bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of nisoldipine and nifedipine as additional treatment in hypertension inadequately controlled by atenolol
Authors: Hoffbrand B I , Earle K A , Nievel J G , Restrick L J , Simmonds N J 
Published: December 2008

Summary
Twenty-eight patients (11 Caucasian, 17 black) whose blood pressure was more than 160/96 mmHg after 4 weeks on placebo added to atenolol 100 mg/day were randomly given, in addition, nisoldipine 10 mg or nifedipine 20 mg each twice a day for 8 weeks in a double-blind cross-over study. There was a statistically significant (P &lt; 0.001) fall in blood pressure with no change in heart rate, both supine and erect, on both drugs. There were no significant differences between nisoldipine and nifedipine. Adverse effects were recorded in 15%, 17% and 35% of the patients available for safety comparison for placebo, nisoldipine and nifedipine, respectively. There were no significant differences between the black and Caucasian patients in blood pressure responses, although the study had only a low power to detect these. However, the fasting serum triglyceride levels at the end of both calcium antagonist treatment periods were highly significantly lower in the black patients compared with the Caucasian patients. Nisoldipine, which has a higher coronary vascular selectivity and less negative inotropism than nifedipine, is as effective and as well tolerated as nifedipine in patients whose hypertension is inadequately controlled on atenolol. It may have a special role in hypertensive patients with impaired left ventricular function.
Resistance to recombinant human erythropoietin due to aluminium overload and its reversal by low dose desferrioxamine therapy
Authors: Yaqoob M , Ahmad R , McClelland P , Shivakumar K A , Sallomi D F , Fahal I H , Roberts N B , Helliwell T 
Published: December 2008

Summary
Seventeen severely anaemic and transfusion-dependent haemodialysis patients with a haemoglobin less than 7 g/dl were treated with recombinant human erythropoietin (r-Hu-EPO). Aluminium toxicity was diagnosed by a positive desferrioxamine (DFO) test and bone biopsy. Seven out of eight patients without aluminium toxicity responded to r-Hu-EPO therapy. Similarly all patients with aluminium toxicity (n = 4) but pre-treated with standard dose of DFO prior to r-Hu-EPO therapy responded but none of the patients with untreated aluminium toxicity (n = 5) responded to r-Hu-EPO therapy. In order to achieve adequate response in these patients, r-Hu-EPO and DFO had to be given in combination. The dose of desferrioxamine used to reverse r-Hu-EPO resistance was less and also used for a short time. We therefore confirm r-Hu-EPO resistance owing to aluminium overload and report its successful and safe reversal with low dose DFO therapy.
Gait disturbances in the acute medically ill elderly
Authors: Steiger M J , Berman P 
Published: December 2008

Summary
The characteristics of acute deterioration in truncal movements, posture and gait were studied in patients admitted with acute non-neurological disease. Reversible gait abnormalities with characteristics of a 'lower-half parkinsonism' were associated with a disorder of axial movement, disability (as assessed by an activities of daily living score), and low mental test score. There was no association of gait dysfunction with tests of upper limb apraxia.
An 'at risk' sub-group of elderly patients was identified who during an acute illness lose their walking independence, of whom some also have great difficulty performing axial movements. Furthermore, any assessment of locomotor and axial movement in elderly patients must consider that any impairment may be the result of an acute medical illness.
Primary liposarcoma of the omentum
Authors: Okajima Y , Nishikawa M , Ohi M , Fukumoto Y , Kuroda K , Shimomukai H 
Published: December 2008

SummaryThis report is of a 54 year old female with omental liposarcoma. Diagnosis was made by ultrasonography, computed tomography, angiography and operation. The patient was treated by surgical excision. The histological examination revealed that the tumour was round cell liposarcoma. This is the first report to our knowledge of round cell liposarcoma of the omentum.
IgA nephropathy in hereditary angioedema
Authors: Srinivasan Jayashri , Beck Peter 
Published: December 2008

SummaryHereditary angioedema is an autosomal dominant disorder of the complement system in which there is a deficiency of the inhibitor of the activated first component of complement. We have previously reported on three generations of a family with classic hereditary angioedema. Three members of this family have now developed IgA nephropathy. The association of hereditary angioedema with various immunoregulatory disorders has been previously reported but this is the first report of IgA nephropathy in association with this condition.
A patient with recurrent hypothermia associated with thrombocytopenia
Authors: Chan Kin Ming , Beard Keith 
Published: December 2008

