bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood eosinophilia and ulcerative colitis—influence of ethnic origin
Authors: Benfield G F A , Asquith P 
Published: December 2008

Summary
Blood eosinophilia is an alleged manifestation of ulcerative colitis. To investigate this association and to determine the effect of race, the occurrence of eosinophilia in all 44 Asians presenting between 1968–84 was compared to that in an age- and sex-matched group of indigenous white Caucasian patients presenting over the same period. Nineteen (43%) of the Asians presented with an eosinophilia compared to only 3 Caucasians (P &lt; 0.0001); similar numbers (14 and 13) in both groups demonstrating transient eosinophilia on occasions during maintenance treatment although not related to clinical relapse. A control group of Asians with other disorders not known to be associated with eosinophilia did not manifest this abnormality on presentation although 3 patients did so transiently during out-patient observation.
Eosinophilia is a feature of ulcerative colitis in many Asians possibly due either to an unusual racial response to ulcerative colitis or as a reflection of the underlying pathogenesis of their disease. We have not confirmed earlier suggestions of such a feature in white Caucasians. Eosinophilia occurring during maintenance treatment in both groups may be drug-related.
Primary hepatocellular carcinoma presenting as fulminant hepatic failure in a young woman
Authors: Levy L J , Swinburne L M , Boulton R P , Losowsky M S 
Published: December 2008

Summary
A 29 year old Caucasian female, with no history of chronic liver disease, presented with fulminant hepatic failure, the cause of which was not established until post-mortem when it was found that she had a rare form of hepatocellular carcinoma. To our knowledge, this is the only detailed report of hepatocellular carcinoma presenting in this manner.
Anorexia nervosa and pancreatic ascites
Authors: Isaacs P , Saunders A J , Rosen B K , Sladen G E 
Published: December 2008

Summary
Acute alcoholic pancreatitis was undiagnosed in a patient with anorexia nervosa who subsequently developed pancreatic ascites and oedema, wrongly attributed to protein malnutrition alone. She became hyperphagic in an attempt to reverse the malnutrition and hence the abdominal swelling, indicating that the goal of attaining a thin shape was the major determinant of the eating disorder in this patient.
Measurement of ascitic fluid amylase concentration should be carried out in all patients with unexplained ascites.
Failure of conventional chemotherapy in aggressive lymphomas
Authors: Cunningham D , Hepplestone A , Gilchrist N L , Dagg J H , Evans I L , Soukop M 
Published: December 2008

Summary
Between 1975 and 1982 in 2 centres in Glasgow, 53 previously untreated patients with aggressive non-Hodgkin’s lymphomas received chemotherapy consisting of one of the following regimens-CVP, MOPP, CHOP or BACOP. Twenty nine patients (55%) entered complete remission (CR), 20 (38%) had partial remission (PR) and 4 (7%) had progressive disease (PD). Of the 29 patients in CR, 9 have relapsed and died, 5 died of infection, 4 died of non-malignant causes, and 11 (21%) remain alive and disease free. The median survival for the CR group is 40 months. All of the patients in the PR and PD group are dead, median survival 11 months.
These chemotherapy regimens will cure only the minority of patients with aggressive lymphomas and the use of more intensive regimens is indicated.
Post-traumatic diabetes insipidus combined with primary polydipsia
Authors: Labib M , McPhate G , Marks V 
Published: December 2008

Summary
We describe a case of diabetes insipidus after head injury in which thirst persisted despite treatment with DDAVP and normal plasma osmolality. Symptoms were only completely relieved when plasma osmolality was below 270 mosmol/kg. We believe that this might have been due to hypothalamic injury causing resetting of the thirst osmostat. To our knowledge, this type of primary polydipsia has not been described before in association with diabetes insipidus following head injury.
Blood lactate changes during exercise at high altitude
Authors: Binns N , Wright A D , Singh B M , Coote J H , Bradwell A R 
Published: December 2008

