bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperlipidaemia and premature coronary artery disease associated with sex-change in a female
Authors: ffrench-Constant C K , Spengel F A , Thompson G R 
Published: December 2008

Summary
We describe the management of a genotypic female who developed hyperlipidaemia and premature coronary artery disease following bilateral oophorectomy and methyltestosterone administration, and present evidence to suggest that the therapeutic androgenization involved in the sex-change was responsible for the hyperlipidaemia.
Hypernatraemic dehydration and necrotizing enterocolitis
Authors: Clarke A J , Sibert J R 
Published: December 2008

SummarySevere hypernatraemic dehydration developed over the first twelve days of life in a breastfed infant girl. Upon oral rehydration with formula milk, no acute neurological problems arose, but she subsequently developed necrotizing enterocolitis. Intravenous rehydration may be preferred to the oral route in such infants.
Confusion and paranoia associated with oral tocainide
Authors: Clarke C W F , el-Mahdi E O 
Published: December 2008

Summary
Two middle aged female patients developed hallucinations and severe confusion with paranoid features during oral tocainide administration at recommended dosage levels. Both patients had evidence of impaired renal function. Symptoms were provoked on re-challenge in the first patient. In the second patient the tocainide blood level was higher than the recommended therapeutic range. Both patients reverted to their normal mental state on withdrawal of the drug.
Cerebrovascular disease in dementia: the importance of atrial fibrillation
Authors: Ratcliffe P J , Wilcock G K 
Published: December 2008

Summary
The relationship between cardiovascular disease and cerebral infarction was analysed in a prospectively assessed post mortem series of 48 demented patients. Hypertension was rare in this group of patients whose mean age was 82.7 y. Atrial fibrillation was the most important underlying cardiac abnormality. It is suggested that atrial fibrillation is more important than hypertension in the aetiology of cerebral infarction in the very aged and that this may be relevant to the pathogenesis of cerebrovascular dementia.
Thoracic inlet compression due to amiodarone induced goitre
Authors: Samanta A , Jones G R , Burden A C , Barrie W W 
Published: December 2008

Summary
We report a case of amiodarone induced toxic goitre, presenting with thoracic inlet obstruction which required surgical intervention. Though thyrotoxicosis caused by amiodarone is recognised, to our knowledge thoracic inlet compression has not been previously described.
Fatal splenic rupture in Ehlers-Danlos syndrome
Authors: Harris S C , Slater D N , Austin C A 
Published: December 2008

Summary
A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition.
Asymptomatic osteomyelitis of the symphysis pubis
Authors: Evans T W , Evely R S , Morcos S K 
Published: December 2008

Summary
A patient presenting with pyrexia of unknown origin is described. Extensive radiological investigations over a six month period failed to localize an infective focus. Osteomyelitis of the symphysis pubis was found at post mortem. The clinical and radiological implications are discussed.
Cardiac imaging techniques in the diagnosis of angiosarcoma of the heart: report of two cases
Authors: Weyne A E , Heyndrickx G R , Cuvelier C C , Afschrift M B , Kunnen M F , Derom F E 
Published: December 2008

Summary
Angiosarcoma of the heart is a rare and highly malignant tumour. Most of the reported cases have been diagnosed post mortem. In a one year period two cases were diagnosed during life and surgically treated. The only possible hope for survival is early diagnosis and surgical removal. Our cases illustrate the contribution of cardiac imaging techniques to early diagnosis and the feasibility of radical excision of this tumour.
Stones in the common bile duct: experience with medical dissolution therapy
Authors: Somerville K W , Ellis W R , Whitten B H , Balfour T W , Bell G D 
Published: December 2008

Summary
Thirty-one patients with radiolucent common bile duct stones received medical treatment. Nineteen had Rowachol, a terpene preparation, eight (42%) achieving complete stone disappearance within 3 to 48 months. Fifteen (including 3 of the above) took Rowachol with bile acid (chenodeoxycholic in 11, ursodeoxycholic in 4) for 3 to 60 months: 11 (73%) achieved complete dissolution within 18 months. Persistent symptoms and complications settled on conservative management: 8 (25%) patients required admission (2 biliary colic, 1 obstructive jaundice, 4 cholangitis, 1 pancreatitis). One patient died of a myocardial infarction during recovery from pancreatitis; the other continued treatment, 2 achieving complete dissolution/disappearance. Oral dissolution therapy with Rowachol and bile acids should be considered when endoscopic sphincterotomy or surgery is not feasible, but careful attention to potential complications is required while stones persist.
Gonadal damage due to radioactive iodine (I131) treatment for thyroid carcinoma
Authors: Ahmed S R , Shalet S M 
Published: December 2008

