bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacteraemia after manipulation of the urinary tract. The importance of pre-existing urinary tract disease and compromised host defences
Authors: Quintiliani R , Klimek J , Cunha B A , Maderazo E G 
Published: December 2008

Summary
The factors related to the occurrence of bacteraemia following urinary tract manipulation were studied in a large community hospital. During a 3-year period, forty-six of 326 episodes of hospital-acquired bacteraemia were associated with urinary tract manipulation. All thirty of forty-six cases felt to be definitely related to urinary tract manipulation (other obvious sources of bacteraemia being absent) had pre-existing urinary tract disease, especially of an obstructive type; only one in this group died from sepsis. The remaining sixteen patients had other possible sources of bacteraemia besides urinary tract manipulation and had disorders associated with defects in host defences; twelve (75%) in this group died from overwhelming sepsis. Thus, if bacteraemia occurs in a patient having had urinary tract manipulation but without any underlying urinary tract abnormality or impairment in host defences, its source should be searched for in other areas of the body.
‘Epidemic neuromyasthenia’ at the Hospital for Sick Children, Great Ormond Street, London
Authors: Dillon M J 
Published: December 2008

Summary
An outbreak of an illness with features in common with ‘epidemic neuromyasthenia’ affected the staff of the Hospital for Sick Children in London between August 1970 and January 1971. At least 145 cases were observed and the majority of these were nurses. Symptomatology was protean, clinical findings minimal and relapses frequent. Care was taken to minimize anxiety and fear in a vulnerable population, and laboratory investigations were purposefully limited in number for this reason. In general, laboratory findings, including virological investigations were negative. A high incidence of anti-complementary activity and the presence of ill defined aggregates in some acute sera on electron microscopy were interesting and possibly significant findings suggesting the presence of immune complexes. These findings, plus the ability of lymphocytes from some patients to proliferate in vitro, were thought to represent possible evidence of an infective process. Although no children were affected during the 1970 outbreak, it is interesting that seven children have recently been referred to the hospital with features compatible with ‘epidemic neuromyasthenia’.
‘Epidemic neuromyasthenia’ in Southwest Ireland
Authors: Corridan J P 
Published: December 2008

Summary
During the course of an obscure illness in a teenage girl it was eventually realized that the diagnosis was ‘epidemic neuromyasthenia’. The illness which occurred between February and September 1976 was characterized by fatigue, pallor, headache, nuchal pain, alterations in mentation, dizziness, nausea and vomiting, paraesthesiae, weakness and heaviness of limbs, and a prolonged relapsing course. Investigation brought to light fourteen patients with similar symptoms—twelve female and two male. In view of the shortcomings of retrospective enquiries, especially those involving the assessment of notes made by other people, and the problem of trying to define a nonfatal illness with protean symptoms, many of a nonspecific nature, with few physical findings and negative laboratory studies, caution is necessary. Under these circumstances it is claimed on clinical epidemiological evidence that a diagnosis of ‘epidemic neuromyasthenia’ could be sustained confidently in three patients and probably in a fourth. Six patients were considered possible cases and four were rejected.
Ill defined neurological diseases of possible viral origin
Authors: Sutton R N P 
Published: December 2008

Summary
Any approach towards elucidating the aetiology of an ill defined disease such as ‘epidemic neuromyasthenia’ has to be a comprehensive and wide-ranging one. Although viruses must be strong candidates, by reason of their ubiquity, this need not necessarily be the case and we have recently seen the onset of Legionnaires' disease as a new entity caused by a bacterium. We do not always recognize that a particular virus may affect the entire community and that the patient seen in hospital may represent only the tip of the submerged iceberg and that, in closed communities more of the iceberg will be seen. Silent viral epidemics are probably frequent and may only be recognized in retorspect. As an example the recent epidemic with adenovirus type 7 will be alluded to. Possible variations in virus and, to a lesser extent, in the host which could modify the course of an individual infection are discussed.
Effect of prolonged therapy with neuroleptics on hepatic microsomal enzyme activity in schizophrenic patients
Authors: Majumdar Sisir K , Kakad Pravin P 
Published: December 2008

