bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of social factors on the control of asthma
Authors: Connolly C K , Chan N S , Prescott R J 
Published: December 2008

Summary
The relationships of pulmonary function with age, duration of asthma and social factors were studied in 630 asthmatics. Pulmonary function was assessed by peak flow rate at routine attendance (actual function). Persistence of obstruction was demonstrated by a trial of corticosteroids where necessary. The best obtainable peak flow rate was recorded (maximum function). Unrelieved potentially reversible obstruction was assessed by actual/maximum function. Age and duration of asthma were directly associated with poor control of reversible wheeze as well as with persistent obstruction. In addition poor control of potentially reversible wheezè was related to lower social class, current cigarette smoking and lack of central heating. Persistent obstruction was related to life time amount smoked, passive smoking and lack of central heating.
Lead encephalopathy from an imported Toby mug
Authors: Zuckerman M A , Savory D , Rayman G 
Published: December 2008

Summary
Encephalopathy is an unusual manifestation of lead poisoning in an adult, the more common presentation being abdominal colic, anaemia and limb palsy.
We report a case of adult lead encephalopathy and describe the use of a simple screening test for lead poisoning together with the increasing number of cases associated with imported ceramics.
Fatal torsade de pointes following jaundice in a patient treated with disopyramide
Authors: Schattner A , Gindin J , Geltner D 
Published: December 2008

Summary
A case of fatal torsade de pointes in a 53 year old patient treated with disopyramide is described. The arrhythmia followed the development of acute hepatocellular dysfunction and may have been due to failure of the liver to efficiently degrade the drug to its metabolites.
Carotid body disease and the physician--chronic carotid glomitis
Authors: Heath D , Khan Q , Nash J , Smith P 
Published: December 2008

Summary
There are three types of histological change in the carotid bodies which appear to have physiological and clinical associations. A prominence of the dark variant of chief cells with their contents of met-enkephalin and other peptides appears to be associated with acute exposure to hypoxia. Proliferation of sustentacular cells around the clusters of chief cells appears to be related to ageing and also to systemic hypertension.
Recently we have described a new condition of chronic carotid glomitis which is characterized by follicles of lymphocytes and may have a basis in auto-immunity. In the present review we report for the first time plasma cell activity in the carotid bodies of an elderly man, especially around nerve fibrils and unmyelinated axons ensheathed in sustentacular cells. Such appearances are consistent with the view that ageing nerve fibrils may be the antigenic stimulus for the development of chronic carotid glomitis.
The effects of low dose intravenous 99-126 atrial natriuretic factor infusion in patients with chronic renal failure
Authors: Woolf A S , Mansell M A , Hoffbrand B I , Cohen S L , Moult P J A 
Published: December 2008

Summary
The aim was to study the renal and hormonal effects of intravenous 99-126 atrial natriuretic factor (ANF) infusion in a mixed group of patients who had moderate to severe chronic renal failure (CRF) and who were not treated with dialysis. The peak mean plasma level of ANF achieved during the experiment was at the upper limit of an absolute range of basal values previously recorded in a larger group of patients with similar degrees of renal impairment. A significant tissue effect was confirmed by rises in plasma and urinary cyclic guanosine monophosphate, the ‘second-messenger’ of ANF. ANF infusion increased sodium excretion rate by a mean of 68% compared with a fall of 40% in a placebo group, and significant increases in urinary albumin excretion occurred during the peptide infusion. Thus, the high levels of plasma ANF found in CRF may have a role in the maintenance of sodium balance. In addition, the proteinuric effect may be detrimental to long-term renal function.
Lack of effect of spironolactone on hair shaft diameter in hirsute females
Authors: McLellan A R , Rentoul J , MacKie R , McInnes G T 
Published: December 2008

Summary
Because of its anti-androgenic activity spironolactone 50-200 mg daily is advocated widely for the management of female hirsutism but this practice lacks adequately controlled experimental support. In a double-blind placebo controlled study of the efficacy of spironolactone 100 mg daily in idiopathic hirsutism we were unable to demonstrate objective benefit from spironolactone treatment. The mean effect of spironolactone given over a 9 month period was to increase hair shaft diameter by +15% with 95% CI (-0.4% to +29%). In addition there were no changes in circulating serum androgen concentrations.
Tumours of the pancreas as a sequel to abdominal irradiation
Authors: Rokkas T , Palmer T J , Sladen G E 
Published: December 2008

