bluuebunny/crossref_metadata_2025_split huggingface dataset:
The syndrome of dilutional hyponatremia
Authors: Misra D P 
Published: December 2008

Summary
Three cases of dilutional hyponatremia are presented. All had ADH bio-assay at the height of biochemical abnormality and the values were found to be normal. The first two cases were due to cortisol deficiency. An interesting feature of these two cases was a high exchangeable sodium which was corrected by administration of cortisone, suggesting that cortisol plays some part in the distribution of sodium between the extracellular and the intracellular space. The third case occurred in association with urinary tract infection. Similar findings have been reported in elderly patients with pneumonia and have been presumed to be due to inappropriate secretion of ADH on indirect evidence. ADH assay has rarely been done and has never been found to be high. On the basis of the findings observed in the three cases, it is suggested that factors other than ADH excess and cortisol deficiency are involved in the production of dilutional hyponatremia.
Complications of dietary deficiency of Vitamin B12 in young Caucasians
Authors: Gleeson M H , Graves P S 
Published: December 2008

Summary
The occurrence of dietary deficiency of Vitamin B12 is reported in two young caucasian adults. In one case megaloblastic anaemia occurred and in the other optic atrophy. The importance of the dietary history, the significance of folic acid intake and the inter-relationship of Vitamin B12 and cyanide detoxication are discussed.
Treatment of pulmonary tuberculosis in a patient on maintenance haemodialysis
Authors: Smith F W , Catto G R D , MacLeod M 
Published: December 2008

Summary
A case of pulmonary tuberculosis in a patient on maintenance haemodialysis is reported. A 37-year-old man who had received intermittent haemodialysis for 5 years, developed pulmonary tuberculosis which was treated initially with isoniazid, sodium aminosalicylate (PAS) and rifampicin. Isoniazid and PAS were discontinued and treatment continued with rifampicin alone. One year later, the patient is well, has no evidence of active tuberculosis and undertakes his own dialysis at home.
The use of dialysis bath fluid as a vehicle for a drug with a narrow therapeutic index—Lithium chloride
Authors: Oakley W F , Clarke W F , Parsons V 
Published: December 2008

Summary
A patient requiring regular haemodialysis treatment (RDT) for end stage chronic pyelonephritis, with a recurrent manic-depressive illness was successfully treated with lithium chloride by adding it to the dialysate, when other routes had failed.
Fatal outcome from administration of a salt emetic
Authors: Roberts C J C , Noakes M J 
Published: December 2008

Summary
A case is described of the death of a young female patient following the administration of a salt emetic after a relatively minor overdose of a proprietary analgesic containing aspirin. It is suggested that death occurred as a direct consequence of the salt ingestion and that the dangers of this method of inducing emesis should be more widely appreciated.
Principles of vascular control
Authors: Neil Eric 
Published: December 2008

Summary
The distribution of nutrient materials to, and the uptake of waste products from, the tissues occurs only in the capillary bed. Arteriolar resistance ensures that blood enters the capillaries at a pressure only slightly higher than that of the colloid osmotic pressure of the blood. Arteriolar resistance is normally under the influence of a sparse sympathetic vasoconstrictor discharge superintended by the activity of ‘vasomotor centres’ in the brain stem. The activity of these ‘vasomotor centres’ is itself modified appropriately by afferent impulses from the sino-aortic baroreceptors.
Veins subserve mainly a capacity role but are also involved in veno-constrictor reflexes.
Sodium nitroprusside: theory and practice
Authors: Verner Ian R 
Published: December 2008

Summary
Sodium nitroprusside, by a peripheral vasodilator action, is a powerful hypotensive drug. In contrast to established agents, its hypotensive action is accompanied by an unchanged or augmented cardiac output. Intravenous administration of sodium nitroprusside rapidly produces a profound and controllable hypotension. Normotension is swiftly restored by ceasing to infuse the agent, and antidotes are unnecessary. Its attributes make it especially suitable for neurosurgical anaesthesia, and although free cyanide is liberated during biotransformation, side effects are virtually absent provided that dosage is reasonable. Special contraindications to its use are hypothyroidism and altered cobalamin metabolism.
Microbiological and other hazards from seafoods with special reference to Vibrio parahaemolyticus
Authors: Barrow G I 
Published: December 2008

