bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint contractures and diabetic retinopathy
Authors: Chapple M , Jung R T , Francis J , Webster J , Kohner E M , Bloom S R 
Published: December 2008

Summary
It has been suggested that joint contractures may be an early marker of microangiopathy, especially retinopathy, in diabetic patients. To investigate this possibility, the prevalence of contractures of the finger joints, as assessed by the painted hand technique, was compared in 106 diabetic patients without, and 105 with retinopathy (proliferative in 66%). There was an increased prevalence of contractures in those with diabetes (25.2%) as compared with an age-matched control of 106 subjects (7.5%, P less than 0.01). The prevalence of contractures was similar in those diabetics with and without retinopathy (29.5% v. 20.8%, P less than 0.1), and did not vary with the type of retinopathy. The contracture prevalence rate was also similar in those with a diabetes duration of 5 or more years (retinopathy 29.3%, no retinopathy, 30%) or of similar diabetic duration (retinopathy 20.8%, no retinopathy, 25%). Diabetic control, as assessed by HbA1, was similar in retinopathic patients with or without contractures. We conclude that although finger joint contractures are more prevalent in adult diabetic patients, they are not necessarily a reliable early indicator of the development of retinopathy of any specific type.
Psoriatic spondylitis in a patient with classical rheumatoid arthritis
Authors: Thurtle O A , Dumbelton I B , Preston J R , Cook P L , Cawley M I D 
Published: December 2008

Summary
A patient exhibiting typical features of classical rheumatoid arthritis and psoriatic spondylitis is described. The patient, a woman, presented at the age of 29 with an inflammatory arthritis. Twenty years later, she developed psoriasis, and after a further 3 years, she was first noted to have rheumatoid nodules and to be strongly seropositive. Now at the age of 60, she has a rigid spine with radiographic changes of spondylitis. Neither rheumatoid arthritis, nor psoriatic spondylitis can account for all the features of her disease and there is evidence to suggest that both conditions combined to damage her peripheral joints.
Kaposi’s sarcoma in a patient after renal transplantation
Authors: Little P J , Farthing C F , Al Khader A , Bunuan H , Haleem A 
Published: December 2008

Summary
A patient is described who developed the lesion of Kaposi’s sarcoma 4 months after receiving a cadaveric renal transplant. Immunosuppression had been achieved using cyclosporin A and prednisolone. The lesions spread from the hands to other areas, but later regressed when the dose of cyclosporin A was reduced to 100 mg daily. The patient remains well with no evidence of rejection 15 months later.
Changes in blood pressure and renal function after parathyroidectomy in primary hyperparathyroidism
Authors: Jones D B , Jones J Henry , Lloyd H J , Lucas P A , Wilkins W E , Walker D A 
Published: December 2008

Summary
Changes in blood pressure and renal function were investigated in 62 patients with primary hyperparathyroidism treated surgically, in an attempt to assess whether or not hypertension and renal impairment should be regarded as important indications for parathyroidectomy.
29% were hypertensive pre-operatively and the blood pressure remained elevated after parathyroidectomy in all of these patients. Hypertension developed for the first time after parathyroidectomy in 45% of those patients who were normotensive before surgery.
Renal function was normal initially in 73% and mild renal impairment developed after surgery in 9% of these patients. At the end of the follow-up period, the prevalence of hypertension was higher in patients with renal impairment pre-operatively (88%) than in those with normal renal function (51%).
We conclude that hypertension alone should not be regarded as an indication for parathyroidectomy in asymptomatic hyperparathyroidism. No firm conclusions can be reached about the importance of mild renal failure as an indication for surgery and the question is unlikely to be resolved without conducting a prospective controlled trial.
The clinical pattern of bronchial asthma in General Hospital, Kandy (Sri Lanka)
Authors: Jeyrajah R , Wickramasinghe M D N 
Published: December 2008

Summary
The clinical features and cutaneous hypersensitivity to skin prick tests were studied in 64 asthmatic patients in General Hospital, Kandy (Sri Lanka). The onset of asthma was mostly in adult life; associated atopic disease and family history of allergy were less frequent when compared with asthmatics in industrialised countries in the temperate zone. In these respects the clinical pattern of asthma in our study resembles that described in other tropical countries. Cutaneous hypersensitivity to one or more of the 10 allergens tested was observed in 75% of asthmatics and 55% of non-asthmatic controls. Although there was a higher incidence of associated allergic disorders, family history of allergy and the onset of asthma before the age of 10 years in the skin test positive group when compared with the skin test negative group of asthmatics, this difference was not statistically significant.
First branchial cleft anomaly
Authors: Al-Fallouji M A R , Butler M F 
Published: December 2008

