bluuebunny/crossref_metadata_2025_split huggingface dataset:
Small bowel obstruction: a review of 264 cases and suggestions for management
Authors: Deutsch A A , Eviatar E , Gutman H , Reiss R 
Published: December 2008

Summary
Two hundred and sixty-four cases of acute small bowel obstruction were retrospectively reviewed for the purpose of defining factors which could point to the presence of strangulated bowel. History, physical signs and investigations, including body temperature, X-rays, white blood count, and serum amylase, were not significantly different in the simple and strangulated groups. Although an elevated urinary white blood count and a palpable mass were more common in the strangulated group, they were not sufficiently reliable for early diagnosis of strangulation.
In reviewing the literature, it is clear that all hernias with obstruction must undergo emergency surgery. Cases with intra-abdominal complete intestinal obstruction should also undergo emergency surgery. A more conservative attitude can only be taken when there is incomplete obstruction.
Algoneurodystrophy following herpes zoster
Authors: Foster O , Askaria A , Lanham J , Perry D 
Published: December 2008

Summary
Algoneurodystrophy frequently follows an identifiable triggering event. It is not widely recognized that herpes zoster can precipitate algoneurodystrophy and three such cases are described here. In one, the affected dermatome did not correspond to the limb involved by the algoneurodystrophy.
Progression of hydrocephalus during corticosteroid therapy for neurosarcoidosis
Authors: Foley K T , Howell J D , Junck L 
Published: December 2008

SummaryWe describe a patient with sarcoid meningitis and hydrocephalus who improved rapidly after initiation of oral prednisone therapy, but who later decompensated acutely and required an emergency ventriculoperitoneal shunt. Hydrocephalus associated with neurosarcoidosis may progress despite steroid treatment, even when symptoms have improved. If hydrocephalus associated with neurosarcoidosis is treated with corticosteroids and without a shunt procedure we suggest that the corticosteroids should be continued at high doses for a prolonged period.
Toxic reaction to inhaled paint fumes
Authors: Atkinson L , Ince P , Smith N M , Taylor R 
Published: December 2008

Summary
An acute confusional state was observed to follow heavy exposure to polyurethane gloss paint fumes in a previously healthy 60 year old man. This state remitted over a 3-day period, but was followed by transient bone marrow suppression and evidence of liver cell damage. The corroborated absence of other toxins and the temporal association of exposure to paint fumes suggest that a volatile paint component was responsible. White spirit is the major volatile solvent in polyurethane gloss paint. Ingestion of related aliphatic hydrocarbons has been reported to cause nausea, drowsiness and hepatotoxicity, but these symptoms have not previously been documented following excessive inadvertent inhalation of paint fumes.
Perirenal and renal subcapsular haematoma as presenting symptoms of polyarteritis nodosa
Authors: Schlesinger M , Oren S , Fano M , Viskoper J R 
Published: December 2008

Summary
Two young men, were hospitalized due to acute massive blood loss with left abdominal flank pain. In both cases renal angiography showed signs of a haemorrhagic event in the left kidney, perirenal in one and subcapsular in the other. Microaneurysms indicated a diagnosis of polyarteritis nodosa, supported by renal biopsy in one case. Renal haemorrhage is an infrequent presentation of polyarteritis nodosa. Furthermore, one patient suffered also from familial Mediterranean fever, and is the fifth reported case with this combination of diseases.
Elderly people taking non-steroidal anti-inflammatory drugs are unlikely to have excess renal impairment
Authors: Allred J , Wong W , Kafetz K 
Published: December 2008

Summary
The importance of possible adverse effects on renal function of non-steroidal anti-inflammatory drugs has been widely discussed. Elderly people have been thought to be particularly at risk. We therefore studied simple indices of renal function and plasma potassium in 54 patients with a mean age of 85 years, 27 taking these drugs and 27 controls. Twenty five of our 54 patients were also taking diuretics. Non-steroidal anti-inflammatory drugs did not affect renal function or plasma potassium in these patients.
Primary cerebral lymphoma presenting with cranial diabetes insipidus
Authors: Patrick A W , Campbell I W , Ashworth B , Gordon A 
Published: December 2008

