bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic lupus erythematosus
Authors: Hughes G R V 
Published: December 2008

Summary
Systemic lupus erythematosus is a common disease--studies throughout the world broadly agree on a prevalence of 1 in 1000 women. Recently an important clinical advance has come from the description of a syndrome of recurrent thrombosis, recurrent abortion and neurological disease associated with antiphospholipid antibodies. The discovery that immunological mechanisms may apply in some cases of thrombosis has led to new insights into the aetiology and treatment of vascular disease in general.
The role of fibreoptic bronchoscopy in the investigation of pleural effusion
Authors: Heaton R W , Roberts C M 
Published: December 2008

Summary
Published data on the role of fibreoptic bronchoscopy in the investigation of pleural effusions are sparse and conflicting. We have reviewed our experience from November 1980 to December 1986. Thirty-two patients were identified from bronchoscopy records as having undergone the procedure during the evaluation of an effusion. Fibreoptic bronchoscopy was diagnostic in 6 of the 32 cases, but less invasive procedures had given the diagnosis in 4, and in the other 2 cases radiological abnormalities other than the effusion suggested an underlying bronchial malignancy. We conclude that routine fibreoptic bronchoscopy is not justified in the evaluation of pleural effusions.
Comparison of the effect of oxitropium bromide and of slow-release theophylline on nocturnal asthma
Authors: Bellia V , Ferrara G , Cibella F , Cuttitta G , Visconti A , Insalaco G , Mirto M , Peralta G 
Published: December 2008

Summary
The effects of a new inhaled antimuscarinic drug, oxitropium bromide, and of a slow-release theophylline preparation upon nocturnal asthma were compared in a placebo-controlled double-blind study. Two samples were studied: 12 patients received oxitropium at 600 micrograms (6 subjects) or at 400 micrograms t.i.d. (6 subjects) whereas 11 received theophylline at 300 mg b.i.d. Morning dipping, assessed by the fall in peak flow overnight, was significantly reduced in the periods when either active drug was taken, whereas no difference was noticed during the placebo administration. No significant difference was noticed between results obtained with either active drug, as well as with either dosage of oxitropium. No subject reported side effects of oxitropium, as compared to three subjects reporting nausea, vomiting and tremors after theophylline.
Oxitropium proves to be a valuable alternative to theophylline in nocturnal asthma, since it is equally potent, safer and does not require the titration of dosage.
Cerebral depression due to propylene glycol in a patient with chronic epilepsy--the value of the plasma osmolal gap in diagnosis
Authors: Lolin Y , Francis D A , Flanagan R J , Little P , Lascelles P T 
Published: December 2008

SummaryA case of propylene glycol poisoning is described in a 39 year old woman which resulted in her admission to hospital in status epilepticus. She had had a long-standing history of uncontrollable epilepsy. The diagnosis of propylene glycol poisoning resulted directly from the finding of a high plasma osmolal gap on admission. This finding would have been missed if later samples only had been analysed. Plasma osmolality and the osmolal gap should be considered first line investigations in patients presenting with metabolic acidosis and cerebral signs and symptoms. Since her discharge from hospital a year ago the patient has had no further seizures.
Massive macroglossia, amyloidosis and myeloma
Authors: Jacobs P , Sellars S , King H S 
Published: December 2008

Summary
A 74 year old man with light-chain myeloma developed amyloidosis with macroglossia after 10 years of therapy with alkylating agents. Over a 2-year period his tongue enlarged to persistently protrude from his mouth, inhibit his speech, interfere with normal swallowing and eventually threaten his airway. As a life-saving procedure the tumorous anterior two-thirds of the tongue was resected, with excellent primary healing. Within two weeks the patient’s speech became comprehensible and his ability to eat returned to normal. Although rare in amyloidosis, massive macroglossia may occur and surgical correction is easily achieved.
Inflammatory demyelinating polyneuropathy in a haemophiliac associated with human immunodeficiency virus infection, responding to high dose intravenous immunoglobulin
Authors: Panicker R , Bloom A L , Compston D A S 
Published: December 2008

