bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastritis and gastric campylobacter-like organisms in patients without peptic ulcer
Authors: Sethi P , Banerjee A K , Jones D M , Eldridge J , Hollanders D 
Published: December 2008

Summary
Gastric biopsy specimens were obtained from 83 patients without peptic ulcer disease and analysed histologically. Culture and serological studies were done on the last 64 patients. The patients were divided into two age groups (young and old groups.) In 34 patients with chronic superficial gastritis, gastric campylobacter-like organisms (GLCO) were identified histologically in 91% and grown on culture in 88%: antibody to GCLO was detected in 81%. No age-related difference in the prevalence of the organism was demonstrated. In the 23 patients with atrophic gastritis (all elderly), presence of the organisms appeared to be related to the presence of an inflammatory cell infiltrate into the gastric mucosa.
These figures for the prevalence of the organism in this selected group of patients are similar to those reported in previous studies of unselected patients which included those with peptic ulcer. This suggests that GCLO is unlikely to be causally related to peptic ulcer.
Severe hypokalaemia from kaolin and morphine abuse
Authors: Kirkham B , Cowell R , Rees J 
Published: December 2008

Summary
A 34 year old man, registered disabled as a result of muscle weakness, was admitted to hospital because of increasing weakness. He had profound hypokalaemia and admitted to taking up to 1400 ml of kaolin and morphine mixture daily. After considerable potassium replacement muscle power recovered completely. The hypokalaemia is likely to have been caused by the combination of liquorice extract and sodium bicarbonate in kaolin and morphine.
Ruptured abdominal aortic aneurysm in Marfan’s syndrome
Authors: Lafferty K , McLean L , Salisbury J , Cotton L T 
Published: December 2008

Summary
A rare case of ruptured abdominal aortic aneurysm in Marfan’s syndrome is described. The patient was treated successfully with a straight aortic tube graft. Histology of the aneurysm wall showed changes typical of cystic medial necrosis.
Acquired immune deficiency syndrome without the recognized risk factors
Authors: Rademaker M , Thomas R H M , Provost T G , McEvoy M , Grint P C , Heath R , Kirby J D T 
Published: December 2008

Summary
We report two cases of acquired immune deficiency syndrome (AIDS), apparently without the usual exposure factors, in whom a temporal association was detected after detailed epidemiological investigation.
The index case, a 45 year old housewife, had provided terminal home-nursing care for a 33 year old African man, who died from an undiagnosed encephalitis. At that time she had fissures of the skin of both her hands. Review of post-mortem pathology specimens of the African man allowed a retrospective diagnosis of AIDS with cerebral toxoplasmosis to be made.
The type of home-nursing care given by the index case was quite different from that normally provided by health care workers with the training and facilities to prevent the spread of infection.
Malignant cysts of the male breast
Authors: Stebbings W S L , George B D , Boyle S , Plowman P N , Gilmore O J A 
Published: December 2008

Summary
Two cases of male breast carcinoma presenting as cystic swellings are reported. Cysts of the male breast are rare, but unlike cysts in female breasts are more likely to represent significant pathology. We recommend consideration of excision biopsy of isolated cysts in male breasts.
Histiocytic necrotizing lymphadenitis
Authors: Shirakusa Takayuki , Eimoto Tadaaki , Kikuchi Masahiro 
Published: December 2008

Summary
Eleven cases of histiocytic necrotizing lymphadenitis were studied. Originally four were misdiagnosed as cervical tuberculous lymphadenitis. The characteristic symptoms and signs were local tenderness, fever, leucocytopenia and good prognosis. Antibody to Epstein-Barr virus was elevated in 2 of 3 cases. Biopsy of the affected lymph node was necessary when the differential diagnosis from lymph node tuberculosis or malignant lymphoma could not be made. The characteristic histological feature was focal necrosis without neutrophil infiltration in cortical or subcortical areas. Ultrastructurally, we found characteristic inclusions (‘tubulo-reticular structures’) in histiocytes and lymphocytes.
Left vocal cord paralysis caused by coalworkers’ pneumoconiosis and progressive massive fibrosis
Authors: Haffar M , Banks J 
Published: December 2008

