bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ehlers Danlos syndrome — masquerading as primary muscle disease
Authors: Banerjee Gautam , Agarwal Ravinder Kumar , Shembesh Noori M , El Mauhoub Mansoor 
Published: December 2008

Summary
A 9 year old Libyan boy presented with a history of delayed walking and abnormal gait. The presence of marked muscle under-development with hypotonia led to the initial diagnosis of primary muscle disease; later, he was found to have hyperelastic, fragile skin and hypermobile joints-the cardinal features of Ehlers Danlos syndrome. In this instance the disease seems to have been inherited in an autosomal recessive manner.
Treatment of hypercalcaemia in thyrotoxicosis with aminohydroxypropylidene diphosphonate
Authors: Tan T T , Alzaid A A , Sutcliffe N , Gardner M D , Thomson J A , Boyle I T 
Published: December 2008

Summary
Two patients had symptomatic hypercalcaemia accompanying thyrotoxicosis, despite initial treatment with volume repletion, beta blockade and antithyroid drugs. They were further managed with intravenous infusions of aminohydroxypropylidene diphosphonate resulting in rapid normalization of the serum calcium, with relief of symptoms. Aminohydroxypropylidene diphosphonate effectively suppressed the increased bone resorption of thyrotoxicosis without any undesirable adverse effects.
Cranial diabetes insipidus secondary to arrested hydrocephalus
Authors: Menzies D G , Shaw J F , Kean D M , Campbell I W 
Published: December 2008

Summary
An unusual case is described linking cranial diabetes insipidus with longstanding arrested hydrocephalus. The latter was demonstrated by computed tomographic (CT) and nuclear magnetic resonance (NMR) scans and cerebrospinal fluid pressure measurements. The increasing use of CT and NMR scans may result in this association of cranial diabetes and hydrocephalus being better defined.
Fulminant hepatic failure in nephrotic syndrome related to withdrawal of immunosuppressive therapy
Authors: Onwubalili J K 
Published: December 2008

Summary
Two patients with nephrotic syndrome developed fatal fulminant hepatitis B following withdrawal of prednisolone or cyclophosphamide. Immunosuppressive therapy probably enhanced hepatitis B virus (HBV) replication and widespread infection of hepatocytes; its withdrawal permitted a return of immune competence resulting in massive destruction of infected hepatocytes. Prior screening of all patients for hepatitis B surface antigen, gradual withdrawal of immunosuppressive drugs with careful monitoring, and prompt intervention with corticosteroids at the first clinical or biochemical signs of liver cell damage may prevent this complication.
Serious hypernatraemia in a hospital population
Authors: Bhatnagar D , Weinkove C 
Published: December 2008

Summary
Severe hypernatraemia in a hospital population should be an avoidable problem. We have looked at its causes and incidence over one year and have shown that serious hypernatraemia (serum sodium greater than 160 mmol/l) as a manifestation of severe dehydration is associated with a high morbidity and mortality. Failure to maintain adequate fluid intake, intentional or unintentional, was the most frequent cause. Nursing and medical staff must be made more aware of this problem and encouraged to initiate early treatment of dehydration.
Jugular vein thrombosis associated with distant malignancy
Authors: Carrington B M , Adams J E 
Published: December 2008

Summary
We describe two patients who developed internal jugular vein thrombosis associated with primary malignant disease arising outside the neck, and in one patient it was the presenting feature. Computed tomography was performed and the findings characteristic of internal jugular vein thrombosis are illustrated. We conclude that malignant disease should be considered in patients presenting with spontaneous internal jugular vein thrombosis with no other predisposing factors and that computed tomography is of value in confirming the diagnosis.
Solitary non-parasitic liver cyst treated by cyst-gastrostomy
Authors: Chang D 
Published: December 2008

Summary
A 66 year old female presented with a symptomatic solitary non-parasitic liver cyst. This was treated by a cyst-gastrostomy following which the patient has remained well without complications for 12 years. Given an appropriate anatomical relationship of cyst and stomach, this would appear to be a safe and effective operation.
Chronic renal failure; an important feature of the Laurence-Moon-Biedl syndrome
Authors: Williams B , Jenkins D , Walls J 
Published: December 2008

