bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malignant islet-cell tumour of the pancreas presenting with non-bacterial thrombotic endocarditis and eosinophilia
Authors: O’Boyle C P , Dempsey J , Otridge B , Barniville H 
Published: December 2008

Summary
A case of severe persistent eosinophilia and non-bacterial thrombotic endocarditis complicating a malignant islet-cell tumour of the pancreas is documented. Although these are well recognized complications of malignant tumours, they do not appear to have been previously documented from the same patient. These complications probably reflect ectopic synthesis and are unlikely to be causally interrelated.
Blood pressure variability: the effects of repeated measurement
Authors: Burstyn Peter , O’Donovan Barbara , Charlton Ian 
Published: December 2008

Summary
A series off 3 BP measurements were carried out on 2 groups of people. People not accustomed to BP measurements showed a decrease in pressure between the 1st and 3rd cuff inflation, while people trained to having their BP measured showed no such change.
Measurement of the BP of 111 people on 2 successive occasions 8 days apart showed that the mean BP of the whole group decreased between visits. Approximately one third of the people showed a drop in pressure bringing them from borderline hypertension to normotension between the 2 visits.
People whose BP dropped substantially between the 1st and 2nd visits achieved higher anxiety scores on a questionnaire than did the remainder of the sample. This may partially explain their labile BP.
Single measurements tend to overestimate the BP and the frequency of hypertension. Training experimental subjects by repeated measurement of their BP may be useful in preventing spurious BP changes unrelated to experimental manoeuvres.
Partial end organ resistance to thyroid hormone in congenital hypothyroidism
Authors: Connell John M C , McLaren E H 
Published: December 2008

Summary
End organ resistance to thyroid hormone has been described for a number of years: the defect may be partial or generalized. A case of partial end organ resistance to thyroid hormone in congenital hypothyroidism is described, with evidence of an alteration in TSH threshold to feedback inhibition by thyroid hormone. The implications of this factor in the management of hypothyroidism are discussed.
Renal vein thrombosis in nephrotic syndrome—a prospective study and review
Authors: Chugh K S , Malik N , Uberoi H S , Gupta V K , Aggarwal M L , Singhal P C , Suri S , Jain S K 
Published: December 2008

Summary
The incidence of renal vein thrombosis (RVT) and other thrombo-embolic phenomena was evaluated in 44 unselected patients with nephrotic syndrome. Renal vein thrombosis was demonstrated by selective renal venography in 10 patients and at post-mortem in one. Extension of the thrombus from the renal veins into the inferior vena cava was seen in 3 patients. Evidence of thrombo-embolism elsewhere in the body was seen in the form of thrombophlebitis in the lower extremities in 4 patients (9.1%), pulmonary embolism in 3 (6.8%) and myocardial infarction in one (2.3%).
Of the 11 patients with RVT, renal histology showed membranous glomerulonephritis in 3, minimal change nephritis in 5, membrano-proliferative in one and focal and diffuse proliferative glomerulonephritis in one patient each. The characteristics clinical findings such as gross haematuria and flank pain were noted in only 3 patients with RVT. No significant difference could be detected between the plasma fibrinogen, serum cholesterol, β-lipoprotein, triglycerides and phospholipid concentration of those who showed RVT and the remainder in whom RVT was not demonstrated. The possible mechanisms involved in the pathogenesis of RVT in nephrotic syndrome are discussed.
Anorexia nervosa, liquorice and hypokalaemic myopathy
Authors: Nightingale S , Smith P E , Turnbull D M 
Published: December 2008

Summary
A patient with a past history of anorexia nervosa developed a hypokalaemic myopathy following a ‘flu-like illness. Although she was apparently in remission from anorexia nervosa, the diet was found to be markedly abnormal with an excessive ingestion of liquorice and a low potassium salt intake. The clinical features and investigations, including muscle biopsy, are described. The patient is compared, with 2 reported cases of liquorice-induced myopathy, and the relationship between anorexia nervosa, liquorice and hypokalaemic myopathy is discussed.
Adrenocortical failure in diabetic pregnancy
Authors: Soler Norman G 
Published: December 2008

Summary
A Caucasian class F diabetic developed features suggestive of adrenocortical insufficiency during the second half of pregnancy. Serial biochemical and hormonal studies confirmed a diagnosis of progressive primary adrenal failure. Replacement therapy was introduced at 31 weeks’ gestation and the pregnancy ended successfully 6 weeks later. Addison’s disease is another autoimmune disorder that may occur in association with diabetic pregnancy.
Serum calcium in pulmonary tuberculosis
Authors: Sharma Subhash C 
Published: December 2008

