bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-dose insulin treatment of hyperosmolar diabetic coma
Authors: Wright A D , Walsh C H , Fitzgerald M G , Malins J M 
Published: December 2008

Summary
The effect of low-dose hourly i.m. injections of insulin has been studied in the treatment of 17 episodes of hyperosmolar non-ketoacidotic diabetic coma compared with 26 episode of hyperosmolar ketoacidosis occurring in patients over 40 years of age. The fall in blood sugar was satisfactory in the majority of episodes of both types of coma and there was no evidence that patients with hyperosmolar non-ketoacidotic coma were more sensitive to insulin. The excess mortality in the non-ketotic group (47%) compared with the ketoacidotic group (16%) was not due to uncontrolled diabetes.
Carcinoma of the oesophagus associated with membrano-proliferative glomerulonephritis
Authors: Walker J F , O’Neil S , Campbell E , Browne O , Doyle G , Carmody M , O’Dwyer W F 
Published: December 2008

Summary
Nephrotic syndrome has been observed in association with different types of neoplasia. This appears to be the first report of the occurrence of the nephrotic syndrome due to membrano proliferative glomerulonephritis in association with carcinoma of the oesophagus. Although proteinuria was present before excision of the tumour, the nephrotic phase occurred subsequently. Eventually it disappeared leaving the patient with a clear urine and biochemical and histological improvement of the renal lesion (including immunofluorescent and electronmicroscopy studies). Possible mechanisms responsible for the nephrotic syndrome in this case are discussed.
Transient cerebral ischaemic attacks related to egg consumption
Authors: Ellis M E , Stevens David L 
Published: December 2008

Summary
A 58-year-old man is described who suffered transient cerebral ischaemic attacks when on a diet containing a large number of eggs. When the egg content and, therefore, the cholesterol content of the diet was reduced the attacks stopped. It was concluded that the variations in his cholesterol intake and in his serum cholesterol, which remained normal or near normal throughout, are relevant to the aetiology of his episodes of cerebral ischaemia and that further study of techniques designed to alter the cholesterol intake and the cholesterol level in patients with such attacks may be useful.
Subdural abscess secondary to covert dental sepsis
Authors: Sprott Mae S , Hall K , Newman P K , Welbury R R , Ingham H R 
Published: December 2008

Summary
The bacterial flora of a subdural abscess in a 17-year-old male, with radiological evidence of unilateral infection of the maxillary and frontal air sinuses, was typical of that encountered in the dental sulcus. Extensive examination revealed no primary focus of infection other than apical infection in the 2 upper first molar teeth, which were extracted. Treatment with ampicillin, gentamicin and metronidazole rapidly controlled the subdural infection, and resolution, as evidenced by computerized tomography, was complete at 10 months.
Distal pancreatectomy for spontaneous rupture of the splenic artery
Authors: Porter J M , Fenton O M 
Published: December 2008

Summary
Two patients with haemoperitoneum due to spontaneous haemorrhage near the tail of the pancreas are described. One patient presented acutely with epigastric pain and was found to be bleeding from the main trunk of the splenic artery. The other presented with a prolonged history of epigastric pain culminating in a haematemesis and was found to have a partially organized haematoma in the tail of the pancreas. In both cases the bleeding was proximal to the splenic pedicle, and distal pancreatectomy with splenectomy was necessary to achieve haemostasis.
Reversible IgA deficiency in hypothyroidism
Authors: Eriksson Sten 
Published: December 2008

Summary
A 50-year-old woman developed pronounced IgA-deficiency and hypothyroidism after 131I treatment for Graves’ disease. The deficiency state was associated with a severe sinobronchial syndrome. Treatment with L-thyroxine resulted in a normal IgA concentration and a dramatic clinical improvement. Of the various possible underlying mechanisms, impaired synthesis of IgA light and heavy light chains seemed most probable. Impaired production of J-chain was excluded.
Paroxysmal nocturnal haemoglobinuria with renal, infective and immunological abnormalities
Authors: Botelho R J , Sainsbury R , Ebrahim S B J , Bendall M J 
Published: December 2008

SummaryAn elderly woman presented with paroxysmal nocturnal haemoglobinuria complicated by renal failure which was almost completely reversible. The illness was further complicated by a transient cerebral ischaemic attack and a chest infection with septicaemia due to Pseudomonas aeruginosa from which she died.
Age, sex, ethnic origin and hospital admission for heart attack and stroke
Authors: Beevers D G , Cruickshank J K 
Published: December 2008

