bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mequitazine in the treatment of hayfever
Authors: Beaumont G , Dobbins S , Latta D , McMillin W P 
Published: April 2023

SummaryA single‐blind, multicentre, comparative clinical trial was performed in 59 hayfever sufferers to compare the efficacy of mequitazine 5 mg bd and terfenadine 60 mg bd over a period of 14 days.Clinical assessments of nasal and ocular symptoms were made on admission to the trial and after seven and 14 days treatment by both physicians and patients. Critical flicker fusion threshold was measured at each assessment.A global assessment of efficacy was determined by both the doctor and patient at the end of treatment. Patients also completed a daily diary card.Thirty patients on mequitazine and 22 on terfenadine completed the trial. There were seven dropouts (five on terfenadine and two on mequitazine). Both treatments were equally effective in reducing the severity of symptoms over the 14 days of treatment. The overall assessment at the end of treatment showed no important significant differences between the two drugs. According to the physicians, 60 per cent of the mequitazine‐treated patients and 63 per cent of the terfenadine‐treated patients had an excellent or good response. Patients assessed their response as excellent or good in 56 and 62 per cent of cases respectively. Neither drug significantly impaired performance.
Breakthrough seizures with generic carbamazepine: a consequence of poorer bioavailability?
Authors: Hartley R , Aleksandrowicz J , Ng PC , McLain B , Bowmer C J , Forsythe WI 
Published: April 2023

SummaryThe bioavailability of carbamazepine from two products (Ethical Generics and Ciba‐Geigy) and their efficacy with regard to seizure control and incidence of side‐effects were compared in 23 children with tonic‐clonic or complex partial seizures. Mean plasma concentrations of carbamazepine, carbamazepine 10. 11‐epoxideand 10, 11‐dihydro‐10, 11‐trans‐dihydroxy‐carbamazepine at comparable sampling times were not significantly different during treatment with the two drug preparations. The incidence of seizures and occurrence of abnormal EEGs were not significantly different during treatment with the two carbamazepine preparations, and, in addition, the overall incidence of side‐effects was not significantly different during the two treatment periods. However, neurological side‐effects were significantly less during treatment with the Ciba‐Geigy product. On the basis of these observations we are confident that the efficacy of these two carbamazepine preparations in children at steady‐state is the same.
Nephrology and astrology – is there a link?
Authors: Hughes Stephen 
Published: April 2023

SummaryAstrologers presume a link between the susceptibility of particular organs to disease and signs of the Zodiac.1 A simple test of the positive connection between renal disease and the sign of Libra was undertaken by studying the birth dates of consecutive nephrology in‐patient admissions. No significant link was found on analysis, thus disproving the traditional astrologers' claims.
Wiskott‐Aldrich syndrome: fatal consequences of splenectomy in an unrecognised attenuated variant
Authors: Standen G R , Orchard J A , Hutton R D 
Published: April 2023

SummaryMonozygotic twin males with an attenuated variant of the Wiskott‐Aldrich syndrome (WAS) are described. Diagnostic features included moderate thrombocytopenia with small platelet size and abnormal platelet aggregation responses, chronic eczema, depressed serum IgM and low isoagglutinin titre. Splenectomy was performed on one twin at age seven years who survived a complicating pneumococcal septicaemia ten days after the procedure, but who succumbed to fulminating infection three years later. The importance of recognising the attenuated variants of WAS is discussed.
Childhood extradural haematomas, not always obvious
Authors: Davies K G , Jamjoom A B , Burgess N A 
Published: April 2023

AbstractExtradural haematomas in children are rare, but they may occur following a trivial head injury. We report a case where, following an unrecognised head injury to a three‐year‐old child, the insidious non‐specific presentation of the extradural haematoma led to delay in the diagnosis and treatment.
CLINICAL AUDIT OF THEOPHYLLINE USE IN GENERAL PRACTICE
Authors: Neville R G , McDevitt D G 
Published: April 2023

SUMMARY The use of therapeutic drug monitoring for theophylline therapy was evaluated in two urban general practices. Of 55 patients studied, 44 (80%) had a sub‐therapeutic serum theophylline concentration, 11 (20%) had a therapeutic concentration (10‐20 μg/ml), and none had an above therapeutic concentration. Patients were reviewed at weekly intervals and had their theophylline dosages adjusted according to serum levels. A therapeutic concentration was achieved in 37 patients (67%). This task proved to be laborious but not difficult'.Side‐effects were less common than previous reports suggest. The general practice workload involved in adjusting theophylline dosage was approximately four consultations, one dose change and two serum assays per ‘average’ patient.
WHY FLUSH PERIPHERAL INTRAVENOUS CANNULAE USED FOR INTERMITTENT INTRAVENOUS INJECTION?
Authors: Walsh D A , Toeg D , Mellor J A 
Published: April 2023

