bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenomatous polyp at the ureterocaecal anastomosis
Authors: Coen L D , Raftery A T 
Published: December 2008

Summary
A case of adenomatous polyp occurring at a ureterocaecal anastomosis, 25 years after urinary diversion following a total cystectomy for carcinoma of the bladder, is reported. Bilateral nephrectomy for chronic pyelonephritis was carried out 25 years after the initial surgery and, following this, a sinus formed at the incision at the right loin. A sinogram showed contrast filling the right ureter and caecum, and outlined a lobulated filling defect at the ureterocaecal anastomosis. Subsequent histology revealed a dysplastic tubulovillous adenoma. The clinical presentation and management of tumours at the ureterointestinal junction are discussed.
Myositis and eosinophilia in a patient with sarcoidosis
Authors: Al-Saffar Z S , Kelsey C R , Kennet R P , Webley M 
Published: December 2008

Summary
We present a patient with muscle manifestations of sarcoidosis associated with raised creatine kinase levels, eosinophilia and interstitial lung disease. She had significant improvement on prednisolone 30 mg per day.
Symptomatic IgG3 deficiency successfully treated with intravenous immunoglobulin therapy
Authors: Snowden J A , Milford-Ward A , Reilly J T 
Published: December 2008

Summary
We report the case of a 35 year old female who presented with an 8 year history of repeated upper respiratory tract infection, lymphadenopathy and sinusitis associated with IgG3 deficiency. Courses of monthly intravenous immunoglobulin therapy (0.4 g/kg) resulted in a dramatic clinical improvement on three different occasions. We suggest that investigation of adults with features of immunosuppression, despite normal levels of total IgG, should include IgG3 subclass analysis and that symptomatic patients should be given a trial of immunoglobulin replacement therapy.
Primary pelvic hydatid cyst presenting with obstructive uropathy and renal failure
Authors: Seenu V , Misra M C , Tiwari S C , Jain R , Chandrashekhar C 
Published: December 2008

Summary
Primary pelvic hydatid cyst is a rare entity. Pelvic hydatid cysts usually present with pressure symptoms involving adjacent organs (bladder and rectum usually). A case of primary pelvic hydatid cyst presenting with obstructive uropathy leading to chronic renal failure is presented. A combination of preoperative albendazole therapy of 1.2 g/day for 8-12 weeks and surgical excision were effective in alleviating the symptoms and improving the renal function.
Late cardiac effects after treatment for childhood Hodgkin’s disease with chemotherapy and low-dose radiotherapy
Authors: Ilhan I , Sarialioglu F , Özbarlas N , Büyükpamukçu M , Akyüz C , Kutluk T 
Published: December 2008

Abstract
Twenty-four patients under 18 years when treated for Hodgkin’s disease (20 male, four female) were examined no less than five years after the completion of the treatment. The mean age was 17 years (range 9.5-25.0 years) at the time of study. All patients received six courses of cyclophosphamide-oncovin-procarbazine-prednisolone chemotherapy; in addition, nine patients received low-dose radiotherapy excluding the mediastinum and eight of 24 patients received mediastinal radiotherapy; the dose was between 20-30 Gy. All patients had normal cardiovascular findings on clinical examination. ECG and chest radiography were within normal limits in all patients. Resting left ventricular ejection fraction and fractional shortening were decreased in only one patient (4%), but there was no significant difference between the patient group and a control group for left ventricular systolic function (p &gt; 0.05). In the patient group, early diastolic peak velocity, peak velocity at atrial contraction, left ventricular isovolumic relaxation time, and the rate of decrease of flow velocity in early diastole were significantly different from that of the control group (p &lt; 0.05). In conclusion, the late effects of our treatment protocol for Hodgkin’s disease appear to be minimal. These observations support combined modality, low-dose irradiation regimens in children and adolescents and suggest the need for careful cardiac screening of treated patients.
The clinical and laboratory correlates of an increased urinary 5-hydroxyindoleacetic acid
Authors: Tormey W P , FitzGerald R J 
Published: December 2008