Summary
A 30 year old woman with an 8-year history of thirst and polyuria was found to have cranial diabetes insipidus. There were no neurological abnormalities at presentation but she subsequently developed diverse signs and died 26 months later. Autopsy revealed a diagnosis of diffuse primary cerebral lymphoma. Cranial diabetes insipidus with otherwise minimal abnormality of hypothalamic/pituitary function has not previously been reported as a presentation of this neoplasm.
Pulmonary vasculitis associated with cholangiocarcinoma of liver
Authors: Ong E L C , Evans S , Hanley S P 
Published: December 2008

Summary
A 62 year old woman presented with an acute pulmonary vasculitis which responded to treatment with oral steroids. Investigations over one year revealed a cholangiocarcinoma of the liver. The association of vasculitis with neoplastic diseases remains a diagnostic challenge.
Pulmonary uptake in 67-gallium citrate scintigraphy-the ‘negative heart’ sign
Authors: Cooke S G , Davies E R , Goddard P R 
Published: December 2008

Summary
Diffuse pulmonary uptake in 67-gallium citrate (67-Ga) scintigraphy occurs in a large number of neoplastic and inflammatory conditions. Discrimination between normal and abnormal 67-Ga uptake over the chest can be difficult and a simple visual method for identifying abnormal studies is described. A series of 39 gallium scintigrams was retrospectively reviewed by the authors and reported without knowledge of the patients’ clinical condition. Subsequent clinical follow up was obtained to establish the accuracy of the scintigram interpretation. Comparison of pulmonary uptake with that over the cardiac area is recommended as a simple and reliable method of confirming that the level of pulmonary activity is abnormal. In highly abnormal cases the cardiac area is seen as a ‘negative heart’ image due to the considerably increased activity in the lungs. This sign is best seen with abnormal diffuse uptake but is also seen with abnormal focal uptake. Care must be taken, as the sign may be masked, if uptake over the cardiac area itself is increased.
Is intravenous cholangiography an alternative to the routine per-operative cholangiogram?
Authors: Huddy S P J , Southam J A 
Published: December 2008

Summary
Ultrasonography, although an accurate method of detecting stones within the gall bladder, is unreliable for the detection of bile duct stones for which per-operative cholangiography remains the standard investigation. Fifty seven patients undergoing elective cholecystectomy had both a pre-operative intravenous cholangiogram and per-operative cholangiography. The pre-operative investigation is shown to be at least as effective in the detection of common bile duct stones and only missed a duct stone in one patient. The substitution of pre-operative intravenous cholangiography for routine per-operative cholangiography would result in a significant reduction in operating time, may provide advance knowledge on the biliary anatomy and would allow advance planning of the likely procedure. It is suggested that pre-operative intravenous cholangiography, carried out on the day of admission, should be considered as a preferred alternative investigation to per-operative cholangiography.
Audit of mortality in upper gastrointestinal bleeding
Authors: Katschinski B D , Logan R F A , Davies J , Langman M J S 
Published: December 2008

Summary
The outcome in 1017 patients with haematemesis and malaena referred to two major hospitals in Nottingham within a 2-year period has been prospectively evaluated. Ninety one (9%) patients died during the time period under consideration and all but four were found to have been over 60 years of age. There were 13 (14%) deaths following rebleeding, of whom 5 (5%) could have been potentially avoided by alterations in management. Some improvement of mortality might result from intensive-care facilities with better management of transfusions and earlier detection of rebleeding allowing earlier endoscopy or surgery. The majority of patients (81%), however, died from concomitant disease which was exacerbated by gastrointestinal haemorrhage or bleeding developed in patients with an already existing end-stage disease. These results show that a reduction of mortality in patients with gastrointestinal bleeding is hampered by the high number of poor-risk patients. The rise in the proportion of elderly patients with this disorder seems to continue.
Spontaneous fracture of the ulna complicating tuberculous osteomyelitis
Authors: Seddon D J , Thanabalasingham T , Weinberg J 
Published: December 2008

