Association of Physicians of Great Britain and Ireland

1.
QJM. 2019 Jun 22. pii: hcz155. doi: 10.1093/qjmed/hcz155. [Epub ahead of print]
The Essence of Humanistic Medicine.
Schattner A1.
Author information
1
The Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel.
PMID: 31228249 DOI: 10.1093/qjmed/hcz155
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Select item 31225618
2.
QJM. 2019 Jun 21. pii: hcz148. doi: 10.1093/qjmed/hcz148. [Epub ahead of print]
Neurosarcoidosis and infliximab therapy monitored by 18FDG PET/CT.
Rivière E1,2, Schwartz P3, Machelart I1, Greib C1, Pellegrin JL1,4, Viallard JF1,2, Lazaro E1,4.
Author information
1
Department of Internal Medicine and Infectious Diseases, Haut-Leveque Hospital, University Hospital of Bordeaux, Pessac, France.
2
University of Bordeaux, INSERM U1034, Pessac, France.
3
Nuclear Medicine Department, Haut-Leveque Hospital, University Hospital of Bordeaux, Pessac, France.
4
University of Bordeaux, CIRID, UMR/CNRS 5164, Bordeaux, France.
KEYWORDS:
18FDG PET/CT; Neurosarcoidosis; glossopharyngeal nerve; infliximab; vagus nerve

PMID: 31225618 DOI: 10.1093/qjmed/hcz148
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Select item 31225617
3.
QJM. 2019 Jun 21. pii: hcz149. doi: 10.1093/qjmed/hcz149. [Epub ahead of print]
IgG4-related disease in a multi-ethnic community: clinical characteristics and association with malignancy.
Poo SX1,2, Tham CSW1, Smith C3, Lee J1, Cairns T1, Galliford J1, Hamdulay S2, Jacyna M2, Levy JB1, McAdoo SP1,3, Roufosse C3, Wernig F1, Mason JC1,3, Pusey CD1,3, Tam FWK1,3, Tomlinson JAP1.
Author information
1
Imperial College Healthcare NHS Trust, London, UK.
2
London North West Healthcare NHS Trust, Harrow, UK.
3
Department of Medicine, Imperial College London.
Abstract
BACKGROUND:
Immunoglobulin-G4-related disease (IgG4-RD) is a recently recognised fibro-inflammatory condition that can affect multiple organs. Despite growing interest in this condition, the natural history and management of IgG4-RD remain poorly understood.

AIM:
To describe the clinical characteristics, treatment and outcomes of IgG4-RD in a multi-ethnic UK cohort, and investigate its possible association with malignancy.

DESIGN:
Retrospective analysis of case-note and electronic data.

METHODS:
Cases were identified from sub-specialty cohorts and a systematic search of an NHS trust histopathology database using 'IgG4' or 'inflammatory pseudotumour' as search terms. Electronic records, imaging and histopathology reports were reviewed.

RESULTS:
66 identified cases of IgG4-RD showed a similar multi-ethnic spread to the local population of North West London. The median age was 59 years and 71% of patients were male. Presenting symptoms relating to mass effect of a lesion were present in 48% of cases and the mean number of organs involved was 2.4. 10 patients had reported malignancies with 6 of these being haematological. 83% of those treated with steroids had good initial response, however 50% had relapsing-remitting disease. Rituximab was administered in 11 cases and all achieved an initial serological response. Despite this, 7 patients subsequently relapsed after a mean duration of 11 months and 4 progressed despite treatment.

