bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in birth – cohort pattern of peptic ulcer mortality in England and Wales
Authors: Katschinski B D , Logan R F 
Published: December 2008

Summary
Previous epidemiological studies have described the secular trends in peptic ulcer mortality in England and Wales as being characteristic of a cohort phenomenon. The most recent data on ulcer mortality, however, show increasing mortality rates from duodenal ulcer in women over 65 and from gastric ulcer in women over 75 years. While the rise in mortality rates in the oldest age groups is partly explained by their greater life expectancy, the increase in mortality from duodenal ulcer in older women shows evidence of an environmental (period) effect being superimposed on female cohorts born between 1895 and 1925. This effect could partly be due to the increasing consumption of non-steroidal anti-inflammatory drugs which coincides with the rise in mortality rates.
Asian endoscopies: is there a difference?
Authors: Harvey J M , Battcock T M , Wicks A C B 
Published: December 2008

Summary
In 1988 2062 adults had their first oesophagogastroduodenoscopy at Leicester General Hospital, of whom 224 (10.9%) were Asian. A greater proportion of the Asian patients were less than 45 years old (46% vs 24%), which reflects the age distribution of the local population. When the findings at oesophagogastroduodenoscopy were analysed in two age groups (less than or older than 45) there were no differences between the races in the younger group. However, in the older group duodenal disease was significantly more common in the Asians (P &lt; 0.001) whereas gastric disease was more common in Caucasians (P &lt; 0.05). The incidence of cancer was much lower in the Asians.
Hiatal hernial ulcers: clinical features and follow-up
Authors: Boyd E J S , Penston J G , Russell R I , Wormsley K G 
Published: December 2008

Summary
We describe the clinical features and therapeutic outcome in 49 patients in whom benign gastric ulceration of an hiatal hernia was demonstrated endoscopically. Hiatal hernia ulcers accounted for 10% of all benign gastric ulcers. The typical patient was an elderly female with a history of dyspepsia who was receiving non-steroidal anti-inflammatory drugs. Twenty-seven (55%) patients had evidence of haemorrhage (acute in 15; chronic in 12) from the hiatal hernial ulcer at presentation. In 16 (33%) patients, symptoms attributable to haemorrhage constituted the sole clinical evidence of the hiatal hernial ulcer. Acute haemorrhage from hiatal hernial ulcers was associated with non-steroidal anti-inflammatory drug (NSAID) treatment (P &lt; 0.05). Chronic blood loss from hiatal hernial ulcers was associated with female gender (P &lt; 0.005) but not with NSAID treatment.
Hiatal hernial ulcers healed slowly in response to medical treatment with H2-receptor antagonists (median time to healing 12 weeks). Surgical treatment may be the therapy of choice for hiatal hernial ulcers because of the high complication rate, poor response to medical therapy, and the apparent predominance of mechanical aetiological factors.
Polymyositis complicating d-penicillamine treatment
Authors: Aydintug A O , Cervera R , D'Cruz D , Ramírez G , Asherson R A , Khamashta M A , Hughes G R 
Published: December 2008

Summary
Although there is good evidence that d-penicillamine can induce polymyositis, the exact pathogenic mechanism remains unclear. We report two patients with psoriatic arthritis and primary biliary cirrhosis respectively, who developed polymyositis while receiving d-penicillamine treatment for their primary diseases. Whether d-penicillamine treatment was the sole cause of polymyositis or acted as a trigger for the development of a secondary autoimmune disease is discussed.
Antibiotic therapy, clinical features and outcome of 36 adults presenting to hospital with proven influenza: do we follow guidelines?
Authors: Jones A , Macfarlane J , Pugh S 
Published: December 2008

Summary
The impact of the 1989/1990 influenza epidemic on the Nottingham hospitals was assessed in a retrospective survey. Thirty-six cases of proven influenza were identified, 14 of whom died. Non-survivors were more likely to be confused, uraemic and to lack focal chest signs and symptoms. Antibiotic therapy both prior to admission and following hospitalization was not optimal and, in many cases, failed to follow previously published guidelines. Such guidelines need emphasis during influenza epidemics.
Helicobacter pylori: a Jordanian study
Authors: Latif A H , Shami S K , Batchoun R , Murad N , Sartawi O 
Published: December 2008

