bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retroperitoneal fibrosis with normal intravenous urogram
Authors: Creagh F M , Stone T , Stephenson T P , Lazarus J H 
Published: December 2008

Summary
A 58 year old male presented with a two week history of low back pain and malaise. The intravenous urogram (IVU) at presentation was normal but within three months he had developed renal failure with bilateral ureteric obstruction on repeat IVU. Primary retroperitoneal fibrosis was confirmed at operation.
This case demonstrates that retroperitoneal fibrosis may progress rapidly to renal failure within a few months of the first symptoms. In addition, the IVU may be normal in the early stages of the illness.
Clinical evaluation of the Infrasonde D4000 blood pressure monitor
Authors: Zezulka A V , Sloan P J M , Davies P , Beevers D G 
Published: December 2008

Summary
Choosing a blood pressure machine from their ever increasing number is often difficult due to lack of performance data. We have evaluated a new automated non-invasive blood pressure recorder, the Infrasonde D4000®. In comparison with the Hawksley random zero mercury sphygmomanometer the Infrasonde showed less variability for both systolic and diastolic readings. However, it was found to record significantly lower mean systolic and diastolic pressures.
Ocular flutter in suspected multiple sclerosis: a presenting paroxysmal manifestation
Authors: Francis D A , Heron J R 
Published: December 2008

Summary
A patient with suspected multiple sclerosis is described who presented with attacks of blurring of vision and ocular flutter. This has not previously been reported as an isolated paroxysmal manifestation of brain stem demyelination. As with other paroxysmal disturbances ocular flutter may present as the first sign of the disease.
Effect of propranolol on thyroid homeostasis of healthy volunteers
Authors: Wilkins M R , Franklyn J A , Woods K L , Kendall M J 
Published: December 2008

Summary
The effect of propranolol on thyroid status was investigated by administering the drug in 2 therapeutic doses (80 mg b.d. and 120 mg b.d.) to 8 healthy volunteers and serially measuring total and free thyroid hormones and their major binding protein. Mean free T3 fell by 1.2 pmol/l (P &lt; 0.05) whilst mean free T4 and mean rT3 rose by 3.3 pmol/l (P &lt; 0.01) and 0.16 nmol/l (P &lt; 0.01) respectively. Mean thyroxine binding globulin (TBG) fell by 1.2 mg/l (P &lt; 0.001). Despite the change in free hormone levels there was no significant change in TSH. For the first time the effect of propranolol on circulating thyroid hormones and binding proteins in healthy subjects is apparent within one study. The biological significance of the change in free hormone levels is discussed.
Drug compliance and seizure control in epileptic children
Authors: Lisk D R , Greene S H 
Published: December 2008

Summary
The drug taking habits and compliance of 16 epileptic children were studied by means of a questionnaire, ‘pill’ count and serum antiepileptic drug levels (AEDL).
The questionnaire method overestimated patients' compliance while, because of the pharmacokinetics of antiepileptic drugs in children, single outpatients' drug levels may be misleading thereby not always reflecting the true degree of compliance.
Ten patients (62%) took more than 85% of their medication. Above this level of compliance there was a positive relationship to seizure control.
It would appear that drug compliance in epileptic children is as unsatisfactory as it is in adults on whom they largely depend for the administration of their medication.
Acute renal failure with polyarteritis nodosa and multiple myeloma
Authors: Williams A J , Newland A C , Marsh F P 
Published: December 2008

Summary
A patient who presented with acute renal failure due to renal cortical necrosis is described. Renal biopsy showed cortical infarction and angiography demonstrated aneurysms in the renal, splenic and hepatic circulations. Concurrently he was found to have an IgA kappa paraprotein with bone marrow changes diagnostic of multiple myeloma. He was treated with haemodialysis, immunosuppressive drugs and plasma exchange but died 3 months after presentation.
Small bowel capillary dilatation in portal hypertension
Authors: Gallagher C , Bonar F , Dempsey J , Crowe J 
Published: December 2008

Summary
A patient with small bowel capillary dilatation and cirrhosis is reported. This patient had persistent, unexplained gastrointestinal bleeding. Small bowel capillary dilatation appears to be unique to patients with portal hypertension. The possible role of small bowel capillary dilatation in causing gastrointestinal bleeding is discussed.
Lowered ultraviolet minimal erythema dose in hemiplegia
Authors: Cox N H , Williams S J 
Published: December 2008