Summary
We describe what we believe to be the first case of chronic inflammatory demyelinating polyneuropathy (CIDP) occurring in a haemophiliac infected with the human immunodeficiency virus (HIV), and the first patient to show a clinical response to treatment with high dose i.v. immunoglobulin. A 55 year old, severe haemophiliac, known to be positive for HIV antibody, presented with a short history of motor weakness and variable sensory loss in both lower limbs. Clinical examination, electrophysiology and sural nerve biopsy confirmed a diagnosis of CIDP. He was treated with a 4-day course of high dose i.v. immunoglobulin, given as a daily infusion. This resulted in dramatic improvement in his neurological status which was evident both clinically and functionally. We conclude that CIDP can occur in HIV-positive haemophiliacs as it does in homosexuals and drug abusers infected with the virus. We also suggest that high dose i.v. immunoglobulin may be effective in the treatment of this condition, especially when practical difficulties preclude the use of plasmapheresis and the use of immunosuppressive drugs is considered hazardous.
Cervical Crohn’s disease with oesophago-pulmonary fistula
Authors: Steel A , Dyer N H , Matthews H R 
Published: December 2008

Summary
We report what we believe to be the first case of Crohn’s disease involving the cervical oesophagus with an oesophago-pulmonary fistula to the apex of the lung. The proximal location of the disease prevented radical therapy and the patient eventually died from chronic sepsis.
Spontaneous expulsion per rectum of an ileal lipoma
Authors: Misra S P , Singh S K , Thorat V K , Gulati P , Malhotra V , Anand B S 
Published: December 2008

Summary
We report a case of spontaneous expulsion of a lipoma in a 32 year old male patient who presented with recurrent attacks of subacute intestinal obstruction. During one such episode the patient developed unusually severe abdominal pain and expelled a fleshy mass per rectum which, on histopathology, was found to be a lipoma attached to a necrosed portion of the small intestine. The pain disappeared immediately; a subsequent barium meal examination revealed normal appearances and the patient has remained completely symptom free 10 months after the incident.
Ten Tanzanian transplants: problems and perspectives
Authors: Basinda S L , Maro E E , McLarty D G , Young A E , Wing A J 
Published: December 2008

Summary
A strategy of live related donor kidney transplantation coupled to the briefest possible preparatory period of haemodialysis was adopted as the most cost effective treatment for a selected group of 9 Tanzanian patients who received a total of 10 grafts. Patient and donor selection and preparation were carried out at Muhimbuli Medical Centre, Dar es Salaam, and the transplant procedure and first few months of follow-up were done at St. Thomas’ Hospital, London. There was a high incidence of complications which drew attention to particular risk factors in the group treated. The high cost of treating these individuals emphasizes the need for research into chronic communicable and non-communicable diseases in Africa and highlights the dilemma of appropriate use of resources in serving the world’s medical needs.
Myasthenia gravis and Schmidt syndrome
Authors: McAlpine J K , Thomson J E 
Published: December 2008

Summary
We describe a 47 year old woman with a 30-year history of generalized myasthenia gravis whose condition had been stable and well controlled on a combination of pyridostigmine and ephedrine until she presented. At this time she gave a 2 month history of weakness, nausea, vomiting and more recently intermittent confusion. Investigations confirmed both primary hypothyroidism and primary adrenal failure (Schmidt syndrome). The autoimmune aetiology of these three conditions was confirmed by positive acetylcholine receptor, adrenal and thyroid microsomal antibodies.
Persistent chorea as a manifestation of thyrotoxicosis
Authors: Javaid A , Hilton D D 
Published: December 2008

Summary
We report a case of persistent chorea as a manifestation of thyrotoxicosis. The chorea was severe and persisted after the patient was rendered euthyroid. Dopamine antagonists only partially suppressed the involuntary movements during the first few months. It was eventually controlled with haloperidol, but whenever she discontinues the treatment the chorea has returned during the 16 months since she first presented.
Jaccoud’s arthropathy--diagnostic and therapeutic implications
Authors: Thakur R , Gupta L C , Misra M , Saran R K , Hasan M 
Published: December 2008

