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J A Vale, J W Scadding
This paper reviews Churchill's illnesses in February 1943 and August/September 1944 when he developed pneumonia; on the first occasion this followed a cold and sore throat. Churchill was managed at home by Sir Charles Wilson (later Lord Moran) with the assistance of two nurses and the expert advice of Dr Geoffrey Marshall, Brigadier Lionel Whitby and Colonel Robert Drew. A sulphonamide (sulphathiazole on the first occasion) was prescribed for both illnesses. Churchill recovered, and despite his illnesses continued to direct the affairs of State from his bed...
December 2017: Journal of the Royal College of Physicians of Edinburgh
Eungu Kang, Yoon-Myung Kim, Minji Kang, Sun-Hee Heo, Gu-Hwan Kim, In-Hee Choi, Jin-Ho Choi, Han-Wook Yoo, Beom Hee Lee
BACKGROUND: Fatty acid oxidation disorders (FAODs) include more than 15 distinct disorders with variable clinical manifestations. After the introduction of newborn screening using tandem mass spectrometry, early identification of FAODs became feasible. This study describes the clinical, biochemical and molecular characteristics of FAODs patients detected by newborn screening (NBS) compared with those of 9 patients with symptomatic presentations. METHODS: Clinical and genetic features of FAODs patients diagnosed by NBS and by symptomatic presentations were reviewed...
March 8, 2018: BMC Pediatrics
Shams Y-Hassan
Spontaneous coronary artery dissection (SCAD) and takotsubo syndrome (TS) are two cardiovascular syndromes with predilection for women. Both conditions may be preceded by an emotional stress or, for the affected individual, an unusual severe physical exercise. "Restitution ad integrum" occurs in most cases suffering from SCAD or TS with complete angiographic resolution of the dissected vessel and left ventricular dysfunction respectively. Recently, many cases, which were initially diagnosed as TS because of typical left ventricular ballooning pattern showed to have SCAD, have been reported; these cases were deemed to be "SCAD misdiagnosed as TS"...
February 8, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Young Choi, Sungmin Lim, Kwan Yong Lee, Ha-Wook Park, Jaeho Byeon, Byung-Hee Hwang, Jin Jin Kim, Yong-Seog Oh, Ho-Joong Youn, Wook Sung Jung, Ki-Bae Seung, Kiyuk Chang
BACKGROUND: The effects of renin-angiotensin system (RAS) blockade on the clinical outcome in patients with stable coronary artery disease (SCAD) are conflicting. We evaluated the long-term effects of RAS blockers (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker) on the clinical outcomes in patients with SCAD without heart failure (HF) who underwent percutaneous coronary intervention (PCI) with drug-eluting stent using a large-scale, multicenter, prospective cohort registry...
February 27, 2018: Coronary Artery Disease
David Adlam, Fernando Alfonso, Angela Maas, Christiaan Vrints
No abstract text is available yet for this article.
February 22, 2018: European Heart Journal
Peiren Shan, Weijian Huang, Rukhsaar Hoosen, Changzuan Zhou, Gary S Mintz, Guosheng Fu
We present two cases of spontaneous left main stem coronary artery dissection. One was underdiagnosed with suboptimal percutaneous coronary artery intervention followed by acute vessel occlusion again during the hospitalization. The other one was identified and confirmed by intravascular ultrasound, followed by conservative medical treatment, with completed healing of SCAD during two-month follow up.
January 31, 2018: American Journal of Emergency Medicine
Qi Zhang, Yao Yu, Jun Zhang, Hua Liang
With the development of biotechnology, high-throughput studies on protein-protein, protein-gene, and gene-gene interactions become possible and attract remarkable attention. To explore the interactions in dynamic gene regulatory networks, we propose a single-index ordinary differential equation (ODE) model and develop a variable selection procedure. We employ the smoothly clipped absolute deviation penalty (SCAD) penalized function for variable selection. We analyze a yeast cell cycle gene expression data set to illustrate the usefulness of the single-index ODE model...
