bluuebunny/crossref_metadata_2025_split huggingface dataset:
Crohn's disease in Bangladeshis and Europeans in Britain: an epidemiological comparison in Tower Hamlets
Authors: Probert C S J , Jayanthi V , Pollock D J , Baithun S I , Mayberry J F , Rampton D S 
Published: December 2008

Summary
The incidence of Crohn's disease in a defined Bangladeshi community was assessed in a retrospective, epidemiological study in the London Borough of Tower Hamlets from 1972 to 1989. The borough population of 164,000 includes over 28,000 Bangladeshis. Potential cases were identified from hospital pathology and medical records. There were 99 cases of Crohn's disease during the study period, of which five were Bangladeshi. The mean standardized incidence in Bangladeshis was 1.2/10(5)/year in the 1970s and 2.3/10(5)/year in the 1980s compared with 3.8/10(5)/year and 4.1/10(5)/year in Europeans, and 4.6/10(5)/year and 5.4/10(5)/year in West Indians, respectively. None of the changes with time was statistically significant. There were no cases amongst Hindus. The relative risk to Europeans, compared to Bangladeshis, was 2.5 during the 1970s and 2.0 in the 1980s. The difference between European incidence and that of other ethnic groups was not statistically significant; however, the number of Bangladeshi cases was small (five), and diminishes the power of the study. The apparent similarity of the incidences of Crohn's disease in Bangladeshis and Europeans contrasts with findings in other South Asians. Further investigations of the differences in incidence of Crohn's disease in South Asians is needed.
Carnitine deficiency associated with long-term pivampicillin treatment: the effect of a replacement therapy regime
Authors: Rose S J , Stokes T C , Patel S , Cooper M B , Betteridge D J , Payne J E 
Published: December 2008

Summary
A 51 year old female developed a skeletal muscle myopathy after 3 months of pivampicillin therapy. Pivampicillin can cause carnitine deficiency due to the pivalic acid side group. Plasma carnitine content and the patients symptoms failed to improve significantly on discontinuing the drug. Oral carnitine replacement therapy was administered for 6 weeks but the patient's plasma carnitine levels responded only slowly to this treatment. It is suggested that pivampicillin inhibits uptake of carnitine from the gut and may either directly or indirectly depress endogenous carnitine synthesis. In such cases a more aggressive carnitine replacement regime is indicated and pivampicillin should be avoided in patients requiring long-term antibiotic administration.
Amoebic psoas and liver abscesses
Authors: O'Leary Colin , Finch Roger 
Published: December 2008

Summary
A 28 year old woman with a history of a dysenteric illness and documented Campylobacter infection presented with amoebic psoas and liver abscesses. A review of the literature of the last 20 years did not yield any reports of an amoebic psoas abscess.
Strongyloides stercoralis hyperinfection in a patient with angioimmunoblastic lymphadenopathy
Authors: Uwaydah Ahmad K , Al Qadah Farouq 
Published: December 2008

Summary
A 29 year old Bengali male patient on chemotherapy for angioimmunoblastic lymphadenopathy developed Strongyloides hyperinfection syndrome 3 months after being treated with a single 3 day course of thiabendazole. His complicated hospitalization and successful management are described. Prevention of this potentially fatal disease in immunocompromised patients by early diagnosis and proper management of intestinal strongyloidiasis is emphasized.
The anti-inflammatory and analgesic action of transdermal glyceryltrinitrate in the treatment of infusion-related thrombophlebitis
Authors: Berrazueta J R , Poveda J J , Ochoteco J , Amado J A , Puebla F , Salas E , Sarabia M 
Published: December 2008

SummaryWe have carried out a prospective double-blind randomized study in 40 patients with infusion-related thrombophlebitis. Twenty-two patients were included in the glyceryltrinitrate (GTN) ointment group and 18 patients in the control heparinoid group. Pain was assessed by an analogue scale. At 48 hours the analgesic index was 84.6 +/- 18 units with GTN and 49 +/- 45 units with heparinoid ointment (P &lt; 0.01). Faster relief of oedema was also observed in the GTN-treated group. All signs of thrombophlebitis were relieved in less than 4 days in the GTN group compared with 9 days in the controls (P &lt; 0.005). We conclude that transdermal GTN is useful therapy for infusion-related thrombophlebitis showing evidence of anti-inflammatory and analgesic effect.
Malignant phaeochromocytoma and hypercalcaemia
Authors: Bridgewater J A , Ratcliffe W A , Bundred N J , Owens C W I 
Published: December 2008

