bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality from coronary heart disease-trends for the Republic of Ireland
Authors: Hickey N. , Mulcahy R. , Daly L. , Graham I. 
Published: December 2008

Summary
A study of certified mortality between 1968 and 1981 indicates that mortality from all causes commenced to decline from the mid 1970s in the Republic of Ireland. This trend was apparent for both sexes and for all ages except for men aged 55–64 years. A similar trend of lesser magnitude is suggested for coronary heart disease mortality in males, but not in females.
The decrease in the percentage of male cigarette smokers in the population which is also reflected in a marked decline of smoking among male coronary patients, may be related to the trends in mortality.
Patients’ evaluation of a post-myocardial infarction teaching programme administered by nurses
Authors: Jenkins B. , Mayberry J. F. , Kent S. , Colbourne G. 
Published: December 2008

Summary
Two-hundred and twenty-eight patients admitted to a District General Hospital Coronary Care Unit with a confirmed myocardial infarction were given a detailed information session by nurses. Information included a detailed programme of exercise during convalescence and attitudes toward diet, smoking and sexual intercourse. Patients were asked to assess the value of these sessions using questionnaires administered during convalescence.
Between 76% and 91% of patients considered the presentation necessary and there was a significant improvement in their understanding of what an infarction was. More than 80% of patients found a booklet entitled Recovering from your Heart Attack particularly helpful. The great majority of patients believed that more health education should be given at school and that members of the general public should be taught the techniques of cardio-pulmonary resuscitation.
The teaching programme appears to have reduced the admitted smoking habits of patients. On admission 56% of patients were smokers. This fell to 7% at the end of 3 weeks, but had risen to 17% at 6 months.
Phaeochromocytoma and acute cardiovascular death (with special reference to myocardial infarction)
Authors: Cohen C. D. , Dent D. M. 
Published: December 2008

Summary
The causes of death, as determined by autopsy, in 10 patients dying from the acute effects of phaeochromocytoma were myocardial infarction (five patients), left ventricular failure (two patients), cerebral haemorrhage (two patients) and circulatory collapse with malignant phaeochromocytoma (one patient). Most patients died shortly after admission during the course of a fulminant cardiovascular illness and the underlying tumour was unsuspected in eight instances. The clinical features and post-mortem cardiovascular findings are reviewed.
Basal ganglia calcification and psychosis in Down’s syndrome
Authors: Thase Michael E. 
Published: December 2008

Summary
A case of basal ganglia calcification (diagnosed in vivo) and schizophreniform psychosis occurring in a young adult with Down’s syndrome is reported. A stress-vulnerability model is suggested. Because of the relatively high prevalence of basal ganglia calcification to Down’s syndrome, this population appears well suited for systematic study of the neuropsychiatric aspects associated with this neurological condition.
Pasteurella multocida pneumonia complicated by Staphylococcus aureus
Authors: Martyn V. , Swift D. 
Published: December 2008

Summary
A 71-year-old woman presented with acute non-cardiogenic pulmonary oedema. She proved to have a Pasteurella multocida pneumonia, with blood stream invasion by the organism, and required positive pressure ventilation for 53 days.
Penicillin G., the drug of choice for this infection, failed to reverse the steady decline in her arterial oxygen-tension, and it was only after treatment with chloramphenicol and prednisolone that she began to improve.
Serological tests strongly indicated the presence of a Staphylococcus aureus infection and the delay in giving antibiotics appropriate to this second pathogen may have been the reason for the patient’s initial downhill course.
Breast mycobacterial infection in a haemodialysis patient
Authors: Modai D. , Weissgarten J. , Reiff R. , Siegal B. , Gabizon D. 
Published: December 2008

Summary
Mycobacterial infection is relatively common among patients maintained on haemodialysis and may present in uncommon locations and acquire an unusual course. We present a patient in whom a breast mass was found to be caused by primary mycobacterial infection. This is to our knowledge the first report on breast mycobacterial infection in a haemodialysis patient.
Amoebic granuloma—an unusual cause of caeco-colic intussusception
Authors: Patra S. B. , Giri D. D. , Shukla G. N. , Mehta H. S. 
Published: December 2008

