bluuebunny/crossref_metadata_2025_split huggingface dataset:
Substitution: right or wrong?
Authors: Barfield J C 
Published: December 2008

Summary
Drug economy has always been and will continue to be important for hospitals. Substitution, as an aid to economy, requires reappraisal in the light of our developing knowledge of formulation and resultant bio-availability. The continued unqualified use of generic names in teaching and prescribing requires re-examination as a part of the problem and this highlights the need for better communication between medicine and pharmacy.
The hospital pharmacist
Authors: Baker J A 
Published: December 2008

Summary
In hospitals, the use of approved names for prescribing and labelling is an essential requirement for precision and safety in giving medicines. Substitution is an unavoidable consequence of using approved names which brings benefits, but creates problems that demand more widespread recognition and urgent attention. In particular, dangerous variations in response following brand changes can occur in patients stabilized on certain products. The Licensing Authority and the Pharmaceutical Industry have a responsibility to eliminate brand bio-availability differences. But there is an immediate need; firstly, to identify the small number of products where brand changes in patients stabilized on them can result in potentially dangerous variations in response; and secondly, to safeguard patients being treated with these products, by avoiding substitution and preventing inadvertent brand changes by including brand or manufacturer’s names on labels and in all communications between hospital doctors and general practitioners. The complete elimination of substitution is not feasible and the indiscriminate use of brand names in hospitals causes confusion and increases risks of error in giving medicines.
Trial of a single low dose of heparin in the prevention of post-operative deep-vein thrombosis monitored by doppler ultrasound
Authors: Bates T 
Published: December 2008

Summary
A consecutive, randomly allocated, controlled, double-blind clinical trial of the prophylactic effect of a single pre-operative low dose of heparin on the incidence o-post-operative deep-vein thrombosis showed no reducf tion in the number of thromboses detected.
Fifty-five patients were given 5000 units of heparin subcutaneously 1-1½ hr pre-operatively and fifty-seven patients were given a placebo. The incidence of thrombosis detected by the doppler ultrasound was 14·5% in the heparin group and 12·3% in the control group.
It is suggested that a further trial monitored by ultrasound is indicated in which low-dose heparin is given for various periods post-operatively in addition to a pre-operative dose.
Oxymetholone in aplastic anaemia
Authors: Mir M A , Delamore I W 
Published: December 2008

Summary
Thirty-one patients with aplastic anaemia were treated with oxymetholone. Twenty-eight patients lived beyond 2 months and of these eleven patients showed clinical and haematological improvement. Ten of these had some active erythropoietic areas as shown by bone marrow biopsies and by the presence of an elevated reticulocyte count in the peripheral blood. Two patients who responded in spite of a markedly hypoplastic marrow and reticulocytopenia became oxymetholone dependent and relapsed when the drug was withdrawn. They failed to respond a second time when oxymetholone was re-introduced. Side effects were frequent. These were mostly tolerable and reversible on reduction of the dose but three patients died of acute myeloblastic leukaemia and in three others the drug had to be withdrawn.
The use of dicobalt edetate (Kelocyanor) in cyanide poisoning
Authors: Hillman B , Bardhan K D , Bain J T B 
Published: December 2008

Summary
A case of accidental poisoning with sodium cyanide is reported. The patient was treated with a new antidote, dicobalt edetate (Kelocyanor). Blood levels of cyanide were shown to fall markedly.
Gastro-oesophageal reflux and hiatus hernia—endoscopy
Authors: Roesch W 
Published: December 2008

Summary
The endoscopic diagnosis of hiatal hernia (sliding type) relies on direct and indirect criteria during the oesophagoscopic or gastroscopic approach. A wide separation between the anatomic and mucosal oesophago-gastric junction, the presence of a so-called Schatzki-ring, a wandering junction with sliding gastric mucosal folds during inspiration and two ring-like structures are important. Whereas radiology seems to be superior to endoscopy in the diagnosis of asymptomatic hiatus hernia, oesophagoscopy may reveal sequelae of reflux like oesophagitis, erosions, ulcers and strictures. Peptic oesophagitis is found in about 10% to cause upper gastrointestinal haemorrhage.
Acute barbiturate poisoning in young epileptics
Authors: Hancock B W 
Published: December 2008