SUMMARY We aimed to investigate whether regular flushing of peripheral intravenous cannulae used for intermittent injections with heparin‐saline, in a unit for acute medicine for the elderly, reduced the incidence of complications necessitating cannula removal. We wanted to see if this could also prolong the time that cannulae may remain functional in situ. In a prospective, open study, 50 consecutively inserted cannulae were flushed regularly and a subsequent 50 consecutive cannulae were not flushed.The incidence of complications necessitating removal was not significantly different between the two groups (18% flushed, 22% unflushed). Overall, only 5% of cannulae were removed because of blockage. Heparin‐saline flushes did not significantly increase the time that cannulae remained in situ. Antibiotic use was found to be associated with an increased rate of complications necessitating cannula removal. We found no significant advantage in heparin‐saline flushing of peripheral intravenous cannulae used for intermittent administration of medications.
WHICH IMMUNOMODULATOR?
Authors: James D Geraint 
Published: April 2023

Immunotherapy has come a long way since George Bernard Shaw lampooned the medical profession in his 1906 play The Doctor's Dilemma. One of the characters, fashionable physician Dr Ralph Bloomfield Bonington, was a devout disciple of immunotherapy at the beginning of this century:‘… Drugs can only repress symptoms; they cannot eradicate disease … There is at bottom only one genuinely scientific treatment for all diseases, and that is to stimulate the phagocytes … they devour the disease and the patient recovers — unless, of course, he's too far gone‘.In this same play, Shaw also caricatured surgeons and perhaps even predicted thymectomy for cancer prevention, for the surgeon Cutler Walpole said:‘… Phagocytosis is pure rot, the knife is the real remedy … it amuses me to hear you physicians talking about clinical experience. What do you see at the bedside but the outside of the patient. What you need is daily familiarity with people's insides. The nuciform sac is full of decay … cut it out. The operation ought to be compulsory. It's ten times more important than vaccination‘.1
DETERMINATION OF PLASMA FIBRONECTIN AND SERUM C‐REACTIVE PROTEIN IN PATIENTS WITH CEREBROVASCULAR EVENTS
Authors: Pen SÇE , Yilmaz G , Yilmaz N , Kocoglu H , Namiduru E , Yüncü M , Gökalp N 
Published: April 2023

SUMMARYThe relationship between the levels of C‐reactive protein (CRP) and fibronectin (FN) and atherosclerotic diseases such as coronary heart disease has already been studied, but their relationship with cerebrovascular events has not. The aim of this study was to determine the levels of plasma FN and serum CRP in cerebrovascular events, and their relationship with the outcome of the disease. CRP and FN levels were analysed in 133 patients with acute cerebrovascular disease, together with 66 healthy controls. Cerebrovascular event patients were divided into subgroups according to disease severity. FN and CRP levels in patients with cerebrovascular disease were found to be significantly elevated compared with the control group (p<0.001). CRP levels correlated with disease severity, in contrast to FN levels. We conclude that FN is not a clinically useful marker in patients with acute differentiative cerebrovascular events, in contrast to CRP which may be useful in such cases.
BREASTFEEDING DOES NOT POSE ANY ADDITIONAL RISK OF IMMUNOPROPHYLAXIS FAILURE ON INFANTS OF HBV CARRIER MOTHERS
Authors: Wang J‐S , Zhu Q‐R , Wang X‐H 
Published: April 2023

SUMMARYWhether babies born to hepatitis B (HB) carrier mothers with HB immunoprophylaxis at birth can be breastfed safely is controversial. A total of 230 such babies were followed up for one year to assess the influence of feeding method on the efficacy of HB immunoprophylaxis. The positive rates of anti‐HBs at different ages are not statistically different between the breastfed group and the bottle‐fed group. At 1 year, the rate was 80.9% in the breastfed group and 73.2% in the bottle‐fed group in infants with HB vaccine alone, and 90.9% in the breastfed group and 90.3% in the bottle‐fed group in infants with HBIG plus HB vaccine. There were no significant differences in the incidence of immunoprophylaxis failure between breastfed and bottle‐fed babies. The results indicated that breastfeeding does not have a negative influence on the response of anti‐HBs and on the failure rates of immunoprophylaxis in the infants born to HB carrier mothers.
21. THE ADJUVANT TREATMENT OF BREAST CANCER
Authors: Kelleher M , Miles D 
Published: April 2023