Abstract
Over a five-and-a-half-year period, there were 298 laboratory requests for urinary 5-hydroxyindoleacetic acid (5-HIAA). The clinical and laboratory associations of the 24 patients in which there were 43 urinary 5-HIAA 24-h collection results greater than the laboratory upper reference limit are detailed. Four were confirmed carcinoid tumours and two were phaeochromocytomas. Flushing was a prominent symptom in 46% and diarrhoea or altered bowel habit in 37%. Associated with the raised urinary 5-HIAA values were increased levels of 4-hydroxy-3-methoxymandelic acid and homovanillic acid in 14.3% and 21%, respectively, of those collections where the metabolites were requested. Diagnostic imaging was performed in 57%. While the specificity was 88%, 5-HIAA is relatively insensitive in the diagnosis of carcinoid tumours and a more widespread use of diagnostic imaging including isotope scanning with labelled metaiodo-benzylguanidine, vasoactive intestinal peptide and octreotide is suggested.
Gallbladder wall thickening in infectious mononucleosis: an ominous sign
Authors: O’Donovan N , Fitzgerald E 
Published: December 2008

Summary
Gallbladder wall thickening (3 mm or greater) is a nonspecific finding with many causes. We describe two cases caused by infectious mononucleosis. Other causes of gallbladder wall thickening are described and the literature is reviewed. We suggest that the finding of gallbladder wall thickening in a patient with infectious mononucleosis implies that the patient is very ill, and its observation should lead to close patient monitoring.
Carbon monoxide poisoning: easy to treat but difficult to recognise
Authors: Balzan M V , Agius G , Galea Debono A 
Published: December 2008

SummaryCarbon monoxide (CO) poisoning is a common medical emergency and a frequent cause of deliberate or accidental death. It can cause acute and chronic central nervous system damage which may be minimised by prompt treatment with 100% oxygen or hyperbaric oxygen therapy. However, recognition of this intoxication can be difficult. Failure to diagnose it may have disastrous effects on the patient, and other members of the household who could subsequently become intoxicated. Guidance on the correct diagnosis of this condition is provided in the light of a number of studies screening emergency room populations. Guidelines for treatment with hyperbaric oxygen therapy are also reviewed.
Successful treatment of intracaval and atrial extension of Wilms’ tumour by chemotherapy
Authors: Berberoğlu S , Akyüz C , Büyükpamukçu M 
Published: December 2008

Summary
A patient presenting with advanced Wilm’s tumour was diagnosed as having inferior vena cava involvement with tumour thrombus extending up to the right atrium, and was treated with preoperative chemotherapy (vincristine, actinocymin D, epirubicin). Atrial and inferior vena cava thrombus disappeared and he underwent a successful nephrectomy.
The irritable bowel syndrome
Authors: Francis C Y , Whorwell P J 
Published: December 2008

Summary
Irritable bowel syndrome is a common disorder varying in severity from trivial to incapacitating. The pathophysiology and epidemiology are gradually being unravelled and it is now becoming apparent just how poor the quality of life of some of these patients can be. It is no longer acceptable practice to diagnose the condition and discharge the patient on a high fibre diet, particularly as the latter can often make the situation worse. Although hard to treat, worthwhile responses can be achieved by careful targeting of therapy to the many different facets of the disorder.
Causes of ischaemic stroke in the young
Authors: Martin P J , Enevoldson T P , Humphrey P R D 
Published: December 2008

Summary
The causes of ischaemic stroke in young adults are many and diverse. Such patients usually require more extensive investigations in order to find an underlying cause than more elderly patients. It is important that a comprehensive search is made since many of the underlying disorders are treatable. Principal causes are extracranial arterial dissection, cardioembolism, premature atherosclerosis, haematological and immunological disorders and migraine. Drug abuse is becoming increasingly important but the risk of stroke in pregnancy remains unclear. Isolated angiitis of the central nervous system, heritable disorders of connective tissue and other genetically determined disorders (mitochondrial cytopathies, CA-DASIL) account for a small proportion of ischaemic strokes in the young. Management is probably best undertaken by a physician with a specialist interest and, if full investigation fails to elucidate a definite cause, the risk of future stoke is low.
Haemophilia
Authors: Cahill M R , Colvin B T 
Published: December 2008

