Fonseca JF, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-220177 Description A 76-year-old man presented with asthenia and proximal muscle weakness during the past 6 months. A general physical examination proved to be unremarkable. Blood tests showed hypercalcaemia (ionised calcium 1.52 mmol/L) and normal creatine phosphokinase (CPK). Additional studies findings included: suppressed parathyroi...

The volume of the intrafibrillar water space--i.e. the water contained inside the collagen fibres--is a key parameter that is relevant to concepts of connective tissue structure and function. Confined compression and swelling experiments on annulus fibrosus samples are interpreted in terms of a dual porosity model that distinguishes between a non-ionised intrafibrillar porosity and an ionised e...

Tachamo N, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-222726 Description A 36-year-old woman presented to the emergency department after she woke up with painful spasm of bilateral hands. She had been vomiting 10–15 times daily for the past few days. She denied any laxative or diuretic abuse. She had 18-year history of bulimia nervosa, primarily involving self-induced vomiting and excessive...

Regional citrate anticoagulation (RCA) for continuous renal replacement therapy (CRRT) has become increasingly attractive in recent years due to its favourable low bleeding risk profile. Its use in liver failure, however, has been limited due to the risk of citrate accumulation and toxicity. In the previous issue of Critical Care, Schultheiss and colleagues look at CRRT using RCA in liver failu...

Thyroid hormones affect bone metabolism by altering normal bone remodeling processes. This study involved assessment of biochemical markers of bone turnover in 94 patients with thyroid dysfunction. Clear hypocalcaemia was observed in hypothyroidism while in hyperthyroid patients there was frank hypercalcaemia. In hyperthyroidism there is increased activity of osteoclast which leads to increased...

Aims. We analyse a long XMM-Newton spectrum of the narrow-line Seyfert 1 galaxy Mrk 766, using the marked spectral variability on timescales > 20 ks to separate components in the X-ray spectrum. Methods. Principal components analysis is used to identify distinct emission components in the X-ray spectrum, possible alternative physical models for those components are then compared statistically. ...

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The aim of the present study was to compare the nutritional status of PHN patients with that of healthy controls, and then to identify risk factors for PHN using multivariate multiple logistic regressions. In the present cross-sectional study, we prospectively enrolled fifty PHN patients for at least 3 months an...

Emission line spectra from H II regions are often used to study properties of the gas in star-forming regions, as well as temperatures and luminosities of the ionising sources. Empirical diagnostics for the interpretation of observational data must often be calibrated with the aid of photoionisation models. Most studies so far have been carried out by assuming spherical or plane-parallel geomet...