CONCLUSIONS:
We report a large UK-based cohort of IgG4-RD that shows no clear ethnic predisposition and a wide range of affected organs. We discuss the use of serum IgG4 concentrations as a disease marker in IgG4-RD, the association with malignant disease and outcomes according to differing treatment regimens.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PMID: 31225617 DOI: 10.1093/qjmed/hcz149
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Select item 31225601
4.
QJM. 2019 Jun 21. pii: hcz153. doi: 10.1093/qjmed/hcz153. [Epub ahead of print]
Placental transmogrification of the lung masquerading as difficult-to-treat pneumonia.
Horiuchi K1, Asakura T1,2, Sakaguchi S1, Saito F1, Yamamoto J3.
Author information
1
Department of Pulmonary Medicine.
2
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
3
Department of Thoracic Surgery, Eiju General Hospital, Tokyo, Japan.
KEYWORDS:
bullae; placental transmogrification of the lung; refractory pneumonia; surgery

PMID: 31225601 DOI: 10.1093/qjmed/hcz153
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Select item 31225600
5.
QJM. 2019 Jun 21. pii: hcz152. doi: 10.1093/qjmed/hcz152. [Epub ahead of print]
Central venous catheter use increases ischemic stroke risk: A nationwide population-based study.
Liao PH1, Lai CY2,3, Wu CH1, Su YC2,4, Wei CW1, Kao CH5,6,7.
Author information
1
Department of Emergency Medicine, Tungs Taichung Metro Harbor Hospital, Taichung, Taiwan.
2
School of Chinese Medicine, China Medical University, Taichung, Taiwan.
3
Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan.
4
Health Data Management Office, China Medical University Hospital, Taichung, Taiwan.
5
Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
6
Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
7
Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
Abstract
BACKGROUND:
Central venous catheter (CVC) placement is a common procedure used for the treatment of critically ill patients. However, ischemic stroke is a complication after CVC placement.

AIM:
This study investigated the association between CVC placement and ischemic stroke risk in an Asian population.

DESIGN:
Population-based retrospective study.

METHODS:
We enrolled 37,623 patients who ever-received CVC placement over 2000-2010 and propensity score-matched individuals without CVC placement as the comparison cohort from the Taiwan National Health Insurance Research Database. We determined the cumulative incidence rates and adjusted hazard ratios (aHRs) for ischemic stroke.

RESULTS:
We finally identified and enrolled 34,164 propensity score-matched pairs of individuals. Compared with the comparison group, CVC placement increased the average annual ischemic stroke incidence (19.5 vs. 11.6 per 10,000 person-years; crude HR = 1.28, 95%, confidence interval [CI] = 1.21-1.35; adjusted subhazard ratio [aSHR] = 1.4, 95% CI = 1.33-1.47; p < 0.001). In addition, compared with those aged >35 years, stroke risk was significantly higher in < 35-year-old patients with CVC placement (aSHR = 14.3, 95% CI = 6.11-33.4; p < 0.001). After <1-year follow-up, the ischemic stroke incidence rate in the CVC placement group was approximately 3.25-fold higher than that in the comparison group (aHR = 3.25, 95% CI = 2.9-3.63; p < 0.0001).

CONCLUSION:
CVC placement increases ischemic stroke risk, particularly in those aged ≤35 years; this trend warrants further investigation.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