Summary
We describe a case of hypercalcaemia secondary to recurrent malignant phaeochromocytoma. Parathyroid-related protein (PTHrp 1-86) immunoreactivity was identified in plasma and PTHrp was identified by immunocytochemistry in tumour tissue.
Gastric acid secretion in typhoid fever
Authors: Khosla S N , Jain Navleen , Khosla Amit 
Published: December 2008

Summary
Gastric acid secretion was studied in 20 patients with typhoid fever (Group A), ten patients with fever other than typhoid (Group B), and ten healthy adults of matched age and sex (Group C). Patients with typhoid showed reduced acid secretion at the time of fever and one week after subsidence of fever as compared to Group C. In uncomplicated patients (Group A1), these values rose thereafter but in complicated patients (Group A2) they remained low even 12 weeks after subsidence of fever. This suggests that these patients had pre-existing hypochlorhydria which predisposed them to a severe form of disease. There may be many factors playing a significant role in making typhoid patients more prone to develop complications but the importance of gastric acid levels has also to be considered.
A safe and simple technique for exchanging central venous catheters
Authors: Shimada Mitsuo , Matsumata Takashi , Wakiyama Shigeki , Maeda Takashi , Kanematsu Takashi , Sugimachi Keizo 
Published: December 2008

Summary
A safe and simple technique for exchanging central venous catheters is herein described. Our technique is based on a modification of Seldinger's method, in which a new outer sheath is introduced over the previous catheter as a guidewire in order to simplify the exchange of central venous catheters. This technique can be successfully performed by new residents and can be applied to the exchange of clotted catheters.
Use of thrombolysis for acute myocardial infarction by general practitioners
Authors: Rule Simon , Brooksby Paul , Sanderson John 
Published: December 2008

Summary
The early administration of thrombolytic agents significantly reduces mortality following a myocardial infarct and ideally they could be given by general practitioners when the patient is first seen. However, the diagnosis of myocardial infarction in the early stages can be very difficult especially if an electrocardiogram is not available. This may limit the use of thrombolytic drugs by general practitioners. We assessed the accuracy of diagnosis in general practice by asking general practitioners referring patients with chest pain, the likelihood that the event was due to a myocardial infarction and if they would use thrombolysis if it were available. Diagnostic accuracy and appropriate use of thrombolysis was analysed retrospectively, comparing the general practitioner with the admitting hospital doctor. One hundred consecutive patients were studied. The general practitioners accurately diagnosed myocardial infarctions in approximately 45% of cases and would have given thrombolysis inappropriately on 67% of occasions mainly because the final diagnosis in most of these patients was unstable angina rather than infarction. The hospital doctors administered streptokinase inappropriately to 33% of the patients and four had complications during treatment. Of those patients receiving thrombolysis, the average time delay from the general practitioner referring the patient to hospital to the patient being treated was 107 minutes.
This study confirms that the diagnosis of myocardial infarction in the early stages is difficult and that thrombolytic therapy may be given inappropriately (mainly to patients with unstable angina). We conclude that until the accuracy of diagnosis of myocardial infarction can be improved in general practice it would seem inappropriate for thrombolysis to be given in the community at the moment.
Ischaemic complications of graduated compression stockings in the treatment of deep venous thrombosis
Authors: Merrett Neil D , Hanel Kevin C 
Published: December 2008

Summary
Graduated compression stockings are frequently used in the prevention of deep venous thrombosis and the treatment of venous insufficiency. Two patients are discussed who sustained ischaemic complications after application of graduated compression stockings. Review of the literature demonstrates that low cutaneous pressures significantly decrease local blood flow and that the amount of pressure exerted by graduated compression stockings increases significantly with increases in leg girth. Ischaemic complications associated with the use of these stockings also appears to be more common than previously thought and any policy of routine prescription to patients should be questioned.
Left ventricular wall thickness and disease duration in systemic sclerosis
Authors: Hegedüs Ida , Czirják László 
Published: December 2008

