The American journal of medicine
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Cardiologists and gastroenterologists often encounter the coexistence of symptoms and functional abnormalities, but determining causation is more difficult. In 1962 Smith and Papp first coined the term "linked angina". Their statement was preceded by the experiment whereby increase in bile duct pressure elicited the typical chest pain in patients with ischemic heart disease. It was demonstrated that dysphagia can be associated with ventricular arrhythmia suggestive of possible cardioesophageal reflex involvement. ⋯ It has been demonstrated that the patients suffering from prolonged gastro-esophageal acid reflux episodes and coronary spasm may be at higher risk for the development of linked-angina and acute myocardial infarction. We believe cardioesophageal reflex is a probable mediator of the linked angina. We recommend early treatment of gastroesophageal disorders in patients with symptomatic coronary arterial disease to alleviate the associated ischemic and arrhythmic burden.
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Review
Gut Microbiome Modulation in Allergy Treatment: The Role of Fecal Microbiota Transplantation.
The prevalence of allergic diseases has been rising, paralleling lifestyle changes and environmental exposures that have altered human microbiome composition. This review article examines the intricate relationship between the gut microbiome and allergic diseases, emphasizing the potential of fecal microbiota transplantation as a promising novel treatment approach. ⋯ The discussion also addresses immune homeostasis and its modulation by the gut microbiome, highlighting the shift from eubiosis to dysbiosis in allergic conditions. Furthermore, this article reviews existing studies and emerging research on the role of fecal microbiota transplantation in restoring microbial balance, providing insights into its mechanisms, efficacy, and safety.
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Reports of nonrheumatic streptococcal pharyngitis associated myocarditis (SPAM) are rare, and its incidence, pathophysiology, and clinical features remain unclear. We evaluated the clinical course and outcome of patients diagnosed with nonrheumatic SPAM, with a particular focus on differentiating it from other etiologies of myocarditis. ⋯ Nonrheumatic SPAM may not be as infrequent as thought and should be considered in the differential diagnosis of acute ST-segment elevation myocardial infarction, especially in male patients with sore throat and fever.