bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphomatoid granulomatosis mimicking bronchial carcinoma
Authors: Paramsothy Y , Ilchyshyn A , Sidky K , Byrne J P 
Published: December 2008

Summary
This report concerns a patient with lymphomatoid granulomatosis who presented with multiple ulcerated skin nodules, a solitary pulmonary mass and a cerebral mass. Biopsies taken from the skin and lung lesion showed necrotic tissue only. This combination of physical signs and the initial non-specific histological changes suggested a diagnosis of primary bronchial carcinoma with secondary spread. However, the subsequent temporary improvement and a further histological examination enabled a diagnosis of lymphomatoid granulomatosis to be made and this was confirmed at post-mortem. This report emphasizes the difficulty in obtaining diagnostic material in lymphomatoid granulomatosis and highlights the need to consider this diagnosis in a patient with suspected carcinoma when biopsy material shows necrotic tissue only.
A life-threatening respiratory complication of gastro-oesophageal reflux in a patient with tetraplegia
Authors: Donald I P , Gear M W L , Wilkinson S P 
Published: December 2008

Summary
Recurrent attacks of life-threatening dyspnoea and choking occurred in a patient with tetraplegia. Conventional investigations for gastro-oesophageal reflux were normal, but 24-hour oesophageal pH recording revealed gross reflux in association with an attack of dyspnoea. Surgical correction of the reflux abolished the attacks. The possibility of autonomic dysreflexia as the mechanism linking reflux and respiratory symptoms in this patient is discussed.
Comparison of the efficacy of nicardipine, a new calcium channel blocker, with nifedipine in the treatment of mild to moderate essential hypertension
Authors: Armstrong C , Garnham J , Blackwood R 
Published: December 2008

Summary
Thirty-nine patients with mild to moderate essential hypertension participated in a parallel, single-blind study comparing 6 weeks’ treatment of nicardipine hydrochloride (90 mg/day) with nifedipine (40 mg/day). Nicardipine-treated patients commenced therapy with a significantly higher mean supine diastolic blood pressure than the nifedipine-treated patients. There was a statistically significant fall in blood pressure (systolic and diastolic) on both treatments at the 3 and 6 week follow-up visits. On adjusting the results for the baseline inequality, no statistically significant differences were found between treatment groups.
Seven patients withdrew from nifedipine therapy and six patients withdrew from nicardipine therapy due to adverse events.
The results show that nicardipine hydrochloride at 90 mg/day is an effective anti-hypertensive agent. The incidence and nature of adverse events were similar on the two treatments.
A study of the use of intravenous cannulas for medical emergencies in Newham--implications for financial savings
Authors: Mason A C , Thomas H J W , Barras C , Kopelman P G 
Published: December 2008

Summary
A study of intravenous (i.v.) cannula usage for medical emergencies admitted to hospitals in the Newham Health District was undertaken during two defined periods (24 and 35 days). Almost half the cannulas inserted (47%) were not flushed following an initial bolus injection of heparinized saline. The duration that cannulas remained in a vein ranged from 24 hours to 8 days (median 2 days) and inflammation around the cannula site was related to the length of time since insertion but unrelated to whether the cannula was flushed regularly or to the type of fluid used. Our findings indicate a substantial wastage of i.v. cannulas due to difficulties with insertion and suggest that isotonic saline, without heparin, is effective in maintaining cannula patency for 48 hours.
It is concluded that these findings are not unique to the Newham Health District and worthwhile financial savings should be achieved throughout the NHS if clinicians reconsider the indications and use of i.v. cannulas for their patients.
Pitfalls in the ultrasonographic diagnosis of gallbladder diseases
Authors: Fitzgerald E J , Toi A 
Published: December 2008

Summary
Ultrasonography is rapidly replacing radiological techniques of gallbladder investigation. While ultrasonography is highly accurate, there are technical, anatomical and diagnostic pitfalls which will trap the unwary. This presentation highlights the pitfalls which we have encountered, reviews the literature in this area and suggests techniques whereby these pitfalls may be avoided.
The breast pain clinic: a rational approach to classification and treatment of breast pain
Authors: Griffith C D M , Dowle C S , Hinton C P , Blamey R W 
Published: December 2008