Summary
A case of isolated chronic severe aortic regurgitation with Jaccoud’s arthropathy involving the foot is presented. The interesting feature of the case is the absence of history of acute rheumatic arthritis at any stage of the illness. The diagnostic and possible therapeutic significance of this otherwise uncommon and benign condition are discussed.
Gas gangrene in a diabetic after intramuscular injection
Authors: Kershaw C J , Bulstrode C J K 
Published: December 2008

Summary
A 47 year old male insulin-dependent diabetic developed two synchronous life-threatening Clostridium perfringens infections under unusual circumstances. Numerous sterile abscesses were also present, being the result of regular pentazocine intramuscular injections. Extensive surgical debridement and parenteral antibiotic therapy proved effective in treating the septicaemia and the large soft tissue abscesses in the buttock and thigh. The patient made an excellent functional recovery. The pathogenesis of gas gangrene after injection is discussed with particular reference to the diabetic patient.
Hepatic abscess and cystic fibrosis
Authors: Canny G J , Roberts E A , Liu P , Reisman J , Levison H 
Published: December 2008

Summary
Extrapulmonary infection is rare in cystic fibrosis. We describe two adult patients with cystic fibrosis whose course was complicated by the development of liver abscesses. The possible aetiology of these abscesses is discussed and the diagnosis, treatment and prognosis of pyogenic hepatic abscess is briefly reviewed.
Incidence and types of acute viral hepatitis in Newcastle upon Tyne
Authors: Hosker H S R , Lindsay D C , Game F , Codd A A , Dale G , Record C O 
Published: December 2008

Summary
The incidence and types of viral hepatitis in the city of Newcastle upon Tyne have been studied by serological analysis of (a) all blood samples sent to the virological laboratory for hepatitis testing and (b) all blood samples sent by general practitioners to the biochemical laboratory for liver function testing. The annual detection rate of acute viral hepatitis was found to be 31.5 cases/100,000 population, of which 9.1 were hepatitis B. Only three sporadic cases of non-A non-B hepatitis were identified. The incidence of hepatitis is at least four-fold greater than suggested by notification rates and may be substantially higher as general practitioners rarely requested laboratory confirmation of household contacts of index cases.
Effect of nifedipine and mefruside on renal reserve in hypertensive patients
Authors: Notghi A , Anderton J L 
Published: December 2008

Summary
Changes in glomerular filtration rate and effective renal plasma flow following a protein meal were measured in seven patients with essential hypertension on no treatment and after 6 weeks’ treatment with nifedipine and mefruside. Glomerular filtration rate and effective renal plasma flow increased significantly following a protein meal in patients on no treatment (P less than 0.01 and P less than 0.05 respectively). The response to a protein meal was lost following antihypertensive treatment (P less than 0.5 and P less than 0.1 respectively). Although there was some increase in the fasting values of glomerular filtration rate and effective renal plasma flow this was less pronounced and more difficult to demonstrate when only fasting values were compared. We propose that the loss of response to a protein meal is due to recruitment of renal reserve function and that protein meal challenge is a sensitive test for detecting changes in renal function.
Myocarditis complicating ethylene glycol poisoning in the absence of neurological features
Authors: Denning D W , Berendt A , Chia Y , Morgan S H 
Published: December 2008

Summary
The consequences of ethylene glycol intoxication are described in a 42 year old man who presented with a profound metabolic acidosis, cardiogenic shock and renal failure. The clinical and electrocardiographic findings suggested a myocarditis and this was confirmed by endomyocardial biopsy. The striking absence of neurological features in this patient delayed diagnosis, which was not suspected until calcium oxalate crystals were demonstrated at renal biopsy. Retrospective analysis of serum retained at his admission to hospital confirmed toxic levels of ethylene glycol. Following a period of intensive cardio-respiratory support and peritoneal dialysis he made a good recovery with cardiac and renal function returning to normal.
Association of small intestinal diverticulosis with chronic pancreatitis leading to severe malabsorption. Report of three cases
Authors: Mahida Y R , Chapman R W , Jewell D P 
Published: December 2008

