Abstract:
:A case of cerebral embolism is described in which paradoxical features have been proved clinically, and which may explain some hitherto unaccountable reported cases, and suggests the value of prospective studies. A successful outcome of such a proved case, associated with oral contraceptives, does not appear to have been reported previously. :In an effort to call attention to a lesion which is possibly provoked by ingestion of oral contraceptives, this case report of a 23-year-old woman, who had been taking Minovlar for 3 years admitted to the hospital after sudden onset of complete right-sided hemiplegia and total motor aphasia is presented. There was no clinical evidence of deep vein thrombosis or other cerebral, coronary, or other arterial occlusions due to embolism on admission. 1 week later, bilateral leg venography showed a normal left leg but the right leg showed nonfilling of the deep veins of the calf. In the process of a right-heart catherization, an atrial communication was crossed which proved to be a patent foramen ovale by pulmonary artery pressures and dilution indicator curves. Hence, a clinical diagnosis of paradoxical embolism was made on the grounds of combined evidence of deep vein thrombosis, electrocardiogram changes of acute cor pulmonale, which were entirely different from those known to accompany primary cerebrosvascular lesions, and catheter studies typical of embolism rather than thrombosis. This case prompted the authors to call for prospective studies to reveal paradoxical embolism in oral contraceptive users, rather than venous thrombosis.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
de Swiet Jdoi
10.1136/pgmj.55.644.419subject
Has Abstractpub_date
1979-06-01 00:00:00pages
419-20issue
644eissn
0032-5473issn
1469-0756journal_volume
55pub_type
杂志文章abstract::The diagnosis and early management of genitourinary disorders in children is challenging for the child, parents and carers. There have been enormous developments in paediatric care medically and surgically and as a result many patients with complex anomalies reach adult life and have a normal desire for a good quality...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2012-131232
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::Tuberculosis of the appendix is rare. It is usually secondary to tuberculosis elsewhere in the abdomen. Tuberculosis of the appendix is not associated with any specific clinical features and diagnosis is revealed only after histopathological examination. Appendicectomy should be performed in all patients with abdomina...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.744.855
更新日期:1987-10-01 00:00:00
abstract::Aspirin was first synthesised 100 years ago and its preparation and marketing is generally reckoned to have been the foundation of the pharmaceutical industry. For most of the time since then it has been used for the relief of pain and fever. The modern phase of aspirin use commenced with the reporting in 1974 of a ra...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.876.587
更新日期:1998-10-01 00:00:00
abstract::The clinical syndrome of heart failure has been investigated so extensively that it may now almost be regarded as a metabolic disorder. Although an initial insult reduces cardiac pump efficacy, the resultant physiological response culminates in complex neurohormonal dysfunction. This has created confusion and prevente...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.75.886.453
更新日期:1999-08-01 00:00:00
abstract::Alcohol is a major cause of liver cirrhosis in the Western world and accounts for the majority of cases of liver cirrhosis seen in district general hospitals in the UK. The three most widely recognised forms of alcoholic liver disease are alcoholic fatty liver (steatosis), acute alcoholic hepatitis, and alcoholic cirr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.76.895.280
更新日期:2000-05-01 00:00:00
abstract::Intraoperative transluminal endoscopic illumination is of benefit to locate angiodysplasias of the small bowel at laparotomy in the quiescent non-bleeding phase. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.745.995
更新日期:1987-11-01 00:00:00
abstract::Ketonaemia is well documented as a consequence of prolonged starvation, acute alcoholism, and uncontrolled diabetes mellitus. However, its occurrence in acute pancreatitis has not been described. In this report, three patients who manifested ketoacidosis at the time of presentation of acute pancreatitis are described....
