bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical presentation of small bowel lymphoma in adult coeliac disease
Authors: Finan P J , Thompson M R 
Published: December 2008

Abstract
A case of perforation of a small bowel lymphoma in a patient with coeliac disease is reported. Postoperative management was complicated by a large protein and fluid loss from the small bowel, rapidly controlled by treatment with corticosteroids. Attention is drawn, by briefly reviewing 11 other cases, to the ways in which small bowel lymphoma in patients with coeliac disease may present to the surgeon. Most patients who develop this complication of coeliac disease will die within 6 months of the diagnosis of small bowel lymphoma. Attention is drawn in this case to the rapidity with which the tumour grew and became disseminated.
Gold colitis, therapy and confirmation of mucosal recovery by measurement of rectal potential difference
Authors: Huston G J 
Published: December 2008

Abstract
A 38-year-old man with rheumatoid arthritis developed colitis after a course of 320 mg sodium aurothiomalate. Recovery comparable with that reported with corticosteroids or chelating agents was achieved by fluid replacement alone. Mucosal recovery was confirmed by measurement of rectal potential differences.
Prevalence of thyroid antibodies in Shiraz, Iran, an area with iodine deficiency
Authors: Khaleeli A A 
Published: December 2008

Summary
The prevalence of thyroid antibodies was 2% among 53 healthy Shirazi volunteers, 3% among 30 consecutive patients with goitre, 41% among 17 patients with thyrotoxicosis and 67% among 18 consecutive patients with myxoedema. A surprising finding was that in a sub-group of 9 of the latter, a high incidence of diabetes (55%) was found and when both diseases co-existed, the prevalence of thyroid antibodies was 80% compared with 67% with myxoedema alone.
Serum cholesterol was marginally lower in the goitre than the control group (P, 0.05-0.025) but when females alone were compared there was no significant difference. It was also lower in the thyrotoxic group (P, 0.0025) and higher in the myxoedema group (P, 0.0025). Serum triiodothyronine was lower in the goitre group than the controls (P, 0.0005) but again, when females alone were considered, this difference lessened (P, 0.025-0.0125). Serum thyroxine and thyroid stimulating hormone levels showed no significant differences in the goitre and control groups.
Improvement in renal function in primary hyperparathyroidism following parathyroidectomy
Authors: Ghose R R , Morgan W D 
Published: December 2008

Summary
Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured pre- and post-parathyroidectomy in 9 patients with primary hyperparathyroidism. Radiological studies had shown no sign of renal calculi or nephrocalcinosis in these patients. Before operation, GFR ranged from 98.5 to 23.4 ml/min/1.7 m2 and ERPF ranged from 510 to 127 ml/min/1.7 m2. After operation, GFR rose to a range of 108.8 to 48.7 ml/min/1.7 m2, and ERPF ranged from 556 to 189 ml/min/1.7 m2.
The results suggest that early diagnosis and surgery are important, both to prevent progressive renal damage and to improve the possibility of recovery where functional damage has occurred.
Vasopressin function in familial cranial diabetes insipidus
Authors: Baylis P H , Robertson G L 
Published: December 2008

SummaryA family suffering from cranial diabetes insipidus, that extends over 4 generations, is described. Inheritance of polyuria was autosomal dominant. Vasopressin function was studied in members of the last 2 generations, 4 of whom had polyuria. Osmoregulation of vasopressin secretion was assessed by infusion of hypertonic saline. Plasma vasopressin remained undetectable in one patient, while 2 others had very blunted vasopressin responses to osmotic stimulation. Three non-osmotic stimuli were applied. Controlled hypotension produced by trimetaphan infusion and insulin-induced hypoglycaemia did not increase plasma vasopressin but apomorphine-induced nausea caused a minimal rise in plasma vasopressin to 0.7 pg/ml. Polyuria and thirst resolved with antidiuretic therapy in all patients studied.Congenital absence of vasopressin as in Brattleboro rats is unlikely to account for diabetes insipidus in this disorder since small increases in vasopressin have been demonstrated in these patients. In view of previous post-mortem findings, familial cranial diabetes insipidus is most likely to be due to degeneration of vasopressin-synthesizing neurones.
Chlorpropamide-induced haemolytic anaemia
Authors: Saffouri B , Cho J H , Felber N 
Published: December 2008