SUMMARYRisk of relapse of breast cancer depends largely on tumour features: size, grade and, particularly, lymph node status. Adjuvant systemic therapies reduce risk of relapse and death, as shown in several meta‐analyses. Relative risk reductions are similar across different prognostic groups but the absolute benefits are greater in those with a worse prognosis. Combination chemotherapy is superior to single agent regimens but longer duration (>6 months) gives no additional benefit compared with six months of therapy. Benefits from adjuvant chemotherapy diminish with the age of the patient. CMF type regimens have been most widely used: anthracyclines can reduce risk of relapse by 12% (an absolute survival benefit of about 3%) but with greater toxicity Early trials of taxoids look promising but benefit was seen only in those with ER‐ tumours. Tamoxifen is the most extensively used endocrine adjuvant therapy, and is associated with a reduction in risk of death of 26% independent of age or menopausal status but only in those with ER+ tumours. Aromatase inhibitors are effective only in postmenopausal women and, although the early results with anastrozole look promising, long‐term efficacy and toxicity studies are presently lacking, so five years of tamoxifen is standard treatment for women with ER+ tumours.
CONGENITAL CORONARY ARTERY FISTULAS IN TURKISH PATIENTS UNDERGOING DIAGNOSTIC CARDIAC ANGIOGRAPHY
Authors: Serçelik A , Mavi A , Ayalp R , Pestamalci T , Gumusburun E , Batiraliev T 
Published: April 2023

SUMMARYA coronary artery fistula is a direct communication between a coronary artery and one of the cardiac chambers or vessels around the heart. The present study was undertaken to define the incidence, clinical findings and angiographic characteristics of congenital coronary artery fistula in Turkish adults who underwent diagnostic cardiac angiography. A consecutive series of 11,350 coronary angiography, performed between January 2000 and December 2001, was retrospectively examined for the presence of coronary artery fistulas. The incidence of congenital coronary artery fistulas was 0.08%. All the patients had chest pain during exertion or at rest. All the fistulas were single and most arose from the proximal left anterior descending coronary artery and drained into the pulmonary artery. All the fistulas were small. Surgical treatment was not indicated. A congenital coronary artery fistula in adults is a distinct though rare entity, variable in its incidence and commonly associated with coronary artery obstructive disease. Diagnosis is mostly incidental during routine coronary angiography.
MASSIVE BLEEDING FROM AN ARTERIOVENOUS MALFORMATION IN THE GASTRIC FUNDUS FOLLOWING GASTRIC BIOPSY TREATED BY EMBOLISATION
Authors: Ibrahim AS , Allangawi MH , Al‐Muzrakch AM 
Published: April 2023

SUMMARYA 60‐year‐old male was admitted with massive upper gastrointestinal bleeding following a gastric biopsy. Repeat gastroduodenoscopy failed to identify the source. Angiography identified bleeding from an arteriovenous malformation at the fundus of the stomach. This was controlled by embolisation.
PREVALENCE OF PERIPHERAL ARTERY DISEASE IN URBAN HIGH‐RISK MALAYSIAN PATIENTS
Authors: Amudha K , Chee KH , Tan KS , Tan CT , Lang CC 
Published: April 2023