Summary
Two young epileptic patients presenting in coma with focal neurological signs were found to be suffering from unsuspected acute barbiturate overdose. There had been strenuous denial of any possibility of psychiatric disturbance or of self-poisoning in the history obtained from their parents at the time of admission. The importance of excluding deliberate drug overdose in any young epileptic patient presenting with prolonged or atypical coma is re-emphasized.
Blood pressure control during maintenance haemodialysis with isonatric (high sodium) dialysate
Authors: Stewart William K , Fleming Laura W 
Published: December 2008

Summary
Isonatric (high sodium) dialysis has several advantages, including relative freedom from cramps. The diastolic blood pressures and body weights of nine originally hypertensive patients on maintenance haemodialysis have been recorded for 15 months throughout alternating periods on isonatric (145 mEq/l) and low (132·5 mEq/l) dialysate sodium concentration. Isonatric dialysis resulted in a temporary 1-2 kg increase in mean pre-dialysis weight, requiring increased ultrafiltration. This coincided with a slight increase in mean pre-dialysis diastolic blood pressure which was corrected when post-dialysis body weights were lowered to compensate for the increased weight gain between dialyses. Once the ‘ideal’ individual post-dialysis body weight for each patient was established, pre-dialysis diastolic pressures less than 90 mmHg were achieved routinely. Ten subsequent patients who have never received low sodium dialysis also have well controlled pressures. These findings are contrary to the orthodox view that low sodium dialysis is mandatory to avoid hypertension.
Giant cell arteritis
Authors: Turner R G , Henry J , Friedmann A I , James D Geraint 
Published: December 2008

Summary
Giant cell (senile, temporal or cranial) arteritis occurs three times more frequently in women and the majority of patients are over 70 years of age. This series of forty-seven patients presented with visual symptoms and most also had a constitutional upset. The ocular signs were of ischaemic papillopathy (in 80%), which was unilateral in 61% and bilateral in 17%; or central retinal artery occlusion (13%). The ESR was always elevated above 40 mm, and in 28% it was above 100 mm. The main ophthalmic differential diagnosis was to determine whether it was arteritic or atherosclerotic ischaemic papillopathy in this age group, and principal differences are outlined (Table 6). Following corticosteroid therapy, vision improved in 23%, remained unchanged in 64% and deteriorated in 13% of patients. Visual deterioration predominated in elderly women who received steroids late in the course of the disorder. Early steroid therapy is recommended in elderly patients with visual symptoms and significantly raised ESRs.
The effect of Verapamil on the cardiac conduction system in man
Authors: Roy P R , Spurrell R A J , Sowton E 
Published: December 2008

Summary
Using His bundle electrograms the effect of Verapamil on the specialized conduction system in eleven patients was studied during routine cardiac catheterization.
In five patients, the absolute and relative refractory periods of the A-V node, and retrograde conduction through the A-V node was studied using programmed electrical stimulation techniques.
Verapamil caused prolongation of anterograde and retrograde A-V nodal conduction times. The effect on anterograde conduction was only partly reversible with Atropine. No significant effect on the remainder of the conduction system was observed.
It is concluded that Verapamil has a direct effect on A-V nodal conduction independent of any vagotonic effect.
Acquisition of hepatitis B antigen in the newborn period
Authors: Cossart Yvonne E 
Published: December 2008

Summary
This paper describes six mother and infant pairs where the mother developed serum hepatitis during pregnancy. These findings are compared with those in three Australian antigen carrier mothers and their babies. The literature is also reviewed and it is concluded that neonatal hepatitis seldom occurs in infants whose mothers have hepatitis early in pregnancy or are chronic carriers of Australia antigen. In contrast the risk of infection of infants born to mothers who develop serum hepatitis later in pregnancy or in the puerperium approaches 50%.
Psychological characteristics of patients with the irritable bowel syndrome
Authors: Palmer R L , Crisp A H , Stonehill E , Waller Sheila L , Misiewicz J J 
Published: December 2008

