bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urography prior to prostatectomy
Authors: Lucas M G , Bodley R N , Lindsell D R M , Fletcher E W L , Scott N P 
Published: December 2008

Summary
As part of the pre-operative assessment for prostatectomy, the routine intravenous urogram continues to be requested by many practitioners.
One hundred and ten patients being considered for prostatectomy underwent, prospectively, intravenous urography and trans-abdominal ultrasound. This paper specifically examines the respective contribution to management of these investigations. In 34% of patients, management was influenced in some way. This could have been achieved by ultrasound and plain abdominal radiograph alone. Additional intravenous urography would not have affected the clinical management of any patient.
Transient atrial fibrillation in hypertensive patients with thiazide induced hypokalaemia
Authors: Emara M K , Saadet A M 
Published: December 2008

SummaryDuring the previous 34 months, 3 hypertensive patients on long-term thiazide therapy were admitted to the medical department, Mubarak Hospital, Kuwait, with atrial fibrillation (AF) and hypokalaemia. They received potassium chloride by intravenous infusion, followed by oral therapy with reversion to sinus rhythm. There were no clinical, electrocardiographic, radiological, or echocardiographic signs of cardiac or pericardial disease, and the other usual cases of AF were also excluded. The contribution of thiazide-induced hypokalaemia to the occurrence of AF in our patients is discussed.
Intussusception in intestinal lymphoma: the role of colonoscopy
Authors: Goldin E , Libson E 
Published: December 2008

Summary
Intussusception is a well known complication and sometimes the presenting symptom of intestinal lymphoma. The final diagnosis in most patients is made by surgery.
We report a 12 year old boy with intussusception in whom the diagnosis was established by colonoscopy and surgery was avoided.
Temporary sequential atrioventricular pacing in myocardial infarction
Authors: Sheron N , Clarke M 
Published: December 2008

Summary
The loss of atrial contraction can seriously impair cardiac output when complete heart block follows myocardial infarction. We describe two cases in which temporary sequential atrioventricular pacing was lifesaving. The pacemaker used was a previously explanted internal pacemaker. By avoiding the need for an expensive dedicated temporary pacemaker this technique may be more widely applied.
Acute pancreatitis and non-Hodgkin’s lymphoma
Authors: Anderson J H , Morran C G , Anderson J R , Carter D C 
Published: December 2008

Summary
We report two patients presenting with acute pancreatitis, the aetiology of which was subsequently proven to be non-Hodgkin’s lymphoma. Histological confirmation of tumour-associated pancreatitis is essential so that appropriate therapy can be planned.
Herpes zoster and its neurological complications
Authors: Chang C M , Woo E , Yu Y L , Huang C Y , Chin D 
Published: December 2008

Summary
Ninety-three Chinese patients with cutaneous herpes zoster were seen during a 4-year period. Thoracic zoster occurred most commonly, followed by ophthalmic, cervical and lumbosacral zoster. Neurological complications were present in eleven patients (11.8%), the commonest being Ramsay-Hunt syndrome and segmental limb paresis. The clinical picture, pathogenesis, treatment and outcome of segmental limb paresis, myelitis and delayed contralateral hemiparesis following zoster ophthalmicus are discussed. Nine immunocompromised patients received intravenous adenine arabinoside (vidarabine) or acycloguanosine (acyclovir), and no cutaneous or visceral spread occurred in these patients.
Reduced plasma high-density lipoprotein and increased platelet activity in arterial versus venous blood
Authors: Aviram M , Viener A , Brook J G 
Published: December 2008

Summary
Plasma lipid and lipoprotein pattern and platelet activity were studied in blood samples derived from veins and arteries of 10 healthy male subjects. A significant reduction in plasma high-density lipoprotein (HDL) cholesterol, triglyceride and protein levels, as well as in plasma apolipoprotein A-I, was found when lipoproteins were derived from arterial blood in comparison to venous blood. All other lipoproteins were not significantly changed. Platelet activity measured as plasma beta-thromboglobulin levels and as collagen-induced platelet aggregation and 14C-serotonin release in platelet-rich plasma was markedly elevated when platelets were derived from arterial blood. Since reduced plasma HDL concentration and platelet activation are known risk factors for atherosclerosis, our study may suggest a further explanation for the presence of atherosclerotic lesions in arteries but not in veins.
Testicular dysfunction in men with sickle cell disease
Authors: Osegbe D N , Akinyanju O O 
Published: December 2008

