bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-partum thyroiditis can be painful
Authors: Othman S , Parkes A B , Richards C J , Hall R , Lazarus J H 
Published: December 2008

Summary
A patient with post-partum thyroiditis is described. She was a 22 year old with a negative family history of autoimmune thyroid disease who was noted to have a high titre of antithyroid microsomal antibody during pregnancy. She developed mild hyperthyroidism 8 weeks post-partum but at 12 weeks she had a mildly painful enlarged thyroid gland. At 20 weeks post-partum she had severe thyroidal pain with dysphagia. The thyroid was exquisitely tender to palpation. She was treated with L-thyroxine and the pain resolved within 4 weeks. This is the first report documenting pain in the thyroid as a feature of post-partum thyroiditis.
First degree atrioventricular block associated with right atrial myxoma
Authors: Roberts D H , Ramsdale D R 
Published: December 2008

Summary
First degree atrioventricular block occurred in a 68 year old man with a large right atrial myxoma. This conduction abnormality resolved within three months of successful surgical removal of the tumour. It is suggested that mechanical compression by the myxoma on either the underlying conduction tissue or the interventricular septum is likely to have caused this phenomenon.
Community defibrillation in the Scottish Highlands
Authors: Jones M C , Kerr F , Eckersley A P R 
Published: December 2008

Summary
Prompt defibrillation after cardiac arrest is necessary to save life. Inexpensive systems providing defibrillation facilities in the community of the Highlands have been devised, one for Inverness town practices, and one for rural practices. Both systems work by ‘blind’ defibrillation, once the clinical diagnosis of cardiac arrest is confirmed. Acute anti-arrhythmic drugs and intravenous infusions were not available. The systems functioned satisfactorily with general acceptance by the general practices concerned.
The natural history of euthyroid multinodular goitre
Authors: Elte J W F , Bussemaker J K , Haak A 
Published: December 2008

SummaryIn this communication data on the natural history of euthyroid multinodular goitres are presented. From a total group of 140 patients (mean age 54.6 years, 14 men and 126 women; 88 with autonomous, 52 with non-autonomous function), follow-up data were available for 90 patients (mean age 54.0 years, 11 men and 79 women; 64 with autonomous, 26 with non-autonomous function). During follow-up (means: 5.0 years, maximum 12.2 years) transitions in function were seen 15 times; 8 autonomous patients became hyperthyroid after &lt; 1–7 years. There were 6 transitions from non-autonomy to autonomy and 1 from autonomy to non-autonomy. One patient who demonstrated the whole cycle from non-autonomy through autonomy up to hyperthyrodism is described in more detail. In one patient operated upon because of hyperparathyroidism a follicular carcinoma was found by chance. Mechanical problems were the reason for surgery in 6 patients only, 16 patients were operated upon because of cosmetic reasons (mostly in the early years of the study). Finally, results from 19 TRH tests in 16 autonomous patients suggest that TRH tests in patients with autonomously functioning euthyroid multinodular goitres are not yet redundant.
Does preoperative computed tomography scanning aid assessment of oesophageal carcinoma?
Authors: Kirk S J , Moorehead R J , McIlrath E , Gibbons J P , Spence R A J 
Published: December 2008

SummaryIn this study 50 patients (36 male, 14 female) with oesophageal carcinoma have been examined preoperatively by computed tomography. Three parameters were assessed, nodal involvement, invasion of adjacent organs, and metastatic disease. For all patients the computed tomography findings were correlated with the subsequent surgical and pathological findings. Sensitivity for both invasion and node involvement is low (36% to 67%). Specificity however, is high (85% to 95%). Computed tomography is therefore relatively reliable when it predicts a ‘negative result’ for either invasion or node involvement. However, its predictive value for a positive result is not as reliable.
Opportunistic Listeria pericardial effusion
Authors: Crellin A M , Shareef D S , Maher E J 
Published: December 2008

Summary
A case is described of pericardial effusion due to Listeria monocytogenes infection in a woman with advanced carcinoma of the cervix, rheumatoid arthritis and on corticosteroid therapy. Focal infection with listeria in immunocompromised adults has a high mortality unless promptly diagnosed. The correct diagnosis may have been made if an unexplained pericardial effusion had been tapped.
Left handedness in an identical twin discordant to his co-twin for handedness and schizophrenia, with neurological and psychometric evidence of left hemisphere damage
Authors: Weller M P I 
Published: December 2008

