bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double‐blind comparison of long acting propranolol and sustained release metoprolol in the treatment of angina pectoris
Authors: Irving J B , Edwards R E 
Published: April 2023

SummaryA double‐blind cross‐over trial was performed in 11 patients with stable angina, comparing the effect of two once‐daily long acting beta‐blocker formulations, Inderal LA (propranolol) and Lopresor SR (metoprolol), each given for a four week period.The patients' response to the two treatments was very similar and no significant differences were noted between the treatments. Patients may have benefited slightly more by Inderal LA therapy. Slightly fewer angina attacks and side effects were reported when the patients were receiving Inderal LA treatment, compared with Lopresor SR treatment. The patients' exercise tolerance, blood pressure and heart rate were assessed approximately 24 hours after the last dose of their once daily treatment. Inderal LA treatment may have allowed patients to exercise a little longer, and there was a trend towards slightly lower blood pressures and heart rates when the Inderal LA treatment period was compared with treatment during the metoprolol period.
Ceftizoxime prophylaxis in major gynaecological surgery
Authors: Hitchcock A , Cooper J C , Liu D T Y 
Published: April 2023

SummarySixty women who were due to undergo major gynaecological surgery consented to enter the trial. Thirty six abdominal and twenty four vaginal procedures were performed for a wide range of gynaecological conditions. The patients were divided randomly into two groups. One group was given an intravenous infusion of 4g of ceftizoxime in one litre of normal saline, starting pre‐operatively to run in continuously over 24 hours. The other group was used as a control. There was no significant difference in post‐operative infection rate between the two groups of patients.
Double‐blind comparison of Inderal LA (160 mg), Half‐Inderal LA (80 mg), and Half‐Inderal LA plus bendrofluazide (2.5 mg) in the treatment of elderly hypertensive patients.
Authors: Agrawal R L 
Published: April 2023

SummaryThirty‐two elderly hypertensive patients completed this randomised, double‐blind, crossover study comparing once‐daily Inderal LA (160 mg) with Half‐Inderal LA (80 mg) and a combination of Half‐Inderal LA (80 mg) plus bendrofluazide. After a placebo run‐in period of two weeks, patients received each of the three treatment regimens in random order for a four week period. Blood pressures and heart rates were measured 24 hours after the last dose of each treatment.All treatment regimens provided control of blood pressure and exercise tachycardia. Treatment with the combination of Half Inderal LA (80 mg) and 2.5 mg of bendrofluazide was well tolerated and achieved a significantly greater reduction in systolic blood pressure than either Inderal LA or Half‐Inderal LA alone. The blood concentrations of propranolol found 24 hours after the last dose of Half‐Inderal LA give pharmacokinetic support for the use of this formulation once daily in elderly hypertensive patients.
Rifampicin causing an exacerbation of pemphigus
Authors: Honeybourne D , Longworth S , Shaffer J 
Published: April 2023

SummaryA 57‐year old man with pemphigus which was well controlled on prednisolone and azothioprine developed tuberculosis. One week after starting anti‐tuberculous chemotherapy, he developed a reactivation of his pemphigus. It is likely that the rifampicin reduced the efficacy of prednisolone by hepatic enzyme induction. With life‐threatening illnesses such as pemphigus, the dose of steroids should be doubled if the patient subsequently requires rifampicin.
Assessment of left ventricular function and prognosis in survivors of acute myocardial infarction using Doppler ultrasound: a comparison with radionuclide ventriculography
Authors: Singer M , Price C C , Monk H , Trotman I F 
Published: April 2023

SummaryDoppler ultrasound was used to measure stroke distance and minute distance, and radionuclide ventriculography to measure left ventricular ejection fraction, before and after exercise, in 18 patients who had survived myocardial infarction a mean 90 days previously.Stroke distance fell on exercise in nine of the subjects and left ventricular ejection fraction in eight. The greatest falls in both stroke distance and ejection fraction occurred in the same seven patients. Within 18 months post‐infarction, two of the seven had died and another had suffered a further non‐fatal infarct. There were no late cardiac events in those whose stroke distance or ejection fraction rose with exercise. The two fatalities were amongst three with the poorest increase in minute distance on exercise.Assessment of left ventricular function in survivors of acute myocardial infarction as measured by Doppler ultrasound thus compares favourably with radionuclide ventriculography. The results suggest that this technique may have potential use as a quick, reliable and non‐invasive prognostic indicator.
An assessment of the clinical efficacy in general practice of cefuroxime axetil when used in the management of unidentified infections of the lower respiratory tract
Authors: Wight L J , Vandenburg M J , Griffiths G K , Gudgeon A C , Kelsey M 
Published: April 2023