Summary
The Eysenck Personality Inventory, the Middlesex Hospital questionnaire, and forearm blood-flow were used to measure aspects of psychological status in forty-one patients with the irritable bowel syndrome, who were compared in this respect with twenty-five matched psychoneurotic subjects and with a general population. The results show a positive association between psychoneurotic disorder and the irritable bowel syndrome.
The incidence of the shock syndrome in a general hospital
Authors: Ledingham I McA , McArdle C S , Fisher W D , Maddern M 
Published: December 2008

Summary
During a 1-year period (May 1971-May 1972), patients developing the shock syndrome in a large general hospital were referred to a multi-disciplinary shock team. Sepsis, haemorrhage and severe hypoxaemia were the principal precipitating factors. Mortality exceeded 70% in the septic and cardiogenic shock series and was lowest in shock attributable to fluid depletion and drug overdose. Whereas improvement in mortality in the haemorrhagic shock group is likely to result from more rapid and aggressive primary surgery, septic shock, particularly arising from intestinal complications, will require a more complex solution. A shock team seems an important addition to the services of a modern general hospital.
The effects of intravenous protein—calorie supplementation on the tissue composition of postoperative body weight loss
Authors: Elebute E A 
Published: December 2008

Summary
The components of postoperative body weight loss were analysed in eleven adult male patients who had uncomplicated abdominal surgery of moderate severity namely vagotomy and a drainage procedure for chronic duodenal ulceration. Four patients (Group I) had the routine postoperative regimen which consisted of intravenous isotonic dextrose and dextrose-saline solutions. Another group of four patients (Group IIa) had supplementation of this regimen with 50% dextrose and an amino-acid/sorbitol preparation whilst a group of three (Group IIb) patients had supplementation with only amino-acid/sorbitol preparation.
Group I patients exhibited the expected losses of lean tissue and body fat, but these were partially obscured by retention of extracellular water. Group IIa exhibited excessive loss of extracellular water which was parallel to an increased urine flow and this loss completely overshadowed the reduction in lean tissue and body fat losses produced by the protein and calorie supplementation. Group IIb patients exhibited the smallest amount of weight loss because they had a reduction in lean tissue and body fat losses whilst they still exhibited a mild antidiuretic response. It is suggested that the amino-acid/sorbitol preparation provides the safest form of supplementation, particularly in the face of increased extra-renal losses of water such as may be dictated by a warm tropical environment.
Eosinophilic leukaemia terminating with an encephalopathy
Authors: Yuill G M , Lascelles R G , Scholtz C 
Published: December 2008

Summary
A 52-year-old man developed an illness which lasted for 2 years until its fatal termination. It comprised in chronological order: mild asthma, skin irritation, mature eosinophilia in the peripheral blood, and finally an encephalopathy. The diagnostic problem of distinguishing between eosinophilic leukaemia and an eosinophilic leukaemoid reaction is discussed. The cause of the encephalopathy was discovered at autopsy to be a widespread intravascular thrombotic process. The question of future possible therapy is discussed.
Amoxycillin: pharmacokinetic studies in normal subjects, patients with pernicious anaemia and those with renal failure
Authors: Lawson D H , Henderson A K , McGeachy R R 
Published: December 2008

Summary
This paper presents data on the absorption and disappearance of a new semisynthetic antibiotic—amoxycillin—in patients with pernicious anaemia and those with renal failure. Absorption of this drug is unimpaired in these patients. Adequate serum and urine levels are obtained even in patients with creatinine clearance levels below 10 ml/min. The half-life of this drug is markedly prolonged in patients undergoing regular dialysis therapy, and a single 250 mg dose will provide adequate serum levels for 24 hr, if this is given after dialysis is complete.
Pulmonary circulation and ventilation
Authors: Leigh Julian M 
Published: December 2008

Summary
The pulmonary circuit receives the whole of the cardiac output, and the flow through it is governed by events in the systemic circulation. Its function is gaseous exchange, and the low resistance and high capacitance of the circuit is subservient to this function. Local flow is affected by intra-alveolar oxygen tension, and regional flow by passive hydrostatic effects due to gravity. The distribution of ventilation is also affected by gravity owing to the effect of the latter on regional compliance. When the cardiac output falls, as it does in most methods of induced hypotension, there is an accompanying increase in physiological dead space owing to an increase in the alveolar component.
The high fibre diet in the treatment of diverticular disease of the colon
Authors: Painter N S 
Published: December 2008