Summary
Serum calcium was studied serially in 94 patients with active pulmonary tuberculosis. An equal number of age- and sex-matched patients with chronic obstructive pulmonary disease were controls. Seventy patients in the study group were normocalcaemic and 10 were hypercalcaemic. These 10 were on a higher supplement of vitamin D than the 70 normocalcaemic patients. There was a positive correlation between the daily vitamin intake and the degree and duration of hypercalcaemia. None of the controls showed hypercalcaemia.
A microbiological study of non-gonococcal proctitis in passive male homosexuals
Authors: Munday P E , Johnson A P , Thomas B J , Jeffries D J , Dawson S G , Osborn M J , Philip S , Harris J R W , Taylor-Robinson D 
Published: December 2008

Summary
In a study of 180 male homosexual patients attending a venereal disease clinic, a correlation was sought between symptoms and signs of proctitis and the isolation of Neisseria gonorrhoeae, group B streptococci, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis and herpes simplex virus. Faecal specimens were examined for enteric pathogens and serological tests for hepatitis B virus, syphilitic and chlamydial infections were performed.
There was no association between proctitis, as diagnosed by examination of a Gram-stained rectal smear, and the isolation of any micro-organism or detection of a positive serological test. There was, in addition, no association between any symptom or abnormal physical sign and any positive microbiological findings. Since 23% of patients from whom N. gonorrhoeae was isolated had no abnormal physical signs, it is difficult to assign a pathogenic role to other micro-organisms isolated from patients with and without clinical signs of proctitis. Approaches to further investigation of the problem are discussed.
Paradoxical embolism associated with patent foramen ovale
Authors: Leonard R C F , Neville E , Hall R J C 
Published: December 2008

Summary
Two patients are described in whom paradoxical embolism was diagnosed during life. One patient with cerebral embolism died and the other, with peripheral embolization, survived after treatment with streptokinase. Thrombolytic therapy has not previously been described in the treatment of patients with paradoxical embolism.
Studies of red cell cation transport in white and black essential hypertensives
Authors: Woods K L , Weissberg P L , West M J , Beevers D G 
Published: December 2008

Summary
It has been reported previously in white patients with essential hypertension that red cell sodium pump activity as measured by ouabain-sensitive uptake of the potassium analogue 86Rb from a potassium-free medium, is very significantly greater than in white controls. In a further study of black (West Indian) subjects reported here no similar abnormality was present in black hypertensives when compared with black normotensive individuals. Red cell rubidium uptake was significantly lower in normotensive blacks than in normotensive whites although sodium pump activity was the same. These results may be relevant to observed racial differences in sodium handling and in the pathophysiology of essential hypertension.
Haemorrhagic breast infarction complicating anticoagulant therapy
Authors: Banik S , Brun C 
Published: December 2008

Abstract
Haemorrhagic infarction of the breast induced by anticoagulant therapy is rare and has been infrequently reported in the literature. The following report illustrates such a case in which there was development of massive haemorrhagic infarction of the breast during treatment with nicoumalone for deep venous thrombosis after an operation for carcinoma of the colon.
Pulmonary paraprotein production in Waldenström’s macroglobulinaemia
Authors: Hull R G , Barton E J 
Published: December 2008

AbstractA case of Waldenström’s macroglobulinaemia is presented where marrow examination was normal and production of the abnormal protein was centered on the lungs. Symptomatic and biochemical improvement was achieved with chlorambucil and prednisone. Lung manifestations in the disease are briefly reviewed.
Ergotamine absorption and toxicity
Authors: Orton D A , Richardson R J 
Published: December 2008

Abstract
Adverse reactions to ergotamine were noted in 16 out of 41 studies in which therapeutic doses of the drug were given to normal, healthy volunteers. In 17 of the studies 0.25 mg ergotamine was given by injection, 6 i.v. and 11 i.m., in 20 studies 2 mg ergotamine was given by mouth, and 4 subjects received 2 mg ergotamine by suppository. Plasma and urinary ergotamine was measured by radio-immunoassay. Adverse reactions were significantly more frequent in subjects in whom plasma ergotamine exceeded 1.8 ng/ml. Pharmacokinetic data derived from the study are presented and their relevance to the therapeutic use of ergotamine are discussed.
Bilateral femoral neck fractures as a result of coeliac disease
Authors: Rubinstein A , Liron M , Bodner G , Gefel A 
Published: December 2008

