bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stridor and parkinsonism
Authors: Read David , Young Alastair 
Published: December 2008

Summary
A patient is described with idiopathic Parkinson’s disease and severe laryngeal stridor. Other than urinary frequency and urgency, not uncommon in this condition, and postoperative levodopa-sensitive postural hypotension, there were no features of generalized autonomic failure. The laryngeal stridor responded to levodopa therapy, and we are not aware that this has been reported previously.
Unrecognised nocturnal hypoglycaemia masquerading as senile dementia
Authors: Ramasamy R 
Published: December 2008

Summary
A 70-year-old woman with insulin dependent diabetes mellitus presented with symptoms suggestive of senile dementia. Outpatient assessment failed to reveal poor diabetic control with frequent nocturnal hypoglycaemia. Eventual appreciation of the poor control resulted in several failed attempts at improving therapy with various subcutaneous insulin regimes. Intramuscular and intravenous routes produced acceptable blood glucose levels with striking reversal of the patient’s symptoms. The possible causes of nocturnal hypoglycaemia in this patient are discussed.
Blood pressure in 15- to 16-year-old adolescents of different ethnic groups in two London schools
Authors: Khaw Kay-Tee , Marmot M G 
Published: December 2008

Summary
A blood pressure screening survey was conducted in 357 students, aged 15-16 years, in 2 London schools. Males had higher systolic blood pressures than females, and white males had significantly higher mean systolic pressures than black males, but diastolic pressures were similar. There is no evidence in this survey that blacks have higher mean blood pressures than whites—rather the reverse. This and the difference in blood pressure between schools suggest environmental factors may be important determinants of blood pressure.
Thoughts on the aetiology of vitamin D deficiency in Asians
Authors: Heath D A 
Published: December 2008

Summary
Following the virtual elimination of vitamin D deficiency in Britain earlier this century, rickets and osteomalacia began to be recognized with increasing frequency in the early sixties (Dunnigan et al., 1962). The disease was almost entirely restricted to Asian subjects and was subsequently reported in all cities having a significant Asian population. The purpose of this review is to point out that most current theories not only fail to explain the occurrence of vitamin D deficiency in Asians, but also cannot adequately explain the deficiency occurring in liver and gastrointestinal disorders. A theory is put forward that more completely encompasses the known facts.
Leprosy in Birmingham—a review
Authors: Ellis C J 
Published: December 2008

Summary
Twenty-three men and seven women from the West Midlands conurbation (population 2.7 million) have been investigated and treated for leprosy since 1970. The clinical features of the patients at presentation are described with an account of treatment given and the outcome. The pattern of this disease in Britain is different from that seen in the U.S.A. and poses little threat to public health. The disease can be cured by chemotherapy but neuropathy is unlikely to recover if it is a presenting symptom. The diagnosis of leprosy should be considered in all patients who have lived in an endemic area who present with disorders of peripheral nerves or skin. Early diagnosis is essential to minimize nerve damage and resulting deformity.
Ethnic differences in birthweight-related parameters with particular reference to possible maternal nutritional risk factors
Authors: Condie R G , Terry P B 
Published: December 2008

SummaryThree birthweight-related parameters were examined in the deliveries occurring from January to July 1982 at Dudley Road Hospital, Birmingham, in 3 major ethnic groups and in relation to possible maternal nutritional risk factors in the European and Indian groups. Ponderal index did not correlate with either mean or ‘corrected’ birthweight especially in the West Indians.The 3 maternal nutritional risk factors appeared to be of greater fetal prognostic value in the Indian group than in the European group.
Ethnicity, self-reported illness and use of medical services by the elderly
Authors: Blakemore K 
Published: December 2008

Summary
Analysis of ethnic differences in disease is complicated by the fact that culture has an effect on whether people identify themselves as ill and how often they use medical services. This paper cities evidence to show that use of selected medical services by older members of ethnic groups appears to be high. Although a relatively high amount of disease among minority ethnic groups partly accounts for this, additional explanations—notably, cultural perceptions of doctors and aspects of the ageing migrant’s position in society—are suggested.
Familial venous thrombosis
Authors: Winter J H , Douglas A S 
Published: December 2008