Summary
A left handed, monozygotic, male twin developed schizophrenia, whilst his right handed brother was free of psychopathology. There was no family history of mental illness or left handedness. The affected twin had left side motor weakness and an EEG showed scattered irregularities, particularly on the left. Psychometry indicated left sided tempero-parietal dysfunction. The relationship between left temporal lobe damage and schizophrenia is considered.
Repeated echocardiography: essential in the management of Staphylococcus aureus endocarditis
Authors: O'Sullivan J J , Aherne T , Erwin J 
Published: December 2008

Summary
Staphylococcus aureus endocarditis in a previously healthy 25 year old man is described. Repeated echocardiography recorded rapid progression of aortic root and interventricular septal involvement and, even though the patient was clinically stable, early surgery was advised with a satisfactory outcome. This case report clearly demonstrates the vital role of repeated cross-sectional echocardiography in the management of such cases.
Precipitation of hypercalcaemia in sarcoidosis by foreign sun holidays: report of four cases
Authors: Cronin C C , Dinneen S F , O'Mahony M S , Bredin C P , O'Sullivan D J 
Published: December 2008

Summary
Hypercalcaemia after foreign sun holidays in four patients is described. Although only one was a known case, all had sarcoidosis. The pathogenic mechanisms are discussed and the implications of excessive sun exposure for the mode of presentation and the management of sarcoidosis are highlighted.
The effective use of cardiac enzymes and electrocardiograms in the diagnosis of acute myocardial infarction in the elderly
Authors: Gama R , Swain D G , Nightingale P G , Buckley B M 
Published: December 2008

Summary
The diagnosis of acute myocardial infarction (AMI) in the elderly is difficult and often depends on the results of investigations. In a 3-month prospective study, 270 patients admitted to an acute geriatric unit were studied to determine the most effective diagnostic strategy for the diagnosis of AMI, and to assess the value of screening acute geriatric admissions for AMI.
Patients were assessed clinically and investigated with serial electrocardiograms and measurements of serum creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase activities on three consecutive days after admission.
Measurement of serum activity of CK and AST had a diagnostic sensitivity of 100% and specificity of 86.8% for AMI. This was the optimum combination of cardiac enzymes in the diagnosis of AMI. Although electrocardiograms on the first two days of admission had a low diagnostic sensitivity (33.3%) their usefulness was their high positive predictive value (100%) when characteristic of an AMI. AMI was considered in the differential diagnosis of 79 patients (29%). All 25 patients (9%) who had an AMI were in this group, and therefore screening all geriatric admissions for AMI is not clinically justified.
Severe haemolytic anaemia due to cold anti-‘i’ antibodies associated with cytomegalovirus infection
Authors: Aguado J M , Castrillo J M , Sanz J , Serrano J 
Published: December 2008

Summary
A 66 year old patient with multiple myeloma and monoclonal cryoglobulinaemia who developed a severe haemolytic anaemia following a cytomegalovirus infection is reported. The presence of a high titre of anti-‘i’ cold antibody of IgM subclass is demonstrated. Anti-‘i’ antibody disappeared when complement-fixation antibody titres against cytomegalovirus decreased. Various pathogenetic mechanisms involved in the development of haemolytic anaemia associated with cytomegalovirus infection are discussed. To our knowledge, this is the first case described in the English language publications associating severe haemolytic anaemia with an anti-‘i’ antibody after a cytomegalovirus infection in an immunocompromised patient.
Immunoblastic lymphoma presenting with syncope due to sinoatrial node disease
Authors: Dolan G , Jones A P , Reilly J T 
Published: December 2008

Summary
A 68 year old man presented with syncope associated with episodes of sinus arrest. He responded to insertion of a demand pacemaker. During investigation he was noted to have generalized lymphadenopathy and biopsy revealed that he had an immunoblastic lymphoma. Before further assessment could be made, he developed rapid atrial fibrillation, resistant to several anti-arrhythmic agents and died several days after admission. At autopsy a nodular plaque of lymphoma was found to overly the sinoatrial node which was markedly fibrosed with evidence of lymphomatous infiltration of the surrounding microvasculature.
Pancreatic carcinoma presenting as bleeding from segmental gastric varices: pitfalls in diagnosis
Authors: Mullan F J , McKelvey S T D 
Published: December 2008

