bluuebunny/crossref_metadata_2025_split huggingface dataset:
An audit of a medical anticoagulant clinic in a District General Hospital
Authors: Shafi M , Mayberry J , Calcraft B 
Published: December 2008

Summary
The working and costs of the anticoagulant clinic at the Royal Gwent Hospital was reviewed over the period July 1980-June 1981. The hospital notes of the patients were reviewed and a questionnaire distributed to each patient. The majority of patients have cardiac valve problems or deep vein thrombosis, the latter sometimes being associated with pulmonary emboli. No major complications were reported during the year, but 9.7% reported rectal bleeding or haematuria. The annual cost of running the clinic is approximately 20,000 pounds and, if this is representative of Britain as a whole, about 3.75 million pounds is spent annually on anti-coagulation clinics.
Several recommendations are made for improving the anticoagulant clinic service, which includes making sure that the doctor at the clinic and the patient are made aware of the reason for anticoagulation, its duration, and possible side effects and interactions with other drugs.
Altered glycosylation and sialylation of serum proteins and lipid bound sialic acids in chronic renal failure
Authors: Kishore B K , Gejyo F , Arakawa M 
Published: December 2008

Summary
Abnormalities in the metabolism of carbohydrates, lipids and proteins are well documented in chronic renal failure (CRF). We have studied the extent of glycosylation and sialylation of serum proteins and also the levels of lipid-bound sialic acids in nondiabetic patients with CRF maintained on haemodialysis. The total neutral sugar content (TNS) and the non-enzymatic glycosylation (NEG) of serum proteins, the protein-bound sialic acids (PSA) and the lipid-bound sialic acids (LSA) were found to be significantly elevated in the patients as compared to a group of healthy controls. A single dialysis therapy produced some alterations in these measurements. The TNS correlated significantly with the NEG and also with the PSA. No correlation existed between total lipids. None of these measurements, however, correlated with the serum creatinine values. The established as well as putative pathophysiological consequences of these findings are discussed.
The natural history of painful diabetic neuropathy—a 4-year study
Authors: Boulton A J M , Armstrong W D , Scarpello J H B , Ward J D 
Published: December 2008

Summary
Thirty-nine patients with painful diabetic peripheral neuropathy were selected for a follow-up study to determine the natural history of this condition. Symptoms, motor conduction velocities (MCV) and ankle pressure indices were recorded at the initial assessment and after a mean study period of 4.7 years. Thirty-six patients completed the study and showed no significant changes in symptoms, but there was a significant fall in median nerve MCV. It is concluded that symptoms of established diabetic neuropathy persist for several years, and the changes in MCV may reflect continuing deterioration in nerve function.
Incomplete suppression of parathyroid hormone activity in sarcoidosis presenting with hypercalcaemia
Authors: Ghose R R , Woodhead J S , Brown R C 
Published: December 2008

Summary
An adult patient presenting in summertime with sarcoidosis and demonstrating raised levels of serum calcium and 1,25-dihydroxycholecalciferol was observed to have a serum immuno-reactive parathyroid hormone concentration in the mid-normal range. Renal function was normal. Corticosteroid administration quickly depressed serum calcium and 1,25-dihydroxycholecalciferol into the normal range; serum parathyroid hormone also fell to low levels.
It was concluded that corticosteroid suppression, when incorporating measurements of serum calcium and 1,25-dihydroxycholecalciferol concentrations, can distinguish between sarcoidosis-related hypercalcaemia and primary hyperparathyroidism. The significance of the changes in parathyroid hormone concentration is obscure.
Sarcoidosis and lymphoma in the same patient
Authors: Brennan Neil J , Fennelly James J , Towers Robert P , FitzGerald Muiris X 
Published: December 2008

Summary
A case of lymphocytic lymphoma in a patient with coincidental sarcoidosis is described, and the possible relationship of the two conditions is discussed. A revised set of diagnostic criteria is proposed to overcome previous difficulties encountered in validating such dual pathology.
Transient hemiparesis—a rare complication of phenytoin toxicity
Authors: Sandyk R 
Published: December 2008

Summary
A 31-year-old man on phenytoin for post-traumatic epilepsy developed transient hemiparesis contralateral to the injury. This appeared to have been precipitated by phenytoin intoxication. A possible mechanism for focal neurological deficit occurring in brain-damaged patients on phenytoin is discussed.
Enflurane for controlled hypotension
Authors: Firn Shirley 
Published: December 2008