Summary
We report a case of recurrent laryngeal nerve palsy caused by coalworkers’ pneumoconiosis with progressive massive fibrosis (PMF). This illustrates that PMF alone may be added to the list of lesions which can cause recurrent laryngeal nerve palsy. However, efforts should always be made to exclude more common causes, in particular bronchogenic carcinoma, before attributing the palsy to PMF.
Progressive multiple cranial neuropathies presenting as a delayed complication of radiotherapy in infancy
Authors: Pall H S , Nightingale S , Clough C G , Spooner D 
Published: December 2008

Summary
A 38 year old woman who had undergone irradiation during infancy for a left facial cutaneous arteriovenous malformation sequentially developed complete palsies of the ipsilateral VII, V, XI, IX, X, XII and VI cranial nerves.
Apart from optic and olfactory nerve damage there are few reports of radiotherapy causing cranial nerve injury. We link the unusually extensive and progressive neural damage and the prolonged latency to the patient’s age at time of irradiation.
Acute phlegmonous gastritis
Authors: O’Toole P A , Morris J A 
Published: December 2008

Summary
A fatal case of acute phlegmonous gastritis in a 30 year old man is reported. It was caused by Group A Streptococcus (M type 1, T type 1). Although extremely rare, clinicians need to be aware of this condition as, without intervention, it is rapidly fatal. The recommended treatment is antibiotics combined with surgical resection.
Acquired hernias of the diaphragm
Authors: Johnson C D , Ellis H 
Published: December 2008

Summary
We present our experience over five and a half years of acquired hernias of the diaphragm. Each case represents a different presentation of this condition, which may follow blunt or penetrating trauma or iatrogenic injury. Diaphragmatic hernia may present in the acute phase after injury but late presentation may occur after many years, with chronic abdominal or respiratory symptoms, or with acute intestinal obstruction. The problems in diagnosis and management are discussed.
Can old people on oral anticoagulants be safely managed as out-patients?
Authors: Joglekar M , Mohanaruban K , Bayer A J , Pathy M S J 
Published: December 2008

Summary
Of 62 patients (mean age 75, range 65-92 years) referred to an out-patient anticoagulant clinic specifically for those aged 65 years or more, treatment was considered unsafe in only one patient and was discontinued. Minor bleeding which did not require a significant change in management was recorded on 25 (7%) of 381 clinic visits and one major haemorrhage occurred requiring emergency hospital admission. Anticoagulation was maintained within the therapeutic range on 284 (75%) visits. The results confirm that with appropriate out-patient care and supervision, the risks of oral anticoagulant therapy in the elderly need be no greater than in younger patients.
Villous adenomas and carcinoma of the duodenum in Gardner’s syndrome
Authors: Sinha J , Williamson R C N 
Published: December 2008

Summary
Patients with Gardner’s syndrome are increasingly found to have polyps on routine upper gastrointestinal endoscopy, and their risk of developing periampullary carcinoma is between 3-12%. We report a 45 year old man with Gardner’s syndrome who presented with periampullary carcinoma 5 years after colectomy. Review of the literature amassed another 21 cases of periampullary carcinoma in patients with Gardner’s syndrome.
Hepatic metastases due to choriocarcinoma
Authors: Alveyn C G , Loehry C A 
Published: December 2008

Summary
A 34 year old female presented with weight loss and hepatomegaly. Liver biopsy revealed clinically unsuspected metastatic choriocarcinoma. Severe haemorrhage occurred, and the patient died following complications after laparotomy. The possibility of choriocarcinoma should be remembered in women of child-bearing age who present with liver metastases; biopsy must be avoided until this diagnosis can be excluded.
Cranial diabetes insipidus caused by giant cell arteritis
Authors: Radhamanohar M 
Published: December 2008

Summary
A 78 year old woman was admitted with symptoms of diabetes insipidus and was found to have a high ESR, the cause of which was uncertain. Five months later she presented with blindness, and cranial arteritis was confirmed by temporal artery biopsy. The endocrine abnormality returned to normal after steroid therapy. The association between these two conditions is discussed.
Spontaneous aortocaval fistula--preoperative diagnosis and management
Authors: Duffy J P , Gardham J R C 
Published: December 2008

