bluuebunny/crossref_metadata_2025_split huggingface dataset:
Familial cerebral palsy associated with normal intelligence
Authors: Wild N J , Rosenbloom L 
Published: December 2008

Summary
We describe two families affected by a recessively transmitted familial cerebral palsy with onset in infancy. Two sisters in the first family have a severe spastic diplegia. The older sister also has mild mental retardation and hypothyroidism whilst the younger sister is of normal intelligence. Two brothers in the second family have a spastic quadriparesis, fifth finger camptodactyly and normal intelligence.
Comparison of the effects of atenolol, sotalol and labetalol on muscle blood flow in man
Authors: Raman G V , Mwongera F M , Warren D J 
Published: December 2008

Summary
A double-blind study of the effect of three beta-adrenoceptor blocking drugs (beta-blockers) on exercise muscle blood flow (MBF) in 14 normotensive volunteers was carried out. MBF was measured by the xenon-133 clearance technique. MBF was not altered by placebo, sotalol or labetalol. Atenolol significantly reduced MBF compared with placebo, sotalol and labetalol.
We conclude that sotalol and labetalol may be more useful than conventional beta-blockers for treatment of hypertension or angina in association with peripheral vascular disease.
Primary hypothyroidism with paradoxically elevated plasma thyroxine due to thyroxine-binding antibody
Authors: Hague R V , Higgins S P , May W J 
Published: December 2008

Summary
Investigation of an elderly patient with clinical hypothyroidism revealed a low serum triiodothyronine (T3) but markedly raised levels of total thyroxine (TT4) and free thyroxine (fT4) when measured by radio-immunoassay (RIA). Primary hypothyroidism was suggested by an elevated basal thyroid stimulating hormone (TSH) and confirmed by a low fT4 when measured by a commercial microencapsulated antibody method. The paradoxically elevated levels of fT4 and TT4 were due to the presence of an antibody which specifically bound T4 and grossly interfered with the RIA thus complicating the diagnosis and later the assessment of replacement therapy. The sensitive immunoradiometric TSH assay proved of value in resolving these problems.
Papillary carcinoma in a giant lateral thyroglossal cyst
Authors: Banerjee S N , Ananthakrishnan N , Veliath A J , Ratnakar C 
Published: December 2008

Summary
The development of carcinoma in a thyroglossal cyst is rare. This report describes the presence of papillary carcinoma in a giant thyroglossal cyst and reviews the literature regarding the clinico-pathological features of the disease and its management.
Hereditary pancreatitis presenting with ascites
Authors: Rao S S C , Riley S A , Foster P N , Losowsky M S , Stone W D 
Published: December 2008

SummaryWe report a case of an adolescent girl who presented with painless massive ascites secondary to chronic pancreatitis and a ductal fistula. The diagnosis was delayed and an unnecessary laparotomy was performed, as initial evaluation of ascites did not include measurement of serum and ascitic amylase. Evidence of pancreatic abnormalities in asymptomatic relatives suggested an underlying hereditary pancreatitis. Hereditary pancreatitis presenting as pancreatic ascites, to our knowledge, has not been described previously.
Skin necrosis following Haemaccel
Authors: Allen M B 
Published: December 2008

Summary
Haemaccel is a plasma substitute in frequent clinical use with a low incidence of side effects. I report a patient who developed necrotic blisters following two Haemaccel-insulin infusions, a previously undescribed complication. The rationale behind carrier solutions for insulin therapy is discussed and some of the problems associated with Haemaccel use are considered. I conclude by urging caution in the use of Haemaccel as a carrier solution for insulin therapy.
C1 esterase inhibitor deficiency in X-linked hypogammaglobulinaemia: an anomaly fostering anaphylactoid reactions following intramuscular gammaglobulin administration
Authors: Pollack S , Cunningham-Rundles C , Good R A , Day N K 
Published: December 2008

