bluuebunny/crossref_metadata_2025_split huggingface dataset:
The accuracy of creatinine clearance with and without urine collection as a measure of glomerular filtration rate
Authors: Waller D G , Fleming J S , Ramsey B , Gray J 
Published: December 2008

Summary
Conventional creatinine clearances involving urine collections over 2, 4 and 24 hours and creatinine clearance predicted from plasma creatinine concentrations without urine collection were compared to glomerular filtration rate (GFR) estimated by 99mTc DTPA clearance in 171 patients with a wide range of GFR.
All creatinine clearance methods involving urine collection had standard errors of the estimate of GFR greater than predictions from formulae.
Predictions of creatinine clearance by formulae had coefficients of variation of the estimate of approximately 23% when compared to isotopically determined GFR.
Creatinine clearances determined by these equations in patients with stable renal function are an easier and at least as accurate a guide to GFR as methods involving urine collection.
A study of admissions to paediatric beds
Authors: Rajaratnam G 
Published: December 2008

Summary
The reasons for admission of children to paediatric beds and the appropriateness of those admissions were investigated by a retrospective study of admission notes by two paediatricians. Approximately 3% and 9% of the admissions according to assessor, were for purely social reasons and the remainder for predominantly medical reasons. There were a number of admissions for whom the assessors were unable to justify admission. Assessor 1 considered that 20% and assessor 2 15%, of those studied could have been managed without admission. Agreement over individual cases between assessors was poor but significant. The assessors agreed that admission was appropriate in 74% and inappropriate in 8% of cases. In the remaining 18 cases, the assessors did not agree on the need for admission. It is suggested that there is a need for local specialty specific admission policies to ensure cost-effective use of facilities.
Acute myocardial infarction with normal coronary arteries in a case of polyarteritis nodosa: possible role of coronary artery spasm
Authors: Rajani R M , Dalvi B V , D'Silva S A , Lokhandwala Y Y , Kale P A 
Published: December 2008

Summary
A 20 year old man with no previous history of heart disease presented with acute left ventricular failure following extensive anterior wall myocardial infarction. Selective angiography revealed multiple aneurysms in the renal, mesenteric and hepatic arteries with an infarct in the lower pole of the right kidney. These findings, along with the presence of circulating hepatitis B surface antigen favoured the diagnosis of polyarteritis nodosa. In view of normal coronary angiogram and absence of myocardial vasculitis, coronary vasospasm was implicated as the cause of myocardial infarction. Such an occurrence, which could have different therapeutic and diagnostic implications, has not, to our knowledge, been previously described in polyarteritis nodosa.
Unstable anginal syndrome and pulmonary oedema due to thyrotoxicosis
Authors: Glikson M , Freimark D , Leor R , Shechter M , Kaplinsky E , Rabinowitz B 
Published: December 2008

Summary
We report on a 40 year old woman who presented with typical unstable angina pectoris associated with pulmonary oedema, due to poorly controlled hyperthyroidism. No cardiac abnormality was detected by echo-Doppler and nuclear ventriculography. Coronary angiography demonstrated normal coronary arteries. This case represents a new manifestation of the known association of cardiac ischaemia with hyperthyroidism in the presence of normal coronary arteries.
Squamous cell carcinoma arising in a subcutaneous dermoid cyst
Authors: Stephenson G C , Ironside J W 
Published: December 2008

Summary
A case of malignant transformation to a squamous cell carcinoma in a long-standing subcutaneous dermoid cyst in a 44 year old man is presented. Malignant transformation in dermoid cysts is extremely uncommon and has never previously been recorded at this site. The need for adequate investigation and treatment of superficial midline lesions presenting in childhood is emphasized.
‘Tru-Cut’ needle biopsy of the liver: importance of the correct technique
Authors: Maharaj B , Pillay S 
Published: December 2008