Summary
The salient features of some of the more important microbiological health hazards to man from seafoods are reviewed briefly. They include poisoning, indirectly from toxins produced by certain marine algae or more directly by Clostridium botulinum, as well as infection with the marine bacterium Vibrio parahaemolyticus. Local culinary habits play a significant role in such kinds of illness, and food well cooked shortly before consumption is always preferable. Since established customs die hard, safety ultimately depends, not so much on arbitrary microbiological standards, but on hygienic production, correct storage and distribution, and on education in intelligent eating habits.
Food additives
Authors: Spencer Michael 
Published: December 2008

Summary
Food additives are discussed from the food technology point of view. The reasons for their use are summarized:
(1) to protect food from chemical and microbiological attack;
(2) to even out seasonal supplies;
(3) to improve their eating quality;
(4) to improve their nutritional value.
The various types of food additives are considered, e.g. colours, flavours, emulsifiers, bread and flour additives, preservatives, and nutritional additives. The paper concludes with consideration of those circumstances in which the use of additives is (a) justified and (b) unjustified.
Diabetes mellitus in Rhodesia: a comparative study
Authors: Wicks A C B , Jones J J 
Published: December 2008

Summary
Diabetes mellitus in the African is compared with the disease in Western populations, where secondary diabetes is uncommon, and primary diabetes is often familial, and can usually be classified as growth-onset and insulin-dependent, or as maturity-onset and insulin-resistant, and particularly liable to vascular complications.
In contrast, amongst 107 newly diagnosed African patients admitted consecutively to Harare Hospital during a 1-year period, five patients had diabetic relatives, and in thirty-four patients, diabetes was clearly secondary to pancreatic and hepatic disease. A high proportion (72%) of the remaining maturityonset patients were found to be insulin-dependent, so that their diabetes may also have been secondary to pancreatic disease. Vascular complications seldom occurred.
After standardizing this population for sex and age, the modal age for onset of diabetes remained earlier than in Britain. Male patients were underweight and female patients overweight compared with healthy contrast groups. The proportion of diabetic patients in skilled occupations, living in urban areas, and with large numbers of children was no greater than for agematched non-diabetic hospital inpatients.
Possible genetic influences in familial sarcoidosis
Authors: James D Geraint , Piyasena K H G , Neville E , Walker A N , Hamlyn A N 
Published: December 2008

Summary
Five families (three English, one Irish, one West Indian) contained eleven members with sarcoidosis, nine of whom have been investigated and followed. Their multisystem involvement and course was similar to that of other patients attending the Sarcoidosis Clinic at the Royal Northern Hospital. There were three brother-sister and two mother-offspring relations; it was not observed in a father-offspring relationship. It is noted that the course of one sister was considerably worse than that of her brother. The evidence suggests a recessive mode of inheritance for sarcoidosis susceptibility. Four other families are reported on in an Addendum.
The diagnosis of pulmonary embolism
Authors: Talbot S , Griffiths P D 
Published: December 2008

Summary
A blind assessment of abnormalities of pulmonary scintiscans in patients with pulmonary emboli and other clinical conditions showed that there was no abnormality specific for pulmonary embolism. However, a normal lung scan virtually excluded pulmonary embolism and an area, or areas, of absent perfusion was confirmatory evidence of embolism, without infarction, if the chest radiograph was normal, and of embolism with infarction if the clinical and radiographic findings were compatible.
A controlled analysis of biochemical and electrocardiographic abnormalities associated with pulmonary embolism showed that abnormalities of liver function and blood urea were more frequent than in a group of patients suspected of, but not having, emboli. A similar analysis of the electrocardiograms showed that a Q3R3S1 with T wave inversion over the right ventricular leads and lead III (±avf) that developed or regressed was pathognomonic of embolism, but other features were of little value.
It is suggested that all hospital patients should have an electrocardiogram performed on admission so that serial changes may be assessed and that lung scanning should be used as a screening test in patients suspected of having pulmonary embolism.
Oral iron tolerance
Authors: Mitchell A B S 
Published: December 2008

