bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesenteric desmoid tumours in Gardner’s syndrome--review of medical treatments
Authors: Eagel B A , Zentler-Munro P , Smith I E 
Published: December 2008

Summary
Gardner’s syndrome comprises a triad of polyposis coli, osteomata and soft tissue tumours including desmoid tumours which can often present difficult problems in management. We report a patient with Gardner’s syndrome treated with tamoxifen and medroxyprogesterone acetate. The literature on this rare syndrome and its management is reviewed.
Xanthogranulomatous cholecystitis associated with carcinoma of the gallbladder
Authors: Benbow E W 
Published: December 2008

Summary
When the histological material from 35 examples of carcinoma of the gallbladder was reviewed, three specimens were found to show xanthogranulomatous cholecystitis as well as the tumour, suggesting that these two lesions are associated with each other. This is important because xanthogranulomatous cholecystitis can mimic carcinoma, and there is potential for diagnostic confusion.
Use of adrenal arterial embolization in severe ACTH-dependent Cushing’s syndrome
Authors: Blunt S B , Pirmohamed M , Chatterjee V K K , Burrin J M , Allison D J , Joplin G F 
Published: December 2008

Summary
The management of a patient with severe Cushing’s syndrome due to ectopic ACTH produced by a medullary carcinoma of the thyroid is described. Initial treatment with maximal adrenolytic medical therapy and two attempts at bilateral adrenal venous infarction had failed to control the disease, and she was at that time unfit for surgery. Subsequent use of bilateral adrenal arterial embolization enabled medical therapy to produce sufficient control of the Cushing’s syndrome to allow bilateral adrenalectomy to be performed successfully, with resultant cure of the excessive cortisol production.
Myocardial abscess and sternal osteomyelitis following myocardial infarction and resuscitation
Authors: Smith R E A , Martin J E , Mills P G 
Published: December 2008

Summary
A 58 year old man presented with an anterior myocardial infarction requiring repeated resuscitation. He had impaired glucose tolerance. He died five weeks later and post-mortem examination revealed a myocardial abscess and sternal osteomyelitis due to Staphylococcus aureus. These had not been apparent clinically. The possible aetiology and difficulties in diagnosis are discussed.
Ilioinguinal nerve entrapment: a little-known cause of iliac fossa pain
Authors: Knockaert D C , D’Heygere F G , Bobbaers H J 
Published: December 2008

Summary
The ilioinguinal nerve entrapment syndrome is an abdominal muscular pain syndrome, characterized by the clinical triad of muscular type iliac fossa pain with a characteristic radiation pattern, an altered sensory perception in the ilioinguinal nerve cutaneous innervation area, and a well-circumscribed trigger point medial and below the anterosuperior iliac spine. Relief of pain by infiltration of a local anaesthetic confirms the diagnosis.
This report describes retrospectively the clinical picture of ilioinguinal nerve entrapment in 32 mainly non-surgical patients. In 14 cases a definite diagnosis was established and in 18 patients the diagnosis was considered probable. The mean delay in diagnosis was 12.8 months. Better knowledge of this syndrome may avoid invasive investigations and be cost saving.
Alveolar proteinosis and nocardiosis: a patient treated by bronchopulmonary lavage
Authors: Pascual J , Gómez Aguinaga M A , Vidal R , Maudes A , Sureda A , Gómez Mampaso E , Fogué L 
Published: December 2008

Summary
Alveolar proteinosis is a relatively rare disease of unclear pathogenesis associated with opportunistic-infections. Although nocardiosis is the most frequent one, only 22 cases have been reported previously and are reviewed here.
We present a patient with alveolar proteinosis with nocardiosis treated as an emergency with bilateral bronchopulmonary lavage and antibiotics. No previous cases of this association have been successfully managed in this way.
Pancreatic pseudocyst haemorrhage presenting as a bleeding duodenal ulcer
Authors: Muckart D J J , Bade P 
Published: December 2008

Summary
We present a case of upper gastrointestinal haemorrhage where the preoperative endoscopic findings suggested a duodenal ulcer as the cause. Although at operation this proved to be the site of bleeding, the source was found to be the splenic artery in the base of a pancreatic pseudocyst.
Localized fibrous mesothelioma of the mediastinum devoid of pleural connections
Authors: Balassiano M , Reichert N , Rosenman Y , Hertcheg E , Lieberman Y , Yellin A 
Published: December 2008

