The Starling as Mimic

The Frank--Starling curve.

A basic property of the normal heart is that if its volume is increased, there is an increase in the strength of the contraction. The phenomenon is known as Starling's Law, and as the FrankStarling mechanism. This phenomenon is of great importance. If the heart were unable to increase its output when distended, the distension would become progressively severe. The underlying important relation ...

The Reunion Starling

Myasthenia gravis as a 'stroke mimic'.

We thank Dr Giles Youngs and Dr Peter Stride for highlighting a factual error in an article on Brucella and Coxiella (Clin Med 2015;15:91–2). The authors confi rm that the statement ‘Coxiella burnetii is the cause of Q fever, a term fi rst used in 1983 during the investigation of a cluster of febrile Australian meat workers’ should in fact read, ‘Coxiella burnetii is the cause of Q fever, a ter...

Acute-Onset Stuttering as a Stroke Mimic

Background and purpose: The acute onset of stuttering in an adult is not uncommon and rarely is caused by ischemic stroke. A neurologist is likely to encounter this presentation and it is important to identify distinguishing features between ischemic stroke and other causes. Adult-onset acquired stuttering is classified as either neurogenic if secondary to brain injury or psychogenic in the abs...

Reappraising Starling: the physiology of the microcirculation.

PURPOSE OF REVIEW Vascular permeability is traditionally explained by Starling's principle, describing two opposing forces across the endothelial cell line to maintain compartments in balance. Several contradictions to this principle have recently questioned its validity. RECENT FINDINGS Hydraulic conductivity is kept low by a properly working endothelial surface layer, created by binding and...