Summary
In order to assess the role of the gonads and anterior pituitary gland in the production of poor quality semen of males with homozygous sickle cell disease (SCD) serum gonadotrophins, namely follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin and serum testosterone, were assayed radioimmunologically in 33 men with sickle cell disease and in 29 age-matched normal control subjects.
Our results show a significantly lower mean serum testosterone, a higher mean FSH and prolactin in SCD subjects than in normal controls. No single SCD subject had significantly low serum testosterone associated with low FSH, LH or prolactin.
The tendency for higher gonadotrophins associated with lower testosterone in subjects with SCD suggests that the hypothalamic/pituitary function in these patients is intact and that the primary fault leading to poor sperm production lies in the testes.
The origin of proteinuria at high altitude
Authors: Winterborn M H , Bradwell A R , Chesner I M , Jones G T 
Published: December 2008

Summary
Urinary protein excretion was measured before and after the intravenous infusion of lysine in 14 normal subjects after 4-6 days’ acclimatization at 4846 m. Urinary albumin excretion before lysine was elevated in 11 subjects but alpha 1-microglobulin was detected in only four. After lysine a large increase in albumin excretion occurred in all subjects. Together with the absence of alpha 1-microglobulin before lysine this implies that increased glomerular capillary permeability is the major cause of proteinuria after acclimatization to high altitude. The estimated minimum glomerular fluid albumin concentration was increased two to three fold above the published values in normal controls.
Carcinoma of the colon presenting with dyspepsia
Authors: O’Reilly D , Long R G 
Published: December 2008

Summary
Three patients with upper abdominal symptoms responding to anti-ulcer medication are reported who had negative upper gastrointestinal endoscopies. Subsequent barium enemas showed that each of the patients had either a carcinoma of the transverse colon or caecum. Investigation of the colon should be considered in all such cases.
Effect of prostaglandin E1 on deposition of autologous labelled platelets onto human atherosclerotic lesions in vivo
Authors: Sinzinger H , O’Grady J , Fitscha P 
Published: December 2008

Summary
The effects of infusions of prostaglandin E1 (PGE1) on platelet deposition at atherosclerotic sites in vivo in man have been examined. Thirteen patients with atherosclerotic vascular disease received intravenous PGE1 25 mg/kg/min for 6 hours daily for 5 days. Prostaglandin E1 had no effect on platelet uptake at atherosclerotic sites but prolonged platelet half-life significantly (P less than 0.001).
Pure red cell hypoplasia secondary to isoniazid
Authors: Lewis C R , Manoharan A 
Published: December 2008

Summary
We describe a 77 year old man who developed pure red cell aplasia while receiving antituberculous therapy including isoniazid. Prompt recovery occurred following cessation of isoniazid. In this paper we also review previously described case reports of isoniazid-induced pure red cell aplasia.
Factors influencing mortality from infective endocarditis in two district general hospitals
Authors: McGivern D , Ispahani P , Banks D 
Published: December 2008

Summary
Factors influencing mortality were studied in 92 consecutive cases of infective endocarditis admitted to two district general hospitals between January 1975 and April 1982. Thirty two patients died, an overall mortality of 35%, 13 patients died before diagnosis and 19 despite aggressive antimicrobial therapy. Bactericidal antibiotic levels were monitored in 39 cases but these did not appear to influence outcome.
Mortality was lowest for Streptococcus viridans infection (15%) but rose to 50% for infections with S. faecalis and other less common organisms. Most deaths were in patients over 50. Cardiac failure on admission was a poor predictor of mortality, although this was the principal cause of death during treatment (14 cases). Eight patients had emergency valve replacement and 3 died post-operatively.
When the diagnosis was missed during life (13 cases) arterial embolus was a common presenting feature (46%). Classical signs of endocarditis, other than pyrexia, were absent. A cardiac murmur (always mitral incompetence) was noted in only 6 cases and considered to be insignificant.
Cyanotic tetralogy of Fallot in a 77 year old man
Authors: Thomas S H L , Bass P , Pambakian H , Marigold J H 
Published: December 2008