Summary
A 63 year old Asian woman presented with tuberculous osteomyelitis of the right ulna and a large subcutaneous cold abscess. During the course of her treatment the midshaft of the ulna sustained a spontaneous transverse fracture. Aspects of her case are reviewed.
Bilateral adrenal phaeochromocytomas associated with unilateral renal artery stenosis
Authors: Burns A P , O’Connell P R , Murnaghan D J , Brady M P 
Published: December 2008

Summary
A 21 year old male was discovered to be severely hypertensive. He was found to have bilateral adrenal phaeochromocytomas and a single renal artery stenosis. More than 40 cases of coexisting renal artery stenosis and phaeochromocytomas have been reported. The aetiology of renal artery stenosis in association with phaeochromocytoma maybe multifactorial and the radiographic appearances are not always clear-cut.
Renin levels in this patient were elevated prior to the removal of the phaeochromocytomas but the renal vein renin ratio did not suggest that the renal artery stenosis contributed significantly to his hypertension. The patient’s hypertension resolved following successful removal of the phaeochromocytomas despite persistence of the renal artery stenosis. Thus, though renin levels may be misleading in these cases, renal vein renin ratios may still be helpful in deciding on patient management.
Dissociation between the secretion and renal action of endogenous atrial natriuretic peptide in the syndrome of inappropriate antidiuresis
Authors: Eadington D W , Cowan F M 
Published: December 2008

Summary
A patient is described with the syndrome of inappropriate antidiuresis (SIAD) and renal sodium retention secondary to a lymphoma. The basal atrial natriuretic peptide (ANP) level and the ANP response to volume expansion were normal (age adjusted) but the natriuretic effect of ANP was attenuated by an unidentified factor. The case emphasizes the dominance of circulating volume over plasma tonicity in the regulation of ANP secretion.
Battered wives—measures by the social and medical services
Authors: Bergman B , Brismar B 
Published: December 2008

Summary
The social files and medical records of 98 acutely battered wives who attended a surgical emergency department were studied. Although all women had been hospitalized during the decade preceding the present incident, wife battering was documented in the records in only 18%. The majority of the women (73%) were also known to the social services, but battering was documented in less than half of the cases in the social service files. The measures taken by the social services to help the battered women consisted mainly of economic support and psychotherapy. The cooperation between the medical and social services and the police in cases of wife battering was very limited or non-existent.
It is concluded that support given to battered women by the formal sources of aid is insufficient. The documentation of the cases is poor, there is a lack of practical measures and the cooperation between the authorities is limited. This study indicates that the social and medical services underestimate the importance of informal help sources like women's groups or shelters which often are the most valued resources by the battered women themselves. With improved cooperation between authorities and between formal and informal sources of aid the battered wives could be helped more effectively.
Neuroleptic malignant syndrome: a case for electroconvulsive therapy
Authors: Harland C C , O'Leary M M , Winters R , Owens J , Hayes B , Melikian V 
Published: December 2008

Summary
A case of prolonged and refractory neuroleptic malignant syndrome was treated successfully with electroconvulsive therapy. Neuroleptic malignant syndrome and its treatment are reviewed.
Recurrent transient thyrotoxicosis in multinodular goitre
Authors: Arem R 
Published: December 2008

Summary
A patient initially presented with an autonomously functioning right thyroid nodule and transient hyperthyroidism which lasted for a few months. Several months after resolution of thyrotoxicosis, the patient had a recurrent episode of hyperthyroidism and was found to have a left hot nodule. The right hyperfunctioning nodule had become cold on scintigraphy, and its aspiration revealed haemorrhagic fluid suggesting haemorrhagic infarction as the mechanism of resolution of the first episode of hyperthyroidism. Again following resolution of the second episode of hyperthyroidism, the left hot nodule also became hypofunctioning on scintigraphy indicating that the spontaneous restoration to euthyroidism was secondary to infarction.
Recurrent hyperthyroidism and resolution due to nodular infarction in a patient with a nodular goitre may mimic the more common causes of transient thyrotoxicosis and should be considered in the differential diagnosis of goitrous hyperthyroidism.
Acquired immunodeficiency, malabsorption and lymphoma
Authors: Fischel B , Burke M , Sasson E , Felner S 
Published: December 2008