SummaryPatients aged 18‐65, presenting to their GP with an acute exacerbation of chronic obstructive airways disease (COAD) were entered into a therapeutic study of cefuroxime axetil 500 mg bd. Of those patients assessed, 87 per cent had a positive clinical response. All clinical signs and symptoms improved. Of those patients with a cough, 86 per cent had improved at Day 7, as had 75 per cent of those with shortness of breath. The quantity and character of sputum also improved consistently throughout the study. There was a significant improvement in peak flow results of 36 (SE 5) L/minute at the end of the study (p< 0.001).Twenty‐six patients reported 36 adverse events, the most frequent being diarrhoea, in nine patients. No serious side effects occurred. Thus, cefuroxime axetil may be considered an appropriate antibiotic for use by GPs in these circumstances.
The investigation of anaemia in the asymptomatic elderly
Authors: Woo J , Au S Y , Teoh R 
Published: April 2023

SummarySince anaemia may be present in asymptomatic elderly men and women, an attempt was made to determine the haemoglobin value which represents anaemia associated with disease. The World Health Organisation criteria of anaemia were used: 13g/dl in men and 12g/dl in women. A cohort of 427 elderly men and women with no apparent illness living in the community were screened. Excluding anaemias due haemoglobinopathies, 4.0% of men and 4.8% of women had anaemia due to identifiable disease and 4.5% of men and 2.8% of women had anaemia without identifiable disease. The haemoglobin values for the latter group tended to be just below 13g/dl for males and 12g/dl for females. It is suggested that, in clinical practice, the criteria for further investigation of anaemia should be values below 12g/dl for men, and either 11g/dl or 12g/dl for women.
Combined administration of controlled release theophylline and ranitidine: a 53‐day controlled survey in patients with chronic obstructive lung disease (COLD) and peptic disease.
Authors: Negro R Dal , Turco P , Pomari C , Trevisan F , De Conti F , Cordaro C I 
Published: April 2023

SummaryThe mean‐term (53 days) effects of controlledrelease theophylline (Theo‐Dur®) alone or combined with ranitidine have been evaluated in two homogeneous groups of 15 patients with chronic obstructive lung disease (COLD) and peptic disease. The severity of the bronchospastic disease evaluated by FEV, and plasma theophylline level in mcg/ml has been monitored at baseline, ie, pre‐treatment, at steady‐state, at Day 18 and at Day 53 of therapy in both groups.By comparing the trends of the two parameters, it was obvious that the bioavailability of Theo‐Dur® and the magnitude of its bronchodilating effect were not influenced by the concomitant use of a potent gastric acid inhibitor, such as ranitidine.Theo‐Dur® is thus confirmed to be a controlled‐release formulation with an absorption independent from gastric pH. As ranitidine increases the lower oesophageal sphincter pressure and does not interfere with the kinetics of theophylline, it is concluded that the combined therapy with the two drugs can be considered a treatment of choice for COLD complicated by peptic disease.
Therapeutic efficacy and gastric tolerance of ibuprofen (Brufen®) at 1600–2400 mg dosage in rheumatoid arthritis
Authors: Porkodi R , Raghuram K , Parthiban M , Chandrasekaran A N 
Published: April 2023