Summary
A 15-year-old girl presented with a cystic swelling since birth behind the ramus of the right mandible and diagnosed clinically as a dermoid cyst. Surgical exploration, however, showed that it was closely related to the external auditory canal, with an extension running medially behind the parotid gland and ending in the bony middle ear. The facial nerve was closely related to the deep part of the cyst. Such an anatomical position indicates that this was a first branchial cleft anomaly. Surgical excision of the cyst was performed.
Multifocal fibrosclerosis and renal amyloidosis
Authors: Hamilton D V , Thiru S 
Published: December 2008

Summary
A 34-year-old female with a 14-year history of multifocal fibrosclerosis developed the nephrotic syndrome due to renal amyloidosis. Although the association between chronic inflammatory processes and amyloidosis is well known, this is the first report of amyloidosis occurring in a patient with multifocal fibrosclerosis. Other interesting features of this case are the involvement of subcutaneous adipose tissue in the inflammatory-fibrotic process and the presence of features of multifocal fibrosclerosis in the patient’s twin sister.
Catecholamine measurements in clinical medicine
Authors: Brown M J 
Published: December 2008

Summary
There are 3 endogenous catecholamines, noradrenaline, adrenaline and dopamine. Noradrenaline is the neurotransmitter in sympathetic nerve endings, while the adrenal medulla secretes mainly adrenaline. The reason for this difference is that adrenaline synthesis from noradrenaline is catalyzed by an enzyme, phenylethanolamine-N-methyltransferase (PNMT), which is absolutely dependent on induction by glucocorticoids (Wurtman and Axelrod, 1966); only in the normal adrenal medulla is there a high local concentration of Cortisol due to the portocapillary circulation from cortex to medulla. There is little circulating dopamine, whereas in urine, dopamine is the predominant catecholamine. It is formed within the kidney from circulating DOPA (Brown and Dollery, 1981), but earlier reports that it may have a natriuretic action have not been confirmed (Alexander et al., 1974; Oates et al., 1979).
Spontaneous haemothorax in Osler-Weber-Rendu disease
Authors: Karnik A M , Sughayer Ali , Fenech F F 
Published: December 2008

Summary
A case of hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu disease) is described who presented with severe, central chest pain mimicking acute myocardial infarction, a presentation which has not been described before. He was found to have developed spontaneous haemothorax which is a very rare complication of this disease.
The anaemia of chronic disorders
Authors: Samson Diana 
Published: December 2008

SummaryChronic disease can cause anaemia in a number of ways, such as poor nutrition, chronic blood loss and as a result of drug therapy. Leaving aside these factors, however, there is a specific type of anaemia associated with chronic infection, chronic inflammatory diseases and malignancy. This anaemia is characterised by decreased plasma iron and iron-binding capacity in the presence of normal or increased reticulo-endothelial iron stores, and has been termed the anaemia of chronic disorders (Cartwright and Lee, 1971). Although the anaemia of chronic disorders is one of the most common anaemias encountered in medical practice, its aetiology remains unclear and treatment unsatisfactory.
Recurrent acute pancreatitis due to haemobilia from a hepatic artery aneurysm
Authors: Mee A S , Turner J A McM , Gow N Menzies 
Published: December 2008

Summary
A case of recurrent acute pancreatitis due to haemobilia secondary to a bleeding hepatic artery aneurysm is presented. Embolization of the hepatic artery resulted in cessation of bleeding and resolution of pancreatitis.
Metronidazole v. cefoxitin in severe appendicitis—a trial to compare a single intraoperative dose of two antibiotics given intravenously
Authors: Corder A P , Bates T , Prior Jean E , Harrison Margaret , Donaldson P J 
Published: December 2008