Summary
We report the clinical details of a 77 year old man with classical tetralogy of Fallot. The patient had clubbing and cyanosis at birth, and exertional squatting in childhood. He was asymptomatic as an adult until the seventh decade, when he developed biventricular failure and had an episode of bacterial endocarditis. He finally died of cerebral infarction and bronchopneumonia following abdominal surgery.
In spite of investigations, the diagnosis was not made in life, but only discovered at post-mortem. A persistent ductus arteriosus was also found. Increased pulmonary blood flow via the ductus is believed to have facilitated this patient’s unusual longevity.
Hemlock water dropwort poisoning
Authors: Ball M J , Flather M L , Forfar J C 
Published: December 2008

Summary
Severe plant poisoning is relatively uncommon in adults. We report two adults who ingested hemlock water dropwort roots, having mistaken them for wild parsnip. One developed prolonged convulsions, severe metabolic acidosis and respiratory distress requiring mechanical ventilation. The toxin--oenanthotoxin--was detected in the gastric aspirate and measured by high performance liquid chromatography.
Isolated colonic tuberculosis
Authors: Wang Y A , Yu W Y 
Published: December 2008

Summary
Two cases of isolated colonic tuberculosis are reported, and recent literature on this field is reviewed. Isolated colonic tuberculosis is defined as a tuberculosis which exists in the colon except for ileocaecum, without focus in any other organ.
The morphological changes are tuberculous granulation primarily located to the submucosa layer of the colon with smooth surfaces of both mucous and serous membrane. Its clinical features are atypical, just like those on X-ray examination, and even on frozen biopsy, it may sometimes be misdiagnosed. The treatment of choice is resecting the diseased segment of colon combined with anti-tuberculosis therapy.
Systemic lupus erythematosus presenting with cardiac tamponade due to a haemorrhagic pericardial effusion
Authors: Rudra T , Evans P A , O’Brien E N 
Published: December 2008

Summary
A 14 year old girl presented with cardiac tamponade due to a haemorrhagic pericardial effusion. Systemic lupus erythematosus was diagnosed. Pericardial stripping was performed due to recurrence of the effusion despite pericardiocentesis and steroid therapy.
Epstein’s syndrome: case report and survey of the literature
Authors: Standen G R , Saunders J , Michael J , Bloom A L 
Published: December 2008

SummaryA diagnosis of Epstein’s syndrome was made in a young female with congenital macrothrombopathic thrombocytopenia, a nephropathy and mild sensorineural deafness. Previous case reports of this rare disorder are briefly reviewed and attention is drawn to the frequent association between inherited thrombocytopenia and renal disease.
Prolonged increase in digital blood flow following iloprost infusion in patients with systemic sclerosis
Authors: Rademaker M , Thomas R H M , Provost G , Beacham J A , Cooke E D , Kirby J D 
Published: December 2008

Summary
Thirteen patients with Raynaud’s phenomenon secondary to systemic sclerosis received three 8-hour infusions of a synthetic prostacyclin analogue (Iloprost) on consecutive days and were followed-up over a period of 10 weeks during the winter of 1985/86. Six weeks after infusion, digital peripheral vascular resistance had fallen (P less than 0.05) and dicrotic notch proportion of pulse amplitude increased (P less than 0.05). Digital blood flow and pulse amplitude (measured by photoplethymography) were also increased but did not reach statistical significance. The trend of improvement in these blood flow parameters was still evident after 10 weeks.
The number of cutaneous lesions (digital ulcers, etc) fell from 26 lesions before infusion to only 7 lesions by the end of the study, confirming the subjective improvement reported by the patients.
The epidemiology of the haemoglobin level--a study of 1057 subjects in general practice
Authors: Forrest R D , Jackson C A , Yudkin J S 
Published: December 2008