SummaryTwenty‐one adult patients of both sexes with active rheumatoid arthritis, diagnosed as per the criteria of the American Rheumatism Association, participated in an open, non‐comparative study to evaluate the therapeutic efficacy and tolerability of ibuprofen (Brufen®)* at doses of 1600 mg–2400 mg per day. The dose was adjusted to suit the needs of the individual as assessed by clinical response. Pain intensity, grip strength, duration of morning stiffness, 50 feet walking time, number of affected joints, swelling and functional capacity were assessed prior to and at weekly intervals for four weeks. Side effects were also recorded. Gastrointestinal tolerance was assessed by endoscopy prior to and at the end of four weeks' treatment. Routine haematological and biochemical investigations were carried out prior to and at the end of the treatment.It is concluded that ibuprofen at a dose of 1600 mg–2400 mg per day is effective in providing symptomatic relief and is well tolerated in patients with active rheumatoid arthritis. Gastrointestinal tolerance, as assessed by endoscopy, is good, including in those patients with pre‐existing congestion or ulceration of the upper gastrointestinal mucosa.
Immunological hypersensitivity to environmental antigens in the irritable bowel syndrome
Authors: Finn R , Smith M A , Youngs G R , Chew D , Johnson P M , Barnes R M R 
Published: April 2023

SummaryFifty eight patients with the irritable bowel syndrome (IBS) have been investigated by skinprick testing, quantitation of total serum IgE levels and determination of serum antibodies reactive with common dietary proteins. An increased incidence of skin reactivity (48.3 per cent; p<0.05), as well as serum IgG antibodies reactive with chicken ovalbumin, bovine milk or wheat gliadin (52.6 per cent; p<0.01), was demonstrated in IBS patients compared with controls. These results provide evidence of immunological hypersensitivity in at least a proportion of IBS subjects and contrasts with the concept that IBS always results from psychological factors.
A comparison of diagnostic techniques in the diagnosis and management of allergic conditions
Authors: Cooper B S , Gerlis L 
Published: April 2023

SummaryA comparison of diagnostic techniques was carried out in the management of 59 patients with allergies who received desensitisation with Migen or Pollinex vaccines. Patients were tested with radioallergosorbent test (RAST) as well as skin tests, IgE levels and eosinophil counts.Significant differences were shown in the ability of RAST and skin tests to detect allergy (p<.05), skin tests being more sensitive. Significant clinical improvement was seen in 76 per cent of patients with house dust allergy and 92 per cent with grass pollen allergy.RAST testing was found to be of little diagnostic assistance. Skin testing and clinical evaluation were the most reliable methods of diagnosing allergy and monitoring response to therapy. No patients had any adverse reactions to desensitisation.
Primary transitional cell carcinoma of the renal pelvis in a duplicated collecting system
Authors: Budd J S 
Published: April 2023

SummaryA case of primary transitional cell carcinoma in a duplicated renal collecting system is reported. A few cases of transitional cell carcinoma in the ureter of a duplicated system have previously been reported but there appears to be no prior report of transitional cell carcinoma in the renal pelvis of a duplicated system.
Pre‐operative investigations — the anaesthetist's perspective
Authors: McCleane G J 
Published: April 2023

SummaryThe information gained when abnormalities are detected by pre‐operative investigations is of interest to the anaesthetist as it may change the anaesthetic technique and anaesthetic drugs used. Tests should not be routinely used in all patients, but only in those over the age of 50 or in those with an increased chance of abnormalities being detected.
Comparison of the effectiveness of slow‐release propranolol (Inderal LA) 80, 160 and 320 mg orally daily in the treatment of angina pectoris
Authors: Odemuyiwa O , Alberts C , Hall R J C , Peart I 
Published: April 2023

SummaryDoses of 80, 160 and 320 mg of Inderal LA (slow‐release propranolol) were compared in 12 patients with stable angina pectoris. There was an unpredictable and variable individual response to treatment and hence no differences were detected between the effects of the three doses on mean treadmill exercise duration, time to angina, frequency of angina or glyceryl/trinitrate consumption. There was a marked deterioration in two patients whilst on 320 mg Inderal LA. In these patients, the time to angina fell by 2 minutes 50 seconds and 4 minutes 20 seconds on 320 mg daily and 160 mg daily respectively. Given the inter‐patient variability in response to Inderal LA, the dose for each patient should be individually titrated according to response. Two patients reported here suggest that some subjects may benefit from lower doses, although further work is required to clarify this point. Possible explanations for this finding are discussed.
An unusual femoral hernia
Authors: Mahdy H Al , Mohanaruban K 
Published: April 2023