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.831.32
更新日期:1995-01-01 00:00:00
abstract::Two hundred and sixty one patients attending a geriatric service were asked to give details of their usual medications without reference to drug bottles or written lists. Recall was tested in 4 categories: name of drugs, drug dosage, frequency of administration, and reason for the drug being prescribed. Drug recall wa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.772.116
更新日期:1990-02-01 00:00:00
abstract::Rectal (both digital and rigid sigmoidoscopic) examination is an important part of the clinical examination. The aim of this study was to find out the opinions of the patients to this routine examination at the time of referral by their general practitioner and during their first hospital interview. Assessment of the ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.792.904
更新日期:1991-10-01 00:00:00
abstract::Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis characterised clinically by frequent presentation with obstructive jaundice, histologically by a lymphoplasmacytic infiltrate with fibrosis, and therapeutically by a dramatic response to steroids. When so defined, AIP can be sub-classified into two subtyp...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-304224rep
更新日期:2014-01-01 00:00:00
abstract::A 25 year old woman with a 15-year history of paroxysmal nocturnal haemoglobinuria developed transient pancytopenia following infection with human parvovirus B19. This is the first report of transient pancytopenia in a patient with an acquired haemolytic anaemia due to parvovirus. The possible mechanism of pancytopeni...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.740.483
更新日期:1987-06-01 00:00:00
abstract::We describe two cases of digoxin toxicity presenting with clinical and electroencephalographic evidence of encephalopathy without other features of digoxin toxicity. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.848.367
更新日期:1996-06-01 00:00:00
abstract::We describe two patients with associations of hereditary neuropathies and heritable skeletal disorders not previously reported. The first patient had Marfan's syndrome and hereditary motor and sensory neuropathy Type 1. The second patient had Ehlers-Danlos syndrome, Klippel-Feil syndrome and tomaculous neuropathy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.71.834.245
更新日期:1995-04-01 00:00:00
abstract::It was considered that the first dose reaction occurring with prazosin may have been due either to hypotension or to a specific reduction in cerebral blood flow. The development of a quantitative non-invasion nuclear medicine technique for cerebral flow has now made it possible to investigate the effects of prazosin o...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.56.662.818
更新日期:1980-12-01 00:00:00
abstract::Antiphospholipid syndrome is a disorder of recurrent vascular thrombosis, pregnancy loss and thrombocytopenia associated with persistently elevated levels of antiphospholipid antibodies. It was first described in a group of patients with systemic lupus erythematosus but has since been associated with a wide range of c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.879.45
更新日期:1999-01-01 00:00:00
abstract::Quantitative lipoprotein level data was obtained from healthy subjects and patients with ischaemic heart disease or peripheral vascular disease in four European communities. Hypertriglyceridaemia, due mainly to an increase in VLDL triglyceride, was commoner in London and Uppsala than in Naples and Geneva. In three com...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::A case of hypereosinophilic syndrome is reported. Investigation failed to reveal any precipitating cause or evidence of leukaemia. Death was due to intractable cardiac failure, and post-mortem examination showed infiltration of the myocardium with sheets of immature cells. The relevance of these cells is discussed and...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.639.39
更新日期:1979-01-01 00:00:00
abstract::Two cases of pubic osteomyelitis presenting as a painful hip are reported. In both cases the diagnosis was delayed by the unusual presentation and by the limited radiological investigation. Pubic osteomyelitis is rare in childhood but should be considered in the differential diagnosis of the 'irritable hip'. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.738.301
更新日期:1987-04-01 00:00:00
abstract::A patient with seven attacks of acute glomerulonephritis is described. Following each attack renal function returned to normal. Investigations strongly suggested immune complex disease as the cause of the nephritis but extensive tests failed to define the antigen. The possibility of an exogenous self-administered anti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.687.60
更新日期:1983-01-01 00:00:00
abstract::A pre-term infant being ventilated for respiratory distress syndrome developed severe localized pulmonary interstitial emphysema which was successfully treated by selective bronchial intubation. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.699.58
更新日期:1984-01-01 00:00:00
abstract::This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960-1990. Patients with a late onset were compared to other selected patient samples. The ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.793.973
更新日期:1991-11-01 00:00:00
abstract::The present report is the first description to our knowledge of a clinical case of bacterial calcification in human infective endocarditic vegetations. Partial calcification of bacteria within vegetations may be a further mechanism of bacterial protection from host defences and antibiotics. Similar calcification has r...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.767.665
更新日期:1989-09-01 00:00:00
abstract::Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage. The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly describe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.692.394
更新日期:1983-06-01 00:00:00
abstract::We describe two patients with diabetes mellitus and associated neuropathy, who presented with painless foot swelling and no history of trauma. X-Rays revealed recent underlying fractures-in one of a metatarsus, and the other of a proximal phalanx. These were assumed to be 'stress' fractures unassociated with pain beca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.858.241
更新日期:1997-04-01 00:00:00
abstract::Fifty two cases of tuberculosis of the breast encountered over a 15 year period and accounting for 3% of all breast lesions are reported. The classic presentation was a breast lump with associated sinus in 39%, isolated breast lump in 23%, sinus without lump in 12%, and tender nodularity in 23% of the patients. Associ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.921.422
更新日期:2002-07-01 00:00:00
abstract::In this study we have examined the ability of senior house officers in the Accident and Emergency (A&E) Department to interpret electrocardiographs (ECGs) and tested the value of a single seminar and guidelines on interpretation. We prospectively audited ECG interpretation taken from notes over a two-month period and ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.833.132
更新日期:1995-03-01 00:00:00
abstract::A patient with alcoholic cardiomyopathy is described in whom cardiovascular function capacity and radiological heart size fluctuated widely with periods of heavy drinking and abstinence. On two occasions, cessation of drinking resulted in clinical recovery from severe degrees of congestive failure and in complete reve...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.700.151
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:We aimed to report the incidence of hospital-acquired hypophosphataemia and hyperphosphataemia along with their associated in-hospital mortality. METHODS:We included 15 869 adult patients hospitalised at a tertiary medical referral centre from January 2009 to December 2013, who had normal serum phosphate le...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2020-138872
更新日期:2020-10-21 00:00:00
abstract::Exacerbations of chronic obstructive pulmonary disease impose a considerable burden of morbidity, mortality, and health care cost. Management guidelines outlining best practice, based largely on consensus expert opinion, were produced by a number of organisations during the last decade. Current interest in the field i...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.019182
更新日期:2004-09-01 00:00:00