Summary
Spontaneous aortocaval fistula is an uncommon complication of an abdominal aortic aneurysm. This report details two cases of this condition presenting with symptoms attributable to arteriovenous shunting. Pain was not a prominent feature so that attention was not initially drawn to the abdomen. Diagnosis and management of the condition are discussed.
Fulminant hyperpyrexia induced by bleomycin
Authors: Leung W H , Lau J Y N , Chan T K , Kumana C R 
Published: December 2008

Summary
Mild and self-limiting fever following bleomycin use is common, and a fatal hyperpyrexial response occurs rarely. In previously reported cases, such hyperpyrexia occurred either after the initial administration of the drug or during subsequent therapy following an initial pyrexial response. We describe a fatal hyperpyrexial reaction after bleomycin in a patient with T-cell lymphoma who had had no febrile response when she received her initial injection 3 weeks earlier. Since the occurrence of this hyperpyrexial response is unpredictable, health care workers as well as patients and relatives should always be alert to this potentially lethal complication and prompt measures should be taken in any patient who develops fever after bleomycin use.
Chronic active hepatitis: a sixteen year survey at a district general hospital
Authors: Tanner A R , Dellipiani A W 
Published: December 2008

Summary
Over a period of 16 years (1971-87) all cases of chronic active hepatitis (CAH) diagnosed following liver biopsy have been reviewed to assess incidence, aetiology, outcome and response to treatment. North Tees District serves a population of 210,000 and 26 cases were identified (20 female) age range 9-73 years (median 56 years). Incidence remained constant at 1:100,000/year. Twenty cases (77%) had an immune aetiology. Other aetiologies were hepatitis B virus (HBV) infection, alpha-1AT deficiency, non-A non-B hepatitis and a complex multisystem disease. The median follow-up period was 50 months.
There were 7 deaths, three unrelated to liver disease. Survival analysis gives an 86% 5-year survival and 56% 10-year survival. Twenty four patients were treated with steroids (and 6 additionally with azathioprine); 15 (63%) were steroid responsive and 9 were non-responsive. In five patients steroids were successfully discontinued but in 10 patients severe symptomatic relapse occurred on steroid reduction below 7.5-10 mg/day. Steroid non-responders were not typical CAH, 5 with predominantly a rise in alkaline phosphatase, one multisystem disease and one HBV positive. Steroid discontinuation was only possible in one third of the patients responding. Eighteen subjects (69%) were cirrhotic at initial biopsy; 9 had follow-up biopsies, 6 were unchanged but three had progressed to cirrhosis despite apparent steroid responsiveness.
Malignant fibrous histiocytoma of sternum: an unusual cause of pyrexia of undetermined origin
Authors: Grieco A , Caputo S , Silvestri E , Caradonna P , Bertoli A , Greco A V 
Published: December 2008

Summary
Malignant fibrous histiocytoma of the bone is a very rare tumour mainly affecting long bones, and the most common presenting symptom is local pain. A case of malignant fibrous histiocytoma presenting with pyrexia of undetermined origin and arising in the sternum, a localization not previously described, is reported. The patient died with septic shock after multi-drug chemotherapy including high dose methotrexate treatment with citrovorum factor rescue.
Biopsy of neck lumps in adults should be preceded by examination of the upper aerodigestive tract
Authors: Premachandra D J , McRae D , Prinsley P 
Published: December 2008

SummaryPremature biopsy of a potentially malignant neck node compromises patient survival. Despite documented evidence that biopsy of a malignant neck mass prior to a search for a primary source will increase the incidence of regional recurrence and distance metastasis, patients are often referred for head and neck assessment having already had a positive neck node biopsy. We maintain that biopsy of an asymmetrically enlarged cervical lymph node in an adult should be preceded by full upper aerodigestive tract evaluation to include indirect laryngoscopy, a high resolution computed tomography scan and panendoscopy with free field biopsy.
Endometrial oxytocin binding sites in normal women and in subfertile patients
Authors: Baker P N , Peat M L , Symonds E M , Maynard P V 
Published: December 2008

