bluuebunny/crossref_metadata_2025_split huggingface dataset:
The hazard of electrocution during patient monitoring
Authors: Lee W R 
Published: December 2008

Summary
The ever-present hazard in patient monitoring is electrocution resulting in ventricular fibrillation. Fire and explosion hazards are possibilities but seem to be very remote.
Iatrogenic electrocution can occur when:
(a) more than one piece of electrical equipment is connected to the patient.
(b) the distal end of an intracardiac electrode is handled.
(c) pericardiocentesis is carried out with ECG monitoring,
Under these circumstances, small currents, of the order of 100-200 μA, may cause ventricular fibrillation. There is evidence that the ventricular fibrillation threshold is substantially lowered by anoxia and acidosis but it seems to be unaffected by barbiturate anaesthesia.
This paper suggests that the physician or surgeon should understand the risks but may need the expert advice of an electrical engineer. Ventricular fibrillation which has occurred under these circumstances requires careful, expert investigation to establish whether or not it was electrically induced.
Aminoglutethimide: a ‘side-effect’ turned to therapeutic advantage
Authors: Hughes S W M , Burley D M 
Published: December 2008

SummaryAminoglutethimide was introduced as an anti-convulsant drug in the U.S.A. in 1960.The occurrence of a number of side-effects, including several endocrine effects such as goitrogenesis, sexual precocity and virilization, led to its withdrawal.Further investigation indicated that the drug inhibited adrenal biosynthesis, particularly of aldosterone, cortisol and androgens, probably by interfering with the conversion of cholesterol to delta-5-pregnenolone.Aminoglutethimide has also been shown to modify the extra-adrenal metabolism of cortisol.The possible clinical applications of these ‘side-effects’ are discussed.
Mass detection of bacteriuria by combination of two screening tests
Authors: Papanayiotou P , Papanayiotou K , Dontas A S , Marketos S G 
Published: December 2008

SummaryThe Uriglox screening test was compared with the modified Griess Nitrite test and with standard urine cultures in the detection of significant bacteriuria on 400 ambulant and asymptomatic residents of the Athens Home for the Aged. The modified Nitrite test alone detected 62%, and the Uriglox test 79% of the 103 cases with positive urine cultures in the examined group. There was significant overlap in the positive cases picked up by each screening test separately, the Uriglox test identifying more Klebsiella infections. Since there were no false-positive cases with either one of the employed tests, the cases identified by one or the other or both screening tests amounted to 95% of the total number of bacteriuric samples. The combination of the moderately sensitive but highly specific test of Nitrite, with the very sensitive test of Uriglox, can effectively substitute for the expensive and time-consuming quantitative bacterial counts with pour-plate techniques in mass screening for bacteriuria.
Definition of sarcoidosis
Authors: Scadding J G 
Published: December 2008

SummaryThe concept of sarcoidosis as a systemic disease arose from the recognition that certain clinical phenomena which were at first described as ‘diseases’ affecting a number of different organs and tissues had in common (i) a histological pattern which can be described in general terms as a non-caseating tuberculoid granuloma and (ii) possible concurrence in the same patient in various combinations. These two features constitute the basis for a workable definition:Sarcoidosis is a disease characterized by the presence in all of several affected organs or tissues of epithelioid cell tubercles, without caseation though some fibrinoid necrosis may be present at the centres of a few tubercles, proceeding either to resolution or to hyaline fibrosis.Because knowledge of the causation of sarcoidosis is fragmentary, investigators must be left free to examine every possible aetiological hypothesis. For this reason, the definition should contain no reference to aetiology.
Frequency of disordered calcium metabolism in sarcoidosis
Authors: Israel Harold L , Goldstein Robert A 
Published: December 2008

SummaryA prospective study of total and ultrafiltrable serum calcium levels in 121 patients with sarcoidosis and thirty-eight control subjects revealed no significant differences. Two patients had hypercalcaemia (11·6 and 12·2 mg%) at the time of initial sampling; one spontaneously returned to normal. Retrospective analysis of 318 cases previously studied demonstrated persistent hypercalcaemia in eight of 262 negroes and two of fifty-six whites, with a male to female ratio of seven to three.Serial calcium measurements in thirty-four patients and single determinations in eighty-seven patients taken during the course of 1 year failed to show seasonal fluctuation.These observations suggest that calcium metabolism is normal in most patients with sarcoidosis. When persistent hypercalcaemia is found in a patient with sarcoidosis, careful study for associated hyperparathyroidism is essential, especially if the sarcoidosis is otherwise asymptomatic or inactive.
The Kveim test in leprosy
Authors: Rees R J W 
Published: December 2008