Summary
Two cases of end stage renal failure occurring in association with the Laurence-Moon-Biedl syndrome are reported. Abnormalities in renal function and morphology are increasingly recognized in these patients in whom uraemia is an important cause of morbidity and early mortality. The presence of renal impairment, occurring as frequently as any of the pentad of features that characterize the syndrome, has important implications for the prognosis and long term management of these patients.
Some connective tissue disorders of the lung
Authors: Turner-Warwick M 
Published: December 2008

Summary
Many connective tissue disorders involve the lungs. The same clinical syndrome may be associated with several distinctive types of pathology in different patients. Fibrosing alveolitis is a common feature of a number of different syndromes. An hypothesis is set out in schematic form which may help to account for some of these differences and emphasizes the potential importance of the pulmonary vasculature in pathogenesis.
Sarcoidosis: the clinical problem
Authors: Neville E 
Published: December 2008

Summary
This paper reviews the clinical manifestations of acute and chronic sarcoidosis. The indications for measuring serum angiotensin converting enzyme and for performing pulmonary function tests, bronchiolo-alveolar lavage and gallium scans are discussed and the modern indications for performing a Kveim Siltzbach test are also considered. The main treatment available for patients with sarcoidosis is systemic steroids and the indications in the various systems for using these drugs are discussed.
Autoimmunity in chronic lymphocytic leukaemia
Authors: Lischner M , Prokocimer M , Zolberg A , Shaklai M 
Published: December 2008

Summary
Seventy-nine patients with chronic lymphocytic leukaemia were evaluated for the presence of autoimmune diseases and autoantibodies. One patient has polymyositis and two additional patients presented with features suggestive of pernicious anaemia and chronic active hepatitis.
The Coombs’ direct test was positive in 7% and immune thrombocytopenia was present in 8.1% of patients. Five (7%) patients had M-protein in the serum. No increased frequency of other autoantibodies was noted in our study group.
We conclude that the propensity to develop antibodies is restricted only to the haematopoietic system and that there is no increased frequency of non-haematological autoimmune diseases in chronic lymphatic leukaemia.
Haematological, neurological and psychiatric complications of chronic hypothermia following surgery for craniopharyngioma
Authors: Griffiths A P , Henderson M , Penn N D , Tindall H 
Published: December 2008

Summary
A patient is described who became poikilothermic following surgery for removal of a craniopharyngioma. Episodes of disturbed behaviour, neurological abnormalities, pancytopenia and deranged liver function could be correlated with episodes of more profound hypothermia on a background of a chronically lowered core temperature. The association of pancytopenia and neuropsychiatric disturbances with hypothermia is discussed with reference to reported cases of periodic spontaneous hypothermia.
Glomerulonephropathy of Laurence-Moon-Biedl syndrome
Authors: Cheng I K P , Chan K W , Chan M K , Kung A , Ma J , Wang C 
Published: December 2008

Summary
A patient with Laurence-Moon-Biedl syndrome and nephrotic range proteinuria is presented. Radiological investigation of the urinary tract revealed clubbed calyces but no evidence of obstruction or vesicoureteric reflux. Renal biopsy revealed occasional sclerotic glomeruli, extensive foot-process fusion and segmental glomerular basement membrane abnormalities with negative immunofluorescence for immunoglobulins and complement. Nephrotic proteinuria responded to steroid therapy but mild proteinuria persisted. The findings were consistent with minimal change nephropathy superimposed on the glomerular lesions of Lawrence-Moon-Biedl syndrome.
Trichinosis diagnosed by computed tomography
Authors: Kreel L , Poon W S , Nainby-Luxmoore J C 
Published: December 2008

Summary
Trichinosis is a worldwide disease contained by good husbandry and culinary practice, presenting unexpectedly in individual cases or mini-epidemics. The disease varies greatly in its manifestation and severity although when marked can be recognized by fever with myositis and periorbital oedema. Antibody tests are specific but the appearance on computed tomography of the brain are sufficiently characteristic to allow a confident diagnosis. Two cases where such appearances led to the diagnosis are reported.
Comparative evaluation of investigations for colorectal carcinoma in symptomatic patients
Authors: Kalra L , Hamlyn A N 
Published: December 2008