SummaryMyocardial thickness, left ventricular functions, and right heart overloading were investigated in 80 patients with systemic sclerosis by echocardiography. Based on the left ventricular wall thickness, three groups were formed. Fifteen patients with asymmetrical left ventricular wall hypertrophy (Group 1) showed shorter mean disease duration with marked diastolic and mild systolic left ventricular functional impairment. The 25 patients with wall thinning (Group 3) had a slight increase in left ventricular diameters, impaired systolic functions and longer disease duration. Group 2 with wall thickness exhibited mixed changes. Patients with increased wall thickness tended to have a shorter disease duration than patients with wall thinning. Patients with systemic sclerosis showed systolic and diastolic function impairment as compared to the 18 control healthy individuals. Pericardial disease was found in 23 cases (28.7%).
Recurrent anaemia due to ischaemic colonic ulceration caused by cholesterol embolism
Authors: Grant David J , Sanders D S A , McMurdo Marion E T , Lyall M H 
Published: December 2008

Summary
We describe an elderly patient with generalized atherosclerosis who presented with recurrent iron-deficiency anaemia. He underwent right hemicolectomy which revealed ischaemic colonic ulceration caused by cholesterol embolism. Surgery appeared to be curative. Cholesterol embolism should be considered as a possible cause of unexplained gastrointestinal blood loss in the elderly.
Clinic blood pressure measurements and blood pressure load in the diagnosis of hypertension
Authors: Lee D R , Sivakumaran P , Brown R 
Published: December 2008

Summary
We have retrospectively compared the blood pressure load derived from 24 hour ambulatory blood pressure monitoring in patients with all clinic blood pressure readings elevated with those with only some elevated pressures to establish whether clinic readings alone are good predictors of blood pressure status. Fifty-seven patients attending a district general hospital hypertension clinic who were not on anti-hypertensive treatment were selected.
Between two and six clinic readings were taken over a period of 1-6 months. Forty out of 57 patients had at least one clinic diastolic blood pressure reading of &lt; 90 mmHg and, of these, 14 (35%) had a high blood pressure load and 26 (65%) had a normal blood pressure load. Patients with all diastolic blood pressure readings &gt; 90 mmHg totalled 17 and of these 11 (65%) had high load and six (35%) had normal load. Patients with clinic diastolic blood pressure &gt; 90 mmHg were significantly more likely to be truly hypertensive on the basis of blood pressure load than if one or more clinic readings was below 90 mmHg (P &lt; 0.05). Diastolic pressures have some predictive power as to the blood pressure status defined by blood pressure load, but even consistently raised diastolic pressures do not necessarily indicate hypertension. Likewise one or more clinic diastolic blood pressure &lt; 90 mmHg does not assuredly indicate normotension. Twenty-four hour ambulatory blood pressure monitoring may have an increasingly important role in the assessment of hypertension.
Recurrent confusion and hypopituitarism
Authors: Gutowski N J , Heron J R 
Published: December 2008

Summary
Three women in late middle age had recurrent episodes of confusion which could not be explained solely on the basis of an associated infection. All three patients had latent hypopituitarism diagnosed on final presentation. Each patient had a previous history of a severe postpartum haemorrhage followed by two further pregnancies.
Experienced clinicians had not made a diagnosis of confusional episodes due to hypopituitary encephalopathy because the history was not immediately available in the confused patient, and the significance of deficient axillary and pubic hair was not given due emphasis.
Evaluation of a commercial enzyme-linked immunosorbent assay (ELISA) kit for serological diagnosis of Helicobacter pylori infection in a group of non-ulcer dyspepsia sufferers
Authors: Ching C K , Thompson S , Buxton C , Holgate C , Holmes G K T 
Published: December 2008

Summary
Helicobacter pylori infection of the stomach is associated with gastritis and peptic ulceration and may be causative. A noninvasive test for this organism might be useful in managing some patients with dyspepsia without the need for further investigation. We have evaluated a new commercially available serological test (Helico-G ELISA, Porton Cambridge, UK) for this infection to assess its diagnostic accuracy in a retrospective study of 115 patients with non-ulcer dyspepsia. Sixty-three of these patients (55%) were found to have H. pylori infection and gastritis on histology. A sensitivity of 81% and specificity of 90% were obtained. No significant fall in the antibody titres was found in a subgroup of 15 patients who were selected to complete a course of triple therapy despite significant improvement in their dyspepsia score and confirmed eradication of H. pylori organism in 80% of these patients. We conclude that the test has limited value in aiding clinical decision of managing patients with dyspepsia.
Patients with atherosclerotic renovascular disease presenting to a renal unit: an audit of outcome
Authors: Scoble J E , Sweny P , Stansby G , Hamilton G 
Published: December 2008