Summary
In severe appendicitis, the effect of a single intravenous dose of metronidazole (500 mg) was compared with cefoxitin (1 g). The antibiotics were given by random allocation once the diagnosis had been established at operation.
In the metronidazole group, 5 out of 48 patients developed a wound infection whilst in hospital compared with 13 out of 48 in the cefoxitin group (P = 0.036). However, 57% of wound infections became apparent after the patient went home and the overall infection rates were similar.
The mean length of postoperative hospital stay was 5.0 days in the metronidazole group and 6.8 days in the cefoxitin group (P = 0.052), but of those who did develop a wound infection, the length of stay was almost double in the cefoxitin group. Anaerobic organisms were cultured from the wound in 7 out of 15 patients who received cefoxitin but in none of 5 patients in the metronidazole group. Whilst metronidazole only delayed the discharge of pus from the wound, it did seem to reduce the severity of infection. Cefoxitin appeared to be less effective, given as a single intravenous injection at a dose of 1 g.
Severe left ventricular dysfunction in critical aortic stenosis—reversal following aortic valve replacement
Authors: Dymond Duncan S , Wolf Francis G , Schmidt Donald H 
Published: December 2008

Summary
A case of aortic valve stenosis is reported with progressive left ventricular dysfunction demonstrated by radionuclide angiography. A gradient of 120 mmHg was present across the aortic valve. At the time of surgery, the patient was in severe cardiac failure with a left ventricular ejection fraction of 22%. Two months postoperatively, the patient was asymptomatic, and repeat radionuclide angiography demonstrated an ejection fraction of 93%. The reversible nature of this patient’s ventricular dysfunction suggests that the cardiac failure was related to ‘afterload mismatch’ caused by the stenotic valve, rather than due to depressed contractility. The encouraging result in this patient reinforces the view that surgical intervention is warranted in some patients with critical aortic stenosis and extreme impairment of left ventricular function, and that the close relation between ejection fraction and operative survival may not hold true in aortic stenosis.
Adult listeriosis—a review of 18 cases
Authors: Samra Y. , Hertz M. , Altmann G. 
Published: December 2008

Summary
Eighteen cases of adult listeriosis (nine with meningitis, one brain abscess and eight bacteraemia) were diagnosed in the Chaim Sheba Medical Center in the years 1964–1982. The infection seemed to be opportunistic in all. Eleven patients had malignant disease, two had cirrhosis of the liver, one had ulcerative colitis, one had bronchial asthma with chronic obstructive pulmonary disease, one had pemphigus, one had diabetes mellitus and one had a renal transplantation. Twelve patients (66%) received radiation therapy and/or cytotoxic and steroid medication.
Diabetes mellitus as an additional underlying disease was strikingly frequent and was found in eight out of 18 patients (44%), in one as the only underlying disease.
In the meningitis group cerebrospinal fluid (CSF) cultures were positive in five patients, and negative in four who had, however, positive blood cultures. The cells in the CSF were predominantly lymphocytes in five and polymorphs in four.
It may be concluded that diabetes mellitus is an important underlying disease in listeriosis. The results also reinforce the fact that lymphocytosis in the CSF does not exclude bacterial meningitis.
Nocturnal activity and the enuresis alarm device
Authors: Crisp A. H. , Sireling L. I. , Faizey J. 
Published: December 2008

Summary
The effect on nocturnal activity of the wire mesh element within the 'buzzer and pad' enuresis alarm device was studied using healthy adult volunteers in a single or double cross-over design. On the nights when the mesh was in the bed there was less activity, supporting the finding of improved polygraphic sleep on the mesh and suggesting an unexpected therapeutic mechanism.
Appendicitis—a study of incidence, death rates and consumption of hospital resources
Authors: Søreide Odd 
Published: December 2008

Summary
The incidence of appendicitis in a population of 1.07 million is estimated based on discharge rates compiled by the Central Bureau of Statistics for the years 1977 and 1978. A crude incidence rate of 140 per 100,000 inhabitants is found with a male dominance (153 v. 126). The lowest incidence rate is found in the age group 0–4, whereas the highest rates are found for patients 15–24 years of age. Seventy-four per cent of all appendicitis cases is found in the age group 5–34 years. The mean length of stay was 6.5 days, but with differences between the counties studied of up to 60%. A yearly death rate of 0.30–0.37% with a male dominance is revealed. Appendicitis cases consume only 1.2% of all hospital discharges but 11.8% of all discharges for gastrointestinal diseases. A comparison with previous studies is performed and it is suggested that most of the reported reduction in incidence rates for appendicitis most probably is caused by a more reliable data base in the recent years.
A cutaneous manifestation of acute lymphoblastic leukaemia mimicking urticaria pigmentosa
Authors: Foulds I. S. , Woodcock B. E. , Slater D. N. 
Published: December 2008