Summary
In order to determine which technique would provide adequate tissue for histological examination when the ‘Tru-Cut’ needle is used for liver biopsy, the livers of cadavers were biopsied by a single operator, under direct vision, using a ‘Tru-Cut’ needle. The modified breast biopsy technique either preceded or followed one of two alternative methods, one of which was recommended by the manufacturer, in a random manner. Thereafter, the biopsies were repeated using the alternative sequence.
The mean length of the liver biopsy specimens that were obtained using the modified breast biopsy technique was 16.3 mm (range: 8–20 mm). The corresponding figures for the manufacturerer's method were 7.7 mm (range: 2–14 mm) and for the third technique were 2.7 mm (range: 0.5–8 mm). Three of the 40 specimens (7.5%) obtained using the latter technique fragmented when placed in formalin; this did not occur in any of the 40 specimens taken using the modified breast biopsy technique.
This investigation indicates that the modified breast biopsy technique should be used when ‘Tru-Cut’ needle biopsy of the liver is performed. This provides specimens which are adequate for histological diagnosis. In addition, the safety of liver biopsy, which is compromised by poor technique, is improved. The alternative methods, including that recommended by the manufacturer, must be avoided.
RelapsingSalmonella enteritidisinfection in a young adult male with chronic granulomatous disease
Authors: Safe A F , Maxwell R T , Howard A J , Garcia R C 
Published: December 2008

SummaryA case of chronic Salmonella enteritidis infection in a young adult patient is reported. Following an initial enteritis with bacteraemia, the illness lasted for a 7-year period and was characterized by recurrent pyrexia, anaemia, weight loss and marked hepatosplenomegaly.Investigations revealed that the patient suffers from a mild form of chronic granulomatous disease presenting in adolescence.
Poor uptake of hepatitis B immunization amongst hospital-based health care staff
Authors: Burden A D , Whorwell P J 
Published: December 2008

Summary
The uptake of hepatitis B vaccine was assessed amongst 100 medical and 100 nursing staff in a teaching hospital with a policy of recommending to those at risk that they should seek immunization from their general practitioners.
Sixteen per cent of nurses and 31% of doctors had completed a course of immunization with confirmation of seroconversion. An additional 9% and 18% respectively had been immunized without post-immunization serology. Ninety three per cent of nurses and 61% of doctors who had not been immunized would like to receive the vaccine. The commonest reasons for non-immunization amongst nurses were fear of vaccine and lack of advice, and amongst doctors, apathy and difficulty in obtaining the vaccine. Eighty seven per cent of medical staff and 57% of nurses had a history of needle stick injury.
The low rates of vaccine uptake in this study combined with the high incidence of needle stick injury calls for a reappraisal of present hepatitis B vaccination programmes in hospitals. In particular the abrogation of responsibility for immunization to general practitioners is probably a major disincentive to potential vaccines.
Recurrent bacterial meningitis occurring five years after closed head injury and caused by an intranasal post-traumatic meningo-encephalocele
Authors: Giunta G , Piazza I 
Published: December 2008

Summary
A case of atypical presentation of a post-traumatic intranasal meningo-encephalocele is described in a patient with a history of recurrent bacterial meningitis occurring 5 years after closed head injury. The usefulness of the CT and MRI findings in diagnostic evaluation of this lesion is emphasized.
Congenital central alveolar hypoventilation syndrome (Ondine's Curse): effectiveness of early home ventilation for normal development
Authors: Chang Y L , Meerstadt P W D 
Published: December 2008

Summary
An 8 month old Caucasian girl, with congenital central alveolar hypoventilation syndrome (Ondine's Curse), was discharged with her home ventilation managed by her parents. Her subsequent neurophysical development assessed at 22 months of age was satisfactory.
Vogt-Koyanagi-Harada syndrome, a rare association of Hodgkin's disease
Authors: Chuah S Y , Lyne A J , Dronfield M W 
Published: December 2008

SummaryVogt-Koyanagi-Harada syndrome (VKHS) is a well-documented clinical entity. We report the case of a 24 year old man who, within 5 months of the diagnosis of VKHS, developed Hodgkin's disease. Like VKHS, the aetiology of Hodgkin's disease is unknown. A viral factor has been suspected in the pathogenesis of both conditions. Similar immunological abnormalities have been described in both, and may be important predisposing factors.
The effect of caffeine on postprandial blood pressure in the frail elderly
Authors: Heseltine D , El-Jabri M , Ahmed F , Knox J 
Published: December 2008

