bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypothalamic hypopituitarism in a patient with a basal encephalocoele—treatment with luteinizing hormone-releasing hormone
Authors: Morris D. V. , Mason W. P. , Wilson-Holt N. , Adams J. , Keene M. , Tanner J. , Jacobs H. S. 
Published: December 2008

Summary
A 20-year-old patient presented with primary amenorrhoea and growth hormone deficiency caused by a basal encephalocoele. She was found to have developed diabetes insipidus in the 8 years following diagnosis. Gonadotrophin release in response to bolus injection of luteinizing hormone-releasing hormone (LHRH) was normal, as was thyrotrophin and adrenocorticotrophin (ACTH) secretion. Pulsatile administration of LHRH by the subcutaneous route resulted in normal ovulation and subsequent menstruation. The investigation and management of patients with basal encephalocoeles are discussed in the light of these findings.
Hodgkin’s disease presenting as idiopathic thrombocytopenic purpura
Authors: Murphy W. G. , Allan N. C. , Perry D. J. , Stockdill G. 
Published: December 2008

Summary
A case of Hodgkin’s disease presenting as idiopathic thrombocytopenic purpura in a 23-year-old male is reported. This is a rare presentation of Hodgkin’s disease having been previously described in only two cases.
Toxoplasmosis associated with digital vasculitis and immunodeficiency—a dilemma in diagnosis
Authors: Ellis M. E. , Webb A. K. , Dunbar E. M. 
Published: December 2008

Summary
We present a case of acquired toxoplasmosis associated with severe digital vasculitis—a previously unreported finding. The rise in Toxoplasma gondii antibody titres may have been attenuated by impaired cellular immunity, and this poses a problem for diagnosis.
Renal carcinoma in Lindau’s disease
Authors: Nagendran Vasantha , Dimond A. H. 
Published: December 2008

Summary
A case of Lindau’s disease is presented where renal carcinoma was detected 2.5 years after surgical removal of a cerebellar haemangioblastoma. This patient had no retinal lesions. The importance of screening for renal carcinoma in patients showing one or more manifestations of the disease and screening relatives is emphasized.
Haemodialysis and charcoal haemoperfusion in acute inorganic mercury poisoning
Authors: Worth D. P. , Davison A. M. , Lewins A. M. , Ledgerwood M. Jill , Taylor Andrew 
Published: December 2008

SummaryA 29-year-old gardener developed acute renal failure following the ingestion of 'Mersil', a combination of mercurous and mercuric chloride, achieving a plasma mercury concentration of 22,000 nmol/litre (400 micrograms/litre). Haemodialysis and charcoal haemoperfusion were ineffective in removing mercury despite prior treatment with the chelating agent dimercaprol. The acute renal failure resolved after 10 days and there are no residual sequelae.
Extreme hypernatraemia in association with renal failure following caecocystoplasty
Authors: Walker W. S. , Thurston C. J. 
Published: December 2008

Summary
A case of extreme hypernatraemia (serum sodium 212 mmol/l) occurring in association with renal failure following a caecocystoplasty procedure is reported. The causative factors in extreme hypernatraemia are reviewed and an unusual reabsorptive mechanism via the transposed intestinal segment is proposed to explain the degree of hypernatraemia present in this case.
Hyperprolactinaemia in male diabetics
Authors: Mooradian A D , Morley J E , Billington C J , Slag M F , Elson M K , Shafer R B 
Published: December 2008

Summary
We recently investigated two patients with diabetes and elevated serum prolactin levels in whom no cause of hyperprolactinaemia could be found. For this reason we measured fasting serum prolactin levels in 72 diabetic males and compared the results with those of 63 healthy males and 90 nondiabetic males attending an Impotence Clinic. The diabetic group had significantly higher serum prolactin levels (13.1 ± 0.9 ng/ml) than the two control groups (9.9 ± 0.6 ng/ml for normal males and 7.7 ± 0.3 ng/ml for the non-diabetic impotent group). Eighteen percent of the diabetics studied had serum prolactin levels above the normal range for males (&gt; 20 ng/ml). There was no correlation between serum prolactin levels and duration of diabetes, glycosylated haemoglobin level or presence of clinically apparent retinopathy. The correlation between serum prolactin level and fasting plasma glucose was weak though statistically significant (r = 0.26, P &lt; 0.05).
Is Nd-Yag laser treatment for upper gastrointestinal bleeds of benefit in a district general hospital?
Authors: Homer A C , Powell S , Vicary F R 
Published: December 2008