Summary
A 69 year old woman had 13 hospital admissions because of hypothermia attributed to self-neglect. On each occasion she was found to be thrombocytopenic, and the platelet count always returned to normal with rewarming. The case records of all patients admitted to the Victoria Infirmary between 1986 and 1990 with a primary diagnosis of hypothermia were reviewed. Two other patients of the 75 assessed were found to have had thrombocytopenia linked to hypothermia, but neither showed a recurrent relationship.
Thrombotic thrombocytopenic purpura associated with pregnancy in two sisters
Authors: Alqadah Farouq , Zebeib Mohammed Amin , Awidi Abdalla S 
Published: December 2008

Summary
Two sisters suffered from thrombotic thrombocytopenic purpura late in their first pregnancies. HLA typing of the patients and their immediate family members demonstrated no obvious relationship. Hereditary aspects, association with pregnancy, prognosis and management of pregnant women with TTP are discussed.
Portal vein thrombosis due to Candida albicans associated with hepatic cirrhosis
Authors: Torres G , Gil Grande L A , Boixeda B , Martín-de-Argila C , Barcena R , Garcia Hoz F 
Published: December 2008

Summary
A case of portal vein thrombosis due to Candida albicans in a patient with alcoholic hepatic cirrhosis in the absence of hepatocarcinoma is described. Infection is a known cause of portal vein thrombosis but thrombosis by Candida albicans has not to our knowledge been previously reported.
Imprint cytology--a cheap, rapid and effective method for diagnosing Helicobacter pylori
Authors: Misra S P , Dwivedi M , Misra Vatsala , Gupta S C 
Published: December 2008

Summary
To compare the efficacy of imprint cytology, histology and CLO-test (for biopsy urease) in detecting Helicobacter pylori infection, antral biopsies were taken from 239 patients undergoing upper gastrointestinal endoscopy. Both imprint cytology and histology showed the presence of H. pylori in 215 (90%) patients. The sensitivity and specificity of imprint cytology vis-à-vis histology was noted to be 100%. The CLO-test was performed in 165 patients and was positive in 130 (79%) patients. The sensitivity and specificity of the CLO-test were 89% and 95%, respectively. The median time required for the CLO-test to become positive and for imprint was 60 minutes for each. The sensitivity of the CLO-test was reduced further in patients receiving colloidal bismuth subcitrate. Of the 27 patients receiving the drug the sensitivity of the CLO-test was only 9% after 4 weeks of therapy. However, the specificity was 100%. The sensitivity and specificity of imprint cytology were unaffected by the antimicrobial therapy and after 4 weeks of treatment were still 100%.
It is concluded that the CLO-test has a lower sensitivity and specificity for diagnosing H. pylori infection compared to imprint cytology, which had a sensitivity and specificity equal to that of histology. Imprint cytology may be prepared as an adjunct to histology in patients in whom antral biopsies are taken as it offers a relatively quick diagnosis of H. pylori infection, is considerably cheaper than the CLO-test and does not require additional biopsy material.
Osteoporosis and the Marfan syndrome
Authors: Gray J R , Bridges A B , Mole P A , Pringle T , Boxer M , Paterson C R 
Published: December 2008

Summary
Fourteen patients with Marfan syndrome, defined according to present criteria, had bone mineral content of the distal forearm measured by single photon absorptiometry. Patients were matched for age and sex with a large local group of healthy volunteers. While further work is needed with other methods of densitometry with measurements at other sites, our results provide no evidence that there is an increased incidence of osteoporosis in Marfan syndrome. Previous reports of an association were probably due to incorrect clinical diagnosis or confusion with clinically similar syndromes known to cause osteoporosis.
A comparison of 10 MHz ultrasound and 201-thallium/99m-technetium subtraction scanning in primary hyperparathyroidism
Authors: Gallacher S J , Kelly P , Shand J , Logue F C , Cooke T , Boyle I T , McKillop J H 
Published: December 2008