Summary
Blood lactate concentrations were measured in 18 normal subjects at the end of an exercise test designed to maintain heart rate at 85% of maximum for 15 minutes. Blood lactate concentrations were reduced at high altitude (4846 m) and correlated positively with basal pH and negatively with basal Pa,O2 levels. Blood lactate concentrations tended to be lower in those subjects on acetazolamide but were not correlated with the severity of acute mountain sickness or with the workload of the exercise test. We conclude that the pH changes are probably the most significant factor in reducing lactate concentrations.
Macrocytic anaemia due to copper deficiency in a patient with late onset hypogammaglobulinaemia
Authors: Oppenheimer S M , Hoffbrand B I , Dormandy T L , Parker N , Wickens D G 
Published: December 2008

SummaryVery few cases of acquired severe copper deficiency have been described. The principal effects are haematological, but the precise abnormalities are uncertain due to the possible association of other deficiencies. A case of isolated severe copper deficiency associated with late onset hypogammaglobulinaemia is reported in which the chief findings were macrocytic anaemia, neutropenia and a decrease in mean platelet volume. All these abnormalities resolved when copper therapy was instituted and recurred when the medication was stopped.
Acute post-streptococcal glomerulonephritis followed shortly by acute rheumatic fever
Authors: Kwong Y L , Chan K W , Chan M K 
Published: December 2008

Summary
A 16 year old girl with post-streptococcal glomerulonephritis developed acute rheumatic fever 19 days afterwards. Previous publications on concurrent post-streptococcal glomerulonephritis and acute rheumatic fever are reviewed.
‘Neutropenia’ in black west Indians
Authors: Zezulka A V , Gill J S , Beevers D G 
Published: December 2008

Summary
A prospective case control study routine haematological parameters was conducted in 294 healthy Black and White age/sex-matched subjects. The most important finding relevant to clinical practice was a reduction of total white cell count in Blacks due mainly to reduced neutrophil numbers. Twenty-one percent of sickle negative Blacks had white cell counts below the lowest value seen in Whites. The haemoglobin concentration, erythrocyte mean cell volume and monocyte count were also significantly lower amongst Blacks though lymphocyte counts were higher. The racial differences in haemoglobin and white count were not accounted for by differences in smoking and drinking habits. They were also found when Blacks with sickle cell trait were compared to age/sex-matched Whites and in others taking the oral contraceptive pill. Awareness of racial group should aid interpretation of routine tests and avoid unnecessary investigation of normal ‘neutropenic’ Blacks.
Primary pulmonary artery sarcoma: intra-operative similarity to pulmonary embolus
Authors: Berg G A , Hamid B N A , Kenyon W E , Drakeley M J 
Published: December 2008

Summary
An infarcted right lower lobe, thought to be due to a thrombotic pulmonary embolus, was resected in a 48 year old man. Subsequent examination of the lobe unexpectedly showed the infarction to be secondary to a primary sarcoma of the pulmonary artery.
Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur
Authors: Goh K L , Wong N W , Paramsothy M , Nojeg M , Somasundaram K 
Published: December 2008

Summary
We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded.
The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics.
Benylin dependence, metabolic acidosis and hyperglycaemia
Authors: MacRury S , Neilson R , Goodwin K 
Published: December 2008

Summary
We describe a patient who had consumed large quantities of a proprietary cough mixture containing diphenhydramine, ammonium chloride and sodium citrate (Benylin expectorant) daily for several months and subsequently presented with confusion, marked metabolic acidosis and non-ketotic hyperglycaemia.
Ulcerative colitis in Asian immigrants
Authors: Benfield G F A , Montgomery R D , Asquith P 
Published: December 2008

Summary
Forty-four Asian immigrants in Birmingham and 44 age- and sex-matched white Caucasians with ulcerative colitis were compared to investigate the existence of any ethnic differences in the pattern of disease. Asian immigrants demonstrated a male preponderance of 2:1, and compared to the matched Caucasians there was a higher incidence of presenting eosinophilia and a milder course of disease, with more patients experiencing only a single initial attack. In spite of this clinical difference, total or subtotal colitis was the commonest pathological type in both white Caucasians and Indians, whereas in Pakistanis localized distal disease predominated. All ethnic groups suffered the same overall complication rate (55%) which is at variance with the experience of low complication rates in India. The age of onset of ulcerative colitis was related to age at immigration with a mean interval of 11 years.
Although in some respects Asian immigrants share the disease pattern of the indigenous population, the observed significant differences could be of importance with regard to pathogenesis.
Hypomagnesaemia causing myopathy and hypocalcaemia in an alcoholic
Authors: Pall H S , Williams A C , Heath D A , Sheppard M , Wilson R 
Published: December 2008