Summary
Enflurane was substituted for halothane in an established technique of controlled hypotension, involving beta-blockade and sympathetic ganglion blockade, for 2 groups of patients. One group was undergoing major plastic surgery and/or major maxillo-facial surgery and these patients breathed spontaneously. The other group was undergoing major neurosurgery and received intermittent positive pressure ventilation (IPPV). All patients were carefully monitored during anaesthesia and for 24 hours postoperatively. Good operation conditions were produced and no ill effects of controlled hypotension were detected in any of the patients.
Ethnic differences in the distribution of normally formed singleton stillbirths
Authors: Terry P B , Condie R G 
Published: December 2008

Summary
The normally formed singleton stillbirth deliveries occurring in Dudley Road Hospital in 1979, 1980 and 1981 were classified according to the primary aetiology. There was a higher than normal stillbirth rate in the Indian group which was almost entirely accounted for by the increased number of stillbirths falling into the ‘intrauterine death before labour’ group.
Breast cancer in blacks, Asians and whites in Birmingham
Authors: Potter J F , Dawkins D M , Terry P , Beevers D G 
Published: December 2008

Summary
A retrospective study was mounted into the frequency of breast cancer in blacks, whites and Asians attending Dudley Road Hospital in the years 1970-1981 inclusive. This figure was compared with the ethnic distribution of the surrounding population and of admissions for all causes. Breast cancer was uncommon in both ethnic minorities compared with whites, but was commoner in blacks than in Asians. These trends are similar to the World Health Organization figures for Britain, Jamaica and India. Differences in parity and breast feeding do not explain the variability of breast cancer in this study.
Indican excretion in the elderly
Authors: Kirkland J L , Vargas E , Lye Michael 
Published: December 2008

Summary
It has been suggested that up to a half of elderly hospitalized patients excrete an abnormally high concentration of indican compared with young individuals. Thus, the commonly used colorimetric qualitative test for urinary indican excess may be invalid in the aged. However, of 21 young control subjects, 18 healthy elderly subjects, and 23 disabled, elderly, long-stay patients, no individual had levels of indican detectable by the standard colorimetric qualitative test. The use of a quantitative assay demonstrated that urinary indican concentration is similar in young and elderly individuals. A diurnal variation in urinary indican concentration was discovered which may affect the interpretation of the qualitative test.
Tracheal obstruction presenting as asthma
Authors: Parrish R W , Banks J , Fennerty A G 
Published: December 2008

Summary
A case is reported in which a tracheal tumour presented with symptoms suggestive of bronchial asthma. In the assessment and management of airways obstruction and wheeze, it is important to bear in mind that disease other than asthma and chronic bronchitis may present in this way.
Strangulated umbilical hernia in a child
Authors: Vyas I D , MacKinnon A E 
Published: December 2008

Summary
We describe a case of strangulated umbilical hernia in a girl aged 5 years. She presented with an acute inflammatory lesion at the umbilicus which was initially thought to be due to cellulitis with possible abscess formation. Exploration revealed an umbilical hernia containing necrotic greater omentum.
The role of echocardiography in the investigation of focal cerebral ischaemia
Authors: Burnett Peter J. , Milne John R. , Greenwood Richard , Giles Martin R. , Camm John 
Published: December 2008

Summary
One-hundred and ten patients referred for echocardiography to exclude a cardiac source of cerebral emboli were prospectively studied. Four patients with known cardiac abnormalities, for which they were receiving inadequate anticoagulation, were excluded from the study, and 18 patients were subsequently found to have a non-embolic cause for their cerebral pathology. Twenty-eight patients with a normal clinical examination, chest X-ray and electrocardiogram, and 27 patients with hypertension alone had echocardiograms which did not reveal a cardiac source of embolus. Of the remaining group of 33 patients, six were found to have a probable cardiac source of embolus and nine had abnormalities which may be associated with cerebral emboli. Echocardiography may not be indicated in patients with a normal clinical examination, chest X-ray and electrocardiogram, and in patients with hypertension alone. However, if these patients are excluded echocardiography gives a high yield of positive findings which may be of practical importance in the management of the patient.
A comparison of isocaloric high carbohydrate and high fat test meals in diabetics
Authors: Jones D. B. , Patel P. , Slaughter P. , Carter R. D. , Mann J. I. , Hockaday T. D. 
Published: December 2008

