bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle dynamics in hypertrophic cardiomyopathy
Authors: Alvares R F , Goodwin J F 
Published: December 2008

Summary
Previous reports have demonstrated that patients with hypertrophic cardiomyopathy (HCM) have prolonged isovolumic relaxation period (IRP) reflecting reduced rate of fall of left ventricular pressure. Eighty four patients with proven hypertrophic cardiomyopathy and 31 normal subjects were studied by simultaneous recordings of echocardiogram, apexcardiogram, phonocardiogram and ECG.
In normal subjects the IRP value was 61 ± 11 ms (mean ± s.d.). In the 84 patients there was enormous variability of the IRP value from 0 to 160 ms reflecting abnormal and incoordinate (but not necessarily impaired) relaxation and it was possible to identify three subgroups among the patients: 60 patients in sinus rhythm who had prolonged IRP and significantly above the normal values, 9 patients in atrial fibrillation in whom the IRP was within the normal range and 15 patients with IRP values between 0–45 ms, with the mean (26 ms) below the normal range (mean ± 2 s.d.). This group of patients with short IRP also had signs of outflow tract systolic pressure gradient, with partial mid-systolic closure of the aortic valve, systolic anterior motion of the anterior mitral valve leaflet and paradoxical splitting of the second heart sound. It is suggested that the short IRP is due to extremely delayed aortic valve closure and careful scrutiny of this subset with haemodynamic evaluation has shown that this non-invasive interval (A2-Mo) may not always be a valid measure of left ventricular relaxation.
Asymmetric apical hypertrophy: ten years experience
Authors: Sakamoto T , Amano K , Hada Y , Tei C , Takenaka K , Hasegawa I , Takahashi T 
Published: December 2008

Summary
This paper reports 10 years experience of 31 patients with asymmetric apical hypertrophy, in whom left ventricular hypertrophy involved the apex exclusively and giant T wave inversion in the left precordial leads was the characteristic finding. This type of hypertrophic cardiomyopathy was observed predominantly in men over 40 years of age. Family history was negative and patients usually had no complaints. Left ventricular hypertrophy was evident by physical examination as in other forms of hypertrophic cardiomyopathy, but a systolic murmur was faint or absent and the second heart sound was frequently split. Electrocardiographic signs may fluctuate, and occasionally progression or regression occurs. Echocardiography including the two-dimensional method was essential for the diagnosis and left ventriculography was helpful for confirmation. To date complications have been infrequent and the prognosis seems good. The relation of asymmetric apical hypertrophy to other forms of hypertrophic cardiomyopathy is under investigation.
Vasodilator therapy of dilated cardiomyopathy
Authors: Cohn J N 
Published: December 2008

Summary
Vasoconstriction increases impedance to ventricular ejection and impairs the performance of the dilated myopathic heart. Vasodilator drug therapy by reducing vascular resistance, increasing vascular compliance and increasing vascular capacitance improves cardiac function and relieves the signs and symptoms of congestive heart failure. Earlier intervention in an attempt to alter the natural history of cardiomyopathy should be studied.
Pituitary apoplexy and haemorrhage into adenomas
Authors: Tsitsopoulos P , Andrew J , Harrison M J G 
Published: December 2008

Summary
A review of 78 cases of surgically managed pituitary adenomas revealed that haemorrhage had occurred in 13. Frank haemorrhage or haemorrhagic infarction caused increasing headache, drowsiness, diplopia and visual failure. The correct diagnosis was suggested by skull X-rays and contrast studies leading to prompt surgical decompression.
Trends in psychotropic prescribing in general practice and general medical patients
Authors: Smith A R , McIntosh M , McInnes G T , Lawson D H 
Published: December 2008

Summary
Psychotropic drug prescribing in 1280 medical inpatients between 1973–75 was compared with that in 1200 similar patients during 1982–83. Three benzodiazepines accounted for 64% of prescriptions in 1973–75 and nine benzodiazepines for 82% of prescriptions in 1982–83. Over the decade, use of psychotropic drugs fell from 56% to 38% (P &lt; 0.001), primarily due to a reduction in patients treated only in hospital (34% vs 16%, P &lt; 0.001). Before admission, the proportions of patients receiving these drugs were similar (17% vs 18%). During admission, concomitant administration of similar drugs declined from 22% of patients in 1973–75 to 11% in 1982–83 (P &lt; 0.001), while concurrent prescribing before admission increased from 13 to 19%. The marked fall in psychotropic drug use and in inappropriate concomitant therapy indicates an encouraging trend towards more rational drug use at least in hospital. This was achieved without fiscal control and further rationalization of prescribing habits may be achieved by self-audit within the profession without legislative action.
Iodine-induced hyperthyroidism in a patient with a normal thyroid gland
Authors: Shilo S , Hirsch H J 
Published: December 2008