KEYWORDS:
central venous catheter; incidence; ischemic stroke; population study

PMID: 31225600 DOI: 10.1093/qjmed/hcz152
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Select item 31222347
6.
QJM. 2018 Dec 1;111(12):837. doi: 10.1093/qjmed/hcy264.
A QJM legacy: medical research during both world wars.
Donnelly SC1.
Author information
1
Editor-in-Chief, QJM.
PMID: 31222347 DOI: 10.1093/qjmed/hcy264
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Select item 31222346
7.
QJM. 2018 Dec 1;111(12):920-924. doi: 10.1093/qjmed/hcy193.
Scientific Business Abstracts of the 112th Annual Meeting of the Association of Physicians of Great Britain and Ireland.
Chauhan A1, Lalor T1, Watson S1, Adams D1, Farrah TE2, Anand A2, Kimmitt R2, Mills NL2, Webb DJ2, Dhaun N2, Kalla R3, Adams A3, Vatn S4, Bonfliglio F5, Nimmo E3, Kennedy N3, Ventham N3, Vatn M6, Ricanek P6, Halfvarson J7, Soderhollm J8, Pierik M9, Torkvist L10, Gomollon F11, Gut I12, Jahnsen J4, Satsangi J3, Body R13, Almashali M14, McDowell G15, Taylor P16, Lacey A17, Rees A16, Dayan C16, Lazarus J16, Nelson S18, Okosieme O16, Corcoran D19, Young R20, Ciadella P21, McCartney P19, Bajrangee A21, Hennigan B21, Collison D21, Carrick D21, Shaukat A21, Good R21, Watkins S21, McEntegart M21, Watt J21, Welsh P19, Sattar N19, McConnachie A20, Oldroyd K21, Berry C19, Parks T22,23, Auckland K23, Mentzer AJ23, Kado J24, Mirabel MM25, Kauwe JK26, Robson KJ23, Mittal B27, Steer AC28, Hill AVS23, Akbar M29, Forrester M30, Virlan AT29, Gilmour A29, Wallace C30, Paterson C29, Reid D30, Siebert S29, Porter D29, Liversidge J30, McInnes I29, Goodyear C29, Athwal V31,32, Pritchett J32, Zaitoun A33, Irving W33, Guha IN33, Hanley NA31,32, Hanley KP32, Briggs T34, Reynolds J35, Rice G34, Bondet V36, Bruce E35, Crow Y37, Duffy D36, Parker B35, Bruce I35, Martin K13, Pritchett J13, Aoibheann Mullan M13, Llewellyn J13, Athwal V13, Zeef L13, Farrow S13,38, Streuli C13, Henderson N39, Friedman S40, Hanley N13, Hanley KP13.
Author information
1
From the University of Birmingham.
2
From the University/British Heart Foundation Centre of Research Excellence, University of Edinburgh.
3
From the University of Edinburgh.
4
Akerhshus University Hospital.
5
Biocruces Health Research Institute.
6
University of Oslo.
7
Orebro University.
8
Linkoping University Hospital.
9
Maastricht University Medical Centre.
10
Karolinska Institutet.
11
HCU 'Lozano Blesa'.
12
CNAG-CRG.
13
From the University of Manchester.
14
Manchester University Hospitals Foundation NHS Trust.
15
Manchester Metropolitan University.
16
From the Cardiff University.
17
Swansea University.
18
Glasgow University.
19
From the British Heart Foundation (BHF), Glasgow Cardiovascular Research Centre, University of Glasgow.
20
Robertson Centre for Biostatistics, University of Glasgow.
21
West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital.
22
From the London School of Hygiene and Tropical Medicine.
23
University of Oxford.
24
Fiji Islands Ministry of Health and Medical Services.
25
French National Institute of Health and Medical Research.
26
Brigham Young University.
27
Babasaheb Bhimrao Ambedkar University.
28
Murdoch Children's Research Institute.
29
From the Institute of Infection, Immunity & Inflammation, University of Glasgow.
30
Division of Applied Medicine, School of Medicine and Dentistry, University of Aberdeen.
31
From the Manchester University Foundation NHS Trust.
32
University of Manchester.
33
Queen's Medical Centre.
34
From the Manchester Centre of Genomic Medicine, University of Manchester.
35
Division of Musculoskeletal & Dermatological Sciences, University of Manchester.
36
Immunobiology of Dendritic Cells, Institut Pasteur.
37
Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR1163, Institut Imagine.
38
Respiratory Therapy Area, GlaxoSmithKline.
39
University of Edinburgh.
40
Icahn School of Medicine at Mount Sinai.
PMID: 31222346 DOI: 10.1093/qjmed/hcy193
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Select item 31222299
8.
QJM. 2019 Jan 1;112(1):1. doi: 10.1093/qjmed/hcy286.
QJM state-of-the art reviews on Fabry disease and Calcipjylaxis.
Donnelly SC1.
Author information
1
Editor-in-Chief, QJM.
PMID: 31222299 DOI: 10.1093/qjmed/hcy286
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Select item 31218368
9.
QJM. 2019 Jun 20. pii: hcz112. doi: 10.1093/qjmed/hcz112. [Epub ahead of print]
Hydroxychloroquine was associated with reduced risk of new-onset diabetes mellitus in patients with Sjögren syndrome.
Chen TH1, Lai TY1, Wang YH2, Chiou JY3, Hung YM4,5,6, Wei JC7,8.
Author information
Abstract
OBJECTIVES:
To determine whether taking Hydroxychloroquine could prevent the development of new-onset diabetes mellitus among patients with Sjögren syndrome.