Summary
Both high resolution (10 MHz) ultrasound and 201-thallium/99m-technetium subtraction scanning (Tl/Tc) were carried out preoperatively in 25 patients with primary hyperparathyroidism.
Operative findings were the standard against which these two imaging methodologies were compared. Tl/Tc scanning showed a sensitivity of 42% and a specificity of 97%. By comparison, sensitivity of ultrasound was 38% and specificity 89%. Both techniques were positive together in nine instances and correctly localized the parathyroid adenoma in eight of these. In 44% of cases, however, both methods together failed to localize any abnormal parathyroid tissue.
The ability of these modalities to localize abnormal parathyroid tissue correctly tended to vary with gland size. Where both ultrasound and Tl/Tc scans were negative, median gland size was smaller at 170 mg (range 50-2,500 mg), compared with where Tl/Tc scanning was correct (750 mg, 150-6,820 mg; P &lt; 0.03), ultrasound was correct (960 mg, 100-6,820 mg; P &lt; 0.03) and both techniques together were correct (980 mg, 600-6,820 mg; P = 0.002).
These results suggest that neither Tl/Tc scanning or ultrasound has sufficient sensitivity or specificity to be used routinely in the preoperative evaluation of patients with primary hyperparathyroidism.
Parathyroid crisis and acute viral hepatitis B infection
Authors: Mulcahy Hugh E , Murray Frank E , Freaney Rosemarie , Hegarty John E 
Published: December 2008

Summary
The simultaneous development of acute hyperparathyroidism and viral hepatitis B infection in a 72 year old male is described. Resolution of the hepatitis was accompanied by improvement in the parathyroid hormone mediated hypercalcaemia. It is postulated that antibodies to the hepatitis B virus may have altered the calcium 'set point' allowing uncontrolled synthesis and release of parathyroid hormone during the acute illness.
Gangrene of the anterior abdominal wall after orthotopic liver transplantation: invasive cutaneous candidiasis
Authors: Rela M , Heaton N D , Vougas V , Rolando N , Wade J , Portmann B , Williams Roger , Tan K C 
Published: December 2008

Summary
Fungal infections following liver transplantation are not uncommon and may be life-threatening. Superficial candidal infections of the bronchus, oesophagus and urinary tract are the most common mode of presentation. Invasive cutaneous and subcutaneous candidiasis is, however, very rare. We report two patients with invasive cutaneous and subcutaneous candidiasis after orthotopic liver transplantation.
Psychosocial aspects of chronic pelvic pain, with special reference to sexual abuse. A study of 164 women
Authors: Fry R P W , Crisp A H , Beard R W , McGuigan S 
Published: December 2008

Summary
Patients with chronic pelvic pain attending a tertiary referral centre show certain social, developmental and psychological characteristics. Specifically, they appear to have fewer children and to report more paternal overprotection, and a trend towards low maternal care compared to normals. They also show more depression, free-floating anxiety and somatic anxiety than such populations. The levels are similar to those found in other outpatient populations presenting with migraine or irritable bowel syndrome. Hostility levels are greater than those in normal subjects. Overall the present patient population reports the same degree of childhood sexual abuse as do many other female clinic and community sample populations. Sexual abuse is unlikely to be a specific aetiological factor in the development of chronic pelvic pain though it may yet be found to be important in subsets of the population.
Hypomagnesaemia and hypocalcaemia in a patient with ovarian carcinoma
Authors: Leese G P , Jung R T , Browning M C K 
Published: December 2008

Summary
A patient with disseminated ovarian carcinoma presented with symptoms of hypocalcaemia secondary to hypomagnesaemia. The low serum magnesium (0.4 mmol/l) appeared to be due to renal leakage with no evidence of ureteric obstruction or hydronephrosis on intravenous urogram. Parathyroid hormone activity (serum levels and cAMP response) was normal, despite hypomagnesaemia. The patient's complaints resolved after magnesium and calcium supplementation. Hypomagnesaemia of malignancy is a rare but important complication, and is both poorly recognized and understood.
Right-sided endocarditis in the non-drug addict
Authors: Naidoo D P 
Published: December 2008