Summary
A case of amoeboma presenting as an intussusception, encountered for the first time in this institute, is reported. The diagnosis was only made postoperatively. The importance of awareness of such lesions in the tropics, in view of the efficiency of trial antiamoebic therapy, is discussed.
Herpes simplex type 2 meningitis treated with acyclovir
Authors: Levy D. M. , Sagar H. J. 
Published: December 2008

Summary
A case of meningitis due to a primary genital herpes simplex type 2 infection, and its prompt response to therapy with intravenous acyclovir is reported. This complication of genital herpes is probably underdiagnosed and it is worthwhile searching for evidence of genital herpetic lesions in a young patient presenting with viral meningitis.
Medullary sponge kidney presenting with hypokalaemic paralysis
Authors: Jayasinghe K. S. A. , Mendis B. L. J. , Mohideen R. , Ekanayake R. , Sheriff M. H. R. , Dharmadasa K. 
Published: December 2008

Summary
Medullary sponge kidney associated with a defect in urine acidification is rare and usually of no clinical significance. We report a case presenting as hypokalaemic paralysis due to associated congenital distal renal tubular acidosis.
Hyperthyroidism due to inappropriate TSH secretion with associated hyperprolactinaemia—a case report and review of the literature
Authors: Spitz Irving M. , Sheinfeld Maxim , Glasser Benjamin , Hirsch Harry J. 
Published: December 2008

Summary
A patient with inappropriate thyrotrophin (TSH) secretion is described. She initially presented with classical hyperthyroidism during pregnancy, responded to propylthiouracil and, subsequently, had a normal delivery. Hyperthyroidism persisted and 7.5 months later a subtotal thyroidectomy was performed. After a further 16 months, mild symptoms of hyperthyroidism recurred. She again responded to propylthiouracil, but developed galactorrhoea. At that stage, it was noted that she had persistently elevated circulating TSH in the presence of elevated T4 and T3 levels. Her symptomatology was mild, although objective indices of thyroid activity, including pulse rate, BMR, sex hormone binding globulin and cholesterol, were indicative of hyperthyroidism. CT scan and tomography of the sella were normal.
She had a markedly exaggerated TSH response to thyrotrophin releasing hormone (TRH). Basal TSH and responsiveness to TRH was suppressed by high dose dexamethasone. The TSH response to TRH was partially suppressed by exogenous T3, but there was no effect on basal TSH levels. TSH also decreased slightly with L-dopa and bromocriptine. Circulating TSH rose markedly during methimazole administration. TSH α and β subunits were elevated and appropriate for the high TSH. In addition, both subunits increased following TRH. The patient had basal hyperprolactinaemia with an impaired prolactin (PRL) response to TRH and metoclopramide. PRL suppressed with L-dopa and bromocriptine. The remaining anterior pituitary function was intact. Most of the laboratory findings argue against the presence of a TSH producing pituitary tumour and the most likely cause for inappropriate TSH secretion in this patient is selective resistance of the thyrotroph to thyroid hormones. A mild element of peripheral resistance might also be present. The hyperprolactinaemia could be related to lactotroph resistance to thyroid hormone.
The complexities of treatment in this patient are stressed. Therapy was initially attempted with low dose dexamethasone, but this had no effect. T3 treatment produced an exacerbation of her symptomatology and did not influence basal TSH, thyroid hormones, or 131I uptake. Bromocriptine administration for 11 months partially suppressed basal TSH without influencing T3 and there was an increase in T4. Methimazole did decrease her T4 and T3, but TSH and PRL rose to even greater levels. Her hyperthyroidism was eventually controlled with an ablative dose of 131I. Thyroid hormone will be given in an attempt to suppress her TSH.
Treatment of asthma in a general practice
Authors: Shee C. D. , Poole D. , Cameron I. R. 
Published: December 2008

Summary
We examined the general practice treatment of 67 patients diagnosed as asthmatic. Compliance with treatment was poor in one-third of patients with severe asthma. Inhaled steroids were under-prescribed and our findings suggest that some severe asthmatics are receiving less than adequate therapy.
Acute renal failure due to glomerulonephritis associated with staphylococcal infection
Authors: Maher E. R. , Hamilton D. V. , Thiru S. , Wheatley T. 
Published: December 2008