Summary
A 66 year old female with a long history of recurrent pulmonary infection presented with a full-blown malabsorption syndrome. She was found to be suffering from acquired immunodeficiency. She later developed non-Hodgkin's lymphoma of the cervical lymph nodes. The possible relationships between immunodeficiency, malabsorption and lymphoma are discussed.
Near fatal puerperal fever due to Mycoplasma hominis
Authors: Young M J , Cox R A 
Published: December 2008

Summary
We describe a case of severe septicaemia caused by Mycoplasma hominis in a 23 year old patient following childbirth. She developed disseminated intravascular coagulation and acute respiratory distress syndrome which have not hitherto been described in association with septicaemia due to this organism. Investigation and treatment leading to full recovery is outlined.
Subungual amelanotic melanoma: a diagnostic pitfall
Authors: Winslet M , Tejan J 
Published: December 2008

Summary
A 35 year old female presented with a persistent amelanotic lesion of the nail bed of the left great toe for 1 year, associated with destruction of the overlying nail. Incision biopsy revealed a nodular malignant melanoma and the toe was amputated. There is no sign of recurrence at 18 month follow-up. As prognosis is related to local disease extent, any persistent nail bed lesion should be biopsied to exclude the possibility of malignant melanoma.
Palmar-plantar erythema associated with combination chemotherapy
Authors: Pagliuca A , Kaczmarski R , Mufti G J 
Published: December 2008

Summary
We report three cases of a distinctive palmar-plantar erythema associated with the treatment of non-Hodgkin's lymphoma and acute myeloid leukaemia. The rash is characterized by a painful, sharply demarcated, intense erythema of the palms and/or soles followed by bulla formation, desquamation and healing. The eruption is self limiting in nature and did not adversely affect prognosis. Treatment need be neither altered nor stopped; only symptomatic measures are required.
Occupational cancer: interaction with life style factors
Authors: Roe F J C 
Published: December 2008

Summary
It is argued that as the major occupational cancer risks become matters of historical interest, research epidemiologists working in the field should broaden their approaches to encompass life style factors. In the investigation of possible low-cancer risks, it no longer makes any sense to confine their data-collecting activities solely to exposure to dusts and chemicals at work and to regard exposure to chemicals at home, in the garden or during leisure activities simply as possible confounding variables. Furthermore it is becoming more and more meaningless to undertake any epidemiological investigation aimed at detecting or defining a low level of cancer risk without taking into account what and how much, for example, people eat, drink and smoke. Possible exposure to chemicals at work is increasingly becoming a source for confounding variables in relation to life-style-associated cancer risks, as distinct from life-style being a source of confounding variables in epidemiological studies of occupation-associated cancer risks.
Physical and intellectual recovery following prolonged hypoxic coma
Authors: Falk R H 
Published: December 2008

Summary
Prolonged coma resulting from hypoxic brain injury is usually associated with a dismal chance of return to independent existence. In this report a case is described of a 60 year old man who recovered and returned to work as a university professor after being in a vegetative state at least 8 weeks after a prolonged cerebral hypoxic event.
Spontaneous haemarthrosis following thrombolytic therapy for myocardial infarction
Authors: Oldroyd K G , Hornung R S , Jones A M , Andrews N P , Dawes P T , Carson P H M 
Published: December 2008

Summary
Two cases of haemarthrosis following thrombolytic therapy for acute myocardial infarction are described. Both patients had active pre-existing inflammatory disease in the affected joints at the time of presentation. This complication of thrombolytic therapy has not been previously reported.
Raised dopamine metabolites in a case of malignant paraganglioma
Authors: Florkowski C M , Fairlamb D J , Freeth M G , Taylor S A , Taylor A , Weinkove C , Jacobs A G 
Published: December 2008

