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Syncope

In linguistics, syncope is the deletion of phonemes from a word, or from a phrase treated as a unit; compare elision. more...

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Syncope gives rise to many of the silent letters in English spelling. The traditional spellings of English place names such as Worcester and Gloucester bear evidence of syncope, as does the usual pronunciation of parliament. Syncope is the reason why Australian English is colloquially known as Strine.

In some traditional English spellings, the syncope suffered by abbreviated forms is indicated by an apostrophe, as in didn't and I'd've. In other, similar words, it is customary to omit the apostrophe, as in gonna for going to or wannabe for want to be. The forms showing syncope, whether indicated or not, are usually marked as colloquial and not used in the most formal sorts of English.

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Brain natriuretic peptide marks cardiac causes of syncope
From American Family Physician, 9/1/04 by Richard Sadovsky

Determining the causes of syncopal episodes can be difficult. Methods that would distinguish between cardiac, reflex-mediated, neurogenic, and idiopathic etiologies would be helpful. Brain natriuretic peptide plasma concentrations are being used widely to identify patients with myocardial dysfunction.

Tanimoto and associates measured brain natriuretic peptide levels on the morning after admission in 118 adult patients who were admitted to the hospital for syncope. The cause of syncope was determined using a diagnostic algorithm suggested by the American College of Physicians. Patients were classified into one of four etiologic categories; a majority (52 percent) had cardiac etiologies for the syncopal episode. The cause of syncope was unknown in 25 percent of the patients.

Brain natriuretic peptide was significantly higher in the cardiac group (118 [+ or -] 42 pg per mL) than in the other groups. The highest levels occurred in patients with organic cardiac disease, followed by those with tachycardia and then by those with bradycardia. Using a cutoff of 40 pg per mL, the sensitivity and specificity of brain natriuretic peptide levels in identifying cardiac syncope were 82 and 92 percent, respectively.

The authors conclude that cardiac causes for syncope are much more likely in patients with a brain natriuretic peptide level greater than 40 pg per mL. Electrocardiography and echocardiography are helpful in identifying specific cardiac causes. Because some patients in the unknown-cause group had elevated levels of brain natriuretic peptide, it is likely that these patients had cardiac syncope but that the specific cardiac disorder was not identified.

Tanimoto K, et al. Usefulness of brain natriuretic peptide as a marker for separating cardiac and noncardiac causes of syncope. Am J Cardiol January 15, 2004;93:228-30.

COPYRIGHT 2004 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group

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