Summary
Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period.
Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification of breast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens’ breast pain was classified as trigger zone (14%), continuous (8%), Tietze’s disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified.
The experience from this clinic is that a majority of women complaining of severe breast pain symptoms can be accurately classified and appropriate therapy instituted.
Colobomata associated with Noonan’s syndrome
Authors: Kleanthous L , D’Cruz D , Graham E , Efthimiou J 
Published: December 2008

Summary
A patient with Noonan’s syndrome and fundal colobomata in both eyes is described. To our knowledge, this is the first report of the association of colobomata with Noonan’s syndrome. Although the patient had poor sight since early childhood and dyspnea on exertion as a teenager, the diagnosis of Noonan’s syndrome was not made until early adulthood. We hope this report will encourage recognition of this syndrome and its implications at an earlier stage.
Candidal endophthalmitis: a manifestation of systemic candidiasis
Authors: Patel B C K , Kaye S B , Morgan L H 
Published: December 2008

Summary
Two patients on total parenteral nutrition who developed endophthalmitis secondary to Candida albicans are described. Candidal endophthalmitis as a manifestation of systemic candidiasis is discussed and its early diagnosis by bedside fundal examination in patients at risk is stressed.
Successful termination of combined rapid atrial flutter/fibrillation and ventricular tachycardia by intravenous sotalol
Authors: Ramsdale D R , Peterson C 
Published: December 2008

Summary
Combined rapid atrial flutter/fibrillation and recurrent ventricular tachycardia occurred in an 82 year old man with acute myocardial infarction. Both arrhythmias were promptly terminated by intravenous sotalol, suggesting another use for this unique drug in the absence of hypotension, heart block or cardiac failure.
Granulomatous mastitis--a rare cause of erythema nodosum
Authors: Adams D H , Hubscher S G , Scott D G I 
Published: December 2008

Summary
Granulomatous mastitis is a recently described, rare condition of unknown aetiology. It occurs in young, parous women as a tender extra-areolar breast lump and therefore needs to be differentiated from carcinoma. Histologically, a discrete granulomatous lobulitis is seen and because of morphological similarities to granulomatous thyroiditis it has been suggested it may be immunologically mediated. We present a patient in whom granulomatous mastitis presented with periarthritis and erythema nodosum, an association not previously described.
Regional lipiodolized chemotherapy for cholangiocarcinoma associated with oral contraceptives
Authors: McAleer J J A , Dickey W , Clarke R , Johnston G W , Callender M E 
Published: December 2008

Summary
We describe a case of cholangiocarcinoma in a young woman, who presented with cholestatic jaundice following oral contraceptive ingestion. Following diagnostic laparotomy she received intra-arterial ‘lipiodolized’ chemotherapy. Intravenous mitozantrone was given for 2 years and she is asymptomatic, with computed tomographic evidence of tumour response, 27 months after diagnosis. We suggest that this form of treatment is of value for cholangiocarcinoma.
Nocturnal convulsions and insulin-induced hypoglycaemia in diabetic patients
Authors: Fisher B M , Frier B M 
Published: December 2008

Summary
Convulsions may occur as a consequence of insulin-induced hypoglycaemia. We report three patients with insulin-dependent diabetes, who presented with generalized tonic-clonic seizures associated with nocturnal hypoglycaemia. None of the patients had experienced hypoglycaemia during waking hours and the convulsions were mistakenly diagnosed as idiopathic epilepsy. Recognition of the possible hypoglycaemia aetiology of these convulsions permitted appropriate alteration of the insulin regimens with no recurrence of convulsions. In one case, the seizure was associated with bilateral fractures of the neck of the humerus. Unrecognized hypoglycaemia should be considered as a possible cause of convulsions in insulin-dependent diabetic patients.
Macroamylasaemia in association with the acquired immunodeficiency syndrome
Authors: Greenberg R E , Bank S , Singer C 
Published: December 2008