Summary
Acute renal failure developed in a diabetic with staphylococcal arthritis and septicaemia in the absence of endocarditis. Renal biopsy showed proliferative glomerulonephritis and there was evidence of alternative pathway of complement activation. Renal function recovered following haemodialysis for 2 months. The association of glomerulonephritis with staphylococcal infection is reviewed.
Carcinoma of the vagina presenting as a ruptured procidentia with an entero-vaginal fistula and prolapse of the small bowel
Authors: Howat J. M. T. , Mohandas I. , Stassan L. , Daw E. 
Published: December 2008

Summary
A case of a carcinoma of the vagina which presented as a ruptured procidentia with an entero-vaginal fistula and prolapse of the small bowel is reported.
Gastric emptying after surgery for the dumping syndrome
Authors: Harries A. D. , Dew M. J. , Crawley E. O. , Leach K. G. , Salaman J. R. , Rhodes J. 
Published: December 2008

Summary
The dumping syndrome following gastric surgery for peptic ulcer disease can cause severe morbidity. In this study the benefit of interposition of an antiperistaltic jejunal loop to reverse peristalsis and delay gastric emptying was assessed in four patients with severe symptoms by performing gastric emptying studies pre-operatively, and at 6 months and 24 months following surgery. Gastric emptying was delayed at 6 months but by 2 years had returned to pre-operative values. Patients' symptoms were improved at 6 months and remained so despite the deterioration in gastric emptying. This surgical procedure is of some value to patients with severe symptoms due to the dumping syndrome.
Hypertrophic pulmonary osteoarthropathy complicating Celestin tube insertion
Authors: Young J. B. , Wilkins W. E. 
Published: December 2008

Summary
A case is reported in which hypertrophic pulmonary osteoarthropathy (HPOA) developed following the insertion of a Celestin tube for a benign oesophageal stricture. The HPOA resolved completely following removal of the tube. It is believed that the Celestin tube was the major factor causing the HPOA, a complication of Celestin tube insertion not previously reported.
Development of Hodgkin’s disease in the course of liver cirrhosis and impaired monocyte function
Authors: Dan Michael , Hassner Avi , Jedwab Medina , Shibolet Shlomo 
Published: December 2008

Summary
The monocyte function, as measured by phagocytosis and killing of Candida albicans and Candida pseudotropicalis by peripheral blood monocytes, was found impaired in a patient with cirrhosis of the liver on two separate determinations before the occurrence of bleeding from oesophageal varices. Unexpectedly, Hodgkin’s disease was diagnosed in enlarged abdominal lymph nodes found on the occasion of an emergency portocaval shunt operation.
Severe postural hypotension following home canoe construction from polyester resins
Authors: MacFarlane I. A. , Wilkinson R. , Harrington J. M. 
Published: December 2008

Summary
On two occasions a 36-year-old man developed severe postural hypotension and neurological signs after working with a polyester resin canoe building kit in an unventilated shed. It is likely that his recurrent illness was caused by styrene intoxication. Postural hypotension secondary to styrene exposure has not previously been reported.
Combined barium meal and cholecystogram—an analysis of 1,444 patients
Authors: Watt P. C. H. , Spence R. A. J. , Campbell R. C. , McGurk J. J. , Whytes D. G. C. 
Published: December 2008

Summary
Since many dyspeptic patients are still investigated initially by radiology, a policy was initiated whereby all such patients were directly referred for combined simultaneous double-contrast barium meal and cholecystogram. This policy was aimed at reducing patient visits to hospital and increasing diagnostic yield.
The results of 1,444 combined procedures are presented. Of these, 310 (25.5%) had a positive finding on barium meal only; 275 (19%) were positive for cholecystogram only; 117 (8.1%) were positive for both examinations; 742 (51.4%) were negative for both examinations. Of all the patients (427) who had a positive finding on barium meal, 27.4% (117) also had a positive finding on cholecystogram. Of all the patients (392) with a positive cholecystogram, 29.8% (117) also had a positive barium meal. Diagnostic yield rose considerably with patient age.
It was found that simultaneous barium meal and cholecystogram presented no serious technical difficulties. It was concluded that in patients over 40 years old, this policy improved diagnostic yield as many patients had both gall bladder and upper gastrointestinal pathology. In all other patients this policy markedly reduced the number of hospital visits. Combined simultaneous double-contrast barium meal and cholecystogram is therefore recommended for hospitals which used radiology for the first line investigation of dyspepsia. Also, the general principle of examination of both gall bladder and upper gastrointestinal tract is pertinent where other first line investigations are used.
Typhoid perforation of the gut
Authors: Khanna A. K. , Misra M. K. 
Published: December 2008