METHODS:
RESULTS:
Patients with Sjögren syndrome treated with Hydroxychloroquine had a significantly lower cumulative incidence of new-onset diabetes mellitus than those not treated with Hydroxychloroquine (adjusted hazard ratio: 0.51, 95% confidence interval: 0.28-0.96, p < 0.05). Hydroxychloroquine use for 3 years or more had favorable protective effects (adjusted hazard ratio: 0.22, confidence interval: 0.05-0.92).

CONCLUSIONS:
Hydroxychloroquine reduced the incidence of diabetes mellitus in a time and dose-dependent manner. Patients with SS who had taken Hydroxychloroquine for 3 years or more exhibited significant protective effects against developing new-onset diabetes mellitus.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PMID: 31218368 DOI: 10.1093/qjmed/hcz112
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Select item 31214693
10.
QJM. 2019 Jun 19. pii: hcz150. doi: 10.1093/qjmed/hcz150. [Epub ahead of print]
Hepatocellular carcinoma in cystic fibrosis liver disease: a cautionary tale.
O'Brien C1, Ramlaul N2, Haughey A1, Nolan N3, Malone DE1, Cormick AM2.
Author information
1
Department Radiology, St. Vincent's University Hospital, Dublin, 196 Merrion Rd, Elm Park, Dublin D04T6F4, Ireland.
2
Department Hepatology, St. Vincent's University Hospital, Dublin, 196 Merrion Rd, Elm Park, Dublin D04T6F4, Ireland.
3
Department Pathology, St. Vincent's University Hospital, Dublin, 196 Merrion Rd, Elm Park, Dublin D04T6F4, Ireland.
PMID: 31214693 DOI: 10.1093/qjmed/hcz150
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Select item 31199491
11.
QJM. 2019 Jun 14. pii: hcz151. doi: 10.1093/qjmed/hcz151. [Epub ahead of print]
Aortic Valve Abscess: Staphylococcus Epidermidis & Infective Endocarditis.
Mishra AK1, Sahu KK1, Lal A1, Menon V1.
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PMID: 31199491 DOI: 10.1093/qjmed/hcz151
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Select item 31199490
12.
QJM. 2019 Jun 14. pii: hcz144. doi: 10.1093/qjmed/hcz144. [Epub ahead of print]
Griscelli syndrome type 2.
Gailson T1, Pandit S1, Chandrasekaran S1.
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PMID: 31199490 DOI: 10.1093/qjmed/hcz144
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Select item 31199485
13.
QJM. 2019 Jun 14. pii: hcz143. doi: 10.1093/qjmed/hcz143. [Epub ahead of print]
Usability of donor corneas harvested from the deceased having septicaemia or malignancy.
Singh T1, Arya SK1, Handa U2, Chander J3.
Author information
Abstract
CONTEXT:
There is a wide gap between supply and demand in relation to healthy corneal grafts. Specific contraindications like infection and malignancy lead to non-usage of many grafts, despite the fact that deeming graft unhealthyness for these two contraindications is debatable.

AIMS:
The present study was conceptualised to assess if corneas donated from the deceased with septicaemia or malignancy can be deemed fit for implantation.

SETTINGS AND DESIGN:
Retrospective histopathological and microbiological analysis of cadaveric donor corneas.

METHODS AND MATERIAL:
76 donor corneas from 38 patients rejected for corneal transplantation in view of patient having septicaemia or malignany were analysed for pathological and microbiological workup, to look for dissemination of disease within corneal tissue.Pathology workup included gross and microscopic histopathological evaluation of tissue.Microbiology workup included Grams stain and KOH with calcoflour mount, culture in blood agar, chocolate agar, Sabourauds dextrose agar and Mc Conkeys broth.

