Introduction This case report details the second described of Whipple's disease-related thrombocytopenia in medical literature. disease is a rare multisystem infection caused by actinomycete Tropheryma whipplei , first George Whipple 1907. The key clinical manifestations are weight loss, diarrhoea and malabsorption, but arthralgia endocarditis also well described. Case presentation A 62-year-old Caucasian female presented with anaemia behavioural changes denied any abdominal symptoms....

New Findings What is the central question of this study? Carotid artery peak circumferential strain (PCS) and rate attenuate with age, but appear to be modulated by cardiorespiratory fitness status in young males. However, relationship between habitual endurance exercise (running) these parameters has not been studied middle‐aged men. main finding its importance? Young runners exhibited elevated PCS systolic (S‐SR) compared non‐runners, running did influence diastolic (D‐SR). Habitual...

This study focused on the influence of habitual endurance exercise training (i.e., committed runner or nonrunner) regulation muscle sympathetic nerve activity (MSNA) and arterial pressure in middle-aged (50 to 63 yr, n = 23) younger (19 30 yr; normotensive men. Hemodynamic neurophysiological assessments were performed at rest. Indices vascular baroreflex function determined from relationship between spontaneous changes diastolic blood (DBP) MSNA. Large vessel stiffness left ventricular...

Changes in the arterial baroreflex arc contribute to elevated sympathetic outflow and altered reflex control of blood pressure with human aging. Using ultrasound microneurography (muscle nerve activity, MSNA) we investigated relationships between aortic carotid artery wall tension (indices baroreceptor activation) vascular operating point (OP; MSNA burst incidence) healthy, normotensive young (n = 27, 23 ± 3 yr) middle-aged men 22, 55 4 yr). In men, OP was positively related magnitude rate...

Left ventricular (LV) structural remodeling following athletic training has been evidenced through training-specific changes in wall thickness and geometry. Whether the LV response to hemodynamic load also adapts a manner is unknown. Using echocardiography, we examined responses of endurance-trained (n = 15), resistance-trained 14), nonathletic men 13) 1) 20, 40, 60% one repetition-maximum (1RM), leg-press exercise 2) intravascular Gelofusine infusion (7 mL/kg) with passive leg raise. While...

Mycotic aneurysms are a well-recognised complication of infective endocarditis. In contrast to many sequelae endocarditis, they can present late in the course disease, despite adequate treatment. We discuss case an 82-year-old patient who was successfully treated for Enterococcus faecalis but presented with hypotensive collapse. CT imaging demonstrated ruptured mycotic aneurysm. He underwent laparotomy, decision made treat conservatively protect vascular supply bowel. The subsequently full recovery.

D-dimer can be significantly elevated in acute aortic dissection and poses a diagnostic challenge someone with pleuritic chest pain occurring after flight. Electrocardiogram abnormalities isolated may mimic other cardiovascular conditions.

<h3>Introduction</h3> Over 1 million metal-on-metal (MOM) hip replacements were performed between 2003 and 2010. These prostheses intended to be more durable than previous models, but have been associated with a higher failure rate. There also isolated cases of fulminant cardiomyopathy in patients very high serum cobalt levels. We screened cohort asymptomatic these for subclinical cardiac abnormalities. <h3>Methods</h3> All MOM at our centre undergo regular follow-up the orthopaedic clinic...

This editorial series provides an in-depth exploration of research avenues in UK cardiology. It underscores the pivotal role cardiology training and addresses challenges faced by trainees identifying apt opportunities. second article categorises available roles, weighing their pros cons, outlines various supervisory styles to guide finding optimal fit. also summarises primary degrees, namely MPhil, MSc, MD, PhD, tailored diverse goals.

Abstract Purpose Central arterial stiffness, a predictor of cardiovascular risk, attenuates with endurance-exercise in ageing populations. However, young individuals, this effect is inconsistent and emerging evidence suggests resistance-exercise may increase stiffness. Two-dimensional (2D)-Strain imaging the common carotid artery (CCA) more sensitive at detecting endurance-training induced alterations CCA stiffness than conventional methods, but has not been used to examine...

