bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nephrotic syndrome complicated by tubular dysfunction. Case report and review of possible mechanisms
Authors: Luder A S , Cohen S L , Fisher C 
Published: December 2008

Summary
A 35-year-old-man presented with nephrotic syndrome due to mesangiocapillary glomerulonephritis; he later developed a potassium-losing state, generalized amino aciduria and glycosuria. Clinical and biochemical improvement occurred after steroid therapy. The possible pathophysiological mechanisms are discussed.
Successful renal transplantation in primary hyperoxaluria
Authors: O’Regan P , Constable A R , Joekes A M , Kasidas G P , Rose G A 
Published: December 2008

Summary
A successful live related renal transplant in a 29-year-old male patient with Type 1 primary hyperoxaluria, who remains well 32 months postoperatively, is described. The plasma oxalate and exchangeable oxalate pool before transplantation were 160 mumol/1 and 4429 mumol respectively. Since the transplant these have been greatly reduced although they remain elevated above the normal by a factor of 2. Pyridoxine therapy and the avoidance of oxalate-rich foods have been effective in maintaining these reduced levels and the 24-hr urinary oxalate excretion has also been maintained close to normal levels on this regime. After review of the previously reported transplants in patients with well documented primary hyperoxaluria and from the experience with this patient, the following guidelines for successful renal transplantation in primary hyperoxaluria are suggested: transplants should only be carried out in those who have shown a response to adequate pyrodoxine therapy; frequent haemodialysis pre-operatively and during periods of oliguria postoperatively is necessary; oxalate-rich foods should be avoided and a high fluid intake should be maintained after transplantation. If these guidelines are followed there is no contra-indicatin to live related renal transplants in primary hyperoxaluric patients.
Isolated gastroduodenal Crohn’s disease in a ten-year-old girl
Authors: Malleson P 
Published: December 2008

Summary
The first case of a child with gastroduodenal Crohn’s disease and no other intestinal lesions is described. She presented with persistent anaemia and failure to thrive. There was megaloblastosis due to B12 deficiency secondary to absent intrinsic factor. The diagnosis was delayed for nearly 3 years andthen treatment with steroids and azathioprine resulted in rapid clinical improvement. The diagnostic possibility of Crohn’s disease in unusual sites should be considered in any child with unexplained failure to thrive.
Heparin, free fatty acids and an increased metabolic demand for oxygen
Authors: Jung R T , Shetty P S , James W P T 
Published: December 2008

SummaryObese and lean subjects were given heparin with or without Intralipid in order to assess the effect of heparin on plasma concentration of free fatty acids (FFA) and oxidative metabolism. The FFA response depended on the triglyceride concentration and was associated with a prompt rise in oxygen consumption. Plasma catecholamines did not alter after heparin and the increase in oxygen uptake was proportional to the rise in FFA. The use of heparin, therefore, has metabolic disadvantages which may outweigh the potential benefits, for example in the management of myocardial infarction where heparin may increase the metabolic demand on the heart by increasing FFA levels.
Primary meningitis caused by Bacteroides fragilis and Fusobacterium necrophorum
Authors: Islam A K M S , Shneerson J M 
Published: December 2008

Summary
A fatal case of meningitis due to Bacteroides fragilis and Fusobacterium necrophorum is reported. This appears to be the first case in which meningitis due to these organisms was not secondary to a disease elsewhere in the body. The organisms are difficult to culture and strict anaerobic methods should be used whenever they are suspected. Intravenous metronidazole is probably the antibiotic of choice.
The site of protein loss in Schönlein-Henoch purpura
Authors: Waller D G , Dalziel K L 
Published: December 2008

Summary
Schönlein-Henoch purpura may be complicated by hypoproteinaemia, which in most patients is due to the development of nephrotic syndrome. However, in some proteinuria is insignificant and enteric protein loss has been suggested as the cause. A case with supportive evidence for this is reported.
The hypereosinophilic syndrome—a diagnostic enigma
Authors: Ellul-Micallef R , Mohammed D E , Fenech F F 
Published: December 2008