Summary
A well-nourished alcoholic patient developed a subacute myopathy which responded rapidly to correction of severe hypomagnesaemia. The finding of profound hypocalcaemia prompted the measurement of serum magnesium. Magnesium deficiency should be looked for in any alcoholic patient with a myopathy as the prognosis seems better than in many other forms of alcoholic myopathy. Correction of the magnesium deficiency corrects the hypocalcaemia without the need for calcium supplementation.
Recurrent ureteric obstruction in association with Henoch-Schönlein purpura
Authors: Powell J M , Ware H , Williams G 
Published: December 2008

Summary
The most common urological manifestation of Henoch-Schönlein purpura is focal proliferative glomerulonephritis. Ureteric obstruction as a consequence of the disease has been reported in children but is rare. We report an adult male patient with Henoch-Schönlein purpura causing unilateral, bi-focal, recurrent ureteric obstruction.
We speculate that ureteric involvement in Henoch-Schönlein purpura may be more common than hitherto suspected and that even with a demonstrable obstructive episode, consideration must be given for an initial conservative approach.
Raised parathyroid hormone levels in the milk alkali syndrome: an appropriate response?
Authors: Bullimore D W , Miloszewski K J 
Published: December 2008

Summary
A case of the ‘milk alkali syndrome’ associated with grossly elevated levels of amino terminal parathyroid hormone is described. The hypercalcaemia (calcium 4.09 mmol/l) and hyperparathyroidism settled on conservative measures. Factors in the milk alkali syndrome which might stimulate the release of parathyroid hormone include parathyroid gland hyperplasia secondary to suppression of ionized calcium, alteration in sensitivity of calcium receptors on the cells of the parathyroid glands, the stimulation of an intermittent alkaline tide in the blood and the high intake of phosphate and bicarbonate. We suggest that high levels of parathyroid hormone in the milk alkali syndrome may be appropriate rather than paradoxical.
Lung cancer, immune thrombocytopenia and the lupus inhibitor
Authors: Kozlowski C L , Johnson M J , Gorst D W , Willey R F 
Published: December 2008

SummaryThis case report describes the simultaneous occurrence of autoimmune thrombocytopenia and the lupus anticoagulant in a patient with primary adenocarcinoma of the bronchus. Treatment with corticosteroids and plasmapheresis resulted in a return to normal of the partial thromboplastin time and the disappearance of the platelet antibodies. The carcinoma was inoperable.
Pregnancy and alpha-1 antitrypsin deficiency
Authors: Atkinson A R 
Published: December 2008

Summary
A 29 year old patient with alpha-1 antitrypsin deficiency and bullous emphysema became pregnant against the advice of her physicians. Despite a mid-trimester pneumothorax requiring the insertion of a chest tube, she went on to deliver a healthy child under epidural anaesthesia using a midforceps technique. Vaginal delivery is not necessarily contra-indicated in multiparous patients with bullous emphysema.
The effective evaluation of thyroid status in patients on phenytoin, carbamazepine or sodium valproate attending an epilepsy clinic
Authors: Connacher A A , Borsey D Q , Browning M C K , Davidson D L W , Jung R T 
Published: December 2008

Summary
To assess the most efficient means of monitoring thyroid status in an epilepsy clinic, total thyroxine (T4), free thyroxine stimulating hormone (TSH) were measured in 71 adult patients treated long-term with either phenytoin (DPH), carbamazepine (CBZ) or sodium valproate (VAL). Twenty-seven patients with one or more abnormal thyroid hormone results were further investigated by a thyrotrophin releasing hormone (TRH) test and clinical assessment. T4 was found to be normal in 85% on VAL, 40% on CBZ and 39% on DPH. FT4 was normal in more patients, namely 95% on VAL, 70% on CBZ and 65% on DPH. The TRH tests indicated that FT4 was the most efficient screening test for hypothyroidism in this epileptic population. We estimate that the use of FT4 alone as a screening test would have reduced by 60% the number of TRH tests required.
Management and outcome of infective prepatellar bursitis
Authors: Wilson-MacDonald J 
Published: December 2008

