrogenic) impairment of host defences. Although the blood is cleared rapidly, the fungus can establish itself in the endocardium, where it grows slowly. Thus, clinical and laboratory procedures (including blood and urine cultures) that have permitted early diagnosis and treatment of bacterial endocarditis, are not reliable in early fungal endocarditis. Greater reliance must be placed on serological monitoring of patients who have had transient fungaemia and are at risk of endocarditis. The clinician must consider factors that enhance fungal proliferation and invasion and be cognizant of its dangers - even in the absence of clear signs of infection. Prophylactic measures should be employed to protect the patient at risk, including topical, oral and systemic use of appropriate antifungal agents. Early therapy, the extent and duration of which can be determined by (1) obtaining the MIC of transitory blood or urine isolates - which should not be ignored - and (2) monitoring serology, might eliminate early invaders of the endocardium. Sixty-four reported cures of fungal endocarditis caused by Candida, the most common fungal pathogen, are tabulated, 29 were of classic fungal endocarditis requiring surgery, 3 of whom were seen later by others as fatal recurrences. Those treated early (shortly after candidaemia was diagnosed - mostly in patients on treatment for bacterial endocarditis or after cardiac surgery) survived without need for surgical removal of vegetations or valve replacement. Despite strong suggestive evidence that the first 35 patients tabulated had fungal endocarditis, histological proof exists for only a few who had surgery.Cures of endocarditis caused by other fungi are noted. Improved surgical and medical therapy has improved the prognosis even of patients with the far-advanced disease. However, development of classic fungal endocarditis has been reported one or more years after cardiac surgery and late recurrences after intensive therapy of fungal endocarditis, that had led to clinical recovery of 2 years or more, have been reported. Serological monitoring of vulnerable patients might alert the physician to recurrence early enough for efficacy of drug therapy, averting fatal outcome or the need for further surgery.
Pharmacokinetics of imidazole antimycotics
Authors: Plempel M 
Published: December 2008

Summary
According to data on the imidazole antimycotics at present on the market, none of these products satisfactorily fills the gaps which exist in the treatment for mycoses of internal organs, although they have brought considerable progress in the topical treatment of mycoses.
On the basis of their very broad spectrum and high intensity of activity under suitable test conditions, and the comparatively tolerable amount of side effects in man, the present imidazole antimycotics are considered to be an encouraging start for future development of derivatives which will lead to products with considerably better pharmacokinetic, and therefore better therapeutic, properties.
Pharmacokinetics of amphotericin B and flucytosine
Authors: Polak A 
Published: December 2008

Summary
The absorption of flucytosine from the digestive tract is very good but minimal with amphotericin B. For this reason, amphotericin B has to be injected intravenously. Fungistatic levels are achieved rapidly with flucytosine and slowly with amphotericin B, since the dose has to be increased slowly. Distribution of flucytosine in other body fluids is high, whereas with amphotericin B it is poor. Flucytosine is excreted mainly via the kidney without metabolism, whereas amphotericin B is eliminated mainly by metabolism. Therefore, amphotericin B dosage does not have to be adapted to kidney function, which is the case for flucytosine. The half-life of flucytosine is short (hours), that of amphotericin B is long (days); flucytosine is haemodialysable, whereas amphotericin B, probably owing to the high protein binding, is not.
In vitro synergy and antagonism of antifungal agents against yeast-like fungi
Authors: Dupont B , Drouhet E 
Published: December 2008

Summary
Some antifungal agents have been tested qualitatively in various associations against species of Candida, Cryptococcus and Torulopsis. The method used was the channel test and the results are confirmed by comparison with the serial dilution test in agar.
The antagonism in vitro with the combination of amphotericin B imidazole suggests that caution must be exercised before prescribing the antifungal drugs in combination for man. The frequent synergy of flucytosine with econazole is, however, encouraging because of the low toxicity of the 2 drugs. Under the limited conditions described, the combination of flucytosine and amphotericin B was not found synergistic but additive on the strains of C. albicans used in this study. This combination was found synergistic for a strain of C. parapsilosis and is useful for avoiding resistance to flucytosine.
A review of the Zollinger-Ellison syndrome – with particular reference to a patient treated with cimetidine
Authors: Wyke R J , Hill G L , Axon A T R 
Published: December 2008