Abstract
An elderly patient presenting with severe tetany secondary to hypocalcaemia causing bilateral fractures of the femoral necks, was proved to have coeliac disease. Severe muscle pains, an organic mental syndrome and personality changes are rare complications of coeliac disease and are reversible with treatment.
Association of von Recklinghausen’s neurofibromatosis with adult polycystic disease of kidneys and liver
Authors: Varma Subhash C , Kaushik S P , Talwar K K , Sharma B K 
Published: December 2008

Abstract
A case of von Recklinghausen’s neurofibromatosis with adult polycystic disease of the kidneys and liver (APDK) is reported. Although neurofibromatosis and APDK have been reported in association with many hereditary disorders, their association together has rarely been described.
Chronic small bowel ischaemia presenting as chronic pancreatitis
Authors: Morgan R J , Imrie C W , Russell R I , Pollock J G 
Published: December 2008

Abstract
A patient presenting with abdominal pain was initially thought to have chronic pancreatitis. Investigation revealed normal pancreatic structure but an indirect test of exocrine function showed low enzyme activity. The true diagnosis of chronic small intestinal ischaemia was demonstrated angiographically and confirmed at laparotomy. The early distinction between chronic pancreatitis and chronic small intestinal ischaemia is important because ischaemia may be the harbinger of acute and possibly fatal bowel infarction. Direct stimulation tests of pancreatic function showing normal results should turn attention to the possibility of small bowel ischaemia.
Blood platelet behaviour during infusion of an Intralipid based intravenous feeding mixture
Authors: Burnham W R , Cockbill S R , Heptinstall S , Harrison S 
Published: December 2008

AbstractBlood platelet behaviour was studied in six patients during infusion of an Intralipid-based intravenous feeding mixture. Lower concentrations of sodium arachidonate were required to induce platelets to aggregate and to undergo a release reaction during intravenous feeding than were required before or after intravenous feeding. This change was not due to a change in serum albumin level. The platelet behaviour that was induced by adenosine diphosphate or by adrenaline remained unchanged during intravenous feeding.
Natural history of severe thrombocytopenia in infectious mononucleosis
Authors: Wong Su Yong , Bennett Bruce 
Published: December 2008

Summary
The natural history of severe thrombocytopenia in two patients with infectious mononucleosis (minimum platelet counts under 10 × 109 and 17 × 109/l respectively) is described. In both, the platelet count rose rapidly and spontaneously, reaching approximately 100 × 109/l on the seventh day. Bleeding symptoms were also transient and never life-threatening. The possibility of very rapid spontaneous recovery from severe thrombocytopenia must be borne in mind in assessing the effect of any drug in the management of this complication of infectious mononucleosis.
Galactorrhoea, hyperprolactinaemia, and pituitary adenoma presenting during metoclopramide therapy
Authors: Cooper B T , Mountford R A , McKee C 
Published: December 2008

Summary
A 49-year-old woman presented with a one month history of headaches, loss of libido and galactorrhoea. She had been taking metoclopramide for the previous 3 months for reflux oesophagitis. She was found to have substantially elevated serum prolactin levels and a pituitary adenoma, which have not been previously described in a patient taking metoclopramide. The drug was stopped and the serum prolactin level fell progressively to normal with resolution of symptoms over 4 months. This suggested that contrary to our original impression that she had a prolactin-secreting pituitary adenoma which had been stimulated by metoclopramide, she had metoclopramide-induced hyperprolactinaemia and an incidental pituitary tumour.
Controlled trial of terfenadine and chlorpheniramine maleate in perennial rhinitis
Authors: Brostoff Jonathan , Lockhart J D F 
Published: December 2008

Summary
A double-blind clinical trial in 60 patients with perennial rhinitis was conducted to compare the efficacy and side effects of two antihistamines, terfenadine and chlorpheniramine maleate, and placebo. There was no statistically significant difference in response between active treatments and placebo. Although side effects were more frequent with chlorpheniramine this also was not statistically significant.
Intestinal vasculitis and lithium carbonate-associated diarrhoea
Authors: Cannon S R 
Published: December 2008

