Biomedical subjects
Publications and source records attributed to Fintan O'Rourke.
Localised herpes zoster infection ('shingles') in older patients is a common presentation to primary, and sometimes secondary, care physicians. However, symptoms of hyponatraemia, caused by the rare complication of 'syndrome of inappropriate antidiuretic hormone secretion' (SIADH), may be mistaken for constitutional symptoms of the infection itself. Such patients may require closer monitoring or hospitalisation.
BACKGROUND AND PURPOSE: Endothelial progenitor cells (EPCs) are associated with endothelial repair after ischemia in cardiac or peripheral circulation. There are no reports of EPCs with cerebrovascular disease. We present our experience with EPCs in patients with cerebrovascular disease. SUMMARY OF REPORT: EPC counts differed significantly (P<0.001) between stroke patients (acute stroke: median 4.75 and range 0 to 33; stable stroke: median 7.25 and range 0 to 43) and control subjects (median 15.5 and range 4.3 to 50), independent of age. The level of EPCs was significantly correlated with the Framingham coronary risk score (FCRS) (rho=-0.349; P=0.002). CONCLUSIONS: Similar to cardiac experience, the low EPC levels may play a role in the pathophysiology of cerebrovascular disease.
Stroke is a major cause of morbidity and mortality in an aging population. The current understanding of the pathophysiology of atherosclerotic diseases, the most common cause of stroke, and the evidence for existing therapeutic interventions for the prevention of stroke are presented. Specifically, we review the evidence for antiplatelet agents, anticoagulants, antihypertensive medications, lipid-lowering agents and carotid endarterectomy for stroke prevention.
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Cardiac myxoma is a source of emboli to the central nervous system and elsewhere in the vascular tree. However, nonspecific systemic symptoms and minor embolic phenomena may be overlooked in the absence of any history of cardiac problems. In this situation, cardiac investigations may not be performed, and diagnosis of this rare condition may be delayed until the onset of more significant embolic disease, such as stroke with functional impairment, as in the case reported here. The clinical presentation of cardiac myxoma is discussed, along with appropriate investigations and treatment, which may prevent such sequelae.