SummaryThe tolerance of volunteer patients to various ferrous salt preparations, administered orally in equivalent doses of elemental iron, has been compared. The palatability of ferrous sulphate tablets, BP, given before meals was not improved by administration after meals, by sustained release formulation, or by substituting other ferrous salts. Intolerance was related to the number of tablets rather than to the dose of iron in a course. The liquid iron preparation was the least acceptable.Ferrous sulphate tablets, BP, given before meals, approximate most closely to the hypothetical ideal iron preparation for therapeutic oral administration.
Rifampicin therapy in Escherichia coli gastroenteritis
Authors: Naveh Yehezkel , Friedman Abraham 
Published: December 2008

SummaryEight infants aged 2-4 months suffering from gastroenteritis associated with enteropathic Escherichia coli were treated with rifampicin. Seven of them had serotype 0125: B15 and the eighth had serotype 0126: B16. One of them had septicaemia due to E. coli 0125: B15. Five cases were initially treated with antibiotics and chemotherapeutic agents to which E. coli was shown to be sensitive but without results. Rifampicin was effective in curing gastrointestinal signs and eradicating the bacilli in seven of eight infants. The drug was given in a dose of 15-25 mg/kg/day divided into two equal parts, for 7 days in most of the cases. No untoward side effects were observed clinically in any of the cases. Our experience should encourage the use of this agent in controlling outbreaks of gastroenteritis caused by enteropathic E. coli.
Study of the lipid-lowering action of choloxin and Nilevar in patients with chronic renal failure
Authors: Wardle E N , Schardt W , Uldall P R , Brown Ann , Jonfiah Dorcas , Moore Audrey , Park Rosemary , Wood Elizabeth 
Published: December 2008

SummaryLowering of lipids in patients with chronic renal failure is advantageous but cannot be done by calorie restriction. In a controlled study the anabolic steroid norethandrolone (Nilevar) was found to lower triglycerides by 50%, while D-thyroxine (Choloxin) lowered the cholesterol by 25%. Both drugs increased the activity of lipoprotein lipase in spite of uraemic inhibition. Norethandrolone also reduced basal serum insulin levels. Norethandrolone seems appropriate for underweight patients and D-thyroxine for overweight patients, but side effects are more frequent than in non-uraemic patients.
Lactic acidosis and hyperamylasaemia associated with phenformin therapy
Authors: Williams D N , Knight A H , Goldberg D M 
Published: December 2008

Summary
A case is described of lactic acidosis and hyperamylasaemia in a diabetic with impaired renal function treated with phenformin. Despite normal blood pressure and adequate tissue perfusion, the patient succumbed. No evidence of pancreatitis could be found at autopsy.
Rupture of the stomach following mouth-to-mouth respiration
Authors: Solowiejczyk M , Wapnick S , Koren E , Mandelbaum J 
Published: December 2008

Summary
Successful repair and survival after rupture of the stomach in a patient who received mouth-to-mouth respiration is presented. We were able to find only one report in the literature where rupture of the stomach occurred following this manoeuvre—the patient did not survive. The possible aetiological factors and measures designed to avoid this complication are discussed.
Prevalences of leg and chest abnormalities in four South African schoolchild populations with special reference to vitamin D status
Authors: Richardson Barbara D , Walker Alexander R P 
Published: December 2008

SummaryPrevalences of bowing and knock knee, measured at a standard stance, have been obtained on Negro, Coloured, Indian and Caucasian schoolchildren aged 7, 12, and 16-17 years. These two abnormalities were unexpectedly common, affecting about one-fifth and one-third of all children respectively. Ranges of prevalences of chest abnormalities were—Harrison’s sulcus, 0-5%, and pigeon chest, 0-2%. Prevalence of bowing increased with age. That of knock knee was little affected by age, but increased markedly with body mass. There was no age trend with prevalences of chest abnormalities.Prevalences appeared unrelated to vitamin D intake. As to sunshine, the annual mean for the Transvaal is 8·4 hr daily. Results from radiological, skin pigmentation, and biochemical studies were non-contributory. Since a primary deficiency of vitamin D is evidently not the causal factor, one explanation is that a secondary deficiency is involved, arising from an impairment in metabolic availability. Further, a proportion of leg abnormalities may be physiological variants; moreover, it cannot be excluded that unknown factors may bear, or share, in responsibility.Elucidation may be forthcoming by investigating the interrelationship between vitamin D status and frequency of leg abnormalities during and after puberty; in addition, results of serial studies of prevalences of abnormalities from birth to post-adolescence would be illuminating.
Phenothiazines and the electrocardiogram
Authors: Raj M V Jeeva , Benson R 
Published: December 2008