Summary
We studied 154 patients presenting with significant colonic symptoms and subsequently diagnosed to have colorectal carcinoma. They were investigated by faecal occult blood tests, fibresigmoidoscopy, double contrast barium enema (DCBE) and colonoscopy. Faecal occult blood tests (Haemoccult) alone were positive in 26% of patients with Dukes’ A, in 69% with Dukes’ B and in 64% with Dukes’ C lesions. DCBE alone identified the lesion in 32% of Dukes’ A, 79% of Dukes’ B and 81% of Dukes’ C carcinomas. Fibresignoidoscopy diagnosed colorectal malignancy in 84% of patients with Dukes’ A, 90% with Dukes’ B and 81% with Dukes’ C stage. A diagnostic yield of 88% for Dukes’ A, 96% for Dukes’ B and 100% for Dukes’ C carcinomas was seen with colonoscopy. Detection rate for all stages of carcinoma was greater than 95% when fibresigmoidoscopy and DCBE were used together. Faecal occult blood tests and DCBE alone are inadequate in diagnosing early malignancy in symptomatic patients. Fibresigmoidoscopy and DCBE used in conjunction compare favourably with the technically difficult procedure of colonoscopy and should routinely be undertaken in these patients before malignancy can confidently be excluded.
Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel
Authors: Mo K M , Craig G M , Clark J V , Champ C 
Published: December 2008

Summary
Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. Death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. Death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.
Left ventriculo-colic fistula--a late complication of colonic interposition for the oesophagus
Authors: Pantelides M L , Fitzgerald M D 
Published: December 2008

Summary
An 18 year old man developed recurrent haematemesis 12 years after colonic interposition for corrosive injury to the oesophagus. A colonic ulcer close to the cologastric anastomosis appeared to have fistulated into the cavity of the left ventricle. This so far unreported complication needs to be considered when patients who have had coloesophageal substitution present with gastrointestinal bleeding.
Reversible acute renal failure due to Churg-Strauss syndrome
Authors: Davenport A , McDicken I , Goldsmith H J 
Published: December 2008

Summary
Renal disease in Churg-Strauss syndrome is generally thought to be benign in nature, thereby distinguishing this rare condition from other necrotizing vasculitides. We report a case in which acute renal failure developed during the aggressive vasculitic phase of the illness requiring dialysis therapy. After one week of daily haemodialysis treatment the patient had become encephalopathic associated with marked peripheral eosinophilia. Treatment with prednisolone resulted in a marked improvement in both clinical condition and renal function.
Angina-like chest pain: a joint medical and psychiatric investigation
Authors: Colgan S M , Schofield P M , Whorwell P J , Bennett D H , Brooks N H , Jones P E 
Published: December 2008

Summary
Sixty three patients with chest pain typical of angina and who had normal coronary angiograms were investigated for left ventricular, oesophageal and psychiatric abnormalities. An additional 21 patients, age and sex matched, who had angina and significant coronary artery disease were also studied. Eighty six per cent of the 63 patients without evidence of coronary artery disease could be demonstrated to have a physical abnormality (left ventricular dysfunction in 35%, oesophageal disorder 51%). There was, however, a wide variation in the incidence of psychiatric morbidity between the diagnostic subgroups-18% in left ventricular dysfunction, 29% in those with coronary artery disease and 59% in patients with oesophageal disorders (P less than 0.01). Thus failure to identify left ventricular dysfunction and inclusion of such subjects in psychological assessments of ‘angiogram-negative’ chest pain might give misleading results. This study confirms that patients with angina and normal coronary angiography have a high incidence of oesophageal disorders. However psychiatric illness is also common in this group of subjects and management needs to take both these factors into account.
Chlortenoxicam pharmacokinetics in young and elderly human volunteers
Authors: Ankier S I , Brimelow A E , Crome P , Johnston A , Warrington S J , Turner P , Ferber H P 
Published: December 2008

Summary
The pharmacokinetics of chlortenoxicam, a new non-steroidal anti-inflammatory drug, have been compared in young and elderly healthy human volunteers. Chlortenoxicam was found to have a relatively short mean elimination half-life of about 4 hours, with considerable inter-subject variability, but there was no significant difference between young and elderly subjects. There was no evidence of accumulation with repeated administration. No unchanged chlortenoxicam was found in urine from any subject, suggesting that it undergoes extensive metabolism in man.
Light chain deposition disease presenting with hepatomegaly: an association with amyloid-like fibrils
Authors: Pelletier G , Fabre M , Attali P , Ladouch-Badre A , Ink O , Martin E , Etienne J P 
Published: December 2008