Summary
A prospective survey of the level of haemoglobin (Hb) has been carried out in 1057 subjects (607, 57.4% women) over the age of 40 randomly selected from the age-sex register of a North London group practice. Mean Hb levels were 15.04 +/- s.d. 1.41 g/dl in men and 13.54 +/- s.d. 1.32 g/dl in women (P less than 0.001). In men, Hb levels did not differ between the ethnic groups represented, but women of Mediterranean origin had significantly lower Hb levels than other women (P less than 0.001). There was no social class difference in Hb levels. Women under age 50 had significantly (P less than 0.001) lower Hb levels than older women. Smokers had significantly higher Hb levels than non-smokers (P less than 0.002) and there was a weak correlation with numbers of cigarettes smoked (men rs = 0.07, P = 0.07; women rs 0.14, P less than 0.001). Haemoglobin levels correlated with diastolic blood pressure in both men (r = 0.07, P less than 0.05) and women (r = 0.23, P less than 0.001). Thirty eight subjects (3.6%), 25 women and 13 men, were found to be anaemic (Hb less than 11.5 g/dl in women or less than 12.5 g/dl in men). Anaemia could be confirmed in only six of 19 subjects in whom repeat levels were measured. Screening for anaemia did not uncover any serious disease.
Myopathy in acute hypothyroidism
Authors: Kung A W C , Ma J T C , Yu Y L , Wang C C L , Woo E K W , Lam K S L , Huang C Y , Yeung R T T 
Published: December 2008

Summary
Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided promptly when the hypothyroid state was reversed.
Candida albicans vertebral osteomyelitis in chronic renal failure
Authors: Neale T J , Muir J C , Mills H , Horne J G , Jones M R 
Published: December 2008

Summary
Invasive candidal infections are encountered with increasing frequency in compromised hosts but bone infection is uncommon. A woman with systemic lupus erythematosus and end-stage renal failure managed by continuous ambulatory peritoneal dialysis developed a painful thoracic kyphosis and a lytic lesion in the vertebral bodies of T10 and T11. Blood cultures were sterile but bone biopsy material contained Candida albicans which also grew on culture. Circulating immune complexes were measured in high levels and contained candida antigens and specific anti-candida antibody as determined by isoelectric focusing, immunoblotting and immunoprinting techniques. Pain persisted after anti-fungal therapy had sterilized the lesion necessitating surgical excision of affected vertebrae, kyphosis correction and iliac crest bone grafting. The titres of circulating immune complexes and anti-candidal precipitins closely paralleled the clinical course.
Intracranial haemorrhage in a 26 year-old woman with idiopathic thrombocytopenic purpura
Authors: Awerbuch G , Sandyk R 
Published: December 2008

SummaryIntracranial haemorrhage (ICH), a rare complication of idiopathic thrombocytopenic purpura (ITP), described only once previously in an adult, is usually fatal. We report a previously healthy 26 year old woman with chronic ITP in whom spontaneous ICH developed. The eventual favourable outcome in this case despite severe initial neurological deficit makes this case unusual. The importance of aggressive management in an ITP associated ICH is stressed and a plan for management is suggested.
Respiratory distress during endoscopy–report of an unusual case
Authors: Narendranathan M , Kalam A 
Published: December 2008

Summary
A 30 year old man developed severe respiratory distress during upper gastrointestinal endoscopy. He had a short oesophagus and part of the stomach was intrathoracic. Air-insufflation during endoscopy caused distension of the stomach inside the chest leading to respiratory distress. When part of the stomach is intrathoracic, the endoscopist should be cautious and the possibility of respiratory embarrassment kept in mind during air-insufflation.
Transient atrial fibrillation precipitated by hypoglycaemia: two case reports
Authors: Collier A , Matthews D M , Young R J , Clarke B F 
Published: December 2008

Summary
We describe two insulin-dependent diabetic females who presented with severe hypoglycaemia associated with atrial fibrillation which reverted to sinus rhythm after intravenous dextrose. Atrial fibrillation has not previously been reported as a complication of hypoglycaemia in insulin-dependent diabetic patients.
Cryptococcal choroidoretinitis and immunodeficiency
Authors: Church W H , Palace J , Dick D J , Gould F K 
Published: December 2008

Summary
A 30 year old man with Hodgkin’s disease, clinically in remission, presented with blurred vision in one eye due to a choroiditis. He developed headaches 10 days after commencing oral steroids and was subsequently found to have cryptococcal meningitis. The meningitis and choroiditis resolved on antifungal medication. This is the first case of cryptococcal choroiditis recorded in the United Kingdom.
Immediate versus deferred treatment for early prostatic cancer
Authors: Smith P H , Armitage T G 
Published: December 2008