Summary
Forty seven cases of prepatellar bursitis are reported. Twenty one patients had sustained a recent injury with a break in the skin which had caused the infection and seventeen patients were employed in jobs which involved kneeling. Oral antibiotics proved to be inadequate treatment in many cases. Splintage and intravenous antibiotics with or without aspiration of the bursa were usually successful in treating the condition, although nine patients required surgical drainage of the bursa. Twelve patients continued to have symptoms months or years after the infection, particularly those with preexisting chronic bursitis, or those who kneeled at work. There was little difference in the results between the different treatment groups.
Cretinism and lingual thyroid presenting in an adult
Authors: Yeung V T F , Loong E P L , Cockram C S 
Published: December 2008

Summary
A 29 year old woman presented with menorrhagia secondary to hypothyroidism. Subsequent investigation confirmed the presence of a lingual thyroid. Features of cretinism were present despite the late presentation. This unusual case is discussed with reference to previous publications.
Common iliac artery aneurysm presenting as acute sciatic nerve compression
Authors: Mohan S R , Grimley R P 
Published: December 2008

Summary
Aneurysms of the iliac arteries usually remain silent, but when they rupture the consequences can be dramatic. They produce few clinical signs suggestive of their presence. However, such aneurysms have been found to be the cause of non-vascular clinical situations. Often they present with features of compression on adjacent viscera. We present a case in which a large common iliac artery aneurysm was found to be causing symptoms of acute sciatic nerve compression.
Coagulation abnormalities in patients with eosinophilia
Authors: Vázquez J J , Fernández Pavón A , Arnalich F , Gil A , López Pastor A , García Muñoz M S , Peña J M , Barbado F J 
Published: December 2008

SummaryHaematological variables in patients with eosinophilia and in healthy control subjects were studied in order to determine whether there were abnormalities in the coagulation system in patients. We found significantly elevated levels of fibrinogen, fibrin degradation products, platelet number and beta-thromboglobulin in patients. The abnormalities were not related to the causes of eosinophilia nor to its severity. This lack of correlation could be due to the heterogeneity of human peripheral blood eosinophils.
Is serodiagnosis of herpes simplex encephalitis safe?
Authors: Coghlan J G , Monaghan C , Carney P A , Moran J H 
Published: December 2008

Summary
We present a case of probable tuberculous meningitis in which serological changes ‘diagnostic’ of herpes simplex encephalitis were found. Evidence is provided that the serological changes in this case represent a true false positive, and that reliance on clinical plus serological criteria to diagnose herpes simplex encephalitis could result in failure to diagnose and treat tuberculous meningitis.
Clostridium difficile colitis following treatment with metronidazole and vancomycin
Authors: Bingley P J , Harding G M 
Published: December 2008

Summary
A 25 year old woman developed Clostridium difficile colitis following a course of vancomycin and metronidazole prescribed for pelvic inflammatory disease. The condition resolved after treatment with vancomycin given alone. Colitis following this combination of antibiotics has not been described previously.
Spontaneous intraperitoneal rupture of a neurogenic bladder; the importance of ascitic fluid urea and electrolytes in diagnosis
Authors: Ramcharan K , Poon-King T M W , Indar R 
Published: December 2008

Summary
Spontaneous intraperitoneal bladder rupture in a 38 year old man with a spastic paraparesis since infancy is described. Delayed diagnosis resulted in peritoneal autodialysis so providing an opportunity for documentation of biochemical abnormalities. Surgery resulted in a successful outcome. The literature on this rare condition is outlined and difficulties in diagnosis are discussed. The diagnostic value of urea and electrolyte levels in ascitic fluid is emphasized.
Routine practice in the diagnosis of adenocarcinoma of the stomach: a survey of tumours diagnosed in the Portsmouth and Oxford Health Districts 1979–1980.
Authors: Deakin M , Colin-Jones D G , Vessey M P 
Published: December 2008