SummaryPapillary carcinoma of the thyroid is the most common type of thyroid cancer and is associated with a good prognosis. Complications of treatment with surgery and radioiodine are uncommon. We report the case of a 13 year old boy who developed testicular damage following treatment with radioactive iodine 350 mCi for a papillary carcinoma of the thyroid. Four years after radioiodine treatment there has been no suggestion of recovery of spermatogenesis. Detailed follow-up studies of similarly treated young patients are required to define the incidence of this complication and to determine its reversibility.
Takayasu's disease in Arabs
Authors: Sattar M A , White A G , Eklof B , Fenech F F 
Published: December 2008

Summary
Four cases of Takayasu's disease in female Arabs are reported. All patients had classical features of the disease. Typing for HLA phenotype showed that all patients had HLA A2, A9, BW35 and DR7 antigens, suggesting an immunogenetic basis for the disease. As far as we know, this is the first report of Takayasu's disease in this ethnic group.
Ventricular tachycardia precipitated by sodium iothalamate (Conray 420) injection during prenylamine treatment: a predictable adverse drug interaction
Authors: Duncan J S , Ramsay L E 
Published: December 2008

Summary
A case of ventricular tachycardia occurring after intravenous injection of sodium iothalamate (Conray 420) into a patient taking prenylamine is described. Both of these drugs may cause prolongation of the corrected QT interval and the mechanisms of this potentially fatal drug interaction are discussed.
Ventricular arrhythmias complicating weight reduction therapy in a patient with a prolonged QT interval
Authors: O'Keefe J C , Butrous G S , Dymond D S , Littlejohns P , Peters N , Banim S O 
Published: December 2008

SummarySerious ventricular arrhythmias are known to occur in patients with long QT intervals. We describe a case of torsade de pointes occurring in a patient with a prolonged QT interval while taking a 1000 calorie diet, diethylpropion hydrochloride (Tenuate Dospan) and bendrofluazide. In patients with long QT intervals, hypokalaemia and drugs which further delay repolarization may facilitate the development of life threatening arrhythmias.
Female type cystic hyperplasia in a male breast
Authors: McClure J , Banerjee S S , Sandilands D G D 
Published: December 2008

Summary
A 28 year old man had a swelling of the right breast. He was phenotypically and karyotypically a normal male. Microscopic examination of the excised specimen showed the pattern of cystic hyperplasia identical to that commonly seen in the female breast. Numerous cysts were grouped in a lobular pattern and their lining showed apocrine metaplasia. There was extensive background fibrosis, some mammary duct ectasia and some features consistent with the more classical microscopic appearances of gynaecomastia. Whilst some of the features noted above are sometimes seen in gynaecomastia the presence of the full range of the features of cystic hyperplasia is distinctly unusual in the male.
Ergotamine abuse and extra-hepatic portal hypertension
Authors: Fisher P E , Silk D B A , Menzies-Gow N , Dingle M 
Published: December 2008

Summary
Arterial complications following ergotamine therapy have been well recognized since the beginning of this century. Venous complications, however, have only rarely been reported. A 48 year old Nigerian woman developed extra-hepatic portal hypertension coincident with a chronic overdosage of ergotamine. The literature elucidating the possible mechanisms involved is reviewed.
Steroid sensitive systemic disease with anaemia in the elderly: a manifestation of giant cell arteritis?
Authors: Allison M C , Gough K R 
Published: December 2008

Summary
Nine elderly patients presented with features of a multisystem disorder thought to be either a connective tissue disease of undefined type or disseminated malignancy. Associated features were a normochromic anaemia, raised erythrocyte sedimentation rate (ESR) (or plasma viscosity) and raised serum alkaline phosphatase levels. None had symptoms to suggest either giant cell arteritis or polymyalgia rheumatica. Temporal artery biopsy was performed before trial of corticosteroid therapy in four, and two showed giant cell arteritis. All nine responded dramatically to corticosteroids and the anaemias resolved. One died after 6 y, and the rest are well after 1 to 7 y.
Breast lumps and lymphoma
Authors: Ellis M , Arno J , Owen-Smith M , Sikora K 
Published: December 2008