RESULTS:
46 donor corneas of 23 septicaemia patients when evaluated showed presence of culture positive infection in 18 patients (78.2%).Histopathological examination done for 30 donor corneas from 15 cancer patients did not reveal presence of tumour cells in the specimen. Corneas of 2 of cancer patients having septicaemia revealed growth on cultures.

CONCLUSIONS:
Corneal tissues harvested from septicaemia donors showed significantly higher incidence of corneal contamination, confirming their unsuitability for usageHowever, there was no incidence of tumour transmission in corneal tissues of the patients with malignancies, suggesting that they can be considered for ophthalmic purpose.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

KEYWORDS:
cancer donor; cancer transmission; cornea donor selection; corneal transplantation; donor corneal contamination; ocular metastasis; septicaemia

PMID: 31199485 DOI: 10.1093/qjmed/hcz143
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Select item 31198950
14.
QJM. 2019 Jun 14. pii: hcz146. doi: 10.1093/qjmed/hcz146. [Epub ahead of print]
A case of diffuse Lepromatous leprosy with Lucio phenomenon.
Suvirya S1, Pathania S2, Malhotra K3, Jain A4, Verma P5, Kumari P2.
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PMID: 31198950 DOI: 10.1093/qjmed/hcz146
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Select item 31198937
15.
QJM. 2019 Jun 14. pii: hcz119. doi: 10.1093/qjmed/hcz119. [Epub ahead of print]
Tuberculosis & Nodular Calcifications in the Spleen.
Singh AK1, Samanta J1, Kochhar R1, Sinha SK1.
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PMID: 31198937 DOI: 10.1093/qjmed/hcz119
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Select item 31198934
16.
QJM. 2019 Jun 14. pii: hcz147. doi: 10.1093/qjmed/hcz147. [Epub ahead of print]
Pott's disease with paraparesis.
Liu SZ1, Zhou X1, Song A2, Wang YP1, Liu Y1.
Author information
PMID: 31198934 DOI: 10.1093/qjmed/hcz147
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Select item 31192368
17.
QJM. 2019 Jun 13. pii: hcz145. doi: 10.1093/qjmed/hcz145. [Epub ahead of print]
The pivotal role of molecular imaging in device-related infections.
Jolobe OMP1.
Author information
PMID: 31192368 DOI: 10.1093/qjmed/hcz145
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Select item 31179506
18.
QJM. 2019 Jun 10. pii: hcz140. doi: 10.1093/qjmed/hcz140. [Epub ahead of print]
A negative d-dimer identifies patients at low risk of death within 30 days: a prospective observational emergency department cohort study.
Lyngholm LE1, Nickel CH2, Kellett J1, Chang S3, Cooksley T4, Brabrand M1,5.
Author information
Abstract
OBJECTIVE:
To determine the ability of a normal d-dimer level (<0.5 mg/L) to identify emergency department patients at low risk of 30-day all-cause mortality.

DESIGN:
In this prospective observational study, d-dimer levels of adult medical patients were assessed at arrival to the ED. Data on 30-day survival status was extracted from the Danish Civil Registration System with complete follow-up.

SETTING:
The Hospital of South West Jutland.

PATIENTS:
All patients aged 18 years or older who required any blood sample on a clinical indication on arrival to the ED. Participants were required to give written informed consent before enrollment.

MAIN RESULTS:
The study population of 1,518 patients with median age 66 years of which 49.4% were female. Of the 791 (52.1%) patients with normal d-dimer levels, 3 (0.4%) died within 30 days; one death resulted from an unrelated traumatic accident. Of the 727 (47.9%) patients with abnormal d-dimer levels (≥0.50 mg/L), 32 (4.4%) died within 30 days. Patients with normal d-dimer levels had a significantly lower 30-day mortality compared to patients with abnormal d-dimer levels (odds ratio 0.08, 95% CI 0.02-0.28): of the 35 patients who died within 30 days, 19 (54.3%) had normal or near normal vital signs when first assessed.