Abstract
The hypereosinophilic syndrome groups together a number of conditions in which eosinophilia occurs for no apparently identifiable cause. Initial reports indicated a uniformly grave prognosis but recent observations suggest a more favourable outcome in certain cases. Two patients with hypereosinophilic syndrome are described whose course of disease and outcome have been completely different.
Prevention of coronary heart disease: the role of high density lipoproteins
Authors: Miller N E 
Published: December 2008

AbstractThere is now strong evidence that the risk of developing clinical coronary heart disease (CHD) in apparently healthy middle-aged men is inversely related to the plasma high density lipoprotein (HDL) cholesterol concentration. This reflects an underlying relationship between HDL cholesterol concentration and the severity of coronary atherosclerosis. This new information represents a significant development in atherosclerosis research. In the author’s opinion, however, it is not yet justifiable, or indeed possible, to utilize this knowledge in CHD prevention programmes for 3 reasons. Firstly, there is still little prospective information on HDL and CHD in women, in younger subjects and in patients with existing clinical disease. Secondly, although there are at least 2 working hypotheses, a causal relationship between HDL metabolism and atherogenesis has not yet been established. Thirdly, there is still a relative paucity of information on the environmental determinants of HDL concentration and metabolism. Thus, premature attempts at intervention in an uncontrolled manner, and particularly the use of drugs for an HDL-raising effect, might only confuse the issue. While further research is being undertaken, attention should continue to be directed towards other reversible coronary risk factors (including hypercholesterolaemia, hypertension, and cigarette smoking) in CHD prevention programmes.
Problems in implementing a good food and nutrition policy in Britain
Authors: James W P T 
Published: December 2008

Abstract
There is no co-ordinated food and nutrition policy in Britain, primarily because it is still not recognized that diet has an important role to play in the development of many diseases of affluence. The demand for absolute proof of the dietary component of disease on a population level ignores both the innate biological susceptibility in only a portion of the population to a particular nutrient as well as the increasing evidence from studies on non-human primates that diet plays a key role in several conditions including heart disease. Government remains unsure of how to implement its own current recommendations and the traditional paternalistic and conservative approach delays action. Vested interests, seeking only short-term gains, are not confined to industrial concerns. Marketing Boards are allowed almost unfettered freedom to promote nutritionally undesirable eating habits. Health education in schools remains inadequate with most of the involved teachers still promoting incorrect concepts. The medical profession is still unwilling to take a physician maintaining treatment programmes for marginal effects on a public health problem. General practitioners are better able to start practising preventive medicine but they need to be helped by community physicians who should begin on their main task of implementing policies for preventing disease rather than limiting themselves to their current preoccupation with systems analyses and operational research.
Incidence of Legionnaires’ disease in a district general hospital
Authors: Atkinson A R , White R J , Clarke S K , Blainey A D 
Published: December 2008

Abstract
In order to assess the incidence of Legionnaires’ disease in a district general hospital, 90 consecutive patients with pneumonia seen over a 3-year period were investigated. Only 2 patients were found to have Legionnaires’ disease, indicating that it is not a frequent cause of pneumonia in the Bristol area.
Bronchiectasis and Marfan’s syndrome
Authors: Foster M E , Foster D R 
Published: December 2008

Abstract
Marfan’s syndrome is a rare hereditary disorder characterized by skeletal, cardiovascular and ocular abnormalities. Pulmonary abnormalities occur in approximately 10% of patients the commonest being spontaneous pneumothorax and emphysema. A patient is described who had Marfan’s syndrome and bronchiectasis, an association only described on 2 previous occasions in the literature.
Experience with cellulose acetate-coated activated charcoal haemoperfusion in the treatment of severe hypnotic drug intoxication
Authors: Crome P , Hampel G , Widdop B , Goulding R 
Published: December 2008

Abstract
A haemoperfusion column containing activated charcoal coated with cellulose acetate was used to treat 7 patients with barbiturate or ethchlorvynol poisoning. Six of the patients showed marked lightening of coma and all showed a significant fall in plasma drug concentration. Plasma drug clearance and platelet loss were similar to those reported for other coated charcoal columns. Cellulose acetate-coated charcoal haemoperfusion may reduce the period of coma in severe poisoning with barbiturates and other hypnotic drugs and thus the morbidity and mortality.
Liver disease in patients with diabetes mellitus
Authors: Foster K J , Griffith A H , Dewbury K , Price C P , Wright R 
Published: December 2008