Summary
A newly diagnosed diabetic patient, recently started on chlorpropamide, required emergency admission because of sudden onset of weakness and syncope. In vitro testing confirmed the diagnosis of chlorpropamide induced haemolysis, and withdrawal of the drug resulted in clinical recovery.
Electrocardiographic changes following a cardiac stab wound. Case report and review of the literature
Authors: Shaw L M A , Lahiri A , Millar-Craig M W 
Published: December 2008

Summary
A patient is described who sustained a cardiac stab wound which was associated with ECG evidence of a full thickness myocardial infarction. Subsequent investigation showed a localized area of dyskinesia on left ventricular angiography, but normal thallium myocardial perfusion and normal anatomy on coronary angiography. The patient was managed conservatively and made a complete and uneventful recovery. It is concluded that extensive ECG changes following a cardiac stab wound need not be associated with major coronary artery damage.
Poor rectal absorption of trimethoprim/sulphamethoxazole in treating Pneumocystis carinii pneumonia
Authors: Dorr Robert T , Powell J Robert , Heick Meredith , Barry David W 
Published: December 2008

Summary
A 24-year-old female with Hodgkin’s disease and Pneumocystis carinii pneumonia was tested with trimethoprim/sulphamethoxazole (TMP/SMX) tablets. Because treatment failure was feared owing to chronic emesis potentially resulting in incomplete drug absorption, the same TMP/SMX dose was administered by rectal suppositories after the 5th day of oral dosing. The relative fractions (rectal/oral) or the suppository dose absorbed for TMP and SMX were 3.0% and 19.5% respectively. When TMP/SMX treatment is required and the oral route is not practical, the investigational i.v. preparation should be obtained.
Symptomatic hypopituitarism revealing a primary empty sella turcica
Authors: Velkeniers B , Desir D , Manicourt D , Chanoine F , Dupont M , Copinschi G 
Published: December 2008

Summary
A 64-year-old nulliparous woman presented with clinical signs of thyroid and adrenocortical insufficiency. Subsequent hormonal investigations demonstrated a failure of all anterior pituitary functions. Pneumotomo-encephalography revealed a large arachnoid herniation, leading to the diagnosis of primary empty sella turcica syndrome with secondary panhypopituitarism. This unusual observation emphasizes the necessity of ruling out an empty sella turcica syndrome in patients with pituitary insufficiency.
Failure of cimetidine to suppress immunoreactive parathyroid hormone and hypercalcaemia in primary hyperparathyroidism
Authors: Mallett Richard B , Sainsbury Richard , Benton Kenneth G F 
Published: December 2008

Summary
Cimetidine has been reported as suppressing the excess parathyroid hormone secretion and hypercalcaemia seen in hyperparathyroidism. A case of primary hyperparathyroidism is described, in which the level of circulating parathyroid hormone and hypercalcaemia remain entirely unaffected by cimetidine. The drug is implicated in the management of primary hyperparathyroidism unsuitable for surgery, but present evidence, as reviewed, is insufficient to recommend the use of cimetidine in this way.
Tuberculosis after jejuno-ileal bypass for morbid obesity
Authors: Werbin N 
Published: December 2008

Summary
A patient contracted tuberculosis after 2 operations for morbid obesity. The difficulty in diagnosis and treatment is described. Jejuno-ileal bypass is a non-physiological operation, with many reported complications and side effects. Following this short experience the author and his colleagues have now abandoned this operation. Patients suffering from malnutrition as a result of slimming operations should be carefully monitored for tuberculosis.
Transient cerebral ischaemic attacks—management and prognosis
Authors: Roden S , Low-Beer T , Carmalt M , Cockel R , Green I 
Published: December 2008

Summary
Fifty patients who had recently had a transient ischaemic attack took part in a double-blind cross-over trial of sulphinpyrazone 200 mg 4 times daily against placebo. Each treatment was given for 4 months. The incidence of recurrences was much greater in the initial 4 months but there was no difference between the 2 treatments. A follow-up of 39 of the patients showed that 2 years later 90% of those who had not had a recurrence during the 8 months had suffered no further neurological events whereas of those who did have a recurrence during the study only 47% had no further neurological events.
Malignant epithelioma of the liver
Authors: Burroughs A K , Barter S J , Jenkins W J 
Published: December 2008