Summary
Fifty-nine (42%) of 140 schizophrenic patients taking phenothiazines were found to have abnormal electrocardiograms. The abnormalities included T wave changes, S-T depression, P-R and Q-T prolongation, persistent sinus tachycardia (110 or more/min) and right bundle branch block.
In forty-eight (34%) of the fifty-nine patients, the ECG abnormalities disappeared after stopping the phenothiazine and reappeared on its resumption.
Asymptomatic autoimmune liver disease in scleroderma
Authors: Gupta M M , Warnes T W , Watson L 
Published: December 2008

Summary
A case is described of scleroderma with asymptomatic autoimmune liver disease. The patient presented with the features of CRST syndrome (calcinosis, Raynaud’s phenomenon, sclerodactyly and telangiectasia) and a raised plasma alkaline phosphatase was found on routine investigation. It is suggested that this latter biochemical finding is likely to indicate associated autoimmune liver disease in patients with scleroderma.
Lactation and the physiology of prolactin secretion
Authors: McNeilly A S 
Published: December 2008

Summary
Prolactin in man appears to form an essential part of the complex of hormones necessary for milk secretion and lactation. Levels of prolactin during pregnancy gradually increase towards term, and remain elevated for up to 6 weeks post partum. The lactogenic effects of prolactin appear to be blocked at the mammary gland by the elevated levels of fetoplacental steroids secreted during pregnancy. The immediate decline in steroid levels at delivery removes this block to prolactin and milk secretion ensues.
The amenorrhoea associated with both puerperal lactation and galactorrhoea appears to reflect failure of cyclical discharge of gonadotrophins and anovulation. This appears to be due to peripheral inhibition of steroidogenesis by the elevated levels of prolactin associated with these situations. No consistent changes in circulating levels of prolactin occur during the menstrual cycle, but changes in prolactin levels within the follicular fluid of the developing ovarian follicle indicate a specific and permissive role of prolactin in steroidogenesis.
Water intoxication associated with oxytocin infusion
Authors: Ahmad Audrey J , Clark Elizabeth H , Jacobs Howard S 
Published: December 2008

Summary
During a mid-trimester abortion with high dose oxytocin infusion and intravenous fluids, a patient developed an acute dilutational hyponatraemia and coma. The relationship of water intoxication and synthetic oxytocin infusion is discussed and the literature reviewed.
Behçet’s disease and the alimentary tract
Authors: Parkin J V , Wight D G D 
Published: December 2008

Summary
Two patients with perforation of the alimentary tract in Behçet’s disease are described. One of these is believed to be the first recorded case of oesophageal perforation in this condition, while the second is one of the few survivors of bowel perforation. The literature, aetiology and treatment are reviewed.
The effects of hyperosmolal coronary perfusion on the haemodynamic, metabolic and ultrastructural changes of myocardial anoxia
Authors: Brachfeld Norman , Erlandson Robert , Christodoulou James , Smithen Charles 
Published: December 2008