Summary
Iodine-induced hyperthyroidism can develop even in the presence of an otherwise normal gland. One of the less common sources of iodine is tablets of seaweed, sold over the counter without prescription. We report the case of a 72 year old female who developed clinical and laboratory evidence of hyperthyroidism while ingesting sea-kelp (Vitalia) tablets. Six months after stopping the tablets, the symptoms and laboratory evidence of hyperthyroidism had disappeared. No evidence of pre-existing thyroid disease was found.
Gait ataxia as a presenting symptom of malignant epidural spinal cord compression
Authors: Karp S J , Ho R T K 
Published: December 2008

Summary
A 68 year old man with prostatic carcinoma developed spinal cord compression. The sole presenting feature was painless gait ataxia indistinguishable from cerebellar ataxia. He was investigated for cerebellar disease but the correct diagnosis was made when he subsequently presented with paraplegia and classical signs of spinal cord compression. Surgical decompression failed to produce neurological recovery.
We discuss the importance of recognizing this unusual presentation of spinal cord compression, its possible mechanism and evidence that it may be under-reported.
Anticholinergic-induced analgesia: possible role for the cholinergic system in abnormal sensory symptoms in Parkinson's disease
Authors: Sandyk R 
Published: December 2008

Summary
Sensory symptoms related to pain perception have been reported to occur in 30–50% of parkinsonian patients. Two patients with Parkinson's disease are reported, in whom painful sensory phenomena preceded or accompanied the disease process. In both patients the sensory phenomena were unresponsive to therapy with oral narcotics, anti-inflammatory drugs or administration of levodopa/carbidopa. Benzhexol (4-6 mg/day) produced dramatic amelioration of symptoms, indicating a role for the cholinergic system in the pathophysiology of abnormal sensory symptoms in Parkinson's disease and possibly in human analgesia in general.
Sensorineural deafness—a new complication of ulcerative colitis?
Authors: Hollanders D 
Published: December 2008

Summary
A case of sudden bilateral sensorineural deafness associated with active ulcerative colitis is reported. Evidence for an autoimmune basis for this condition is reviewed and the potential benefit of systemic corticosteroids emphasized. The condition may represent a recently recognized extra-intestinal complication of ulcerative colitis.
Primary carcinoma of the gall bladder associated with ulcerative colitis
Authors: O'Connor R , Harding B , Greene D , Coolican J 
Published: December 2008

Summary
The report concerns a case of primary carcinoma of the gall bladder in a 53 year old man, who, 13 years previously underwent a pan-proctocolectomy for ulcerative colitis. Previous reports are reviewed, highlighting the difficulty of early diagnosis.
Cryofibrinogenaemia and acute gangrene in systemic sclerosis
Authors: Barrett M C , Prendiville J S , Pardy B J , Cream J J 
Published: December 2008

Summary
A 49 year old man with systemic sclerosis developed ischaemia of his extremities with massive peripheral gangrene. High levels of circulating cryofibrinogen were detected in the plasma and the significance of these findings is discussed.
Hypercalcaemia due to sarcoidosis corrects with bisphosphonate treatment
Authors: Gibbs C J , Peacock M 
Published: December 2008

Summary
We report a case of sarcoid hypercalcaemia treated with the bisphosphonate, APD [(3-amino-1-hydroxypropylidene)-1,1-bisphosphonate]. Investigations showed that the hypercalcaemia was associated with a high plasma 1,25 dihydroxy vitamin D concentration. A low dietary intake of calcium partially corrected the hypercalcaemia but APD rapidly normalized plasma calcium without reducing the elevated 1,25 dihydroxy vitamin D concentration. The case demonstrates that hypercalcaemia in sarcoidosis results from the effects of 1,25 dihydroxy vitamin D on bone as well as on calcium absorption and that prolonged suppression of the effect on bone occurs with APD treatment.
Rupture of a cerebral aneurysm associated with nifedipine treatment
Authors: Gill J S , Zezulka A V , Horrocks P M 
Published: December 2008

