bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary hyperparathyroidism unmasked by donor nephrectomy
Authors: Hollands M J , Williams Gordon 
Published: December 2008

Summary
A patient who was normocalcaemic before donation of a kidney to her son developed hypercalcaemia in the immediate postoperative period, which was subsequently found to be due to a parathyroid adenoma. It is assumed that the hypercalcaemia was unmasked by the reduction in glomerular filtration rate following the nephrectomy.
Amniotic fluid embolism and disseminated intravascular coagulation complicating hypertonic saline-induced abortion
Authors: Ballas S , Lessing J B , Michowitz M 
Published: December 2008

Summary
Amniotic fluid embolism (AFE) associated with disseminated intravascular clotting (DIC) is usually fatal. Such a combination generally occurs at the term of pregnancy or in the immediate postpartum period. A case of AFE with DIC following a hypertonic-saline-induced abortion, is reported. The patient was in the midtrimester with a live fetus. Prompt recognition and treatment of her condition ensured her complete recovery. Such a case has not, to our knowledge, been previously reported.
Epidemiology aspects of endomyocardial fibrosis
Authors: Hutt M S R 
Published: December 2008

Summary
Endomyocardial fibrosis (EMF) is a specific clinicopathological entity. It occurs sporadically throughout the world but is endemic in parts of Africa, India and South America. In sporadic cases, blood eosinophilia is a common feature; this is a variable finding in endemic cases. The curious geographical distribution of EMF in the tropics remains unexplained.
Endomyocardial disease—clinical features
Authors: Goodwin J F 
Published: December 2008

Summary
The clinical features of tropical and temperate zone endomyocardial fibrosis (EMF) are the same, allowing for certain regional, environmental and possibly genetic variations. For example, the seasonal incidence in rainy humid areas probably reflects the large and repeated parasitic infestations in tropical EMF, while the absence of tissue eosinophilia in organs other than the heart in tropical EMF may reflect racial and environmental differences between tropical and western geographical areas that have still to be elucidated. That EMF occurs in Europeans who have lived in the tropics is undoubted, but the absence of right ventricular involvement in Europeans in the tropics, but not in temperate climes, is unexplained; perhaps it is a chance finding. It is also apparent that the extreme degrees of right ventricular EMF that are commonly seen in the tropics, with almost complete obliteration of the ventricular cavity are not usually seen in eosinophilic EMF in temperate areas. Involvement of both ventricles and of both atrioventricular valves is, however, common both in the tropics and in temperate climate EMF.
A case of insulinoma with peripheral neuropathy
Authors: Jayasinghe K S A , Nimalasuriya A , Dharmadasa K 
Published: December 2008

Summary
A 25-year-old woman with chronic neuropsychiatric symptoms, peripheral neuropathy and hypoglycaemia was found to have an islet cell adenoma in the pancreas. Her neuropsychiatric symptoms disappeared following its removal and she partially recovered from her peripheral neuropathy.
The lymphomas—current management
Authors: Lister T A , Malpas J S 
Published: December 2008

Summary
The malignant lymphomas are an heterogeneous group of diseases, manifest most frequently by the development of painless lymphadenopathy with or without splenomegaly and sometimes associated with constitutional symptoms. The natural history of these conditions is one of progressive increase in lymphadenopathy, both in terms of size and the number of sites, with death occurring from intercurrent infection or as a consequence of compression of a vital organ by lymph nodes. Spontaneous regression, although it has been reported, is very rare. The rate of progression, and the specific sites most frequently involved, vary with the specific subtype of lymphoma in question. Happily, the natural history is rarely observed nowadays since treatment is available which may cure a significant proportion of patients and be of very considerable palliative benefit to others. Their importance to the physician lies in the fact that, as a group, they are the seventh commonest malignancy in the United Kingdom, they afflict a relatively young population and have become potentially curable.
Efficacy and side effects of mianserin, a tetracyclic antidepressant
Authors: Wakeling A 
Published: December 2008

