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Scottish Medical Journal

Siba P Paul, Matthew Hoghton, Bhupinder Sandhu
The European guidelines for diagnosing coeliac disease in children were revised in 2012. These recommend that in symptomatic children, a diagnosis of coeliac disease can be made without small-bowel biopsies provided their anti-tissue transglutaminase (anti-tTG) titre is >10 times of upper-limit-of-normal (>10×ULN) and anti-endomysial antibody is positive. In order to firm up the diagnosis in these children with very high anti-tTG titre, HLA-DQ2/DQ8 should be checked and be positive. Approximately 25-40% of white Caucasian population has HLA-DQ2/DQ8 haplotype...
January 1, 2017: Scottish Medical Journal
José Pedro L Nunes
Large-scale randomised controlled trials, carried out in the context of secondary cardiovascular prevention, have shown that statins are superior to placebo: these drugs were shown to decrease cardiovascular events and total mortality. A further set of clinical trials compared high intensity to low/standard intensity LDL cholesterol lowering in the same setting (using either statins or a statin/ezetimibe association). In this case, a decrease in LDL cholesterol and a concomitant significant reduction in cardiovascular events were seen with intensive therapy, however with no change in total mortality...
November 26, 2016: Scottish Medical Journal
Prasad Palani Velu, Susan E Fernandes, Ian F Laurenson, Donald D Noble
A 65-year-old man presented with a six-month history of lethargy, weight loss and dry cough. He had a background of mild chronic obstructive pulmonary disease. Chest radiograph showed new right upper lobe cavitary opacification. Sputum cultures were acid-fast bacilli smear positive and yielded Mycobacterium marinum - a non-tuberculous mycobacterium (NTM) often found in aquatic environments and rarely associated with respiratory disease. The suspected source was silent aspiration of contaminated water, likely due to his initiating the siphon of his fish-tank by mouth...
November 2016: Scottish Medical Journal
Lara DA Zegers, Richard Hc Zegers
BACKGROUND AND AIMS: One of the characteristics in Laurel and Hardy films is a lot of physical violence. The present study examines the occurrence of eye trauma in Laurel and Hardy movies and discusses the impact they could have been had if the films were set in reality. METHODS AND RESULTS: All 92 movies starring Laurel and Hardy as a pair in leading roles were watched together by the authors and were scored for any eye trauma. Eighty-eight eye traumas happened, of which 48% were directed at Hardy...
November 2016: Scottish Medical Journal
John Larkin
No abstract text is available yet for this article.
November 2016: Scottish Medical Journal
A Lazaridis, M E Drosou, A Fontalis, E Prousali, S E Hadwe, O Giouleme, K Petidis
INTRODUCTION: Celiac disease is an autoimmune disease of the small intestine which occurs in genetically predisposed people of all ages. A large clinical spectrum of manifestations accompanies the onset of the disease with diarrhoea, flatulence and weight loss being the most common. However, findings like osteoporosis, iron deficiency, anaemia and hypocalcaemia could also insinuate the existence of the disease. CASE PRESENTATION: We report the case of a 55-year-old man with numbness and tingling of the upper extremities due to hypocalcaemia that proved to be an uncommon case of celiac disease...
November 2016: Scottish Medical Journal
David Fitzpatrick, Patrick O'Meara, Andrew Cunningham
This short report describes the case of a young adult male who had smoked a synthetic cannabinoid legal high product called 'Exodus Damnation'. The patient's presentation was atypical from that described in the literature, with hypotension and hypoxaemia. Of note was the rapid recovery after pre-hospital intervention with high-flow oxygen therapy and intravenous fluids. The patient refused on-going care, despite repeated advice to attend the Emergency Department. The distinct lack of specialist support and referral to drug treatment for this patient population, with whom ambulance services are coming into contact with increasing frequency, is reported...
November 2016: Scottish Medical Journal
Agapios Gkentzis, Grenville Oades
BACKGROUND AND AIMS: Small renal masses are commonly diagnosed incidentally. The majority are malignant and require intervention. The gold standard treatment is partial nephrectomy unless the patient has significant co-morbidities when surveillance or ablative therapies are utilised. The latter are relatively novel and their long-term efficacy and safety remain generally poorly understood. We performed a literature review to establish the current evidence on the oncological outcome of thermal ablative techniques in small renal masses treatment...
November 2016: Scottish Medical Journal
Thavenesh K Ramachandren, Renée Ma Petrilli
INTRODUCTION: SJS and TEN are two rare self-limited but serious cutaneous drug reactions with significant morbidity and mortality. There are many drugs associated with the condition. We report a case of early TEN syndrome post Carbamazepine use, review the current literature and discuss the management challenges. CASE REPORT: A 51-year-old female was admitted to hospital for investigation and management of complex partial seizures secondary to a meningioma. She was commenced on 100mg BD of Carbamazepine for seizure control and discharged home...
November 2016: Scottish Medical Journal
Suha Akpinar, Güliz Yilmaz
Non-ischemic, high-flow priapism is defined as the state of painless and permanent erection of the penis which generally develops by perineal trauma. Selective transarterial embolisation is one of the treatment options. We present an 18-year-old men who had complaints of painless and permanent erection after a blunt perineal trauma. Colour Doppler ultrasound revealed a pseudoaneurysm and fistula at the left cavernosal artery. Hence autologous blood clot injection was performed to embolise the pseudoaneurysm...