Summary
It is not uncommon for a patient presenting with deep venous thrombosis or pulmonary embolism to describe the occurrence of such disease in members of his or her family. The occasional familial clustering of venous thromboembolic disease has been recognized for many years; for example, Briggs in 1905 states: ‘The patient, a man of 35 years, has since 1887 passed through 8 attacks of thrombophlebitis in the lower extremities… Of 16 adult individuals among this gentleman’s ancestors and collateral relatives, 8 have shown a marked susceptibility to venous disease, in the manifestation of varices and haemorrhoids or in extreme liability of thrombosis in the puerperium or following acute infections’.
Corticosteroids in terminal cancer—a prospective analysis of current practice
Authors: Hanks G W , Trueman T , Twycross R G 
Published: December 2008

Summary
Over half of a group of 373 inpatients with advanced malignant disease were treated with corticosteroids for a variety of reasons. They received either prednisolone or dexamethasone, or replacement therapy with cortisone acetate. Forty percent of those receiving corticosteroids benefited from them. A higher response rate was seen when corticosteroids were prescribed for nerve compression pain, for raised intracranial pressure, and when used in conjunction with chemotherapy. No significant difference in efficacy was noted between the 2 drugs. The results, however, suggest that with a larger sample, dexamethasone would have been shown to be significantly better than prednisolone in the management of nerve compression pain.
The incidence of side effects was broadly similar with dexamethasone and prednisolone. The most common side effect was oral candidosis and there was a highly significant relationship between the use of corticosteroids and the prescription of nystatin suspension. Dexamethasone was more likely than prednisolone to cause oro-pharyngeal candidosis. Dexamethasone was also associated with significantly more cases of psychological disturbance and hyperactivity. On the other hand, dexamethasone seems less likely to cause oedema, weight gain and dyspepsia. Corticosteroids were withdrawn because of side effects in only 11 patients (5%)—6 were receiving dexamethasone and 5 prednisolone. Dexamethasone has been adopted as the standard corticosteroid for terminal cancer patients at Sir Michael Sobell House.
Immune complex glomerulonephritis and chronic anaerobic urinary infection—complications of filariasis
Authors: Ormerod A D , Petersen J , Hussey J K , Weir J , Edward N 
Published: December 2008

Summary
We describe a patient with chyluria due to abdominal Bancroftian filariasis. The patient showed two unusual complications, an immune complex glomerulonephritis and a chronic urinary infection. We also discuss the use of the CT whole body scanner in the diagnosis and delineation of the extent of the disease.
Value of profiling liver function in the elderly
Authors: Lubin J R , Coles J A , Millward B A , Croker J R 
Published: December 2008

Summary
The value of measuring three routine tests of liver function was assessed prospectively in 523 geriatric patients. Abnormalities were found in 27% of patients and were clinically helpful in half of these cases. Profiling liver function, without clinical indication, revealed abnormal results in 17% of patients and was important in one-third of these (6% of total). The two most important diagnoses were unsuspected osteomalacia and gall stone disease.
Nocturnal nasogastric tube feeding at home
Authors: McIntyre P B , Wood S R , Powell-Tuck J , Lennard-Jones J E 
Published: December 2008

Summary
Five malnourished patients who consistently failed to maintain or gain weight with other oral diets have been taught to give themselves a nocturnal nasogastric tube feed at home to supplement their dietary intake by day. All patients gained weight at a rate of about 0.5 kg per week. Nasogastric tube feeding at home can be an acceptable, safe, economical and efficient treatment for nutritional depletion, particularly in patients with a short functional length of small intestine for whom simpler dietary manipulation has been unsuccessful.
Urinary iron loss in the nephrotic syndrome—an unusual cause of iron deficiency with a note on urinary copper losses
Authors: Brown E. A. , Sampson B. , Muller B. R. , Curtis J. R. 
Published: December 2008

Summary
Two patients with long-standing nephrotic syndrome are described in whom urinary iron losses may have contributed towards an iron deficiency state. Seven other nephrotic patients were also studied. Increased urinary iron excretion was found in six out of nine patients and increased urinary copper excretion in all eight patients in whom it was measured. Trace metal losses in the urine in nephrotics may be important clinically.
Reversibility of alcoholic cardiomyopathy
Authors: Kupari Markku 
Published: December 2008