Summary
In view of recent reports of increased tanning in hemiplegic limbs, we have investigated ultraviolet (u.v.) minimal erythema dose (MED) in hemiplegia using the bilateral comparison technique. Seven of 10 patients had a lower MED in the hemiplegic arm compared to the normal side, the mean reduction being 16% (range 0–33%, P = 0.003). No patients had a higher MED in the hemiplegic arm. We review the literature regarding other non-neurological features of hemiplegia, in particular asymmetry of temperature, oedema, and finger clubbing, and we propose a vasomotor or trophic aetiology for these findings.
Subconjunctival haemorrhage: a feature of acute severe asthma
Authors: Rodriguez-Roisin R , Torres A , Agustí A G N , Ussetti P , Agustí-Vidal A 
Published: December 2008

Summary
Bilateral subconjunctival haemorrhage was observed on 5 separate occasions in 4 patients presenting a fulminant form of acute severe asthma. Four of these episodes required ventilatory support. All patients recovered from their asthma attack after treatment with bronchodilators, corticosteroids, and oxygen. The incidence of this previously unreported finding represents 5% of the total number of patients with acute severe asthma mechanically ventilated in our intensive care unit from 1976.
Malignant inflammatory fibrous histiocytoma of bone and acute lymphoblastic leukaemia
Authors: Woodcock B E , Parsons M A , Winfield D A 
Published: December 2008

Summary
A patient is described who developed a malignant inflammatory fibrous histiocytoma of vertebral bone (MFH) 4 months after the onset of acute lymphoblastic leukaemia. This is the first report of the simultaneous occurrence of these two conditions. Similarities to the more frequent occurrence of another histiocytic malignancy, histiocytic medullary reticulosis, following acute lymphoblastic leukaemia, are noted. The usefulness of gallium scanning to monitor the response of this tumour to treatment is demonstrated.
Spontaneous perforation of a pyometra presenting as generalized peritonitis
Authors: Hosking S W 
Published: December 2008

Summary
Eleven cases of spontaneous perforation of a pyometra have previously been reported. All were associated with, and probably secondary to, cervical occlusion. A further case is described, but differs in that the cervical canal was patent. In the absence of other possible causes of uterine perforation, the aetiology of the perforation in this case remains uncertain.
Non-invasive assessment of early cardiac involvement in systemic sclerosis
Authors: Butrous G S , Dowd P M , Milne J , Dymond D S , Caplin J , Camm A J 
Published: December 2008

Summary
Twenty-eight patients with wide spectrum organ involvement of progressive systemic sclerosis but without signs or symptoms suggestive of cardiac involvement were studied by non-invasive cardiac techniques. The 12-lead electrocardiogram showed abnormalities in 6 patients: one had abnormal T waves and 5 had complete or incomplete right bundle branch block. Twenty-four hour ambulatory electrocardiography demonstrated higher average heart rates than in similar aged controls (82 +/- 9 vs 74 +/- 9 beats/min, P less than 0.05). In one patient a short run of ventricular tachycardia was recorded. No other significant arrhythmia was documented. Echocardiographic measurements were within normal ranges but small pericardial effusions were observed in two patients (7%). Resting first pass radionuclide angiography, utilizing 12 mCi of technetium 99m were performed in 23 patients. Seven patients (30%) had abnormal wall motion (diffuse hypokinesia), with a significant decrease in ejection fraction in comparison to those with normal wall motion (44 +/- 6% vs 60 +/- 6% P less than 0.01). Those with abnormal wall motion had suffered the disease longer than those with normal wall motion (13 +/- 4 vs 9.5 +/- 7 y). In conclusion, the heart is involved in half of the patients in this series; non-invasive cardiac assessment is useful in disclosing the early cardiac involvement and may influence long-term management.
The clinical value of Haemoccult and Fecatwin in the detection of colorectal neoplasia in hospital and general practice patients
Authors: Barrison I G , Parkins R A 
Published: December 2008