Summary
Localized fibrous mesothelioma of the pleura is an uncommon neoplasm. Very rarely (there have been three previous cases) it may occur as an isolated mediastinal tumour. Such a tumour was present for at least 3 years in a 47 year old man, causing shortness of breath and superior vena cava syndrome. A mass weighing over 600 g was completely resected through a median sternotomy. The pertinent literature is reviewed.
Duodenal pseudotumour: a silent impacted common bile duct calculus
Authors: Finch P J , Haddock J , Grundy A 
Published: December 2008

Summary
We report the case of a man with mild dyspeptic symptoms referred for barium meal, who was initially thought to have a duodenal tumour. Subsequent investigation showed this to be a pseudotumour caused by impaction of a gallstone in the distal common bile duct, and endoscopic sphincterotomy effected a cure. This readily treatable condition should be remembered when filling defects are demonstrated in the duodenal loop.
Renal tubular function in hyperparathyroidism
Authors: van’t Hoff W , Bicknell E J 
Published: December 2008

Summary
Renal tubular function was assessed in a group of patients with mild hyperparathyroidism before and after a mean period of 2.7 years conservative management. It was also assessed, before and after a mean of 3.3 years following surgery in a group of patients with initially higher plasma calcium concentration.
Mean maximum urine osmolality was within the accepted range as was the maximum urine plasma hydrogen ion gradient in both groups at the time of diagnosis.
No significant change in renal tubular function was observed in either group over the periods of this study. Although deterioration after a long period cannot be excluded, we do not consider that regular assessment of renal tubular function is necessary in the conservative management of primary hyperparathyroidism.
Pulmonary embolism--incidence and prognosis in hospitalized elderly
Authors: Mangion D M 
Published: December 2008

Summary
In a retrospective study of 210 patients with pulmonary embolism diagnosed by ventilation perfusion lung scan or at post-mortem, the incidence of pulmonary embolism was greater in patients over 50 years old (1.4%; P less than 0.05). This was largely due to an increased prevalence of serious associated disease (53%; P less than 0.05).
Mortality in elderly patients (70 years and older) diagnosed by ventilation perfusion lung scan was similar to that in younger age groups (P greater than 0.05). However, the number of cases first diagnosed at post-mortem (44.50%; P less than 0.05) and total mortality (55%; P less than 0.05) were highest in this age group. Of elderly patients first diagnosed at post-mortem 14 (32%; P less than 0.05) had no other associated disease and had a recorded duration of symptoms sufficient to have allowed premortem diagnosis.
Comparison of chlortenoxicam and indomethacin on frusemide-induced diuresis
Authors: Hitoglou-Makedou A , Lawson M , Turner P , Ferber H P 
Published: December 2008

Summary
A single oral dose of chlortenoxicam 4 mg, a new non-steroidal anti-inflammatory drug, significantly antagonized the diuretic and natriuretic actions of frusemide when compared with placebo in normal human volunteers. Indomethacin 50 mg significantly reduced the natriuretic, but not diuretic action of frusemide.
A thrilling case of hiatus hernia
Authors: Gleadle J , Dennis M 
Published: December 2008

Summary
A 65 year old woman was found to have a left parasternal heave and a systolic murmur associated with a thrill. A chest radiograph, echocardiogram and gastrograffin swallow demonstrated a massive obstructed hiatus hernia which displaced the heart anteriorly. Aspiration of the contents of the hernia led to complete resolution of the physical signs. Possible mechanisms for their production are discussed.
The anti-phospholipid antibody syndrome in a 77 year old man with digital gangrene
Authors: Roche S W , Niriella D C , O’Mahoney A , Cayley A C D 
Published: December 2008

Summary
A 77 year old man with digital gangrene of his left hand had anti-phospholipid antibodies, the lupus anticoagulant and antcardiolipin antibodies. This patient, as far as we are aware, is the first elderly person to present in such fashion with this uncommon syndrome.
Syndrome of downward gaze paralysis, amnesia and hypersomnolence
Authors: Nagaratnam N , Ghougassian D F , Mugridge V 
Published: December 2008