Summary
Two cases of tumours arising in or near the pancreatic head are reported in patients previously treated with abdominal irradiation for testicular tumours. These are only the third and fourth such cases to be reported and they suggest that second cancers may develop as a result of abdominal irradiation for malignant disease.
Hyperammonaemic coma in ureterosigmoid urinary diversion
Authors: Oliver R M , Talbot S , Raman G V 
Published: December 2008

Summary
We report on a patient with ureterosigmoid anastomosis, who presented with recurrent episodes of confusion, agitation and aggressive behaviour, culminating in coma. Investigations revealed profound hyperammonaemia, which responded to treatment with sodium benzoate and sodium phenylacetate. No definite cause was found for the abnormality, apart from possible urinary tract infection. The patient remains well on a protein restricted diet with mildly elevated levels of plasma ammonia.
Yield of the admission complete blood count in medical inpatients
Authors: Mozes B , Haimi-Cohen Y , Halkin H 
Published: December 2008

Summary
The clinical efficacy of routine admission complete blood count was evaluated in 302 patients admitted to internal medicine wards of a university teaching hospital. Patient medical problems, physical findings and medication history were evaluated by preset criteria to determine the proportion of tests performed for screening and the proportion of test results directly influencing patient management. Of the 282 complete blood counts performed, 80% were ordered routinely with no medical indications (screening tests). An haemoglobin abnormality was found in 16.7% of the patients, leucocyte abnormality in 16.1% and platelet abnormality in 4.6%. However, these results directly influenced patient management in only one case (0.14%). It is concluded that the utility of screening admission complete blood counts in medical inpatients is negligible.
Strychnine poisoning as an unusual cause of convulsions
Authors: Burn D J , Tomson C R V , Seviour J , Dale G 
Published: December 2008

Summary
A fatal case of strychnine poisoning is presented. The patient vomited then suffered a series of tonic convulsions which were triggered by tactile stimulation. In between paroxysms he was initially alert. Eventually the patient became comatosed due to anoxia and had a cardiac arrest. He presented with a marked metabolic acidosis and rapidly developed renal failure caused by acute rhabdomyolysis. This clinical picture is classical for strychnine poisoning and the complications which the intoxication produces. Attention is drawn to the fact that survival can even follow the ingestion of very large doses of strychnine providing there is no delay in diagnosis and treatment.
Painless giant cell thyroiditis
Authors: Piazza I , Girardi A 
Published: December 2008

Summary
We describe an atypical case of subacute thyroiditis affecting a 50 year old patient with long lasting fever, weight loss, malaise and a high erythrocyte sedimentation rate. Cytological examination of the thyroid gland showed the classic granulomas with giant cells. However, the patient had neither painful enlargement of the gland nor thyrotoxicosis. This case, as well as others previously described, probably represents a new subtype of subacute thyroiditis, painless giant cell thyroiditis. The presence of painless giant cell thyroiditis should be considered in any patient with undiagnosed pyrexia, weight loss and elevated ESR.
Goodpasture’s syndrome in a patient with two endocrine tumours
Authors: McMahon R F T , Lawler W , O’Donoghue D J , Ballardie F W 
Published: December 2008

Summary
We describe the occurrence of two anatomically separate and histologically distinct endocrine tumours of bronchus and pancreas in a 64 year old woman with biopsy and serology proven Goodpasture’s syndrome. The association between anti-glomerular basement membrane antibody disease and multiple endocrine tumours has not been reported previously; possible pathogenetic mechanisms are discussed.
The Vogt-Koyanagi-Harada syndrome: association with hypothyroidism and diabetes mellitus
Authors: Jaggarao N , Voth D , Jacobsen J 
Published: December 2008

Summary
A 45 year old Saudi male with poliosis, alopecia areata, vitiligo, anterior uveitis, inflammatory changes in the posterior pole of the retina and paraparesis presented with features of the Vogt-Koyanagi-Harada syndrome, uncontrolled diabetes mellitus and hypothyroidism. To the best of our knowledge the association of diabetes mellitus and hypothyroidism in this syndrome has not been reported previously.
Simultaneous occurrence of systemic lupus erythematosus and coeliac disease-like features
Authors: Varkel Y , Braester A , Suprun H , Nusem D , Horn Y 
Published: December 2008