Summary
From the older literature it has been claimed that a significant proportion of patients with the tuberculoid, but not the lepromatous, form of the disease, gave positive Kveim reactions. It is concluded, however, from a review of this older literature that none of the claims are based on studies using a validated Kveim antigen and that the majority of the readings were based on macroscopic, rather than microscopic assessment.
The International Study by Siltzbach on Kveim tests in leprosy patients using a validated antigen and assessed microscopically reveal no positive reactions among fifty-seven patients with all types of leprosy from Finland, Israel, Italy and Turkey. However, this same study on Japanese patients gave two positive and five equivocal Kveim reactions among ten lepromatous patients and one equivocal reaction among three tuberculoid patients. Our own studies in Malaysia with the same validated Kveim antigen used by Siltzbach and assessed microscopically gave one weak positive Kveim reaction among twenty-one lepromatous patients and four equivocal Kveim reactions among nine tuberculoid patients.
It is concluded from these results that, with the possible exception of Chinese and Japanese patients, false positive Kveim reactions are extremely rare in patients with all types of leprosy. Therefore in parts of the world where leprosy is endemic the Kveim reaction can still be accepted as an important confirmatory diagnostic test for sarcoidosis.
It is suggested that further surveys of Kveim reactivity be undertaken on Chinese and Japanese leprosy patients, since both have a similar ethnic origin, in order to determine whether such patients are more liable to elicit a granulomatous reaction to Kveim antigen.
The Kveim test in Crohn’s disease
Authors: Mitchell D N , Dyer N C , Cannon P , Hinson K F W , Willoughby J M T 
Published: December 2008

Summary
Kveim tests were done in forty-eight patients with Crohn’s disease. Of forty-five with definite or probable Crohn’s disease, twenty-three had a positive Kveim test. This finding could be explained:
(1) By cross-reactivity between sarcoidosis and Crohn’s disease antigens;
(2) By an aetiological agent common to the two diseases, or
(3) By a property of the Kveim test material used in testing.
Renal involvement in sarcoidosis
Authors: Lebacq E , Verhaegen H , Desmet V 
Published: December 2008

Summary
Among 152 sarcoidosis patients, 11% had hypercalcaemia, 62% had hypercalciuria and 13·8% had at least one renal stone. Impairment of renal function was mostly conspicuous in patients with hypercalcaemia. Twenty-five successful percutaneous renal biopsies were performed. Epithelioid granulomas were seen in ten cases, with inflammatory reaction more prominent than in other organs involved by sarcoidosis, due to simultaneous pyelonephritis. Thickening and hyalinization of capsular membrane and glomeruli as well as arterial walls were frequently encountered. Amyloid deposits could be seen in one case with chronic lung infection. Histopathological changes specific of sarcoidosis are related to an abnormal amount of serum gammaglobulins and calciuria exceeding 200 mg in 24 hr, which seem to be the best tests of involvement by the disease.
Tubular reabsorption of calcium was low in two patients with hypercalciuria, which was corrected after corticosteroid treatment.
High intestinal calcium absorption was lowered after hydrochlorothiazide had decreased urine calcium.
The tragedy of viral diagnosis
Authors: Herrmann Ernest C 
Published: December 2008

Summary
The shortcomings of the methods commonly recommended for the diagnosis of viral infections are emphasized.
Most of them are laborious and expensive, and are of very little practical value to the clinician.
Nine years’ experience has confirmed that the use of a single swab, obtained during the acute stage of the illness, for bacterial culture and viral isolation (looking for cytopathic effects or haemadsorption) provides the diagnosis quickly in the great majority of viral infections.
A 2-year study of the efficacy and tolerability of prenylamine in the treatment of angina pectoris
Authors: Cardoe Neil 
Published: December 2008

