RESUMEN
We present 2 cases of Progressive supranuclear palsy (PSP), both of the cases presented to us with typical signs of Parkinson’s disease (PD), but they also had history of falls and difficulty in looking downwards. PSP is one of the variants of Parkinson Plus Syndromes.
Asunto(s)
Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/epidemiología , Parálisis Supranuclear Progresiva/complicaciones , Parálisis Supranuclear Progresiva/diagnóstico , Parálisis Supranuclear Progresiva/epidemiologíaRESUMEN
BACKGROUND: Longitudinal studies have revealed significant correlation between exaggerated blood pressure response to exercise and higher incidence of developing resting hypertension in future. Normotensive persons at high risk of developing systemic hypertension have greater cardiovascular reactivity to exercise. METHODS AND RESULTS: Our study compared the blood pressure response to treadmill exercise in normotensive offspring of the hypertensive parents (age 22 +/- 1.7 years, n = 50; study group) with those of the normotensive parents (age 22 +/- 1.4 years, n = 50; control group). The morphometric characteristics, resting, exercise (treadmill exercise with Bruce protocol) and recovery blood pressure values of all the subjects were recorded. The analysis showed that the difference in mean peak systolic blood pressure during exercise was the only statistically significant parameter in the study and control groups (188.52 +/- 25.16 mmHg and 178.56 +/- 14.96 mmHg, respectively, p < 0.05). The number of hyperreactors (defined as peak systolic blood pressure > 200 mmHg during exercise) was significantly more in study group compared to control group (10 and 3 respectively). The mean resting systolic blood pressure of hyperreactors (126.46 + 8.49 mmHg) falls in the pre-hypertension category as designated by JNC VII. Also, their resting diastolic blood pressure, recovery blood pressure and body mass index were significantly higher as compared to normoreactors. Conclusions: Our study showed that this response pattern could represent impairment in cardiovascular adjustment to exercise indicating a greater risk for development of resting hypertension in the future. Therefore there is a need for early lifestyle modifications to postpone/prevent development of hypertension.
Asunto(s)
Adulto , Factores de Edad , Análisis de Varianza , Determinación de la Presión Sanguínea/métodos , Estudios de Casos y Controles , Educación de Postgrado en Medicina , Prueba de Esfuerzo , Estudios de Seguimiento , Humanos , Hipertensión/diagnóstico , Incidencia , Modelos Lineales , Masculino , Análisis Multivariante , Probabilidad , Valores de Referencia , Medición de Riesgo , Sensibilidad y Especificidad , Estudiantes de Medicina , Factores de TiempoRESUMEN
Two brothers born to same parents were diagnosed with inherited factor X deficiency of severe type. Clinical presentation in both the cases were haemarthrosis. The elder brother was diagnosed in the year 1991 when he was four and half years old. Recently the youngest child in the family also presented with haemarthrosis at age of one and half years. Diagnosis was made by abnormal results of Coagulation factors screening mainly Prothrombin time, Activated partial thromboplastin time, Russell's viper venom test, mixing tests factor X assay. Both the brothers had Factor X activity less than one percent.