Summary
The prevalence of Helicobacter pylori in patients with upper gastrointestinal symptoms in the north of Jordan was studied prospectively. The occurrence of H. pylori was documented histologically and bacteriologically in 169 patients attending endoscopy for upper gastrointestinal symptoms. Our results showed that H. pylori was present in 70% of patients with acute gastritis, 73% of patients with chronic gastritis, 68% of patients with acute on chronic gastritis, 83% of patients with duodenal ulceration, 75% of the patients with gastric ulceration, 64% of patients with no pathology, and 68% of patients regardless of the pathology found. There was a sharp rise in the prevalence of H. pylori with age, up to the age of 40 years with an annual increase in the prevalence of 2%. This study shows that the prevalence of H. pylori in Jordan is similar to that seen in other developing countries with infections occurring at a lower age and with the annual infection rate being double that seen in developed countries.
A five year audit of the role of parathyroid hormone assays and thallium–technetium isotope subtraction scanning in the preoperative investigation of primary hyperparathyroidism
Authors: Livingstone J I , Tellez M , Burke M , Ashby P J , Rinsler M G 
Published: December 2008

Summary
An audit has been performed of the value of parathyroid hormone assays and thallium–technetium isotope scanning in the pre-operative investigation of 67 hypercalcaemic patients referred for surgery over a 5 year period. Parathyroid hormone assay by region-specific technique was found to have a diagnostic sensitivity of 75% (n = 52) whilst the more recent assay for the intact molecule was 97% sensitive (n = 34). Thallium-technetium isotope scanning was only 64% sensitive overall (n = 59), due in part to the small size of adenomata now being referred for surgery. This study confirms the role of the intact parathyroid hormone assay but questions that of thallium–technetium isotope scanning in standard protocols of investigation for hypercalcaemia.
Absenteeism and sickness absence
Authors: McEwan I M 
Published: December 2008

Summary
The majority of time lost from work as a result of absenteeism is classified as due to sickness although only a small proportion of the total can be regarded as a result of unfitness for work for medical reasons. An occupational health service assists a business in minimizing absenteeism by promoting an early return to work, assists general practitioners and hospital specialists in tailoring return to work packages, and assists employees by liaising with both management and their medical specialists to facilitate a return to normal work.
Hyperpyrexia due to meningococcal septicaemia treated with cold peritoneal lavage
Authors: Khan Izhar H , Henderson Iain S , Mactier Robert A 
Published: December 2008

Summary
An 18 year old male presented with fulminant meningococcal septicaemia and renal failure. He subsequently developed hyperpyrexia which failed to respond to conventional methods of treatment. Cold peritoneal lavage was employed which resulted in rapid lowering of his core temperature and helped manage his renal failure. The possible causes of the late onset of hyperpyrexia and the use of cold peritoneal lavage to treat refractory hyperpyrexia are discussed.
Testotoxicosis: gonadotrophin-independent male sexual precocity
Authors: Aziz Arif Abdul , Jafri S M W , Haque Naeem Ul 
Published: December 2008

Summary
In this era of rapidly developing investigational tools and pharmacology, the pathophysiology of precocious puberty is becoming well defined. What was previously thought to be a form of gonadotrophin releasing hormone (GNRH)-dependent central precocious puberty is now classified as GNRH-independent familial testotoxicosis. We present two such cases and review the clinical features, pathophysiology and treatment of testotoxicosis.
Lymphocytic adenosine deaminase activity in typhoid fevers
Authors: Khosla S N , Kumar Dinesh , Singh V 
Published: December 2008