Summary
We report an unusual case of lambda light chain deposits without overt plasma cell dyscrasia. The clinical presentation was hepatomegaly without biochemical sign of renal involvement. Portal hypertension, spontaneous rupture of the spleen and fracture of the 12th thoracic vertebra occurred during the course of the disease. Ultrastructural studies showed that lambda light chain deposits were associated with amyloid-like deposits. This case suggests that light chain deposition disease and amyloidosis could be two expressions of the same disease.
Ginseng--is there a use in clinical medicine?
Authors: Chong S K F , Oberholzer V G 
Published: December 2008

Abstract
Panax ginseng occupies an important place among the tonic remedies of Oriental medicine. Pharmacological investigations show that crude ginsenosides can increase non-specific resistance of an organism to various untoward influences. The effects of purified derived derivatives have only recently become better studied in immunological and cell growth studies in animals and in man. This has now provided some evidence to suggest that ginseng is a drug that contains many derivatives with different pharmacological properties, which could be useful in clinical medicine.
Follicular carcinoma of the thyroid following radioactive iodine treatment for Graves’ disease
Authors: Staffurth J S , Holl-Allen R T J 
Published: December 2008

Summary
A 67 year old man presented with a well differentiated follicular carcinoma of the thyroid 17 years after he had been given radioactive iodine for Graves’ disease. As this was insufficient to cure him he had continued to take propylthiouracil regularly. The tumour, which had completely replaced the thyroid, was apparently maintaining thyrotoxicosis. The implications of this management are discussed and it is concluded that antithyroid drugs should not be given on a long term basis after therapeutic radioiodine has been administered.
Henoch-Schönlein purpura and Hodgkin’s disease
Authors: Ng J P , Murphy J , Chalmers E M , Hogg R B , Cumming R L , Peebles S 
Published: December 2008

Summary
A 39 year old man who presented with classical Henoch-Schönlein purpura was shown to have mediastinal nodular sclerosing Hodgkin’s lymphoma. The Henoch-Schönlein purpura resolved after treatment of the lymphoma.
Non-Hodgkin’s lymphoma presenting as ‘chronic active toxoplasmosis’
Authors: Dudley N J , Balfour A H 
Published: December 2008

Summary
We report the case of a 58 year old man in whom an unusually prolonged infection with Toxoplasma gondii was the presenting feature of an underlying non-Hodgkin’s lymphoma. This case demonstrates the particular usefulness of the IgM ELISA test in monitoring disease activity.
Portal hypertension secondary to azathioprine in myasthenia gravis
Authors: Fonseca V , Havard C W H 
Published: December 2008

Summary
A 52 year old man with myasthenia gravis and normal liver function was treated with neostigmine, prednisolone and azathioprine. Three years after starting azathioprine he developed clinical evidence of portal hypertension. A liver biopsy showed nodular regenerative hyperplasia (NRH). The development of NRH following azathioprine treatment in a patient with myasthenia gravis strengthens the case for a causal role of azathioprine in producing NRH and portal hypertension.
Nephrotic syndrome and hepatitis in early syphilis
Authors: Tang A L , Thin R N T , Croft D N 
Published: December 2008

Summary
A 54 year old man presented with features of acute hepatitis and the nephrotic syndrome. A diagnosis of active syphilis was only made by chance after extensive investigation. Syphilis should be considered in the differential diagnosis of both acute hepatitis and the nephrotic syndrome occurring separately as well as together.
Post-operative respiratory failure due to bilateral phrenic nerve palsy
Authors: Burgess R W , Boyd A F , Moore P G , Oldfield G S 
Published: December 2008

Summary
A 65 year old female patient developed a large left pleural effusion and a sternal split dehiscence following aorto-coronary artery bypass grafting. A second operation was performed to investigate and drain the pleural effusion and to repair the sternum. Subsequent to this operation the patient was in acute respiratory failure due to bilateral phrenic palsy. It is probable that the left phrenic nerve was damaged in the initial operation and the right nerve in the second. The patient’s subsequent progress is described.
Massive haematemesis--presenting symptoms of cystadenocarcinoma of the pancreas
Authors: Baruch Y , Levy Y , Goldsher D , Munichor M , Eidelman S 
Published: December 2008