Summary
Diverticular disease of the colon causes symptoms even in the absence of inflammatory diverticulitis. These symptoms vary from vague dyspepsia to severe colic which may lead to resection of the sigmoid for ‘diverticulitis’. This paper discusses the use of a high fibre diet, including miller’s bran, in the treatment of uncomplicated diverticulosis. In the majority of cases this diet relieves symptoms and lessens the need for surgery in diverticular disease.
Villous papilloma of the appendix associated with mucocoele and intussusception
Authors: Darby A J , Doctor A 
Published: December 2008

Summary
A case of villous papilloma of the appendix, associated with mucocoele formation and intussusception, is described. The literature is reviewed and it appears that there is no previous report of this association. It is suggested that so-called malignant mucocoeles of the appendix arise from pre-existing villous papillomas.
Radiological changes in left lobe amoebic liver abscesses
Authors: Ramachandran S 
Published: December 2008

Summary
Elevation of the left dome of the diaphragm occurred in 43% of cases with left lobe amoebic liver abscesses. It was rarely seen in patients with an abscess in the right hepatic lobe. Elevation of the right dome of the diaphragm, which occurred in 36% of cases, is also compatible with a diagnosis of left lobe abscess. This radiological sign was present in 75% of cases with right lobe abscesses. Pleuro-pulmonary changes in the left chest, when associated with an elevation of the left dome of the diaphragm, favours the diagnosis of an amoebic abscess of the left lobe of the liver. Radiological changes in barium studies are usually confined to patients with large hepatic abscesses. In clinical practice the information obtained from simple radiology can provide adequate diagnostic confirmation of the presence of a left lobe liver abscess.
Some clinical pharmacological studies with indoramin, with observations on its therapeutic usefulness
Authors: de B. White C , Royds R B , Turner P 
Published: December 2008

Summary
In the treatment of fifteen patients with essential hypertension, in open trial indoramin caused a mean blood pressure fall from 180/115 mmHg to 159/98 mmHg. No reversal of antihypertensive effect was seen in four patients after additions of the tricyclic antidepressant drug desipramine. Blood pressure did not begin to rise in these four patients for at least 5 weeks after stopping indoramin. The implications of these findings are discussed.
An evaluation of sotalol, a β-blocking agent, in patients with angina pectoris
Authors: Gooding P G , Berman E 
Published: December 2008

SummaryIn a multi-centre study, sotalol was compared with placebo in 146 patients with angina pectoris using a double-blind crossover design. Sotalol had a significant effect in reducing the number of anginal attacks and the number of nitroglycerin tablets used. The medication was safe and produced minimal side effects.
Purpura fulminans with haemolytic anaemia
Authors: Nagi N A , Al-Hasso A R A 
Published: December 2008

SummaryA 10-month-old female infant with purpura fulminans is reported. The patient had clotting abnormality compatible with consumption coagulopathy. Histopathological examination revealed the presence of microthrombi. Heparin was effective in correcting the clotting defects. The infant also suffered from microangiopathic haemolytic anaemia. She died 17 days after the onset of the illness from infection in spite of antibiotic therapy.
Effects of anticonvulsants and inactivity on bone disease in epileptics
Authors: Murchison Lilian E , Bewsher P D , Chesters Marion , Gilbert J , Catto G , Law Elizabeth , McKay E , Ross H S 
Published: December 2008

Summary
No significant biochemical or radiological features of vitamin D deficiency were found in groups of juvenile and adult epileptics and control groups of non-epileptic patients in hospitals for the mentally retarded. There was evidence of hepatic enzyme induction in patients on anticonvulsants, in that urinary D-glucaric acid concentration and excretion were raised. No effect was found of prolonged anticonvulsant therapy on bone densitometry, but in children immobility was closely associated with decreased bone density. The evidence suggests that disuse osteoporosis is the major bone disease in these mentally retarded children.
An unusual self-inflicted injury of the breast
Authors: Sampson D 
Published: December 2008

