Medicine (Abingdon, England : UK ed.)最新文献_第7页

Arterial cannulation 动脉管子

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.010

Rathai Anandanadesan, Susanna Price

引用次数: 0

Physiology of the normal heart 正常心脏的生理机能

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.015

Andrew Constantine, Kaushiga Krishnathasan, Konstantinos Dimopoulos

引用次数: 0

Biochemistry and physiology of cardiac muscle 心肌的生物化学和生理学

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-28 DOI: 10.1016/j.mpmed.2026.03.003

Adam Nabeebaccus

{"title":"Biochemistry and physiology of cardiac muscle","authors":"Adam Nabeebaccus","doi":"10.1016/j.mpmed.2026.03.003","DOIUrl":"10.1016/j.mpmed.2026.03.003","url":null,"abstract":"<div><div>The heart is composed of muscle cells (cardiomyocytes) that account for most of the heart mass and generate its pumping force. Other cell types (fibroblasts, vascular endothelial cells, vascular smooth muscle cells, immune cells) and the extracellular matrix also play key roles in cardiac function, in both health and disease. Excitation–contraction coupling links the electrical activation of cardiomyocytes to cellular contraction. Calcium is a key second messenger in this process; its entry into the cell triggers further calcium release from the sarcoplasmic reticulum, which then activates the contractile machinery. A subsequent reduction in calcium concentration brings about cardiac relaxation, which is necessary for the heart to refill. Calcium also regulates other critical processes in the heart, including the transcription of genes and matching of energy supply from the mitochondria with cellular demand. In health, the contractile function of the heart is regulated by several factors, including its loading conditions, autonomic influences and many locally produced autocrine/paracrine agents. These factors alter contractile strength through two main mechanisms: modulation of the calcium transient within cardiomyocytes, and/or changes in myofilament sensitivity to calcium.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 6","pages":"Pages 388-393"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nuclear imaging 核成像

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.012

Katharine Thomas, Nikant Sabharwal

{"title":"Nuclear imaging","authors":"Katharine Thomas, Nikant Sabharwal","doi":"10.1016/j.mpmed.2026.03.012","DOIUrl":"10.1016/j.mpmed.2026.03.012","url":null,"abstract":"<div><div>Nuclear cardiology provides physiological information on myocardial perfusion and function. Three techniques are described: myocardial perfusion scintigraphy (MPS, the most widely used), radionuclide ventriculography (RNV) and positron emission tomography (PET). MPS is used to diagnose or exclude ischaemic heart disease, and is an option for the functional assessment of suspected coronary disease, as specified in current UK National Institute for Health and Care Excellence guidance. It is validated in patients undergoing non-cardiac surgery, before and after coronary revascularization, and for assessment of myocardial viability. MPS relies on changes in cellular uptake of radioactive tracers at rest and during myocardial stress. Matched defects represent sites of infarction, whereas mismatch between normal perfusion at rest and reduced perfusion during stress indicates ischaemia. Cardiac risk is proportional to the size of the perfusion defect. RNV relies on blood pool labelling to assess ventricular function and has excellent reproducibility. Cardiac PET has seen a recent increase in use because of improved techniques and new tracers. It employs positron-based tracers that resemble physiologically occurring compounds to characterize myocardial metabolism, assess cardiac perfusion and viability, and assist diagnosis of intracardiac infection and sarcoid. Combining functional data from nuclear imaging with anatomical data from CT or MRI produces hybrid imaging, which improves diagnostic yields.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 6","pages":"Pages 426-429"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Taking the history and examining the cardiovascular system 记录病史并检查心血管系统

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.007

Clive Lawson

引用次数: 0

Echocardiography in clinical practice 超声心动图在临床中的应用

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.013

Michael McDermott, Matthew Lowry, Patrick H Gibson

引用次数: 0

Cardiovascular magnetic resonance imaging: techniques and clinical applications 心血管磁共振成像：技术与临床应用

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.016

Raheel Ahmed, Evelyn Brown, James Dundas

{"title":"Cardiovascular magnetic resonance imaging: techniques and clinical applications","authors":"Raheel Ahmed, Evelyn Brown, James Dundas","doi":"10.1016/j.mpmed.2026.03.016","DOIUrl":"10.1016/j.mpmed.2026.03.016","url":null,"abstract":"<div><div>Cardiovascular magnetic resonance (CMR) has emerged as a cornerstone in assessing a broad spectrum of cardiac conditions, offering unparalleled accuracy in evaluating ventricular volumes, function and myocardial tissue characterization. This chapter provides a comprehensive overview of CMR principles, including basic magnetic resonance physics, imaging sequences and the use of gadolinium-based contrast agents for late gadolinium enhancement and tissue mapping. Clinical applications are discussed across major domains: ischaemic heart disease, cardiomyopathies, inflammatory and infiltrative myocardial disorders, valve disease, congenital heart defects and cardiac masses. CMR enables a precise phenotyping of cardiomyopathies, risk stratification and monitoring of disease progression, while multiparametric imaging facilitates non-invasive ‘tissue biopsy’ for myocarditis, amyloidosis, sarcoidosis and Fabry disease. In valve disease and congenital heart lesions, flow quantification and four-dimensional imaging enhance clinical decision-making and guide surgical timing. CMR helps differentiate benign from malignant cardiac masses, influencing therapeutic strategies. The chapter highlights current guideline-based indications, technical considerations including imaging in patients with cardiac devices or arrhythmias and the prognostic implications of imaging findings.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 6","pages":"Pages 435-445"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electrophysiological investigation 电生理研究

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-28 DOI: 10.1016/j.mpmed.2026.03.006

Andrew Sullivan, Richard Schilling, Nicholas Gall

引用次数: 0

Self-assessment/CPD answers 自我评价/ CPD答案

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-06-01 Epub Date: 2026-04-30 DOI: 10.1016/j.mpmed.2026.03.017

引用次数: 0

Vaginal discharge 阴道分泌物

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1016/j.mpmed.2026.02.006

Naomi Sutton, Sian Pearson

{"title":"Vaginal discharge","authors":"Naomi Sutton, Sian Pearson","doi":"10.1016/j.mpmed.2026.02.006","DOIUrl":"10.1016/j.mpmed.2026.02.006","url":null,"abstract":"<div><div>Abnormal vaginal discharge is a common clinical presentation, and causes can be physiological, infectious, and non-infectious. Infections are the leading cause of abnormal vaginal discharge; bacterial vaginosis (BV) is the most common, followed by vulvovaginal candidiasis (VVC). Sexually transmitted infections (STIs) such as <em>Chlamydia trachomatis</em>, <em>Neisseria gonorrhoeae</em> and <em>Trichomonas vaginalis</em> can also alter vaginal discharge and should be excluded in sexually active patients. Management has changed and ‘triple swabs’ are no longer recommended. If symptoms suggest acute BV or VVC, empirical treatment can be given without microbiological testing once nucleic acid amplification testing for STIs has been performed, if the individual is sexually active. If there is diagnostic uncertainty, or if the symptoms are recurrent or associated with vaginitis, pain, bleeding or pregnancy, examination should be offered. pH testing of vaginal discharge with narrow-range litmus paper can help guide diagnosis. If uncertainty remains, a high vaginal swab for culture should be obtained and/or specialist advice sought. Less common causes include genital tract malignancies, dermatoses, foreign bodies, and vaginal fistulas. Accurate diagnosis requires a clinical history, examination, and targeted investigations, as well as patient education and preventive measures.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 5","pages":"Pages 302-307"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0