Summary
The frequency of admission for heart attack and stroke in blacks, whites and Asians to Dudley Road Hospital, Birmingham, was studied. The study population (denominator) was 17 739 consecutive admissions to this hospital for the years 1975 to 1979, in 35- to 64-year-old men and women. Admission for heart attack was half as common in blacks compared with whites and, in some age groups, there was a slightly increased rate in Asians. By contrast, in both sexes and in all age groups, stroke admission was commoner in blacks. These differences cannot be explained by differing levels of blood pressure or cigarette smoking in the 3 ethnic groups.
Familial multiple myeloma. A review of thirty-seven families
Authors: Shoenfeld Y , Berliner S , Shaklai M , Gallant L A , Pinkhas J 
Published: December 2008

AbstractThe review of the pertinent literature disclosed 36 reports of familial multiple myeloma, described mostly in siblings, to which the authors add one more family. These patients did not differ significantly from those with non-familial myeloma with regard to sex, age, distribution of monoclonal proteins, clinical and laboratory data, and the course and prognosis of the disease. An increased incidence of immunoglobulin abnormalities was observed in healthy relatives of patients affected with familial myeloma. In most cases the time interval of the diagnosis of myeloma in a family member of a known patient was under 4 years. These observations, in conjunction with reports of myeloma occurring in clusters in a community and the appearance of myeloma in spouses raise the possibility of an environmental factor (virus?) which may contribute to the pathogenesis of myeloma in genetically predisposed individuals. Multiple myeloma should be added to the list of neoplastic diseases in which the family history is relevant and in which genetic and possibly environmental factors may be pathogenetically involved.
A comparison of antrafenine and aspirin on platelet aggregation and frusemide-induced diuresis
Authors: Hassan S M , Olivesi A , Fish A , Turner P 
Published: December 2008

Abstract
The effects of antrafenine were compared with aspirin and placebo on platelet aggregation and on the diuretic action of frusemide in normal volunteers. Aspirin significantly reduced platelet aggregation at 3 and 6 hr after administration, but antrafenine only at 3 hr. Only aspirin significantly reduced the increase in urine sodium and potassium produced by frusemide.
Osteoradionecrosis of the skull stimulating bone metastases
Authors: Kaplinsky N , Pines A , Tadmor R , Frankl O 
Published: December 2008

Abstract
Multiple skull erosions which simulated bone mestatases developed in a 54-year-old patient who had been treated for favus by radiotherapy 40 years earlier. Radiation necrosis should be recognized and differentiated from defects and erosions due to malignant or infectious process in order to prevent unnecessary procedures and treatment.
The clinical course of acute type A hepatitis in chronic HBsAg carriers—a report of 3 cases
Authors: Viola L A , Coleman J C , Barrison I G , Murray-Lyon I M 
Published: December 2008

Abstract
The clinical, virological, and biochemical course of 3 chronic HBsAg carriers who developed acute hepatitis A is described. Two of the patients had pre-existent chronic active hepatitis. The clinical course in each case was benign with resolution within one month, and there was a marked fall in HBsAg titre in one of the patients with chronic active hepatitis.
Cerebral aneurysm presenting with epilepsy
Authors: McCulloch David K , Ashworth Bryan 
Published: December 2008

Abstract
Two patients with cerebral aneurysm are reported. Both presented with temporal lobe epileptic attacks. In one of the patients there was a family history of aneurysm and cerebral haemorrhage. One aneurysm was recognized by calcification on a plain radiograph but could not be demonstrated by angiography during life. The aneurysms were large and originated from the middle cerebral artery. Previous reports are reviewed. Difficulties of diagnosis and prognosis are discussed.
Haemoperitoneum caused by a dissecting aneurysm of the left gastroepiploic artery
Authors: Gibb William R G , Archer Timothy J , van der Walt Jon D 
Published: December 2008

Abstract
A dissecting aneurysm of the left gastro-epiploic artery in a 79-year-old woman ruptured spontaneously into the peritoneal cavity. The insidious onset and the later progression to shock is discussed with relevance to the likely diagnoses. At laparotomy the aneurysm was excised.
Hypokalaemic myopathy following ileal resection
Authors: Lawrence Clifford 
Published: December 2008