SummaryIn a double-blind, random-order, cross-over study the effects of placebo and 100 mg of caffeine on postprandial sitting and erect blood pressure and heart rate were studied in 20 frail elderly subjects (mean age 84, range 75–93 years) after a standardized 400 K-calorie glucose drink. Maximal postprandial reduction in sitting systolic blood pressure occurred, at 60 minutes post-placebo, of − 11 mmHg (95% confidence interval −5 to −17 mmHg, P&lt;0.01), and was attenuated by caffeine (P&lt;0.05) with changes in systolic blood pressure, at 60 minutes post-drink, of 1 mmHg (95% CI −6 to 7 mmHg, not significant). Four subjects developed symptomatic postprandial hypotension after placebo which was prevented by caffeine. There were no significant changes in erect systolic blood pressure, postural systolic blood pressure change, sitting and erect, diastolic blood pressure and heart rate between treatment phases.Caffeine attenuates the postprandial fall in sitting blood pressure in frail elderly subjects and in particular prevented symptomatic blood pressure reductions in subjects with postprandial hypotension.
Safety and efficacy of fluconazole treatment for Candida oesophagitis in AIDS
Authors: Gil A , Lavilla P , Valencia E , Pintado V , Dupla M L , Khamashta M A , García-Puig J , Ortiz-Vázquez J 
Published: December 2008

Summary
The efficacy and safety of fluconazole in the treatment of oesophageal candidiasis in patients with the acquired immunodeficiency syndrome (AIDS) was assessed in 36 patients. Fluconazole, 200 mg orally, was given on the first day, followed by 100 mg daily for 4 weeks. Clinical and mycological evaluation was performed in 31 patients at the end of treatment and 24 were also assessed after 8 weeks of starting treatment. In 1 patient fluconazole was discontinued, 5 patients were lost to follow-up and 6 patients died during the study.
Clinical and mycological cure was achieved in all patients; in 31 of 36 patients the clinical picture resolved within a week. The cure was confirmed in 27 patients by oesophagoscopy. Two patients relapsed 1 month after stopping fluconazole but the reinstitution of therapy achieved cure. Asymptomatic fungal oropharynx colonization was evident in about 40% of patients during treatment and follow-up period. Fluconazole was well tolerated by all patients but mild to moderate increase of liver enzymes values occurred in 16. Treatment had to be discontinued in 1 patient with hepatic tuberculosis because of severe liver function abnormalities, but their relation with the drug was uncertain.
Fluconazole is an effective and safe treatment of oesophageal candidiasis in AIDS patients.
Congenital hypothyroidism—correlation between radiographic appearances of the knee epiphyses and biochemical data
Authors: Newland C J , Swift P G F , Lamont A C 
Published: December 2008

Summary
Plain knee radiographs of 20 neonates with congenital hypothyroidism, were reviewed. The size and appearances of the epiphyses were compared with the biochemical data at the time of referral.
Fifteen infants had unequivocal evidence of delayed bone maturation based on absence of the distal femoral epiphysis or small epiphyseal size. Seven cases had fragmentation of at least one epiphysis.
A positive correlation was found, at diagnosis, between the thyroxine and triiodothyronine levels and the size of the knee epiphyses. All 14 infants with thyroxine levels of less than 70 nmol/l had small epiphyses with a combined mean diameter of the proximal tibial plus distal femoral epiphyses of 7 mm or less. Conversely, of the 6 infants with thyroxine levels of 70 nmol/l or above, 5 had combined epiphyseal diameters of greater than 10 mm.
We suggest that in infants with no clinical symptoms and only moderately raised raised screening thyroid stimulating hormone, a knee radiograph showing the described radiological changes should prompt institution of thyroxine treatment before awaiting biochemical confirmation of the diagnosis.
Arthritic presentation of childhood leukaemia
Authors: Bradlow A , Barton C 
Published: December 2008

Summary
Three cases of childhood acute lymphatic leukaemia masquerading as juvenile chronic arthritis are presented. All had symptoms and signs for at least 4 months before leukaemia was diagnosed and in two the full blood count was normal at presentation. The importance of a high index of suspicion is emphasized, particularly if the white cell count is low.
The Dieulafoy gastric malformation: an under-recognized cause of massive upper gastrointestinal haemorrhage
Authors: Welch M , Hoare E M 
Published: December 2008

Summary
The Dieulafoy gastric malformation is a rare cause of upper gastrointestinal haemorrhage. When no obvious bleeding lesion is seen at laparotomy this diagnosis ought to be considered. Three such cases were identified and treated with simple underrunning of the lesion with no mortality and minimal morbidity. Follow-up endoscopy in each patient showed complete healing of the lesion.
Histiocytosis X involving the thyroid and hypothalamus
Authors: Gaines P , Chan J C N , Cockram C S 
Published: December 2008