Summary
Antidepressant drugs have been in extensive use for over 20 years. Initially 2 groups of compounds, the monoamine oxidase inhibitors (MAOI) and tricyclic compounds based on the imipramine configuration were widely used. In the early 1960’s after a few years of wide use, interest in the MAOI group fell following the recognition of a serious adverse effect. Blackwell (1963) described the occurrence of hypertensive crisis with occasional fatalities when these compounds were taken with certain foodstuffs. It is of interest, however, that in recent years there has been some resurgence of interest in these compounds and the suggestion that their dangers may have been exaggerated (Tyrer, 1979) or might be ameliorated by combination with tricyclics (Pare et al., 1982). Interest in the tricyclic group however has continued unabated and over the years at least 20 antidepressants based on the original imipramine configuration have been produced. There is now a widespread and extensive accumulated experience of these compounds and although they remain the most widely prescribed antidepressant, it is now clear that they have a number of serious disadvantages. The most important of these are cardiotoxicity, potential fatality in overdose, marked peripheral anticholinergic activity and reduction in seizure threshold (Blackwell, 1981a). As these disadvantages exist to some extent with all the tricyclics produced so far, there have, not surprisingly, been active attempts to produce different and safer antidepressant compounds.
Cryosurgery in the treatment of rectal carcinoma
Authors: Lambrianides A L , Ghilchik M W 
Published: December 2008

Summary
Four patients with adenocarcinoma of the rectum were treated by cryosurgery. In all cases there was considerable improvement in local symptomatology following treatment, although in 2 patients troublesome complications were encountered following application of the cryoprobe. All 4 patients are alive at 2 years.
Hypertrophic osteoarthropathy: two unusual causes
Authors: Barber P V , Lechler R 
Published: December 2008

Summary
Two patients with hypertrophic osteoarthropathy of unusual aetiology are described. The first patient developed the condition in association with oesophageal carcinoma and the second as a complication of active pulmonary tuberculosis. In the second case, substantial resorption of new bone was seen following treatment.
Kaposi’s sarcoma associated with hairy cell leukaemia
Authors: De Cock K M , Lucas S B , Gichuyia N R , Kasili E G , Radia K , Wankya B M 
Published: December 2008

Summary
The case is described of a patient with hairy cell leukaemia who later developed Kaposi’s sarcoma. This association has not been reported before and the coexistence of hairy cell leukaemia with another tumour is very rare. The implications of this unusual association are briefly discussed.
Reversible diminished insulin requirement during acute renal failure
Authors: Naschitz Johanan E , Barak Carmella , Yeshurun Daniel 
Published: December 2008

Summary
Very little is known concerning insulin requirements in diabetic patients who develop acute renal failure, although decrease in daily insulin requirement in patients with chronic renal failure is recognized.
A 46-year-old diabetic patient is described, whose daily insulin requirement decreased from 56 to 8 units per day during an episode of acute post-streptococcal glomerulonephritis causing acute reversible renal failure. The insulin requirement returned to its previous level after the patient recovered.
Spontaneous abortion and diabetes mellitus
Authors: Wright Alexander D , Nicholson Hamish O , Pollock Andrew , Taylor Kenneth G , Betts Susan 
Published: December 2008

Summary
In 58 consecutive pregnancies in insulin-dependent diabetic women, glycosylated haemoglobin levels were abnormally high in 78% at the time of booking for antenatal care.
Spontaneous abortion was the outcome in 15 pregnancies, 10 occurring before the 15th week of gestation. Glycosylated haemoglobin levels were significantly higher in those women who aborted spontaneously than in women who delivered successfully (12.8 +/- 1.8% v. 11.2 +/- 2.3%, mean +/- s.d.). These results emphasise the inadequacy of diabetic control in the first trimester and lend further support to the importance of good control at this critical time in insulin-dependent diabetes.
Haemoperitoneum from benign ileal leiomyoma
Authors: Tasker D Gordon 
Published: December 2008

Summary
Intraluminal gastrointestinal haemorrhage is a common feature of benign leiomyoma of the small bowel. A case is reported of an ileal leiomyoma which caused free intraperitoneal haemorrhage. It is believed that such an occurrence has not been reported previously.
Reno-vascular disease in polycythaemia rubra vera
Authors: Biggs Beverley , Anderton J L 
Published: December 2008