Summary
A patient with alcoholic cardiomyopathy is described in whom cardiovascular function capacity and radiological heart size fluctuated widely with periods of heavy drinking and abstinence. On two occasions, cessation of drinking resulted in clinical recovery from severe degrees of congestive failure and in complete reversal of cardiac enlargement. Echocardiographic follow-up showed, however, that the true rapidity of myocardial recovery was much slower than estimated clinically and radiologically and than suggested by the previous reports.
Progressive multifocal leukoencephalopathy, myelodysplastic syndrome type II and prostatic carcinoma
Authors: Barber P. , Gorst D. W. , Morris J. A. , Pearson J. D. 
Published: December 2008

Summary
A case is described of progressive multifocal leukoencephalopathy (PML) occurring in a man with myelodysplastic syndrome type II (MDS II) and prostatic carcinoma. This is the first case, to our knowledge, of the association of PML with MDS II.
Osteosarcoma of breast recurring with mediastinal obstruction
Authors: Hutton C. W. , Strang C. 
Published: December 2008

Summary
A case of osteogenic sarcoma of the breast in an 82-year-old woman is described. It was treated by simple mastectomy but recurred and caused mediastinal obstruction. Radiotherapy gave only mild symptomatic benefit. Previous publications in osteosarcoma of the breast are reviewed.
Pre-operative mediastinal evaluation in primary bronchial carcinoma—a review of staging investigations
Authors: Elliott John A. 
Published: December 2008

SummaryA review of staging investigations in the preoperative evaluation of mediastinal involvement in primary bronchial carcinoma is presented.The following conclusions are offered as guidelines for the use of mediastinal staging procedures in clinical practice:Surgical staging methods have the over-riding advantage of superior specificity over indirect imaging techniques. Where 67Ga-imaging or CT scanning are not available, routine pre-operative mediastinoscopy or, when appropriate, mediastinotomy will identify most patients with non-resectable disease but this approach entails a high proportion of true negative examinations.Radioisotope ventilation and perfusion lung imaging has no place in the pre-operative staging of lung cancer.Where the techniques are available, 67Ga-imaging and CT scanning have a use in selecting patients for mediastinal exploration.A negative mediastinal 67Ga scan or a negative CT examination suggest that mediastinal exploration will be unrewarding in the vast majority of cases and may be omitted prior to thoracotomy.A positive mediastinal 67Ga scan or the demonstration of abnormal mediastinal nodes by CT is an indication for mediastinal exploration which, if negative should be followed by thoracotomy.
Serum angiotensin converting enzyme in Sjogren’s syndrome—a case report and study of 21 further cases
Authors: Machin N. Dianne , Chard Michael D. , Paice E. W. 
Published: December 2008

Summary
We report the case of an elderly woman with primary Sjogren’s syndrome and abnormal liver function tests indicative of primary biliary cirrhosis. She was found to have a raised serum angiotensin converting enzyme activity. We proceeded to study 21 further cases of Sjogren’s syndrome to discover whether raised levels of this enzyme were a feature of Sjogren’s syndrome. None of them had any features to suggested associated primary biliary cirrhosis. The cases included 12 with associated rheumatoid arthritis, two with systemic sclerosis, three with systemic lupus erythematosus and four with primary Sjogren’s syndrome. In only two of these 21 patients was a raised serum angiotensin converting enzyme obtained, the elevation being modest. We conclude that a raised activity of the enzyme is not usually associated with primary or secondary Sjogren’s syndrome, and that discovery of such an abnormality should prompt a search for an associated condition.
Mastication and acid secretion
Authors: Dubey Pushpa , Nundy S. 
Published: December 2008

Summary
The gastric acid response and the buffer capacity of the stomach were measured in 30 control subjects and 22 duodenal ulcer patients in response to a masticatory (solid) and a non-masticatory (homogenized) meal having the same chemical composition. The peak acid output values were equal after a masticatory and after a non-masticatory diet in control subjects (masticatory 18.1 ± 1.2, non-masticatory 15.7 ± 1.3 mmol/hr) as well as in duodenal ulcer patients (masticatory 35.7 ± 1.5, non-masticatory 33.7 ± 1.1 mmol/hr). The buffer capacity of the stomach contents 1 hr after the meal was significantly greater after a masticatory diet than a non-masticatory diet in both controls (14.6 ± 1.4 and 9.0 ± 1.9 mmol) and in duodenal ulcer patients (9.5 ± 1.5 and 7.5 ± 1.2 mmol). Duodenal ulcer patients had a significantly lower buffer capacity compared with controls. Masticatory diets may play a part in protecting individuals from developing duodenal ulcer.
Significance of idiopathic deep venous thrombosis
Authors: O’Connor N. T. J. , Cederholm-Williams S. A. , Fletcher E. W. , Allington M. , Sharp A. A. 
Published: December 2008