Summary
Ten diabetic patients were given test meals at breakfast and lunch on successive days to compare the acute glycaemic responses to meals either high (65%) (HC) or extremely low (12%) in carbohydrate; the latter was very high (71%) in fat (HF). The meals were isocaloric and fibre content, though higher in HC, was within the range of the average British intake for both diets.
The mean fasting blood glucose levels were similar on the 2 days (9.8 mmol/l; 9.6 mmol/l) but mean peak post-prandial levels were significantly greater after the HC meals (17.7 mmol/l after breakfast and 14.1 mmol/l after lunch) than after the HF meals (11.7 mmol/litre after breakfast; P less than 0.02; 8.1 mmol/l after lunch; P less than 0.02). Mean blood glucose value for the 6-hr study period was significantly higher after the HC meals (14.0 mmol/l) than after the HF meals (9.2 mmol/l; P less than 0.001). There was no significant difference in mean fasting, peak or total mean triglyceride level.
In the short term, therefore, meals very low in carbohydrate and high in fat are followed by a lower glycaemic response than meals high in carbohydrate but with only a usual (22 g/day) fibre content. Delayed gastric emptying after HF meals may well contribute to the results but long-term use of such HF meals is not advised in view of the extremely high fat content.
Horner’s syndrome with ipsilateral vocal cord and phrenic nerve palsies
Authors: Amin Rajni 
Published: December 2008

Summary
Two further cases of a recently described syndrome (Rowland Payne, 1981) constituting a triad of sympathetic ophthalmoplegia, phrenic nerve palsy and ipsilateral vagus or recurrent laryngeal nerve paralysis are described. This is a syndrome of signs, but hoarseness, dysphagia, dysaesthesia and pain in the ipsilateral shoulder may be associated symptoms. Development of this syndrome in patients with malignant disease does not necessarily signify a very grave prognosis.
Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent
Authors: Nathan A. W. , Bexton R. S. , Hellestrand K. J. , Camm A. J. 
Published: December 2008

Summary
A man with a past history of malignant ventricular arrhythmias occurring late after myocardial infarction was admitted for assessment. Monitoring revealed frequent ventricular premature beats and occasional non-sustained runs of ventricular tachycardia. Other drugs having failed, he was started on oral propafenone which is a new Vaughan Williams class IC antiarrhythmic agent. Several hours after starting this drug he had incessant ventricular tachycardia and subsequently died. Other class IC agents have been shown to have a high incidence of proarrhythmic effects, and particular care should be taken with these potent new drugs.
Does health education prevent childhood accidents?
Authors: Minchom P. E. , Sibert J. R. , Newcombe R. G. , Bowley M. A. 
Published: December 2008

Summary
In an attempt to test the assumption that health education directed at parents and children can reduce childhood accidents, a controlled study was carried out in Ely , one area of Cardiff. Using conventional health education techniques, the campaign was carried out in June and July 1981 and monitored by the numbers of injured children attending the local Accident and Emergency Department.
Comparison of accident numbers in Ely between 1980 and 1981 and between Ely and the whole of Cardiff in 1981 showed no significant change. A slight increase in trivial injuries suggested an increased willingness to attend hospital. There was no change in the age distribution of victims.
The benefits of health education and alternative methods of accident prevention are discussed and the need for further research is emphasized.
Laryngocoele causing airflow obstruction—a case report and summary of clinical manifestations in five other patients
Authors: Banks J. , Davis B. R. , Monie R. D. H. 
Published: December 2008

Summary
We present six patients with laryngocoeles , one of whom presented as an emergency to a Chest Unit. A swelling in the neck was present in five, two patients had hoarseness progressing to stridor and three complained of dysphagia. No underlying cause was found in any of the patients. Surgical management was necessary in five with good results.
Impaired nitrazepam metabolism in hypothyroidism
Authors: Kenny Rose Anne , Kafetz Kalman , Cox Maria , Timmers Josepha , Impallomeni Mario 
Published: December 2008

Summary
Delayed metabolism of a number of drugs has been described in hypothyroid patients. We report an elderly hypothyroid female who had prolonged delay in the metabolism of a commonly-used sedative, nitrazepam, and discuss the importance of delayed drug metabolism in hypothyroidism.
Effect of the H2-receptor antagonist ranitidine on depression and anxiety in duodenal ulcer patients
Authors: Robins Ashley H. , Lucke Wendy , McFadyen M. Lynn , Wright John P. 
Published: December 2008