Summary
104 consecutive patients with upper gastrointestinal bleeding admitted to a district general hospital over a period of 20 months were considered for laser photocoagulation. 58 patients were found to have peptic ulcers, of which 42 had stigmata of recent haemorrhage accessible to laser photocoagulation. 17 were treated with a Nd-YAG laser and 25 were managed conservatively. There was no significant difference in the number of patients who re-bled and required surgery, mortality rate, length of stay in hospital or the amount of blood transfusion required in either group. We suggest that the routine use of a laser for bleeding peptic ulcers in a district general hospital is not justified.
Survival after profound hypocalcaemia with tetany complicating severe haemorrhagic acute pancreatitis
Authors: Jones P A 
Published: December 2008

Summary
A patient is reported who developed severe haemorrhagic pancreatitis, without hyperamylasemia, which was complicated by gross hypocalcaemia presenting as tetany. Tetany is very uncommon in acute pancreatitis and is a grave prognostic indicator, recovery being exceptionally rare. The mechanisms responsible for disordered calcium homeostasis associated with acute pancreatitis are reviewed. CT scanning was an important feature of this patient's management and its role in severe pancreatitis is discussed.
Symptomatic hypercalcaemia precipitated by magnesium therapy
Authors: Nanji A A 
Published: December 2008

Summary
A patient with Crohn's disease receiving vitamin D and calcium had normal serum calcium levels when serum magnesium was low. Hypercalcaemia was precipitated when supplemental magnesium was given. The reason why serum calcium was initially normal is probably related to the effect of magnesium deficiency in reducing serum calcium level.
Hypothyroidism presenting as destructive arthropathy of the fingers
Authors: Gerster J C , Quadri P , Saudan Y 
Published: December 2008

Summary
A patient presenting with destructive arthropathy of the proximal interphalangeal (PIP) joints of the hands is described. She was initially believed to have rheumatoid arthritis but non-steroidal anti-inflammatory drugs were of no help. The patient was subsequently found to have hypothyroidism and erosive osteoarthritis of the fingers. Joint swelling, pain and stiffness responded dramatically to thyroid hormone substitution. The PIP joint spaces reappeared on the radiographs within 9 months.
This case suggest that hypothyroidism may induce destructive arthropathy of the finger joints. As thyroxine replacement may reverse the rheumatic complaints, hypothyroidism should be considered in the differential diagnosis of a destructive arthropathy of unclear aetiology.
Jejunal perforation secondary to metastatic bronchogenic carcinoma
Authors: Quayle A R , Holt S , Clark R G 
Published: December 2008

Summary
A case of peritonitis secondary to the perforation of a bronchogenic small bowel metastasis is reported. To our knowledge this is only the fourth case in which peritonitis was the presenting feature of a squamous cell carcinoma of the bronchus. The publications to date are reviewed and the need to biopsy every small bowel perforation found at laparotomy is stressed.
Alpha-1-antitrypsin associated liver disease in rheumatoid arthritis
Authors: Teh L G , Steven M M , Capell H A 
Published: December 2008

Summary
Two cases of alpha-1-antitrypsin associated liver disease occurring in patients with rheumatoid arthritis are described. Both presented with abnormal liver function tests and the true diagnosis was only apparent after liver biopsy and detailed serological studies. The concurrence of these two conditions is noteworthy because of the postulated role of proteolytic enzymes in producing the characteristic cartilaginous erosions of rheumatoid arthritis.
Yersinia colitis associated with Crohn's disease
Authors: Treacher D F , Jewell D P 
Published: December 2008

Summary
A previously healthy patient developed serologically-proven Yersinia pseudotuberculosis enterocolitis and made a complete recovery. Over a year later, further gastrointestinal symptoms developed and Crohn's disease was diagnosed. The possible relevance to the aetiology of Crohn's disease is discussed.
Puerperal ovarian vein thrombophlebitis
Authors: Tang L C H , Woo J S K , Choo Y C 
Published: December 2008

Summary
A 16 year old Chinese female with puerperal ovarian vein thrombophlebitis following uneventful vaginal delivery is reported. This infrequent, but potentially fatal, complication in the febrile postpartum patient may present as a surgical emergency. Non-invasive diagnostic procedures and conservative treatment with heparinization and antibiotics have been suggested. However, early exploratory laparotomy for ovarian vein or caval ligation may be life-saving if the diagnosis is in doubt or the response to conservative treatment is unsuccessful.
Metoprolol in the aged hypertensive: a comparison of two dosage schedules
Authors: Martin A , Browning R C 
Published: December 2008

