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2.  Coeliac disease in monozygotic twins 
Postgraduate Medical Journal  1982;58(686):797-798.
A case of concordance for coeliac disease in monozygous twins is reported. One presented with failure to enter puberty and responded to the exclusion of gluten from her diet. The other twin was asymptomatic. They represent a well documented example of monozygous twins with concordance for coeliac disease.
PMCID: PMC2426616  PMID: 6892062
6.  Treatment of Hypothyroidism: A Reappraisal of Thyroxine Therapy 
British Medical Journal  1973;3(5872):131-134.
Twenty-two subjects with hypothyroidism have been studied in detail before and during replacement therapy with L-thyroxine (T-4). All subjects were stabilized on the minimum dose of T-4 which was necessary to suppress their serum thyroid-stimulating hormone (TSH) concentration to normal, and on this dose most subjects had a normal or impaired TSH response to thyrotrophin-releasing hormone (TRH). The daily dose of T-4 required to suppress TSH was 0·1 mg (13 subjects), 0·15 mg (six subjects), and 0·2 mg (three subjects). It was shown that all subjects were euthyroid on these doses and, using a range of thyroid function tests, that they were normal in all respects when compared with a group of euthyroid controls, with the exception of a small group who had a marginally raised serum triiodo-L-thyronine (T-3) concentration. It has been shown that those subjects who required the larger doses of T-4 had a more advanced degree of thyroid failure than those who were stabilized on 0·1 mg T-4 daily. It is concluded that conventional doses of T-4 (0·2-0·4 mg daily) are often associated with subclinical hyperthyroidism.
PMCID: PMC1586331  PMID: 4720761
9.  Further Observations on the Effect of Synthetic Thyrotrophin-releasing Hormone in Man 
British Medical Journal  1971;2(5755):199-202.
Synthetic thyrotrophin-releasing hormone (TRH) given intravenously in doses of 50 μg or more causes a significant rise in serum thyroid-stimulating hormone (TSH) levels but has no effect on serum growth hormone, plasma luteinizing hormone, or plasma 11-hydroxycorticosteroids under carefully controlled basal conditions.
The peak TSH response to intravenous TRH occurs at 20 minutes. The mild and transient side effects, which occur only after intravenous TRH, include nausea, a flushing sensation, a desire to micturate, a peculiar taste, and tightness in the chest. There is considerable variability in response to a given dose of TRH in the same subject on different occasions and in different subjects. Oral administration of TRH in doses of 1 mg and above causes a rise in serum TSH, maximal at two hours, a consistent response being obtained at doses of 20 mg and above. A rise in serum protein-bound iodine (P.B.I.) follows that of TSH, a consistent response being observed at 40-mg doses of TRH orally. Measurements of serum TSH after intravenous administration of TRH or of serum TSH or serum P.B.I. after oral TRH should prove useful tests of pituitary TSH reserve.
PMCID: PMC1795339  PMID: 4102606
10.  Diazepam and Tests of Thyroid Function 
British Medical Journal  1971;1(5749):585-586.
The effect of diazepam on thyroid function tests was examined in 12 euthyroid patients requiring the drug for psychiatric reasons and in six patients with thyrotoxicosis. Assessment was made before and after four weeks' therapy.
There was no significant difference in results from tests of thyroid iodide trapping and binding (thyroid radioiodine uptake, thyroid clearance, and absolute iodine uptake) except in the one-hour thyroid uptake in the euthyroid group, which was increased after diazepam. This increase occurred without alteration in serum thyroid stimulating hormone levels. No change occurred in either group in tests of thyroid hormone release (protein-bound iodine, T-3 resin uptake, or Thyopac-3 and free thyroxine index).
Patients with suspected thyroid disease who are taking diazepam do not need to stop therapy while their thyroid status is being determined.
PMCID: PMC1795231  PMID: 4100951
11.  Radioimmunoassay of Human Serum Thyrotrophin 
British Medical Journal  1971;1(5749):582-585.
The double antibody radioimmunoassay of serum thyroid-stimulating hormone (TSH) allows measurement of circulating levels of the hormone in most normal subjects. The serum TSH level in normal subjects is 1·6 ± 0·8μU/ml. Patients with non-toxic goitre and acromegaly have normal TSH levels. Values are always raised in hypothyroid patients (with primary thyroid disease) and are significantly lowered in those with hyperthyroidism. Of the many stimuli used in an attempt to raise TSH levels in normal adult subjects only three—synthetic thyrotrophin-releasing hormone, ethinyloestradiol, and carbimazole plus iodides—have been effective. The major clinical application of the TSH immunoassay lies in the diagnosis of minor degrees of hypothyroidism. An impaired response of serum TSH to synthetic thyrotrophin-releasing hormone should also help in the diagnosis of hypopituitarism affecting TSH production.
PMCID: PMC1795217  PMID: 5548300
13.  Chlordiazepoxide (Librium) and Tests of Thyroid Function 
British Medical Journal  1970;2(5704):266-268.
The effect of chlordiazepoxide (Librium) on thyroid function was examined in 14 euthyroid patients who required the drug for psychiatric reasons and in six patients with clinically mild thyrotoxicosis. There was no significant difference in results from tests of thyroid iodide trapping (thyroid radioiodine uptake, thyroid clearance, and absolute iodine uptake) or of thyroid hormone release (protein-bound iodine, T3 resin uptake, and free thyroxine index) carried out before and during treatment with the drug over a four-week period. It is suggested that chlordiazepoxide need not be withdrawn before thyroid status and function are assessed in any patient taking the drug.
PMCID: PMC1700424  PMID: 4192645
17.  Medical Ethics 
The Ulster Medical Journal  1957;26(2):108-121.
PMCID: PMC2480404  PMID: 13507203
19.  Acne Vulgaris 
The Ulster Medical Journal  1940;9(1):39-43.
PMCID: PMC2576968  PMID: 20476240

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