Summary
Hypertension and polycythaemia rubra vera commonly occur in the same patient. This is regarded as coincidence and the hypertension does not respond to correction of polycythaemia. We report a case of renal artery stenosis occurring simultaneously with polycythaemia rubra vera and suggest that renovascular occlusive disease should be excluded in such patients with refractory hypertension.
Vaginal vein thrombosis in pregnancy
Authors: Gitstein S , Ballas S , Peyser M R 
Published: December 2008

Summary
Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage.
The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly described. Surgical management is suggested as being both simple and effective.
An unusual late sequel to hysterectomy
Authors: Hertzanu Yancu , Hurwitz Julius 
Published: December 2008

Summary
A case is reported of a large infected foreign body granuloma associated with a retained non-opaque swab presenting 9 years after hysterectomy. An abdominal radiography and whole body computed tomography (CT) scanning demonstrated gas collections in a large abdominal mass. The case underlines the necessity for using radioopaque swabs in all surgical operations.
Trigeminal neuralgia—earlier referral for surgery
Authors: Garvan Neil J , Siegfried Jean 
Published: December 2008

Summary
Patients with trigeminal neuralgia may be treated in many ways before referral for definitive surgery. This aspect has been looked at in a group of 140 consecutive patients. Patients on prolonged medication have been studied with respect to the period over which the pain occurred and the amount of carbamazepine taken. Earlier referral for surgery is recommended for some of these patients and guidelines are given.
Diabetic ketoacidosis associated with outpatient treatment using continuous subcutaneous insulin infusion
Authors: Boulton A J M , Knight G , Drury J , Ward J D 
Published: December 2008

Summary
The occurrence of ketoacidosis in out-patient diabetics treated with continuous subcutaneous insulin infusion (CSII) has received little attention. We report two such cases of ketosis, each precipitated by infection and occurring in patients previously well controlled on CSII. This report illustrates that the risk of ketoacidosis is ever present in insulin-treated patients, whether the insulin is infused by pump or injected intermittently.
Severe ulcerative colitis during successful pregnancy
Authors: Greenfield C , Pounder R E , Craft I L , Lewis A A M 
Published: December 2008

Summary
A 31-year-old patient presented with fulminant colitis during the 27th week of her first pregnancy. Despite failed medical treatment, colectomy was delayed because of the gravid uterus. A healthy child was delivered at 32 weeks by caesarian section, but a postoperative ileus appeared to induce transient colonic dilatation. A colectomy was performed 10 days post-partum. Both mother and child survived.
Fenoterol versus salbutamol nebulization in asthma
Authors: Hockley B , Johnson N McI 
Published: December 2008

Summary
A double-blind crossover study was conducted in 10 stable asthmatics comparing 5 mg fenoterol with 5 mg salbutamol, both given via a Hudson nebulizer. Although both drugs caused significant bronchodilatation at the doses used, fenoterol had a significantly greater peak effect than salbutamol and its duration of action was 4 hr as opposed to 3 hr.
Extreme metabolic alkalosis with fludrocortisone therapy
Authors: Burns A , Brown T M , Semple P 
Published: December 2008

Summary
We present an unusual case of extreme metabolic alkalosis resulting from severe hypokalaemia caused by unmonitored fludrocortisone therapy. Biochemical aspects of the disorder are discussed, as is the successful treatment with diuretics and potassium replacement. Some dangers of this therapy and necessary precautions are emphasized.
Tetany and osteolysis in light chain myeloma with amyloidosis
Authors: Bhakri H L , Cundy T F , Pettingale K W 
Published: December 2008

Summary
A patient is described with light chain myeloma and amyloidosis in whom 2 unusual complications occurred, diffuse osteolytic lesions and tetany. These observations extend the previously recognized clinical spectrum of this disorder.
Fistulating duodenal diverticulum with associated vitamin B12 deficiency
Authors: Hughes Stephen , Marsh Michael N 
Published: December 2008

Summary
A 72-year-old man with severe megaloblastic anaemia due to a benign duodeno-colic fistula originating from an antimesenteric duodenal diverticulum is described. Previous reports of fistulae from duodenal diverticula are reviewed.
Hemifacial spasm in tuberculous meningitis
Authors: Sandyk R 
Published: December 2008