Summary
Specific binding of oxytocin to high affinity sites in endometrial membrane preparations has previously been shown in sheep. Endometrial tissue preparations from 27 ‘normal’ women of proven fertility were incubated with tritiated oxytocin and the existence of significant binding sites in human endometrium was shown. Furthermore, the level of binding sites underwent a cyclical variation with the highest concentration of binding at midcycle. A cyclical pattern of binding site concentration not unlike that found in the normal women was shown in 19 subfertile patients taking clomiphene.
However, in 20 subfertile patients not taking clomiphene, no cyclical pattern emerged with significantly lower levels of binding sites in the mid-portion of the cycle (P &lt; 0.02) and significantly higher levels in the mid-late luteal phase (P &lt; 0.01), as compared to the normal women. In the mid-portion of the cycle levels were significantly lower in the subfertile patients not taking clomiphene (P &lt; 0.03) as compared to those taking clomiphene. No significant differences were shown between the normal women and those patients taking clomiphene.
Ergotamine-induced solitary rectal ulcer
Authors: Shpilberg O , Ehrenfeld M , Abramowich D , Samra Y , Bat L 
Published: December 2008

Summary
A rare case of ergotamine-induced solitary rectal ulcer is described in a 41 year old woman who used high doses of ergotamine tartrate-containing suppositories for severe migraine headaches. Complete recovery of the ulcer was noticed after cessation of treatment with the suppositories. The relevant literature is discussed.
Heparin-associated skin necrosis
Authors: Fowlie J , Stanton P D , Anderson J R 
Published: December 2008

Summary
A case of skin necrosis at the sites of injection of subcutaneous heparin is described. The patient went on to develop heparin-induced thrombocytopenia and pulmonary embolism. Review of the previously described cases of heparin-associated skin necrosis reveals that this sequence of events is not uncommon.
Synchronous adenocarcinoma and primary malignant lymphoma of the stomach
Authors: Akosa A B , Clark D M , Desa L 
Published: December 2008

Summary
A synchronous presentation of an adenocarcinoma and a primary low grade B cell lymphoma of the stomach is reported in a 79 year old man. Both diagnoses were made on endoscopic biopsies and immunocytochemistry was essential in confirming the lymphoma. The true incidence, aetiology and spatial relations of these tumours are unknown since only few cases of such synchronous gastric tumours have been reported in the literature.
Thrombotic thrombocytopenic purpura with terminal pancytopenia
Authors: Ng S-C , Adam B A 
Published: December 2008

Summary
A 27 year old housewife developed thrombotic thrombocytopenic purpura during the twelfth week of pregnancy. She had partial response to initial plasma infusion and subsequent plasmapheresis. However, her clinical course was complicated by the development of severe pancytopenia the consequence of a hypocellular marrow. She succumbed to septicaemic shock one month after diagnosis. The development of hypocellular marrow in thrombotic thrombocytopenic purpura has not been reported before.
A review of typhoid fever in South African black children
Authors: Ellis M E , Moosa A , Hillier V 
Published: December 2008

Summary
Typhoid fever continues to escape swift diagnosis, even in an endemic country, and its multi-system nature led to delayed diagnosis in 25% of the patients in this study. This may have been an avoidable factor, leading to death in some patients through delay in instituting appropriate antimicrobial therapy. Neurological features and diarrhoea were particularly common in this paediatric population. Relative bradycardia has been shown to be a highly statistically significant finding for our group as a whole. Amoxycillin remains an effective and useful alternative to chloramphenicol. The mortality rate of 2.5% remains unchanged over the last 10 years. The relative inaccessibility to good primary health care, acceptable water supplies and sanitation that the black South African child encounters cannot be ruled out as a co-factor.
An oral treatment for lead toxicity
Authors: Thomas P S , Ashton C 
Published: December 2008

Summary
Chronic lead poisoning has traditionally been treated by parenteral agents. We present a case where a comparison of ethylene diaminetetra-acetic acid was made with 2,3-dimethyl succinic acid (DMSA) which has the advantage of oral administration associated with little toxicity and appeared to be at least as efficacious.
The association between haemospermia and severe hypertension
Authors: Close C F , Yeo W W , Ramsay L E 
Published: December 2008

