British Journal of General Practice, November 2013 609 IntroduCtIon Chronic breathlessness which is refractory to treatments for the underlying condition is a common symptom of frequently encountered conditions that present in primary care, including lung and heart disease, and cancer. Primary-care based chronic illness initiatives such as clinics for asthma or chronic obstructive pulmonary dis...

A 55-year-old woman with chronic refractory idiopathic thrombocytopenic purpura (ITP) presented with gum bleeding for 1 day. Over the course of several years, she had failed, or became resistant to, multiple treatments including glucocorticoids, intravenous immunoglobulin, splenectomy, rituximab, and, recently, a 9-month course of weekly romiplostim with moderate compliance. A complete blood co...

Idiopathic ventricular arrhythmias (VA) consist of various subtypes of VA that occur in the absence of clinically apparent structural heart disease. Affected patients account for approximately 10% of all patients referred for evaluation of ventricular tachycardia (VT). Arrhythmias arising from the outflow tract (OT) are the most common subtype of idiopathic VA and more than 70-80% of idiopathic...

In order to analyze the usefulness of different types of treatment in relation to the interval since the onset of idiopathic thrombocytopenic purpura (ITP), a collaborative study of 934 adult patients was undertaken. Prednisone was administered to 818 patients, and 32% of them achieved prolonged complete remission (PCR). However, only 14% of patients who had ITP for more than six months achieve...

AIM To identify simple, objective, accurate histological criteria for distinguishing acute infective-type colitis, chronic idiopathic inflammatory bowel disease, and irritable bowel syndrome on rectal biopsy in patients with acute onset diarrhoea at first presentation, one to 10 weeks after onset. METHODS Cell counts and measurements of mucosal architecture were made on initial rectal biopsie...

CONTEXT A serum antibody to carbonic anhydrase II has been reported in patients with Sjögren's syndrome and idiopathic chronic pancreatitis. OBJECTIVE To evaluate cellular immune response to carbonic anhydrase II in patients with Sjögren's syndrome and idiopathic chronic pancreatitis. PATIENTS Idiopathic chronic pancreatitis (n=23), Sjögren's syndrome (n=12), alcoholic chronic pancreatitis ...

In idiopathic and immune neutropenias the susceptibility to infectious agents is highly variable, but the reason why some patients exhibit no undue susceptibility whereas others contract life-threatening infections is poorly understood. An important factor is the efficacy of delivery of neutrophils to the tissues. Recent investigations of the mechanisms for mild to moderate chronic neutropenias...

Idiopathic thrombocytopenic purpura (ITP) is a common hematologic disorder manifested by immune-mediated thrombocytopenia. The diagnosis remains one of exclusion, after other thrombocytopenic disorders are ruled out based on history, physical examination, and laboratory evaluation. The goal of treatment is to raise the platelet count into a hemostatically safe range. The disorder is usually chr...

Juvenile idiopathic arthritis (JIA) is defined as arthritis of unknown cause that starts before 16 years of age and lasts at least 6 weeks. It is the most common chronic inflammatory disease in childhood and often persists through adulthood and can lead to severe disability. Biologics are an important therapeutic option for treating patients with JIA. The efficiency of rituximab has not been pr...