Abstract
Liver function tests were assessed in 60 unselected out-patient diabetics stabilized on insulin or oral hypoglycaemic agents. Routine liver function tests, particularly plasma concentrations of gamma-glutamyl transpeptidase and alkaline phosphatase were elevated occasionally but rarely to more than twice the upper limit of normal. There was no correlation between measures of diabetic control and results of liver function tests. Twelve (20%) patients had evidence of gall stones, a prevalence above the expected from the community. Fourteen (23%) patients had an abnormally bright liver ultrasound echo pattern, probably indicative of fatty infiltration of the liver. This echo pattern was associated with only a minimal rise in plasma alanine amino transferase and alkaline phosphatase concentrations. It is concluded that functionally significant liver disease is uncommon amongst stabilized diabetic patients.
A comparative study of automated blood pressure recorders
Authors: Rubin P , McLean K , Reid J 
Published: December 2008

Abstract
Four automated blood pressure machines (Arteriosonde 1225, Bosomat 11D, Elag Koln BE 237R and Omron HEM 3) have been compared with each other and with the Hawksley Random Zero Sphygmomanometer in 18 subjects with a wide range of BP. Each form of measurement provided a high degree of internal consistency. The Arteriosonde 1225 consistently recorded systolic and diastolic pressures which were below the values obtained with the Random Zero instrument (P=0.001). The other 3 automated machines recorded BPs which did not differ significantly from the Random Zero or from each other. Heart rate readings did not differ significantly for any of the machines compared to manual recording. The disparity attributable to the Arterisonde could result from its being the only form of measurement to use an ultrasonic rather than a microphonic recording technique. However, the cheaper and more portable automated machines produce results which closely reflect those obtained by using a mercury sphygmomanometer.
Consumption of refined carbohydrate by patients with Crohn’s disease in Tel-Aviv-Yafo
Authors: Silkoff K , Hallak A , Yegena L , Rozen P , Mayberry J F , Rhodes J , Newcombe R G 
Published: December 2008

Abstract
In 27 patients with Crohn’s disease living in Israel the current intake of refined carbohydrate (total sugars) and added sugar is significantly greater than in healthy controls. The dietary survey was retrospective and showed that patients with Crohn’s disease ate 269 g of monosaccharides and disaccharides each day compared with 192 g by matched controls. Similar differences were also found at the onset of the symptoms, 314 g compared with 207 g. These findings were independent of the country of origin or cultural grouping. Several factors are discussed which suggest a secondary rather than causal relationship between sugar consumption and Crohn’s disease.
The effect of anosmia on smoking habits
Authors: Peatfield R C , Turner J A McM , Sillett R W , McNicol M W 
Published: December 2008

Summary
Sixteen cigarette smokers who had developed complete anosmia were questioned about their smoking habits. Four subjects increased their cigarette consumption, 8 were unchanged and 4 decreased. The development of anosmia has no consistent effect on cigarette smoking.
Total body potassium depletion and severe myopathy due to chronic liquorice ingestion
Authors: Sundaram M B M , Swaminathan R 
Published: December 2008

Summary
A 33-year-old patient with hypokalaemia associated with severe myopathy following liquorice ingestion is described. Potassium depletion was confirmed by total body potassium measurements and myopathy was established by electromyography and enzyme studies. The potential hazard of chronic liquorice consumption even as a sweet is illustrated by this case.
Comparison of the chronic effects of bendrofluazide, bumetanide and frusemide on plasma biochemical variables
Authors: Gabriel Roger , Baylor Peter 
Published: December 2008

Summary
Eleven plasma variables have been studied in 18 elderly patients with cardiac oedema treated with bendrofluazide, frusemide and bumetanide, using a fully balanced, cross-over trial design. Bumetanide caused the least disturbance of plasma potassium and bendrofluazide the greatest. Frusemide produced an intermediate effect. The difference between the changes in plasma potassium produced by bumetanide and bendrofluazide was significant (P &lt; 0.02).
Meningitis and bacteraemia due to Listeria monocytogenes in compromised hosts
Authors: Maayan Mosche C , Wajsman Cilla , Nitzan (Zaidenzaig) Yeshayahu 
Published: December 2008