Summary
Depression and anxiety were measured during the course of a double-blind, placebo-controlled trial of the histamine H2-receptor antagonist, ranitidine (150 mg twice daily), in patients suffering from duodenal ulcer but free of systemic disease. There were 25 patients in the ranitidine group (mean age: 33.2 years) and 28 in the placebo group (mean age: 37.2 years). In both groups there was a highly significant and progressive decrease in depression and anxiety scores over the 4 weeks of treatment. There were no instances of mental confusion. In our group of otherwise physically healthy patients, ranitidine appeared to be free of neuropsychiatric complications.
Hypertensive encephalopathy complicating transplant renal artery stenosis
Authors: McGonigle R. J. S. , Bewick M. , Trafford J. A. , Parsons V. 
Published: December 2008

Summary
A 26-year-old female diabetic patient developed hypertensive encephalopathy with gross neurological abnormalities complicating renal artery stenosis of her transplant kidney. The elevated blood pressure was unresponsive to medical treatment. Surgical correction of the stenoses in the renal artery cured the hypertension and renal failure and led to the patient’s complete recovery.
Recurrence of asthma following removal of a noradrenaline-secreting phaeochromocytoma
Authors: Harvey J. N. , Dean H. G. , Lee M. R. 
Published: December 2008

Summary
A patient with asthma and a phaeochromocytoma is described. At about the time she was first noted to be hypertensive her asthma resolved spontaneously but bronchospasm returned with some severity when the tumour was removed. The phaeochromocytoma was of the noradrenaline secreting variety. Possible mechanisms through which this catecholamine might have produced the observed alleviation of asthma are considered.
Serum phosphorus levels in pulmonary tuberculosis
Authors: Kardjito T. , Ediyanto S. P. , Grange J. M. 
Published: December 2008

Summary
The mean level of phosphorus was significantly higher in a group of 96 Indonesian patients with pulmonary tuberculosis than in 100 control subjects. The levels in disease showed a moderate correlation with those of the globulin proteins, but not the gamma-globulins. There was an association between levels of phosphorus and those of transferrin but not with those of seven other acute-phase associated proteins.
There was a tendency for phosphorus levels to be higher in those with elevated polymorphonuclear leucocyte counts and, although not significantly so, in those with more extensive active disease, suggesting an association with tissue destruction. It appears therefore more relevant to study the behaviour of this element than that of calcium in tuberculosis.
Immobilization hypercalcaemia with severe bone mineral loss and hypogonadism
Authors: Need Allan G. , Morris Howard A. , Horowitz Michael , Nordin B. E. Christopher 
Published: December 2008

Summary
Moderate hypercalcaemia occurred in a 17-year-old male who was immobilized with abdominal and right hip sepsis for 9 months after a motor vehicle accident.
The hypercalcaemia was due to bone resorption, with a urine hydroxyproline:creatinine ratio of 0.203 (normal less than 0.017) and a urine calcium loss of 22.9 mmol/24 hr, associated with impaired renal function. There was radiological evidence of severe bone demineralization in the pelvis over 42 weeks.
Radiocalcium absorption, using 47Ca, was decreased (0.17, normal range 0.35–1.30), renal tubular maximum for calcium reabsorption was decreased (1.61 mmol/1 glomerular filtrate, normal range 1.8-2.2), the serum parathyroid hormone concentration was in the low normal range (3.2, 3.6 u/l, normal range 2-6) and the plasma 1,25-dihydroxy-vitamin D concentration was decreased despite a normal 25-hydroxy-vitamin D concentration, indicating suppression of the parathyroid, 1,25-dihydroxy-vitamin D axis. The patient was found to be hypogonadal at 41 weeks after admission and testosterone therapy was begun, with associated improvement in mobilization and a reduction of the hypercalcaemia.
Cerebral arterial occlusion and intracranial venous thrombosis in a woman taking oral contraceptives
Authors: Montón F. , Rebollo M. , Quintana F. , Berciano J. 
Published: December 2008