Summary
Gamma-glutamyl transpeptidase (GGT) is one of the hepatic microsomal enzymes and is now considered to be a reliable biochemical marker of enzyme induction.
Serum levels of this hepatic microsomal enzyme were estimated in twenty-eight schizophrenic patients treated with neuroleptics (fluphenazine, flupenthixol and chlorpromazine) for a prolonged period. No biochemical evidence of induction of the hepatic microsomal enzymes was noticed. It is suggested that these drugs may not cause hepatic microsomal enzyme induction in humans and that interference of rates of metabolism via enzyme induction in other drugs used concurrently need not be anticipated.
Postpartum thyroiditis
Authors: Hoffbrand B I , Webb S C 
Published: December 2008

Summary
Three women presented 4–6 months after delivery with a goitre and spontaneously changing thyroid function believed to be due to autoimmune thyroiditis. All three patients had transient hypothyroidism and one initially had evidence of thyrotoxicosis. Hypothyroidism in autoimmune thyroiditis is generally regarded as permanent. However, evidence is now accumulating, and is reviewed here, to suggest that relapses or onset with transient thyrotoxicosis and hypothyroidism followed by spontaneous, more or less complete, remission occur in one or more varieties of thyroiditis in the postpartum period.
Fetal drug syndromes
Authors: Gordon Neil 
Published: December 2008

Summary
Certain drugs which affect fetal development are considered. Phenytoin taken during pregnancy may result in infants who remain mentally and physically retarded, with abnormal craniofacial appearance and limb defects. A boy with such a syndrome is reported. Trimethadione is another drug which has been said to be teratogenic, and to cause a typical phenotype which is described. The fetal alcohol syndrome is now well recognized and has similar features to those related to anti-epileptic drugs taken during pregnancy. A high level of suspicion of possible associations between congenital defects and drugs must be maintained.
Total body potassium depletion and renal tubular dysfunction following carbenoxolone therapy
Authors: Dickinson R J , Swaminathan R 
Published: December 2008

Summary
A patient with hypokalaemia-associated renal tubular damage following carbenoxolone therapy is described. The hypokalaemia was reflected by a low level for total body potassium (TBK) and investigations confirmed renal tubular dysfunction. Hypokalaemic nephropathy may be secondary to intracellular potassium depletion rather than the hypokalaemia itself.
Unusual extra-intestinal manifestations in inflammatory bowel disease (IBD)
Authors: Alroy G G , Kursbaum A 
Published: December 2008

Summary
The extra-intestinal complications of inflammatory bowel disease (IBD) usually appear in patients with long standing active intestinal disease. A patient with Crohn's colitis is described, in whom extra-intestinal symptoms, some of which were unusual, preceded the definitive diagnosis by 9 years.
Amiodarone in the treatment of refractory supraventricular and ventricular arrhythmias
Authors: Wheeler P J , Ingram D V , Puritz R , Chamberlain D A 
Published: December 2008

Summary
Amiodarone is an antiarrhythmic agent unrelated to other drugs in current use. It has been little used in Britain, and no formal clinical trials have been possible because the drug has not been licensed by the Committee on Safety of Medicines. Nevertheless it has unique properties which can be valuable in the treatment of a wide spectrum of arrhythmias, particularly supraventricular tachycardias. Amiodarone has a slow onset of action and is cumulative. A sustained action is therefore achieved without the need for frequent maintenance dosage. Fifty patients have been treated with amiodarone in maintenance doses ranging from 200 mg on alternate days to 200 mg twice daily either alone, or in combination with conventional therapy. All were resistant to conventional therapy alone or could not be treated with usual agents because of unwanted drug effects. Of 27 patients with supraventricular arrhythmias, 18 were completely controlled and the other 9 were markedly improved. Six of 8 patients with recurrent life-threatening ventricular arrhythmias were well controlled symptomatically. Results were predictably less satisfactory in 15 high risk post-infarction patients with malignant arrhythmias and severe myocardial damage, but 6 were probably improved as a result of amiodarone. All patients on maintenance therapy for 3 months or more developed corneal microdeposits. None has any visual symptoms or other ocular defect, and treatment has not been curtailed as a result of this well recognized effect which is believed to be reversible and benign. Amiodarone can control patients with otherwise refractory arrhythmias including some which are life-threatening. Formal clinical trials are needed to define accurately its future role in the prevention and treatment of serious rhythm disorders of the heart.
The cause of the raised plasma urea of acute heart failure
Authors: Thomas R D , Newill A , Morgan D B 
Published: December 2008