CONCLUSION:
Normal d-dimer levels identified patients at low risk of 30-day mortality. Since most patients who died within 30 days presented with normal or near normal vital signs, d-dimer levels appear to provide additional prognostic information.

CLINICALTRIALS.GOV, IDENTIFIER:
NCT03108807.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

KEYWORDS:
30-day mortality; D-dimer; Early warning score; emergency department; risk stratification

PMID: 31179506 DOI: 10.1093/qjmed/hcz140
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Secondary source ID
Select item 31179498
19.
QJM. 2019 Jun 10. pii: hcz141. doi: 10.1093/qjmed/hcz141. [Epub ahead of print]
Absence of a Cerebral Hemisphere.
Boppana LKT1, Teelucksingh S2, Goli S3.
Author information
Abstract
A 60 year-old woman was referred with a visual field examination of left homonymous hemianopia with macular sparing, left hemiparesis, microcephaly and developmental delay since childhood. CT Brain revealed a diagnosis of Dyke-Davidoff-Masson Syndrome. This is the first report in the literature of a 60 year-old female with this diagnosis.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

KEYWORDS:
Cerebral hemiatrophy; Dyke-Davidoff Masson Syndrome; Hemiparesis

PMID: 31179498 DOI: 10.1093/qjmed/hcz141
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Select item 31179495
20.
QJM. 2019 Jun 10. pii: hcz142. doi: 10.1093/qjmed/hcz142. [Epub ahead of print]
'Crochetage' Sign of Atrial Septal Defect.
Singh H1, Pannu AK2, Dahiya N2,3, Suri V4, Bhalla A5, Kumari S5.
Author information
KEYWORDS:
Atrial septal defect; Echocardiography Ostium secundum; Electrocardiography; Right bundle branch block; sign; ‘Crochetage’

PMID: 31179495 DOI: 10.1093/qjmed/hcz142
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Select item 31173142
21.
QJM. 2019 Jun 7. pii: hcz138. doi: 10.1093/qjmed/hcz138. [Epub ahead of print]
Pulmonary Embolism: An often forgotten differential diagnosis for Abdominal Pain.
Hosein AS1, Mahabir V1, Konduru SKP2, Giddings SL3.
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PMID: 31173142 DOI: 10.1093/qjmed/hcz138
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Select item 31168630
22.
QJM. 2019 Jun 5. pii: hcz135. doi: 10.1093/qjmed/hcz135. [Epub ahead of print]
Tongue infection caused by Dirofilaria repens.
Velev V1, Popov M1, Pavlova M2, Karageorgiev M2,3, Mangarov A1.
Author information
PMID: 31168630 DOI: 10.1093/qjmed/hcz135
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Select item 31168610
23.
QJM. 2019 Jun 5. pii: hcz137. doi: 10.1093/qjmed/hcz137. [Epub ahead of print]
Trident sign in Osmotic Demyelination Syndrome.
Cheo SW1, Low QJ2, Tan YA3, Kang CY4.
Author information
Abstract
Osmotic demyelination syndrome (ODS) is a clinic-pathologic entity characterized by edema and demyelination of pons and extra pontine area. It frequently occurs as a result of rapid correction of chronic hyponatremia. It is characterized by altered sensorium and neurological deficits. Diagnosis of ODS is often difficult. MRI brain remains the gold standard for diagnosis. Here, we reported a case of osmotic demyelination syndrome resulting from rapid correction of hyponatremia. Through this case, we would like to illustrate the classical MRI brain findings of ODS.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PMID: 31168610 DOI: 10.1093/qjmed/hcz137
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Select item 31168577
24.
QJM. 2019 Jun 5. pii: hcz136. doi: 10.1093/qjmed/hcz136. [Epub ahead of print]
Forced sterilization during post-war era in Japan.
Higuchi A1, Takita M1, Ozaki A1, Kimura H2, Watanabe M2.
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PMID: 31168577 DOI: 10.1093/qjmed/hcz136
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