bluuebunny/crossref_metadata_2025_split huggingface dataset:
Black urine
Authors: Altmann P , Mansell M A 
Published: December 2008

AbstractA patient is described in whom spontaneous blackening of the urine, due to melanin formation, resulted from treatment with alpha-methyldopa. The colour change became apparent only after the correction of a severe postoperative hyponatraemic alkalosis, the urinary pH had become alkaline, as melanin formation in acid urine is very slow.
Pattern of renal amyloidosis in Indian patients
Authors: Chugh K S , Datta B N , Singhal P C , Jain S K , Sakhuja V , Dash S C 
Published: December 2008

Summary
Two hundred and thirty-three patients with renal amyloidosis were studied in an attempt to identify the incidence and pattern of the disease in northern India. The incidence of amyloidosis was 1.01% of 6431 post-mortems and 8.4% of 1980 renal biopsies from patients who presented with clinical evidence of glomerular disease. Two hundred and three patients (87.1%) had secondary amyloidosis, 22 (9.4%) had primary amyloid and 8 patients (3.5%) had amyloidosis associated with multiple myeloma. Tuberculosis of various organs was the commonest predisposing disease accounting for 59.1% of secondary amyloidosis, followed by chronic suppurative lung disease in 24.1%. Rheumatoid arthritis, chronic osteomyelitis and lepromatous leprosy were seen in a small percentage of patients (2 to 8%). Proteinuria of varying degree was present in all the 233 patients and 12.9% of them had a daily protein excretion of more than 10 g.
Post-mortem examination of 65 patients with renal amyloidosis showed that 75.3% also had amyloid deposit in the spleen, 63% in the liver, and 50.8% in the adrenals. Clinical evidence of disappearance of proteinuria was observed in 3 patients with secondary amyloidosis; in 2 of them, the regression of amyloidosis was confirmed by serial renal biopsy performed 3 and 5 years after the initial diagnosis.
Obstructive sodium-losing nephropathy--a case report and review
Authors: Nunn P P , Owens C W I , Scholberg C B , Prichard B N C 
Published: December 2008

Summary
The third case in the literature of sodium-losing renal disease due to obstruction is presented. The experimental evidence and limited clinical experience is reviewed which suggests that the sodium loss is due to an inappropriate response in the adaptive processes that are initiated by the loss of functioning nephrons. The immediate treatment is by replacement of sodium but in the long term the condition may be reversed by very cautious reduction in sodium intake. Definitive treatment may be indicated where obstruction is the cause and consequently this should be sought in all cases of salt-losing renal disease.
Colonic gall-stone ileus
Authors: Anseline P 
Published: December 2008

Summary
A case of obstruction of the colon by a solitary, large gall-stone is described. This rare event usually occurs in elderly females in whom there is frequently an underlying pathological condition at the site of obstruction in the colon. The calculus usually migrates via a cholecystocolic fistula. Diagnosis may be assisted by plain abdominal X-ray and contrast radiography. Immediate operative treatment should be tailored to the patient’s general condition and the nature of the pathological changes.
Sipple syndrome: marked variability of the disease within a family and implications for management
Authors: Stevenson John C , Hillyard Carmel J , Spanos Evangelos , MacIntyre Iain , Ackroyd Nigel , Lynn John , Brown Morris J , Stevenson Bonnie M 
Published: December 2008

Summary
Familial medullary carcinoma of the thyroid gland is often associated with phaeochromocytoma; this condition is known as Sipple syndrome. The rate of progression of the disease and the degree of malignancy of the medullary carcinoma may vary from family to family. Thus the nature and behaviour of this disease in any particular family influences the management of the thyroid carcinoma component. The authors measured plasma calcitonin and plasma catecholamines in 21 members of a family with Sipple syndrome. In one branch of this family 5 out of 7 members have so far been affected, 4 with metastases or recurrence of the carcinoma and 2 with development of phaeochromocytomas. In contrast, of the 14 members in the other 4 family branches, only 4 have had pathologically elevated plasma calcitonin concentrations following alcohol provocation, probably representing C-cell hyperplasia or very early neoplasia and apparently not progressing. None has evidence of phaeochromocytoma.
This family demonstrates a striking variability in the natural history of Sipple syndrome which, despite increasing discovery of more families with medullary thyroid carcinoma, has not been previously reported. In the light of this finding, a reappraisal of the management of the thyroidal component of this disease is necessary. It appears that radical neck surgery may be needed to prevent recurrence of the disease.
Haemophilus endocarditis
Authors: Emmerson A M , Perinpanayagam R M , Barnado D E 
Published: December 2008