Summary
Thirty-one patients aged 65 y or over suffering from moderate hypertension were studied for 16 weeks using a cross-over design in which metoprolol 100 mg daily and metoprolol 200 mg daily were compared. Both treatment regimes were effective in controlling hypertension and no difference was found between the two with regard to efficacy. The 100 mg regime was, however, better tolerated and we propose this as the preferred metoprolol dose for the aged hypertensive.
Severe Coombs positive autoimmune haemolytic anaemia associated with ulcerative colitis
Authors: Wodzinski M A , Lawrence A C K 
Published: December 2008

Summary
We describe a case of severe autoimmune haemolytic anaemia developing in newly diagnosed ulcerative colitis of moderate severity. Full immunosuppression with steroids and azathioprine failed to bring about a full remission and a splenectomy was performed which resulted in a remission enabling immunosuppression to be discontinued. This case is compared with three previously described cases of autoimmune haemolytic anaemia associated with severe colitis requiring splenectomy.
Immune complex-mediated cutaneous vasculitis in a scar–the importance of local anatomical factors
Authors: Karp S J , Winter R J D , Ridley C M 
Published: December 2008

Summary
A vasculitic rash developed on the legs and arms of a 47 year old woman. Similar vasculitic lesions also erupted in a scar sustained ten years previously. Circulating immune complexes consisting of IgG were detected by Clq binding. We discuss the factors involved in the localization of vasculitic lesions, and in particular stress the role of microvascular injury.
Smoking and myocardial infarction: secondary prevention
Authors: Perkins J , Dick T B S 
Published: December 2008

Summary
This prospective study examines the question ‘Is it too late to stop smoking cigarettes once you have had a myocardial infarction?’
One hundred and nineteen cigarette smokers (90 men, 29 women) who survived their first myocardial infarction for one month were followed for five years or until their death if earlier. The age corrected mortality rate of men who continued to smoke cigarettes was 2.2 times the age corrected mortality rate of those who stopped smoking after their infarct. The women who continued to smoke had 2.4 times the age corrected mortality of those who stopped smoking. The age and sex corrected mortality rates for the combined group of men and women show that those who stopped smoking after their infarction have 55% of the mortality of those who continued to smoke (P &lt; 0.05). These results suggest that smoking is not merely a ‘risk factor’ for myocardial infarction but is also a causal factor whose effects can be avoided by both men and women after an initial myocardial infarction.
Disseminated aspergillosis following radiation therapy for medulloblastoma
Authors: Hamilton P , Darbyshire P J , McKeever P , Oakhill A 
Published: December 2008

Summary
A 16 year old girl who underwent surgery and radiotherapy for medulloblastoma is described. Shortly following the completion of treatment symptoms developed suggestive of tumour recurrence. At post mortem the cause was identified as disseminated aspergillosis with extensive cerebral involvement. The importance of this unusual complication is discussed.
Amiodarone and chronic lung fibrosis
Authors: Finnegan M J , Faragher E B 
Published: December 2008

Summary
A covariate analysis was performed on the major lung function indices that are affected by pulmonary fibrosis in 29 patients who had recently started amiodarone therapy and compared with those of a group of 41 patients who had been treated for a mean of 19.6 months. Patients with other factors which affect gas transfer were excluded. A trend towards reduction in transfer factor, transfer coefficient and membrane diffusion was detected but did not reach statistical significance. A lower than expected incidence of acute pulmonary fibrosis was observed. In the treated group, there was no deterioration of transfer factor, transfer coefficient or membrane diffusion with either increasing duration of therapy or total dose taken.
Blood lipid variability in relation to relative weight and biochemical markers of tobacco and alcohol consumption
Authors: Janzon L , Franzén J , Lindell S-E , Trell E 
Published: December 2008

