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Scottish Medical Journal

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https://www.readbyqxmd.com/read/29739268/a-rare-cause-of-proximal-muscle-weakness-immune-necrotising-myopathy
#1
Deniz Can Guven, Abdulsamet Erden, Levent Kilic, Sevim Erdem Ozdamar, Omer Karadag
Background Immune-mediated necrotising myopathies are characterised clinically by the subacute onset of proximal limb weakness, accompanied by elevated creatinine kinase levels. They are distinguished from other myopathies by the absence of prominent infiltration of the muscle with inflammatory cells in the biopsies. Case presentation A 44-year-old man presented with upper extremity weakness and dysphagia. Laboratory tests included a creatinine kinase level of 4362 U/L (normal: 52-336 U/L). Rheumatological markers were all negative...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29739267/relapsed-refractory-thrombotic-thrombocytopenic-purpura-treated-with-n-acetylcysteine-a-case-report
#2
Sinan Demircioğlu, Ömer Ekinci, Ali Doğan, Cengiz Demir
Thrombotic thrombocytopenic purpura is a rare condition that presents with microangiopathic haemolytic anaemia, thrombocytopaenia, fever, renal impairment and neurological symptoms. Plasma exchange is a lifesaving treatment for this condition. However, some cases may be non-responsive to plasma exchange, or loss of response may occur. Treatment options for refractory cases include high-dose corticosteroids, rituximab, vincristine, cyclophosphamide, splenectomy, bortezomib and N-acetylcysteine. We present a refractory case of thrombotic thrombocytopenic purpura responding to the last of these therapies...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29514585/current-standards-for-assessing-pregnancy-status-before-surgery-are-subjective-and-should-be-replaced-with-definitive-objective-evidence
#3
Keiran D Clement, Andreas Luhmann, Michael Sj Wilson, Pradeep Patil
We report a case of a young woman admitted electively for laparoscopic Nissen fundoplication, and again three days post-operatively as an emergency with profuse vomiting and abdominal pain. She underwent diagnostic laparoscopy, and a small gastric perforation was found at the site of the fundoplication and this was suture-repaired. On both admissions, she was "screened" for pregnancy as per current guidelines. On the second admission, following a CT scan, she was found to have a gravid uterus with a foetus of 16-18 weeks' gestation...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29514584/unstable-angina-in-the-era-of-high-sensitivity-troponin-testing-a-genuine-entity-and-a-cautionary-tale
#4
Thomas Krysztofiak, John Byrne
High-sensitivity cardiac troponin assays have emerged as a powerful tool in the management of patients presenting acutely to hospital with suspected cardiac chest pain. Recent guidelines emphasize the reassurance offered by low troponin concentrations early after admission. We describe a patient with known coronary artery disease, who presented with a classical history of recurrent myocardial ischaemia. High-sensitivity cardiac Troponin-I concentrations remained in the low-normal sex-specific reference range, despite serial testing on the day of admission, and despite recurrent pain with dynamic ECG changes...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29514583/a-prospective-observational-study-of-emergency-department-presentations-following-novel-psychoactive-substance-use
#5
David E Henshall, Callum Wd Innes, Scott R Morrison, Blair Wilson, Ryan A Brown, Shannon M McAllister, Seamus L Culshaw, Elaina Reda
Background and aims Novel psychoactive substances are compounds intended to mimic the effects of illicit drugs. They provide a unique challenge to healthcare, as complications of their use and their impact on services are relatively unknown. This study aims to determine nature of presentations, patient demographics and impact on healthcare. Methods Novel psychoactive substances users who presented to a large urban emergency department over 4 weeks were prospectively identified and followed for 1 year. Patients over 13 years old were eligible for inclusion...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29514582/a-case-of-an-acute-cutaneous-drug-reaction-with-hydroxychloroquine
#6
Amritakaur Randhawa, Grant Wylie
Hydroxychloroquine is considered a relatively benign drug and is regularly used by rheumatologists and dermatologists. We highlight the severe adverse drug reaction potential of this commonly prescribed medication. We report the case of a 63-year-old male, who presented with widespread skin eruption following initiation of hydroxychloroquine two weeks earlier for an inflammatory arthritis. He had typical clinical, biochemical and histological features of the now recognised formal 'diagnosis' of severe cutaneous adverse drug reaction...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29514581/strangulation-of-giant-rectal-prolapse