Summary
Two cases are presented of Haemophilus endocarditis in patients with presumed normal valves. One case was due to H. influenzae presenting as a typical case of infective endocarditis and the other was due to H. para-influenzae presenting as an acute pyrexia of unknown origin.
The difficulties in making the diagnosis and the optimal treatment are discussed.
Control of osteitis deformans using glucagon, calcitonin, and mithramycin
Authors: Condon John R , Surtees John , Robinson Victor 
Published: December 2008

Summary
Glucagon, porcine calcitonin, and mithramycin were given to patients with Paget’s disease of bone. There was rapid complete relief of bone pain accompanied by biochemical improvement or normalization in all cases. Calcitonin and glucagon appear to have additive properties in Paget’s disease and the use of the 3 drugs in combination may reduce the incidence of side effects and the development of "drug resistance". The cost of treatment might also be reduced if periodic treatment as demonstrated in Case 1 is used.
A single-dose comparison of four slow-release theophylline preparations in normal subjects
Authors: Sharma J N , Blackett A , Johnston A , Hathway N R 
Published: December 2008

Summary
The plasma theophylline concentrations produced by 4 different slow release formulations, Theograd, Theodur, Theolair-SR and Rona-slophylline were measured over a 24-hr period in 8 healthy subjects. All 4 preparations maintained plasma levels over 12 hr and had similar AUC values when the difference in theophylline content was taken into account. Paired saliva and plasma theophylline concentrations gave a ratio of 1: 0·38, saliva: plasma, but with a large inter and intra individual variation.
Blood vitamin status in chronic alcoholics after a single dose of polyvitamin. A preliminary report
Authors: Majumdar Sisir K , Shaw G K , Thomson Allan D 
Published: December 2008

Summary
Blood vitamin status (B1, B2 and B6) was assessed by erythrocytic enzyme activation tests in 7 male and 1 female chronic alcoholics (mean age (±s.d.), 43·12 (13·7) years; range, 25-64 years) on admission and 6 hr later on the same day after oral administration of a single dose of polyvitamin. Seven out of 8 patients were found to be deficient in vitamin B1, 5 in B6 and none in B2. But after single-dose oral therapy, tendency to improvement of blood vitamin status was clearly evident in all patients. It is therefore suggested that a subgroup of chronic alcoholics may benefit from oral supplementation of vitamins. Clinical implications of vitamin deficiency in chronic alcoholics are briefly discussed.
Steroid-induced benign intracranial hypertension
Authors: Vyas C K , Bhatnagar V , Talwar K K , Sharma B K 
Published: December 2008

SummaryA 41-year-old man whose systemic lupus erythematosus (SLE) had been successfully treated for 15 months with a daily maintenance dose of 5 mg prednisolone, developed benign intracranial hypertension (BIH) when the steroid was increased to 60 mg daily for recrudescence of SLE symptoms. The BIH remitted when the steroid was discontinued.
Varicella myocarditis producing congestive cardiomyopathy
Authors: Thandroyen F T , Asmal A C , Armstrong T G 
Published: December 2008

Summary
A 14-year-old boy with proved varicella developed severe, intractable heart failure with the clinical features of congestive cardiomyopathy. Detailed investigations failed to disclose any alternative aetiological factor. It is proposed that varicella myocarditis was the cause of the acute congestive cardiomyopathy found in this patient.
Bromocriptine therapy in acromegaly. A long-term review of 35 cases
Authors: Sachdev Y , Gopal K , Garg V K 
Published: December 2008