Summary
Although the nature of haemophilia has been understood for thousands of years, knowledge of its molecular genetics is recent. These X-linked bleeding disorders have diverse underlying DNA defects and, in 1992, DNA inversion within the X chromosome was found to explain half of the most serious cases of haemophilia A. The life-span and quality-of-life for patients with haemophilia had improved steadily throughout the early 1980s but the principal cause of death remained intracranial haemorrhage until the epidemic of HIV infection due to contaminated factor concentrates. Infection with hepatitis C virus is almost universal for patients treated with clotting factors before 1985. No curative treatment is available for hepatitis C at present. Knowledge of the transmission of viruses in concentrates has led to important developments in processing techniques to eliminate them. Recombinant technology has produced factor VIII and, more recently, factor IX concentrate which is likely to be very safe. Development of inhibitors to factor concentrates (especially factor VIII) remains one of the most serious complications of haemophilia. The variety of treatments available testifies to the lack of a single universally efficacious one. The use of prophylactic treatment has been conclusively demonstrated to result in a preservation of joint function in severely affected patients who might otherwise develop significant joint problems. The many facets of the care of patients with severe haemophilia, ranging from dental care to genetic counselling, can be advantageously co-ordinated in a haemophilia comprehensive care centre.
Barium peritonitis: a rare complication of upper gastrointestinal contrast investigation
Authors: Karanikas I D , Kakoulidis D D , Gouvas Z T , Hartley J E , Koundourakis S S 
Published: December 2008

Summary
Contrast examination of the gastrointestinal tract is rarely complicated by perforation. The colon and rectum are most commonly affected, with many perforations limited to the retroperitoneum. Generalised peritonitis is therefore rare, but is life-threatening and difficult to treat. We present two analogous cases in which extravasation of barium sulphate complicated contrast meal investigation. These cases illustrate important aspects in the management of this unusual occurrence.
Primary infection by type 1 human immunodeficiency virus: diagnosis and prognosis
Authors: Vanhems P , Beaulieu R 
Published: December 2008

Summary
Primary infection by type 1 human immunodeficiency virus (HIV) is symptomatic in about 70% of cases. The acute illness is a mononucleosis-like syndrome with characteristics such as mucosal ulcerations. The duration and severity of the symptoms appear to be related to the prognosis. After reviewing the most frequent signs and symptoms of primary HIV infection, we report different prognostic studies which examined the association between the acute illness and the progression of HIV disease.
The use of angiotensin-converting enzyme inhibitors in the treatment of heart failure in hospital practice
Authors: Missouris C G , MacGregor G A 
Published: December 2008

Summary
Several well-controlled trials in patients with heart failure have shown that the use of angiotensin-converting enzyme (ACE) inhibitors, in combination with a diuretic, causes a reduction in mortality and morbidity, which seems to be mainly due to a reduction in fatal and nonfatal cardiovascular events. Our aim was to determine whether 249 consecutive patients discharged from hospital with a primary diagnosis of heart failure were routinely being treated with an ACE inhibitor at an appropriate dose. At the time of admission to hospital, 91 (36.5%) were receiving a combination of a diuretic and an ACE inhibitor, 129 (51.8%) were receiving a diuretic alone, and 29 (11.6%) had not previously received either a diuretic or an ACE inhibitor. At the time of discharge from hospital all patients were on a diuretic and 144 (57.8%) were also receiving an ACE inhibitor. Although 41 patients (16.5%) had a relative or absolute contraindication for the use of an ACE inhibitor, 64 patients (25.7%) with no contraindication were not receiving an ACE inhibitor. Many of the patients who were prescribed an ACE inhibitor were given it at an inappropriate dose; only 24 patients (16.7%) were on the dose that was used in the clinical trials showing a reduction in mortality. These results show that in one in four patients admitted to hospital with heart failure who should be receiving an ACE inhibitor by the time of discharge, are not. The average age of these patients was 76 years. Whilst it has been shown that the benefit of ACE inhibitors does not appear to be age-related, most published studies have not included many patients over the age of 80. Specific studies looking at the effect of ACE inhibitors in elderly patients would be helpful, as well as studies to determine the optimum treatment regimen for this age group.
Ocular purpura in a swimmer
Authors: Jowett N I , Jowett S G 
Published: December 2008