Abstract
A patient developed an acute hypokalaemic myopathy due to persistent diarrhoea 4 months after a resection of ileum and a right hemicolectomy for carcinoma of the colon. The need for potassium supplements in the management of chronic diarrhoea following ileal resection is emphasized and the method of potassium replacement discussed.
Sleep apnoea occurring only in REM (possible relevance of the case for some cot deaths)
Authors: Beary M D , Crutchfield M B , Mintram M K , Crisp A H 
Published: December 2008

Summary
A case of sleep apnoea occurring only within REM sleep in a 57-year-old man is described. It was successfully treated with clomipramine for a period. The patient probably had persistent phrenic nerve damage which accounted for, or contributed to, the phenomenon. It is suggested that this mechanism may operate in some cot deaths.
Symptoms and diagnostic delay in patients with carcinoma of oesophagus and gastric cardia: a retrospective study of 225 patients
Authors: Ojala K , Sorri M , Jokinen K , Kairaluoma M I 
Published: December 2008

SummaryA retrospective review of 225 patients was made with regard to the symptoms of carcinoma of the oesophagus and gastric cardia, and the duration of the symptoms before medical attention was sought and before the establishment of the diagnosis. The age of the patients was 37-84 (mean 62·5) years (139 male, 86 female). The most common symptoms were dysphagia (93%), loss of weight (46%), vomiting (33%), gastric pain (25%) and thoracic pain (21%).The average duration of the symptoms before the establishment of the diagnosis was 4·1 months in carcinoma of the oesophagus and 4·3 months in carcinoma of the gastric cardia. The patients with oesophageal disease had sought medical attention on average 5 weeks earlier than those with gastric disease. The role of the physician who initially examines the patient is decisive for early diagnosis.
Nodular purpura in infancy
Authors: Nagi N A , Al-Dubooni H M , Al-Shirkat S A R 
Published: December 2008

SummarySeventeen infants with nodular purpura are reported. All these infants suffered from a coagulation abnormality due to vitamin K deficiency. Contributing factors were breast-feeding, the use of milk substitutes, diarrhoea and antimicrobial therapy. The patients responded rapidly and completely to parenteral vitamin K. In the management of infantile diarrhoea use of antibiotics should be restricted to specific bacteriologically proven cases.Vitamin K administration is suggested in infants with prolonged gastroenteritis and limited milk intake and particularly those receiving antibiotics.
Gastric ulcer healing by cimetidine in non-Hodgkin’s lymphoma of the stomach
Authors: Bendall M J , Sainsbury R 
Published: December 2008

Summary
A man presented with what appeared clinically and histologically to be a benign gastric ulcer which healed with cimetidine. His condition subsequently deteriorated and a further endoscopy revealed a huge tumour in the body of the stomach with the histological appearances of non-Hodgkin’s lymphoma. The presentation of non-Hodgkin’s lymphoma in the elderly is discussed, together with the problem of gastriculcer healing by cimetidine in the presence of underlying malignancy.
Maternal blood glucose control and outcome of diabetic pregnancy
Authors: Wright A D , Nicholson H O , Taylor K G , Insley J , Evans S E 
Published: December 2008

Summary
The results of management of 128 consecutive pregnancies occuring in diabetic patients who received insulin from before conception and throughout pregnancy are described. Mean maternal blood glucose levels were at least 1 mmol/litre greater than levels reported in normal pregnancy. Thirty-nine percent of the neonates had significant morbidity; respiratory distress syndrome (7·7%), hypocalcaemia (4·6%) and polycythaemia (10%) could be related to higher maternal blood glucose levels. Neonatal hypoglycaemia (9·2%), hyperbilirubinaemia (13·8%) and birth weight corrected for gestational age were not directly related to maternal blood glucose. This degree of maternal blood glucose control has reduced the large for dates infants (greater than 90th centile for gestational age) to 7%. Further reduction in the morbidity of infants of diabetic mothers requires studies of physiological maternal blood glucose levels which may not be possible with conventional insulin treatment as well as further efforts to reduce prematurity.
Limited joint mobility in Type I diabetes mellitus
Authors: Kennedy Laurence , Archer Desmond B , Campbell Sarah L , Beacom Rosalind , Carson Dennis J , Johnston Patrick B , Maguire Charles J 
Published: December 2008

Summary
Forty-two of 115 patients with Type I (insulin dependent) diabetes were found to have limited joint mobility affecting mainly the small joints of the hands. The presence of joint abnormalities was related to duration of diabetes. Patients with limited joint mobility had a significantly higher incidence of proliferative retinopathy than patients with normal joint mobility and a similar duration of diabetes (P&lt;0·001). Limited joint mobility appears to be an early marker for the development of microvascular complications in diabetes.
The glucagon test in obstructive and hepatocellular jaundice
Authors: Berstock David A , Wood John R , Williams Roger 
Published: December 2008