Summary
A case of the Zollinger-Ellison syndrome, presented with watery diarrhoea, malabsorption and multiple duodenal ulcers. Resection of a gastrinoma from the head of the pancreas was ineffective. Cimetidine, administered for more than 30 months produced an immediate and sustained relief of symptoms with a gain in weight of 19 kg and improvement of the biochemical features of malabsorption. Gastric acid secretion has been markedly inhibited and duodenal ulceration healed.
An insulinoma presenting with reactive hypoglycaemia
Authors: Connor H , Scarpello J H B 
Published: December 2008

Summary
A 57-year-old woman presented with symptoms which were cured by the removal of an insulinoma. The case was atypical in that symptomatic hypoglycaemia occurred only after meals or glucose administration but never during fasting, and thus if plasma insulin activity had not been measured an incorrect diagnosis of reactive hypoglycaemia might have been made on the basis of symptoms and oral glucose-tolerance test. Reactive hypoglycaemia resulted from an increased rate of glucose assimilation and possibly also from a decreased rate of gluconeogenesis due to the immense insulin secretion provoked by glucose or food.
The findings suggest that a diagnosis of hypoglycaemia should not be made until the possibility of an insulinoma has been excluded by measurement of plasma insulin activity during a period of hypoglycaemia.
Combined rifampicin and chloramphenicol therapy for Enterobacter osteomyelitis
Authors: Naveh Y , Friedman A 
Published: December 2008

Summary
A 2-month-old infant with Enterobacter osteomyelitis complicating total parenteral nutrition was successfully treated with rifampicin and chloramphenicol. No untoward side effects attributed to rifampicin has been noted despite prolonged administration of rifampicin.
The existence of inflammatory bowel lesions in gluten-sensitive enteropathy
Authors: Kumar P J , O'Donoghue D P , Gibson J , Stansfeld A , Dawson A M 
Published: December 2008

Summary
Three patients with coincident coeliac disease and inflammatory bowel disease are described. In 2 patients with known coeliac disease the recurrence of diarrhoea was not due to dietary deviation but to an additional large bowel pathology.
Pneumatosis cystoides intestinalis secondary to chronic jejunal diverticulitis
Authors: Sammon A M , Malcolm A J 
Published: December 2008

Summary
Pneumoperitoneum due to pneumatosis cystoides intentinalis is reported in a patient with congenital jejunal diverticula. Attention is drawn to the potential diagnostic problems in patients with known intestinal pathology who present with pneumoperitoneum.
Rifampicin-induced thrombocytopenia
Authors: Hadfield J W 
Published: December 2008

Summary
Rifampicin occasionally causes thrombocytopenia when given as part of an intermittent regimen. A case is reported of severe thrombocytopenia developing after one dose of rifampicin, following a 4-month gap in daily therapy. The literature on rifampicin-induced thrombocytopenia is reviewed.
Bacterial pyomyositis in a patient with aplastic anaemia
Authors: Mitsuyasu R , Gale R P 
Published: December 2008

Summary
Bacterial pyomyositis is common in the tropids but is rare in temperate climates. A patient with aplastic anaemia who had never left the continental United States developed bacterial pyomyositis secondary to Staphylococcus aureus which responded to antibiotics and surgical drainage. Bacterial pyomyositis should be considered in the differential diagnosis of fever and myalgias in the immunocompromised patient.
Baclofen overdose
Authors: Lipscomb D J , Meredith T J 
Published: December 2008

Summary
A 57-year-old woman suffering from multiple sclerosis took an estimated 1500 mg of baclofen. She became deeply unconscious with generalized flaccid muscle paralysis and absent tendon reflexes. Toxicological analysis confirmed the presence of baclofen together with small amounts of paracetamol and glutethimide. Supportive therapy, including assisted ventilation for 3 days, led to complete recovery; anticonvulsant drugs were necessary for the treatment of grand mal fits. The clinical features and treatment of baclofen overdose are discussed.
Brucella endocarditis on double valvular prosthesis
Authors: Lezaun R , Teruel J , Maître M J , Artaza M 
Published: December 2008