Summary
We describe rupture of a cerebral arterial aneurysm in a 32 year old hypertensive woman following the introduction of nifedipine treatment. It is suggested this relationship is causal rather than coincidental and mediated through cerebral arterial vasodilatation.
Successful treatment of scleroderma renal crisis with enalapril
Authors: Milsom S R , Nicholls M G 
Published: December 2008

Summary
A patient with scleroderma renal crisis is described. At presentation he had severe hypertension, deteriorating renal function, microangiopathic haemolytic anaemia, and elevated levels of renin, aldosterone and noradrenaline. Enalapril controlled blood pressure, stabilized renal function, lowered aldosterone and noradrenaline levels, and improved peripheral circulation. It appears that converting-enzyme inhibitors can favourably alter the outlook of this otherwise fatal disorder.
Pericarditis with pericardial effusion complicating chickenpox
Authors: Seddon D J 
Published: December 2008

Summary
A girl with chickenpox is presented. She developed arthritis, pericarditis with pericardial effusion and meningism during the course of her illness. Pericarditis is an unusual complication of this disease, and in this instance was associated with characteristic electrocardiographic changes. Aspects of her case history are discussed.
No effect of verapamil on calcium stimulated calcitonin release
Authors: Amado J A , Gómez C , Pesquera C , Antón M A , Freijanes J , González Macías J 
Published: December 2008

Summary
We investigated the effect of infusing 5 mg/h of verapamil on calcitonin release in normal males. After 60 minutes of infusion, ionized calcium and calcitonin levels were unchanged. At 60 minutes we infused 3 mg/kg of body weight of elemental calcium over 10 minutes and we found that calcitonin release was no different from when the subjects were receiving verapamil. These results suggest that, despite blocking calcium channels, acute hypercalcaemia produces normal calcitonin release.
Idiopathic oedema and diuretics
Authors: Dunnigan M G , Denning D W , Henry J A , de Wolff F A 
Published: December 2008

Summary
Diuretic abuse has been invoked as the cause of idiopathic oedema. In this study, eight patients with idiopathic oedema were studied. Symptoms and weight variation continued despite the proven absence of diuretics in seven of them as determined by urinary chromatograms. Idiopathic oedema cannot therefore be attributed to diuretic use alone.
Insulinoma presenting as alcoholic stupor
Authors: Dandona P , Fonseca V A , Mikhailidis D P , Menon R K 
Published: December 2008

Summary
We report a case of prolonged loss of consciousness due to hypoglycaemia following ethanol abuse in a non-diabetic. The patient also reported symptoms compatible with hypoglycaemia following heavy manual work. Further investigations revealed a pancreatic insulinoma, which was successfully removed surgically. The patient remains asymptomatic 18 months later, despite occasional episodes of ethanol abuse. This case illustrates how heavy exercise and/or alcohol abuse can aggravate spontaneous hypoglycaemia.
Calcium channel blockers cannot prevent pure vasospastic myocardial infarction
Authors: Depelchin P , Degre S 
Published: December 2008

Summary
Coronary artery spasm is a recognized cause of myocardial infarction. This report describes a case of myocardial infarction attributed to pure coronary spasm which was halted by a double perfusion with streptokinase and nitroglycerin. Further coronary artery spasm leading to a myocardial infarction could not be avoided several weeks later, although the patient was left on calcium channel blocker therapy. The two attacks were not preceded by warning angina pectoris, contrary to accepted belief. The best objective of end-point drug therapy and its assessment in vasospastic angina are discussed.
Pancytopenia and folate deficiency in alcoholics
Authors: Weston C F M , Hall M J 
Published: December 2008

Summary
Three alcoholic patients are reported who presented with pancytopenia and macrocytosis due to acute folate deficiency. While folate deficiency is a common finding in alcohol abusers due to abnormalities in diet, intestinal absorption, internal metabolism and excretion, this life-threatening complication has not been well documented.
Bilateral submandibular gland lymphoma in Sjögren’s syndrome
Authors: Law N W , Leader M 
Published: December 2008

Summary
Salivary gland lymphoma is associated with Sjögren’s syndrome. A case of bilateral submandibular gland and sublingual gland lymphoma, arising in Sjögren’s syndrome, is presented. A lymphoma involving more than one salivary gland may occur in Sjögren’s syndrome, and there is an increased risk of developing an extrasalivary lymphoma.
Comparison of nifedipine, prazosin and hydralazine added to treatment of hypertensive patients uncontrolled by thiazide diuretic plus beta-blocker
Authors: Ramsay L E , Parnell L , Waller P C 
Published: December 2008