Summary
Involvement of the gastrointestinal tract in systemic lupus erythematosus is well documented but small intestinal malabsorption is a rare event. We report a 27 year old woman with systemic lupus erythematosus who had malabsorption and coeliac-like changes on intestinal biopsy. This is the eighth reported case of this association the significance of which is discussed.
The association between sequential changes in serum antineuronal antibodies and neuropsychiatric systemic lupus erythematosus
Authors: Hanly J G , Behmann S , Denburg S D , Carbotte R M , Denburg J A 
Published: December 2008

Summary
To determine the significance of changes in serum antineuronal antibody levels in systemic lupus erythematosus, 9 patients who had a rise and 11 patients who had a fall in neuronal antibody titre over a mean duration of 2.1 years (range 0.25-5.2) were identified. These changes were examined in the light of concurrent changes in other serological variables, overall disease activity, neuropsychiatric disease and neuropsychological tests.
Changes in antineuronal antibodies were frequently associated with concurrent changes in anti-DNA antibodies and overall disease activity. When neuropsychiatric disease or cognitive dysfunction were present, their course showed a close correlation with changes in antineuronal antibody levels. The results support the association between antineuronal antibodies and neuropsychiatric-systemic lupus erythematosus, but suggest that their measurement will provide useful information of disease status in only a subpopulation of patients.
Proximal motor neuropathy, IgA paraproteinaemia and anti-myelin-associated glycoprotein reactivity
Authors: Hemachudha T , Phanuphak P , Phanthumchinda K , Kasempimolporn S 
Published: December 2008

Summary
We report a case with proximal motor neuropathy associated with benign IgA lambda paraproteinaemia. Immunoblot demonstrated reactivity to myelin-associated glycoprotein and not to P2 protein of peripheral nerve. Dramatic improvement of the polyneuropathy was observed with steroid treatment alone within 4 weeks.
Bacterial calcification in infective endocarditis
Authors: Poller D N , Curry A , Ganguli L A , Routledge R C 
Published: December 2008

Summary
The present report is the first description to our knowledge of a clinical case of bacterial calcification in human infective endocarditic vegetations. Partial calcification of bacteria within vegetations may be a further mechanism of bacterial protection from host defences and antibiotics. Similar calcification has recently been reported in vegetations formed on porcine valvular prostheses implanted experimentally in sheep.
Pneumococcal Waterhouse-Friderichsen syndrome despite a normal spleen
Authors: Bramley P N , Shah P , Williams D J , Losowsky M S 
Published: December 2008

Summary
A previously fit 56 year old female presented with a rapidly progressive and fatal pneumococcal septicaemia with disseminated intravascular coagulation. Post-mortem studies confirmed a Waterhouse-Friderichsen syndrome and revealed an anatomically normal spleen; intracellular diplococci were seen within splenic macrophages providing evidence of normal splenic function. This appears to be only the second case of Waterhouse-Friderichsen syndrome due to pneumococcal septicaemia in a patient with a normal spleen.
Axillary artery occlusion as a presenting feature of Crohn’s disease
Authors: Sheehan-Dare R A , Goodfield M J D , Wilson P D , Rowell N R 
Published: December 2008

Summary
A 20 year old Caucasian woman with Crohn’s disease is described in whom axillary artery occlusion due to arteritis dominated the clinical picture. This case demonstrates that isolated large vessel arteritis can be an unusual feature of Crohn’s disease. Crohn’s disease should be considered in any patient presenting with a large vessel arteritis.
Central hypoventilation in a seven year old child following pertussis treated with negative pressure ventilation
Authors: Russell-Jones D L , Treacher D F , Lenicker H M , Tashanov M , Spencer G T 
Published: December 2008

Summary
We report the case of a 7 year old girl who developed central hypoventilation following pertussis and who was treated by negative pressure ventilation using a new portable tank respirator. We believe this is the first reported case of central hypoventilation following pertussis successfully treated by intermittent negative pressure ventilation.
Cardiac tamponade complicating leukaemia: immediate chemotherapy or pericardiocentesis?
Authors: Leung W H , Tai Y T , Lau C P , Wong C K , Cheng C H , Chan T K 
Published: December 2008