Summary
The plasma glucose response to an intravenous bolus of glucagon was examined in patients with obstructive jaundice, hepatocellular jaundice and in healthy volunteers. Plasma glucose levels were determined before and at 15, 30 and 45 min after glucagon. The glucose response to glucagon differed markedly in the two patient groups with significantly higher plasma glucose values in the obstructive jaundice group.
Measurement of blood glucose after intravenous glucagon provides a simple test to assist in the differential diagnosis of obstructive and hepatocellular jaundice.
Clinical and biochemical effects of parachlorophenylalanine in a patient with the carcinoid syndrome
Authors: Bax N D S , Woods H F , Boulton A J M , Green A R 
Published: December 2008

SummaryThe clinical and biochemical features of a patient with flushing and severe diarrhoea due to the carcinoid syndrome are described. The patient had a paradoxical response to the tryptophan hydroxylase inhibitor parachlorophenylalanine with complete abolition of flushing and no effect on the diarrhoea. Treatment with this drug was limited by adverse effects.
Extrapyramidal and cerebellar syndrome with encephalopathy associated with cimetidine
Authors: Handler Clive E , Besse Christopher P , Wilson Adrian O 
Published: December 2008

Summary
A possible case of cimetidine induced extrapyramidal and cerebellar features is reported. Although confusion is a well recognized toxic effect of cimetidine, other neurotoxic features are less common, especially in patients without evidence of renal or hepatic disease. Cimetidine should be used with great care and possibly in a reduced dose in the elderly as neuropsychiatric side effects may occur.
Bacteroides meningitis complicating chronic mastoiditis
Authors: Siegler D , Faiers M C , Willis A T 
Published: December 2008

Summary
A 70-year-old man with a history of chronic middle and external ear suppuration presenting with acute meningitis due to Bacteroides uniformis is described. Anaerobic organisms including Bacteroides species were cultured from the affected external auditory meatus. Administration of metronidazole led to complete clinical recovery and a cholesteatoma was subsequently surgically evacuated. Chronic suppuration in the middle ear and paranasal sinuses is the commonest primary cause of cerebral abscess and in this setting meningitis is associated with a particularly high mortality. The major role of anaerobic sepsis in otolaryngological practice is well established. Metronidazole is the chemotherapeutic agent of choice.
Fatal late-onset group B streptococcal sepsis on a special care baby unit
Authors: Hastings M J G , Rivers R P A , Easmon C S F 
Published: December 2008

SummaryA 3-week-old preterm baby developed late-onset group B streptococcal sepsis and died, despite therapy with penicillin, granulocyte transfusions and fresh frozen plasma. Serotyping and phage typing results strongly suggested late acquisition of the organism from the mother. The baby had previously developed and recovered from an Escherichia coli bacteraemia.
Ptosis in systemic lupus erythematosus
Authors: Lanham John G , Elkon Keith B , Hughes Graham R V 
Published: December 2008

Summary
Mild unilateral ptosis was observed in 11 women with systemic lupus erythematosus. It was associated with active disease in 8 patients, but only 2 had overt cerebral involvement. Isolated ptosis should not therefore be regarded as an indication of cerebral lupus.
Patients presenting with Addison’s disease need not be pigmented
Authors: Barnett A H , Espiner E A , Donald R A 
Published: December 2008

Summary
Three consecutive cases of Addison’s disease without increased pigmentation are described. We suggest that the absence of this important physical sign contributed to serious delays in diagnosis and markedly increased morbidity. We emphasize that, despite the usual textbook description, excess pigmentation is not necessarily a feature of Addison’s disease.
Pseudomembranous colitis following cephradine prophylaxis
Authors: Sankarankutty M , McGeorge D , Galasko C S B 
Published: December 2008

Summary
Two patients on antibiotic prophylaxis with cephradine after orthopaedic implant surgery developed pseudomembranous colitis. Routine administration of antibiotics after such surgery is the policy at many centres. Development of diarrhoea in these patients should be viewed seriously lest this condition is overlooked. Despite recent advances, pseudomembranous colitis can still have a fatal outcome.
Neurological aspects of hyponatraemia
Authors: Daggett Peter , Deanfield John , Moss Fiona 
Published: December 2008