Summary
Four hundred and fifty asymptomatic general practice patients and 330 hospital inpatients had their stools tested for occult blood with the Haemoccult and Fecatwin methods.
In general practice, 9/64 (14%) of patients with a positive result had a colonic neoplasm (three carcinomas, one Dukes' Stage A, two Dukes' Stage C, six adenomas) and in hospital 12/142 patients (8%) were found to have colonic tumours, (nine carcinomas, two Dukes' Stage A, two Dukes' Stage B, five Dukes' Stage C and three adenomas). The overall detection rates for colonic neoplasia were 2% in general practice and 3.4% in hospital. In 2 years of follow-up, none of the general practice patients have presented with colonic symptoms. Two hospital patients with colonic carcinomas produced negative tests with both methods.
Out of the total of 21 colonic neoplasms, nine were detected by Fecatwin alone, but this trend in favour of the more sensitive test did not reach the 5% level of statistical significance. In contrast, the number of false positive results were significantly greater with Fecatwin than Haemoccult.
From our data it would appear that the Fecatwin method warrants assessment in a full controlled trial of its value as a population screening test for colonic cancer.
Pseudo-phaeochromocytoma due to alcohol withdrawal
Authors: Potter J F , Beevers D G 
Published: December 2008

Summary
Alcohol withdrawal hypertension is a common clinical problem which often goes unrecognized. We report a case in which the symptoms and signs of withdrawal with a marked elevation in blood pressure mimicked the features of a phaeochromocytoma. Despite a positive phentolamine test no further evidence for phaeochromocytoma was found and both blood pressure and symptoms settled as the features of alcohol withdrawal abated.
Anti-arthritic propionic acid derivatives and 17-oxosteroid measurements—a direct interference
Authors: Ng L L , Chalmers T M , McLeish R L , Raggatt P R 
Published: December 2008

Summary
Many drugs interfere with the assay of urinary 17-oxo and oxogenic steroids. Some propionic acid derivatives, in particular, tiaprofenic acid, have now been shown to affect this assay. Care should be taken when interpreting results in patients on these drugs.
Primary nongestational choriocarcinoma of the ovary
Authors: Raju G C , Woo J , Marchack D , Naraynsingh V 
Published: December 2008

Summary
Primary choriocarcinoma of the ovary arising, presumably, from a germ cell is extremely rare. The patient, a 16 year old girl who presented with dysuria and frequency of micturition developed fatal haemoperitoneum due to rupture of a pure primary nongestational ovarian choriocarcinoma.
Alpha and beta cell evaluation in patients with thalassaemia intermedia and iron overload
Authors: De Sanctis V , Gamberini M R , Borgatti L , Atti G , Vullo C , Bagni B 
Published: December 2008

SummaryInsulin and glucagon secretion were studied during an oral glucose tolerance test and arginine infusion in 11 patients with thalassaemia intermedia, who showed laboratory evidence of iron overload. Mean blood glucose concentrations in patients with thalassaemia intermedia were significantly higher than normal and 3 of 11 patients had impaired glucose tolerance. The principal abnormality appears to be a deficiency in insulin and glucagon from the pancreas in response to oral glucose tolerance and arginine stimulation tests. Several factors, such as iron overload, chronic hypoxia, zinc deficiency and increased catecholamine production secondary to anaemia, might play a part in the pathogenesis of these abnormalities. Each of these factors affect individual cases to a varied degree. Our data emphasize the mildness of carbohydrate defect as compared to the degree of insulinopenia and indicate the necessity for prescribing measures which prevent excessive iron deposition and improve iron excretion in thalassaemic patients with iron overload.
How often can an embolic stroke be diagnosed clinically? A clinicopathological correlation
Authors: Humphrey P R D , Harrison M J G 
Published: December 2008

Summary
A retrospective case note survey of 103 autopsy proven cases of cerebral infarction was carried out to assess how often a cardiac source for embolism had been correctly suspected on clinical grounds. Only 61% of 46 patients with cardiac embolic sources were so identified. Cases of rheumatic heart disease and bacterial endocarditis were more frequently identified than cases of mural thromboembolism from ischaemic heart disease. This relative failure of unaided clinical diagnostic criteria probably accounts for the discrepancy between the autopsy evidence of cardiac embolism as a cause of stroke (about 40%), and clinical studies (about 20%).
Small bowel stricture following abdominal trauma
Authors: Welch G H , Anderson J R 
Published: December 2008

Summary
A case of small bowel stricture developing 2 months after blunt abdominal trauma from a lap seat belt is presented. The cause of the stricture was probably a small perforation sustained at the time of the injury but overlooked clinically. At operation an abscess around the terminal ileum was found. The patient made an uneventful recovery following resection of the strictured small bowel.
Cytomegalovirus and inflammatory bowel disease
Authors: Morton R 
Published: December 2008