Summary
The diagnosis of early (non-metastatic) prostatic cancer is dependent upon the patient presenting himself with symptoms or for routine rectal examination or ultrasound screening. Diagnosis in the absence of symptoms is more common outside the United Kingdom and as a result the opportunity to treat such patients occurs more commonly in other countries.
The treatment options for the different stages are reviewed and the evidence for their effectiveness is considered.
A review of the literature yields conflicting evidence of the efficacy of and the necessity to institute early therapy. This basic gap in our current knowledge should be filled when the results of the existing Medical Research Council (MRC) clinical trial of immediate and deferred orchidectomy are available.
Toxic megacolon in cryptosporidiosis
Authors: Connolly G M , Gazzard B G 
Published: December 2008

Summary
A 33 year old man with acquired immunodeficiency syndrome developed a toxic megacolon. The patient was admitted with a two month history of diarrhoea. Cryptosporidia were isolated from all stool specimens. Clinically and radiographically he developed toxic dilatation of the colon which responded to conservative management.
Hypoglycaemia following treatment of hyperkalaemia with insulin and dextrose
Authors: Williams P S , Davenport A , Bone J M 
Published: December 2008

Summary
We describe four patients who developed symptomatic hypoglycaemia following treatment of hyperkalaemia with insulin and dextrose. Two patients had a delayed onset of hypoglycaemia, between 5 and 6 hours after treatment despite use of a ‘soluble’ type of insulin. A review of the literature revealed a variety of insulin and dextrose regimes but no research to assess the metabolic effects of such therapy in patients with renal failure. The possibility of significant hypoglycaemia following use of insulin and dextrose in the recommended dosages is rarely mentioned. The cases we describe demonstrate that there is no ‘correct’ dose of insulin and dextrose to suit every circumstance. Regular blood glucose estimations should be performed in all patients receiving such therapy for hyperkalaemia.
Concomitant alveolar haemorrhage and cytomegalovirus infection in a patient with systemic lupus erythematosus
Authors: Kwong Y L , Wong K L , Kung I T M , Chan P C K , Lam W K 
Published: December 2008

Summary
We report a 37 year old Chinese woman with systemic lupus erythematosus complicated by concomitant cytomegalovirus pneumonia and alveolar haemorrhage. The cytomegalovirus pneumonia may have been causally related to the alveolar haemorrhage.
Collagenous colitis with rapid response to sulphasalazine
Authors: Rokkas T , Filipe M I , Sladen G E 
Published: December 2008

Summary
A case of collagenous colitis in a young female with a rapid response to sulphasalazine both symptomatically and histologically is reported. This is only the third such response to be reported. In most published accounts, collagenous colitis fails to respond to treatment and runs a very prolonged course.
Disseminated mucormycosis due to Cunninghamella bertholletiae in a liver transplant recipient
Authors: Nimmo G R , Whiting R F , Strong R W 
Published: December 2008

Summary
Disseminated mucormycosis occurred in a 19 year old female following orthotopic liver transplantation for fulminant Wilson’s disease. The causative organism Cunninghamella bertholletiae has previously been described in ten clinical cases, but never before in this setting.
The diagnosis and classification of scleroderma (systemic sclerosis)
Authors: Barnett Alfred J , Miller Marian , Littlejohn Geoffrey O 
Published: December 2008

Summary
Difficulty in the diagnosis of the disease scleroderma may occur at the early stage prior to the development of obvious skin sclerosis. A presumptive diagnosis may be made if Raynaud’s phenomenon is accompanied by a positive ‘neck test’, ‘scleroderma’ capillary changes in the nailfolds or antinuclear antibodies. Definitive diagnosis may have to be delayed for several years from the onset of Raynaud’s phenomenon until definite characteristic skin changes are seen. Ten cases in which an earlier diagnosis of scleroderma was not substantiated are listed. The earlier incorrect diagnosis would have been avoided by use of the methods described in this paper.
Various terms have been used to denote subdivisions of scleroderma. These include acrosclerosis, diffuse scleroderma and CREST. We have used the terms Type 1, Type 2 and Type 3 based on the early extent of the skin sclerosis where Type 1 (limited extent) indicates sclerodactyly only, Type 2 (moderate extent) indicates sclerosis proximal to the metacarpophalangeal joints but excluding the trunk and Type 3 (extensive) indicates diffuse skin sclerosis including the trunk. The clinical value of this simple classification is reviewed and contrasted to other classifications which appear to be poorly defined and of limited use.