Summary
We report two cases of young women in whom a breast lump was the first symptom of disseminated lymphoma. They were managed by wide excision of the affected segments of breast. Histological diagnosis was aided by immunoperoxidase stains for immunoglobulin chains. Further investigations demonstrated the wide spread nature of the disease, with involvement of bone marrow, bone cortex, lymph nodes and lung. Both patients received systemic chemotherapy, which achieved complete remission in one.
Carcinoma of the prostate: remission of paraparesis with inhibitors of bone resorption
Authors: Percival R C , Watson M E , Williams J L , Kanis J A 
Published: December 2008

Summary
We describe a patient with metastatic carcinoma of the prostate associated with paraplegia. The patient also had Paget's disease of bone elsewhere. Because the neurological lesion was thought to be due to Paget's disease, the patient was treated with inhibitors of bone resorption. Treatment rapidly induced clinical remission and inhibition of bone resorption, and withdrawal was associated with relapse. This suggests that such agents may be of value in the treatment of bone disease of prostatic carcinoma.
Serum creatine kinase after intramuscular injections
Authors: Konikoff F , Halevy J , Theodor E 
Published: December 2008

Summary
Serum creatine kinase (CK) activity was measured after intramuscular injections in 44 patients hospitalized for non-cardiac reasons. The drugs injected were: diazepam, dipyrone, metoclopramide, meperidine, pentazocine and procaine penicillin. Only 3 out of 44 patients (7%) demonstrated significant elevation of CK levels following the intramuscular injections. In these 3 patients the elevation was mainly due to a rise of the MM-isoenzyme fraction with MB levels increased in one patient.
These findings do not justify the common clinical notion of regarding intramuscular injections as a frequent cause of serum CK elevation. It is concluded that high CK serum values in a patient with chest pain should always be considered with utmost suspicion, disregarding the possible effects of a previous intramuscular injection.
Disordered oesophageal motility in thyrotoxic myopathy
Authors: Sweatman M C M , Chambers L 
Published: December 2008

SummaryDysphagia is an uncommon feature of thyrotoxic myopathy, and is usually associated with other signs of bulbar weakness, such as dysarthria and nasal regurgitation. We report a case of thyrotoxicosis presenting with dysphagia due to diminished oesophageal motility associated with significant hypercalcaemia; both abnormalities resolved rapidly following treatment.
Myxoedema followed by TSAb-induced hyperthyroidism: report of 2 cases
Authors: Steel N R , Bingle J P , Ramsay I D , Kendall-Taylor P 
Published: December 2008

Summary
The development of spontaneous hyperthyroidism following primary hypothyroidism is an unusual occurrence. We report two cases of confirmed primary hypothyroidism who subsequently became hyperthyroid. Thyroid stimulating antibodies were present in the sera of both patients during the hyperthyroid state. The significance of this sequence of events is discussed and a possible explanation proposed.
Bilateral primary malignant lymphoma of the breast
Authors: Shpitz B , Witz M , Kaufman Z , Griffel B , Manor Y , Dinbar A 
Published: December 2008

Summary
A rare case of bilateral primary malignant lymphoma of breast in a 76 year old woman is presented. The lesion was examined by electron microscopy and immunochemistry. The diagnosis of primary malignant lymphoma remains a diagnosis by exclusion and requires extensive work-up to exclude widespread malignant process. The behaviour of this malignancy tends to be an aggressive one and the prognosis is generally poor.
Glucagonoma without cutaneous manifestations
Authors: Parr J H , Ramsay I D , Keeling P W N , Thompson R P H , Mallinson C N 
Published: December 2008

Summary
A 63 year old man presented with features of the glucagonoma syndrome, that is thromboembolic disease, weight loss, raised sedimentation rate, diabetes mellitus, hypoproteinaemia and reduced plasma amino acid levels, but without necrolytic migratory erythema. The plasma glucagon level was raised and the tumour was demonstrated by abdominal CT scan. Immunofluorescent studies of the resected tumour confirmed the diagnosis. The normal tissue zinc status supports the view that necrolytic migratory erythema is related to zinc deficiency.
Spontaneous pneumomediastinum: a complication of anorexia nervosa?
Authors: Fergusson R J , Shaw T R D , Turnbull C M 
Published: December 2008