Summary
Carcinoma complicating congenital cystic conditions of the liver is rare. The authors report a primary malignant epithelioma of the liver in association with multiple intrahepatic biliary cysts, which are not usually considered to predispose to malignancy.
Pyrexia of unknown origin. Presenting sign of hypothalamic hypopituitarism
Authors: Marilus R , Barkan A , Leiba S , Arie R , Blum I 
Published: December 2008

Summary
A 62-year-old man was admitted to hospital 10 times over 12 years because of pyrexia of unknown origin. Hypothalamic hypopituitarism was diagnosed by dynamic tests including clomiphene, LRH, TRH and chlorpromazine stimulation. Lack of ACTH was demonstrated by long and short tetracosactrin tests. The aetiology of the disorder was believed to be previous encephalitis. Following substitution therapy with adrenal and gonadal steroids there were no further episodes of fever.
Hypohyperparathyroidism: a model for renal osteodystrophy?
Authors: Junor B J R , Edward N 
Published: December 2008

SummaryA child who presented with features of renal osteodystrophy but with normal renal function is described. Improvement occurred both on large doses of vitamin D and small doses of 1, alpha-hydroxy-vitamin D3 (1, alpha-OHD3). Investigations suggested that the primary defect was an impaired renal response to parathyroid hormone. The relationship between renal osteodystrophy, abnormalities of vitamin D metabolism and hypohyperparathyroidism is discussed and an alternative hypothesis for the development of renal bone disease suggested.
Death from a sharp stone. A fatal case of haemobilia
Authors: Broderick N J , Jones J S P , Cullen M H , Fletcher J 
Published: December 2008

Summary
A case of fatal gastrointestinal haemorrhage due to haemobilia as a direct result of cholelithiasis is described. Erosion of a branch of the cystic artery by a stone was shown to be the source of the bleeding at post-mortem. The features of the haemobilia syndrome are discussed.
Adenocarcinoma of the stomach and Fanconi’s anaemia
Authors: Hill L S , Dennis P M , Fairham S A 
Published: December 2008

Summary
A case of Fanconi’s anaemia is described. The patient developed gastric ulcers at 14 years and died of adenocarcinoma of the stomach at the age of 21 years. The need fully to investigate gastric pathology by endoscopy and biopsy, as well as radiology, is stressed. So far as the authors are aware this is the first description of adenocarcinoma of the stomach occurring in Fanconi’s anaemia, a condition known to predispose to malignancy.
Hypercalcaemia in alphacalcidol therapy
Authors: Paterson C R 
Published: December 2008

Summary
Three women with hypoparathyroidism are described who developed severe symptomatic hypercalcaemia while being treated with alphacalcidol (1 alpha-hydroxycholecalciferol; One-Alpha). One sustained permanent renal damage. Alphacalcidol may have advantages over calciferol in its speed of action but poisoning may be more likely to occur. Frequent follow-up checks on the plasma calcium is needed for any patient on alphacalcidol. For long-term management calciferol may still be the drug of choice.
Glucose 6-phosphate dehydrogenase deficiency and cystic fibrosis
Authors: Congdon P J , Aggarwal R K , Littlewood J M , Shapiro H 
Published: December 2008

Summary
A child born to Pakistani parents is described. He had both cystic fibrosis and G-6PD-deficiency. So far as can be ascertained, the occurrence of both these conditions in the same individual has not previously been reported.
Hypercalcaemia and phaeochromocytoma
Authors: Fairhurst B J , Shettar S P 
Published: December 2008

Summary
A patient with a phaeochromocytoma associated with hypercalcemia is described. The hypercalcaemia was corrected by removal of the phaeochromocytoma. Parathyroid hormone-like peptide was isolated from the tumour suggesting that ectopic parathyroid hormone production from the phaeochromocytoma was the explanation of the hypercalcaemia.
Severe hypertriglyceridaemia responding to insulin and nicotinic acid therapy
Authors: Smith Stephen R 
Published: December 2008