Summary
A case of histiocytosis X involving the thyroid and hypothalamus is reported. A 16 year old female presented with amenorrhoea and diabetes insipidus. She subsequently developed a painful goitre with biochemical hypothyroidism, and stridor. The stridor and goitre responded to cyclophosphamide. Previous publications on the use of cytotoxics in histiocytosis X involving the thyroid are reviewed. We describe for the first time both the ultrasound appearances of the thyroid in this condition and the use of serial volumetric measurements to monitor therapy.
Medical disorders in Alzheimer's disease and vascular dementia
Authors: Förstl H , Cairns N , Burns A , Luthert P 
Published: December 2008

Summary
The clinical and postmortem findings of 29 patients with Alzheimer's disease were evaluated and compared to the findings of 19 patients with vascular dementia. The patients with Alzheimer's disease had received treatment for an average of 2.0 internal medical disorders, the patients with vascular dementia for 2.1 disorders. The average number of medical diseases found at postmortem was 3.7 in the group with Alzheimer's dementia and 4.1 in vascular dementia. Apart from a marginally increased rate of peripheral occlusive artery disease in vascular dementia, the proportions of the most common disorders of the cardiovascular, genitourinary, gastrointestinal and endocrinological disorders and the most common causes of death did not differ significantly between these groups. Therefore patients with Alzheimer's disease should receive the same internal medical attention as patients with vascular dementia.
Delayed recovery of renal function in patients with acute renal failure due to accelerated hypertension
Authors: Yaqoob M , McClelland P , Ahmad R 
Published: December 2008

Summary
Five patients with acute renal failure due to accelerated hypertension required regular dialysis treatment for 2–12 months (mean 8.8), before recovering sufficient renal function for dialysis to be withdrawn. Two patients who had prior evidence of chronic renal impairment remained off dialysis for 20 and 27 months before decompensating again to require regular dialysis treatment. Two patients with no prior history of renal disease have remained independent of dialysis for 32 and 48 months. The fifth patient was lost to follow-up after a 7 month dialysis-free period.
Delayed recovery of renal function following accelerated hypertension is a distinct possibility and should be considered in such patients before contemplating long term strategies such as renal transplantation.
Association of Addison's disease with autoimmune disorders—a long-term observation of 180 patients
Authors: Kasperlik-Zaluska A A , Migdalska B , Czarnocka B , Drac-Kaniewska J , Niegowska E , Czech W 
Published: December 2008

Summary
This study aimed at evaluating the frequency of autoimmune disorders in Addison's disease. We have observed 180 patients (113 females, 67 males, aged 9–74 years) for 1 to 26 years. Tuberculosis was noted in 54 patients. Autoimmune disorders were found in 80 patients (44%); however, 125 (69%) patients were believed to have an autoimmune origin of adrenocortical insufficiency. In 20 patients two or more autoimmune disorders were found to coexist with Addison's disease.
Functional bowel symptoms in diabetes—the role of autonomic neuropathy
Authors: Maxton D G , Whorwell P J 
Published: December 2008

Summary
The autonomic nervous system may have a role in the pathogenesis of irritable bowel syndrome. If so, the occurrence of irritable bowel symptomatology in patients with autonomic neuropathy might indicate which, if any, of these symptoms are dependent on autonomic innervation. The prevalence of abdominal pain, abdominal distension and an abnormal bowel habit was recorded in 200 patients with diabetes, screened for autonomic neuropathy, and 200 matched controls. Constipation was significantly more common in patients with autonomic neuropathy than in those without, or controls (22.0% vs 9.2% vs 6.8%). The prevalence of abdominal pain and abdominal distension was no different in patients with and without autonomic neuropathy and their respective controls. The results of this study suggest that control of bowel habit is more dependent on the total integrity of the autonomic nervous system than the perception of pain or the production of distension.
Partial splenectomy for massive splenomegaly secondary to Gaucher's disease
Authors: Thomas W E G , Winfield D A 
Published: December 2008