Summary
An 80 year old man was admitted to hospital with a 4 month history of diarrhoea with blood and mucus. The diarrhoea could not be controlled by a variety of drugs and he died 7 weeks later. Rectal biopsy showed both intranuclear and intracytoplasmic inclusional bodies consistent with cytomegalovirus infection.
Incidence of dilated cardiomyopathy
Authors: Abelmann Walter H 
Published: December 2008

Summary
Full reliable data on the incidence and prevalence of dilated cardiomyopathy are not available. In the United States, at least 0.7% of cardiac deaths are attributable to cardiomyopathy. Dilated cardiomyopathy probably contributes the great majority of these cases. The mortality rate for cardiomyopathy in males is twice that of females, and for blacks it is 2.4 times that of whites. Cardiomyopathy was diagnosed in 0.67% of patients discharged from hospitals in 1979 with diagnoses of disease of the circulatory system. Cardiomyopathy accounted for 1% of general cardiologists' and for 7% of academic cardiologists' patient encounters.
In Scandinavia, population surveys suggested an annual incidence of dilated cardiomyopathy ranging from 0.73 to 7.5 cases per 100,000 population; for Tokyo this figure is 2.6. The prevalence of cardiomyopathy in underdeveloped and in tropical countries is considerably higher than in developed countries.
Viral myocarditis and dilated cardiomyopathy — an experimental study with special reference to immunological behaviour of T- and B-lymphocytes
Authors: Kawai Chuichi , Kishimoto Chiharu 
Published: December 2008

Summary
The direct transition from acute myocarditis to dilated cardiomyopathy has been demonstrated in an inbred strain of DBA/2 mice inoculated with the M-variant of EMC virus. The severity of myocarditis, which determines the development of congestive heart failure and, later, the diseased state resembling dilated cardiomyopathy, seems to be mediated by T-lymphocytes.
Behçet's disease presenting as benign intracranial hypertension
Authors: Wilkins M R , Gove R I , Roberts S D , Kendall M J 
Published: December 2008

Summary
Two siblings with Behçet's disease presenting as benign intracranial hypertension are reported and the literature is reviewed. We suggest that raised intracranial pressure should be added to the clinical criteria considered for the diagnosis of Behçet's disease.
An unusual volvulus—the ileosigmoid knot
Authors: Johnson C D 
Published: December 2008

Summary
A case is presented of an ileosigmoid knot in a 70 year old man. A strangulated loop of ileum was wrapped around the neck of a sigmoid volvulus. Following small bowel resection and sigmoid colectomy with colostomy, the patient made an uneventful recovery.
Metastatic follicular carcinoma of the thyroid presenting with thyrotoxic induced impaired control of diabetes mellitus
Authors: Samanta A , Burden A C , Jones G R , Nicol N T 
Published: December 2008

Summary
We report a patient with pulmonary and bony metastases due to follicular carcinoma of the thyroid, occurring 12 years after the initial diagnosis. This was brought to light by worsening diabetic control due to thyrotoxicosis from functioning malignant thyroid tissue. Following radio-active iodine therapy, she remains well with good control of her diabetes.
Intramural pseudodiverticulosis—an unusual cause of benign oesophageal stricture
Authors: Stephens W P , Mossman A , Ratcliffe J F , Gould D A , Oleesky S 
Published: December 2008

Summary
Three cases of intramural pseudodiverticulosis of the oesophagus are described together with a review of the relevant literature. This unusual condition, diagnosed by characteristic features on the barium swallow, is associated with a high incidence of benign oesophageal stricture which responds readily to endoscopic dilatation.
Renal vein thrombosis with recurrent pulmonary emboli in the nephrotic syndrome: use of the Greenfield filter
Authors: O'Brien A A , O'Donnell J P , Keogh J A B 
Published: December 2008

Summary
We describe a case of renal vein thrombosis in association with the nephrotic syndrome. The patient had recurrent pulmonary emboli which, having failed to respond to routine anticoagulant treatment, were managed successfully by the insertion of a Greenfield filter into the inferior vena cava above the renal vein thrombosis site. The only coagulation abnormality in this patient was a deficiency of antithrombin III.
The relationship of arrhythmias to walking activity during mobilization after myocardial infarction
Authors: Roland J M , Banks D C , Edwards B , Fentem P H 
Published: December 2008