Summary
Fifteen patients with right-sided infective endocarditis during a 5 year period (1985-1990) were retrospectively reviewed. Isolated tricuspid valve involvement occurred in nine patients.
Staphylococcus aureus was the causative organism in seven cases; four were culture negative. The diagnosis was established by two-dimensional echocardiography in 11 patients and at postmortem in the remaining four patients who succumbed shortly after admission. Fever, tachypnoea and pneumonia were universal features. A successful outcome ensued in eight patients with medical therapy alone and in two patients who were submitted to valve replacement. Five patients died, two from uncontrolled infection with repeated pulmonary emboli.
Right-sided infective endocarditis should be suspected in any pneumonic illness that complicates post-abortal infection or other inadequately treated sepsis. Two-dimensional echocardiography is important in diagnosis since cardiac signs are minimal at presentation.
Atypical presentations of pulmonary tuberculosis diagnosed by fibreoptic bronchoscopy
Authors: Jayasundera C I W , Attapattu Maya , Kumarasinghe M P 
Published: December 2008

Summary
A total of 356 patients were subjected to fibreoptic bronchoscopy from September 1989 to June 1991 to exclude bronchial carcinoma. Bronchial biopsy, bronchial brush smears and bronchial wash were obtained. Bronchial wash was examined for acid fast bacilli (AFB) compatible with Mycobacterium tuberculosis. The total number diagnosed as pulmonary tuberculosis by fibreoptic bronchoscopy was 21(5.8%). The sputum smears were negative for AFB in all these patients. Previous studies have shown the importance of fibreoptic bronchoscopy in suspected cases of tuberculosis where the sputum smear is negative. This study is further evidence of the importance of routine examination of bronchial wash for AFB in all cases undergoing fibreoptic bronchoscopy to detect atypical cases of pulmonary tuberculosis.
Lymphocytic meningitis as the sole manifestation of Q fever
Authors: Schattner A , Kushnir M , Zhornicky T , Fenakel G 
Published: December 2008

Summary
A young man who presented with a 3 week history of fever and severe headache accompanied by mild leukocytosis, was found to have lymphocytic meningitis due to Coxiella burnetti. Thus, Q fever can present as lymphocytic (aseptic) meningitis responsive to tetracycline with no evidence of pulmonary involvement.
Hairy leukaemic cell influx into the cerebrospinal fluid secondary to encephalomyelitis
Authors: Wierzbicki A S , Luxton R , McLean B N , Gilois C , Norman P M , Thompson E J 
Published: December 2008

Summary
A case report of a 53 year old male with hairy cell leukaemia is presented in whom encephalomyelitis caused by toxoplasmosis resulted in an influx of hairy cells into the cerebrospinal fluid following disruption of the blood-brain barrier. These cells subsequently disappeared as the barrier reformed. It is suggested that the presence of hairy cells in the cerebrospinal fluid is a secondary self-limiting phenomenon.
Gastric phytobezoar: unusual association and resolution
Authors: Wyatt J P , Haddock G , Aitken R J 
Published: December 2008

Summary
A 58 year old man underwent a laparotomy for intestinal obstruction, which proved to be due to intestinal pseudo-obstruction. Following a slow postoperative course, he was discovered to have a gastric phytobezoar. The association between bezoars and pseudo-obstruction has not been previously described, but might be expected. The gastric phytobezoar could not be fragmented mechanically, but it completely disappeared when enteral feeding was commenced. The possibility of a future role of enteral feeding in this situation is suggested.
Rigors in tuberculosis
Authors: Harvey Christopher , Eykyn Susannah , Davidson Craig 
Published: December 2008

Summary
Rigors are not a recognized characteristic of miliary tuberculosis. We report two patients presenting with persistent rigors, thought to be suggestive of acute pyogenic infection, who were subsequently found to have miliary tuberculosis. In both cases, there was significant diagnostic delay. Miliary tuberculosis should therefore be included in the differential diagnosis of any patient presenting with unexplained rigors.
Spontaneous biloma in an elderly patient
Authors: Mason J C , Babbs C , Lee S H , Connolly M J 
Published: December 2008

Summary
A previously well 84 year old man without prior history of abdominal trauma, instrumentation or surgery presented with localized biliary peritonitis (biloma). An associated bile duct stone was detected by abdominal ultrasound and endoscopic retrograde cholangiopancreatography and was successfully treated with systemic antibiotics and percutaneous and endoscopic stenting. The case is unusual in that the presentation was spontaneous.
A study of plasma sodium levels in elderly people taking amiloride or triamterene in combination with hydrochlorothiazide
Authors: Fidler H M , Goldman J , Bielawska C A , Rai G S , Hoffbrand B I 
Published: December 2008