Summary
Splenic vein occlusion leading to gastric variceal haemorrhage should be considered in cases of obscure upper gastrointestinal bleeding. We report an unusual case in which the underlying pathology was a resectable carcinoma of the pancreatic tail.
Efficacy of enalapril in essential hypertension and its comparison with atenolol
Authors: el Mangoush M , Singh N K , Kumar S , Basha A , Gupta B S , Bolya Y K , Gamati A 
Published: December 2008

Summary
The effect of enalapril was evaluated in 67 patients with essential hypertension, and its therapeutic efficacy was compared with atenolol in a placebo run-in, single-blind, cross-over trial. Enalapril significantly reduced blood pressure in all grades of essential hypertension. As monotherapy it ‘normalized’ blood pressure in 88%, 50% and 25% of patients with mild, moderate and severe hypertension respectively. Optimal dose for most of the patients was 20 to 40 mg/day. Comparison with atenolol revealed almost parallel efficacy of the two drugs, although enalapril produced a significantly greater reduction in systolic blood pressure in patients with mild and moderate hypertension (P &lt; 0.01 in each group). No serious side effects were encountered with either drug. Enalapril, therefore, has a potent and slightly superior antihypertensive effect to that of atenolol, and may be used as a ‘first-step’ drug in the treatment of hypertensive patients.
A gastrectomy population: 25–30 years on
Authors: Tovey F I , Godfrey J E , Lewin M R 
Published: December 2008

SummaryPrior to 1960 a Polya gastrectomy was the most frequent operation for duodenal ulcer. The majority of these patients now have reached the age of sixty or older. A prospective longitudinal study of a cohort of patients who underwent gastrectomy between 1955 and 1960 was undertaken. Twenty five to thirty years later the study has revealed the extent of the nutritional problems that may arise with the passage of time and shows that these numerically far outweigh the mechanical post-gastrectomy syndromes and weight loss which tended to dominate the earlier post-gastrectomy scene.By the end of the first decade, iron deficiency was the commonest nutritional problem. Vitamin B12 deficiency assumed more importance in the second decade. During the third decade both reached equal prevalence, being found in some 90% of the female and 70% of the male residual population. Vitamin D deficiency and early osteomalacia was a lesser problem, reaching its climax in the second decade. Evidence suggested a high incidence of osteoporosis and this requires further investigation. Overall, women fared worse than men with a higher and earlier incidence of iron deficiency, particularly in the pre-menopausal group.This study emphasizes the increasing need for regular screening of post-gastrectomy patients to detect early iron, vitamin B12 and vitamin D deficiencies as patients grow older.
The Employment Medical Advisory Service
Authors: Henderson R T S , Carter J T 
Published: December 2008

Summary
The historical development of the Employment Medical Advisory Service is described, and the Service's present organization is related to its range of activities, including its role as a source of information and advice on occupational health. The Employment Medical Advisory Service's influence on the development of occupational health practice, the collection of new knowledge and its adaptability in changing social and employment conditions is described, and examples of its work are given.
Non A, non B hepatitis in the aged
Authors: Sonnenblick M , Oren R , Tur-Kaspa R 
Published: December 2008

Summary
In order to study the clinical picture of non A, non B hepatitis in the elderly, a retrospective study was carried out in the two main hospitals in Jerusalem. Thirty-six patients with acute viral hepatitis, older than 65, have been hospitalized between the years 1982–1988. Seventy-two percent were diagnosed as non A, non B hepatitis. All patients were symptomatic and the main symptoms were abdominal pain, fever and jaundice. Thirty percent of the patients had marked cholestasis, while the disease was uneventful in 96% of the cases. Non A, non B hepatitis is the main type of viral hepatitis in the aged and should be suspected in patients with abdominal pain, fever and cholestasis.
Dipyridamole echocardiography: the bedside stress test for coronary artery disease
Authors: Buchalter M B , Bourke J P , Heads A , Hawkins T 
Published: December 2008