Summary
A patient with unusually severe hypertriglyceridaemia (serum concentration initially 258 mmol/l or 22600 mg/dl) and hypercholesterolaemia is reported and discussed. The triglyceride elevation was found to reside within the very low density lipoprotein fraction and was probably attributable to the combination of diabetes mellitus and familial hypertriglyceridaemia. Treatment with insulin and restriction of dietary carbohydrate led to a 50% reduction in the triglyceride concentration, and the addition of nicotinic acid in modest doses led ultimately to a complete normalization of the patient’s lipid values. A close correlation was noted between the falling triglyceride concentration and the rising serum sodium concentration during the course of successful therapy. Overall, it is felt likely that this patient’s severe and reversible hypertriglyceridaemia was on the basis of excessively rapid lipolysis leading to high concentrations of very low density lipoprotein production. Combined therapy with insulin and nicotinic acid is recommended for other patients of this nature.
Long-term use of potassium perchlorate
Authors: Connell J M C 
Published: December 2008

Summary
A case of Graves’ disease with potassium perchorate for 22 years without ill effect is described. Thyrotoxicosis recurred 4 weeks after the medication was withdrawn, suggesting that euthyroidism had been maintained by chronic use of the drug. As toxicity of perchlorate is probably dose related, it is suggested that long-term use of low dose perchlorate may be no more hazardous than alternative antithyroid therapy.
Recurrent erythema nodosum and pulmonary sarcoidosis
Authors: Macfarlane J T 
Published: December 2008

Summary
The case is described of a female patient who has had 3 separate episodes of erythema nodosum, hilar lymphadenopathy and pulmonary infiltration due to sarcoidosis over 20 years, with complete remissions in between. This has not been reported before and it raises questions about the aetiology of sarcoidosis.
Polymyositis associated with Hodgkin’s disease
Authors: Fui S Ng Tang , Teoh R , Houston J C 
Published: December 2008

Summary
A patient is reported who presented with severe polymyositis and pulmonary collapse with infection. Investigations failed to confirm an underlying bronchial carcinoma but post-mortem examination revealed unsuspected Hodgkin’s disease. The authors wish to draw attention to the rare but important association between polymyositis and treatable lymphomas.
Primary thrombocythaemia following splenectomy
Authors: O’Donnell J R , Bailey P A M , Erskine J G , Davidson J F 
Published: December 2008

SummaryA 20-year-old male who required splenectomy following abdominal trauma was subsequently shown to have primary thrombocythaemia. This report illustrates the diagnostic problems associated with a refractory post-splenectomy thrombocytosis, and the therapeutic difficulties in the management of primary thrombocythaemia are discussed.
Arterial embolization in the management of liver tumour with recurrent hypoglycaemia
Authors: Bell G M , Buist T A S 
Published: December 2008

Summary
A patient with recurrent hypoglycaemic episodes resulting from hepatic metastases of a malignant retroperitoneal haemangiopericytoma is described. Effective control of hypoglycaemia has been achieved by trans-catheter hepatic arterial embolization on 5 separate occasions.
Bladder instability in patients with prostatic hypertrophy
Authors: Appell Rodney A 
Published: December 2008

Summary
In 29 patients with urinary obstruction due to prostatic enlargement, medium-fill water cystometry was performed before prostatectomy and again 3 months after. A high incidence of detrusor hyperreflexia was observed pre-operatively, but findings were essentially normal 3 months after resection of the prostate. Possible mechanisms to explain these findings are developed. However, it was clear that the cystometric findings were not related to prostatic size.
Spontaneous pneumothorax complicating Legionnaires’ disease
Authors: Bali A , Pierry A A , Bernstein A 
Published: December 2008

Summary
Spontaneous pneumothorax is a known but rare complication of pneumonia in adults. A case is described of Legionnaires’ disease complicated by spontaneous hydropneumothorax. So far as is known such an association has not been reported previously.
Association of retroperitoneal fibrosis, proctitis and rectal stenosis
Authors: Manna R , Pigini M G , Pala M A , Caturelli E , Lanza-Tomasi M C , Zupi E 
Published: December 2008

Summary
Retroperitoneal fibrosis (RF) in most cases is ‘idiopathic’. In the case reported, RF could be the result of a proctitis that followed a haemorrhoidectomy.
Haemorrhoids: a doctor’s dilemma
Authors: Deutsch Alexander A , Sternberg Ahud , Reiss Raphael 
Published: December 2008

Summary
The different forms of treatment for haemorrhoids are described. These include conservative therapy, elastic band ligation, sclerotherapy, cryosurgery, anal dilatation, lateral sphincterotomy and formal surgery. Controlled trials comparing these methods of treatment indicate that surgery should be rarely performed. Of the remaining methods available, elastic band ligation or anal dilatation are recommended.
Jejunal villous changes associated with farmer’s lung
Authors: Robinson T J , Haire Margaret , McMillan S A , Nelson S D , Middleton D , Evans J P 
Published: December 2008