Summary
We describe a patient with anorexia nervosa who developed a spontaneous pneumomediastinum. Five other patients have been reported with this association, suggesting that tissue changes in anorexia nervosa may predispose to this condition.
Autoerythrocyte sensitization (Gardner-Diamond syndrome) in men: a case report and review of the literature
Authors: Ingber A , Alcalay J , Feuerman E J 
Published: December 2008

Summary
Autoerythrocyte sensitization (AES) is a rare syndrome particularly among males. A young male with typical AES is herewith described. We review all seven published cases of AES in men for which details are available and compare the age of onset, somatic manifestations, associated diseases and psychiatric disturbances between the sexes. We emphasize that the criteria essential for a diagnosis of AES should include typical clinical presentation, longstanding clinical history and a positive skin test with the patient's blood. Because of the rarity of AES there is a lack of awareness regarding it among many doctors.
Perforated duodenal diverticulum: a report of two cases
Authors: Stebbings W S L , Thomson J P S 
Published: December 2008

Summary
Perforation is a rare complication of congenital duodenal diverticula. The case histories of 2 patients are reported. Operative treatment to excise the diverticulum and close the defect in the duodenum and to drain associated sepsis is required.
Idiopathic sclerosing peritonitis
Authors: Dehn T C B , Lucas M G L , Wood R F M 
Published: December 2008

Summary
A girl of 12 years old presented with acute small bowel obstruction nine weeks after an uncomplicated appendicectomy. The obstruction was found to be due to the development of sclerosing peritonitis. Previous reports of this rare condition have suggested that it is predominantly found in adolescent girls residing in subtropical climates.
Gentamicin serum half-life: a comparison between pregnant and non-pregnant women
Authors: Lazebnik N , Noy S , Lazebnik R , Hezroni Y , Amoday I , Aviram A 
Published: December 2008

Summary
The serum half-life of gentamicin following an intravenous dose was compared between 19 pregnant women (28-34 weeks of pregnancy) with premature rupture of the membranes and 17 non-pregnant women with pelvic inflammatory disease, the groups being age and weight matched. A significant reduction of gentamicin half-life was found in the pregnant group.
Spinal subarachnoid haemorrhage presenting as spinal block without meningism
Authors: Duncombe A S , Kennedy P G E 
Published: December 2008

Summary
A case of spinal subarachnoid haemorrhage with progressive spinal cord compression and without any evidence of meningism is described. Spinal block was demonstrated by myelography and computerized tomography and surgical decompression of the subarachnoid blood clot resulted in almost complete recovery. A diagnosis of spinal subarachnoid haemorrhage should be considered in any patient who presents with acute back pain and slowly or rapidly progressive neurological signs in the limbs, even when meningism is absent.
Cardiac arrhythmia and myocardial ischaemia related to cocaine and alcohol consumption
Authors: Boag F , Havard C W H 
Published: December 2008

Summary
Following the drinking of 150 g of alcohol and a large amount of intra-nasal cocaine a previously healthy 31 year old man developed severe retrosternal pain and circulatory failure. An electrocardiogram showed supra-ventricular tachycardia with widespread ischaemic changes. Following electrical cardioversion electrocardiographic evidence of myocardial ischaemia persisted for 1 h. Two days later basal and exercise electrocardiograms were normal. The combination of alcohol and cocaine may be life threatening.
Recurrent idiopathic pneumomediastinum
Authors: Channer K S , Roberts C J C , Jeyasingham K 
Published: December 2008

Summary
A case is described of the rare syndrome of recurrent idiopathic pneumomediastinum which had been mistakenly diagnosed as recurrent spontaneous perforation of the oesophagus. The case illustrates the importance of distinguishing between pneumomediastinum and oesophageal rupture because of their markedly differing prognosis and management.
Acute renal failure in association with cosmetic suction lipectomy
Authors: Rose G E 
Published: December 2008

Summary
A case of severe non-oliguric acute renal failure following cosmetic suction lipectomy in a 33 year old woman is described. The renal failure, although requiring emergency treatment, resolved spontaneously with only negligible residual impairment of renal function. An aetiology involving rhabdomyolysis and myoglobinuria is proposed and other mechanisms are discussed.
Clinical significance of myocardial echo intensity in hypertrophic cardiomyopathy and other forms of left ventricular hypertrophy
Authors: Gibson D G 
Published: December 2008