Summary
Twelve out-patients with established angina pectoris who had previously participated in a double-blind trial of prenylamine lactate continued to record their daily anginal attack rate and glyceryl trinitrate consumption over the subsequent 18 months. The improvement noted while taking prenylamine during the trial was maintained and a further double-blind study confirmed that this was, in fact, due to the administration of the drug, which was again shown to be significantly more effective than identical placebo in the prophylaxis of angina pectoris.
Experiences of intensive coronary care in a regional hospital
Authors: McAllen P M 
Published: December 2008

Summary
Seven hundred and twenty-one patients were admitted during 22 months. Recent myocardial infarction was confirmed in 518. In this group, 115 (22%) died in hospital and 33 (6%) were resuscitated and left hospital alive. Prophylactic measures probably prevented cardiac arrest in a number of patients and contributed to lowering the mortality rate. Other factors influencing cardiac arrest and death were sex, age, time after onset of infarction and ECG pattern. Anticoagulants had no influence. The clinical presentation was most varied and several difficult diagnostic patterns are described.
Some mental symptoms in neurology
Authors: Behrman Simon 
Published: December 2008

Summary
Cases are presented in which cerebral disease was associated with schizophrenic-like or manic-depressive-like psychoses, anxiety or obsessional states i.e. psychiatric disorders usually classed as ‘functional’.
Evidence is presented to suggest that this association is not due to chance.
The cerebral structural changes are characterized either by the presence of ‘focal’ lesions, e.g. multiple sclerosis, or by neuronal loss e.g. Huntington’s chorea. The probable mechanisms whereby these two types of structural changes effect psychiatric disturbances are discussed.
It is inferred that psychiatric disturbances will occur insofar as these cerebral structural changes exert an influence on the limbic systems.
Reasons against referral to the psychiatrist
Authors: Mezey Alex G , Kellett John M 
Published: December 2008

Summary
Consultants practising clinical specialties other than psychiatry in six general hospitals were asked by questionnaire about reasons which might prevent the referral of patients to a psychiatrist. The purpose of the enquiry was to find out the causes of the discrepancy between the prevalence of psychiatric disorder among medical and surgical patients and the low rate of referral.
Forty-five per cent of the consultants were influenced by the patient’s dislike of referral; there was also evidence of marked dissatisfaction with existing psychiatric services at certain hospitals, felt chiefly by the younger consultants. Part-time consultants gave more reasons for non-referral, but there was no significant difference between medical and surgical specialties despite reported variations in referral practice.
It is concluded that general hospital psychiatric units have a role to play in improving the relationship between psychiatrists and other specialties so that referral practice can meet the needs of the patient.
Comparison of propranolol and LB 46 (prinodolol) on hyperthyroid tachycardia
Authors: Arbab A G , Turner P 
Published: December 2008

SummaryLB 46 (prinodolol) a β-adrenergic receptor blocking drug which is more potent than propranolol in euthyroid subjects, is less effective in inhibiting hyperthyroid tachycardia. This is probably due to its intrinsic sympathomimetic activity.
Psychiatry in a postgraduate teaching hospital
Authors: Abrahamson David 
Published: December 2008

Summary
A study is presented of 217 adults referred for psychiatric assessment from the wards of a postgraduate teaching hospital.
The pattern of referral and the disproportionate importance of disturbed behaviour amongst referrals from non-medical wards are discussed. The main diagnostic groups, namely, affective disorders, organic states, psychogenic somatic symptoms and attempted suicide, are tabulated and discussed. Complex problems of diagnosis and management were common and are considered under five headings: multiple pathology; the effects of intensive treatment procedures; language and cultural differences, and difficulties in follow-up.
It is concluded that the problems met in this specialized setting are likely to become general as intensive treatment and diagnostic procedures become more widespread.
The importance of organic reactions is stressed and their relative neglect by both psychiatrists and physicians commented on. The frequency of social precipitants of affective disorders and attempted suicide, however, is considered to emphasize the range of activities required of the psychiatrist in even the most technologically advanced centres.
Radiological changes in hepatic amoebiasis
Authors: Ramachandran S , Jayawardena D L N , Perumal J R A 
Published: December 2008