Summary
Eighty-one patients with farmer’s lung were screened for evidence of coeliac disease by assessing their clinical features, haemoglobin indices, serum vitamin B12 and folic acid levels. HLA typing was carried out and the frequency of antireticulin and other auto-antibodies was determined. Two out of 21 patients selected for jejunal biopsy had subtotal villous atrophy, a further 6 had partial villous atrophy and 8 out of 21 had increased lamina propria cellularity. The group as a whole had an increased number of intra-epithelial lymphocytes in the jejunal musosa. Sera of 7 out of 81 patients contained antireticulin antibody compared with 2 of 81 control subjects, a difference without significance. Other autoantibodies were not more frequent in the patient than in the control group and were of normal incidence. HLA antigens were also similar in both groups.
Recurrent groin hernia
Authors: Cox P J , Leach R D , Ellis Harold 
Published: December 2008

Summary
One hundred consecutive recurrences following repair of inguinal hernias have been studied; 62 were direct, 30 indirect, 7 pantaloon and one a femoral hernia. Half the indirect recurrences occurred within a year of repair and probably represented failure to detect a small indirect sac. Later indirect recurrences probably represented failure to repair the internal ring. Nine of the direct hernias were medial funicular recurrences and represented failure to anchor the darn medially. The rest of the direct recurrences were attributable to tissue insufficiency and could probably have been averted by larger tissue bites.
Recurrences following inguinal herniorrhaphy remain an all too common problem but can be reduced by meticulous surgical technique.
Camphor intoxication treated by charcoal haemoperfusion
Authors: Mascie-Taylor Brian H , Widdop Brian , Davison Alexander M 
Published: December 2008

Summary
A case of camphor intoxication in which lipid haemodialysis and charcoal haemoperfusion were applied is described. Although the patient recovered rapidly with no resultant sequelae, the analytical data indicated that extra-corporeal therapy was ineffective.
Efficacy of peritoneal dialysis in severe thiazide-induced hyponatraemia
Authors: Cundy T , Trafford J A P 
Published: December 2008

Summary
A patient with severe thiazide-induced hyponatraemia (plasma sodium 99 mmol/l) is described, who had signs suggestive of cerebral oedema. Co-existent problems of cardiac and respiratory insufficiency were thought to make treatment with hypertonic saline hazardous. A 40-hr peritoneal dialysis successfully reversed both hyponatraemia and the associated cerebral signs, plasma sodium increasing at a rate of 0·83 mmol/hr. Peritoneal dialysis appears to be a safe and efficacious method of treating severe thiazide-induced hyponatraemia.
Racial differences in blood pressure: genetic and environmental factors
Authors: Sever P S 
Published: December 2008

Summary
The present study shows that different racial groups (black and white) living in a similar environment have different levels of blood pressure. Furthermore the same ethnic group living in a dissimilar environment also has different blood pressure distributions: thus it seems that both genetic (racial) and environmental factors influence the levels of arterial pressure.
The data presented also reveal that there are racial differences in certain biochemical correlates of blood pressure, namely plasma renin activity and plasma noradrenaline concentration, and it is suggested that these observations may underline differing pathogenetic mechanisms for blood pressure elevation in blacks and whites.
Asthma and atopic disease in immigrants from Asia and the West Indies
Authors: Morrison-Smith John , Cooper Susan M 
Published: December 2008

Summary
The clinical pattern of asthma and atopic disease was compared in 2331 children of European, Asian and West Indian parentage seen in Birmingham in the past 10 years. The main findings were that a higher proportion of children born in England of all races developed asthma within the first 4 years of life than children born abroad; the sex ratio of roughly 2 boys to every girl with asthma was similar in each race wherever born; the ratio of persistent to intermittent asthma was similar in each race wherever born; there was no difference in the proportion with eczema between the racial groups; hay fever and pollen allergy was less frequent in Asian and West Indian children even if born in England; hospital admission was more frequent in immigrant groups; positive skin reactions to grass pollen and domestic animals were more frequent in European children than in immigrants but positive reactions to house-dust mites were less frequent in European children.
It was considered that most differences could be explained on the basis of differences in environmental conditions and were unlikely to be of genetic origin.