Summary
One-hundred consecutive patients with typhoid perforation of the gut admitted in the same surgical unit of the University Hospital have been studied. The cases were diagnosed on the basis of history, clinical examination, exploratory findings, histopathological examination, Widal test and blood culture. Forty-six patients had perforation in the second week of fever. Sixty-one patients presented 48-96 hr after perforation. All the patients were subjected to surgery, 16 under local anesthesia. Mortality rate increased from 25% to 83% as the duration between perforation and operation increased.
Renovascular hypertension associated with bilateral aldosteronoma
Authors: Vircburger M. I. , Prelević Gordana M. , Todorović P. , Bojić P. , Perić Ljiljana A. , Paunković N. 
Published: December 2008

Summary
The authors present a 35-year-old male patient with renovascular hypertension caused by the stenosis of both renal arteries of the right kidney. Two years after the diagnosis of hypertension was made, an endarterectomy was performed but a successful correction of the upper stenotic artery was not achieved. During the next 2 years the hypertensive disease was uncontrollable with antihypertensive medications and gradually entered into a malignant phase. In addition to the atrophy of the right kidney, an adenoma of the left adrenal gland was revealed (19.75 g) which was operated on. Left adrenalectomy had only a transitory benefit on blood pressure level. Five months later an adenoma of the right adrenal gland was diagnosed and together with the ischaemic right kidney was operated on (right adrenalectomy and nephrectomy) which definitely cured the hypertension.
The chronological sequence of events and the course of the disease in the patient point to the possibility that long-standing hyper-reninaemia, due to renal ischaemia, may cause the development of multiple bilateral adrenocortical adenomas and that secondary aldosteronism may transform into primary.
Galactorrhoea following hypophysectomy in a boy with a prolactinoma
Authors: Dandona P. , Mohiuddin J. , Lindsay K. W. 
Published: December 2008

Summary
An 18-year-old boy with delayed puberty was found to have a large prolactinoma. Hypophysectomy led to a fall in serum prolactin concentration, although it remained markedly elevated. The introduction of replacement therapy, including testosterone, resulted in painful swelling of the breasts and galactorrhoea. Bromocriptine therapy resulted in a cessation of galactorrhoea and normalization of serum prolactin concentrations. The absence of galactorrhoea in association with an astronomical concentration of prolactin, and its onset in association with diminished prolactin concentrations following hypophysectomy and the introduction of testosterone therapy, indicate that galactorrhoea requires the presence of high prolactin concentrations to act on mature breast tissue. This would account for the rarity of galactorrhoea in prepubertal children with prolactinomas.
Acute oliguric renal failure secondary to lymphomatous infiltration of the kidneys
Authors: Leung A. C. T. , McKean M. , Mactier R. , Dobbie J. W. 
Published: December 2008

Summary
A case of lymphomatous infiltration of the kidneys presenting as acute oliguric renal failure of unknown cause is described. Renal biopsy was required to establish the diagnosis. Combined chemotherapy (MOPP) produced significant improvement in renal function.
Agranulocytosis during malaria prophylaxis with Maloprim (pyrimethamine and dapsone)
Authors: Booth F. , Barker L. C. , Barton C. J. , Naik R. B. 
Published: December 2008

Summary
A case of agranulocytosis during malaria prophylaxis with Maloprim (pyrimethamine and dapsone) is described. At the recommended dose of one tablet weekly this is apparently a rare occurrence but highlights one of the hazards in a changing climate of malarial prophylaxis in which the use of Maloprim is increasing.
Exposure to sunlight and vitamin D deficiency in Saudi Arabian women
Authors: Fonseca V. , Tongia R. , el-Hazmi M. , Abu-Aisha H. 
Published: December 2008