Summary
The clinical history of 3 adult patients infected by Listeria monocytogenes is presented. One patient with chronic lymphatic leukaemia developed purulent meningitis; the 2 others had chronic renal failure and were undergoing routine haemodialysis. Of the latter, one developed meningitis and the other bacteraemia after receiving 2 blood transfusions. Immuno-suppression, or the underlying disease of the hosts, probably played a role in permitting the infection to establish itself. The rural environment may also have been conducive to the transfer of this particular, rarely infectious, micro-organism to these patients.
Primary hyperparathyroidism and thiazide diuretics
Authors: Klimiuk P S , Davies M , Adams P H 
Published: December 2008

Summary
Six patients receiving thiazide diuretics were referred for evaluation of mild to moderate hypercalcaemia (serum calcium 2.65-2.98 mmol/l). All patients were considered to be suffering from primary hyperparathyroidism. Withdrawal of the diuretic was followed by a reduction in the serum calcium, one patient becoming normocalcaemia.
The mechanisms responsible for these changes are discussed. In hypercalcaemic patients taking thiazides, it is recommended that the effects of withholding the diuretic should be observed before more radical measures are considered.
Thyroid carcinoma in an autonomously hyperfunctioning thyroid nodule
Authors: Khan O , Maclennan K A , Ell P J , Kurtz A , Williams E S 
Published: December 2008

Summary
A 44-year-old woman presented with hyperthyroidism and a nodule in her thyroid. 131I-scintigraphy of the gland showed concentration of the tracer within the nodule and suppressed activity in the rest of the gland. Histology of the resected thyroid proved the nodule to be a papillary carcinoma. The presence of carcinoma within an autonomous hyperactive thyroid in a patient with hyperthyroidism has been reported only rarely, and to the authors’ knowledge such a case has never been reported in Great Britain. Furthermore, unlike previously reported cases, the carcinoma was confined solely to the nodule.
Beta-adrenoreceptor blocking drugs and thyroid hormones in hyperthyroid subjects
Authors: Jones M K , Birtwell J , Owens D R , Jones G R , Lewis M 
Published: December 2008

SummarySerum thyroid hormone concentrations were measured before and during 10 days’ treatment with atenolol (200 mg/day), acebutolol (400 mg/day), oxprenolol (160 mg/day) and propranolol (160 mg/day) in 24 hyperthyroid patients. During propranolol treatment serum triiodothyronine (T3) concentrations fell significantly (P less than 0.05) but there was no change in thyroid hormone concentrations in the other groups although all patients reported a symptomatic improvement.
Toxic megacolon in ulcerative colitis: a continuing challenge
Authors: Muscroft T J , Warren P M , Asquith P , Montgomery R D , Sokhi G S 
Published: December 2008

Summary
The incidence, predisposing factors, management and outcome of toxic megacolon (TM) has been reviewed in 65 cases of severe ulcerative colitis (UC) and compared in 2 successive 6-year periods before and after January, 1973. Nineteen episodes of TM occurred in 18 patients. Despite a conscious aim towards earlier surgery in recent years this was not achieved, and despite more intensive medical therapy the incidence of TM was unchanged. Emergency operative mortality in UC fell from 36% to 21% but the mortality of TM remained at 30%. The chief cause of death was colonic perforation. Mortality was associated with increased age, longer pre-operative hospital stay and lower levels of serum albumin. These findings reemphasize the need for earlier surgery if TM is to be prevented, but such a policy must result in some unnecessary emergency colectomies.
‘Malignant’ macroscopic appearance of an inflammatory testicular lesion—a reminder for surgeons
Authors: Sternberg A , Mor C , Servadio C , Reiss R 
Published: December 2008

Summary
Inflammatory changes in the tunica vaginalis testis may assume a misleading appearance which is highly suggestive of malignancy. Obviously, histological examination is crucial for establishing the corrent diagnosis. This phenomenon has been described in texts dealing specifically with testicular pathology, but is not emphasized in standard text books of urology, surgery or pathology. An illustrative case serves as the basis for discussing this entity, for the purpose of familiarizing it to surgeons, urologists and pathologists who are yet unaware of it.
Relapse of ulcerative proctocolitis during treatment with non-steroidal anti-inflammatory drugs
Authors: Rampton D S , Sladen G E 
Published: December 2008