Summary
A 60 year old woman with computed tomographic-verified bilateral thalamic infarction is described. She demonstrated downward gaze paralysis, amnesia and hypersomnolence. On the functional level such tasks as walking and eating were disconcerting. Although there have been only a few reports of the complete triad it may be more common than realized and represents a distinct syndrome that can be identified by the bedside.
Danazol-induced hypercalcaemia in alphacalcidol-treated hypoparathyroidism
Authors: Hepburn N C , Abdul-Aziz L A S , Whiteoak R 
Published: December 2008

Summary
We report a case of idiopathic hypoparathyroidism, maintained on alphacalcidol who developed hypercalcaemia during treatment with danazol for endometriosis.
Pulmonary infiltrates--diagnostic problems in lymphoma
Authors: Campbell J H , Raina V , Banham S W , Cunningham D , Soukop M 
Published: December 2008

Summary
The use of invasive investigations in immunocompromised patients with pulmonary infiltrates is controversial. We report a series of 22 pulmonary lesions occurring in 19 patients with underlying Hodgkin’s (7) and non-Hodgkin’s (12) lymphoma in whom invasive investigations were performed. The principle techniques used were fibreoptic bronchoscopy, bronchoalveolar lavage and transbronchial lung biopsy. A specific diagnosis was made on 12 occasions (55%). Involvement of the lung with lymphoma (6) and cytotoxic drug induced pneumonitis (4) were the commonest diagnoses, infection being found on only one occasion. In 15 of these 22 procedures (68%) the information obtained made a positive contribution to patient management.
Metastatic non-seminomatous germ cell tumour and dermatomyositis
Authors: Barker R A , Currie D C , Horwich A , Spiro S G 
Published: December 2008

Summary
Twenty to thirty percent of cases of dermatomyositis in adults are associated with malignancy. We report a case in which dermatomyositis heralded the development of a testicular germ cell tumour. Germ cell testicular tumours are treatable and our case emphasizes the importance of measuring blood levels of beta-human chorionic gonadotrophin and alpha-fetoprotein and examination of the testes in young males with indications of possible malignancy.
Spontaneous benign pneumoperitoneum complicating scleroderma in the absence of pneumatosis cystoides intestinalis
Authors: London N J M , Bailey R G , Hall A W 
Published: December 2008

Summary
We describe a 64 year old woman with a 3-year history of scleroderma who presented as an emergency with increasing painless abdominal distention. Radiological investigations revealed a pneumoperitoneum in the absence of either visceral perforation or pneumatosis cystoides intestinalis. This is only the fourth report of spontaneous benign pneumoperitoneum complicating scleroderma without pneumatosis cystoides intestinalis. The possible aetiology of this condition is discussed.
Survival after ultrasonographic demonstration of portal venous gas due to mesenteric artery occlusion
Authors: Bloom R A , Lebensart P D , Levy P , Craciun E , Anner H , Manny J 
Published: December 2008

Summary
Portal vein gas as a result of bowel necrosis following occlusion of the superior mesenteric artery has an extremely grave prognosis. Only two previous cases have been recorded as having survived. In both those cases the diagnosis of portal vein gas was made on an abdominal radiograph. The present report is of the first such case surviving after ultrasonic demonstration of portal gas. In this case, no evidence of portal gas was seen on the abdominal radiograph. The increased sensitivity of ultrasound over plain radiography mandates urgent liver and portal ultrasound in all cases of suspected mesenteric event.
Neurosarcoidosis: therapeutic success with methotrexate
Authors: Soriano F G , Caramelli P , Nitrini R , Rocha A S 
Published: December 2008

Summary
Sarcoidosis affects the nervous system in 5% of cases. Treatment with corticosteroids is usually effective. We describe the case of a patient with neurosarcoidosis in which therapy with prednisone failed whereas the result of methotrexate administration was satisfactory.
A study of serum zinc, albumin, alpha-2-macroglobulin and transferrin levels in acute and long stay elderly hospital patients
Authors: Craig G M , Evans S J , Brayshaw B J , Raina S K 
Published: December 2008