Summary
Although leukaemic infiltration of the pericardium is frequently observed at post-mortem, clinically evident cardiac tamponade is rare. Two cases of cardiac tamponade complicating leukaemia are presented. One patient had cardiac tamponade as the initial presentation of acute lymphoblastic leukaemia and experienced complete resolution of the pericardial effusion within 6 days after chemotherapy without therapeutic pericardiocentesis. The other patient with chronic myeloid leukaemia developed cardiac tamponade requiring pericardiocentesis as the first sign of acute blastic transformation. The roles of early chemotherapy and pericardiocentesis in managing this complication are discussed.
Dyskinesia in the elderly presenting as respiratory disorder
Authors: Godlee F N , Brooks D J , Impallomeni M 
Published: December 2008

Summary
Two elderly women suffering from dyskinesia affecting the respiratory muscles are described. The diagnosis was initially missed in both cases, and thought to be anxiety syndrome in one patient, and chronic obstructive airways disease in the other. Drug therapy further increased the severity of the dyskinetic movements which greatly improved when it was discontinued. Dyskinesia should be considered as the cause of respiratory disorder in old age, especially when this develops slowly in patients with movement disorders and a history of taking antidopaminergic drugs.
Acute organic brain syndrome due to drug-induced eosinophilia
Authors: Ng S C , Lee M K , Teh A 
Published: December 2008

Summary
A 72 year old man developed acute organic brain syndrome associated with marked eosinophilia following self medication with a variety of drugs. Investigations revealed no other known causes of eosinophilia. Withdrawal of drugs resulted in dramatic drop in eosinophil count paralleled by clinical resolution of neurological problems. To our knowledge drug-induced eosinophilia has not previously been associated with acute organic brain syndrome.
Conn’s syndrome due to an ectopic adrenal adenoma
Authors: Arnold J , Mitchell A 
Published: December 2008

Summary
A 31 year old woman presented with resistant hypertension. Investigations revealed that she had Conn’s syndrome. Computed tomography showed both adrenals to be normal but an ectopic adenoma was identified posterior to the stomach. Surgical excision of the tumor confirmed benign aldosteronoma and cured her hypertension. We believe this to be the first report of Conn’s syndrome caused by an ectopic adrenal adenoma.
The metabolic effects of fatal cyanide poisoning
Authors: Singh B M , Coles N , Lewis P , Braithwaite R A , Nattrass M , FitzGerald M G 
Published: December 2008

Summary
Metabolic and toxicological data were obtained during the first 24 hours following severe and eventually fatal cyanide poisoning. Initial blood cyanide concentrations were 804 mumol/l but fell rapidly over 24 hours following cobalt edetate therapy to 15 mumol/l. However, plasma thiocyanate concentrations rose over 24 hours (147-267 mumol/l) suggesting continued tissue detoxification. The major metabolic abnormality was lactic acidosis (initial pH 7.21, blood lactate 17.5 mmol/l) which corrected over 12 hours. Despite high circulating insulin concentrations the responses of blood glucose, plasma non-esterified fatty acid, blood glycerol and 3-hydroxybutyrate suggested marked insulin resistance.
Malignant fibrous histiocytoma of the mediastinum
Authors: Aggarwal P , Sharma S K , Dey A B , Chattopadhyay T K , Mathur M 
Published: December 2008

Summary
A case of malignant fibrous histiocytoma of the mediastinum presenting with unusual features of fever and leucocytosis is reported. This is the youngest patient reported in the literature who had this tumour in the mediastinum.
Amitriptyline overdose complicated by intestinal pseudo-obstruction and caecal perforation
Authors: McMahon A J 
Published: December 2008

Summary
I report a case of intestinal pseudo-obstruction, spontaneous caecal perforation and faecal peritonitis caused by an overdose of amitriptyline. This rare but serious complication should be borne in mind in patients who remain constipated while convalescing after self-poisoning with tricyclic antidepressants.
Acetonitrile ingestion: delayed onset of cyanide poisoning due to concurrent ingestion of acetone
Authors: Boggild M D , Peck R W , Tomson C R V 
Published: December 2008