We determined the effect of habitual endurance exercise and age on aortic pulse wave velocity (aPWV), augmentation pressure (AP) systolic blood (aSBP), with statistical adjustments aPWV AP for heart rate mean arterial pressure, when appropriate. Furthermore, we assessed whether muscle sympathetic nerve activity (MSNA) correlates in young middle-aged men.Aortic PWV, AP, (applanation tonometry; SphygmoCor) MSNA (peroneal microneurography) were recorded 46 normotensive men who either or...

Carcinoid heart disease (CHD) is a consequence of neuroendocrine tumors releasing 5-hydroxytryptamine (5-HT) into the systemic circulation, affecting right valves, causing fibrosis, and eventually failure. The aim this study was to determine effect valve-replacement on kidney function, liver 5-hydroxyindoleacetic acid (5-HIAA) levels.A Retrospective 17 patients with CHD who had undergone heart-valve replacement surgery between 2010 2019, from Queen Elizabeth Hospital Birmingham. 5-HIAA...

Right ventricular size and function on cardiac MRI provides thresholds for referral pulmonary valve intervention in repaired Tetralogy of Fallot (RTOF). However, different contouring techniques are available to calculate right volumes ejection fraction. It is not known whether these impact threshold triggers intervention.

We present the case of a female patient in her 40s who presented with jaundice, orthopnoea, paroxysmal nocturnal dyspnoea and bilateral pedal oedema. After extensive investigations, she was diagnosed hepatic dysfunction, dilated cardiomyopathy (DCM) coeliac axis thrombosis. Her further complicated episodes torsades de pointes due to metabolic disturbance, consequent sudden cardiac arrest. In this report, we explore clinical features, pathophysiology treatment acute failure thrombosis,...

The case of a patient with confirmed amyloid, initially believed to be light chain (AL) type, whose diagnosis was clouded by an atypical gastrointestinal tract system presentation and concomitant haematological condition, is presented. Duodenal biopsy samples subsequently stained positive for transthyretin the revised senile systemic amyloidosis. managed medically remains alive more than 2 years after formally established. Differentiating amyloidoses from one another can challenging as...

We read with interest the study carried out by Dr Ng et al1 While we agree entirely their conclusion about importance of better education for competent diabetes management junior doctors—as reflected in a similar at London teaching hospital—we would, however, suggest that there is also room improvement these patients nursing staff. reviewed all inpatients having capillary blood glucose (CBG) monitoring on two medical and surgical wards over two-week period. examined charts, written notes...

<h3>Introduction</h3> The hallmark of Heart Failure with Preserved Ejection Fraction (HFpEF) is exercise intolerance. mechanisms for this are numerous, but chronotropic incompetence, defined as a failure to reach at least 70% the age-predicted maximum heart rate (HR) on maximal exercise, has been reported contribute. Impaired Rate Reserve, measure HR achieved compared rate, correlated negative cardiovascular outcomes. In normal subjects, PR interval shortens during parasympathetic tone...

<h3>Introduction</h3> Patients with repaired tetralogy of Fallot (RTOF) develop chronic pulmonary regurgitation and require monitoring for right ventricular dilatation. Pulmonary valve replacement can prevent irreversible (RV) dilatation dysfunction cardiac magnetic resonance (CMR) is used to facilitate its optimal timing. There are however, different techniques published measuring RV volumes. We sought determine whether the choice myocardial contouring technique affects preoperative...

What is the central question of this study? Endurance athletes demonstrate altered regional right ventricular (RV) wall mechanics, characterized by lower basal deformation, in comparison to non-athletic control subjects at rest. We hypothesized that adaptations RV base reflect an enhanced functional reserve capacity response haemodynamic volume loading. main finding and its importance? Free longitudinal strain elevated acute loading both endurance subjects. However, segment infusion greater...