Summary
A patient with apparent X-linked agammaglobulinaemia was found to be inordinately susceptible to anaphylactoid reactions to intramuscular injections of gammaglobulin. The patient was found also to have low levels of C1 esterase inhibitor (C1 INH). The possibility that the C1 INH deficiency and in this patient, whether genetic or acquired, fostered the susceptibility to the production of anaphylactoid reactions after gammaglobulin injections urges further studies of the association of C1 INH deficiency and anaphylactoid reactions to gammaglobulin injections. The possibility that C1 INH levels like C1q levels may be low in hypogammaglobulinaemic patients as a consequence of increased catabolism of this regulator of the complement system when IgG levels are low is considered.
Recurrent sub-mucosal dissection of the oesophagus in association with achalasia
Authors: Hooper T L , Gholkar J , Smith S R , Manns J J , Moussalli H 
Published: December 2008

Summary
Submucosal dissection of the oesophagus is a rare oesophageal disorder. We report a patient who had recurrent episodes of dissection and achalasia. Both recurrence and the association with achalasia are to our knowledge unique.
Post-menopausal breast abscess
Authors: Raju G C , Naraynsingh V , Jankey N 
Published: December 2008

Summary
Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma. Although the usual treatment of an abscess is incision and drainage, in post-menopausal women, excision of the lesion is helpful for accurate histological diagnosis.
Incomplete Reiter's syndrome following chemotherapy of acute myeloid leukaemia
Authors: Dharmasena F , Englert H , Catovsky D , Galton D A G , Drysdale H C 
Published: December 2008

Summary
Reiter's syndrome and other reactive arthritides have been described following infection with various organisms although they can occur in unusual circumstances without an obvious infectious precipitant. We have recently witnessed two attacks of reactive arthritis and keratoderma blenorrhagica occurring in an HLA B27 adult male following chemotherapy on two separate occasions with the same drugs for acute myeloid leukaemia. No attacks occurred before or following the cessation of these drugs. This supports the view that in Reiter's syndrome a common pathogenic pathway is triggered by an ‘arthritogenic factor’ which in this case appears to have been chemical.
Fatal intraperitoneal haemorrhage of hepatic origin
Authors: Fidas-Kamini A , Busuttil A 
Published: December 2008

Summary
Eight cases of fatal haemoperitoneum due to liver bleeding are reported. Two followed trauma (liver biopsy and cholecystectomy). The remaining six were spontaneous, 5 being due to malignant liver disease. The sixth case due to polycystic liver disease appears to be unique. The aetiology and importance of spontaneous hepatic bleeding is discussed.
The distinction between worth and affordability: implications of costs and benefits for the allocation of health care resources
Authors: Charny M C , Roberts C J 
Published: December 2008

Summary
There is an important distinction between worth and affordability which remains largely unrecognized. It is widely supposed that if an economic analysis shows that the benefits of a service exceed its costs, failure to fund it is irrational and inefficient. By means of a simplified model of a health care system, it is shown that although an excess of benefits over costs is a necessary precondition for providing a service, it is by no means sufficient. If society is to make the best use of its resources in health care, worthwhile services—those which make a social ‘profit’—must be compared with other such services. Since the resources available to any health care system will always be limited, it is likely that not all services whose benefits exceed their costs can be afforded, because the budget has already been committed to those worthwhile services which yield higher benefits per unit cost.
Internal carotid artery occlusion in a young female with mitral valve prolapse
Authors: Saadah M A , Shakir R A , Rudwan M A , Khan N 
Published: December 2008

Summary
A healthy 28 year old housewife presented with sudden right hemiplegia and aphasia. No predisposing factors could be ascertained apart from posterior cusp mitral value prolapse on two dimensional echocardiography. Extensive investigations confirmed the presence of cerebral infarction and persistent occlusion of the left internal carotid artery near its origin.
A combination of cranial and peripheral nerve palsies in infectious mononucleosis
Authors: Mohanaruban K , Fisher D J H 
Published: December 2008

Summary
A 44 year old woman presented with bilateral brachial neuritis and an isolated Bell's palsy. Subsequently she was found to have infectious mononucleosis. The association of cranial and brachial neuropathy has not previously been reported. Without any specific drug therapy she recovered completely within 5 months.
The association of non-Hodgkin's lymphoma with glomerulonephritis
Authors: Girón González J A , Yebra Bango M , Merino Morales F , Menéndez Caro J L , Diego Marín F J , Durántez Martínez A 
Published: December 2008