Summary
A patient with macroamylasaemia in association with the acquired immunodeficiency syndrome is described. Patients with the acquired immunodeficiency syndrome commonly have gastrointestinal symptoms that often prompt serum amylase determination. Macroamylasaemia has been found to occur in a variety of diseases including various autoimmune disorders. The marked immunological abnormalities and increased circulating immunoglobulins associated with the acquired immunodeficiency syndrome may have predisposed this patient to macroamylase formation. Macroamylasaemia is a benign condition that requires no treatment and must be excluded in the patient with unexplained hyperamylasaemia to avoid unnecessary diagnostic tests and treatment.
Disappearing hypercalcaemia
Authors: Wood G M , Sidhu B , Saunders W A , Zalin A M , Heath D A 
Published: December 2008

Summary
Four women presented with symptomatic hypercalcaemia and raised concentrations of serum parathyroid hormone (PTH). In each case, serum calcium returned spontaneously to normal. In two patients serum PTH also fell to the normal range and biochemical relapse has not occurred despite prolonged follow-up. In the others, serum PTH remained elevated and subsequent symptomatic hypercalcaemia necessitated parathyroidectomy. In the first two cases, autoparathyroidectomy is the most likely explanation; the initial fall in serum calcium in the other two patients is unexplained. Large fluctuations in serum calcium may occur in some patients with hyperparathyroidism and prolonged and careful observation is required when this occurs.
Incidence of overt and covert neurological damage in children with sickle cell disease
Authors: Hindmarsh P C , Brozovic M , Brook C G D , Davies S C 
Published: December 2008

Summary
We studied 25 patients with sickle cell disease (15 with HbSS; 8 with HbSC and 2 with HbS beta degree) using neurological examination as a marker of overt and computed tomographic (CT) scan as a marker of covert neurological damage. Of the 25 patients, 5 (20%) had evidence of cerebral infarcts on CT scan, but only 4 of these 5 patients had neurological signs. Neurological problems were only seen in patients with HbSS. We could not identify any haematological risk factors, but in this small group of HbSS patients a crisis rate greater than 1 per year of follow up was associated with a significant risk of neurological damage.
Cyclosporin A in steroid-sensitive nephrotic syndrome with frequent relapses
Authors: Chan M K , Cheng I K P 
Published: December 2008

Summary
Eight patients with steroid-sensitive nephrotic syndrome which frequently relapsed despite cyclophosphamide treatment were given cyclosporin A (7.5 mg/kg/day to 10 mg/kg/day) for 8 to 12 weeks. Six had minimal change glomerulonephritis and two had focal segmental glomerulonephritis. Cyclosporin A was given to 5 patients when their nephrotic syndrome was in relapse and to 3 patients when the nephrotic syndrome was in remission. Cyclosporin A induced a transient remission in only one patient.
The significance of pancytopenia in miliary tuberculosis
Authors: Hunt B J , Andrews V , Pettingale K W 
Published: December 2008

Summary
Patients with miliary tuberculosis accompanied by a pancytopenia rarely survive their disease. If the peripheral blood picture does recover it has been taken as an indication that there is no underlying haematological disease, and so re-examination of the bone marrow is not performed. A case is described where resolution of the pancytopenia occurred but a persisting haematological disease remained. Aspects of haematological disease associated with tuberculosis are discussed.
Paraneoplastic papilloedema in neuroblastoma
Authors: Kennedy M J , Eustace P , O’Briain D S , Daly P A 
Published: December 2008

Summary
We report a case of bilateral papilloedema in an adult male with neuroblastoma, in the absence of hypertension or detectable intracranial disease. This complication has not previously been described in the English-speaking literature. Possible mechanisms are discussed.
Adult Gaucher disease in association with acute leukaemia
Authors: Corbett G M , Darbyshire P J , Besley G T N , Parker A C 
Published: December 2008

Summary
A non-Jewish patient diagnosed as having Gaucher disease at the age of 67 is described. Fourteen months after presentation he was diagnosed as having acute myeloid leukaemia. A possible association between Gaucher disease and acute myeloid leukaemia is suggested.
Recurrent gastric outlet obstruction due to an inguinal hernia
Authors: Naraynsingh V , Sieunarine K , Raju G C 
Published: December 2008

Summary
Although gastric strangulation in an inguinal hernia has been reported on three previous occasions, recurrent gastric outlet obstruction due to this hernia has not been previously documented. Prolonged traction on the distal stomach by omentum and transverse colon can draw the antrum and pylorus into the hernia and produce gastric outlet obstruction.
Colonic stricture secondary to blunt abdominal trauma--report of a case and review of the aetiology
Authors: Davidson B R , Everson N W 
Published: December 2008