Summary
A 37-year-old female developed what appeared to be the typical cutaneous manifestations of urticaria pigmentosa. These preceded the peripheral blood changes of acute null cell lymphoblastic leukaemia and skin biopsy revealed that the cutaneous changes were due to leukaemic infiltration. Chemotherapy resulted in clearance of the rash. The importance of skin biopsy in patients presenting with suspected urticaria pigmentosa is emphasized.
Beta-adrenoceptor and epoprostenol (prostacyclin) responsiveness of lymphocytes in migraine patients
Authors: Kilfeather S. A. , Massarella A. , Gorgolewska G. , Ansell E. , Turner P. 
Published: December 2008

Summary
Beta-adrenoceptor blocking drugs are of prophylactic value in some patients with migraine. Beta-adrenoceptor responsiveness as measured by lymphocyte cAMP responsiveness to isoprenaline has, therefore, been compared in ten untreated classical migraine patients and ten matched non-migraine control subjects. Lymphocyte responsiveness to epoprostenol (prostacyclin, PGI2) was also compared. No difference in response to either agent was found between the two groups. A generalized abnormality of beta-adrenoceptor function does not appear to be present in classical migraine, but a defect localized to specific vascular regions cannot be excluded.
Malignant ureteric obstruction relieved by dexamethasone
Authors: Walsh Thomas D. , West Thomas S. 
Published: December 2008

Summary
A case is described where dexamethasone relieved tumour-induced ureteric obstruction with improvement in the biochemical abnormalities and clinical features of post-renal failure. Such intervention is not always appropriate but may be of great value in symptom control. Because of this and similar applications, corticosteroids are finding increasing favour in the palliative care of patients with advanced cancer.
Duodenal diverticula occurring in a family—chance or inheritance?
Authors: Sternberg Ahud , Deutsch Alexander A. , Kott Itamar , Reiss R. 
Published: December 2008

Summary
The incidence, aetiology and possible inheritance of duodenal diverticula remain controversial. These aspects are discussed through the presentation of a family, in which duodenal diverticula occurred in a man and his two sons. To the best of our knowledge, this is the first such family documented in the medical literature. This familial occurrence may be attributed solely to the high incidence of duodenal diverticula in the general population (set by various authors at up to 14.2%), and, therefore, of no hereditary significance at all. We believe a screening study of the families of individuals with proven duodenal diverticula is most desirable, for it could shed light upon the controversial questions of incidence, aetiology, and inheritance patterns of duodenal diverticula.
Cholecystoduodenocolic fistula and gallstone ileus
Authors: Gibbons C. P. , Ross B. 
Published: December 2008

Summary
A patient with cholecystoduodenocolic fistula and gallstone ileus is described. Barium enema and barium meal and follow through demonstrated the passage of the gallstone from the gallbladder region to the small bowel. The clinical features and operative management are discussed in the light of four previously recorded cases.
Ketanserin in essential hypertension: a double-blind, placebo-controlled study
Authors: Cameron H A , Ramsay L E 
Published: December 2008

SummaryThe antihypertensive effect of the selective serotonin antagonist ketanserin was examined in a double-blind, placebo-controlled, parallel group study in 20 patients with essential hypertension. After 7 weeks treatment with ketanserin (mean dose 71 mg/d) there was a significant fall of both systolic and diastolic blood pressure, as compared to placebo, with a peak effect of 19.1/9.1 mmHg lying (P &lt; 0.01/P &lt; 0.01), and 16.5/11.3 mmHg standing (P &lt; 0.01/P &lt; 0.01); twice daily dosage appeared satisfactory. Subjective side effects were similar in the ketanserin and placebo groups. Ketanserin is an effective antihypertensive drug of moderate potency when given twice daily, with no orthostatic effect.
Addison's disease due to metastases to the adrenal glands
Authors: Mor F , Lahav M , Kipper E , Wysenbeek A J 
Published: December 2008

Summary
A 43 year old patient with Addison's disease secondary to extensive metastases to both adrenal glands is presented. Thirty two previously reported cases are reviewed; in only 13 cases was the diagnosis of Addison's disease confirmed biochemically. Reasons for the apparent rarity of Addison's disease in spite of the frequency of adrenal metastases are discussed. The need to consider the possibility of Addison's disease complicating known malignant disease arising in other tissues is stressed.
Fetal heart rate variation with umbilical haematoma
Authors: Ballas S , Gitstein S , Kharasch J 
Published: December 2008