Summary
Paraneoplastic glomerulonephritis is an infrequent complication in the course of non-Hodgkin's lymphoma (21 cases to date). We report a modality not previously described: mesangioproliferative glomerulonephritis and mixed lymphocytic lymphoma, and review the literature on the subject. The onset of the two processes was simultaneous. Antitumour treatment induced simultaneous remission of the lymphoma and glomerulonephritis.
Ultrasound diagnosis of portal vein thrombosis following splenectomy
Authors: Tudway D , Sangster G 
Published: December 2008

Summary
We present a case of clinically unsuspected portal vein thrombosis occurring soon after splenectomy in a patient with chronic lymphocytic leukaemia. Ultrasound provided a means of easy and accurate diagnosis and allowed frequent reassessment of the thrombus during the period of its resolution under conservative management.
Psychosis with propranolol: still not recognized?
Authors: Cunnane J G , Blackwood G W 
Published: December 2008

Summary
A 21 year old male developed hallucinations, personality change and severe depression following an increase in oral propranolol administration at recommended dosage levels. The symptoms improved markedly on stopping the drug. Without provocation, the patient developed further symptoms, mainly depressive, with marked suicidal impulses. Again, this quickly settled. The case identifies the need for careful observation of patients with psychiatric side effects from propranolol, following discontinuation of the drug.
A report of acute overdosage of the anti-serotonergic drug pizotifen
Authors: Griffiths A P , Penn N D , Tindall H 
Published: December 2008

Summary
An acute overdosage of 30 mg of pizotifen causing a pyrexial illness is reported. The clinical features suggest that the effects of overdosage are principally due to the anticholinergic activity of this drug. Resolution of symptoms occurred after 10 hours, without specific therapy.
Co-secretion of calcitonin gene-related peptide, gastrin-releasing peptide and ACTH by a carcinoid tumour metastasizing to the cerebellum
Authors: Ghatei M A , Stratton M R , Allen J M , Joplin G F , Polak J M , Bloom S R 
Published: December 2008

Summary
A carcinoid tumour presenting as Cushing’s syndrome is reported. Although no tumour mass could be initially identified the patient returned with first a liver and subsequently a cerebellar mass both of which were resected. Only at post-mortem was the lung primary discovered. ACTH, gastrin-releasing peptide (GRP) and calcitonin gene-related peptide were elevated in plasma before resection of the hepatic tumour. These peptides were demonstrated in both the hepatic and cerebellar tumours by immunocytochemistry and radioimmunoassay. This case illustrates the occasional tendency of primary lung carcinoids to remain small and clinically undetectable while generating secondary tumours which are symptomatic. It is suggested that immunological demonstration of GRP may be diagnostically helpful in directing attention to the lung as a primary site in neuroendocrine tumours which present in this fashion.
Stab injury--the experience of an East London Hospital 1978-1983
Authors: Stebbings W S L , Chalstrey L J , Gilmore O J A , Shand W S , Staunton M D , Thomson J P S 
Published: December 2008

Summary
A retrospective review of 201 patients with stab wounds admitted to an East London Hospital over a period of six years was performed. There was no striking increase in the annual incidence of these injuries over the period reviewed. The majority of patients were young males who arrived at the Accident and Emergency Department after 1800 h on a Friday, Saturday, or Sunday and had consumed alcohol prior to admission. There were 47 abdominal injuries (23%), 69 thoracic (34%), 51 limb injuries (25%) and 34 injuries involving the head and neck (17%). Forty patients (20%) had injuries involving more than one site. Abdominal stabbings were managed by a selective approach resulting in 28 laparotomies of which only 2 (7%) were negative. Evisceration of small bowel or omentum was always associated with significant intraperitoneal injury.
Pubic osteomyelitis presenting as irritable hip
Authors: Weinberg J R , Berman L , Dootson G , Mitchell R 
Published: December 2008

Summary
Two cases of pubic osteomyelitis presenting as a painful hip are reported. In both cases the diagnosis was delayed by the unusual presentation and by the limited radiological investigation. Pubic osteomyelitis is rare in childhood but should be considered in the differential diagnosis of the ‘irritable hip’.
Hyperventilation and Raynaud’s disease
Authors: Williams H , Freeman L J , Nixon P G F 
Published: December 2008