Summary
If the poor prognosis for patients with adenocarcinoma of the stomach is to be improved, it is important to make the diagnosis at an early stage. In order to evaluate our routine diagnostic practice, we have performed a retrospective study of patients in the Portsmouth and Oxford Health Districts who were diagnosed as having adenocarcinoma of the stomach during 1979 and 1980. Three hundred and forty-two patients were identified; the great majority had advanced disease at the first presentation. Only 9 patients (2.6%) were identified as having early gastric carcinoma and a total of 46 patients (13.4%) had either Stage 1 or 2 disease. Despite the provision of an endoscopy service, gastric carcinoma is still being diagnosed at an advanced stage. Initial false negative investigations caused a delay in diagnosis in 18.4% of patients. During the year preceding diagnosis (when tumour was likely to have been present), the false negative rate for barium meal examination was 25.5% and for endoscopy 13.5%. Negative results should not deter us from pursuing the diagnosis of tumour in those patients with persisting symptoms.
Acquired common variable hypogammaglobulinaemia and lymphoedema
Authors: Lozewicz S , Morris G , Garbett N , Browse N , Slavin B , Cole P 
Published: December 2008

Summary
Two patients with lymphoedema of the legs developed recurrent respiratory infections and were found to have panhypogammaglobulinaemia. The early recognition and treatment of this form of immunity deficiency in patients with lymphoedema is important in order to prevent recurrent infections which could cause pulmonary damage and further lymphatic stasis.
Covert inhalation of tablet causing fatal pneumonia
Authors: Hill S N , Main A N H , Fuggle W J 
Published: December 2008

Summary
Inhalation of foreign bodies is usually associated with acute respiratory symptoms. We report a case of an elderly woman who died from pneumonia due to covert tablet inhalation. Clinicians caring for the elderly should consider this as a possible cause for pneumonia which fails to respond to usual therapy.
Non-Hodgkin’s lymphoma of bone causing avascular necrosis of the femoral head
Authors: Renowden S , Fitzgerald E J , Kemp A M 
Published: December 2008

Summary
A 14 year old boy presented with a painful hip, initially attributed to Perthes’ disease although it is uncommon in teenagers. Subsequent investigation showed that the underlying pathology was non-Hodgkin’s lymphoma.
Iron deficiency in pernicious anaemia: a neglected diagnosis
Authors: Atrah H I , Davidson R J L 
Published: December 2008

Summary
In 114 patients (52 males and 62 females) with long-standing pernicious anaemia, hypoferritinaemia was found in 27 (23.7%) and hypochromic microcytic anaemia in 19 (16.6%). Our findings indicate that iron deficiency is a common yet neglected complication of long-standing pernicious anaemia and warrants greater diagnostic and therapeutic attention.
Prolongation of the QT interval by ketanserin
Authors: Cameron H A , Waller P C , Ramsay L E 
Published: December 2008

Summary
In hypertensive patients single doses of ketanserin 40 mg prolonged the corrected QT interval (QTc) for at least 8 hours, with a maximal increase of 35 ms (P less than 0.001, n = 6) after 2 hours. During chronic dosing (20 and 40 mg b.d.) the QTc was further prolonged, by 46 and 45 ms respectively. QTc prolongation after treatment with a mean dose of 73 mg/day for 7 weeks (n = 26) was significantly related to body weight (r = -0.58, P less than 0.01), and to the dose of ketanserin corrected for body weight (r = 0.63, P less than 0.01), but not to plasma concentrations of ketanserin, ketanserinol, potassium or calcium. High doses of ketanserin (mean dose 167 mg/day, n = 9) increased the QTc by 40 ms (P less than 0.001), with prolongation of up to 80 ms in individual patients. Treatment with ketanserin at doses proposed for clinical use (40-80 mg/day) may carry a risk of ventricular arrhythmias.