SummaryLymphocyte adenosine deaminase (L-ADA) activity, a measure of lymphocyte activity, was estimated in 10 healthy controls and 30 patients with typhoid fever (20 uncomplicated and 10 complicated) at the time of admission, at onset of complications and weekly until recovery. Mean L-ADA activity in healthy controls was 20.49 +/- 3.62 mU/10(6) cells. In uncomplicated patients L-ADA activity was 36.33 +/- 5.09 mU/10(6) cells at time of admission, which is significantly raised as compared to controls. It remained high at the height of the fever and at defervescence. In complicated patients L-ADA activity was significantly low at admission (15.33 +/- 2.35 mU/10(6) cells) and fell further with development of complications (7.86 +/- 4.07 mU/10(6) cells). At defervescence L-ADA activity increased significantly above the control activity (31.24 +/- 5.37).Serial L-ADA activity can be of prognostic significance. A cut-off value of 24 mU/10(6) cells is suggested to predict prognosis and severity of disease. Activity below this indicates a probability of a severe, prolonged course and may help in instituting early and energetic treatment.
Life threatening hypophosphataemia in a patient with Philadelphia chromosome-positive chronic myelogenous leukaemia in acute blastic crisis
Authors: Ra'anani P , Lahav M , Prokocimer M , Poles L , Theodor E 
Published: December 2008

Summary
Life-threatening hypophosphataemia developed in a 47 year old woman with blastic crisis of chronic myelogenous leukaemia. The patient's hospitalization was characterized by reciprocal relationship between her white cell count and the serum phosphorus levels. The patient did not demonstrate any of the usual causes of profound hypophosphataemia. The postulated mechanism of this patient's hypophosphataemia is uptake by the rapidly dividing leukaemic cells. To the best of our knowledge this is the first case in the English literature of hypophosphataemia associated with blast crisis of Philadelphia chromosome-positive chronic myelogenous leukaemia.
Portal vein thrombosis in a complicated case of Crohn's disease
Authors: Crowe A , Taffinder N , Layer G T , Irvine A , Nicholls R J 
Published: December 2008

Summary
Portal vein thrombosis is a rare complication of ulcerative colitis and is invariably fatal. This report describes a patient with severe Crohn's disease who underwent elective surgery complicated by an anastomotic disruption with faecal peritonitis. Following emergency laparotomy he developed left hypochondrial pain which was a manifestation of splenomegaly consequent upon portal vein thrombosis. Anticoagulation was successful in preventing further spread of the thrombosis as monitored by colour Doppler ultrasound. Severe active disease, surgery and sepsis have been recognized as predisposing factors for thromboembolic complications in inflammatory bowel disease and this patient was exposed to all three. It is conceivable that portal vein thromboses occur more commonly than suspected and ultrasound scanning could ascertain the prevalence if performed prospectively.
Inguinal bladder hernia associated with vesico-ureteric reflux
Authors: Noble J G , Christmas T J , Chapple C R , Rickards D 
Published: December 2008

Summary
The urinary bladder is frequently found as a component of inguinal herniae. This report describes a case of 'bladder hernia' associated with vesico-ureteric reflux. The current methods of investigation and subsequent treatment for this condition are reviewed along with the possible underlying cause of vesico-ureteric reflux in this case.
Experience with tracheostomy in medical intensive care patients
Authors: Gunawardana R H 
Published: December 2008

SummaryThirty-four intensive care patients who received elective tracheostomies were studied to determine the incidence and nature of complications associated with tracheostomies. Indication for tracheostomy was long-term ventilation. Adverse consequences occurred in 47% of the patients. The most frequent problem was pneumonia. There were no intraoperative complications. Two deaths occurred due to delayed haemorrhage. Some complications of tracheostomy were influenced by the preceding period of endotracheal intubation. In patients requiring prolonged mechanical ventilation, tracheostomy carries a considerable risk. Optimal airway care only will reduce the incidence of complications.
'Chest epilepsy' in a child
Authors: Gulati Sanjeev , Kumar Lata 
Published: December 2008

Summary
Pain is a most unusual manifestation of epilepsy, and it is rarer still for chest pain to be the primary manifestation of a seizure disorder. We report here a 6 year old boy with epileptic chest pain--'chest epilepsy'--an entity not previously described in children.
Infusion rate and pharmacokinetics of intravenous pamidronate in the treatment of tumour-induced hypercalcaemia
Authors: Dodwell D. J. , Howell A. , Morton A. R. , Daley-Yates P. T. , Hoggarth C. R. 
Published: December 2008