SUMMARYAtherosclerosis is a progressive, disseminated condition that affects all the vascular beds. Peripheral arterial disease (PAD), a manifestation of atherosclerosis, measured non‐invasively in the legs by ankle‐brachial index (ABI) is associated with increased cardiovascular morbidity and mortality Though several studies in the western industrialised countries have shown that PAD is widely prevalent in the general older population at risk, not much data are available in the South East Asian developing countries. We have conducted an epidemiological survey on the prevalence of PAD in high‐risk patients at an urban hospital in Malaysia. A total of 301 consecutive patients aged 32–90 years were recruited during their follow‐up clinic visits for established cardiovascular disease, ischaemic stroke or diabetes mellitus ≥5 years. All participants underwent ABI measurement and were subjected to the Edinburgh claudication questionnaire to assess leg symptoms. The prevalence of PAD in our high‐risk population was 23%, of which only 27% were symptomatic with the classical intermittent claudication. All the patients with PAD were diagnosed at the time of the study. PAD was found in 33% of patients with pre‐existent cardiovascular disease, 28% in patients with ischaemic stroke and 24% in diabetic patients. PAD was also highly prevalent among the younger patients. Our study has shown that PAD is highly prevalent among high‐risk Malaysian patients and is not necessarily a disease of older age. Only 27% of these patients were symptomatic. All the subjects with PAD were diagnosed at the time of the study, which would suggest it is an unrecognised and underdiagnosed condition, even in patients with atherosclerotic risk factors.
PSOAS HAEMATOMA AND FEMORAL NEUROPATHY ASSOCIATED WITH ENOXAPARIN THERAPY
Authors: Ho KJ , Gawley SD , Young MRA 
Published: April 2023

SUMMARYHaemorrhage into the iliopsoas muscle causing femoral neuropathy is an infrequent complication of haemophilia or anticoagulant therapy. The association of an iliopsoas haematoma with enoxaparin therapy is very rare. We describe a case of femoral neuropathy secondary to psoas haematoma in a patient who was on enoxaparin therapy for suspected non‐Q wave myocardial infarction. There is no clear consensus for the treatment of these haematomas, with both surgical and conservative options advocated. In this case, our patient recovered fully following conservative management.
PEGINTERFERON ALFA‐2A (40KD) (PEGASYS®) FOR THE TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS C
Authors: Ferenci P 
Published: April 2023

SUMMARYCompared with conventional interferon alfa, peginterferon alfa‐2a (40KD) has improved pharmacokinetics, provides sustained therapeutic plasma levels, and can be administered once weekly. In randomised, multinational trials, peginterferon alfa‐2a (40KD) 180 μg once weekly was significantly more effective than three times weekly interferon alfa‐2a in patients with chronic hepatitis C, including patients with cirrhosis. Peginterferon alfa‐2a (40KD) and ribavirin 1000/1200 mg/day for 48 weeks produced significantly higher sustained responses than three times weekly interferon alfa‐2b and ribavirin 1000/1200 mg/day in patients with chronic hepatitis C including those with HCV genotype 1, genotypes 2/3 and those with high or low viral loads at baseline. The drug is well tolerated when given alone or in combination with ribavirin. Health‐related quality of life was significantly less impaired during treatment with peginterferon alfa‐2a (40KD) than interferon alfa‐2a in randomised trials. Peginterferon alfa‐2a (40KD) is widely approved for use in patients with chronic hepatitis C. (Int J Clin Pract 2003; 57(7): 610–615)
DUTASTERIDE: A NEW 5‐ALPHA REDUCTASE INHIBITOR FOR MEN WITH LOWER URINARY TRACT SYMPTOMS SECONDARY TO BENIGN PROSTATIC HYPERPLASIA
Authors: Brown CT , Nuttall MC 
Published: April 2023

SUMMARYDutasteride is a new 5‐alpha reductase inhibitor for the treatment of men with moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia. It has been available in the UK since March 2003. It is a competitive inhibitor of both type I and type II isoforms of the 5‐alpha reductase enzyme that converts testosterone to the more potent androgen, dihydrotestosterone. Randomised controlled studies have shown dutasteride to be statistically more effective than placebo in reducing lower urinary tract symptoms and increasing maximum urinary flow rates. This is a consequence of a reduction in serum dihydrotestosterone and hormone dependent prostate volume. Dutasteride has also been shown to decrease the absolute risk of urinary retention and the need for prostate‐related surgery when compared to placebo taken over a 24‐month period. In this review article we discuss the pharmacology and clinical effects of dutasteride, a new dual‐acting 5‐alpha reductase inhibitor.
CLINICOPATHOLOGICAL AND THERAPEUTIC PATTERNS OF IDIOPATHIC PULMONARY FIBROSIS IN KUWAIT: A PROSPECTIVE STUDY
Authors: Khadadah ME , Onadeko BO , Abul AT , Behbehan NA , Cerna M , Cherian JM , Adesina O , Maradni N , Jayakrishnan B 
Published: April 2023