Summary
Three cases of chronic pancreatitis occurring in patients with small intestinal diverticulosis and bacterial overgrowth are reported. In two of the cases, pancreatic supplements were therapeutically beneficial (the third being unable to tolerate them). Two of the patients also developed diverticular perforation. The possible nature of the association between small intestinal diverticulosis and chronic pancreatitis is discussed.
Addison’s disease presenting as anorexia nervosa in a young man
Authors: Tobin M V , Morris A I 
Published: December 2008

Summary
A young man with a long history of obsessional traits and food fads presented with anorexia, vomiting and marked weight loss. He showed little concern for his physical state and his vomiting was frequently witnessed as self-induced. A diagnosis of anorexia nervosa was made and he took his own discharge from hospital. He was readmitted one month later, severely cachectic and with biochemical abnormalities consistent with advanced Addison’s disease which was subsequently confirmed. He responded dramatically, both mentally and physically, to corticosteroid therapy. It is likely that anorexia nervosa, relatively rare in males, was a manifestation of the psychological abnormalities commonly seen in severe Addison’s disease.
Blood alcohol levels in acute elderly admissions to hospital
Authors: Penn N D , Corrado O J , Pitchfork L J , Evans R T , Mascie-Taylor B H 
Published: December 2008

Summary
Blood alcohol levels were estimated in 141 patients admitted acutely over a one month period to a geriatric unit. Only four (2.8%) had alcohol detectable in their blood. The levels were low, suggesting that alcohol intoxication is not a major factor in the admission of the elderly to hospital.
Renovascular hypertension in neurofibromatosis
Authors: Pollard S G , Hornick P , Macfarlane R , Calne R Y 
Published: December 2008

Summary
We present two patients with renovascular hypertension in association with neurofibromatosis. In both cases the diagnosis was established by angiography. The first patient suffered occlusion of the right renal artery combined with intrarenal arterial lesions. Treatment was by autotransplantation. The second patient suffered bilateral intrarenal arterial lesions alone and was treated medically. In both patients, control of the hypertension was established. We discuss the aetiology of renovascular hypertension in neurofibromatosis and consider its treatment.
Ulceration of the entire small intestine accompanied by rash, hepatitis and pancytopenia
Authors: Park R H R , Mills P R , Danesh B J , Russell R I , Kennedy D H , McArdle C , Lee F D 
Published: December 2008

Summary
A case of acute mucosal ulceration of the entire small intestine accompanied by skin rash, hepatitis and marrow suppression is reported. Recovery was complicated by a severe protein losing enteropathy and small intestinal strictures and the patient died post-operatively of a pulmonary embolism. The aetiology remains unknown.
Angiofollicular lymph node hyperplasia with amyloidosis
Authors: West K P , Morgan D R , Lauder I 
Published: December 2008

Abstract
Two cases of angiofollicular lymph node hyperplasia are described, one of the solitary plasma cell type the other of the multicentric hyaline vascular type. Both cases illustrate the wide ranging clinical and pathological findings associated with this condition but both also have unusual features. The solitary plasma cell lesion had an exceptional 32 year clinical history and was associated with systemic amyloidosis of AL type. The multicentric hyaline vascular case was associated with coexistent multiple myeloma and amyloid deposition also of AL type. These cases are presented with a review of the relevant literature.
Listeria monocytogenes meningitis in previously healthy adults
Authors: Hearmon C J , Ghosh S K 
Published: December 2008

Abstract
A retrospective study of four sporadic cases of Listeria monocytogenes meningitis is reported. Contrary to the conventional epidemiology these patients were adults who were not immuno-compromised. Although all four cases produced positive cerebrospinal fluid cultures, in three, listeria was not microscopically identified. Protein and glucose contents of cerebrospinal fluids were variable and all samples showed lymphocytic pleocytosis. All four had neutrophil leucocytosis in peripheral blood. The unwary may dismiss lymphocytic meningitis as being of ‘viral’ origin, thereby making an important diagnostic misjudgement of vital therapeutic importance. Intravenous ampicillin is the drug of first choice for treatment of listeria meningitis; third generation cephalosporins are ineffective.
Occupational medicine as a specialty
Authors: Slattery D A D 
Published: December 2008