Summary
Radiological abnormalities were observed in 88·3% of patients with the syndrome of hepatic amoebiasis. While this figure is higher than those reported in previous studies, it appears that it is due to the large number of patients who showed an elevation of the diaphragm in the right lateral views of the chest. It was observed that a proportion of the patients with an elevation of the right dome of the diaphragm in the lateral views showed no significant elevation in the postero-anterior views, these patients constituting a radiologically distinct group. It is thus important that lateral views of the chest should be performed routinely in all cases of suspected hepatic amoebiasis.
Cases of proved hepatic abscesses also conform to one or other of the radiological groups described. Abscesses situated inferiorly or anteriorly in the liver could be associated with an elevation of the right dome of the diaphragm.
While chest radiology is of importance in the diagnosis of the syndrome of hepatic amoebiasis, it is not peculiar to this syndrome alone and is of only relative diagnostic value in clinically differentiating the cases where pus may be demonstrated from the cases where pus may not be demonstrable.
Myocardial infarction during pregnancy: report of two cases with a review of the literature
Authors: Husaini M H 
Published: December 2008

Summary
Two further cases of myocardial infarction during pregnancy are reported.
From the review of the literature of forty-three cases of myocardial infarction during pregnancy and labour, it appears that myocardial infarction in the last trimester and labour is frequently fatal.
Short-term anticoagulant therapy to suppress any thrombo-embolic tendency is desirable.
Termination of pregnancy is indicated for patients in cardiac failure or persistent angina. For patients who are well, either assisted vaginal delivery or Caesarean section are equally good.
Tuberculin sensitivity in tuberculosis
Authors: Scadding J G 
Published: December 2008

SummaryIt is generally accepted that patients suffering from Mycobacterium tuberculosis infections show positive tuberculin skin tests, with certain rare exceptions. Recognized causes of these exceptions include extreme illness, whether due to extensive tuberculosis or to other severe disease, and certain viral infections, notably measles. It is not so generally recognized that a few patients with pulmonary tuberculosis, generally of rather indolent type, who are not acutely ill, persistently fail to react to tuberculin; and that the range of tuberculin sensitivity observed in patients with the more usual forms of tuberculosis is very wide.The effect of cortisone in diminishing the size of tuberculin reactions in patients with pulmonary tuberculosis is directly related to the degree of sensitivity; reactions produced by small doses of tuberculin in patients with high sensitivity are greatly diminished or inhibited, while those produced by 100 T.U. in patients with low sensitivity are not significantly altered. Patients with tuberculosis can be desensitized to tuberculin by increasing injections of tuberculin under chemotherapy cover. In patients who have been so desensitized, the addition of cortisone to tuberculin in an intradermal test produces positive reactions in 70%. Among patients with sarcoidosis giving no reaction to 100 T.U., about half react when cortisone is added.These observations show that in patients with sarcoidosis, a negative tuberculin test cannot be taken to exclude M. tuberculosis infection.
Tuberculous cervical lymphadenopathy
Authors: Newcombe J F 
Published: December 2008

Summary
Forty-five cases of tuberculous cervical lymphadenopathy have been treated by a combination of early surgery and long-term chemotherapy. The majority of these patients have been immigrants of Asiatic origin.
The posterior cervical group of nodes has been the most commonly involved. The site of primary infection was not identified.
Histological examination of biopsy material proved the most reliable diagnostic method.
Possible alternative methods of managing these cases are discussed.
Myocardial involvement in infectious hepatitis
Authors: Nagaratnam N , De Silva D P K M , Gunawardene K R W 
Published: December 2008

Summary
Four cases with myocarditis due to infectious hepatitis are described. Infectious hepatitis, though it pre-dominantly affects the liver could be a disseminated illness and myocarditis, usually benign, could be a serious complication as in one of the cases in this series.
Clinical experience with metolazone in fifty-two African patients: synergy with frusemide
Authors: Gunstone R F , Shani H G P , Njemo D , Wing A J , Sabuka E M W 
Published: December 2008

SummaryThe use of metolazone (Zaroxolyn), a new diuretic, in fifty-two African patients is described. The drug was found to be safe and moderately effective when used alone, but combined with frusemide it proved to be of great value in patients whose fluid retention was refractory to other diuretics.
Minimal dose of histamine for maximal acid secretion in control subjects and patients with duodenal ulcerPart of the work was supported by a grant from TNMC and BYL Nair Charitable Hospital Research Society.
Authors: Desai H G , Zaveri M P , Antia F P 
Published: December 2008