Summary
The concentrations of urea, urate, phosphate and creatinine were measured in the plasma of 30 consecutive patients admitted acutely with heart failure. On admission, 20 had a raised plasma urea, 21 had a raised plasma urate, but only 6 had a raised plasma phosphate and only 6 had a raised plasma creatinine. A further 9 of the patients developed a raised plasma urea after admission. The increase in plasma urea present on admission was greater than expected for the fall in GFR (as indicated by the increase in plasma creatinine). The results for plasma and urine taken together suggest that a major cause of the raised plasma urea was an increased urea production rather than a reduced glomerular filtration rate. There was no obvious relationship between plasma urea and clinical features, or diuretic therapy.
Extra-cranial aneurysm of the internal carotid artery treated by proximal ligation
Authors: Haywood I R , Ellis H 
Published: December 2008

Summary
A case of aneurysm of the extra-cranial section of the internal carotid artery extending to the base of the skull is described. Treatment comprised proximal vessel ligation, the tolerance of the patient's cerebral circulation to this procedure first being assessed by measuring the back pressure across the circle of Willis after temporary carotid artery occlusion. The value of this technique is discussed.
Subendocardial infarction and thrombocytopenia
Authors: Fireman Z , Yust I , Zahavi J , Kahn Y , Abramov L A 
Published: December 2008

Summary
Two female patients who suffered from drug-induced thrombocytopenic purpura and subendocardial myocardial infarction are presented. One of them died from cerebral haemorrhage and diffuse subendocardial punctate haemorrhages were found at post-mortem. The abnormal haemostasis which is associated with thrombocytopenia might induce diffuse damage of the myocardium and might impair heart performance. This finding may be more frequent than hitherto appreciated and calls for serial electrographic tracings in thrombocytopenic patients.
Volvulus of the transverse colon
Authors: Mortensen N J McC , Hoffman G 
Published: December 2008

Summary
Volvulus of the transverse colon is a rare condition requiring early diagnosis and treatment. In the absence of ischaemic changes within the redundant bowel, success can be anticipated with conservative fixation procedures. A case is reported which was treated by reduction, decompression and parallel colopexy. Although this disease has been infrequently reported in the past there may well be an increasing incidence with the introduction of high fibre diets and the use of the colonoscope.
The pathogenesis of respiratory viral infection
Authors: Heath R B 
Published: December 2008

SummarySendai virus is used as a model to study the histological response and the mechanism of recovery of mice from infection. Although mice infected intranasally do not appear ill, the ciliated columnar cells of the bronchial epithelium undergoes rapid necrosis followed later by repair. Interferon is produced at an early stage of infection and antibody formation follows later. Cyclophosphamide given to mice infected with Sendai virus abolishes the humoral antibody response but not interferon production; the mice develop pneumonic lesions. They cannot eliminate virus and they die. On the other hand, deprivation of ‘T’ lymphocytes by thymectomy, irradiation and bone marrow reconstitution renders mice more susceptible to Sendai virus but they do not die. The humoral response is thus apparently helped by ‘T’ lymphocytes and interferon production is not vital for recovery.
The human enteric coronaviruses
Authors: Clarke S K R , Caul E O , Egglestone S I 
Published: December 2008

Summary
A coronarirus was seen in the faeces from 15 (4·2%) of 355 adults with diarrhoea and from 5 (5·2%) of 96 adults without diarrhoea. Similar particles were seen in the faeces from 5 (2·2%) of 227 children aged 1–14 years with gastroenteritis, but in none of those from 230 infants under one year of age with gastroenteritis.
There was no evidence that the coronavirus was responsible for any of 34 outbreaks of gastroenteritis, although it possibly caused diarrhoea in patients admitted to a psycho-geriatric unit. Excretion of the virus often continued for many months.
One strain was propagated in human embryo kidney monolayers and human embryo intestinal organ cultures, although serial passage could not be accomplished.
Slow viruses and chronic disease of the central nervous system
Authors: Sutton R N P 
Published: December 2008