November 2016: Scottish Medical Journal
Rosemary Haddock, Christopher Deighan, Peter C Thomson
BACKGROUND AND AIMS: Higher mortality rates have been reported for patients admitted at a weekend compared to a weekday. Our aim was to assess in-patient mortality patterns by day of the week, in a tertiary renal unit. METHOD AND RESULTS: Mortality related to day of admission and day of death was analysed over a two-year period at Glasgow Western Infirmary renal unit. Typical caseload was also assessed over two random four-week periods. As a proportion of admissions, 30-day mortality was 46/540 (8...
November 2016: Scottish Medical Journal
(no author information available yet)
No abstract text is available yet for this article.
August 2016: Scottish Medical Journal
John Larkin
No abstract text is available yet for this article.
August 2016: Scottish Medical Journal
Rajdeep Routh, Catriona Mcneill, Graham A Jackson
BACKGROUND AND AIMS: Power of Attorney as a form of surrogate decision making was introduced within the Adults with Incapacity, Scotland Act (2000) to help individuals who lack mental capacity due to illnesses like dementia. Even after a decade, little was known if it has been useful. We sought to find out how useful the power of attorney document has been so far in supporting people when they lose their capacity and identify any barriers. METHODS AND RESULTS: We did a survey and approached a random sample of 5000 attorneys in Scotland...
August 2016: Scottish Medical Journal
Haixia Hu, Xu Wang, Jiaqi Lv, Jing Sun, Jihong Xing, Xiaoliang Liu
This study aims to determine therapeutic effect of hemoperfusion on patients with acute toxic encephalopathy induced by silkworm chrysalis ingestion. Three patients who developed toxic encephalopathy after chrysalis ingestion were analysed. Two patients lost their consciousness, while two patients had typical extrapyramidal tremor symptoms. Further neurological examination revealed various degrees of muscle strength impairment in these patients. All of them received treatments of omeprazole (40 mg/day), furosemide (one dose of 20 mg), vitamin C (2...
August 2016: Scottish Medical Journal
Jean Macrae Turner
BACKGROUND AND AIMS: Altitude-related medical literature provides very few simple clinical studies relating to those on 'adventure holidays'. Systemic blood pressure has seldom been studied closely in relation to altitude. This study aimed to address both these issues and to assist GPs approached by patients for pre-trek advice. METHODS AND RESULTS: A total of 17 hillwalkers, evenly distributed for gender and age, trekked gradually from moderate to extreme altitude on Mera Peak in the Himalaya, noting any altitude sickness symptoms...
August 2016: Scottish Medical Journal
Zartash Javaid, Shahzaib M Rehan, Ayad Al-Bermani, Gareth Payne
We write to report a rare case of unilateral cancer-associated retinopathy previously undocumented in the literature. Cancer-associated retinopathy is an uncommon paraneoplastic syndrome. It is characterised by retinal antigen autoantibodies causing rod and cone dysfunction and abnormal electroretinography findings with consequent progressive visual loss.Our patient, known to have a primary cervical intraepithelial neoplasia, presented with unilateral blurred vision as well as a disturbance in colour and night vision...
August 2016: Scottish Medical Journal
A Saleh, U Ihedioha, B Babu, J Evans, P Kang
BACKGROUND: Preoperative localisation of tumour is an essential requirement in laparoscopic colorectal surgery. Since the introduction of laparoscopic colorectal resections in NGH in February 2010, the difficulties of tumour localisation at the time of surgery without tattoo have been highlighted. Furthermore, endoscopic documentation of site of tattoo with respect to the tumour can be inconsistent and at times misleading or difficult to interpret. Tattooing guidelines should be simple to follow and consistent for all lesions irrespective of the location of the tumour...
August 2016: Scottish Medical Journal
Cho Ee Ng, Hazem Khout, Rory Farrell, Tarannum Fasih
INTRODUCTION: Visceral artery aneurysms are very rare. Patients usually present as emergency secondary to the sudden rupture of the aneurysm or as an incidental finding on ultrasound, MRI or abdominal computed tomography. Among these, splenic artery aneurysms are the most common ones accounting for 60% of all splanchnic aneurysms and gastric and gastroepiploic aneurysms account for only about 4%. CASE PRESENTATION: We present a 61-year-old Caucasian male previously fit and well, presenting with sudden onset epigastric pain due to retroperitoneal haemorrhage secondary to ruptured left gastric artery aneurysm...
August 2016: Scottish Medical Journal
Y Tabbakh, U Ihedioha, S Panteleimonitis, Z Gevech, J Evans, P Kang
INTRODUCTION: Advanced age is often associated with higher incidence of co-morbidities, advanced cancer and post-operative complications. The aim of this study was to compare the differences in pre-operative, co-morbidities, cancer stage and surgical outcome measures between patients over the age of 80 and those below 80 undergoing elective laparoscopic colorectal resection. METHOD: Data were analysed from a prospectively maintained database between February 2011 and June 2012 and patients were subdivided into two groups (over 80 and under 80)...
August 2016: Scottish Medical Journal
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