Summary
An approach by quantifying the echoes arising from hypertrophied myocardium, is described in patients with left ventricular hypertrophy of various causes, including hypertrophic cardiomyopathy. Amplitude of echoes judged by pixel count was significantly increased in patients with hypertrophic cardiomyopathy, hypertension and aortic stenosis as compared with normals and athletes with a comparable increase in left ventricular mass.
It is suggested that the increase in echo intensity reflects an increase in myocardial collagen content.
Calcium blockade - nifedipine in the treatment of hypertrophic cardiomyopathy
Authors: Lorell Beverly H , Grossman William , Paulus Walter J , Craig William E , Murgo Joseph P 
Published: December 2008

Summary
The acute effects of the calcium channel blocking agent nifedipine in hypertrophic cardiomyopathy are described. Improved diastolic function was suggested by the increase in the rate of filling of the left ventricle and the fall in left ventricular end-diastolic pressure. Left ventricular relaxation time was shortened. There was a downward shift in the left ventricular pressure-echo dimension relationship, suggesting increased left ventricular distensibility. Nifedipine caused a fall in systolic, systemic blood pressure and an increase in heart rate, but no change in the cardiac index.
The reasons for the improvement in the diastolic function were thought to be systemic vasodilatation and change in left ventricular loading conditions, coronary vasodilatation with reduction of subendocardial left ventricular ischaemia and a direct myocardial effect and modification of myocardial calcium availability.
Dysarthria and visual hallucinations due to flecainide toxicity
Authors: Ramhamadany E , Mackenzie S , Ramsdale D R 
Published: December 2008

Summary
A 65 year old man with recurrent ventricular tachyarrhythmias post myocardial infarction developed dysarthria and visual hallucinations due to flecainide toxicity. A readily available assay is required for estimating serum flecainide levels in patients with diminished renal or hepatic function or failed arrhythmia suppression.
Teratogenic inborn errors of metabolism
Authors: Leonard J V 
Published: December 2008

SummaryMost children with inborn errors of metabolism are born healthy without malformations as the fetus is protected by the metabolic activity of the placenta. However, certain inborn errors of the fetus have teratogenic effects although the mechanisms responsible for the malformations are not generally understood. Inborn errors in the mother may also be teratogenic. The adverse effects of these may be reduced by improved metabolic control of the biochemical disorder.
Detection of hepatic encephalopathy
Authors: Gazzard B G , Price H , Dawson A M 
Published: December 2008

Summary
The most sensitive index of hepatic encephalopathy in 29 patients following a porta-caval shunt appeared to be the assessment of a close relative who had known the patient pre-operatively. They noticed that 19 of the 20 patients were mentally slower; 11 were markedly aggressive and 8 had become placid and uncaring about family problems. Only 9 of these patients had clinical encephalopathy as judged by two independent observers, 14 had a prolonged trail test and 8 produced an abnormal five-pointed star.
Eight patients were forced to retire prematurely after the operation due to ill health and 20 felt that their marriage had deteriorated.
Eighteen of the 29 patients had a lie score on the Eysenck personality questionnaire (an index of ‘social naïvety’) which was more than one standard deviation above the mean value for a large control group (P &lt; 0.01). This did not correlate with other measurements of encephalopathy, but 8 out of the 11 patients who exhibited aggressive behaviour had an abnormal score.
Radiological appearances of hydatid disease in Wales
Authors: Clements R , Gravelle I H 
Published: December 2008

Summary
Thirty six patients with hydatid disease have been investigated in the Radiology Departments of Cardiff hospitals between June 1973 and June 1984; thirty two of these patients are likely to have acquired the disease in Wales. There were 16 hepatic cysts, 3 renal cysts, 2 cerebral cysts, 15 pulmonary cysts, 1 pleural cyst, 1 recurrent spinal cyst, and 1 cyst of the broad ligament. The radiological features are discussed. These patients emphasize the higher incidence of hydatid disease in Wales, compared with other regions of the United Kingdom, and the need to consider this diagnosis in Welsh patients from rural areas, who have large pulmonary opacities, or hepatic, renal, or cerebral cystic abnormalities.