SUMMARYThough common, the exact incidence and clinical pattern of idiopathic pulmonary fibrosis (IPF) in Gulf countries are not known. The results of a four‐year prospective study undertaken in two tertiary hospitals in Kuwait are presented. The mean age at diagnosis of the 52 patients studied was 55 40±11 87 years. Thirty‐two (61.5%) patients were male and 22 (42.3%) were smokers. The mean duration of symptoms at diagnosis was 2.1 ±0.92 years. Digital clubbing was found in 34 (65%) patients The mean FVC, TLC and TLCO were 57%, 64.4% and 55% of predicted normal, respectively. The FVC value showed a significant difference between smokers and non‐smokers (p<0.05). HRCT findings were abnormal in all patients. Typical histological and high‐resolution computed tomography findings of usual interstitial pneumonia, desquamative interstitial pneumonia and non‐specific interstitial pneumonia were observed. This study revealed that IPF is prevalent in Kuwait, with patterns showing some similarities to those established elsewhere. The response to treatment was not encouraging, especially in the usual interstitial pneumonia subtype. (Int J Clin Pract 2003; 57(10): 879–884)
TIOTROPIUM BROMIDE: A LONG‐ACTING ANTICHOLINERGIC BRONCHODILATOR FOR THE TREATMENT OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Authors: Joos GF , Brusselle G , Derom E , Pauwels R 
Published: April 2023

SUMMARYPrevention and relief of symptoms by regular use of bronchodilators is central to the management of patients with chronic obstructive pulmonary disease (COPD). The bronchodilators in use are β2‐agonists, anticholinergics and theophylline. Since the 1970s the anticholinergic ipratropium bromide has been widely used for the treatment of patients with regular symptoms, but because it has a relatively short duration of action, it needs to be administered four times a day. Tiotropium bromide is a long‐acting anticholinergic suitable for once daily administration. It has been developed as a dry powder inhaler for the treatment of patients with COPD. Large clinical trials with administration of the drug for one year have now been published. Compared with placebo and ipratopium bromide, significant and long‐lasting bronchodilatation was observed, which was maintained over the year. The bronchodilator effect of tiotropium bromide was accompanied by improvements in other health outcomes. A significant decrease in dyspnoea, improvement in health‐related quality of life, and a reduction in the number of COPD exacerbations and hospitalisations were noted. In this review we summarise the clinical development of this compound.
In vitro and in vivo study of the efficacy of a new sebum control essence
Authors: Wei Juan , Ma Xuemei , Chen Min , Pan Sha , Pang Ying 
Published: April 2023

AbstractBackgroundPeople with oily skin often suffer from skin problems such as oily face, blackheads, acne, and enlarged pores. It is necessary to regulate oily skin with skin care products.AimsTo develop an effective sebum control essence to reduce oiliness of skin.MethodsThe composition of the essence was designed in consideration of different oil control mechanism targets. The skin irritation was assessed in 30 volunteers by a single application close patch test. The efficacy of the essence was evaluated by in vitro experiment, short‐ and long‐term clinical trials with over 60 volunteers.ResultsThe results of both in vitro and clinical trials showed that the essence had significant oil control and moisturizing effect, the skin oil content decreased by 21.8% within 8 h and 30.05% after 28 days, which indicated that the essence could achieve rapid and persistent sebum control efficacy. In addition, the essence could relieve the problems of enlarged pores, blackheads and whiteheads in long‐term use.ConclusionsThe essence developed in this study can alleviate the problems of oily skin from many aspects, and achieve an excellent effect in oily skin regulation. It is suitable for a daily application in oily skin regulation.
Exploring the Emotional Functions of Co‐Speech Hand Gesture in Language and Communication
Authors: Kelly Spencer D. , Ngo Tran Quang‐Anh 
Published: April 2023

AbstractResearch over the past four decades has built a convincing case that co‐speech hand gestures play a powerful role in human cognition . However, this recent focus on the cognitive function of gesture has, to a large extent, overlooked its emotional role—a role that was once central to research on bodily expression. In the present review, we first give a brief summary of the wealth of research demonstrating the cognitive function of co‐speech gestures in language acquisition, learning, and thinking. Building on this foundation, we revisit the emotional function of gesture across a wide range of communicative contexts, from clinical to artistic to educational, and spanning diverse fields, from cognitive neuroscience to linguistics to affective science. Bridging the cognitive and emotional functions of gesture highlights promising avenues of research that have varied practical and theoretical implications for human–machine interactions, therapeutic interventions, language evolution, embodied cognition, and more.