Summary
Swimming goggles are increasingly being worn by children during swimming lessons to protect their eyes, although reports of ocular damage associated with their use is becoming more common. We describe a new injury, ‘purpura gogglorum’, caused by overtight application of faulty goggles. Whilst no permanent harm to the eyes resulted in this case, other swimmers have sustained more serious ocular damage, including loss of sight, from goggle-associated injury.
Isolated diastolic heart failure—what is it?
Authors: Shiels P , MacDonald T M 
Published: December 2008

Summary
Epidemiological evidence suggests that 20 to 40% of all patients with heart failure have normal systolic function. Isolated diastolic dysfunction may be the principle pathophysiological mechanism in these patients. The diagnosis of isolated diastolic heart failure is problematic and not merely based on demonstrating normal systolic function. The prognosis in isolated diastolic heart failure is more favourable than in systolic heart failure. At the present time, there is no licensed treatment for isolated diastolic heart failure and treatment is largely empirical.
Barrett's oesophagus
Authors: Navaratnam R M , Winslet M C 
Published: December 2008

Summary
Barrett's oesophagus represents the replacement of stratified squamous epithelium by metaplastic columnar epithelium for 3 cm of the distal oesophagus. Gastro-oesophageal reflux, which affects 40% of the adult population, is the principal aetiological factor. This results in predominantly acid but also bile reflux (due to duodenogastrooesophageal reflux) through the lower oesophageal sphincter, transient relaxation of which accounts for the main mechanism of reflux. Conventional Barrett's oesophagus is reported in 11–13% of patients with symptomatic reflux and short segment Barrett's oesophagus (&lt; 3.0 cm) in 18%. Approximately 50% of these patients have recognised complications on presentation, eg, carcinoma (15%). The disparity between clinical symptoms and endoscopic severity is due to reduced oesophageal mucosal sensitivity as a consequence of prolonged mucosal acid exposure. These rather alarming figures combined with the knowledge that Barrett's oesophagus is a pre-malignant condition (the diagnosis is associated with a 25–130-fold increase of malignancy) may account for the substantial increase in junctional gastrooesophageal malignancies. Symptomatic Barrett's oesophagus should be managed with full-dose proton pump inhibitors, eg, lansoprazole. Anti-reflux surgery should be reserved for the medically fit patient with recurrent symptomatic relapse in the histological absence of premalignant change. There is no evidence suggesting that surgery can be used as a prophylactic measure against malignancy. Encouraging short-term results have been obtained with photodynamic therapy in the management of high-grade dysplasia. However, columnar epithelium has been found underlying the regenerated squamous epithelium, suggesting that life-long surveillance is warranted.
Does psychological intervention help chronic skin conditions?
Authors: Capoore H S , Rowland Payne C M E , Goldin D 
Published: December 2008

Summary
The objective of the study was to assess the impact of psychological/psychiatric assessment in patients with chronic or intractable dermatological conditions. A diagnostic interview was undertaken in order to pin-point any temporal connection between an adverse life-event and the first appearance of the skin disorder. Following this, the dermatologist's assessment of subsequent changes in the skin disorder were noted. The three main dermatological diagnoses were atopic eczema (10), prurigo (10), and psoriasis (nine). Follow-up was for up to 5 years.
A favourable response was noted in 40 out of the 64 patients who participated in the study; this was usually evident within a few weeks and maintained thereafter. Remission was achieved in 12, while 28 showed some improvement. We conclude that this liaison between dermatology and psychiatry proved a valuable adjunct to normal dermatological treatment and was followed by improvement in the majority of patients.
Syntactic Maturity and Vocabulary Richness of Learning Disabled Children at Four Age Levels
Authors: Andolina Charlene 
Published: December 2008