Summary
The risk of developing an overt malignancy after an isolated deep venous thrombosis (DVT) is poorly documented. We therefore reviewed a series of patients in whom a solitary idiopathic DVT had been proven by venography at least 12 months earlier. No patient had developed a malignancy at follow-up. However, decreased fibrinolytic activity was observed in five out of the six patients aged less than 45 years. Patients with an idiopathic DVT should not be subjected to an exhaustive search for malignancy.
Dressler’s syndrome after right ventricular infarction
Authors: Streifler Jonathan , Pitlik Silvio , Dux Shlomo , Perry Gershon , Hellman Chaim , Greenwald Mark , Rosenfeld Joseph B. 
Published: December 2008

Summary
Undiagnosed myocardial infarction of the right ventricle presented as Dressler’s syndrome. Radioisotopic diagnostic procedures including first-pass and multigated acquisition nuclear angiography ( MUGA ) and thallium-201 perfusion studies enabled a retroactive diagnosis of myocardial infarction, showed it to be in the right ventricle, and clarified the aetiology of the unexplained fever and pleuropericarditis.
Persistent akathisia associated with early tardive dyskinesia
Authors: Barnes Thomas R. E. , Braude Walter M. 
Published: December 2008

Summary
Two psychiatric patients developed moderate or severe oro-facial dyskinesia, and limb dyskinesia, at a relatively young age and within a year of starting antipsychotic drug-treatment. This early appearance of tardive dyskinesia was preceded by akathisia that had developed at the beginning of drug therapy and persisted, despite the reduction of their drug doses to maintenance levels. The possibility that persistent akathisia may herald the early onset of tardive dyskinesia, is discussed.
Hypersensitivity to azathioprine in myasthenia gravis
Authors: Watts G. F. , Corston R. 
Published: December 2008

Summary
A patient with myasthenia gravis is described who exhibited hypersensitivity including an apparent acute exacerbation of the underlying disorder when treated with azathioprine. 6-mercaptoprine (6-MP) also produced hypersensitivity which, in contrast, did not manifest as a myasthenic exacerbation.
Hyperkalaemia in diabetes mellitus—potential hazards of coexisting hyporeninaemic hypoaldosteronism
Authors: Large D. M. , Carr P. H. , Laing I. , Davies M. 
Published: December 2008

Summary
Two patients with insulin-dependent diabetes mellitus (Type I), developed severe, life-threatening hyperkalaemia, the first following treatment with spironolactone, the second during treatment for staphylococcal septicaemia when glucose-induced hyperkalaemia occurred. Investigations demonstrated co-existing hyporeininaemic hypoaldosteronism. Prompt recognition of this combined hormone-deficiency syndrome led to appropriate treatment and recovery. The biochemical features and clinical importance of hyporeninaemic hypoaldosteronism are discussed.
Choledochal cysts—report of three cases and review
Authors: Waldron R. , Drumm J. , McCarthy C. F. , Murphy B. 
Published: December 2008

Summary
Three cases of choledochal cyst are presented, with a review of previous publications. We re-emphasize the diagnostic dilemma involved and discuss current surgical management. A new complication is illustrated and an association with polycystic kidneys is reported.
Choledochal cysts are uncommon, but correct management ensures a symptom-free future for the patient. Recent reports support cyst excision if technically feasible.
Abdominal incisions—vertical or transverse?
Authors: Ellis Harold , Coleridge-Smith Philip D. , Joyce Adrian D. 
Published: December 2008

Summary
Two-hundred and nine patients were entered into a prospective, randomized trial in order to determine whether a vertical or transverse abdominal incision is the more satisfactory in producing sound wounds. Ninety-six patients were randomized between paramedian and transverse incisions, and followed up for at least 1 year. No significant difference in the incidence of wound failure could be shown between 46 paramedian and 50 transverse incisions. Those patients who were considered to require a vertical incision were randomized between median and paramedian incisions. No significant difference in wound failure rates between 39 median and 40 paramedian incisions could be demonstrated. No advantage or disadvantage of a transverse over a vertical abdominal incision or of a paramedian over a median incision could be shown in this study.
Paradoxical lipodystrophic changes due to conventional bovine and highly purified porcine/bovine insulins
Authors: Campbell I. W. , Duncan C. , Anani A. R. 
Published: December 2008