Summary
During a 6 year period 60 patients with atherosclerotic renovascular disease were followed by a single renal unit. Angiotensin converting enzyme inhibitors were being taken by 22% of patients at the time of diagnosis of the atherosclerotic renovascular disease. Intervention to revascularize renal tissue by surgery or angioplasty was performed in 32 patients. Revascularization was not undertaken because of unilateral disease, patient preference, poor operative risk or renal size. The mean age for the nonintervention group was 66.9 years and 63.4 years for the intervention group. Peripheral vascular, disease was common in both groups (96% nonintervention group versus 86% intervention group). There was a statistically significant difference in improvement in renal function in the intervention group (34.4% versus 10.7%) in spite of more patients being dialysis dependent in the intervention group (28.1% versus 14.3%). There was no statistically significant difference in survival between the two groups although the trend was for better survival in the group with intervention.
Patients presenting with impaired renal function and atherosclerotic renovascular disease can have useful improvement in renal function with revascularization without any detriment to survival.
Reversibility of myocardial dyskinaesia due to severe hypertension
Authors: Veen C , den Hartog F R , Verburgh C A , Dees A , de Leeuw P W 
Published: December 2008

Summary
Two cases of acute left ventricular failure associated with severe essential hypertension are presented. On admission echocardiography indicated severe dyskinaesia of all wall segments of the heart. Anti-hypertensive treatment resulted in significant improvement in clinical and echocardiographic findings.
Hypercalcaemia and multiple osteolytic lesions in childhood acute lymphoblastic leukaemia
Authors: Soni P N 
Published: December 2008

Summary
A 12 year old boy presenting with hypercalcaemia (calcium 3.25 mmol/l) and osteopaenia with multiple osteolytic lesions was found to have acute lymphoblastic leukaemia without lymph-adenopathy or organomegaly. Hypercalcaemia is a rare feature of acute leukaemia, but the patients previously described all show very similar characteristics, which were highlighted in this patient. These include age (10-20 years), severe osteolytic bone lesions, lymphoblastic leukaemia, and normal white cell count with absent or rare circulating blasts. Parathyroid hormone levels were normal in this patient, and response to induction therapy was good. This case demonstrates that acute lymphoblastic leukaemia may present in an atypical form without peripheral blasts but with hypercalcaemia and gross skeletal changes.
Microalbuminuria and coronary heart disease in non-diabetics
Authors: Buggy Donal , Feely John , Murphy John , O'Sullivan Cathal , Walsh Michael 
Published: December 2008

Summary
Microalbuminuria (or urinary albumin excretion rates (AER) above normal limits) is associated with coronary heart disease (CHD) particularly in diabetics. To determine the sensitivity and specificity of AER for CHD in a non-diabetic population we prospectively studied 115 consecutive patients undergoing coronary angiography and 66 undergoing exercise electrocardiography (ECG). There was no relationship between AER and the severity of CHD determined by angiography (Gensini-scored). While microalbuminuria (AER &gt; 20 micrograms/minute) was 91% specific it had low sensitivity (12%). Microalbuminuria is not a sensitive indicator of CHD in a non-diabetic population.
Serum soluble interleukin 2 receptor levels in anti-neutrophil cytoplasmic autoantibodies--positive systemic vasculitis
Authors: Lai Kar Neng , Lockwood C Martin 
Published: December 2008