Summary
The association between haemospermia and hypertension was examined in a case-control study comparing 5 hypertensive patients with haemospermia to 20 age-matched hypertensive men. Patients with haemospermia had much higher blood pressures than hypertensive controls (200/131 mmHg vs 147/90 mmHg; P &lt; 0.0005/P &lt; 0.0001), higher left ventricular voltage on ECG (P &lt; 0.02), and higher concentrations of serum creatinine, proteinuria and renovascular disease (all P = 0.06 vs controls). Haemospermia is associated with severe uncontrolled hypertension. It is not, however, associated with hypertension per se, as the prevalence of hypertension in published series of patients with haemospermia is no higher than that expected in the general population. Men presenting with haemospermia should have their blood pressure measured carefully as they may require antihypertensive treatment urgently.
Hyperhomocysteinaemia and multiple aneurysms
Authors: Colwell N , Clarke R , Robinson K , Keane F , O'Briain S , Graham I 
Published: December 2008

Summary
Homozygous homocystinuria, the most common genetic disorder of transulphuration, is associated with elevated plasma concentrations of homocystine, homocysteine, multiple clinical abnormalities and life-threatening thromboembolism. Several instances of vascular aneurysms have also been documented. More recently, an association between premature occlusive vascular disease and the heterozygous state has been proposed. We now report an unusual case in whom multiple aneurysms were associated with heterozygous homocystinuria.
A preliminary study of the ocular hypotensive effects of bromocriptine in diabetic patients with autonomic neuropathy
Authors: al-Sereiti M R , Turner P , Gale E A 
Published: December 2008

Summary
The effect of bromocriptine on intraocular pressure has been investigated in a group of 8 diabetic patients with autonomic neuropathy, to test the hypothesis that bromocriptine exerts its ocular hypotensive action through presynaptic dopamine receptors. Bromocriptine eye drops (0.025%) produced a significant fall in intraocular pressure in a control group of 8 matched normal volunteers, but this effect was not seen in the eyes of the diabetic patients. These results are consistent with a presynaptic site of action of bromocriptine.
Congestive heart failure and converting enzyme inhibition: failure of current prognostic criteria for predicting subsequent renal insufficiency
Authors: Odum J , Carson P , Russell G 
Published: December 2008

Summary
Angiotensin-1-converting enzyme inhibitors have an effective and established role in the treatment of patients with congestive heart failure. However, a small number of such patients will subsequently develop renal insufficiency. These patients may be identified prior to, or shortly after, commencement of therapy by recognized criteria. This report describes 4 patients with congestive heart failure who developed severe renal insufficiency secondary to either enalapril or captopril therapy in the absence of any currently recognized predisposing factors. One patient died.
Shrinkage of thyrotrophin secreting pituitary adenoma treated with octreotide
Authors: Orme S M , Lamb J T , Nelson M , Belchetz P E 
Published: December 2008

Summary
Thyrotrophin secreting pituitary adenomas are a rare cause of recurrent thyrotoxicosis. We report on a 47 year old woman with an 8-year history of this condition. In this case the somatostatin analogue, octreotide, normalized thyroid hormone levels. It was associated with marked tumour shrinkage, with striking reduction of the suprasellar extension and improved appearances in the region of the left cavernous sinus shown by high resolution computerized tomography. Following surgery she developed a biochemical relapse which responded to the reinstitution of octreotide. On long term treatment she developed stomach cramps and gallstones. Octreotide was discontinued. We review previous reports of this condition and discuss the role of octreotide in its management.
Primary hyperparathyroidism presenting as unilateral visual loss
Authors: Chappel D , Farrington K 
Published: December 2008

Summary
A 58 year old woman presented with unilateral visual loss due to ischaemic optic neuropathy. Investigations revealed severe hypercalcaemia due to hyperparathyroidism. Excision of a large parathyroid adenoma restored normocalcaemia. Visual acuity was unchanged. There was no evidence of any condition known to be associated with ischaemic optic neuropathy, or of any abnormal clotting tendency. The association between primary hyperparathyroidism and ischaemic optic neuropathy may be causal and related to vascular damage mediated by hypercalcaemia.
Primary HIV-I infection associated with pneumonitis
Authors: Ong E L C , Mandal B K 
Published: December 2008

Summary
A 21 year old homosexual man presented with an acute pneumonitis during symptomatic seroconversion for human immunodeficiency virus (HIV-I) infection. The symptoms resolved spontaneously without any therapeutic interventions needed. Acute pneumonitis should be added to the ever-increasing spectrum of clinical manifestations in primary HIV-I infection.