Summary
A 16 year old girl with Type 1 Gaucher's disease presented with massive splenomegaly, hypersplenism and abdominal discomfort. Traditionally hypersplenism has been treated with splenectomy, but this results in a high incidence of overwhelming sepsis and accelerated sphingolipid deposition in both liver and bone. A 90% partial splenectomy was therefore performed leaving a fully vascularized inferior segment of the spleen and resecting 5.8 kg of splenic tissue. The patient made an uneventful recovery with a marked improvement in her haematological parameters and general condition.
Intestinal pseudo-obstruction due to amyloidosis of the colon in association with an intestinal plasmacytoma
Authors: Nicholl D , Jones T 
Published: December 2008

Summary
A case of large bowel pseudo-obstruction due to colonic amyloidosis associated with an intestinal plasmacytoma is described. The association of an intestinal plasmacytoma with massive local amyloid deposition has not to our knowledge been previously reported.
Changing patterns of malaria in south-east Scotland: implications for practitioner awareness and prophylactic advice
Authors: Willocks Lorna , Jones Michael , Brettle Ray , Welsby Philip , Gray James 
Published: December 2008

Summary
The medical records of all 229 patients with malaria admitted to the Edinburgh City Hospital between 1969 and 1988 were studied retrospectively. A total of 137 were from Africa, 44 from the Indian subcontinent, 19 from the Far East, 18 from New Guinea, 5 from the Middle East and 3 from South America. The number of yearly admissions rose markedly after 1983, mainly due to an increase in Plasmodium falciparum cases. Ninety-four cases (15 with severe parasitaemia) mainly from Kenya and Nigeria were due to P. falciparum infection and 99 to P. vivax. There were no deaths. A seasonal distribution of onset of fever in patients with P. vivax infections originating from the Indian subcontinent showed that most patients presented during the summer.
Prophylaxis had generally been irregular or non-existent but many compliant patients may have been receiving an inadequate dose of chloroquine on a mg/kg body weight basis. General practitioners are likely to see at least one case of malaria every 4 years. They are encouraged to seek advice from a specialist unit whenever necessary whether before or after their patient travels abroad. Travellers, in particular to Kenya and Nigeria, and Asian immigrants to the UK returning on holiday to their country of origin should be strongly advised to take regular prophylaxis including on return to the UK.
Erythromelalgia--the role of hypnotherapy
Authors: Chakravarty K , Pharoah P D P , Scott D G I , Barker S 
Published: December 2008

Summary
Erythromelalgia is an unusual condition characterized by attacks of burning pain in the hands and feet with local congestion and increased skin temperature. We report a case of erythromelalgia, with transient hypertension and elevated urinary catecholamines successfully treated by hypnotherapy. Such an association has not to our knowledge been previously reported in English language publications.
Actinomycosis complicating chronic diverticulitis of the sigmoid colon: a missed association?
Authors: Samuel I , Dixon M F , Benson E A 
Published: December 2008

Summary
The diagnosis and treatment of abdominal actinomycosis is difficult. We report a case of chronic diverticulitis of the sigmoid colon with stricture formation and obstruction, which was complicated by intramural actinomycosis. We suggest that diverticular strictures and actinomycosis may coexist more often than the literature suggests.
Malignant small cell tumour (Askin-Rosai) of the pericardium
Authors: Mohandas K M , Chinoy R F , Merchant N H , Lotliker R G , Desai P B 
Published: December 2008

SummaryAn Askin-Rosai tumour presenting as effusive constrictive pericarditis is reported. A 2-D echocardiogram was strongly suggestive of a primary pericardial tumour, and multiple pericardial and pleural aspiration failed to yield malignant cells. The final diagnosis was made at autopsy. Primary pericardial Askin-Rosai tumour has not to our knowledge been previously reported.
Extrapulmonary small cell carcinoma of bone
Authors: Raina Vinod , Milroy Robert , Al-Dawoud Abdul , Dunlop David , Soukop Michael 
Published: December 2008

Summary
Small cell carcinoma has been reported to arise in many extrathoracic sites. However, such tumours arising from bone have not been previously described. We report what we believe is the first reported case of extrapulmonary small cell carcinoma of bone. The tumour arose from the fifth dorsal vertebra in a 60 year old woman. The patient was treated with local radiotherapy and combination chemotherapy and remains in remission, 18 months after diagnosis. As such extrathoracic small cell tumours are rare, there seem to be no clear-cut guidelines for treating them, but combination chemotherapy is recommended.