Summary
Umbilical cord haematoma is an infrequent condition associated with high perinatal and fetal mortality and morbidity. This report describes a rare case of umbilical cord haematoma associated with loss of fetal beat to beat variation during labour. The infant exhibited mild asphyxia only.
Previous publications are reviewed and fetal heart rate changes associated with umbilical cord haematoma are discussed.
Amyloid (AL) in an octogenarian diagnosed by abdominal wall fat biopsy
Authors: Mallinson W J W , Corrado O J , Milkins S R 
Published: December 2008

Summary
Systemic amyloid (AL) was diagnosed by abdominal wall fat biopsy in an 81 year old woman presenting with severe postural hypotension. The advantages of this little-used diagnostic method are discussed.
Intestinal absorption at high altitude
Authors: Chesner I M , Small N A , Dykes P W 
Published: December 2008

Summary
Three tests of small intestinal function were performed at 3100 m and 4846 m to seek evidence of malabsorption of high altitude. Xylose tolerance did not change in 11 subjects but, in three who ascended to 5600 m, one-hour xylose levels were significantly lower. The results of an oxalate loading test did not suggest significant fat malabsorption. A direct fat absorption test using chylomicron levels after ingestion of 100 g fat showed significantly increased levels at high altitude. We conclude that there is no evidence of malabsorption up to 4846 m.
Bronchobiliary fistula due to acute cholecystitis in a suprahepatic gall bladder
Authors: Allison M C , Milkins S , Burroughs A K , Rogers H S , Thomas H C 
Published: December 2008

Summary
We describe a patient presenting with painless jaundice, anorexia and pruritus. The gall bladder was found to be lying above and behind a hypoplastic right lobe of liver. There was no evidence of cholangitis or biliary obstruction. The patient subsequently developed a bronchobiliary fistula with severe wheeze, cough and bile-stained sputum. Emergency percutaneous drainage of the gall bladder led to immediate cessation of bronchospasm and biloptysis, rendering the patient fit for definitive surgery.
Missed Addisonian crisis in surgical wards
Authors: Small M , MacCuish A C , Thomson J A 
Published: December 2008

Summary
Three women were admitted to the surgical wards with acute gastro-intestinal symptoms and despite good clinical (pigmentation, hypotension) and biochemical (hyponatraemia, acidosis) evidence of Addisonian crisis had unnecessary investigations with delay in the diagnosis and appropriate management of this medical emergency. Clinicians should take careful note of the typical electrolyte upset seen in Addisonian crisis.
Location of extra-adrenal catecholamine secreting tumours by selective venous sampling and nuclear magnetic resonance scanning
Authors: Cockcroft J R , Ritter J M , Allison D J , Causon R , Brown M J 
Published: December 2008

Summary
Iodinated meta-iodobenzylguanidine (MIBG) scanning is a safe non-invasive method for locating extra-adrenal paragangliomas. However, a positive result is dependent on the presence of an uptake mechanism in the tumour. We report two cases of MIBG negative intracranial catecholamine secreting tumours successfully located by selective venous sampling and nuclear magnetic resonance scanning.
A cumulative dose comparison between salbutamol and fenoterol metered dose aerosols in asthmatic patients
Authors: Bellamy D , Penketh A 
Published: December 2008

Summary
The potency and side effects of salbutamol and fenoterol inhalers have been compared in 8 asthmatic patients using a dose response curve. There was no significant difference in the absolute or percentage increase in FEV1 with the two treatments, but fenoterol caused a significantly greater (P less than 0.01) increase in heart rate than did salbutamol. A greater degree of bronchodilatation was observed with increased doses and we suggest that regular higher doses may provide better bronchodilatation and control of asthma in selected patients.
Neoplastic transformation in longstanding fistula-in-ano
Authors: Welch G H , Finlay I G 
Published: December 2008

Summary
A case in which an infiltrating mucinous carcinoma developed within a suprasphincteric fistula-in-ano is presented. The diagnosis was suspected on biopsy and confirmed by repeat biopsy. The clinical and histological features of this case establish with certainty that the carcinoma arose within the fistula and was not a secondary manifestation of the tumour. It is suggested that this rare complication of chronic fistula-in-ano may be prevented by prompt expert management of complex primary fistula.