2018: PloS One
Sharonne N Hayes, Esther S H Kim, Jacqueline Saw, David Adlam, Cynthia Arslanian-Engoren, Katherine E Economy, Santhi K Ganesh, Rajiv Gulati, Mark E Lindsay, Jennifer H Mieres, Sahar Naderi, Svati Shah, David E Thaler, Marysia S Tweet, Malissa J Wood
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction...
February 22, 2018: Circulation
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
J A Vale, J W Scadding
This paper reviews Churchill's illness in Carthage in December 1943. It was characterised by fever that lasted 6 days, left lower lobe pneumonia and two episodes of atrial fibrillation. He was managed in a private villa by Lord Moran, his personal physician, with the assistance of two nurses and the expert advice of colleagues. Sulphadiazine and digitalis leaf were prescribed and Churchill recovered. It is remarkable that, despite the severity of his illness, he continued to direct the affairs of State from his bed...
September 2017: Journal of the Royal College of Physicians of Edinburgh
Øistein Rønneberg Mjelva, Gard F T Svingen, Eva K R Pedersen, Reinhard Seifert, Jan Terje Kvaløy, Øivind Midttun, Per M Ueland, Jan E Nordrehaug, Ottar Nygård, Dennis W T Nilsen
Systemic fibrinogen and neopterin are related to inflammation. We investigated the prognostic utility and possible interactions of these biomarkers in stable coronary artery disease (SCAD) patients undergoing coronary angiography. We included 3,545 patients with suspected stable angina with a median follow-up of 7.3 and 10.2 years for incident acute myocardial infarction (AMI) and all-cause mortality, respectively. Prospective associations were explored by Cox regression. Potential effect modifications were investigated according to strata of fibrinogen, neopterin or high-sensitivity troponin T (hsTnT) below and above the median, as well as gender and smoking habits...
February 19, 2018: Thrombosis and Haemostasis
James Lomas, Miqdad Asaria, Laura Bojke, Chris P Gale, Gerry Richardson, Simon Walker
BACKGROUND: Variation exists in the resource categories included in economic evaluations, and National Institute for Health and Care Excellence (NICE) guidance suggests the inclusion only of costs related to the index condition or intervention. However, there is a growing consensus that all healthcare costs should be included in economic evaluations for Health Technology Assessments (HTAs), particularly those related to extended years of life. OBJECTIVE AND METHODS: We aimed to quantify the impact of a range of cost categories on the adoption decision about a hypothetical intervention, and uncertainty around that decision, for stable coronary artery disease (SCAD) based on a dataset comprising 94,966 patients...
February 14, 2018: PharmacoEconomics Open
John W Scadding
No abstract text is available yet for this article.
February 2018: Journal of the Royal Society of Medicine
Sung-Jin Hong, Byeong-Keuk Kim, Sanghoon Shin, Yongsung Suh, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
BACKGROUND: The long-term outcome of percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG), particularly for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), remains controversial.Methods and Results:We retrospectively analyzed 2,827 patients (stable coronary artery disease [SCAD], n=1,601; NSTE-ACS, n=1,226) who underwent either PCI (n=1,732) or CABG (n=1,095). The 8-year composite of cardiac death and myocardial infarction (MI) was compared between PCI and CABG before and after propensity matching...
February 9, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
H Yao, A Ekou, J J N'Djessan, A Zoumenou, I Angoran, R N'Guetta
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) or sudden death, which typically affects young women. We reported two cases of black Africans patients, aged 56 and 52 years old, who presented to Abidjan Heart Institute for ACS. Coronary angiography showed spontaneous dissection of the right coronary artery in the first case, and dissection of the distal left anterior descending artery in the second. A conservative approach was preferred. Both patients received antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors and statins, with a favorable in-hospital course...