SummaryIn four patients with inactive ulcerative proctocolitis, oral administration of non-steroidal anti-inflammatory drugs appeared to precipitate relapse. These observations suggest that inhibitors of prostaglandin synthesis should be used with care in patients with this disease, and are consistent with the hypothesis that prostaglandins may have a protective role in the lower as well as the upper gastrointestinal tract.
Sotalol-induced torsade de pointes
Authors: Kontopoulos A , Manoudis F , Filindris A , Metaxas P 
Published: December 2008

Summary
The authors report a case of torsade de pointes atypical ventricular tachycardia in a patient with chronic renal failure and hypertension treated with sotalol hydrochloride which they believe induced the arrhythmia.
Orogenital ulcers, SLE and hydralazine
Authors: Neville E , Graham P Y , Brewis R A L 
Published: December 2008

Summary
The case is reported of a man developing drug-induced systemic lupus erythematosus while taking hydralazine. The illness was characterized by arthritis and a purpuric rash particularly in the light-sensitive areas as well as orogenital and cutaneous ulceration. Anti-nuclear antibody and DNA binding were positive. All clinical manifestations disappeared on withdrawal of hydralazine.
Hepatic artery aneurysm following cholecystectomy
Authors: Thomas W E G , May R E 
Published: December 2008

Summary
A rare case is reported of an hepatic artery aneurysm developing 5 months after cholecystectomy. This presented as massive haemobilia as a result of the aneurysm communicating with the cystic duct stump. The diagnosis was delayed owing to the complicating features of Waldenström’s macroglobulinaemia and jejunal diverticulosis.
Malignant lymphomas: results and observations from St George’s Hospital
Authors: Lee R , Tungekar M F , Harmer C L , Rose M S 
Published: December 2008

Summary
With both Hodgkin’s and non-Hodgkin’s lymphoma, the results documented compared well with reference series. Hence the advantages of a modest clinic need not be at the cost of recovery or of survival.
A major factor attenuating the scale of therapy in Hodgkin’s disease is the risk of inducing second malignancies. Four such complications have been observed amongst 27 patients with Hodgkin’s disease.
Amongst the patients with non-Hodgkin’s lymphoma better results were noted than the designation ‘poor prognosis histology’ had led the authors to expect. These findings suggest that the concept of histologically based prognosis may be over-subscribed and that contemporary therapeutic strategies can be extremely effective in this group.
Acute transverse myelopathy complicating tetanus
Authors: Bahemuka M 
Published: December 2008

Summary
A 12-year-old boy presented with typical features of short incubation tetanus. Spastic paraparesis with a mid-thoracic sensory level was present from the time of the initial examination. X-rays of the spine and lumbar myelogram were normal. The paraparesis improved rapidly and within a month the patient was free of neurological deficit. The case is possibly a rare example of tetanus involving the central nervous system other than the anterior horn cells.
Umbilical haemorrhage—an unusual complication of cirrhosis
Authors: Douglas J G 
Published: December 2008

Summary
A 59-year-old woman known to have micronodular cirrhosis presented with haemorrhage from the umbilicus. She eventually required exomphalectomy at which a huge patent umbilical vein was found and ligated. Selective coeliac and superior mesenteric angiography with late phase films confirmed a large umbilical vein filling from the left branch of the portal vein. So far as the author knows, umbilical haemorrhage as a complication of cirrhosis has never previously been reported.
Hypokalaemia in leukaemia
Authors: Nanji Amin A , Denegri Jorge 
Published: December 2008

Summary
Five cases are presented which demonstrate the various factors contributing to the development of hypokalaemia and the relevant literature is briefly reviewed. Hypokalaemia is a common finding in leukaemia. Proper evaluation, adequate replacement of potassium and careful follow-up are necessary for prevention of potential dangers related to hypokalaemia.
Bronchial carcinoma presenting as autoimmune haemolytic anaemia
Authors: Cooper R , Tappin J A , Deveshevar S 
Published: December 2008

Summary
A 68-year-old man presented with autoimmune haemolytic anaemia. Investigation revealed underlying bronchial carcinoma. A positive direct Coombs’ test failed to revert to negative after removal of the primary tumour. This suggested the presence of metastases which was subsequently shown. The possible significance and origin of the autoantibody is discussed.