Summary
Although recognized since the 1930s, slow infections have only recently received considerable attention. There are three types, group A (related to the type C RNA viruses), group B (bizarre agents such as scrapie and kuru) and group C (viruses such as measles which normally produce acute infections but which are behaving here in an unusual fashion). These viruses are only united in that they produce disease with excessively long incubation periods. Many slow infections result in neurological diseases and these will be discussed, together with some possible explanations of their action.
Antigenic memory to influenza A viruses in man determined by monovalent vaccines
Authors: Marine W M , Thomas J E 
Published: December 2008

Summary
This study was conducted to test the limits of the doctrine of ‘original antigenic sin’ in influenza A. The design included use of zonal purified 1000 CCA (chick cell agglutinating) units monovalent vaccines consisting of H0N1, H1N1, H2N2 and H3N2. Age cohorts with different primary influenza A infections were established for the 687 volunteers. The vaccines administered to each age cohort were selected to test the responsiveness of original antigenic sin antibody to homologous and heterologous challenge. Anamnestic responses were demonstrated with Hsw1N1,H0N1, and H1N1 and with H2N2 and H3N2 but not between the groups. The synthesis of these findings is that there are 2 original antigenic sins - 2 families of influenza A viruses.
Chlormethiazole—no hangover effect but not an ideal hypnotic for the young
Authors: Castleden C M , George C F , Sedgwick E M 
Published: December 2008

Summary
The hangover effects of 768 mg chlormethiazole, an hypnotic with a half-life of approximately 4 hr, were compared with those of placebo in a double-blind cross-over study in 8 young subjects. Ten hours after dosing there were no differences between the preparations in the subjects' psychomotor performance, EEG sleep scores, or visual analogue ratings. Thus, an hypnotic which is rapidly removed from the body may confer considerable advantages. However, all 8 subjects had unpleasant nasal symptoms following chlormethiazole, and it is therefore not an ideal hypnotic for this age group.
Sarcoma obstructing right ventricular cavity: clinical, echocardiographic, haemodynamic and angiographic features
Authors: Malcolm A D , Shiu M F , Jenkins B S 
Published: December 2008

SummaryRight atrial hypertension and pericardial effusion developed 2 years after mastectomy for fibrosarcoma. Clinical and echocardiographic features suggested right ventricular tumour. At catheterization the right ventricular cavity was almost obliterated, with an infundibular gradient of 13 mmHg, and biopsy of the mass was attempted. Post-mortem revealed extensive infiltrating and intracavitary right ventricular fibrosarcoma without extracardiac tumour.
The effect of darkness on vitamin D in adults
Authors: Fairney A , Fry J , Lipscomb A 
Published: December 2008

Summary
Circulating 25-hydroxy vitamin D measurements were made on Caucasians in the Antarctic. Following a period of 3 months' complete darkness there was a significant fall in 25-hydroxy vitamin D values. These results emphasize the importance of u.v. light on skin synthesis of cholecalciferol and support the view that the geriatric and immigrant population should be adequately exposed to sunlight to prevent vitamin D deficiency.
Nutrition in pregnancy
Authors: Hytten F E 
Published: December 2008

SummaryEpidemiological evidence shows that women living in affluent circumstances have bigger babies with a lower mortality than underpriviliged women. How much of that effect is due to nutrition alone is not known but supplementary feeding in pregnancy of chronically ill nourished women does appear to increase mean birth weight, and famine conditions in a basically well nourished community reduce the birth weight; in both cases the birth weight difference is relatively small and could be accounted for by no more than fetal adipose tissue.The fetus may be much less vulnerable to vagaries of maternal diet than has been thought because of protective physiological mechanisms associated with pregnancy. Firstly the mother's energy balance changes, so that if she has access to extra food in the first half of pregnancy she will store large amounts of depot fat as an energy buffer against possible privation later. Secondly, there are widespread changes in nutrient metabolism one of which is to lower plasma levels of most nutrients, and that may tip the balance of advantage away from maternal tissue towards the placenta. Finally, the placenta itself has developed elaborate mechanisms to acquire nutrients from the maternal circulation. A notable exception to that rule is glucose for which no active transport mechanism has evolved and which might therefore be regarded as a low priority nutrient; it may be that the generous supply of glucose for the fetus which would be provided by a well fed woman does little more than allow the fetus to build up its fat stores.
Blood clotting and fibrinolysis in pregnancy
Authors: Howie P W 
Published: December 2008