Summary
Identification of dipyridamole-induced regional wall motion abnormalities by echocardiography has recently been proposed as an alternative diagnostic stress test for coronary artery disease. This study evaluates this new technique by comparing the results obtained (overall, regionally and by abnormality type) with those of thallium-201 myocardial imaging after dipyridamole stress in 25 patients.
Acceptable echocardiograms were obtained in 20 patients (80%). Concordance of echocardiographic abnormalities for both overall and regional thallium abnormalities was 85%. Sensitivity, specificity and predictive value of dipyridamole echocardiography for overall and regional thallium defects were 92%, 71% and 85%, and 91%, 81% and 85% respectively. However, concordance between the two for abnormality type (i.e. ischaemia versus infarction) was only 66% and the sensitivity, specificity and predictive value of dipyridamole echocardiography for identifying ischaemia as opposed to infarction were only 43%, 82% and 63%, respectively.
There was substantial agreement between thallium and echocardiographic imaging after dipyridamole infusion in the diagnosis of coronary artery disease. Echocardiography appears less well able to distinguish infarction from active ischaemia. Dipyridamole echocardiography provides a highly versatile, noninvasive bedside stress test for the detection and localization of coronary artery disease.
Cerebellar syndrome with hydrocephalus due toMycoplasma pneumoniaeinfection
Authors: Coleman R J , Brown J S , Butler P , Swash M 
Published: December 2008

SummaryA 27 year old woman developed a cerebellar syndrome with serological evidence of recent Mycoplasma pneumoniae infection. The cranial computed tomographic scan showed effacement of the fourth ventricle, enhancement of the basal meninges and hydrocephalus affecting the lateral and third ventricles. Clinical and radiological recovery occurred over 5 weeks. We propose that this was a manifestation of immune-mediated encephalomyelitis induced by the infection rather than direct invasion of the central nervous system.
Mefenamic acid-induced neutropenia and renal failure in elderly females with hypothyroidism
Authors: Handa S I , Freestone S 
Published: December 2008

Summary
We report mefenamic acid-induced non-oliguric renal failure and severe neutropenia occurring simultaneously in two elderly females. The neutropenia was due to maturation arrest of the myeloid series in one patient. Both patients were also hypothyroid, but it is not clear whether this was a predisposing factor to the development of these adverse reactions. However, it would seem prudent not to use mefenamic acid in hypothyroid patients until the hypothyroidism has been corrected.
Economic evaluation of gastric ulcer prophylaxis in patients with arthritis receiving non-steroidal anti-inflammatory drugs
Authors: Knill-Jones R , Drummond M , Kohli H , Davies L 
Published: December 2008

Summary
This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with gastric ulcer recorded in the routine data was substantially less (4% Scotland, 10% West Midlands) than the 21% found at case review. These data were combined with cost and patient management data in a decision analysis model to explore whether prophylactic use of misoprostol altered substantially the average cost of managing gastric ulcer. Using conservative assumptions and a daily dose of 400 micrograms, cost savings per patient to the National Health Service of £5–£8 pounds over a 3-month period are expected in the groups of patients studied, while at the 800 micrograms dose there would be a net cost of £23–£25 pounds. Sensitivity analysis showed that under many assumptions misoprostol is expected to be cost saving or cost neutral.
Early diagnosis of Graves' optic neuropathy using visual evoked responses
Authors: Batch J A , Lepre F 
Published: December 2008

Summary
A 27 year old woman with Graves' disease developed progressive ophthalmopathy and was noted to have abnormal visual evoked responses (VER). She was treated with high dose prednisone with clinical improvement and return of the visual evoked responses to normal. On withdrawal of steroids symptoms recurred and VER again were abnormal. Orbital irradiation was given with improvement in the ophthalmopathy and VER again normalized. To our knowledge this report represents the first demonstration of improvement in VER with treatment in Graves' optic neuropathy.
Diagnostic aspiration of an iatrogenic hydrothorax following subclavian catheterization
Authors: Steiger M J , Morgan A G 
Published: December 2008

