Biomedical subjects
I Ramsay
Publications and source records attributed to I Ramsay.
Primary prevention of Streptococcus suis meningitis.
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Systemic metronidazole in the treatment of periodontitis.
The present study evaluated the effect of systemic metronidazole on advanced periodontitis in 10 patients with inadequate oral hygiene. Clinical and microbiological observations were made at a total of 173 bleeding pockets of 5 mm depth or more. The clinical observations comprised plaque index scores, dichotomous measurements of gingival redness and suppuration, pocket depths and attachment levels. The microbiological variables investigated were the % spirochaetes, % black-pigmented Bacteroides species, % facultative streptococci and presence of absence of Bacteroides gingivalis. At baseline, after clinical measurements and microbiological samples had been taken, each patient received a thorough scaling and root planing. After 3 months, the clinical measurements and microbiological sampling were repeated and a 5-day course of metronidazole was administered while one side of the mouth was scaled and root planed. After a further 3 months, the final measurements and samples were taken. In comparing pre- and post-treatment data, the following significant differences were observed: for debridement alone, a reduction in mean % spirochaetes from 11.5% to 4.9% and an increase in mean % streptococci from 4.7% to 8.8%; for metronidazole alone, a 0.3 mm gain in mean attachment level, a 0.4 mm reduction in mean pocket depth and a reduction in the frequency of suppurating sites from 32% to 16%; for debridement plus metronidazole, a 0.2 mm gain in mean attachment level, a 0.5 mm reduction in mean pocket depth and a reduction in mean % spirochaetes from 5.6% to 2.5%. Thus systemic metronidazole, either alone or accompanied by debridement, produced a modest clinical improvement after debridement alone had failed.(ABSTRACT TRUNCATED AT 250 WORDS)
Postpartum thyroiditis--an underdiagnosed disease.
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Drug and non-thyroid induced changes in thyroid function tests.
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Metastatic carcinoma of bronchus associated with Hashimoto's thyroiditis.
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The presentation of osteomalacia in pregnancy. Case report.
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The use of ultrasound in the localisation of parathyroid glands in parathyroid disorders.
Eleven patients with clinical and biochemical evidence of primary hyperparathyroidism were studied with ultrasonography. In nine patients who were treated surgically, four had predictive ultrasound scans (44% consistency). There was no correlation between the transverse diameters of the glands, as measured from the scans, and either the pathologist's measurements or the mean protein-corrected serum calcium and parathormone (PTH) levels. The investigation failed to identify the only patient with parathyroid hyperplasia. The difficulties encountered and the reasons for the high number of both false positive and false negative scans are discussed. Five patients with parathyroid disorders associated with hyperplasia were also studied and in four patients the enlarged glands were identified. A variation in size between the glands in each patient was noted. No correlation between the total of the transverse diameters and either the protein-corrected serum calcium or PTH levels was found. Reduction in size of the glands in one patient occurred over a 12-month period on treatment and a role for ultrasonography in the follow-up of patients with secondary hyperparathyroidism is discussed.
Thyrotoxicosis in pregnancy: results of treatment by antithyroid drugs combined with T4.
Treatment of thyrotoxicosis in pregnancy with antithyroid drugs plus supplementary T4 is controversial. Data are presented on twenty consecutive pregnancies treated by this method. The mean birth weights of the babies and their gestation did not differ from those of normal controls. Cord blood mean T4 and free T4 index (FT4I) were not significantly different from controls and total T3 and free T3 index (FT3I), though significantly lower than the controls, were all within the normal range. In five babies in whom they were measured, FT3, FT4 and rT3 levels were not significantly different from controls. Cord TSH was significantly higher in the babies of thyrotoxic mothers than in the control babies. One baby had a goitre at birth which disappeared after a few days. Another baby, born euthyroid, developed neonatal thyrotoxicosis the day after birth. Data collected from the literature on this method of treatment are compared with similar data from women treated with antithyroid drugs alone.
Sotalol in hyperthyroidism.
Ten hyperthyroid patients were studied before and after 2 weeks' beta-adrenoceptor blockade with sotalol. The following variables were measured: resting pulse rate, blood pressure, weight, thyroid hormone levels, plasma lipids, alkaline phosphatase, plasma glucose and insulin responses to oral glucose, bromsulphthalein retention and the 24-h urinary excretion of calcium, hydroxyproline, creatine and creatinine. Sotalol produced a significant fall in pulse and blood pressure. Weight loss continued during treatment. No metabolic changes of any consequence were found. It is concluded that sotalol should not be used as the sole treatment of a patient with hyperthyroidism.
Hyperosmolar diabetes presenting as acute urinary retention: report of three cases.
Three elderly patients presented at one hospital in a 2-week period with acute urinary retention precipitated by the hyperosmolar non-ketotic diabetic state. In each case routine urine testing was reported as showing 1 per cent glycosuria. The first two patients were admitted at night and blood glucose estimations were not done. This led to a delay of 16 and 12 h respectively before the appropriate therapy was instituted. It is suggested that this clinical presentation, previously unreported, may not be a rarity and represents an avoidable cause of death in patients with acute urinary retention.
Further studies on the stimulation of the nuclear-envelope nucleoside triphosphatase by polyguanylic acid [proceedings].
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Thyroid function and antibody studies in pernicious anaemia.
Thyroid antibodies were demonstrated in 57% of thirty pernicious anaemia patients without overt thyroid disease. Elevated basal thyroid stimulating hormone (TSH) levels and an enhaced TSH response to thyrotrophin releasing hormone (TRH) only occurred in thyroid antibody positive subjects; by contrast the thyroid antibody negative subjects in the older age group frequently and undetecable basal TSH levels and an impaired TRH response. Thyroid hormone concentrations provided no absolute evidence of hypothyroidism in any of the patients.
The cardiovascular and lipid status of pernicious anaemia patients with and without thyroid antibodies.
A study has been undertaken of the cardiovascular and lipid status of patients with pernicious anaemia (PA). There was no evidence of elevated cholesterol, triglyceride and lipoprotein concentrations nor of an increased prevalence of ischaemic heart disease and peripheral vascular disease in those patients who had positive thyroid antibodies compared with those who had not. There were also no significant differences in cardiovascular or lipid status in the antibody positive patients between those who had an exaggerated thyroid stimulating hormone (TSH) response to thyrotrophin releasing hormone (TRH) and those who had a normal or impaired response. It is suggested that an exaggerated response to TRH in these PA patients usually indicates 'compensated euthyroidism' and not 'subclinical hypothyroidism' or 'premyxoedema' and that they are no more at risk for cardiovascular disease than are PA patients with no evidence of thyroid abnormality.
Attempted prevention of neonatal thyrotoxicosis.
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Attempted prevention of neonatal thyrotoxicosis.
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