Summary
A 24 year old man sustained multiple injuries including blunt abdominal trauma in a motor cycle accident. Five months following the accident he developed a large bowel obstruction. Barium enema examination revealed a stricture of the sigmoid colon which, following surgical resection, was found to consist of a fibrous stenosis. The aetiology of such strictures following blunt abdominal trauma is likely to be a combination of mural haemorrhage and ischaemia.
High fever (greater than 39 degrees C) as a clinical manifestation of pulmonary embolism
Authors: Watanakunakorn C , Hayek F 
Published: December 2008

Summary
This is a review of seven patients with pulmonary emboli manifested as high fever (temperature greater than 39 degrees C) seen over a 3 year period by an infectious disease consultant for unexplained fever. The patients’ ages ranged from 16 to 81 years. Bed confinement was the underlying condition of all but one patient. Fever resolved with intravenous heparin therapy in three patients and one patient recovered without heparin therapy. Three patients died. Regardless of the degree of fever, pulmonary emboli should be among the list of differential diagnoses in patients with unexplained fever, especially in those who are confined to bed.
Intranasal squamous cell carcinoma in a renal transplant recipient on long term immunosuppression
Authors: Pace-Balzan A , Timms M S 
Published: December 2008

Summary
An increased risk of developing malignant disease after renal transplantation and immunosuppression with azathioprine and corticosteroids is well documented. We report a case of intranasal carcinoma occurring in a renal transplant recipient. The possible role of immunosuppression on the development and on the outcome of treatment of this tumour is discussed.
Autonomic neuropathy in an alcoholic population
Authors: Barter F , Tanner A R 
Published: December 2008

Summary
Autonomic nervous system integrity has been assessed in 30 alcoholic subjects and 30 age-sex matched controls using five simple tests of cardiovascular responses. There was evidence of parasympathetic neuropathy alone in five of the alcoholic subjects (16%) and of combined parasympathetic and sympathetic neuropathy in an additional six (20%). None of the controls showed any abnormality. Within the alcoholic group, those with autonomic neuropathy were older, were more likely to be female and to have established alcoholic liver disease. Symptoms were a poor guide to the presence or absence of autonomic neuropathy.
Acyclovir treatment of herpes simplex encephalitis: experience in a district hospital
Authors: Gulliford M C , Chandrasekera C P , Cooper R A , Murphy R P 
Published: December 2008

Summary
Herpes simplex encephalitis may be underdiagnosed in Britain. We report eight patients treated at one hospital over three years. Fever, impaired consciousness or focal neurological signs were seen in all patients at presentation but herpes simplex encephalitis was rarely considered as the initial diagnosis. The electroencephalogram was the only initial investigation that was abnormal in each case and was the most useful test in establishing a clinical diagnosis. The diagnosis was confirmed by laboratory methods in each case. Following acyclovir treatment five patients were able to resume normal activities, one patient has moderate disability and two patients died. Three patients showed clinical evidence of relapse but two improved after further treatment with acyclovir. Herpes simplex encephalitis is a treatable condition and should be considered in all patients presenting with fever and neurological signs. The electroencephalogram is usually abnormal and the changes may be characteristic of the condition.
Congenital hypothyroidism from complete iodide transport defect: long-term evolution with iodide treatment
Authors: Albero R , Cerdan A , Sanchez Franco F 
Published: December 2008

Summary
Hypothyroidism from iodide transport deficiency is a rare disease, especially when found in two affected siblings. Treatment with high doses of iodide has been recommended, but no long term results have been reported. Two siblings with congenital hypothyroidism due to total failure to transport iodide have been followed up during twelve and a half years of treatment with oral potassium iodide. Iodine doses varied between 10.3 and 22 mg/day, and serum total iodine concentrations between 100 and 210 micrograms/dl. Total triiodothyronine (T3), thyroxine (T4) and free T4 were in the normal range during the time of study. Basal thyroid stimulating hormones (TSH) and maximum TSH response to thyrotrophin releasing hormone (TRH) were also in the range of normal values. These data along with clinical findings confirmed the potential usefulness of iodine in hypothyroidism due to complete iodide transport defect.
Sheehan’s syndrome presenting with type III hyperlipoproteinaemia
Authors: Carr D , Thornes H M , Rutter A C , Finney R D , Turner P R 
Published: December 2008