Summary
Central venous catheterization is not without hazard. Inadvertent placement in the pleural space can occur without the development of a pneumothorax and pressure measurements may appear misleadingly normal. This case report illustrates an effective method of diagnosing and draining an iatrogenic hydrothorax which resulted in this way.
Do non-steroidal anti-inflammatory drugs or smoking predispose to Helicobacter pylori infection?
Authors: Maxton D G , Srivastava E D , Whorwell P J , Jones D M 
Published: December 2008

Summary
Susceptibility to Helicobacter pylori infection is a poorly understood phenomenon. This study was undertaken to establish whether either smoking or chronic non-steroidal anti-inflammatory drug (NSAID) consumption might in some way predispose to H. pylori infection and hence lead to peptic ulceration. Serological evidence of H. pylori infection was assessed in 100 consecutive subjects receiving NSAIDs without any evidence of gastrointestinal upset and 100 matched controls. All subjects had a full assessment of their smoking habits. Sixty-three per cent of patients taking NSAIDs compared to 51% of controls had evidence of H. pylori infection (NS). Smoking habit also had no effect on H. pylori colonization. The ulcerogenic potential of NSAIDs and smoking does not appear to be mediated via a prediposition to H. pylori infection.
Whipple's disease with cerebral involvement
Authors: Robson D K , Faraj B B , Hamal P B , Ironside J W 
Published: December 2008

Summary
A case of Whipple's disease, initially presenting with abdominal symptoms and later with neurological manifestations, is reported. The diagnosis was not made in life, but on post-mortem examination of the brain. This case emphasizes the importance of early diagnosis and treatment of this uncommon disorder.
Erosive arthritis in relapsing polychondritis
Authors: Jawad A S M , Burrel M , Lim K L , Scott D G I 
Published: December 2008

Summary
We report the case history of a 57 year old man who has suffered from typical deforming, relapsing polychondritis for 13 years. He has also developed erosive destructive seronegative polyarthritis involving some of his distal interphalangeal, proximal interphalangeal, metacarpophalangeal, intercarpal, wrist, intertarsal and metatarsophalangeal joints. The distribution of joint involvement in the small joints of the hands and feet is asymmetrical. Both hips and knee joints have also been involved necessitating bilateral total hip and right total knee replacement. The articular associations with relapsing polychondritis are discussed.
Immunotactoid glomerulopathy associated with mycosis fungoides
Authors: Torrelo A , Rivera M T , Mampaso F , España A , Marcèn R , Ortuño J , Ledo A 
Published: December 2008

Summary
A patient with mycosis fungoides developed a nephrotic syndrome. Renal biopsy revealed deposits of a highly organized fibrillar material which did not stain with the typical amyloid stains; this picture was consistent with the diagnosis of non-amyloidotic fibrillary glomerulopathy or immunotactoid glomerulopathy. We believe this is the first case reported of immunotactoid glomerulopathy associated with mycosis fungoides. Possible pathogenetic implications are discussed with reference to previous publications.
Emotionalism following brain damage: a complex phenomenon
Authors: Allman P , Hope R A , Fairburn C G 
Published: December 2008

Summary
Emotionalism is a common and distressing consequence of many forms of brain damage. There is uncertainty about its classification, aetiology and treatment. A commonly used typology is difficult to apply in practice as illustrated by three clinical examples. We describe the various components of emotionalism and highlight their range and variability. In future research each component should be examined in detail using a standardized form of assessment.
Anticoagulation instability with life-threatening complication after dietary modification
Authors: Chow W H , Chow T C , Tse T M , Tai Y T , Lee W T 
Published: December 2008

Summary
Anticoagulation instability due to a change in intake of vitamin K after dietary modification was observed in 2 patients on long-term oral anticoagulants. One patient developed diffuse bruises treated conservatively with fresh frozen plasma transfusion and the other had a thrombosed aortic prosthesis which required emergency operation. To prevent such complications, dietary modification especially with food rich in vitamin K should be undertaken with care in patients on long-term oral anticoagulants.
Anaphylactic reactions to topical antibiotic combinations
Authors: Eedy D J , McMillan J C , Bingham E A 
Published: December 2008

SummaryWe describe two patients who developed anaphylaxis type reactions following the application of the topical antibiotic Polyfax (polymixin B and bacitracin). We draw attention to this potentially serious complication of topical antibiotic preparations and emphasize the need for careful history taking before prescribing such preparations.