Summary
We report the results of two consecutive randomized studies in the treatment of malignant hypercalcaemia with intravenous pamidronate. Overall normocalcaemia was achieved in greater than 90% of patients and a single infusion of 60 mg pamidronate given over 2 hours was as effective in restoring normocalcaemia as infusions given over 4, 8 or 24 hours. Similarly duration of normocalcemia after treatment with pamidronate and the control of the symptoms of hypercalcaemia were independent of infusion rate. Study of the pharmacokinetics of pamidronate in the treatment of hypercalcaemia show this drug to have a very high clearance due to calcified tissue retention and renal excretion. The initial half life of the drug in plasma is very short and most of the drug is cleared before distribution equilibrium is achieved. Short infusions of pamidronate are as safe and effective as infusions given over a longer time and are therefore to be preferred because of their greater convenience.
Carotid sinus syndrome after carotid artery surgery
Authors: Dees A. , Batenburg de Jong R. J. , Meeuwis C. A. , de Boer M. F. , de Leeuw P. W. 
Published: December 2008

Summary
A 63 year old woman had been intensively treated for recurrent carcinoma of the neck. Following acute vascular surgery of the carotid artery, she developed the vasodilatory type of the carotid sinus syndrome. The presentation of this type of the syndrome was remarkable, since it is usually associated with primary or metastatic carcinoma in the neck region. Previous cancer treatment may have modified the course of disease in this patient, which ultimately had a lethal outcome.
A late complication of pectus excavatum repair
Authors: McWilliams R. , Hooper T. , Lawson R. 
Published: December 2008

Summary
We report a late complication of pectus excavatum repair which highlights the importance of a chest X-ray in evaluating chest pain in patients who have had previous chest surgery. It also raises the question of whether or not implanted wires should be electively removed following bony union.
Eradication ofHelicobacter pylori: therapies and clinical implications
Authors: O'Connor Humphrey J 
Published: December 2008

SummaryThis review presents a critical evaluation of the role of Helicobacter pylori eradication in the management of peptic ulcer disease and non-ulcer dyspepsia. On current evidence, H. pylori eradication therapy seems likely to emerge as the most rational and cost-effective treatment for duodenal ulcer. The role of H. pylori eradication in the treatment of gastric ulcer and non-ulcer dyspepsia is unclear and requires further study. The emerging problem of antibiotic resistance in H. pylori is of major clinical importance and a prime cause of treatment failure. There is increasing evidence of a link between H. pylori and gastric cancer but it is premature to recommend large-scale eradication of H. pylori as a valid strategy for the primary prevention of gastric cancer. The search continues for the ideal H. pylori eradication regimen.
One year experience in the treatment of familial hypercholesterolaemia with simvastatin
Authors: Quiney J , Watts G F , Kerr-Muir M , Slavin B , Lewis B 
Published: December 2008

Summary
Patients with heterozygous familial hypercholesterolaemia (FH) have a substantially increased risk of atherosclerosis due to very high plasma levels of cholesterol. Recent evidence has shown that coronary heart disease in these patients may regress with lipid-lowering therapy. In this study the efficacy and safety of simvastatin, an inhibitor of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A, was investigated in 30 patients with FH over a period of one year. Substantial reductions in the plasma concentrations of total cholesterol (-28%), low-density lipoprotein (LDL) cholesterol (-32%), intermediate-density lipoprotein (IDL) cholesterol and apolipoprotein (apo) B (-33%) were achieved with 20 mg/day of simvastatin; there were no significant changes in triglycerides high-density lipoprotein cholesterol or apo A. In contrast to previous studies, 40 mg/day of simvastatin did not result in a further statistically significant fall in LDL cholesterol, IDL cholesterol or apo B in the group as a whole. The drug was well tolerated and no adverse clinical or laboratory events were recorded. In particular, no ophthalmological, hepatic or renal disorders were observed and there were no sleep disturbances. We conclude that simvastatin is an efficacious and safe drug to treat patients with heterozygous FH and that rarely will the dose need to be increased above 20 mg/day.
Cardiovascular complications of parenteral nutrition
Authors: Naidoo Datshana P , Singh B , Haffejee A 
Published: December 2008