Summary
A 43 year old woman presented with attacks of abdominal pain, haematemesis and hyperamylasaemia. Gastrointestinal X-rays and repeated upper gastrointestinal endoscopy failed to reveal the source of bleeding. Ultrasound and computed tomographic scan demonstrated a calcified mass in the tail of the pancreas. Surgical exploration revealed a solitary mass in the pancreas and histological examination showed cystadenocarcinoma. The patient died 2 years later because of local recurrence, but haematemesis and melaena did not recur. This case presents an unusual manifestation of cystadenocarcinoma of the pancreas with massive bleeding from the tumour via the pancreatic duct and associated pancreatitis. Other possible reasons for bleeding with cystadenocarcinoma of the pancreas are discussed.
Protracted systemic illness and interstitial nephritis due to minocycline
Authors: Wilkinson S P , Stewart W K , Spiers E M , Pears J 
Published: December 2008

Summary
A severe hypersensitivity-like illness with acute renal failure, lymphadenopathy and skin rash is reported following minocycline treatment in a 16 year old male. Following haemodialysis and steroid therapy his illness remitted, only to recur on withdrawal of the steroids. With further steroid treatment he recovered completely. Lymphocyte function tests, performed in an attempt to positively incriminate minocycline, were inconclusive due to a general suppression of the patient’s lymphocytes to in vitro stimulation. Hypersensitivity reactions attributed to minocycline include skin rashes, lymphadenopathy and one previous case of acute interstitial nephritis.
A comparison of the acute-phase response in middle aged and elderly patients
Authors: Woo J , Arumanayagam M , MacDonald D , Woo K S 
Published: December 2008

SummaryThe acute phase response in middle aged and elderly patients was compared by measuring the ratio of the peak C-reactive protein to peak creatine kinase level during the three day period after acute myocardial infarction. No difference in ratio was observed between a middle aged group of 14 patients (10.2 +/- 4.0 mean +/- s.e.), and an elderly group of 13 patients (9.1 +/- 1.5). C-reactive protein levels in two groups of middle aged and elderly control patients were similar (10.1 +/- 0.04 mg/l and 11.8 +/- 0.10 mg/l respectively). Production of C-reactive protein does not appear to be impaired in the elderly.
Acute splenic sequestration crisis in a young woman with homozygous sickle cell anaemia
Authors: Sarma P S A 
Published: December 2008

Abstract
Acute splenic sequestration crisis in a 20 year old female with homozygous sickle cell anaemia (Hb SS) is described. The resemblance of this complication to that of splenic vein ligation is discussed. This is the first case report known to the author of acute splenic sequestration crisis in an adult with homozygous sickle cell anaemia treated successfully.
Effect of treatment with botulinum toxin on spasticity
Authors: Das T K , Park D M 
Published: December 2008

Summary
Botulinum toxin, a product of Clostridium botulinum, produces presynaptic neuromuscular block by preventing release of acetylcholine from nerve endings. The toxin was injected directly into the skeletal muscles of six patients with severe spasticity due to stroke-related hemiplegia. It produced both subjective and objective improvement. The toxin injections were well tolerated and no significant side effect was reported.
Toxic gases
Authors: Matthews G 
Published: December 2008

Summary
An overview of the widespread use of gases and some volatile solvents in modern society is given. The usual circumstances in which undue exposure may occur are described. The most prominent symptoms and general principles of diagnosis and treatment are given and are followed by more specific information on the commoner, more toxic materials. While acute poisonings constitute the greater part of the paper, some indication of chronic disorders arising from repeated or prolonged exposure is also given.
Subarachnoid haemorrhage in Plasmodium falciparum malaria
Authors: Murugavel K , Saravanapavananthan S , Anpalahan A , James R F 
Published: December 2008

Summary
A 41 year old man with cerebral malaria was found to have numerous bilateral retinal haemorrhages and very high parasitaemia. Despite intensive treatment his condition deteriorated and he died. Autopsy showed subarachnoid haemorrhage, which has not been previously described in cerebral malaria.