Summary
A 42 year old woman with long standing Raynaud’s disease, unresponsive to medical and surgical treatment, was noted to have a typical history of the hyperventilation syndrome. Rewarming of the hands following cold challenge was markedly prolonged in the presence of hypocapnia. It is suggested that hyperventilation may have an aetiological role in maintaining digital artery spasm in Raynaud’s disease, which would benefit from recognition and treatment.
Internal medicine in The Netherlands
Authors: Elte J W F 
Published: December 2008

Summary
In this overview various aspects concerning internal medicine in the Netherlands are discussed. Special attention is given to training, which is likely to be increased from 5 to 6 years in the near future. Current problems in internal medicine are mostly related to under-funding of health care and include unemployment (which necessitates reduction of training facilities), disagreement with the government about finances and an argument with the sickness funds concerning professional responsibility and the termination of free enterprise. Also the issue of task definition of the general internist is reviewed. Funding of research used to be mainly the task of the government. Problems with the national economy, however, have resulted in a reduction of the governmental contribution. Private research foundations related to patients’ associations, (pharmaceutical) companies and non-university hospitals have increased in importance.
Nocardia infection in splenectomized patients: case reports and a review of the literature
Authors: Abdi E A , Ding J C , Cooper I A 
Published: December 2008

Summary
Opportunistic infections are increasingly becoming a problem in cancer patients amongst whom infection with Nocardia species is particularly difficult to detect due to the capricious natural history of the disease. Three cases of Nocardia infection in patients who had undergone splenectomy for haematological malignancy are presented. These cases illustrate the diverse mode of presentation, the natural history and the difficulties in early and accurate diagnosis of Nocardia infection. Despite the difficulties in arriving at the correct diagnosis, these cases highlight the importance of early institution of appropriate antibiotic therapy. Antibiotics should be given in adequate doses to control the initial infection and be maintained for a prolonged period to prevent relapses.
Transient pancytopenia associated with parvovirus infection in paroxysmal nocturnal haemoglobinuria
Authors: Lakhani A K , Malkovska V , Bevan D H , Anderson M J 
Published: December 2008

Summary
A 25 year old woman with a 15-year history of paroxysmal nocturnal haemoglobinuria developed transient pancytopenia following infection with human parvovirus B19. This is the first report of transient pancytopenia in a patient with an acquired haemolytic anaemia due to parvovirus. The possible mechanism of pancytopenia in such a case is discussed.
Cardiac bypass surgery with haemorrhagic endocrine sequelae
Authors: Khardori R , Bussing R C , Burns G M , Soler N G 
Published: December 2008

Summary
Cardiac bypass surgery is associated with changes in haemostatis which can lead to bleeding. This report highlights two examples of such bleeding which led to unusual clinical presentations and endocrinological consequences: adrenal and pituitary haemorrhage.
Unusual causes of calf swelling--3. Popliteal vein obstruction by an osteochondroma of the proximal tibia.
Authors: Prosser A J , Brenkel I J , Pearse M , Gregg P J 
Published: December 2008

Summary
Vascular complications of osteochondroma are uncommon. We report a case of popliteal vein obstruction by an osteochondroma, arising from the proximal tibia, in which the diagnosis was initially missed. The pathogenesis and management of these complications are discussed.
Subacute myelopathy caused by spinal venous infarction
Authors: Clarke C E , Cumming W J K 
Published: December 2008

Summary
A 44 year old female presented with a subacute myelopathy in association with pelvic venous thrombosis. It is inferred from the temporal relationship of these events that the patient suffered a subacute spinal venous infarction. This is discussed along with the aetiology, anatomical distribution and management of the condition.
Ulcerative colitis complicated by disseminated intravascular coagulation
Authors: Muller S , Chesner I M , Sheridan J , Newman J 
Published: December 2008

Summary
We report a case of chronic ulcerative colitis complicated by clinical evidence of disseminated intravascular coagulation and pathological evidence of intestinal ischaemia secondary to venular and capillary fibrin thrombi. This may well represent an example of univisceral Shwartzman reaction occurring in a sensitized target organ.
Amyloidosis in continuous ambulatory peritoneal dialysis
Authors: Beaman M , Boon A P , Michael J , Adu D 
Published: December 2008