Summary
A self-inflicted injury of the breast can present difficult diagnostic problems as is illustrated by the case report. A young woman had excoriated her left nipple causing profuse haemorrhage. Following excision of the nipple and a breast biopsy, the patient presented 1 month later with an abscess caused by the introduction of stones and gravel into the biopsy wound.
Prostaglandins in reproductive physiology
Authors: Craig Gillian M 
Published: December 2008

SummaryThe role of prostaglandins in reproductive physiology is reviewed with particular emphasis on their possible importance in ovulation in humans. A possible interaction between gonadal steroids, biogenic amines and prostaglandins at hypothalamic-pituitary level, in relation to the release of luteinizing hormone releasing factor, and LH, is discussed. Anomalies regarding the role of oestrogens in LH release are noted, and it is suggested that high oestrogen levels may release prostaglandins from the uterus and/or centrally in humans, in connection with the mid-cycle LH surge and ovulation. A hypothetical role for prostaglandins in sexual behaviour and premenstrual changes is discussed.The hypotheses open up new areas for clinical research to establish the role of prostaglandins in human endocrinology. The need for measurement of prostaglandin metabolites in blood and urine is emphasized.
Muscle fatigue
Authors: Edwards R H T 
Published: December 2008

Summary
Muscle fatigue is a common symptom but there are no universally accepted methods for quantitating the function of voluntary muscle. This paper describes three main methods of assessment: simple clinical tests of muscle function; thermal probe measurements of metabolic heat production during muscular contraction; needle biopsy studies of muscle structure and chemistry. These methods, though at a relatively early stage of development, have given promising results which suggest that they could be useful in assessing possible new forms of treatment in patients with neuromuscular disorders.
Precipitating antibody in the sputum in chronic respiratory disease
Authors: Clarke C W 
Published: December 2008

Summary
Precipitating antibody against bacterial antigens obtained from known pathogens has been looked for in sputum of patients with chronic respiratory disease. Preliminary results suggest that detection of precipitating antibody to a cell wall extract of the organism may be important in determining its pathogenicity in a particular patient. Local antibody production appears to be important in these conditions. It is proposed that this locally produced precipitating antibody may be contributing to the underlying lung pathology.
Clindamycin for acute osteomyelitis in children
Authors: Wharton M R , Beddow F H 
Published: December 2008

Summary
A series of thirty-five children with acute haematogenous osteomyelitis who received clindamycin as the antibiotic of choice is described. Successful primary healing was achieved in thirty-three patients. The advantages of operation when indicated are discussed in relation to bacteriological identification.
Diurnal patterns of oral glucose tolerance in diabetics
Authors: Walsh C H , Wright A D 
Published: December 2008

Summary
Oral glucose tolerance tests were performed in the morning and afternoon in twenty newly diagnosed untreated diabetic patients. Fasting blood glucose levels were significantly higher in the morning than in the afternoon. Blood glucose values after glucose ingestion also tended to be higher in the morning than in the afternoon. This pattern, however, was most marked for the patients with the greatest degrees of hyperglycaemia. It was also more evident in females than males. Serum insulin values did not differ significantly in the morning and afternoon.
Forced alkaline diuresis for lithium intoxication
Authors: Forrest John A H 
Published: December 2008

Summary
A case of lithium intoxication treated with forced alkaline diuresis is described. Although clearance of lithium from the plasma by this method is less efficient than by haemodialysis it is as effective as peritoneal dialysis, is easier for nursing and medical staff to undertake and carries less risk of complications. In the absence of facilities for haemodialysis forced alkaline diuresis is the treatment of choice for lithium intoxication.
Hirsutism
Authors: London D R 
Published: December 2008

SummaryHirsutism is usually caused either by an increase in androgen production by the ovary or adrenal or it may be due to increased sensitivity of the hair follicle to normal amounts of circulating androgens. The diagnostic possibilities can be resolved on clinical grounds by laparoscopy and by hormone measurements. The commonest causes of this symptom are ‘idiopathic hirsutism’ and the polycystic ovary syndrome. Treatment is of the underlying condition or, when that is not possible, by local removal of hair or by the administration of oral contraceptives or glucocorticoids.