Summary
Occlusion of the middle cerebral artery and thrombosis of the superior sagittal sinus are reported in a 30-year-old woman taking oral contraceptives (OC). The coexistence of arterial and venous cerebral pathology as a complication of OC use has only been previously reported in one case. The pathogenesis of this rare association is briefly discussed.
Cardiac tamponade in rheumatoid arthritis
Authors: Sanchez-García Pedro , Cordero-Sánchez Miguel , Pavón-Osuna Pedro , Arribas-Jiménez Antonio , del Pino-Montes Javier , de Portugal-Alvarez José 
Published: December 2008

Summary
A 56-year-old woman with definite rheumatoid arthritis developed cardiac tamponade while her disease was both clinically and serologically inactive. To our knowledge such a complication has been reported only once previously.
Idiopathic hypergammaglobulinaemia associated with nephrogenic diabetes insipidus and distal renal tubular acidosis
Authors: Spruce Barbara A. , Baylis P. H. , Kerr D. N. S. , Morley A. R. 
Published: December 2008

Summary
Renal tubular dysfunction may be recognized in patients suffering from urinary light chain disease or non-myelomatous hypergammaglobulinaemia. We report a patient who has the combination of distal renal tubular acidosis and nephrogenic diabetes insipidus in association with hypergammaglobulinaemia due solely to increased IgG. We postulate that the abnormalities of distal nephron function resulted from cell-mediated immune damage.
Myxoedema presenting as epilepsy
Authors: Rowell N. P. , Clarke S. W. 
Published: December 2008

Summary
A case of myxoedema presenting as epilepsy is described. In myxoedematous patients without demonstrable cause for their fits, the epilepsy commonly responds to thyroid replacement therapy alone. In this patient, control of hypertension was ineffective in eradicating fits. The association between myxoedema and epilepsy, though previously reported, is surprisingly uncommon and represents a good prognosis within new epileptics.
Meningococcal meningitis presenting with bilateral deafness and ataxia
Authors: Sandyk R. , Brennan M. J. W. 
Published: December 2008

SummaryA 50-year-old man presented with bilateral deafness and ataxia of sudden onset and without constitutional symptoms or signs of meningeal irritation. He was subsequently proved to have meningococcal meningitis, and the deafness and ataxia resolved following appropriate antibiotic therapy.
The CREST syndrome—successful reduction of pulmonary hypertension by captopril
Authors: Prouse P. J. , Lahiri A. , Gumpel J. M. 
Published: December 2008

Summary
A patient with severe pulmonary hypertension due to pulmonary arteriolar obliteration complicating a long standing CREST variant of systemic sclerosis showed improvement in cardiac output and exercise tolerance during treatment with captopril, which was discontinued because of persistent systemic hypotension.
It is suggested that captopril would have a useful and possible prophylactic effect early in pulmonary hypertension in systemic sclerosis.
A patient with six primary carcinomata
Authors: La Ferla Godfrey , Thomson William O. 
Published: December 2008

Summary
We report a patient who developed six different primary carcinomata over a period of 3 years. These were of sigmoid colon, left breast, left kidney, right breast and two basal cell carcinomata of her face. These were all excised and she remains well with no apparent metastases 5 years after her initial presentation.
Although patients with multiple tumours are uncommon, recognition of such an occurrence is important to avoid attributing symptoms to metastases from a previously diagnosed tumour. Sequential primary tumours may be amenable to treatment.
Human placental lactogen (hPL) deficiency in a normal pregnancy
Authors: Giampietro Ottavio , Ferdeghini Marco , Scatena Paolo 
Published: December 2008

Summary
A case of human placental lactogen (hPL) deficiency together with normal oestriol levels associated with a normal pregnancy in a woman in her second pregnancy is reported. The woman gave birth to a healthy male infant. The placenta was normal. Extremely low hPL levels may be compatible with the delivery of a healthy infant.
Severe hypertension and raised haematocrit: unusual presentation of Guillain-Barré syndrome
Authors: Richards A M , Nicholls M G , Beard M E J , Parkin P J , Espiner E A 
Published: December 2008

SummaryA 36 year old man presented with headache, polyuria, thirst and weakness of the lower limbs. Hypertension and a high haematocrit were striking features on initial assessment. Subsequently the full picture of Guillain-Barré syndrome developed. Hormone measurement revealed marked sympathetic nervous system and renin-angiotensin system activation with a return to normal of both blood pressure and hormones with neurological recovery.