Summary
The case is reported of a 48-year-old man suffering from Brucella endocarditis on a double prosthesis. The successful medical and surgical treatment is described. So far as the authors know, this is the first report of Brucella endocarditis from a heart valve prosthesis.
A possible association of partial lipodystrophy with anti-GBM nephritis (Goodpasture’s syndrome)
Authors: Blake D R , Rashid H , McHugh M , Morley A R 
Published: December 2008

SummaryPartial lipodystrophy is known to be associated with mesangiocapillary glomerulonephritis. A case is described of a possible association of partial lipodystrophy with anti-GBM nephritis (Goodpasture’s syndrome).
Salivary theophylline estimation in the management of asthma in children
Authors: Lena S M , Hutchins P , Wood C B S , Turner P 
Published: December 2008

SummarySimultaneous sampling was performed to determine whether saliva could replace plasma in the monitoring of theophylline dosages. Forty-eight children with moderate to severe asthma received oral theophylline preparation (usually sustained release) on a daily basis. They provided simultaneous saliva and plasma samples at routine out-patient visits. Saliva and plasma theophylline concentrations showed a wide variation between individuals, and their ratios also differed. Saliva theophylline concentrations below 7 micrograms/ml reflect plasma concentrations below 10 micrograms/ml, i.e. sub-therapeutic, while saliva concentrations above 7 micrograms/ml are consistent with therapeutic dosage.Estimation of saliva theophylline concentration on routine visits avoids the discomfort of blood sampling. It reflects whether daily oral theophylline dosage in childhood asthma is below or within the therapeutic range. The need for changes in dosage and the degree of patient-compliance with therapy can be usefully indicated.
Diffuse involvement of the leptomeninges by tumour--a clinical and pathological study of 63 cases
Authors: Boyle R , Thomas M , Adams J H 
Published: December 2008

Summary
The clinical and pathological features of 63 cases of post-mortem-proved diffuse infiltration of the leptomeninges by tumour are presented. A wide variety of tumours of the nervous system, both primary and secondary, was found to give rise to such involvement, with adenocarcinoma having a particular propensity to behave in this manner. Dysfunction of cranial and spinal nerves, a confusional state and headache were prominent clinical features. Examination of the cerebro-spinal fluid was found to be less useful diagnostically in cases of primary tumours of the nervous system with leptomeningeal involvement than in cases of diffuse infiltration of the meninges by carcinoma.
Mixed connective tissue disease with associated glomerulonephritis and hypocomplementaemia
Authors: Palferman T G , McIntosh C S , Kershaw M 
Published: December 2008

Summary
Mixed connective tissue disease is an increasingly recognized entity in which renal disease is thought to be unusual and associated hypocomplementaemia even more uncommon. A patient is described who had both these features and who also illustrates many of the characteristic features of this syndrome. The response to steroids of the systemic sclerosis component is well shown and an additional feature of interest is the family history of other connective tissue diseases.
Behçet’s syndrome: unusual multisystem involvement and immune complexes
Authors: Hyman N M , Sagar H J 
Published: December 2008

Summary
A case of-Behçet’s syndrome is described in which, in addition to the usual features of the condition, there was evidence of renal, gastric and cardiac involvement. Neurological involvement presented as hemisphere, transient ischaemic episodes. Immune complexes were detected and the patient responded promptly to prednisolone.
Successful management of serious disopyramide poisoning
Authors: Holt D W , Helliwell M , O’Keeffe B , Hayler A M , Marshall C B , Cook G 
Published: December 2008