Summary
Hemifacial spasm developed in a 47-year-old man with tuberculous meningitis. The spasms ceased completely following vigorous antituberculous treatment. A selective compression of the facial nerve root along its exit at the brainstem by a localised inflammatory process is the most tenable explanation for the development of the hemifacial spasm.
Exercise-induced urticaria and angio-oedema with relief from cromoglycate insufflation
Authors: Hatty S , Mufti G J , Hamblin T J 
Published: December 2008

Summary
The pathogenesis of physical urticarias is unknown and the treatment is often difficult and unsatisfactory. A patient with severe exercise-induced angio-oedema and urticaria is reported who responded dramatically to cromoglycate by insufflation and not when treated with orally active cromoglycate.
Gammaglobulin therapy in burn management with a report on the treatment of a 5-year-old burn victim
Authors: Watkins John , Appleyard Neil 
Published: December 2008

Summary
This communication reviewed briefly the immunological problems of the burn patient and the frequent complication of septicaemia. Antibiotic therapy alone is not sufficient. There is a case for boosting the patient’s natural immunity. Attempts to do so have been reported in the literature over the last 20 years and involve either infusion of exogenous immunoglobulin (IgG) or vaccination. Problems of the former ‘passive’ therapy largely involve transfusion reactions but this has been solved by enzymatic modification of the native IgG molecule to reduce its antigenicity. One such product, Gamma-Veinine, is available from the Behring Institute, Marburg.
Introduction
Authors: Beevers D G 
Published: December 2008

Summary
There is an increasing awareness of the importance of ethnic factors in the pathogenesis, clinical features and treatment of many diseases (Donaldson and Taylor, 1983). This topic was the subject of a multidisciplinary conference held at the Birmingham Medical Institute in November 1982, and the present issue of the Postgraduate Medical Journal constitutes the conference proceedings. The proceedings of the first Birmingham Conference were published in the Journal in December 1981 (Vol. 57, pp. 747–792).
Ethnic differences in peak expiratory flow rate in Birmingham factory workers
Authors: Jackson S H D , Beevers D G , Cruickshank J K , Bannan L T 
Published: December 2008

Summary
Among 698 Birmingham factory workers, Asian men (n = 75) tended to have lower peak expiratory flow rates (PEFR) than black (n = 156) or white (n = 138) men when age, height and smoking habits were accounted for. This trend reached statistical significance in Asian females (n = 20), despite a small sample size. There were no significant differences in PEFR between blacks and whites of either sex.
Malignant pleural mesothelioma at St Mary’s Hospital, Portsmouth—a review of 29 fatal cases
Authors: Harrison R N , Hibberd S C , Dadds J H 
Published: December 2008

Summary
The clinical details are presented of 29 fatal cases of pleural mesothelioma in the majority of which there was a history of exposure to asbestos during dockyard work in Portsmouth. Chest pain, breathlessness and weight loss dominated the clinical picture. Analgesia and repeated pleural aspirations provided temporary relief but symptoms invariably progressed. The mean survival time was 39 weeks. Only one patient survived longer than 2 years from hospital presentation. At autopsy, extensive local spread was usual but a high proportion of patients also had metastases at distant sites.
Pulmonary involvement in angio-immunoblastic lymphadenopathy
Authors: Price D , Dent Richard G 
Published: December 2008

Summary
Two patients are described who complained of dyspnoea and systemic symptoms. They were found to have angio-immunoblastic lymphadenopathy with extensive pulmonary involvement. In both cases, high dose corticosteroid therapy led to relief of symptoms and clearing of the diffuse radiographic shadowing seen in both lung fields.
Pitfalls in the diagnosis of asthma
Authors: Hetzel M R 
Published: December 2008

Summary
Asthma is a common disease which affects at least 2% of the British population (Gregg, 1977). The last two decades have seen major advances in safe treatment with regular inhalation of sodium cromoglycate, selective beta2 stimulant drugs (salbutamol, terbutaline etc.) or beclomethasone. For the majority of asthmatics, these drugs can achieve excellent control and allow the patient to lead a normal life even if treatment with oral corticosteroids is also required. It is therefore depressing to note that there is, as yet, little evidence of a significant improvement in asthma mortality. A recent survey (British Thoracic Association, 1982) reported a mortality rate of 1·84 per 100,000, which indicates no real improvement on rates of 0·46-1·34 per 100,000 reported over the last century by Speizer and Doll (1968). Several recent studies of asthma mortality (Cochrane and Clark, 1975; Ormerod and Stableforth, 1980; British Thoracic Association, 1982) have highlighted two consistent problems; failure to diagnose and assess the severity of asthma by using simple respiratory function tests and, as a result, failure to implement adequate treatment. In this article, I would like to remind the reader of some of the more important pitfalls in the diagnosis of asthma.
Erythema nodosum progressing to pyoderma gangrenosum as a complication of Crohn’s disease
Authors: Gellert A , Green E S , Beck E R , Ridley C M 
Published: December 2008