February 2018: Journal de Médecine Vasculaire
J Allister Vale, John W Scadding
This paper will review Winston Churchill's severe respiratory illness in March 1886 when he developed pneumonia of the right lung as an 11-year-old boy. Winston was treated supportively with 'nourishment, stimulants [probably alcohol] and close watching' at his school by the 'celebrated' family physician, Dr Robson Roose, with the assistance of Dr Joseph Rutter. Roose was exemplary in his commitment to his young patient and assiduous in informing Lord Randolph Churchill of his son's clinical progress by letter...
January 1, 2018: Journal of Medical Biography
Julie R Robinson
Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a rare but life-threatening condition of the peripartum and postpartum mother. The gold standard of diagnosing P-SCAD is a left cardiac catheterization; however, this diagnostic tool may not be used early because myocardial infarction is not typically a top differential diagnosis for women and especially young pregnant women presenting with acute chest pain. Providers and registered nurses, particularly those in the prehospital setting, the emergency department, and labor and delivery units, should be aware of signs, symptoms, potential risk factors, and diagnostic results that could indicate P-SCAD and initiate early and appropriate treatment to improve maternal outcomes...
March 2018: Dimensions of Critical Care Nursing: DCCN
Peter B Sporns, Thomas Niederstadt, Walter Heindel, Michael J Raschke, René Hartensuer, Ralf Dittrich, Uta Hanning
INTRODUCTION: Cervical artery dissection (CAD) is an important etiology of ischemic stroke and early recognition is vital to protect patients from the major complication of cerebral embolization by administration of anticoagulants. The etiology of arterial dissections differ and can be either spontaneous or traumatic. Even though the historical gold standard is still catheter angiography, recent studies suggest a good performance of computed tomography angiography (CTA) for detection of CAD...
January 26, 2018: Clinical Neuroradiology
Daniel A Culver, Robert P Baughman
No abstract text is available yet for this article.
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Jonas Christian Schupp, Sandra Freitag-Wolf, Elena Bargagli, Violeta Mihailović-Vučinić, Paola Rottoli, Aleksandar Grubanovic, Annegret Müller, Arne Jochens, Lukas Tittmann, Jasmin Schnerch, Carmela Olivieri, Annegret Fischer, Dragana Jovanovic, Snežana Filipovic, Jelica Videnovic-Ivanovic, Paul Bresser, René Jonkers, Kate O'Reilly, Ling-Pei Ho, Karoline I Gaede, Peter Zabel, Anna Dubaniewicz, Ben Marshall, Robert Kieszko, Janusz Milanowski, Andreas Günther, Anette Weihrich, Martin Petrek, Vitezslav Kolek, Michael P Keane, Sarah O'Beirne, Seamas Donnelly, Sigridur Olina Haraldsdottir, Kristin B Jorundsdottir, Ulrich Costabel, Francesco Bonella, Benoît Wallaert, Christian Grah, Tatjana Peroš-Golubičić, Mauritio Luisetti, Zamir Kadija, Stefan Pabst, Christian Grohé, János Strausz, Martina Vašáková, Martina Sterclova, Ann Millar, Jiří Homolka, Alena Slováková, Yvonne Kendrick, Anjali Crawshaw, Wim Wuyts, Lisa Spencer, Michael Pfeifer, Dominique Valeyre, Venerino Poletti, Hubertus Wirtz, Antje Prasse, Stefan Schreiber, Michael Krawczak, Joachim Müller-Quernheim
Sarcoidosis is a highly variable, systemic granulomatous disease of hitherto unknown aetiology. The GenPhenReSa (Genotype-Phenotype Relationship in Sarcoidosis) project represents a European multicentre study to investigate the influence of genotype on disease phenotypes in sarcoidosis.The baseline phenotype module of GenPhenReSa comprised 2163 Caucasian patients with sarcoidosis who were phenotyped at 31 study centres according to a standardised protocol.From this module, we found that patients with acute onset were mainly female, young and of Scadding type I or II...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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