Summary
During normal pregnancy, the concentrations of many of the clotting factors rise, thereby increasing the potential to generate fibrin. There is also evidence of increased thrombin activity during normal pregnancy which sharply increases during placental separation. Antithrombin III, the main inhibitor of thrombin and activated factor X, shows no compensatory rise during pregnancy but increases during the puerperium.
Plasminogen and antiplasmin concentrations rise during pregnancy but systemic fibrinolytic activity, as measured by the euglobulin lysis time, is markedly depressed during pregnancy; the reduced fibrinolytic activity returns to non-pregnant values very soon after delivery. The loss of fibrinolytic activity is presumed to be loss of plasminogen activator, because when this is added in excess in the urokinase sensitivity test, the fibrinolytic response is normal. The capacity for localized fibrinolytic activity is not lost, however, because fibrinolytic degradation products are slightly raised during pregnancy.
The overall pattern is one of increased coagulant and reduced fibrinolytic capacity during pregnancy which may protect the pregnant woman against the haemostatic challenge of placental separation.
Diabetes insipidus, diabetes mellitus, optic atrophy and deafness. A clinical and genetic study
Authors: Nagi N A 
Published: December 2008

Summary
Two Iraqi sisters and a female cousin developed diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), and deafness (D), (the ‘DIDMOAD’ syndrome) before the age of 12 years. One girl exhibited all the features of this disease complex only 3 months after an unusually late onset of recognizable symptoms at 11 years 9 months. Another girl died suddenly and unexpectedly. This family study illustrates the recessive inheritance pattern of the syndrome.
Weight and skeletal maturation - a study of radiological and chronological age in an anorexia nervosa population
Authors: Lacey J H , Crisp A H , Hart G , Kirkwood B A 
Published: December 2008

Summary
The carpal bones of 18 anorexia nervosa patients were radiographed and the X-ray age assessed by 2 different standard methods.
The study demonstrates that skeletal development in anorexia nervosa patients is delayed such that there is no association between radiological assessment of age and chronological age. It is strongly suggested that bony development actually ceases when body weight falls sufficiently to stop menstruation. There was a highly significant (P = 0.001) linear relationship between radiological age and the sum of the age of onset of the illness plus any period(s) of re-feeding. Weight gain seems to re-kindle the bone maturing mechanisms: the role of weight thresholds and associated hormone activity being discussed.
The findings of this study strongly support the existing evidence that the anorexia nervosa patient is biologically and psychologically immature.
Cimetidine in the prevention of gastric ulcer relapse
Authors: Machell R J , Ciclitira P J , Farthing M J G , Dick A P , Hunter J O 
Published: December 2008

Summary
Twenty-five patients with healed gastric ulcers completed an 11-month double-blind controlled trial comparing cimetidine 1 g daily with placebo in the prevention of ulcer relapse. Ulcers recurred in 14 patients, 12 on placebo, 2 on cimetidine. In 11 patients, 9 on cimetidine, 2 on placebo, the ulcers remained healed at the end of the trial (P &lt; 0.002).
Cimetidine 1 g daily significantly reduces the relapse rate in gastric ulceration.
Paradoxical embolism associated with oral contraceptives: an underdiagnosed lesion?
Authors: de Swiet J 
Published: December 2008

Summary
A case of cerebral embolism is described in which paradoxical features have been proved clinically, and which may explain some hitherto unaccountable reported cases, and suggests the value of prospective studies. A successful outcome of such a proved case, associated with oral contraceptives, does not appear to have been reported previously.
Investigation of a case of prednisolone malabsorption
Authors: Mant T G K 
Published: December 2008

Summary
Malabsorption of prednisolone administered as enteric coated tablets was suspected following therapeutic failure in an asthmatic. This was investigated by cortisol estimation and a Synacthen test and substantiated by the demonstration of abnormally low absorption of prednisolone from these tablets which nevertheless were normally absorbed by a volunteer. The absorption of prednisolone from conventional tablets in this patient was normal.