Summary
Erythema nodosum occurs more frequently than pyoderma gangrenosum in Crohn’s disease. We report the occurrence of both lesions in a woman with Crohn’s disease and the transformation of one to the other. Pyoderma gangrenosum has been described at the site of previous trauma in Crohn’s disease and at the site of other skin conditions in other circumstances, but, to the best of our knowledge, actual progression from erythema nodosum to pyoderma gangrenosum has been reported on only one previous occasion in Crohn’s disease.
Bilateral retinal detachment in a case of Reiter’s disease
Authors: Belcon Michael C. , Bensen William G. , Zahoruk Ronald M. 
Published: December 2008

Summary
A patient is described who developed co-existent Reiter’s disease and bilateral non-traumatic retinal detachment. Although numerous ophthalmological disorders are associated with Reiter’s disease and HLA-B27, to our knowledge this is the first report of co-existent retinal detachment. Although this relationship may be fortuitous, there are a number of immunological mechanisms common to both entities. Retinal detachment, unlike bilateral conjunctivitis and acute anterior uveitis, may be clinically asymptomatic and its sequelae prevented by appropriate ophthalmological assessment.
Immune complex mediated lung haemorrhage and nephritis—successful treatment with plasma exchange, haemodialysis and immunosuppressive drug therapy
Authors: Drew P. J. , Newland A. C. , Marsh F. P. 
Published: December 2008

Summary
A 16-year-old boy developed an immune complex illness associated with lung haemorrhage, proliferative nephritis with crescents and renal failure. Treatment with plasma exchange, haemodialysis and immunosuppressive drugs resulted in a rapid reduction in levels of immune complexes and other mediators of inflammation and was associated with good recovery of renal and lung function. Subsequently, deterioration in renal function occurred whilst the patient was on treatment with prednisolone alone but this was reversed with a short course of plasma exchange and the addition of azathioprine. No further deterioration in renal or lung function has been observed during 18 months treatment with azathioprine and prednisolone.
Immediate plasma exchange and immunosuppressive drug treatment have been recommended for Goodpasture’s syndrome. Immune complex mediated lung haemorrhage and nephritis is the main clinical differential diagnosis. Our case suggests that the same treatment is effective for both conditions if given early, and that detailed renal and immunological investigations should not be allowed to delay this.
Spontaneous rupture of distal oesophagus (Boerhaave’s syndrome) with unusual clinical presentation of pneumoperitoneum
Authors: Witz M. , Jedeikin R. , ZagerM  , Shpitz B. , Elyashiv A. , Dinbar A. 
Published: December 2008

Summary
We present a case of spontaneous rupture of the distal oesophagus that was accompanied by a pneumoperitoneum and was successfully treated surgically.
Hemipelvectomy for liposarcoma: an unusual case and course
Authors: Deutsch Alexander A. , Bachar A. , Reiss R. 
Published: December 2008

Summary
A patient with liposarcoma of the upper thigh and pelvis treated by hemipelvectomy is described. Preoperative treatment with radiotherapy and chemotherapy induced regression and necrosis of the growth. The treatment of this tumour is discussed as well as the possibility that the pre-operative therapy converted an inoperable tumour into an operable one.
Prolonged coma and delayed peripheral neuropathy after ingestion of phenoxyacetic acid weedkillers
Authors: O’Reilly John F. 
Published: December 2008

Summary
A case of prolonged coma and delayed peripheral neuropathy is reported following self-poisoning with a widely available domestic weedkiller containing phenoxyacetic acids. Attention is drawn to the potential toxicity of these weedkillers which may be delayed in onset, and to the possibility of spontaneous recovery from neurological abnormalities which may be severe and prolonged or late in onset.