Summary
Systemic vasculitis is characterized by the presence of autoantibodies to neutrophil cytoplasmic antigens (ANCA). The role of T-lymphocytes in systemic vasculitis remains uncertain. In the present study, we attempted to explore the role of T-lymphocytes in systemic vasculitis by measuring the serum soluble interleukin 2 receptor (sIL2R) levels in seven vasculitic patients and comparing the sequential measurements with the titres of ANCA which satisfactorily reflect the disease activity. The serum levels of both ANCA and sIL2R were elevated at clinical presentation. Contrary to ANCA, the serum sIL2R remained elevated in most patients despite clinical remission following immunosuppressive therapy.
These findings suggest that T-lymphocytes may be activated in the acute phase of the disease. The finding of elevated serum sIL2R levels in most patients during clinical remission indicates that it is not a good measure of the disease activity and tends to argue against the role of T-lymphocytes as a major effector mediating inflammatory injuries in systemic vasculitis.
Gastro-duodenal injury associated with intake of 100-325 mg aspirin daily
Authors: Oren Ran , Ligumsky Moshe , Lysy Joseph , Gonzales Julio , Zimmerman Joseph 
Published: December 2008

Summary
During the year 1991, 43 patients with upper gastrointestinal bleeding and one with severe epigastric pain associated with intake of non-steroidal anti-inflammatory drugs were admitted for emergency endoscopy to our unit. Fourteen patients (33%) had been treated with 100-325 mg aspirin daily, 11 of them for at least one year. The mean age of this group was 71. Only two patients had a previous history of peptic ulcer. Five patients used anticoagulants or antiplatelet drugs concomitantly with aspirin. The endoscopic diagnosis of the sources of bleeding was erosive gastritis in eight patients, gastric ulcer in four, duodenal ulcer in five and oesophageal ulcer in one. Our results support findings by other groups, showing that doses of aspirin as low as 75 mg daily should be used in the management of elderly patients with thrombo-embolic disease.
Cervical spondylotic myelopathy with occult foramen magnum meningioma--a case for MRI?
Authors: Chakravarty K , Scott D G I , Dick D , Visick J 
Published: December 2008

Summary
A fatal case of occult foramen magnum meningioma is described which presented with features of cervical myelopathy confirmed by cervical myelogram. Surgical decompression led to initial improvement followed by progressive deterioration and death. Postmortem examination revealed a 4 cm diameter foramen magnum meningioma. The dangers of using only standard radiographic investigations of the cervical cord are discussed.
Bartter's syndrome in two generations of an Irish family
Authors: Crowe P , Ahmad A , O'Byrne K , Cullen M J 
Published: December 2008

Summary
We report four cases of Bartter's syndrome in two consecutive generations of an Irish family. Diagnoses were made on the basis of characteristic clinical features, blood and urine biochemistry with additional evidence from renal biopsy in one case. The aetiology, treatment and inheritance of the syndrome are discussed.
Giant hydronephrosis masquerading as massive ascites
Authors: Singh N K , Jha B , Khanna R , Khanna N N 
Published: December 2008

Summary
A case of unilateral giant hydronephrosis containing about 20 litres of old haemorrhagic fluid, clinically simulating massive ascites, is reported. The role of preceding abdominal trauma in the pathogenesis and the rapidity of the disease process is discussed.
Postpartum pain due to thrombosed varicose veins of the round ligament of the uterus
Authors: Al-Qudah Mohammed S 
Published: December 2008

Summary
Postpartum thrombosis of varicose veins of the round ligament may present in a clinical picture similar to an irreducible inguinal hernia. Two such unusual cases are reported. One patient underwent surgery while the other, with a presumptive diagnosis of the same condition, was observed, with no complications occurring in both patients. This condition has not to my knowledge been previously reported. The increased incidence of both varicose veins and thrombosis in the postpartum period should alert the physician to the diagnosis of such conditions.
Transient regional osteoporosis presenting as a septic arthritis
Authors: McAlindon T E , Ward S A , MacFarlane D , Mathews J A 
Published: December 2008

Summary
A 52 year old man developed a painful swollen left knee. Clinically there was an effusion and radiographs showed local osteoporosis. Sepsis was suspected but tests proved negative and the symptoms gradually settled. During the course of the following year he developed similar pain migrating from the left foot to the right knee then to the right foot. Investigations showed a right knee effusion and 'punctate' radiographic lucencies in the patellae thought to be erosions. A bone scan demonstrated increased uptake at all four sites and sepsis was once again suspected. Biopsies and culture proved negative and a computed tomographic scan confirmed that the lucencies were due to focal osteoporosis rather than erosions. This case of transient regional osteoporosis illustrates two unusual features of this condition which resulted in diagnostic difficulty with respect to sepsis.