Scar shape analysis and simulated electrical instabilities in a non-ischemic dilated cardiomyopathy patient cohort.

This paper presents a morphological analysis of fibrotic scarring in non-ischemic dilated cardiomyopathy, and its relationship to electrical instabilities which underlie reentrant arrhythmias. Two dimensional electrophysiological simulation models were constructed from a set of 699 late gadolinium enhanced cardiac magnetic resonance images originating from 157 patients. Areas of late gadolinium enhancement (LGE) in each image were assigned one of 10 possible microstructures, which modelled the details of fibrotic scarring an order of magnitude below the MRI scan resolution.

Fibrosis Microstructure Modulates Reentry in Non-ischemic Dilated Cardiomyopathy: Insights From Imaged Guided 2D Computational Modeling.

Patients who present with non-ischemic dilated cardiomyopathy (NIDCM) and enhancement on late gadolinium magnetic resonance imaging (LGE-CMR), are at high risk of sudden cardiac death (SCD). Further risk stratification of these patients based on LGE-CMR may be improved through better understanding of fibrosis microstructure. Our aim is to examine variations in fibrosis microstructure based on LGE imaging, and quantify the effect on reentry inducibility and mechanism.

The future of prenatal diagnosis: rapid testing or full karyotype? An audit of chromosome abnormalities and pregnancy outcomes for women referred for Down's Syndrome testing.

Objective: To assess the implications of a change in prenatal diagnosis policy from full karyotype analysis to rapid trisomy testing for women referred primarily for increased risk of Down's Syndrome.

Design: Retrospective collection and review of data.

Setting: The four London Regional Genetics Centres.

Emergency endovascular stent grafting of a traumatic thoracic aortic dissection.

An endovascular stent graft was successfully used in the management of a patient with multiple injuries, who sustained an acute type B dissection of the thoracic aorta. We discuss the multidisciplinary approach taken, the contra-indications of conventional surgery, and the radiological imaging employed. We conclude that stent grafts can be safely deployed without morbidity or mortality in a multiply injured patient.

Submerging an endodontically treated root to preserve the alveolar ridge under a bridge--a case report.

The loss of teeth results in the resorption of the residual alveolar ridges. This case report describes the successful maintenance of the alveolar ridge contour in the maxillary anterior region under a fixed prosthesis by the mucosal coverage and submersion of an endodontically retreated root, including a 6-year follow-up.

The influence of health beliefs on the presentation and consultation outcome in patients with chemical sensitivities.

Objective: This study was carried out to investigate the impact of the physical effects of a chemical exposure, health and chemical beliefs, and chemical sensitivities treatment preferences on the consultation outcome at a tertiary liaison clinic.

Method: Eighty-five patients exposed to a range of chemicals were assessed at a joint medical toxicology and psychiatric clinic. Patient's beliefs about chemicals and health, chemical sensitivities and their treatment preferences were assessed using a 23-item questionnaire.

Pharmacokinetics of meropenem in intensive care unit patients receiving continuous veno-venous hemofiltration or hemodiafiltration.

Objective: To evaluate an intravenous meropenem dosage regimen in adult intensive care patients with acute renal failure treated by continuous renal replacement therapy.

Design: A prospective, clinical study.

Setting: General intensive care unit of a university hospital.

Apparent poisoning by wood preservatives: an attributional syndrome.

Recent reports have pointed to an increased number of patients presenting with multisystem symptoms which they attribute to chemical exposures or to heightened chemical sensitivity. Twenty patients exposed to wood preservative products, who attended a joint toxicology and psychiatric clinic, were reviewed by a retrospective case note analysis. Thirteen patients attributed their symptoms to the wood preservative soon after the exposure, and seven patients developed the attribution only at a later date.

Possible association of liver damage with the use of Chinese herbal medicine for skin disease.

From January 1991 to December 1993, we received reports of 11 cases of liver damage following the use of Chinese Herbal Medicine (CHM) for skin conditions. There was strong evidence of an etological association in 2 cases in which recovery after dechallenge and recurrence of hepatitis after rechallenge were observed. The time-course relationship, recovery after ceasing CHM, and absence of alternative causes of liver damage suggested an association in 2 further symptomatic cases following a single period of exposure.