Summary
This paper describes the case of a malignant retroperitoneal paraganglioma with extensive metastases. The patient presented with a supraclavicular mass and an absence of hypertension. Exclusively raised dopamine metabolites were detected which may be a marker of a malignant process and account for the lack of hypertension.
An evaluation of combining thiopentone and etomidate for the induction of anaesthesia
Authors: Slater R M , Pollard B J , Young T M , Hunt L P 
Published: December 2008

Summary
The characteristics of three combinations of thiopentone and etomidate [in the ratios of thiopentone (mg):etomidate (mg) of 5:1, 13:1 and 25:1] have been compared with the individual agents alone for the induction of anaesthesia. The incidence of pain on injection and abnormal movements was less with the combination containing the highest ratio of thiopentone to etomidate, when compared to etomidate alone. The mixtures did not otherwise confer any advantages over the individual agents.
Acquired von Willebrand disease associated with free lambda light chain monoclonal gammopathy, normal bleeding time and response to prednisone
Authors: Stewart A K , Glynn M F X 
Published: December 2008

Summary
We report a case of acquired von Willebrand's syndrome with severe gastrointestinal bleeding and associated free monoclonal lambda light chains. The patient had a rapid sustained clinical and laboratory response to the administration of prednisone. Of note in this patient was the occurrence of angiodysplasia which has previously been reported in association with acquired von Willebrand's syndrome. No inhibitors of VWF:Ag, VWF:RCoF, or factor VIII:C were detected by mixing studies and the bleeding time was normal. Very few high molecular weight von Willebrand multimers were present prior to prednisone; however, the pattern reverted to a normal distribution following treatment.
In appropriate patients with acquired von Willebrand's syndrome and monoclonal para-proteins, a trial of prednisone may be indicated.
An unusual case of adrenal cortical carcinoma
Authors: Mufti G R , Farrell J 
Published: December 2008

Summary
We describe a case of non-functioning adrenal cortical carcinoma, which recurred 16 years after surgical adrenalectomy. In addition, the patient was successfully treated for two anatomically separate and histologically different, primary malignant tumours. This case highlights the importance of lifelong follow-up after apparently curative surgical excision of an adrenal tumour.
An audit of the usage of operating theatre time in a peripheral teaching surgical unit
Authors: Haiart D C , Paul A B , Griffiths J M T 
Published: December 2008

Summary
A recent report by the National Audit Office found that only 50% to 60% of weekday operating time was being used. This report was examined by the Committee of Public Accounts and much of the blame for underutilization of operating theatres was attributed to poor working practices among surgeons. We investigated theatre utilization in our hospital and found underutilization on the same scale as the National Audit Office. Twenty-five per cent of theatre sessions were not allocated for use, 23% of general surgical lists were cancelled and, of the lists which did take place, a further 23% of theatre time was not utilized. The single largest cause of underutilization was understaffing. To increase theatre utilization higher levels of staffing and expenditure are needed rather than changes in the working practices of surgeons.
A critical look at nursing observations
Authors: Burroughs J , Hoffbrand B I 
Published: December 2008

Summary
Our experience has suggested that not only do nurses on hospital wards waste time making too many unnecessary clinical observations, but that it is very difficult to persuade them to modify the pattern of their practice.
We therefore conducted a survey by questionnaire among trained nurses in one health district of their everyday ward practice and attitudes to clinical observations. This showed that whilst a majority of nurses questioned believe in the importance of routine observations for patient care, there is a lack of consistency in the criteria and communication procedures used that must seriously limit the value of the information obtained by the individual nurse.
We believe that uncritical faith in routine observations is a barrier to rationalizing procedures to optimize efficient use of the professional skills of ward nurses in this regard. There is need for more thought to be given to the problem and in particular it is important that doctors play a more active role in decision making.
Anicteric hepatitis and uveitis in a worker exposed to trichloroethylene
Authors: Schattner A , Malnick S D H 
Published: December 2008

Summary
A previously healthy woman developed acute anicteric hepatitis which slowly resolved, though bilateral anterior uveitis then appeared. No other cause than an occupational exposure to trichloroethylene was found, and rechallenge by resuming work has led to a transient increase in serum alkaline phosphatase. Both manifestations may constitute a rare systemic reaction to trichloroethylene.