Summary
A 57-year-old male manic depressive patient is described who presented as an ‘acute abdomen’ whilst receiving treatment with lithium carbonate. Small bowel resection was performed, the histopathology of which revealed local vasculitic changes with thrombosis and subsequent infarction of the ileal wall. The possible aetiological role of lithium in this vasculitis is discussed.
Echocardiography in the diagnosis of right ventricular endomyocardial fibrosis
Authors: George B O , Gaba F E , Talabi A I , Adeniyi D S 
Published: December 2008

Summary
Twenty-one patients with endomyocardial fibrosis (EMF) and right ventricular involvement were studied by M-mode echocardiography. All 21 patients showed echocardiographic findings consisting of (i) increased right ventricular dimension, (ii) paradoxical septal motion, (iii) increased right ventricular outflow dimension (iv) thickening of the right ventricular anterior wall with increased right ventricular anterior wall motion, and (v) easily recordable tricuspid valve. In addition, some of the patients had posterior pericardial effusion, and fine fluttering of the tricuspid valve. EMF was diagnosed clinically in all the patients, haemodynamically and angiographically in 15 and confirmed at autopsy in one.
None of these echo findings was present in two patients with constrictive pericarditis, and two patients with massive ascites due to portal hypertension.
The management of large congenital liver cysts
Authors: Rashed A , May R E , Williamson R C N 
Published: December 2008

Summary
Congenital solitary cysts of the liver seldom exceed 10 cm in diameter. Four such cases were seen over a 5-year period in a city with a catchment population of about 800,000. One of these cysts was asymptomatic, but the others were complicated by intracystic haemorrhage, probable perforation and cyst-enteric fistula. Pre-operative liver scans and findings at laparotomy indicated a different treatment in each case—observation, aspiration, enucleation and drainage.
Wernicke’s encephalopathy in hyperemesis gravidarum
Authors: Nightingale S , Heath P D , Bates D , Barron S L 
Published: December 2008

Summary
A 20-year-old woman developed severe persistent vomiting early in pregnancy. In three months she lost 18 kg of body weight and showed the biochemical features of mild hepatic failure. Four days after starting intravenous dextrose and insulin, she developed short-term memory loss, confusion, ataxia, dysarthria, mild left upper motor neurone facial weakness and upbeat nystagmus. Thiamine was given and no further deterioration occurred. The vomiting persisted until intra-uterine fetal death. Thereafter, her medical, neurological and psychological problems gradually improved. The association of hyperemesis gravidarum, intravenous calorie load and Wernicke’s encephalopathy is discussed.
Post-biopsy renal arteriovenous fistula: successfully embolized with a Gianturco Mini Coil
Authors: Cassidy M J D , Harries-Jones E P , Van Zyl-Smit R 
Published: December 2008

Summary
A case is reported of a renal arteriovenous fistula following percutaneous needle biopsy resulting in heavy haematuria that was successfully occluded by transcatheter embolization with a Gianturco Mini Coil.
Sclerotherapy in the treatment of a recurrent lymphocele
Authors: Pope A J , Ormiston M C , Bogod D G 
Published: December 2008

Summary
The management of postoperative lymphoceles is often lengthy and unsatisfactory. We describe the successful treatment of a recurrent lymphocele by the repeated injection of sodium tetradecylsulphate (STD) after percutaneous aspiration. This method of treatment has not to our knowledge been previously described.
The Zollinger-Ellison syndrome and ectopic gastric mucosa
Authors: Galland R B , Fletcher D R , Evans D J , Shlugman D , Polak J M , Baron J H , Welbourn R B 
Published: December 2008

Summary
Ectopic gastric mucosa in an intramesenteric ileal diverticulum caused fatal bleeding after total gastrectomy in a patient with the Zollinger-Ellison syndrome (ZES).
Glandular fever-like illness associated with sulphasalazine
Authors: Carr-Locke David L , Ali Muntaz 
Published: December 2008

Summary
A patient with ulcerative colitis is described in whom a glandular fever-like illness was associated with the use of sulphasalazine which recurred in part on re-exposure to the drug. This complication has been previously described three times from the United States but not from the United Kingdom.
The effects of amiodarone on thyroid function
Authors: Jaggarao N S , Sheldon J , Grundy E N , Vincent R , Chamberlain D A 
Published: December 2008