Summary
During a 3 year period, 1987-1989, we encountered three major complications associated with parenteral nutrition leading to congestive cardiac failure--acute beriberi, right atrial and superior vena caval thrombosis, and fungal endocarditis. Unrecognized, these are invariably fatal. Persistent vomiting from intestinal obstruction led to the development of thiamine deficiency in the patient with beriberi. Recurrent catheter tip sepsis probably accounted for thrombosis and endocarditis in the second and third cases, respectively. These conditions are preventable with careful attention to nutritional replenishment and aseptic technique. In patients with catheter-related sepsis early, repeated blood culture is of diagnostic value. Patients with Staphylococcus aureus catheter-associated bacteraemia require at least 4 weeks of appropriate antibiotic therapy. Recurrent sepsis, especially when associated with pulmonary embolic phenomena, is an indication for echocardiography.
Chronic idiopathic anhydrosis--a rare cause of heat stroke
Authors: Dann Eldad J , Berkman Neville 
Published: December 2008

Summary
A 27 year old man presented with heat stroke following exposure to a humid, hot environment in the absence of physical exertion. Investigation revealed the presence of generalized anhydrosis without evidence of an associated disease. Although chronic idiopathic anhydrosis is rare, this entity should be considered in cases of unexplained heat intolerance and heat stroke.
Idiopathic hypereosinophilic syndrome presenting as childhood hemiplegia
Authors: Kumar K Ashok , Anjaneyulu A , Murthy J M K 
Published: December 2008

Summary
A case of childhood hemiplegia due to idiopathic hypereosinophilic syndrome is reported. There was no cardiac lesion. The neurological complications associated with hypereosinophilic syndrome and the pathophysiological mechanism of neurotoxicity of human eosinophils are discussed. It is likely that the neurological deficit was due to eosinophilic neurotoxicity.
Mycobacteria as a cause of infective exacerbation in bronchiectasis
Authors: Chan Christopher H S , Ho Andrew K C , Chan Raphael C Y , Cheung H , Cheng A F 
Published: December 2008

Summary
In 91 patients with bronchiectasis seen over 6 years, a positive mycobacterial culture was obtained in 12 cases (13%). The organisms isolated were Mycobacterium tuberculosis in nine cases, Mycobacterium avium in two cases and Mycobacterium tuberculosis and chelonei were obtained on separate occasions in one case. Computed tomography and/or bronchography showed that the bronchiectatic changes commonly involved the lower lobes and to a lesser extent, the middle and lingula lobes. In none of these 12 cases was tuberculosis strongly suspected on clinical or radiological grounds.
We conclude that mycobacterial infections are common in patients with bronchiectasis and sputum should be cultured for mycobacteria periodically in these patients. In doubtful cases, bronchoscopy may be helpful to obtain a positive mycobacterial culture.
Splenic rupture following splenic vein thrombosis in a man with protein S deficiency
Authors: Williams N , Gerrand C , London N J , Chapman C , Bell P R F 
Published: December 2008

Summary
We present a case of spontaneous splenic rupture in a man with splenic vein thrombosis. The splenic vein thrombosis appears to have been caused by protein S deficiency. We are not aware of this having been described before.
Cervical ribs: a cause of distal and cerebral embolism
Authors: Bearn P , Patel J , O'Flynn W R 
Published: December 2008

Summary
The thoracic outlet syndrome occurs when the neurovascular structures are compressed as they traverse the thoracic outlet. Degenerative changes can occur in the subclavian artery and the vessel may become a source of embolism with the risk of acute or chronic upper limb ischaemia. Rarely, distal thromboembolism in the thoracic outlet syndrome may be associated with retrograde flow when there is the added risk of cerebral thromboembolism.
Pulmonary alveolar microlithiasis presenting with chronic cough
Authors: Türktas Ipek , Saribas Sezen , Balkanci Ferhun 
Published: December 2008

Summary
A case of a 10 year old boy with pulmonary alveolar microlithiasis is presented. Although most children with this disease are asymptomatic, our patient had persistent cough for more than 3 years. It is likely that his chronic cough was a direct consequence of the disease.
Polyglandular autoimmune syndrome type III associated with coeliac disease and sarcoidosis
Authors: Papadopoulos Konstantin I , Hallengren Bengt 
Published: December 2008

Summary
A female patient demonstrating a previously not reported constellation of polyglandular autoimmune syndrome type III (including autoimmune thyroiditis, Graves' ophthalmopathy, insulin-dependent diabetes mellitus and vitiligo), coeliac disease and sarcoidosis is described. This may be a random association but might also indicate a common immunological and/or genetic disturbance.