Summary
The extent to which everyday walking activity is responsible for ventricular arrhythmias in the first 6 weeks after suspected myocardial infarction has been studied by simultaneous 24-hour recordings of electrocardiogram and walking activity. Forty-eight recordings from 46 patients were identified which contained couplets, ventricular tachycardia or R-on-T extrasystoles. In 24 recordings (50%) all the arrhythmias occurred whilst the patient was at rest and in a further four recordings there were fewer arrhythmias during activity than would have been expected by chance. Nineteen recordings (40%) contained arrhythmias which may have been induced by activity but in only three of these was the relationship definite. Clear evidence of arrhythmias precipitated by walking was found in only a minority of patients mobilizing after suspected myocardial infarction.
Generalized muscular pseudohypertrophy in cysticercosis
Authors: Chopra J S , Nand N , Jain K , Mittal R , Abrol L 
Published: December 2008

Summary
A 32 year old male Hindu, presenting with generalized muscular hypertrophy (Veritable Hercules), together with subcutaneous nodules and epilepsy, due to cysticercosis is described.
Tuberculosis and renal transplantation—observations from an endemic area of tuberculosis
Authors: Malhotra K K , Dash S C , Dhawan I K , Bhuyan U N , Gupta A 
Published: December 2008

Summary
Ninety-five renal transplant recipients from an endemic area of tuberculosis were investigated to find out the prevalence and course of tuberculosis in pre- and post-transplant periods. Eleven patients had tuberculosis in the pre-transplant period - pulmonary (2), pleural (2), miliary (1), abdominal (2), lymph node (5) and pericardial (1). They were transplanted after antituberculous therapy of 3 to 6 months with satisfactory results. The anti-tuberculous treatment was usually continued for 2 years. Only one of the above 11 patients had evidence of tuberculosis in the post-transplant period. Nine patients developed tuberculosis for the first time in the post-transplant period - pulmonary (4), pleural (1), miliary (1), lymph node (4) and pericardial (1). There was no mortality due to tuberculosis. Thorough search for tuberculosis is mandatory both during pre-transplant assessment and post-transplant follow-up in areas of endemic tuberculosis.
Pulmonary infection with opportunist mycobacteria on Merseyside 1974–1983
Authors: Clague H W , El-Ansary E H , Hopkins C A , Roberts C 
Published: December 2008

Summary
During a 10 year period 49 patients were recorded as having pulmonary infection caused by opportunist mycobacteria. Six different species were identified of which M. kansasii (65%) and M. avium-intracellulare (20%) were the most common. Cough and sputum (82%) or haemoptysis (26%) were frequent symptoms on presentation and over two thirds of patients had pre-existing respiratory disease. Chest radiographs showed predominantly apical disease with the right apex (44%) being twice as commonly affected as the left (22%). In 30% the radiograph showed bilateral disease.
Clinicians had an individual approach to treatment with no uniform pattern of drug prescribing. A majority of patients (59%) received rifampicin for at least 9 months and those patients with M. kansasii infection responded well with no bacteriological relapses in 20 patients followed for a mean period of 3.9 years. M. avium-intracellulare, M. malmoense and M. xenopi were less responsive to treatment and in four patients receiving chemotherapy death was attributed to mycobacterial infection.
Chronic granulomatous disease presenting as an oculomucocutaneous syndrome mimicking Behçet's syndrome
Authors: Kelleher D , Bloomfield F J , Lenehan T , Griffin M , Feighery C , McCann S R 
Published: December 2008

Summary
A female patient who presented for the first time at the age of 19 with oculomucocutaneous syndrome was found to have an absolute deficiency of neutrophil peroxide production. Neutrophil peroxide production as measured by chemiluminescence was zero on stimulation with opsonized zymosan. Direct membrane stimulation with FMLP and calcium ionophore also failed to elicit peroxide production. The diagnosis of chronic granulomatous disease should be considered in young patients with oculomucocutaneous syndrome.
Reversible agranulocytosis due to meprobamate
Authors: Ward S , Meecham J 
Published: December 2008

Summary
A 52 year old man admitted to hospital in a toxic state, was found to have agranulocytosis, which recovered when an analgesic containing meprobamate was stopped. The patient was known to have had similar symptoms 9 months previously when the drug was first used, thereby demonstrating an idiosyncratic reaction to meprobamate.