Summary
A fatal case of acetonitrile ingestion is reported. The patient presented having apparently taken an overdose but was well until around 24 hours after the supposed ingestion, when cardiovascular collapse and profound metabolic acidosis developed. Later investigation revealed that the patient had taken acetone and acetonitrile. Acetone is known to slow the metabolism of acetonitrile to cyanide, thereby delaying the appearance of toxicity.
Vagal nerve schwannoma—a new diagnostic sign
Authors: Morrissey M S C , Sellars S L 
Published: December 2008

Summary
A case of vagal nerve schwannoma with a new physical sign is presented. The tumour was largely cystic and aspiration, performed twice, immediately elicited a cough reflex from the patient.
Treatment was by total excision and the patient made a good recovery. Complete cystic degeneration of a vagal nerve schwannoma is uncommon. A search of the literature has failed to find any previous reports of fine needle aspiration causing a cough reflex in these tumours.
Acute renal failure associated with a labetalol overdose
Authors: Korzets A , Danby P , Edmunds M E , Feehally J , Walls J 
Published: December 2008

Summary
A case of acute renal failure in association with a deliberate labetalol overdose is described. The possible pathogenetic mechanisms behind the deterioration in renal function are discussed. Treatment of beta-blockade overdose, with special emphasis on the place of glucagon in such poisoning, is reviewed.
Long term treatment of myasthenia gravis with azathioprine
Authors: Fonseca V , Havard C W H 
Published: December 2008

Summary
Twenty-seven patients with myasthenia gravis have been treated with azathioprine in conjunction with pyridostigmine and prednisolone for a total of 138 patient years. Side effects necessitated discontinuation of treatment in only four patients. Treatment with azathioprine was associated with marked clinical improvement in all the remaining 23 patients, resulting in reduction in the dose of pyridostigmine and prednisolone. The number of hospital admissions as well as the number of episodes of respiratory failure were markedly reduced.
Adverse effects of captopril in hospital outpatients with hypertension
Authors: Walley T , Winstanley P , Roberts D , Grimmer M , Orme M , Breckenridge A 
Published: December 2008

Summary
Hypertensive patients prescribed captopril while attending a hospital hypertension clinic were studied, to identify the benefits of the drug, its adverse effects and factors predisposing to them. One hundred and eighty two patients were followed for a mean of 18 months; 24 received captopril alone, and 158 combinations of captopril and other antihypertensive drugs, especially loop diuretics (91/158), or thiazide diuretics (57/158), or other vasodilators (57/158). The mean final dose of captopril was 67 mg/day.
Blood pressure (BP) was effectively controlled in 73% of patients (mean fall in systolic BP 29 mmHg, CI 24 to 34, P ≤ 0.001; mean fall in diastolic BP 18 mmHg, CI 16 to 20, P ≤ 0.001). Blood urea and creatinine rose slightly in all patients (urea by 0.9 mmol/l [13%], CI 0.5–1.3, P ≤ 0.001 and creatinine by 9 mumols/l [8%], CI 4–13, P ≤ 0.001). Twenty six patients were withdrawn from captopril therapy: 6 because of poor control of their blood pressure, two because it was no longer necessary and 12 (7.7%) because of extrarenal adverse effects—10 for rashes, one each for gastric upset and impotence. Captopril was withdrawn in a further 6 patients, because of deteriorating renal function. Factors discriminating those at risk of renal dysfunction were high doses of captopril, concomitant high dose diuretic therapy and undiagnosed renovascular disease.
Solitary cerebral metastasis from a papillary carcinoma of the thyroid
Authors: Goolden A W G , Mclaughlin J E , Valentine A R , Pease C 
Published: December 2008

Summary
A woman aged 52 was treated with radioactive iodine for a papillary carcinoma of the thyroid. Four years later she developed signs and symptoms of an intracranial space occupying lesion. A computed tomographic scan showed a mass in the right posterior frontal region. Although she was suspected of having metastatic disease a definite diagnosis was not established until she died 6 months later when post-mortem examination confirmed that she had a cerebral metastasis from a papillary carcinoma of the thyroid. There was no evidence of metastatic disease elsewhere in the body.
Cerebral metastases from papillary carcinoma of the thyroid are uncommon but may occur in patients who have metastases in bones or lungs. A search of the literature has revealed only two patients with solitary cerebral metastases.