Summary
A patient is described in whom the presenting feature of hypopituitarism was the development of palmar xanthomata associated with type III hyperlipoproteinaemia. Treatment of her secondary hypothyroidism with thyroxine caused resolution of the xanthomata and hyperlipidaemia, but the underlying compositional abnormality of the lipoproteins could still be observed.
Chest pain--a common feature of ankylosing spondylitis
Authors: Dawes P T , Sheeran T P , Hothersall T E 
Published: December 2008

Summary
We compared the incidence, nature and frequency of chest pain in a group of 45 ankylosing spondylitis patients with an age and sex matched group of normals. Twenty-five ankylosing spondylitis patients had experienced recurrent chest pain compared to three normals, and had a significantly reduced chest expansion. The presence of chest pain in ankylosing spondylitis can be an early presenting feature of the disease (eight patients had chest pain before spinal symptoms), and is associated with more severe disease.
Treatment of portal hypertension by subtotal splenectomy and central splenorenal shunt
Authors: Petroianu A 
Published: December 2008

Summary
A method is proposed to reduce portal hypertension utilizing subtotal splenectomy and a central splenorenal shunt. The advantages of this method are: diversion of the splenic component of the portal circulation, creation of a shunt for the portal blood into the systemic circulation, preservation of the splenic function and correction of the manifestations of the hypersplenism. Two cases are presented who remain well four years after surgery.
Disseminated intravascular coagulation with Fusobacterium necrophorum septicaemia
Authors: Potter M N , Drysdale H C , Price P A , Buck A C 
Published: December 2008

Summary
A 23 year old woman died within six hours of admission from acute disseminated intravascular coagulation. Fusobacterium necrophorum, a Gram negative anaerobic organism, was isolated as a single pathogen from the blood cultures. This association has not previously been reported.
Calcified thoracic disc with herniation of the nucleus pulposus in a child
Authors: Schapira D , Goldsher D , Nahir M , Scharf Y 
Published: December 2008

Summary
A twelve year old boy presented with acute cervical and interscapular pain, torticollis and low grade fever. The neurological examination was normal. Roentgenograms showed calcification of the T3-T4 disc and posterior herniation of the nucleus pulposus was demonstrated by computed tomography. A rapid and dramatic amelioration of the symptoms was produced by treatment with a non-steroidal anti-inflammatory drug.
Intervertebral disc calcification in childhood is an uncommon and usually benign condition. Its clinical and radiological features are discussed in the light of the relevant literature.
Hypersensitivity reaction with intravenous GnRH after pulsatile subcutaneous GnRH treatment in male hypogonadotrophic hypogonadism
Authors: Popović V , Milošević Z , Djukanović R , Micić D , Nesović M , Manojlović D , Djordjević P , Mićić J 
Published: December 2008

Summary
Chronic pulsatile subcutaneous administration of low doses of gonadotrophin releasing hormone (GnRH) is an effective therapy for men with hypogonadotrophic hypogonadism. Hypersensitivity reactions to GnRH are rare.
We wish to report hypersensitivity reactions with intravenous GnRH after low dose subcutaneous pulsatile GnRH treatment in two men with hypogonadotrophic hypogonadism due to suprasellar disease.
Intra-vascular leiomyoma of the popliteal vein
Authors: Grimer R J , Armstrong G R 
Published: December 2008

Summary
A large mass in the popliteal fossa was found to be a leiomyoma of the popliteal vein with portions of tumour both inside and outside the vein. This is only the second recorded case of a benign smooth muscle tumour of a peripheral vein.
Abdominal epilepsy misdiagnosed as psychogenic pain
Authors: Singhi P D , Kaur S 
Published: December 2008

Summary
The authors present the case report of a child with abdominal epilepsy who had suffered from abdominal pain for several months under the label of psychogenic pain. The important historical clues were pallor and cold sweating during the paroxysm, followed by lethargy and prolonged sleep. An abnormal electroencephalogram and a remarkable response to anticovulsants confirmed the diagnosis. This condition must be considered in a child with undiagnosed recurrent abdominal pain.