Summary
Bromocriptine (CB-154, Parlodel, Sandoz) was given to 35 acromegalic patients for a period of 6-36 months. Basal and post-therapy endocrine functions including estimation of serum growth hormone (GH) profile; and GH kinetics during oral glucose tolerance test, augmented insulin tolerance test and thyrotrophin releasing hormone test were determined. The pituitary tumour size was delineated by a pneumoencephalogram. The mean GH levels ranged from 14 micrograms/l to 316 micrograms/l. Bromocriptine suppressed GH values to 5 micrograms/l or less in 16 patients and less than 10 micrograms/l in a further 6 patients. In 33 patients GH values fell to 50% of the basal value or less. There was no significant GH reduction in 2 ‘nonresponders’. Bromocriptine did not block the stress-induced GH secretion. It did not disturb pituitary functions other than prolactin which was suppressed much earlier and was maintained with smaller doses. GH suppression on the other hand was shortlived and rebounded when the drug was omitted. It had no adverse effect on tumour size in 2 patients having suprasellar extension of the tumour. Bromocriptine improved carbohydrate tolerance and sexual function although it did not affect insulin and gonadotrophin values. It seems reasonable to offer a trial of bromocriptine in all patients with acromegaly where therapy is deemed necessary as it is well tolerated, has insignificant side effects and no adverse drug interactions. Its high cost and prolonged course are obvious disadvantages. Caution should be exercised in cases with suprasellar extension and visual field involvement.
The association of oesophagitis with disease in the stomach and duodenum
Authors: Bateson M C , Bouchier I A 
Published: December 2008

Summary
The records of all upper digestive endoscopies performed in one year in the Clinical Measurement Department of a teaching hospital serving a population of 250 000 were reviewed; 25% of patients had oesophagitis, which was usually associated with other significant findings such as peptic ulcer and gastroduodenal erosions. Only about 1 in 6 patients with oesophagitis had an endoscopically identified hiatus hernia. Oesophagitis was associated with gastric acid hypersecretion in both men and women.
Insulinoma masquerading as carotid transient ischaemic attacks
Authors: Illangasekera V L U 
Published: December 2008

Summary
A patient who initially presented with classical internal carotid territory transient ischaemic attacks, on further investigations was found to have an insulinoma, the removal of which completely alleviated the symptoms. This appears to be an unusual form of presentation of a rare tumour. The possible mechanisms of focal neurological disturbances during hypoglycaemia are discussed.
Recurrent septic arthritis due to Pseudomonas sp
Authors: Dan Michael , Jedwab Medina , Shibolet Shlomo 
Published: December 2008

Summary
Two episodes of Pseudomonas septic arthritis occurred in an 84-year-old diabetic man separated by a 6 year interval. Pseudomonas is an unusual cause of septic arthritis requiring vigorous antibiotic therapy. The recurrence of the infection may be related to the inadequate response to treatment in the first episode, however, the long interval remains unexplained.
Granulomatous vasculitis of the penis with glomerulonephritis
Authors: Vella E J , Waller D G 
Published: December 2008

Summary
Wegener’s granulomatosis is characterized by a necrotizing granulomatous vasculitis of the upper and lower respiratory tract together with glomerulonephritis. Presentation is usually with symptoms referrable to the upper respiratory tract, the glomerulonephritis manifesting itself weeks or months later. A case is reported of a man presenting with a necrotizing granulomatous vasculitis of his penis who subsequently developed glomerulonephritis 18 months later.
Acute respiratory failure and CNS-depressing drugs
Authors: Gray J M B , Henry D A , Paice B , Gettinby G , Moran F , Lawson D H 
Published: December 2008

Summary
Data from a drug surveillance programme were analysed to estimate the frequency with which patients with a diagnosis of respiratory failure had been exposed to CNS-depressing drugs. Eleven out of 37 patients with respiratory failure had received such medication. A detailed comparison of these patients and controls admitted to hospital because of respiratory disease who did not develop respiratory failure failed to reveal significant differences in drug usage. This unexpected finding suggests that patients with respiratory disease of equal severity may vary greatly in their tendency to develop carbon dioxide retention following administration of drugs with respiratory depressant properties.
Congenital adrenal hyperplasia in a 66-year-old female
Authors: Wright A D , Harvey T C , Holder G , Anderson D C , Rudd B T 
Published: December 2008

Summary
A 66-year-old genotypically female patient was reared as a man. Investigations showed a partial adrenal 21-hydroxylase deficiency, and pituitary gonadotrophin secretion typical of a post-menopausal woman.
Central pontine myelinolysis in association with Hodgkin’s lymphoma
Authors: Loizou Louis A , Rokos Jan 
Published: December 2008