Summary
Recovery from anoxia has been evaluated in the isovolumic non-recirculating paced perfused rat heart. Seventy studies were performed consisting of 15 min of aerobic perfusion (AP); AP+15 min anoxic perfusion; and AP+15 min anoxic perfusion+15 min reoxygenation (recovery). Krebs-Ringer-bicarbonate+5 mmol glucose (KRB) (290 mmol) was compared to KRB+mannitol (350 mmol). Mannitol decreased myocardial water content. It improved recovery of haemodynamic function after reoxygenation. With KRB alone left ventricular systolic peak pressure (LVSP) decreased 32% and maximum dP/dt by 50%. With mannitol added LVSP decreased 18% and dP/dt 21% (P&lt;0·01). KRB and mannitol did not differentially affect total coronary flow, lactate and glucose extraction, tissue glycogen, creatine phosphate or adenine nucleotide concentrations.
No difference in submicroscopic appearance was noted with either perfusate during aerobic perfusion. Anoxic hearts perfused with isosmolal KRB demonstrated the most severe ultrastructural alterations including mitochondrial swelling with disruption of cristae and extraction of matrix components, myofibrillar fusion and contraction bands, and subsarcolemmal oedema and vacuolization. These changes were only partially reversed during reoxygenated perfusion. However, cellular changes were reversed or markedly improved during both the anoxic and reoxygenation perfusion periods with hyperosmolal solutions. When studied by silicone rubber injection of the microcirculation, only focal capillary endothelial cell swelling was noted and no difference in arteriolar or capillary filling was observed with either perfusate. Mannitol appears to improve LV function by direct myocardial osmotic action unrelated to enhanced energy production.
The coronary arteries in active viral cardiomyopathies
Authors: Burch G E 
Published: December 2008

Summary
These studies reveal that in mice, Coxsackie B4 and EMC viruses produce not only myocardial disease but extensive disease of the myocardial capillaries, coronary arteries, aorta and mesenteric arteries and veins and other arteries and veins. These lesions impair luminal calibre and, in turn, lead to myocardial ischaemia. This ischaemia contributes further to the myocardial damage. It is postulated that viruses initiate arteriosclerosis in man. A 19-year-old man who died of Coxsackie B4 viral cardiomyopathy had changes in the aorta noted on light and electron microscopy which are compatible with atherosclerosis. The relationship of these aortic changes to the viral infection can only be opened to speculation. Nevertheless, all of these studies establish a new concept of the possible initiating cause of arteriosclerosis, a common and extremely important disease of man.
Effect of ethanol infusion on the ultrastructure of human myocardium
Authors: Klein H , Harmjanz D 
Published: December 2008

Summary
To study the influence of a moderate dose of ethanol on the ultrastructure of myocardium in patients with heart disease, a 7·5% solution of ethanol was infused in six patients with myocardial and valvular disease, who underwent diagnostic cardiac catheterization. Before and after infusion of ethanol an endomyocardial biopsy was performed and the specimens were examined by electron microscopy. After ethanol all six patients revealed alterations in the mitochondrial structure and three of them also showed significant dilatation of the sarcoplasmic reticulum. Cardiac output increased in three of the patients, whereas in two patients a decrease of cardiac output was measured.
The results suggest that the infusion of even small amounts of ethanol is able to provoke structural alterations of myocardial cell organelles and, therefore, possible impairment of myocardial function.
New approach in studying cardiac muscle cell injury
Authors: Rona G , Boutet M , Hüttner I 
Published: December 2008

Summary
A new approach for investigating the mechanisms and evolution of cardiac muscle cell injury was presented by applying fine structural extracellular protein tracers in the catecholamine-induced cardiac muscle cell injury model. The results with these diffusion tracers indicated striking functional changes at the level of coronary microcirculation followed by early permeability alteration of cardiac muscle cell membranes, thus suggesting the role of these factors in myocardial changes which develop without narrowing or obstruction of coronary arteries.
The plasma membrane in cardiomyopathy
Authors: Nayler Winifred G , Burian W 
Published: December 2008

Summary
A drug-induced change in the fine morphology of the plasma membrane of heart muscle cells is described. Thus, in rabbits the chronic administration of oxyfedrine caused a marked proliferation of the plasma membrane. At the same time the mitochondria became swollen and vacuolated, and there was evidence of lysis of myofibrils. These changes are not accounted for in terms of the release of endogenous stores of catecholamines.
Measurement of blood pressure—a routine test in need of standardization
Authors: Thulin T , Andersson G , Scherstén B 
Published: December 2008

Summary
Some of the different factors that can influence the measurement of blood pressure are discussed. It is essential that those engaged in the care of patients with high blood pressure should standardize the measurement of blood pressure so that the established routine is followed at each attendance. This is especially important today because so many people perform blood pressure checks.
It is important to use the correct cuff and manometer. When considering costs, one should remember that the measurement of blood pressure is an inexpensive examination, but that poor equipment will prove costly both for the patient and for the community medical programme.