Primary and Secondary Prevention of CAD: A Review.

Coronary artery disease is the leading cause of death in both men and women, yet adequate control of risk factors can largely reduce the incidence and recurrence of cardiac events. In this review, we discuss various life style and pharmacological measures for both the primary and secondary prevention of coronary artery disease. With a clear understanding of management options, health care providers have an excellent opportunity to educate patients and ameliorate a significant burden of morbidity and mortality.

Spinal cord compression due to extramedullary hematopoiesis in a patient with E-beta-thalassemia managed without radiation or surgery.

Extramedullary hematopoiesis (EMH) in individuals with thalassemia is often the result of undertreated severe anemia. Radiation or surgery is often the chosen approach to handle spinal cord compression due to these paraspinal EMH elements. Our patient is a 28-year-old male with E-beta-thalassemia who presented with both upper thoracic and lower extremity symptoms of spinal cord compression and was successfully managed with the combination of transfusion and hydroxyurea. Given the variation in symptoms as a result of the sporadic location as well as the extent of these EMH elements along the spinal canal, the hematological communities will continue to benefit from case reports that offer treatment therapy.

Dilemma in management: a patient with active systemic lupus erythematosus presenting with pulmonary cavitary lesion.

Pulmonary manifestations of systemic lupus erythematosus (SLE) include, but are not limited to, pneumonia, interstitial pneumonitis, atelectasis and pleural effusion. Cavitary lung lesions are rarely associated with SLE. We present herein the case of a female patient with SLE and lupus nephritis who presented to the hospital with respiratory failure, rash and arthralgias. She was found to have a cavitary lung lesion most concerning for infection. However, despite an extensive inpatient antibiotic course, her symptoms persisted. After a collaborative effort between the primary team, pulmonology, infectious disease and rheumatology, she was placed on systemic glucocorticoid therapy, which resolved not only her respiratory failure, but also her cavitary lung lesion on subsequent follow-up with imaging. The dilemma of management in such cases will be discussed in addition to a review of previously reported cases.

White-throated sparrows alter songs differentially in response to chorusing anurans and other background noise.

Animals can use acoustic signals to attract mates and defend territories. As a consequence, background noise that interferes with signal transmission has the potential to reduce fitness, especially in birds that rely on song. While much research on bird song has investigated vocal flexibility in response to urban noise, weather and other birds, the possibility of inter-class acoustic competition from anurans has not been previously studied. Using sound recordings from central Ontario wetlands, we tested if white-throated sparrows (Zonotrichia albicolis) make short-term changes to their singing behaviour in response to chorusing spring peepers (Pseudacris crucifer), as well as to car noise, wind and other bird vocalizations. White-throated sparrow songs that were sung during the spring peeper chorus were shorter with higher minimum frequencies and narrower bandwidths resulting in reduced frequency overlap. Additionally, sparrows were less likely to sing when car noise and the vocalizations of other birds were present. These patterns suggest that birds use multiple adjustment strategies. This is the first report to demonstrate that birds may alter their songs differentially in response to different sources of noise. This article is part of a Special Issue entitled: insert SI title.