Summary
Central pontine myelinolysis was found histologically in a young man who died with Hodgkin’s lymphoma. Clinically he had developed a progressive peripheral sensory deficit, ataxia, quadriparesis, dysarthria, incontinence and drowsiness. This is the fifth case reported in the British literature. The pathogenesis and aetiology of this primary demyelinating disease are considered.
Reversible hypothyroidism after steroid replacement for Addison’s disease
Authors: Burrows A W 
Published: December 2008

Summary
An insulin-requiring diabetic patient who developed Addison’s disease is described. At diagnosis, investigations revealed biochemical hypothyroidism and these abnormalities resolved after replacement therapy for the adrenal failure only. The possible mechanism of this change is discussed in relation to the presence of organ-specific antibodies.
Myocardial infarction - a rare complication in Henoch-Schönlein purpura
Authors: Abdel-Hadi O , Greenstone M A , Hartley R B , Kidner P H 
Published: December 2008

Summary
A 29-year-old man with previous Henoch-Schönlein disease presented with multiple systemic emboli and a myocardial infarction. Subsequent investigation by angiography showed normal coronary arteries. This appears to be the first reported case of Henoch-Schönlein disease and myocardial infarction probably due to coronary vasculitis.
Renal involvement in Gaucher’s disease
Authors: Siegal A , Gutman A , Shapiro M S , Griffel B 
Published: December 2008

Summary
A patient with chronic Gaucher’s disease is described who developed glomerulopathy 24 years after splenectomy terminating in renal failure. The pathological changes of this very rare complication of Gaucher’s disease are described. The few similar cases reported in the literature are reviewed and the possible pathogenetic pathways discussed.
Anti-hypertensive therapy with propranolol during pregnancy and lactation
Authors: Taylor E A , Turner P 
Published: December 2008

Summary
A hypertensive women was treated throughout pregnancy with propranolol 40 mg daily without complication. At delivery the umbilical cord plasma concentration was similar to that in the maternal venous plasma. Milk:plasma ratios were less than 1, although a higher ratio would be predicted. Estimated daily intake of propranolol in breast milk by the infant was about 3 micrograms. There appears to be no reason to advise women receiving propranolol to avoid breast feeding.
Pseudohypoparathyroidism presenting as severe Parkinsonism
Authors: Pearson D W M , Durward W F , Fogelman I , Boyle I T , Beastall G 
Published: December 2008

Summary
A case of pseudohypoparathyroidism in a middle-aged female presenting with severe Parkinsonism is reported. Correction of serum calcium led to marked clinical improvement suggesting that symptoms and signs were exacerbated by hypocalcaemia and tetanic spasm. Calcification of the basal ganglia was not detected on skull X-ray but was revealed by computerized axial tomography.
Platelet monoamine uptake in relatives of patients with Huntington’s chorea
Authors: Ehsanullah Raihana S B , Turner Paul 
Published: December 2008

Summary
Uptake of dopamine and 5-hydroxytryptamine (5-HT) by the platelets of 25 symptom-free relatives of patients with established Huntington’s chorea (HC) was not significantly different from that of control subjects. Platelet uptake of 5-HT in 3 subjects with early signs of the disease showed increased Km and Vmax values. Increased platelet uptake of 5-HT in patients with established HC was confirmed in a further 3 patients. It seems that this phenomenon appears with the clinical evidence of the disease. Further investigation of the nature of the platelet uptake abnormality may cast light on pathogenic factors in HC.
Mexiletine in human blood and breast milk
Authors: Lewis Angela M , Patel Lata , Johnston A , Turner P 
Published: December 2008

Summary
Twelve paired samples of breast milk and blood were obtained, between the 2nd and 5th days after she had given birth, from a 30-year-old woman who was a 8-hourly propranolol (20 mg) and mexiletine (200 mg). Propranolol was detected in 9 of the samples of blood and in only 4 of the milk samples. Mexiletine was measurable in all samples, and the milk : plasma ratio varied between 0.79 and 1.89 with a mean of 1.45. However, the large volume of distribution of mexiletine makes it unlikely that the small dose of the drug received from the milk would be detrimental to the health of infants.
Antibiotic blood concentrations in patients successfully treated with tobramycin
Authors: Fiala Milan , Chatterjee Satya N 
Published: December 2008