#7
Imad El Moussaoui, Augustin Limbga, Manke Dika, Abdelilah Mehdi
Introduction Rectal prolapse is the complete protrusion of the rectum through the anal canal, incarceration rarely complicates rectal prolapse. Even more rarely, it becomes strangulated and gangrenous, necessitating emergency surgery. Case presentation We present the first reported case of strangulated acute rectal prolapse as the first manifestation of rectal prolapse. The patient was a 26-year-old man who presented with a 20×6 cm semi-spherical mass extra-anally. Rectosigmoidectomy with sacral rectopexy was performed, resecting 20 cm of the incarcerated rectum and sigmoid colon...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29506437/adult-onset-still-s-disease-with-prominent-polyserositis
#8
Ali Sibtain Farooq Sheikh, Jonathan Marks, Neil Hopkinson
Adult-onset Still's disease is a systemic autoinflammatory disease the presentation of which can often mimic infection. As a consequence, there is often a delay in diagnosis. Serositis is a recognised but less common clinical feature that can result in complications including cardiac tamponade and constrictive pericarditis. We describe a case of adult-onset Still's disease without the hallmark rash or significant arthritis, presenting with polyserositis that showed a good response to initial steroid treatment and sustained remission with anakinra...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29471735/cognitive-impairment-in-older-patients-undergoing-colorectal-surgery
#9
Jonathan Hewitt, Margaret Marke, Calum Honeyman, Simon Huf, Aida Lai, Anni Dong, Tom Wright, Sarah Blake, Rebecca Fallaize, Jane L Hughes, Lyndsay Pearce, Kathryn McCarthy
Background With increasing numbers of older people being referred for elective colorectal surgery, cognitive impairment is likely to be present and affect many aspects of the surgical pathway. This study is aimed to determine the prevalence of cognitive impairment and assess it against surgical outcomes. Methods The Montreal Cognitive Assessment (MoCA) was carried out in patients aged more than 65 years. We recorded demographic information. Data were collected on length of hospital stay, complications and 30-day mortality...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29381107/retraction-notice
#10
(no author information available yet)
No abstract text is available yet for this article.
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29368581/purple-urine-bag-syndrome-a-truly-harmless-sign
#11
H Rooney, L Mokool, A Ramsay, S Nalagatla
Purple urine bag syndrome is an uncommon condition that describes the purple discolouration of a catheter bag and tubing. It mainly affects patients with limited mobility who have long-term catheters. Although benign in nature per se, its presence can alarm both patient and practitioner unfamiliar with the syndrome. Here, we describe two cases of asymptomatic patients who both presented to outpatient clinic with the characteristic purple discolouration of their long-term catheters and tubing. The report discusses the pathophysiology of the syndrome and initial investigation and management...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29226770/an-unexpected-image-on-a-chest-radiograph
#12
Dogus Hemsinli, Hasan Mutlu, Gokalp Altun, Zerrin Pulathan, Ahmet C Ozdemir
Introduction Central venous catheterisation is an essential component of patient care in hospital. A forgotten complete guide-wire is a rare complication, although the reported incidence has increased rapidly over the last decade. Case report We report a 72-year-old man with a complete guide-wire inadvertently overlooked during catheter insertion. A central venous catheter had been inserted for total parental nutrition during treatment for pancreatitis. Five years later, the patient was readmitted with a painful lesion on his neck and the sensation of a sharp object under his skin...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29214906/lingua-patientis-new-words-for-patient-communication-and-history-taking
#13
Donald F Weaver
The English language sometimes fails in its ability to describe the severity or complexity of medical symptoms and complaints. In frustration, patients (or families) occasionally create new words to convey the subtleties of their medical history. Although medicine has created a comprehensive technical lexicon for physicians, we have failed to develop a corresponding patient-centric vocabulary (lingua patientis) that provides more accurate symptom description. The social networking of lingua patientis words might enhance history taking and afford improved appreciation of disease impact on individual patients...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29192564/rare-case-of-atypical-parkinsonism-why-family-history-is-important