Summary
Plasma 25-hydroxy cholecalciferol (25-OH vitamin D) concentrations were measured in 31 adult Saudi Arabian women who presented with acute minor illness. Patients with chronic diseases, malignancy and overt metabolic bone disease were excluded from this study. The median plasma 25-OH vitamin D concentration was 6 ng/ml (range: 2-18 ng/ml). Only three subjects had a concentration within the normal range (10-55 ng/ml). Plasma 25-OH vitamin D concentrations were significantly lower in subjects living in apartments than in those living in villas or rural areas (P less than 0.02). When direct questioning was used to assess exposure to sunlight, plasma 25-OH vitamin D concentrations were significantly lower in those subjects whose average exposure was less than 30 min daily than those whose exposure was more than 30 min daily (P = 0.002).
Our findings confirm the importance of inadequate exposure to sunlight in the aetiology of vitamin D deficiency. Social customs may contribute to this deficiency in spite of abundant sunshine.
Direct questioning to assess the adequacy of sunlight exposure is an essential part of history taking in cases of suspected vitamin D deficiency.
Prospective measurement of glomerular filtration rate and effective renal plasma flow during treatment of malignant essential hypertension
Authors: Ghose R. R. 
Published: December 2008

Summary
A longitudinal study of sequential measurement of glomerular filtration rate and effective renal plasma flow was conducted over a 5-year period of antihypertensive drug treatment, in four adult patients admitted to hospital with previously untreated malignant essential hypertension. Treatment produced a substantial and sustained lowering of systemic arterial blood pressure, compared with grossly elevated pretreatment levels. Nevertheless, glomerular filtration rate and effective renal plasma flow remained relatively stable in all four patients, at roughly the same level at which they were admitted. It was concluded that effective therapy for hypertension may not necessarily reverse the vascular changes of arteriolar fibrinoid necrosis, which characterize malignant essential hypertension. Permanent damage to the renal arterioles, and the territory of kidney supplied by these vessels, may be a feature of this condition.
The effect of cimetidine on the maintenance of healing of gastric ulceration
Authors: Kinloch J. D. , Pearson A. J. G. , Woolf I. L. , Young P. H. 
Published: December 2008

Summary
The rate of endoscopically confirmed gastric ulcer relapse was compared in two groups of patients with newly healed benign gastric ulcers, receiving either cimetidine 400 mg nocte or matching placebo, over a period of 1 year. Six of 24 (25%) patients on cimetidine and 16 of 27 (59%) patients on placebo had endoscopically confirmed relapse. These included two patients in each group with asymptomatic relapses. The difference in the rate of relapse between the two groups was statistically significant (P = 0.01).
Gastrins and gastrinomas
Authors: Hansky J. 
Published: December 2008

Summary
The past 20 years have seen gastrin attain true hormonal status. Its structure has been characterized, it has been synthesized, radioimmunoassays for its measurement in blood and tissues have been developed and its physiology and metabolism elucidated. Of much interest to clinicians has been the association between gastrin and tumours of the pancreas (gastrinomas) and atrophic gastritis. The advent of gastrin measurement has facilitated the diagnosis of gastrinoma and the availability of powerful acid suppressants has altered the therapy of gastrinoma.
Acute pancreatitis and gastric dilatation in a patient with anorexia nervosa
Authors: Backett S A 
Published: December 2008

Summary
A case is described in which a young woman undergoing treatment for anorexia nervosa developed gastric dilatation and acute pancreatitis.
Two previous reports have described these as complications of anorexia nervosa and in view of this case attention is drawn to a possible association between these conditions. The importance of monitoring the anorectic patient's clinical state during the early phase of treatment is stressed.
Secondary hypertension accompanying high pressure chronic retention
Authors: Ghose R R , Birks J L 
Published: December 2008

Summary
Two middle-aged men were referred for control of severe hypertension, presumed to be ‘essential’. Late-onset enuresis, a small palpable bladder, and slight prostatic enlargement were elicited in one patient; history and examination were unremarkable in the other patient, apart from moderate prostatic enlargement. Intravenous urography revealed massive bilateral hydronephrosis with hydroureters in both patients. Surgical relief of retention was associated with post-obstructive diuresis and normalization of blood pressure, although recurrence of hypertension occurred later in one patient. These patients suffered from high pressure chronic retention, a syndrome characterized by impairment of renal function and hypertension. Surgical relief of retention was accompanied by prompt correction of hypertension, and gradual, sustained recovery of renal function.