Summary
This study was performed to compare the effect of one month's treatment with hydrochlorothiazide (25 mg) in combination with either amiloride (2.5 mg) or triamterene (50 mg) on plasma sodium levels in elderly people in institutional care. Fifty residents of NHS nursing or social service residential care established on diuretics for congestive cardiac failure and aged 64 years or over were recruited. Forty-one patients were included in the final data analysis. Patients on hydrochlorothiazide/amiloride had a significantly lower plasma sodium (137 vs 139 mmol/l, 95% confidence interval for difference between medians 0-2 mmol/l) than those on hydrochlorthiazide/triamterene (P = 0.01). In equivalent potassium-retaining doses, amiloride is associated with significantly lower plasma sodium levels than triamterene, when given in combination with hydrochlorothiazide in elderly patients with congestive cardiac failure. This finding adds weight to uncontrolled observations implicating thiazide/amiloride diuretic combinations in causing serious hyponatraemia. This danger, although uncommon, should perhaps influence prescribing habits in an at-risk population.
Recurrent infective endocarditis
Authors: Lossos Izidore S , Oren Ran 
Published: December 2008

Summary
Infective endocarditis is a serious disease associated with high mortality. Patients surviving recurrent bouts of infective endocarditis are reported infrequently. We report on a non-drug abuser patient who experienced seven episodes of infective endocarditis--the largest number reported to our knowledge in a single non-drug abuser patient.
Type IV renal tubular acidosis associated with Alport's syndrome
Authors: Tkácová Ruzena , Roland R , Böör A , Kovácová Anna , Lazúrová Ivica , Tkác I , Hildebrand T , Sefara P 
Published: December 2008

Summary
A case of hereditary nephritis with mild reduction of renal function associated with renal tubular acidosis type IV is described. The patient was admitted with life-threatening hyperkalaemia. To our knowledge, type IV renal tubular acidosis has not been reported previously in association with Alport's syndrome in an adult patient.
Prognostic factors in Wegener's granulomatosis
Authors: Briedigkeit L , Kettritz R , Göbel U , Natusch R 
Published: December 2008

Summary
We analysed data from 64 patients with Wegener's granulomatosis to determine predictor variables of outcome. The mean period of observation after the diagnosis had been established was 3.2 (range 0.1-11.2) years. At the time of diagnosis, 15 (23%) patients had only local symptoms. The disease was generalized to multiple organs in 49 (77%) patients. Renal biopsies were obtained in 33 patients; 13 (39%) had extracapillary glomerulonephritis, which was the most common renal lesion. All but three patients received immunosuppressive therapy. At time of follow-up, 17 (27%) patients were in complete, and 26 (40%) in partial remission. We employed a Kaplan Meier analysis to identify predictor variables of outcome. Renal involvement, initial creatinine concentration, serum albumin or total protein concentration, leukocyte count and erythrocyturia proved to be predictor variables. These variables may be of value in guiding the intensity of treatment in patients with Wegener's granulomatosis.
A pharmacokinetic interaction between cimetidine or ranitidine and lornoxicam
Authors: Ravic M , Salas-Herrera I , Johnston A , Turner P , Foley K , Rosenow D E 
Published: December 2008

Summary
Cimetidine 400 mg twice daily significantly increased serum concentrations and reduced apparent oral clearance of lornoxicam 8 mg twice daily in 12 healthy volunteers. Ranitidine 150 mg twice daily produced no significant changes in lornoxicam pharmacokinetics.
Type IV renal tubular acidosis and spironolactone therapy in the elderly
Authors: O'Connell J E , Colledge N R 
Published: December 2008

Summary
Spironolactone therapy is a well-known cause of hyperkalaemia, but in susceptible patient, it may also be associated with metabolic acidosis. We report a case of severe renal tubular acidosis (Type IV) with life-threatening hyperkalaemia caused by spironolactone, and discuss the mechanisms by which this may occur.
Successful use of a transjugular intrahepatic portosystemic stent shunt to control severe refractory oesophageal variceal haemorrhage in a poor risk patient
Authors: Beales I L P , Jackson J E , Rudolf M , Arnold J 
Published: December 2008

Summary
This report describes a 44 year old man with a severe gastrointestinal haemorrhage from oesophageal varices. Bleeding could not be controlled with conservative therapy and sclerotherapy. He was successfully treated with a radiologically guided transjugular intrahepatic stent shunt at a time when his condition was too poor to attempt an open surgical procedure.