#14
Naveed Malek, Ravi Jampana, Donald G Grosset
We discuss the clinical presentation and assessment of a middle aged previously fit and well man who presented with two episodes of syncope to the cardiologists followed by the development of a rapidly progressive parkinsonian syndrome a couple of years later, which was not responsive to standard dopaminergic replacement therapies. Magnetic resonance imaging scan of the brain was normal and a DAT SPECT scan showed reduced dopamine uptake in the basal ganglia. On further enquiry, a family history of a similar presentation in his first cousin was elicited and that cousin had tested positive for a mutation in the PRNP gene...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29169299/the-changing-case-mix-of-hip-fractures-in-scotland-evidence-from-the-scottish-hip-fracture-audit
#15
Stephen D Hannah, K B Ferguson, R Smith, J Hutchison, G Holt
Until discontinued in 2008, the Scottish Hip Fracture Audit collected and reported on data relating to the quality of care of hip fracture patients in Scotland. In 2013, the audit was recommenced under the umbrella of the MSK Audit group, which audits high volume orthopaedic pathways across Scotland. Our aim is to report on the changes in the demographics of hip fracture patients in Scotland between 2003 and 2013. There was an increase in the proportion of male patients from 2003 to 2013 (22.4% to 29.5%; p < 0...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29126377/what-s-in-a-name-the-orchestrated-erosion-of-doctor-power-in-the-nhs
#16
John Larkin
No abstract text is available yet for this article.
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28959919/a-case-of-multiple-myeloma-with-navicular-bone-involvement
#17
Esra Yildizhan, Leylagul Kaynar, Nicolette Tiren, Ozlem Canoz, Bulent Eser
Multiple myeloma is a haematological disease caused by proliferation of malignant plasma cells in bone marrow. It frequently has lytic bone lesions. However, involvement of the small bones of the hands and feet is extremely rare. We report a unique multiple myeloma patient with first recurrence in navicular bone after allogenic stem cell transplantation.
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28899218/relationship-between-serum-25-hydroxy-vitamin-d-levels-and-retinopathy-of-prematurity
#18
Emrah Utku Kabataş, Nurdan Fettah Dinlen, Ayşegül Zenciroğlu, Dilek Dilli, Serdar Beken, Nurullah Okumuş
Aim To evaluate the relationship between serum 25-hydroxy vitamin D, 25 (OH) D, levels and retinopathy of prematurity. Methods and Results Serum 25 (OH) D levels were measured in 97 very low birth weight infants, prior to vitamin D supplementation. The development of retinopathy of prematurity and its treatment requirement were evaluated. At follow-up, retinopathy of prematurity developed in 71 (73.2%) infants. Serum 25 (OH) D levels were significantly lower in infants with retinopathy of prematurity than ones without retinopathy of prematurity ( P < 0...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28899217/-the-psychological-problem-is-looking-at-you-are-you-looking-for-it-psychological-associations-with-symptomatic-musculoskeletal-referrals
#19
M S Arshad, R W Paton
It is important that paediatric orthopaedic surgeons recognise that psychological conditions may present with musculoskeletal symptoms. Identification through careful and sensitive history taking is vital. There is a lack of training in this regard in paediatric orthopaedics. We present a series of cases initially referred for a musculoskeletal complaint. Further probing revealed an underlying psychological problem which was neither picked up by the referring physician nor volunteered by the patient. In our opinion, it is important that this training omission is addressed as such psychological problems may be devastating for these individuals and their families...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28480790/wound-botulism-its-neurological-manifestations-treatment-and-outcomes-a-case-series-from-the-glasgow-outbreak-2015
#20
Sarah-Jane Martin, Gillian Penrice, Corinne Amar, Kathie Grant, George H Gorrie
Background and aims We examined the neurological manifestations, treatment and outcomes of a subset of 25 patients within the largest ever outbreak of wound botulism in Europe. Methods and results All 25 cases were intravenous drug users. The most common presenting symptom was dysarthria in 19/25 (76%), followed by dysphagia in 12/25 (48%), blurred vision in 10/25 (40%) and double vision in 8/25 (32%). Microbiological analysis confirmed the diagnosis in nine cases (36%). Duration of admission positively correlated with time to antitoxin, time to wound debridement and female sex...
November 2017: Scottish Medical Journal
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