SummaryA case of deliberate disopyramide overdosage is described. Circulatory collapse was treated by means of a large dose of isoprenaline, and charcoal haemoperfusion was used in an attempt to enhance the elimination of disopyramide. The suitability of this treatment regime is discussed in the light of findings from animal studies and the implications for the management of the disopyramide-poisoned patient are considered.
Xanthogranulomatous pyelonephritis presenting with unilateral renal vein thrombosis
Authors: Akintewe T A , Dealler S , Hutcheon A W 
Published: December 2008

Summary
Haematuria in an elderly patient is a common urological complaint. A patient is described in whom xanthogranulomatous pyelonephritis presented as unilateral renal vein thrombosis. So far as the author is aware, this is the first report of such an association.
The diagnosis and management of hyperparathyroidism during pregnancy
Authors: Deutsch A A , Zager M , Bernheim J , Steiner Z , Reiss R 
Published: December 2008

Summary
Hyperparathyroidism during pregnancy is rare and very few cases have undergone parathyroidectomy during the course of gestation. In reviewing the literature it is apparent that surgery during the second trimester should be the treatment of choice. The complication rate of untreated cases may reach 80% and include spontaneous abortion, fetal death and neonatal tetany. The paper is illustrated with appropriate cases.
Severe barbiturate and paracetamol overdose: the simultaneous removal of both poisons by haemoperfusion
Authors: Helliwell M 
Published: December 2008

Summary
Charcoal haemoperfusion was successful in the treatment of severe butobarbitone poisoning complicated by resistant hypotension. At the same time the rapid removal of paracetamol may have lessened the severity of the subsequent hepatic injury. The mechanism and management of shock associated with barbiturate poisoning, and the possible application of haemoperfusion in paracetamol poisoning are discussed.
Aortic regurgitation and false aortic aneurysm formation in Behçet’s disease
Authors: Rae S A , Vandenburg M , Scholtz C L 
Published: December 2008

Abstract
Behçet’s disease is associated with vascular complications. Aortic regurgitation associated with this condition has never previously been described. A case is now reported in which this occurred and which was followed postoperatively by a false aneurysm of the ascending aorta.
Mucinous adenocarcinoma of the renal pelvis
Authors: Joshi K , Jain K , Mathur S , Mehrotra G C 
Published: December 2008

Abstract
A case of mucinous adenocarcinoma of the renal pelvis occurring in association with staghorn calculus and severe pyelonephritis is reported. The incidence and aetiopathogenesis of this neoplasm is briefly discussed.
Comparative effect of cimetidine and ranitidine on prolactin secretion
Authors: Nelis G F , Van de Meene J G 
Published: December 2008

Abstract
Cimetidine has been shown to stimulate prolactin secretion after a intravenous administration. Cimetidine 200 mg and ranitidine 50 mg was given i.v. in a randomly allocated order to 22 volunteers on consecutive days; these doses can be regarded as equivalent as far as inhibition of gastric acid output is concerned. Plasma prolactin was estimated at regular intervals. The prolactin stimulating effect of cimetidine was confirmed while ranitidine did not influence plasma prolactin levels. Although cimetidine and ranitidine seem to be equally effective in reducing gastric acid output, the effect of the drugs are not the same on their entire spectrum of action since ranitidine does not influence plasma prolactin. It still has to be established in clinical trials which drug is the best choice in clinical medicine.
Growth hormone, prolactin and thyrotrophin responses to thyrotrophin-releasing hormone in diabetic patients
Authors: Harrower A D 
Published: December 2008

Abstract
Growth hormone (GH), prolactin (PRL) and thyrotrophin (TSH) responses to thyrotrophin-releasing hormone (TRH) were studied in 15 insulin-dependent diabetic patients. Basal plasma GH levels were raised above 5 mu./l in 6 patients and following the injection of TRH there was a significant rise in plasma GH levels in 9. The mean rise in plasma GH from basal to peak values was significant in the group as a whole (P &lt; 0.01).
Basal PRL and TSH levels were normal and rose normally in response to TRH.
GH release may be qualitatively abnormal in some diabetics and any such loss of specificity of GH-releasing mechanisms would further contribute to the raised GH levels found in many diabetics which would be of importance if GH is a factor in the aetiology of diabetic microangiopathy.