Summary
Thirty-nine patients with severe Gram-negative infections were treated with parenteral tobramycin. Thirty-one (79%) were cured of their infection. Tobramycin was most effective in the therapy of patients with urinary tract infections, arthritis and skin and soft tissue infections and relatively less effective in patients with septicaemia, pneumonia, and osteomyelitis. The infection was cured more frequently in patients who achieved a high ratio between the peak serum concentration of tobramycin and the minimal inhibitory concentration of tobramycin against the pathogenic organism (so-called therapeutic ratio). The ratio was greater than 4.0 in 11 of 13 (85%) assays performed in 12 cured patients, whereas this ratio was achieved in only 3 of 10 (30%) instances in 5 patients in whom the therapy failed (P less than 0.05). The latter group also included a greater proportion of patients with an ultimately fatal illness, such as lung cancer and uraemia, compared to the former successfully treated group. Adverse effects of tobramycin on renal function were transitory. No significant effect of tobramycin on the hearing was observed.
Failure of anti-hypertensive drugs to control blood pressure rise with isometric exercise in hypertension
Authors: O’Hare J A , Murnaghan D J 
Published: December 2008

SummaryIsometric exercise causes a substantial rise in BP in normotensive and untreated hypertensives. The authors studied the isometric hand-grip test in 5 groups of treated hypertensives, namely β-blockers, β-blockers + diuretics, β-blockers + diuretics + vasodilators, alpha-methyldopa alone and labetalol. All groups showed a substantial rise in both systolic and diastolic BP, and the increments in BP differed little from that in normotensives. Some patients, despite multiple therapy, achieved increments of up to 60 mmHg from rest. Treated hypertensives with cardiac and cerebro-vascular disease are at risk performance isometric exercise.
Sex hormone-binding globulin concentrations in women with severe premenstrual syndrome
Authors: Dalton Maureen E 
Published: December 2008

Summary
Sex hormone binding globulin (SHBG) binding capacity was measured in 50 women with severe premenstrual syndrome and 50 age-matched controls. The binding capacity was significantly lower (P = 0.001) in the patients. This finding suggests that the levels of SHBG binding capacity could be useful in the diagnosis and may help to explain the aetiology of the premenstrual syndrome.
Tinnitus in a patient with beta-thalassaemia intermedia on long-term treatment with desferrioxamine
Authors: Marsh M N , Holbrook I B , Clark Christine , Shaffer Jon L 
Published: December 2008

Summary
A women with β-thalassemia intermedia, and iron overload following many years’ treatment with oral iron, was treated with subcutaneous desferrioxamine. During the course of this treatment she developed tinnitus, which was considered to be a rare complication of the use of this chelating agent. The mechanism of this effect is not understood.
Chronic lymphatic leukaemia terminating as erythroleukaemia
Authors: Al-Hilali Mahir M , Edgcumbe John O P , Joyner Miles V 
Published: December 2008

Summary
Terminal development of acute leukaemia in chronic lymphatic leukaemia is well recognized but often difficult to classify. A case with an unequivocal erythroblastic termination is described, occurring after 18 months’ treatment with chlorambucil.
Light chain plasmacytoid lymphocytic lymphoma
Authors: Tabilio Antonio , Mecucci Cristina , Falini Brunangelo , Martelli Massimo F 
Published: December 2008

SummaryA case of plasmacytoid lymphocytic lymphoma characterized by the exclusive finding of a λ-light chain paraprotein, in the absence of heavy chains, is described. The immunoperoxidase study on bone marrow biopsy sections confirmed the production and secretion of the only λ-light chain.
Basal and postprandial serum concentrations of pancreatic polypeptide in pancreatitis and after pancreaticoduodenectomy
Authors: Lamers C B H W , Diemel J M 
Published: December 2008

Summary
Basal and postprandial serum concentrations of pancreatic polypeptide (PP) were measured in 22 normal subjects, in 6 patients with a history of acute pancreatitis, in 21 patients with chronic pancreatitis and in 6 patients with previous pancreaticoduodenectomy. Eighteen of the 21 with chronic pancreatitis and all 6 with pancreaticoduodenectomy had abnormally low serum PP-responses to the standard test meal, while all patients with a history of acute pancreatitis had normal postprandial increases in serum PP. The impaired serum PP-responses to food in patients with chronic pancreatitis were not related to the aetiology of pancreatitis, to glucose tolerance, to exocrine pancreatic function (absorption of fat) or to pancreatic calcifications. It is concluded that impaired postprandial serum PP responses in patients with pancreatitis indicate damage to the pancreas.