Summary
A 78-year-old woman developed marked insulin lipoatrophy due to conventional bovine insulin injected into the upper limbs. Changing to a combination of highly purified porcine/bovine insulins injected into the lower limbs resulted in the opposite effect, namely insulin-induced lipohypertrophy. Use was then made of this effect by injecting the highly purified insulins into the atrophied upper limb injection sites with resultant improvement in these wasted areas over the next 10 months.
Plasma cholesterol concentration and extra lipid band in monoclonal gammopathies
Authors: Levy Yishai , Aviram Michael , Spira Gad , Tatarsky Ilana , Brook Gerald J. , Carter Anna 
Published: December 2008

SummaryPlasma lipids and lipoproteins were studied in 21 patients with benign monoclonal gammopathy, 21 patients with multiple myeloma and seven patients with Waldenström’s macroglobulinaemia. Results were compared with those of a control group, age and sex matched. Low plasma cholesterol levels in all three patient groups were associated with low HDL-cholesterol concentrations. Apo A-I, but not apo B, was significantly reduced. Sixty per cent of the patients exhibited an extra lipid band on plasma lipoprotein electrophoresis, which could be an immunoglobulin-lipid complex. In these patients plasma and LDL-cholesterol levels were significantly lower than in those patients in whom this band was absent. No correlation was found between the severity of the disease and plasma lipid pattern.
Acute pancreatitis complicating excessive intake of phenolphthalein
Authors: Lambrianides A. L. , Rosin R. D. 
Published: December 2008

Summary
A case is described in which a patient presented with acute pancreatitis following inadvertent ingestion of large quantities of phenolphthalein for the treatment of his chronic constipation. There was complete recovery and no sequelae from the acute attack of pancreatitis.
Carcinoma of the breast in a male with hypogonadotropic hypogonadism
Authors: Prince R. L. 
Published: December 2008

Summary
There is an increased risk of development of carcinoma of the breast in males with hypogonadism due to Klinefelter’s syndrome. A patient with isolated hypogonadotropic hypogonadism and gynaecomastia developed an intraduct carcinoma of the breast. This is believed to be the first reported case of this association.
Captopril-induced acute renal artery thrombosis and persistent anuria in a patient with documented pre-existing renal artery stenosis and renal failure
Authors: Williams P. S. , Hendy M. S. , Ackrill P. 
Published: December 2008

Summary
We describe an elderly man, with pre-existing renal failure and atheromatous renal artery stenosis, who developed persistent anuria due to renal artery thrombosis after acute hypotension following captopril administration. Caution should be used when captopril is first administered to patients with impaired renal function in whom renal artery stenosis is known or suspected.
Tuberculous meningitis in the elderly
Authors: Dixon P. E. , Hoey C. , Cayley A. C. D. 
Published: December 2008

Summary
Six cases of tuberculous meningitis, all occurring in patients over the age of 65, are described. All patients presented with an acute illness, primarily with a confusional state. Headache was a symptom in only two patients and the cases were not confined to ethnic minority groups. The mortality was 50%.
Acute pancreatitis and Cushing’s syndrome
Authors: Clague H. W. , Warren B. , Krasner N. 
Published: December 2008

Summary
A case of acute necrotizing pancreatitis in a 53-year-old man with an ectopic adrenocorticotrophin (ACTH) producing bronchial carcinoma is described. The aetiology of acute pancreatitis in relation to steroid therapy and malignancy is discussed and it is suggested that excess endogenous steroid production may also cause acute pancreatitis.
Massive gastric distension in acute pancreatitis—a report of two cases
Authors: Murray W. J. G. 
Published: December 2008

Summary
Massive gastric distension was diagnosed in 2 patients with acute pancreatitis. Both showed signs of severe peripheral circulatory failure, and responded well to intravenous fluid replacement and nasogastric aspiration. A review of the literature revealed only 2 previously reported cases. The possible mechanisms linking the pathogenesis of these 2 conditions are discussed.