Summary
Hyponatraemia is a common biochemical finding, but clinical features due to it are infrequent. They are most likely to occur when the plasma sodium concentration has fallen quickly to below 120 mmol/litre. In a study of 73 hyponatraemic individuals, it was possible to identify four categories of patient, the clinical features becoming more severe as the sodium level fell. In 25 instances there were no effects (mean plasma sodium 118\u00b73 mmol/litre), in a further 25 cases there was confusion only (mean plasma sodium 117\u00b71 mmol/litre), in 13 there were focal neurological signs and in 10 there were convulsions (mean plasma sodium 110\u00b78 mmol/litre). In the group with convulsions there were six deaths, the four survivors all being young women. The 13 cases of \u2018focal\u2019 neurological signs included three instances each of hemiparesis and monoparesis, seven of extra-pyramidal disturbance and six of cerebellar ataxia. All these abnormalities resolved when the plasma sodium concentration rose to 125 mmol/litre.
Active measures to raise the plasma sodium level are only needed when there have been convulsions and the aim should be to achieve a value no higher than 120 mmol/litre. In other cases, the only treatment required is to restrict fluid intake.
Bone and joint tuberculosis: phthisis changes course
Authors: Gawkrodger David J , Cole R B 
Published: December 2008

Summary
Eighteen cases of bone and joint tuberculosis occurred in North Staffordshire between 1976 and 1980. The immigrant population is small and the disease was commonest in whites over 60 years old. There were only three cases of spinal tuberculosis. A lack of uniformity was found in the chemotherapeutic regimens used.
The incidence of the dumping syndrome following gastrojejunostomy with Roux-en-y anastomosis
Authors: Cade Richard J , Kilby John O 
Published: December 2008

Summary
A clinical study was undertaken to determine the incidence of the dumping syndrome following partial gastrectomy and Roux-en-y gastrojejunostomy. Twenty-three patients were scored according to a clinical diagnostic index. There were no dumpers identified. A theoretical explanation for these findings is offered. A Roux-en-y conversion should be considered for patients with disabling dumping symptoms following gastric surgery.
Hypothalamic-pituitary disease as the sole manifestation of sarcoidosis
Authors: Lawton F G , Beardwell C G , Shalet S M , Daws R A 
Published: December 2008

Summary
Hypothalamic-pituitary disease is a well-recognized, although uncommon, occurrence in sarcoidosis. Almost always the endocrine manifestations occur in a patient with widespread disease involving the lungs, skin or liver. A case is reported of central nervous system (CNS) sarcoidosis with no other clinical, biochemical or histological evidence of the disease.
Impaired ACTH and glucagon response to hypoglycaemia in an insulin-treated diabetic
Authors: Ohwovoriole A E , Bevan J , Nairn I M , Baird J D 
Published: December 2008

Summary
A 32-year-old woman who had been diabetic for 24 years presented with frequent, oligosymptomatic episodes of hypoglycaemia. Investigations showed that she had attenuated adrenocortical and pancreatic A-cell response to hypoglycaemia. Her plasma ACTH response to hypoglycaemia was also impaired but there was normal adrenocortical response to the injection of synthetic ACTH. Plasma glucagon response to intravenous arginine was also normal.
It is concluded that the blunted plasma cortisol response to insulin-induced hypoglycaemia in some long-standing diabetics is due to a pituitary or higher dysfunction, rather than adrenocortical dysfunction.
The Japanese plasma cell dyscrasia syndrome: case report and theory of pathogenesis
Authors: Tobin Martin J , FitzGerald Muiris X 
Published: December 2008

SummaryA 54-year-old man developed pigmentation, clubbing, weight loss, oedema, hepatomegaly, lymphadenopathy, cold intolerance, hypotonia and hyporeflexia. Dominant laboratory findings were increased marrow plasma cells with IgA lambda paraproteinaemia, hypothyroidism, hyperprolactinaemia, hyperoestrogenaemia and biopsy-proven peripheral neuropathy. The clinical features and dramatic response to corticosteroids are consistent with the syndrome of plasma cell dyscrasia, polyneuropathy and endocrinopathy found predominantly in Japan. In our patient, immunofluorescence of neural tissues revealed paraprotein deposition. Although the pathogenesis is unknown, these multisystemic features may result from antibody activity or tissue deposition of paraprotein. Furthermore, the endocrinopathy may be localized at the hypothalamic level.