This past decade has witnessed an increasing number of studies attending to vocabulary and language maturity. Some of these studies analyzed oral language or written language, while a few included oral and written discourse. Several of the studies that looked at spontaneous oral language were directly related to this research (Ciani 1974, Fox 1970, O'Donnell, Griffin, & Norris 1967). There was a question however whether the findings with normal children would be generalizable to a population of learning disabled children. In a population sample of learning disabled children what is the developmental trend in their language? How does it compare to the trend found in studies with normal children? Are the findings the same when measured by different instruments? Findings are summarized as follows. (1) A syntactic developmental pattern existed as measured by the number of T-units (one main clause and all subordinated clauses) and the word length per T-unit. (2) A comparison of the syntactic developmental trend of learning disabled and normal children revealed that normal children experience periods of rapid growth, while learning disabled children exhibit gradual control of syntax across the four age levels. (3) A vocabulary developmental pattern exists as measured by the corrected type-token ratio and the number of different words spoken. (4) A comparison of the vocabulary developmental trend of normal and learning disabled children revealed that vocabulary increases for both groups with advancing age.
Component Deficit and Academic Remediation of Learning Disabilities
Authors: Wade Joseph , Kass Corrine E. 
Published: December 2008

The purpose of this study was to compare the effects of (1) remediation of hypothesized component deficits given prior to remediation of known academic deficiencies, and (2) remediation of known academic deficiencies alone. A corollary purpose was to study the immediate effect, if any, of the component deficit remediation on the criterion measure. The component deficits for the Re-Cognition Function (ages eight through 11) were: (1) haptic discrimination, defined as difficulty in noting differences in sense of touch and muscle sensation, (2) visualization deficit, defined as difficulty in recognizing wholes from sensation of the parts, and (3) figureground, defined as difficulty in sifting important from unimportant stimuli. The criterion measure was the Stanford Diagnostic Reading Test (SDRT), Forms A and B. In this study, the SDRT was used in two ways: (1) as a basis for planning asademic remediation, and (2) as pretest and posttest measures of academic improvement after component deficit remediation and academic deficit remediation. Two research questions were investigated: (1) How do scores on the SDRT of children having component deficit remediation plus academic deficit remediation compare with scores of children having academic deficit remediation only, and (2) Do scores on the SDRT improve immediately after component deficit remediation? Twenty-seven certified learning disability teachers carried out the remediation under the supervision of the researcher with 76 children labeled learning disabled by the school district, ages eight through 11. The answer to question one was, the scores on the SDRT of children having component deficit remediation plus academic deficit remediation were higher than scores of the children having academic deficit remediation only, when effect size analyses were made. The answer to the second question was “yes,” scores on the SDRT improve immediately after component deficit remediation on every subtest when effect size analyses were made. Effect size, a measure of treatment effectiveness, was calculated by finding the difference between the means of the experimental and control groups divided by the control group standard deviation. Effect size was then translated into notions of overlapping distributions of scores and comparable percentiles. Its descriptive nature made it appealing for this investigatory research of treatment effects.
Grounding LD Definitions and Practices in Systems of Educational Thought
Authors: Warner Michael M. , Bull Kay Sather 
Published: December 2008

Any definition of learning disabilities (LD), if it is to be relevant to the needs of teachers, must address fundamental educational concerns, including implications for intervention. In addition, a useful definition must be embedded in a system of educational thought. Such a system must be both internally consistent and non-reductionistic. Inconsistency within a system leads to the use of mutually exclusive and contradictory approaches with students, sometimes with the same student. Reductionism leads to the tendency to be anti-theoretical and to view basic issues of educational philosophy as unimportant. Theory is necessary however, in order to evaluate as well as to defend one's practices. The current LD literature is used to provide examples of reductionism. While not advocating that all of us should adhere to the same specific system of thought, we argue that each of us should develop or adopt a system and try to use it consistently. The paper concludes with an example of how one could proceed as we suggest, using the cognitive-field system of thought as a base. The cognitive-field approach is shown to encompass some aspects of other approaches, to be non-reductionistic, and to have considerable potential as a foundation for the education of LD students.