Summary
Dose-response curves were obtained from forty adult male control subjects and forty patients with duodenal ulcer by administering 1·6, 2·0, 2·4, 2·8, 3·2-mg doses of histamine acid phosphate (HAP) subcutaneously.
The results showed that the minimal dose of HAP for MAO for patients with duodenal ulcer was significantly greater than that required for control subjects.
A significant positive correlation between the minimal dose of HAP, independent of body weight, for MAO and the maximal acid secretory capacity of an individual was observed both in control subjects and patients with duodenal ulcer.
Body weight and maximal acid outputPart of the work was supported by a grant from TNMC and BYL Nair Charitable Hospital Research Society.
Authors: Desai H G , Zaveri M P , Antia F P 
Published: December 2008

Summary
Dose-response curves were obtained from forty male control subjects and forty male patients with duodenal ulcer from India on the subcutaneous histamine test.
The body weight and maximal acid output (MAO) showed a positive correlation just significant at the 5% level in control subjects (P=0·05) but not in patients with duodenal ulcer.
The values of MAO on dose-response curves are comparable in control subjects but are appreciably lower in patients with duodenal ulcer from India compared with those from Britain and North America. However, the values expressed as μEq/kg body weight are considerably higher in both groups of subjects from India compared with those from western populations.
Giant gas-filled cyst of sigmoid colon. Report of a case and review of the literature
Authors: Sibson D E , Edwards A J 
Published: December 2008

Summary
The largest recorded gas-filled cyst of the sigmoid colon, in a man of 67, is presented. The literature of the other recorded cases is reviewed. The gas in the cyst was analysed and a suggestion put forward that bacteria play some part in the aetiology of the gas in the cyst.
Antazoline in the treatment of cardiac arrhythmias
Authors: Shah S S , Vaidya C H , Doshi H V 
Published: December 2008

SummaryAntazoline was administered in sixty-five episodes of various types of cardiac arrhythmia.A complete suppression of the ectopic beats was achieved in five out of six episodes of premature atrial systoles and in twenty-one of the twenty-four episodes of ventricular premature systoles.Conversion to sinus rhythm was observed in seven out of ten and four out of five episodes of paroxysmal atrial and nodal tachycardia respectively.Six out of ten episodes of ventricular tachycardia were controlled by intravenous therapy. However, the drug proved to be ineffective in cases of atrial fibrillation.The side-effects were few and transitory, consisting of nausea, vomiting and drowsiness.
Six cases of poisoning after a parenteral organic mercurial compound (Merthiolate)
Authors: Axton J H M 
Published: December 2008

Summary
The case histories of four children and two adults who were accidentally given toxic amounts of Merthiolate are recorded. The possible modes of action of Merthiolate in causing symptoms are discussed.
Five out of the six patients died, and necropsy showed extensive renal tubular necrosis in each case, and in two, evidence of diffuse intravascular coagulation.
Cardio-thoracic ratio in Negroes in Southern Africa
Authors: Walker Alexander R P , Richardson B D , Wadvalla M , Walker B F 
Published: December 2008

Summary
Negro groups in West, Central and Southern Africa, also in Jamaica, have mean cardio-thoracic ratios significantly greater than those in corresponding age-sex groups of Caucasians.
To throw more light on the situation, studies on young and elderly Negroes have been made in certain groups in Southern Africa, also on local Caucasian groups. Only slight differences in ratio were found between local Negro groups, and Caucasian groups in South Africa, also in Wales and Tecumseh (U.S.A.). Yet ratios in Negro males from Malawi and Mozambique, resident in South Africa, were significantly greater than values in local Negroes. High ratios are not therefore invariable for Negroes. The difference observed relates to heart, not thoracic diameter. Since the phenomenon, which concerns heart position, is apparent in the young, almost certainly it is of ethnic origin. Investigations on cardiomegaly in African populations must take this factor into reckoning. Its presence or absence locally may readily be assessed by determining ratios in relatively small numbers of young people of both sexes.