Takotsubo cardiomyopathy with severe bradyarrhythmia following epidural insertion

Peer reviewedPublisher PD

Dynamic changes of the extracellular matrix after acute tako-tsubo cardiomyopathy

Funding Tenovus Scotland. Grant number G13/10.Peer reviewedPublisher PD

Right Ventricular Involvement and Recovery after Acute Stress-Induced (Tako-tsubo) Cardiomyopathy

Acknowledgment: The authors would like to thank all National Health Service Consultant Colleagues at Aberdeen Royal Infirmary for help with prompt recruitment of these patients (Dr. M Metcalfe, MD, Dr. AD Stewart, MD, Dr. A Hannah, MD, Dr. A Noman, MD, Dr. P Broadhurst, MD, Dr. D Hogg, MD, and Dr. D Garg, MD) and to Dr. Gordon Prescott, PhD for help and advice with the statistical methods. This work was supported by a Tenovus Scotland, Nice, France award to Dr. Dawson and presented in part at the Society for Cardiovascular Magnetic Resonance Imaging/EuroCMR 2015 Joint Scientific Sessions from February 5 2015 to February 7, 2015Peer reviewedPostprin

Persistent Long-Term Structural, Functional, and Metabolic Changes After Stress-Induced (Takotsubo) Cardiomyopathy

The HEROIC study was funded by the British Heart Foundation Project Grant no. PG/15/108/31928 (D.K.D.), the Josephine Lansdell British Medical Association 2015 Award (D.K.D.), and the Chief Scientist Office CGA-16-4 Catalytic Grant (D.K.D). D.E.N. is supported by the British Heart Foundation (CH/09/002) and a Wellcome Trust Senior Investigator Award (WT103782AIA).Peer reviewedPublisher PD

Alterations in Cardiac Deformation, Timing of Contraction and Relaxation, and Early Myocardial Fibrosis Accompany the Apparent Recovery of Acute Stress-Induced (Takotsubo) Cardiomyopathy : An End to the Concept of Transience

This work was supported by grants from Tenovus Scotland and the British Heart Foundation (to Dr. Dawson, G13/10 and PG/15/108/31928, respectively). Dr. Dawson has a research agreement with Philips Healthcare and holds a material transfer agreement with AMAG Pharmaceuticals.Peer reviewedPostprin

Report from the Annual Conference of the British Society of Echocardiography, November 2016, Queen Elizabeth II Conference Centre, London.

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Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Evaluating the relevance and effectiveness of AF8 since the project began in 2016

The work of AF8 is fundamentally about supporting good planning and coordination of all key agencies in the South Island to effectively respond (in the first seven days) to a significant future earthquake on the Alpine Fault. Work to date has focussed on bringing leading science research into the development of an Alpine Fault magnitude 8 scenario, which then informed the response planning phase, culminating in the SAFER Framework. Engaging in wider engagement and outreach activities has been on-going, aimed to increase the understanding and access to information by the wider community around how to plan and respond to a future Alpine Fault earthquake. A key feature of AF8 has been that is has represented a collaborative effort across a range of agencies, organisations, and locations. An additional aspect of AF8’s work has therefore been testing and demonstrating how to undertake a complex collaborative project, that requires the integration of knowledge, skills and expertise. Given the period of time that has elapsed since the AF8 was established, it is timely to conduct an evaluation of the project to identify: - the extent to which it is contributing to its intended outcomes - any other unintended outcomes (positive and negative) - lessons learned, that could be usefully applied to other similar types of projects. In essence, this evaluation research aims to understand the relevance, need and coherence of AF8’s efforts, as well as the effectiveness and efficiency of the work produced. Key informant interviews will be conducted over the next two months to ascertain the contribution AF8 has made to building resilience. This process is vital to continuing the co-creation approach taken by AF8, which requires reflection and listening to feedback from across the network of stakeholders who have helped to make AF8 a success

Voltage-gated potassium channel antibody-related encephalopathy: a case which may extend the documented phenotype of this condition

A 51-year-old man presented with a focal epileptic, fluctuating encephalopathy. Antibodies to voltage-gated potassium channels (VGKC-Abs) were detected in his serum. Several features of this case were different from those previously reported in VGKC-Ab-associated encephalitis, illustrating that it may have a broader phenotype than previously documented. These features were: excess hepatic iron deposits without cirrhosis, reduced consciousness and fluctuating neurological signs. Previous history included personality change, depression, type 2 diabetes mellitus, pupil sparing third nerve palsy and epilepsy secondary to a head injury. He had never drunk alcohol and had recovered from a similar episode 4 years previously. Both episodes resolved after approximately 2 months. The cerebrospinal fluid had a raised protein content but no organisms. The patient was heterozygous for C282Y and negative for H63D mutations excluding classical idiopathic haemochromatosis. He recovered with supportive care to his premorbid level of health