SummaryAn elderly woman presented with a lump in the right groin, clinically suggestive of a femoral hernia, but surgical exploration revealed a cystic mass of poorly differentiated adenocarcinoma. Post mortem examination showed it to be a metastic deposit of carcinoma of the gall‐bladder. Presentation of gall‐bladder carcinoma as a femoral hernia has not been previously reported.
Acute non‐calculous cholecystitis
Authors: Mayer M , Strosche H , Lindecken K D 
Published: April 2023

SummaryShock gall‐bladder is a complication that can arise following trauma or after an operation. The sex distribution, disease frequency and mortality rate associated with this condition are presented and possible pathophysiology is discussed.Post‐traumatic cholecysitis seems to occur most often in the second to fourth decade of life. The aetiology remains unknown and may be multifactorial. An awareness of this complication and a resort to early surgery can largely protect the patient from severe consequences.
Problems with clinical trials in general practice — a double‐blind comparison of cream containing miconazole and hydrocortisone with hydrocortisone alone in the treatment of intertrigo
Authors: Hedley K , Tooley P , Williams H 
Published: April 2023

SummaryA double‐blind comparative study between 1 % hydrocortisone cream and a combination of 1% hydrocortisone cream and 2% miconazole cream has highlighted some of the problems with this type of research in general practice. The collection of adequate patient numbers within a predefined time scale proved a major problem. However, the study demonstrated the safety and efficacy of both these preparations in the treatment of intertrigo.
Effect of ketotifen on the reactivity of eosinophils with the incubation of anti‐IgG
Authors: Kishimoto T , Sato T , Ono T , Takahashi K , Kimura I 
Published: April 2023

SummaryBlood eosinophils obtained from 25 patients with bronchial asthma were reacted with anti‐IgG or with normal rabbit serum as the control. Morphological changes were examined by light microscopy, scanning electron microscopy and transmission electron microscopy. Reactive eosinophils in morphology with anti‐IgG (27.8 per cent) were significantly higher (p<0.001) than those with the control (1.2 per cent).We also examined the effects of ketotifen and tranilast, both of which have eosinophil chemotactic inhibitory functions, on the morphological changes. Ketotifen altered the morphological reactivation of eosinophils and the generation of leukotrienes induced by anti‐IgG, and this inhibition occurred in a concentration‐dependent manner. Tranilast had no effect on the morphology of eosinophils and the generation of leukotrienes. These results suggest that eosinophil IgG receptors may have a role in the pathogenesis of asthma and that ketotifen may prevent their reactivity and, thus, could be of potential use in the treatment of asthma.
Three ‘silent’ mastoid abscesses
Authors: Wickham M H , Marven S S , Narula A A 
Published: April 2023

SummaryAcute mastoiditis with abscess formation is uncommon, its incidence being modified by modern antibiotic usage for acute suppurative otitis media (ASOM). It tends to occur in young children who have no previous history of ear disease. The diagnosis is a clinical one, and treatment requires hospital admission and some form of surgical drainage procedure, in order to prevent intracranial complications, eg, meningitis and intracerebral abscess.
Pancreatic ascites in childhood
Authors: Mucklow E S , Freeman N V 
Published: April 2023

SummaryA case is reported of pancreatic ascites in a 14‐year‐old girl who had acute and chronic pancreatitis associated with pancreatic duct stones and a ruptured pancreatic duct. Abdominal erythema ab igne was considered to be an important physical sign of genuine severe abdominal pain.
Pulmonary agenesis associated with fourteen other congenital abnormalities
Authors: Courtney S P , MacKinnon A E 
Published: April 2023

SummaryPulmonary agenesis is a rare congenital defect associated with certain previously described anomalies. This is the first case described associated with exomphalos. In addition there were 13 other congenital defects, three of which have not previously been recorded with either condition.
Comparison of the efficacy and tolerability of diclofenac gel (Voltarol Emulgel) and felbinac gel (Traxam) in the treatment of soft tissue injuries
Authors: Bouchier‐Hayes T A , Rotman H , Darekar B S 
Published: April 2023