Abstract
Occupational medicine is one of the more recently accepted specialties and is best defined by the social context in which it is practiced. The current structure of the specialty is more easily understood in the light of its historical background. Occupational medicine brings together knowledge from a wide spectrum of disciplines which is reflected in its academic and research bases. A great variety of activities and environments are covered and this has posed problems in defining and organizing higher specialist training. Occupational considerations impact on almost every aspect of medical practice and there is a need for wider understanding of occupational medicine principles in the profession as a whole both in this country and abroad.
Hypothalamic disease in association with dysgenesis of the corpus callosum
Authors: Page S R , Nussey S S , Jenkins J S , Wilson S G , Johnson D A 
Published: December 2008

Summary
We describe two cases of dysgenesis of the corpus callosum demonstrated by magnetic resonance. The first patient presented with chronic hyponatraemia. Investigation demonstrated re-setting of the osmoreceptor and thirst centres. The calculated threshold for arginine vasopressin (AVP) release was reduced at 252 mosmol/kg while severe thirst was perceived at a plasma osmolality of 260 mosmol/kg. Insulin-induced hypoglycaemia produced an exaggerated AVP response. The second patient presented with hypothermia. The calculated threshold of AVP release was 296 mosmol/kg with increased sensitivity of AVP response to hypertonic saline. The plasma AVP response to insulin-induced hypoglycaemia was absent. Both cases had normal anterior pituitary function and psychological assessment showed a similar prefrontal defect. Specific tests of callosal function were normal. These cases illustrate the importance of undertaking complete neuroradiological assessment of cases of unexplained hypothalamic disease regardless of the age of presentation to avoid overlooking this rare congenital association.
Alopecia totalis in a patient with Crohn’s disease and its treatment with azathioprine
Authors: Goddard C J R , August P J , Whorwell P J 
Published: December 2008

Summary
A patient with Crohn’s disease and alopecia totalis is described. Despite relative inactivity of the Crohn’s disease, treatment with azathioprine was commenced. This led to complete regrowth of hair which was lost when the drug was discontinued. Re-institution of azathioprine restored hair to normal again and the patient has since declined to try stopping the drug despite the knowledge of potential side effects.
Temporary transvenous cardiac pacing: 6 years experience in one coronary care unit
Authors: Jowett N I , Thompson D R , Pohl J E F 
Published: December 2008

Summary
The role of temporary percutaneous endocardial pacing has been examined in a retrospective analysis of all paced patients admitted to one coronary care unit over a 6 year period. The majority of 162 cases (84.6%) were paced for complete heart block complicating acute myocardial infarction. These patients had a higher incidence of previous hypertension, myocardial infarction and diabetes, compared to matched controls (P less than 0.05, less than 0.02 and less than 0.001, respectively). Admission blood glucose levels were also higher (P less than 0.05). The in-hospital mortality was high (46.7%), especially for those with anterior myocardial infarction (74.5%). Twenty-five (15.4%) patients without recent myocardial infarction were paced for symptomatic brady-dysrhythmias, usually due to chronic complete heart block (Lenegre’s disease) or sick sinus syndrome. Most later required permanent pacing. Complications of temporary pacing were more frequent in those who died, the most common being dysrhythmias during pacemaker insertion. Review of our cases suggests that whilst facilities for temporary pacing were extremely valuable, many cases treated were not haemodynamically compromised and probably did not require pacing. Guidelines should be established on coronary care units to prevent the unnecessary morbidity, mortality and expense of the procedure.
Hyperkalaemic periodic paralysis: a rare presentation of Addison’s disease
Authors: Sowden J M , Borsey D Q 
Published: December 2008

Summary
A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison’s disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis.
Septicaemia in a granulocytopenic patient caused by Corynebacterium striatum
Authors: Dall L , Barnes W G , Hurford D 
Published: December 2008

Summary
A 64 year old woman with metastatic endometrial carcinoma was admitted to the hospital after three grand mal seizures. Blood cultures yielded Corynebacterium striatum. The patient responded to parenteral ampicillin therapy. This is believed to be the first case of sepsis caused by this organism.