Summary
In 93 patients with hypertension uncontrolled by bendrofluazide 5 mg plus atenolol 100 mg daily, the effects of adding nifedipine (up to 60 mg/day, n = 31), prazosin (up to 20 mg/day, n = 31), or hydralazine (up to 200 mg/day, n = 31) were compared in a 6 month open random parallel group study. The three drugs did not differ significantly as regards antihypertensive effect, withdrawal rate, total number of side effects, or effect on serum biochemical variables. The pattern of side-effects differed. Headache, flushing and oedema were common with nifedipine, tiredness and drowsiness with prazosin, and headache with hydralazine. Nifedipine is an acceptable third-line antihypertensive drug which may have some advantage over hydralazine and prazosin.
The ventilatory response to hypoxia: how much is good for a mountaineer?
Authors: Milledge J S 
Published: December 2008

Summary
Methods for measuring the ventilatory response to hypoxia (HVR) are reviewed. The criteria for success as a high altitude mountaineer are defined as freedom from acute mountain sickness (AMS) and ability to perform well at extreme altitude.
The evidence for a brisk HVR being protective against AMS and associated with successful high altitude performance is reviewed. The contrary evidence of blunted HVR in high altitude residence and some elite climbers is discussed. The effect of a brisk HVR in producing periodic breathing when asleep at altitude is noted.
It seems that there is an optimum HVR for different circumstances and peoples. A brisk HVR is a benefit in lowlanders going to altitude for the first time whereas a blunted HVR is appropriate for high altitude residents and possibly for very experienced elite climbers.
Effect of acetazolamide on blood gases and 2,3 DPG during ascent and acclimatization to high altitude
Authors: Milles J J , Chesner I M , Oldfield S , Bradwell A R 
Published: December 2008

Summary
Blood gases and red cell 2,3 DPG concentrations were measured during ascent and a stay for 6 days at 4846 m in 20 subjects. Acetazolamide improved Pa,O2 and reduced pH and Pa,CO2. 2,3 DPG concentrations were lower in the acetazolamide group during ascent and at high altitude. However, 2,3 DPG concentrations were significantly greater at high altitude in both the acetazolamide and placebo groups compared with low altitude. The acetazolamide group remained different from the placebo group during the stay at high altitude with higher Pa,O2, lower PaCO2, lower pH and lower 2,3 DPG concentrations.
The effect of acetazolamide on breath holding at high altitude
Authors: Morrissey S C , Keohane K , Coote J H 
Published: December 2008

Summary
The effect of altitude and acetazolamide on breath holding was studied in 20 individuals. Breath holding time was reduced progressively during ascent. There was an additional reduction in the acetazolamide group at low but not at high altitude. The initial difference between the two groups may have been related to a lower CSF pH when on acetazolamide. At high altitude the finding of similar breath holding times in the two groups may have been due to acclimatization in the placebo group.
Hepatic metastasis from intracranial meningioma
Authors: Jenkinson M L , Watson A J M , Boyle S 
Published: December 2008

Summary
A 38 year old man presented with a hepatic mass which biopsy showed to be a metastasis from an intracranial meningioma. The meningioma originally followed cranial radiotherapy. Previous reports of extracranial metastases are reviewed.
Recurrent hyperparathyroidism: a study of 3 cases with evaluation of some pathogenetic and clinical aspects
Authors: Mazzuoli G , Minisola S , Scarda A , De Matteis A , Tabolli S , Bigi F , Valtorta C , D’Erasmo E 
Published: December 2008

Summary
Three patients with recurrent hyperparathyroidism (15, 8 and 3 years respectively, after the first operation) are described in order to establish the causes and define the clinical characteristics of the disease.
The observation that in the present series recurrent hyperparathyroidism was associated either with an adenoma (two cases) or a carcinoma (one case), appears to stress the possibility of the pathological involvement of one gland even though recurrent hyperparathyroidism should be considered due to the chronic extrinsic stimulation of the parathyroid glands. The severity of the clinical and metabolic picture observed at the time of the first diagnosis and/or at the time of recurrence together with the simultaneous presence of bone and stone disease in the patients described is of particular interest.
The cases reported underline the importance of carrying out careful metabolic investigations in patients with hyperparathyroidism not only before but also for a prolonged period of time after operation.
Chronic perianal fistula: beware of rectal duplication
Authors: Narasimharao K L , Patel R V , Malik A K , Mitra S K 
Published: December 2008