Summary
Carboxyhaemoglobin (COHb%) and gamma-glutamyl-transferase (GGT) are today frequently used as objective indicators of tobacco and alcohol consumption. The relationships between COHb%, GGT and relative body weight, cholesterol, triglyceride and apolipoprotein AI (Apo-AI) were studied in middle-aged men attending a preventive medical programme in Malmö, Sweden. Although statistically significant the influence of COHb% on cholesterol and triglyceride was found to be clinically insignificant. GGT and body weight had, independent of each other, a significant influence on cholesterol and triglyceride. GGT was found to have a positive correlation to Apo-AI whereas body weight was found to have a negative correlation to Apo-AI. Four per cent of the cholesterol variability, 16% of the triglyceride variability and about 10% of the variability in Apo-AI could, in this study, be accounted for by COHb%, GGT and relative body weight.
The value of screening for autoantibodies in patients with non-specific symptoms
Authors: Patel C , Lloyd R S , Holdstock G 
Published: December 2008

Summary
An autoantibody screen is often requested in patients with non-specific symptoms such as pyrexia of unknown origin. However, in a survey of 100 consecutive requests for this investigation in such patients only one patient was encountered in whom the investigation led to a positive diagnosis at an estimated cost of £2500. These requests accounted for 5% of the total workload. These observations reaffirm that this should remain a second line investigation and should be deferred until more likely diagnoses have been excluded.
Pituitary function with a solitary intrasellar plasmacytoma
Authors: Evans P J , Jones M K , Hall R , Scanlon M F 
Published: December 2008

Summary
A solitary intrasellar plasmacytoma with marked pituitary fossa destruction and yet near normal pituitary gland function is described. We suggest that a minimal disturbance of endocrine function together with a radiologically abnormal pituitary fossa indicates that the primary lesion may lie outside the pituitary fossa.
Fatal varicella in a healthy young adult
Authors: Coppack S W , Doshi R , Ghose A R 
Published: December 2008

Summary
A healthy adult presented with severe neurological disturbance 4 d after developing chicken-pox. Although pneumonic and renal problems were also present the neurological state dominated the clinical picture. After the patient's sudden death an autopsy revealed that renal and cerebral problems were secondary to myocardial involvement. This was of an unusual type for varicella with features of dilated cardiomyopathy resembling that previously related to Coxsackie infections. We conclude that cardiac problems in this patient produced anoxic brain damage and subsequently death.
Intramural gas in the small bowel followed by chronic obstruction
Authors: Waldron R P , Dawkins D , Donovan I A 
Published: December 2008

Summary
A 63 year old male presented with recurring abdominal pain dating from an acute episode 3 months previously. Abdominal X-rays in the acute phase demonstrated small intestinal intramural gas. A jejunal stricture with panmural necrosis was resected.
A clinical trial using co-trimoxazole in an attempt to reduce wound infection rates in dog bite wounds
Authors: Jones D A , Stanbridge T N 
Published: December 2008

Summary
One hundred and thirteen patients were entered into a randomized, prospective double-blind, placebo controlled trial to assess the use of co-trimoxazole in reducing wound infections after dog bites. Although there was a reduction in the wound infection rate from 13.8% in the placebo group to 5.5% in the treatment group this did not reach statistical significance (P = 0.135). If hand wounds are considered separately, no infections occurred in the treatment group and a benefit seems likely.
Periductal mastitis and mammary duct ectasia in a male
Authors: Ashworth M T , Corcoran G D , Haqqani M T 
Published: December 2008

SummaryA case of periductal mastitis and mammary duct ectasia is presented in a 50 year old male, with presenting symptoms similar to those of females, namely subareolar breast lump and mastalgia. As far as can be ascertained only 4 cases of mammary duct ectasia and periductal mastitis in males have been reported previously. Since this entity is not well known in males it is possible that it may be underdiagnosed or misdiagnosed clinically and histologically.
Sudden death due to isolated adrenal tuberculosis
Authors: Ward S , Evans C C 
Published: December 2008

Summary
A 65 year old man admitted to hospital for investigation of pleural thickening was found to have carcinoma of the prostate with metastases. Before investigations were completed the patient collapsed unexpectedly with hypotension. A post mortem examination revealed tuberculosis of both adrenal glands without evidence of tuberculosis in any other organ.
Segmental infarction of the omentum: diagnosis by ultrasound
Authors: Naraynsingh V , Barrow R , Raju G C , Manmohansingh L U 
Published: December 2008

Summary
Pre-operative diagnosis of segmental infarction of the omentum is difficult because of its rarity and non-specific clinical features. We present a case of omental infarction and suggest that ultrasound scan may be helpful in the diagnosis of this entity.
Normal thyrotrophin response to intravenous thyrotrophin releasing hormone administration: the best index of optimal L-thyroxine therapy in primary hypothyroidism
Authors: Kabadi U M 
Published: December 2008