Summary
Serum zinc levels measured by atomic absorption spectrophotometry were found to be low (less than 10.5 mumols/l) in 38% of acute geriatric admissions, 69% of long stay geriatric patients and 19% of a control group of elderly hospital patients with a normal serum albumin.
There was a significant positive correlation between serum zinc and serum albumin in all groups. In acutely ill geriatric patients only, there was a weak but statistically significant positive correlation between serum zinc and alpha-2-macroglobulin (A2M) (r = 0.20), P &lt; 0.05).
Serum transferrin was low in 46% of acute geriatric patients and 22% of long stay geriatric patients but there was no correlation between serum zinc and serum transferrin levels in any patient group. There were significant differences in serum zinc, A2M and transferrin levels between the acute and long stay geriatric patients. The differences in serum zinc levels between these patients groups could not be explained by changes in serum A2M, transferrin or albumin. Changes mediated by an acute phase response may have influenced results in the acute geriatric group of patients.
Accidental self administration of xylazine in a veterinary nurse
Authors: Samanta A , Roffe C , Woods K L 
Published: December 2008

Summary
A 19 year old male veterinary nurse accidentally injected himself with 200 mg of xylazine (a muscle relaxant and sedative used in veterinary practice). He subsequently became comatose, hypotensive, bradycardic and acidotic. He required intensive supportive therapy, and made a full recovery over the next few hours.
Xylazine toxicity in humans is very rare, and the effects are discussed.
Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism
Authors: Fennerty A G , Shetty H G M , Paton D , Roberts G , Routledge P A , Campbell I A 
Published: December 2008

Summary
The presenting features of 250 consecutive patients who underwent a ventilation/perfusion lung scan for suspected pulmonary embolus (PE) were analysed. Ninety-six patients had lung scans highly suggestive of PE, with one or more unmatched segmental perfusion defects (scan positive), 86 had low probability scans (scan negative) and 68 an indeterminate scan.
Scan positive patients were more likely to have a PaO2 of less than 10.7 kPa, an elevated P(A-a)O2 and an abnormal chest X-ray compared with scan negative patients but these measurements were of poor specificity. Furthermore, scan-positive patients had a higher incidence of lung disease. Localized chest wall tenderness was more common in scan-positive patients, occurring in 9% of patients, but there were no other significant differences in individual symptoms, signs or electrocardiographic findings between scan-positive and scan-negative patients.
The diagnosis of PE should not be made on clinical grounds alone and all patients suspected of having a PE should at least undergo isotope lung scanning.
Leaking thoraco-abdominal aortic aneurysm presenting with a massive left haemothorax: a clinical trap
Authors: Huddy S P J , Joyce W P , Pepper J R 
Published: December 2008

Summary
A case is described in which a patient, who had had an aortic aneurysm repair 10 years previously, presented with a thoraco-abdominal aortic aneurysm which ruptured immediately above the previous graft. The implications for the management of patients with an abdominal aortic aneurysm repair are discussed.
Irradiation-induced penile angiosarcoma
Authors: Prescott R J , Mainwaring A R 
Published: December 2008

Summary
We report a case of angiosarcoma of the glans penis in a 77 year old male Caucasian. The tumour developed 18 years after a course of radiotherapy for a penile ulcer which was an intra-epidermal squamous carcinoma. The differential diagnosis and the concept of radiotherapy-induced angiosarcomas are discussed.
A controlled trial of a low sodium, low fat, high fibre diet in treated hypertensive patients: the efficacy of multiple dietary intervention
Authors: Little P , Girling G , Hasler A , Trafford A , Craven A 
Published: December 2008

Summary
An 8-week combination low sodium, low fat, high fibre diet was compared to the individual components of this diet in a controlled trial using 193 patients already on treatment for essential hypertension. No significant changes were observed in the high fibre group. The low sodium group showed a decrease in systolic blood pressure which was close to significance. The low fat group showed a small but significant decrease in seated diastolic blood pressure and weight. The combination group showed larger and highly significant decreases in seated and standing systolic blood pressures, seated diastolic blood pressure and weight, as well as a significant reduction in standing diastolic blood pressure.
We conclude that multiple dietary intervention in this case in the form of a low sodium, low fat, high fibre diet, is more effective than any single dietary intervention and is useful in patients already on medication.
Failure of thiazide diuretics to increase plasma calcium in mild primary hyperparathyroidism
Authors: Farquhar C W , Spathis G S , Barron J L , Levin G E 
Published: December 2008