Summary
We report a 53 year old man with chronic renal failure on continuous ambulatory peritoneal dialysis. Following eight episodes of severe peritonitis over a 2 year period, he died and was found to have widespread AA amyloid at post-mortem.
The clinical use of cerebrospinal fluid studies in demyelinating neurological diseases
Authors: Harrington M G , Kennedy P G 
Published: December 2008

Summary
The clinical diagnosis of definite multiple sclerosis is supported by abnormalities in the cerebrospinal fluid: variable mild pleocytosis and elevation of total protein, moderately elevated total IgG in most patients, and the almost invariable presence of discrete immunoglobulins after electrophoresis, the oligoclonal bands. The oligoclonal bands are non-specific, and are seen in most diseases of the nervous system, but their temporal uniformity in each patient with multiple sclerosis is characteristic. Prognostically, patients with a single episode of optic neuritis or paraesthesia who have oligoclonal bands are more likely to develop multiple sclerosis than if the spinal fluid were normal. In the Guillain-Barré syndrome, the spinal fluid total protein is transiently elevated, with no pleocytosis. Oligoclonal bands are usually found in the acute phase and only persist in those patients with chronic or relapsing polyneuropathy.
The incidence and causes of hypercalcaemia
Authors: Dent D M , Miller J L , Klaff L , Barron J 
Published: December 2008

Summary
A prospective screen for hypercalcaemia in 58,053 hospital in-patients was conducted over 12 months. The incidence of hypercalcaemia was 0.6%, being transient in 19.2% of patients and sustained in the remainder. The most common causes in the sustained group were malignancy (45%) and primary hyperparathyroidism (16.5%). The incidence of primary hyperparathyroidism was 78/100,000 hospital in-patients, and its discovery was directly attributable to the survey in over half the cases.
Can thyroid stimulating hormone levels by TSH (IRMA) predict relapse of thyrotoxicosis following carbimazole treatment?
Authors: Wilson R , Semple C G , Reid A M , Glen A C A , McKillop J H , Thomson J A 
Published: December 2008

Summary
Serum thyrotrophin receptor antibody (TRAb) and thyroid stimulating hormone (TSH) (IRMA) levels were measured in 38 patients at one month after the end of a course of carbimazole/T3 therapy for Graves’ disease. Despite the increased sensitivity of the IRMA assay a TSH measurement at this stage was found to be of no predictive value, in contrast to estimation of serum TRAb levels which correctly predicted relapse and remission in 90% of patients.
Combined irradiation and low-dose cyclophosphamide in the treatment of Graves’ ophthalmopathy
Authors: Teoh R , Woo J 
Published: December 2008

Summary
The treatment of a patient with euthyroid Graves’ ophthalmopathy is described. A poor response was obtained from large doses of prednisone whereas a combination of orbital irradiation and low dose cyclophosphamide induced a dramatic resolution. As there is no fully satisfactory treatment for this condition, this combined therapy deserves further investigation.
Chronic renal failure and tuberous sclerosis: a rare association
Authors: Nimr A B , Patel P J , Tongia R K , Tamizuddin F 
Published: December 2008

Summary
A 38 year old Saudi patient with tuberous sclerosis and chronic renal failure is described. The association of these two conditions has rarely been described. This case supports the observation that when chronic renal failure occurs in patients with tuberous sclerosis, cystic renal disease (with or without hamartomas) is more likely to be the underlying cause, rather than hamartomas alone.
Carcinoma of the duodenum
Authors: Carragher A , Russell C 
Published: December 2008

Summary
We report two patients with primary adenocarcinoma of the duodenum who underwent successful pancreatico-duodenectomy (modified Whipple operation). One patient died from an unrelated cause three years following surgery whilst the other remains well and clinically free of disease 3 years after resection. An aggressive surgical policy in patients with this rare tumour seems justified.
Gastric outlet obstruction due to gall stones (Bouveret syndrome)
Authors: Ah-Chong K , Leong Y P 
Published: December 2008

Summary
Gastric outlet obstruction by gall stone is a rare complication of a common disorder. Two cases are reported here. The investigations are conducted along the same lines as for pyloric stenosis. The diagnosis can be made with a barium meal or gastroscopy. Treatment is by surgical intervention after adequate resuscitation.