SummaryIn an observer‐blind, randomised study, the efficacy and tolerability of two topical NSAID preparations were assessed in 384 patients with acute soft tissue injuries. The patients were allocated to receive treatment with either diclofenac gel (Voltarol Emulgel) 4 g tds or felbinac gel (Traxam) 4 g tds for three or seven days, depending on the rate of recovery.In every parameter studied (pain at rest, pain on movement, pain on local pressure, swelling, range of movement, bruising, degree of recovery, requirement for rescue analgesics, daily pain levels), diclofenac was found to be more effective at day 3 and day 7, with the single exception of bruising at day 7. Treatment differences were statistically significant in favour of diclofenac for pain at rest (p = 0.03) and bruising on day 3 (p = 0.03), and pain on pressure at day 7 (p = 0.009). The difference in favour of diclofenac in reduction of daily pain level (as recorded on diary cards) did not quite reach significance (p = 0.06). Both preparations were well tolerated, with no significant treatment‐related side‐effects reported.
Efficiency of treatment and monitoring of ablative radio iodine therapy for hyperthyroidism: a DGH centre study
Authors: Safe A F , Maxwell R T 
Published: April 2023

SummarySixty‐three hyperthyroid patients received ablative dosages of radio iodine. The efficacy of this treatment and the follow‐up were assessed one to two and a half years later from case records and general practitioners. Fifty‐seven percent of patients were hypothyroid at six months and 65% at one year; 4.8% had failed to become euthyroid within one year; 68.2% of patients were on thyroxine at the time of survey. Two patients had not been seen by their doctor for follow‐up and one patient stopped her thyroxine. Most general practitioners preferred patients to be returned to their care once thyroxine treatment was stabilised. Rapid responses and predictable outcome are important advantages of this form of therapy over established methods of management. Intentional ablation is particularly convenient in situations where clinical and biochemical follow‐up may be difficult. Good communications and a computer‐controlled recall system should ensure effective follow‐up.
THE EFFECT OF SUSTAINED‐RELEASE THEOPHYLLINE IN NOCTURNAL ASTHMA
Authors: Freeman W , Packe G E , Cayton R M 
Published: April 2023

SUMMARY Nocturnal symptoms are common and often disabling in asthmatic subjects. Furthermore, they often persist, in spite of appropriate dosages of inhaled β2‐agonists and topical steroids. In such a clinical situation, theophylline preparations may have a therapeutic role. This double‐blind, placebo‐controlled, cross‐over trial was designed to evaluate the effectiveness of a twice‐daily Bioavail slow‐release theophylline capsule in a group of out‐patient asthmatics, with a history of nocturnal and/or early morning wheeze or chest tightness. Theophylline was initially prescribed and monitored in an ‘open’ phase to obtain the drug dosage required to achieve a serum level in the therapeutic range of 10‐20 mg/l. In the ten patients who completed the study, serum theophylline levels were stable throughout.During active treatment there was an improvement in morning peak expiratory flow rate (PEFR), and a reduction in measurements of diurnal variation. In addition, the bronchodilator response to an inhaled β2‐agonist was preserved. Bioavail theophylline has thus been shown to be an effective agent in the management of adults with nocturnal asthma.
DOCTORS, NURSES, AND TRAINING IN THE ADMINISTRATION OF INTRAVENOUS DRUGS
Authors: Hardern R , Sutcliffe J , Catto A , Pope R 
Published: April 2023

SUMMARY To assess the knowledge of staff and the effect of formal training on house officers we conducted telephone questionnaires of 40 house officers and 18 nurses. The following points were assessed: knowledge of dilution of drugs; knowledge of the rate at which drugs should be given; and the rate at which drugs were given. Appropriately trained nurses had greater knowledge than ‘untrained’ house officers. In all, 17/18 (94%) nurses compared with 9/18 (50%) house officers knew the correct rate at which to give ampicillin (P=0.0036, Fisher's exact test); 14/18 (78%) nurses and 1/18 (6%) house officers said they gave ampicillin at the correct rate (P<0.001); 13/18 (72%) nurses and 7/18 (39%) house officers said they gave ranitidine at the correct rate (P=0.037).Only 1 of the 10 house officers who knew how rapidly to administer ampicillin said they took the correct length of time; 6 of the 10 who knew how rapidly to give ranitidine said they gave it at the correct rate. Training improves the knowledge of house officers, but other factors besides lack of knowledge (possibly lack of time) adversely affect delivery of intravenous drugs.