Summary
Normalization of basal thyrotrophin (TSH) level is used as the endpoint in L-thyroxine (L-T4) therapy of primary hypothyroidism. However, several reports have questioned the reliability of this index because of seasonal variation of TSH. Therefore, we studied 85 consecutive patients with primary hypothyroidism over a period of 3.5 y. In these patients, TSH response (delta TSH) to intravenous thyrotrophin releasing hormone (TRH) administration was examined when basal TSH was normalized with L-T4 therapy. Eight patients showed a blunted response (delta TSH less than 5 microU), whereas 27 patients demonstrated an exaggerated response (delta TSH greater than 25 microU). Thus, 42% of patients were apparently on inappropriate L-T4 dosage. These abnormal TSH responses normalized on adjusting the L-T4 dosage alone; prolonged therapy with the same dose failed to normalize TSH responses. Minor seasonal variations of basal TSH were observed in 30% of patients. However, TSH response to TRH remained normal. Hence, no adjustment of L-thyroxine dose was required. This study, therefore, demonstrates that normalization of TSH response to TRH administration rather than basal TSH may be the best index of adequate L-thyroxine therapy in primary hypothyroidism.
Disseminated cryptococcosis in a patient receiving chronic haemodialysis
Authors: Banks R , Williams A , Glover S , Burton P , Warnock D , Mackenzie C 
Published: December 2008

Summary
Systemic infection with Cryptococcosis neoformans is described in a young man receiving maintenance haemodialysis. The organism was identified in thin sections of a cervical lymph node using resin embedding and silver staining. There were no predisposing factors other than uraemia. His clinical infection responded to the combination of oral 5-flucytosine and a total of 2.5 g of intravenous amphotericin B. He remains free of relapse after 30 months.
Microcrystalline hydroxyapatite compound in prevention of bone loss in corticosteroid-treated patients with chronic active hepatitis
Authors: Stellon A , Davies A , Webb A , Williams R 
Published: December 2008

Summary
To determine whether microcrystalline hydroxyapatite compound (MCHC) could reduce bone loss or its consequences in patients with chronic active hepatitis (CAH) on corticosteroid therapy, a controlled trial was conducted in 36 such patients over a period of 2 years. Both skeletal symptoms (back pain) and fractures were uncommon during the trial period but both showed non-significant differences in favour of the MCHC group and biochemical investigations were suggestive of a reduction in parathyroid over-activity. Continued reduction in bone mineral content of the radius (photon absorptiometry) was halted in those receiving MCHC and iliac crest bone biopsy showed a non-significant increase in trabecular bone volume. The fall in iliac crest cortical plate thickness was significantly less (P &lt; 0.025) in the MCHC group and the results overall were consistent with a beneficial effect from MCHC in corticosteroid-induced osteoporosis.
Asymmetrical lipomatosis: report of two cases
Authors: Enzi G , Digito M , Baldo Enzi G , Perin B , Fiore D 
Published: December 2008

Summary
We report on two patients with an asymmetrical expansion of fat tissue. At computed tomography, lipomatous tissue proved to be superficially located in one patient and both subcutaneously and deeply located in the second. Signs and symptoms of a peripheral neuropathy were observed in both patients, who were otherwise asymptomatic. The lipolytic activity in post-heparin plasma was normal in both patients. The fat cell size of lipomatous tissue, obtained in one patient by percutaneous needle biopsy, was higher than that of contralateral, uninvolved adipose tissue. The adipose tissue lipoprotein lipase activity in lipomatous tissue was higher than that in normal tissue. High density lipoprotein (HDL), HDL2 and HDL3 cholesterol values were elevated in both patients but not exceeding 1 standard deviation the values of age and sex matched controls. Isoprenaline-stimulated lipid mobilization was similar in lipomatous and in control tissue.
Hypertrophic osteoarthropathy, spider naevi and oestrogen hyperexcretion associated with adenocarcinoma
Authors: Brear S G , Edwards J D , Rademaker M , Doyle L 
Published: December 2008

Summary
We describe two patients with hypertrophic osteoarthropathy, spider naevi and elevated 24 h urinary oestrogen excretion associated with an adenocarcinoma. In one of the patients, the spider naevi and the clinical signs of hypertrophic osteoarthropathy disappeared and the 24 h urinary oestrogen returned to normal following removal of the tumour.