Summary
Thirteen patients with mild primary hyperparathyroidism who were taking thiazide diuretics intermittently for periods of up to 18 months were followed up for a mean of 5.3 years. No significant difference was found in either plasma total calcium corrected for albumin or whole blood ionized calcium in these patients between the periods on or off thiazides.
We conclude that thiazide diuretics are not contraindicated in such patients.
Relationship of urinary pH to symptoms of ‘cystitis’
Authors: Brumfitt W , Hamilton-Miller J M T , Cooper J , Raeburn A 
Published: December 2008

Summary
The pH of urine samples from patients suffering symptoms suggesting urinary infection (e.g. dysuria, frequency, urgency) was measured while the patients were symptomatic and again when they had become asymptomatic. There was no correlation between the urine pH and the incidence or number of symptoms. No differences were observed between either the distribution or means of urine pH values in symptomatic and asymptomatic patients. There were also no significant differences in either symptomatology or urine pH between patients with significant bacteriuria and those without significant bacteriuria. These results cast doubt upon the traditional (but unproved) belief that alkalinizing the urine helps to reduce symptoms of dysuria and/or frequency, whether or not associated with urinary infection.
Clinical hyperthyroidism due to non-neoplastic inappropriate thyrotrophin secretion
Authors: Chan A W , MacFarlane I A , van Heyningen C , Foy P M 
Published: December 2008

Summary
We report a case of hyperthyroidism due to inappropriate thyrotrophin (TSH) secretion in a patient with selective pituitary resistance to thyroid hormone action. Symptoms of hyperthyroidism in patients with this disorder are usually mild, implying some peripheral tissue resistance to the metabolic effects of thyroid hormone. Our patient had unusually severe symptoms, including marked weight loss and cardiac arrythmias which required carbimazole and beta-blocker therapy for control. Somatostatin was ineffective in suppressing TSH secretion. The introduction of sensitive thyrotrophin assays should facilitate the accurate diagnosis of TSH-induced hyperthyroidism and avoid inappropriate treatment.
Psoas abscess as a complication of subclavian venous catheterization
Authors: Kwok T , Coles J 
Published: December 2008

Summary
A 76 year old woman developed a psoas abscess from vascular seeding of an infected subclavian venous catheter. The presentation was insidious and diagnosis delayed. Despite adequate surgical drainage, the case proved to be fatal. Venous catheters should be regarded as a potential source of septicaemia and occult abscess formation.
Torsion of an accessory spleen in an elderly patient
Authors: Hems T E J , Bellringer J F 
Published: December 2008

Summary
Torsion of an accessory spleen is recognized as a rare cause of acute abdominal pain in childhood. A case is reported which, however, is unusual in that it occurred in a patient of 75, who had had no previous symptoms which might have suggested the presence of an accessory spleen.
Spontaneous pyelo-jejunal fistula
Authors: Evans P F 
Published: December 2008

Summary
This case report describes a patient with a spontaneous jejunal fistula. This is a rare type of nephro-intestinal fistula with only two previously recorded similar cases.
Our patient presented with such a fistula diagnosed by antegrade pyelography, associated with a staghorn calculus and proven at surgery. The value of antegrade pyelography is discussed along with the treatment options and the outcome to be expected in such patients.
Aperistaltic oesophageal disorders unmasked by severe post-fundoplication dysphagia
Authors: O'Brien C J , Collins J S A , Collins B J , McGuigan J 
Published: December 2008

Summary
Two patients were referred because of persistent dysphagia which developed for the first time after Nissen fundoplication. Investigations, including oesophageal manometry, demonstrated the presence of achalasia in one case, confirmed histologically, and aperistaltic oesophagus associated with an underlying connective tissue disorder in the other case. Our observations highlight the importance of assessing oesophageal motility before referring patients for anti-reflux surgery and illustrate the effect of such surgery on patients in whom oesophageal dysmotility was not suspected.
Infective arthritis secondary to bladder outflow obstruction
Authors: Ubhi S S , Cooke T J C 
Published: December 2008

Summary
We describe two cases of septic arthritis occurring in association with lower urinary tract infection in elderly men. In both cases the organism isolated from both the joint and the urine was Staphylococcus aureus. Further investigation of the urinary tract in both individuals identified bladder outflow obstruction secondary to benign prostatic hyperplasia predisposing them to infection.
The urinary tract should be suspected as a focus of infection in septic arthritis in elderly men and further investigation of the urinary system may disclose a surgically correctable lesion.