Summary
The effects of amiodarone on thyroid function tests in 100 patients treated for 6 weeks to 8 years are reported. One patient became thyrotoxic and 10 developed latent or overt hypothyroidism. Twenty-five patients remained clinically euthyroid throughout, but had free thyroxine indices above the normal range. In these patients with apparently anomalous results, total tri-iodothyronine was normal in 19 cases and low in 1; conversely, free thyroxine was high in all 17 cases in which it was measured. Thyrotrophin releasing hormone (TRH) tests were abnormal in 4 of the 13 patients who had the test. Reverse tri-iodothyronine was significantly raised after 2 weeks amiodarone in 5 healthy subjects, but an equivalent amount of iodine in 9 healthy individuals did not significantly affect any of these tests. We believe that these changes are due in part to inhibition of peripheral conversion of thyroxine to tri-iodothyronine with diversion to reversed tri-iodothyronine. Thyroid function tests should be checked once or twice a year in all patients on maintenance amiodarone. Tests indicating hypothyroidism are likely to be clinically relevant, whereas levels of thyroxine suggesting thyrotoxicosis may be misleading and do not usually imply the need to discontinue treatment with the drug.
The symptomatic and objective effects of nifedipine in combination with beta-blocker therapy in severe angina pectoris
Authors: Jenkins R M , Nagle R E 
Published: December 2008

SummaryNine patients with severe coronary artery disease and disabling angina receiving either regular metoprolol or oxprenolol, together with glyceryl trinitrate tablets as required for chest pain, were studied. Nifedipine 10 mg three times per day was compared to placebo in a double blind randomized control trial, using patient diary cards and exercise tests. The number of recorded episodes of angina during the placebo period of 15.0 +/- 2.1 (mean +/- s.e.m.) per patient per week was significantly reduced to 11.2 +/- 2.5 during the nifedipine period (P less than 0.05). Similarly, the recorded number of glyceryl trinitrate tablets consumed during the placebo period of 12.6 +/- 2.1 was significantly reduced to 9.1 +/- 2.0 tablets per patient per week during the nifedipine period (P less than 0.05). There was a statistically significant increase in both the duration of exercise to onset of chest pain (from 241 +/- 16.3 seconds on placebo to 306 +/- 38.4 seconds on nifedipine (P less than 0.05)) and the total work performed to the onset of chest pain during the nifedipine period compared to the control and placebo periods (P less than 0.05). There was a significant increase (P less than 0.05) in exercise time before the onset of appreciable ST depression (greater than 1 mm) on exercise testing during the nifedipine period (66.2 +/- 4.2 sec) compared to the control period (51.2 +/- 3.0 sec) and placebo periods (58.7 +/- 3.5 sec). Although nifedipine was generally well tolerated, one patient experienced a severe episode of angina whilst taking the drug, which required admission to hospital.
The role of the routine pre-operative chest X-ray in the elderly general surgical patient
Authors: Seymour David Gwyn , Pringle Robert , Shaw James William 
Published: December 2008

SummaryIn an unselected group of 233 patients aged 65 years and over undergoing non-cardiopulmonary surgery, 57·5% had some abnormality on routine pre-operative chest X-ray and 40·3% had an abnormality which was regarded as clinically significant. Of all patients, 32·2% subsequently required a postoperative chest film for diagnostic purposes, and in these cases the pre-operative X-ray was invaluable as a baseline. During the study period there were ten occasions where the discovery of an abnormality on a routine pre-operative chest film directly affected the treatment plan. Pre-operative chest radiology proved ineffective as a method of predicting postoperative respiratory complications and was of only limited effectiveness in predicting postoperative cardiac morbidity.It is concluded that a routine pre-operative chest X-ray should be available in all elderly surgical patients (a) as a baseline measurement and (b) to exclude unsuspected disease. The prediction of postoperative cardiac and respiratory morbidity, however, is best achieved by non-radiological means.
Fatal renal haemorrhage following haemodialysis in a patient with obstructive uropathy
Authors: Palaniswamy R , Singhal P C , Rao M S , Laimayum D S , Raghu K , Chary K S 
Published: December 2008

Summary
A 22-year-old male with obstructive uropathy and renal failure was given pre-operative haemodialysis. He collapsed five hours later. Autopsy revealed massive intrarenal haemorrhage and rupture of a dilated superior calyx intraperitoneally. Anticoagulation employed during haemodialysis was probably responsible for this spontaneous renal haemorrhage and subsequent calyceal rupture.