Summary
A child with cystic duplication of the rectum containing ectopic duodenal mucosa and aberrant pancreatic tissue presenting as a chronic perianal fistula is reported. The duplication was removed by subtotal excision of the cyst along with mucosal sleeve resection from the common septum with the rectal wall.
Calcium and calcitonin responses to calcium infusion in type I diabetes mellitus
Authors: Amado J A , Gomez C , Obaya S , Otero M , Gonzalez-Macias J 
Published: December 2008

Summary
We studied calcium and calcium and calcitonin responses to intravenous calcium infusion (3 mg of elemental calcium/kg of body weight in 10 minutes) in 21 type I diabetic males and 17 age-matched normal males. Baseline total calcium, parathyroid hormone and calcitonin levels were normal in the diabetic group, but ionized calcium was lowered. Cortical bone status and osteocalcin levels were normal, suggesting a normal osteoblastic function. Total calcium and ionized calcium responses to calcium infusion were lowered in the diabetic group. Despite these lowered calcaemic responses, calcitonin secretion was normal.
‘Apathetic’ thyrotoxicosis presenting with hypercalcaemia and spurious normalization of serum thyroid hormone levels
Authors: Ralston S H , Fraser W D , Soukop M , McKillop J H 
Published: December 2008

Summary
A patient with thyrotoxicosis presented with weight loss and hypercalcaemia, leading to an erroneous diagnosis of occult malignant disease. Intercurrent illness and drug treatment of hypercalcaemia in this patient caused a depression of circulating thyroid hormone levels, leading to a delay in diagnosis. Radionuclide studies of thyroid function, in contrast, consistently suggested a thyrotoxic state. It is suggested that in this situation, radionuclide studies may give a more accurate assessment of thyroid status than biochemical tests, which may be difficult to interpret in the presence of non-thyroidal illness.
Bone marrow granulomas in mononucleosis
Authors: Fiala M , Colodro I , Talbert W , Ellis R , Chatterjee S 
Published: December 2008

Summary
Two patients with mononucleosis, one due to cytomegalovirus (CMV), and the other due to Epstein-Barr virus (EBV), presenting with high fever, malaise and hepatitis, had granulomas in the bone marrow but not in the liver. In patients who have unexplained fever, bone marrow granulomas may be a clue to CMV or EBV infection and need not initially raise the fear of prognostically more severe illness.
Somatostatin analogue SMS 201-995 long term therapy for vipoma
Authors: Juby L D , Burke D A , Axon A T 
Published: December 2008

Summary
The definitive treatment of a pancreatic tumour secreting vasoactive intestinal polypeptide is surgical removal of the tumour, but when curative resection is not possible symptomatic treatment of the endocrine hyperfunction is important. Streptozotocin, although effective for palliation, can involve unpleasant side effects. We report the long term use of subcutaneous somatostatin analogue SMS 201-995 in an elderly man presenting with severe watery diarrhoea and anaemia due to a pancreatic vipoma. Good symptomatic improvement has been achieved with no side effects over a period of 24 months. We suggest there is a use for subcutaneous SMS 201-995 in elderly patients with inoperable pancreatic gut hormone producing tumours with metastases and in those where surgery would carry a high operative risk.
Benign recurrent intrahepatic cholestasis--25 years of follow-up
Authors: Putterman C , Keidar S , Brook J G 
Published: December 2008

Summary
Only 70 cases of recurrent intrahepatic cholestasis have been reported in the literature since the original description of this entity in 1959.
The benign nature of the disease has been questioned, some authors suggesting progression to biliary cirrhosis. We report our follow-up of one such patient for over 25 years with no adverse physical consequences or histological deterioration. Sequential liver biopsies were obtained during this period. A conservative approach to diagnosis and treatment is therefore indicated.
Membranous nephropathy caused by mercury-containing skin lightening cream
Authors: Oliveira D B G , Foster G , Savill J , Syme P D , Taylor A 
Published: December 2008

Summary
A 46 year old woman developed membranous nephropathy following the use of a mercury-containing skin lightening cream. This association has not been reported in the literature for over a decade and apparently never from this country. It is important that clinicians are aware of this usually eminently treatable cause of the nephrotic syndrome as it is likely to be missed unless specifically enquired for.