ABSTRACT
We electrophysiologically evaluated the autonomic function (AF) in a consecutive series of patients with beta-thalassemia and in normal individuals. Six quantitative autonomic function tests (AFTs) were used: tilt test, hand grip test and sympathetic skin response for sympathetic function; R-R interval, inspiration-expiration difference and 30/15 ratio for parasympathetic function. The prevalence of impaired AF was higher in beta-thalassemia patients (13%, n = 5) than in control subjects (0%, n = 0; p = 0.026). Subclinical autonomic dysfunction appeared to be more prevalent in beta-thalassemia patients compared to controls in our series. Further independent validation of this finding is required in larger cohorts of beta-thalassemia patients.
Subject(s)
Autonomic Nervous System Diseases/diagnosis , Autonomic Nervous System Diseases/physiopathology , beta-Thalassemia/physiopathology , Adult , Autonomic Nervous System Diseases/epidemiology , Cohort Studies , Comorbidity/trends , Disability Evaluation , Female , Hand Strength/physiology , Humans , Male , Neurologic Examination/methods , Prevalence , Tilt-Table Test/methods , Young Adult , beta-Thalassemia/epidemiologyABSTRACT
Postpartum spontaneous cervicocephalic artery dissection is an uncommon, poorly understood condition following pregnancy. We report a case of a 32-year-old woman with no history of trauma, chiropractic manipulation, connective tissue disorder, or previous headache who developed a mild, unilateral headache 7 days after the uneventful delivery of her third child (no general or neuraxial anesthesia was delivered). Seven days latter she presented to our emergency department complaining of recurrent episodes of right-sided headache coupled with a transient episode of sensory deficits in her left lower limb. Brain magnetic resonance imaging disclosed small infarctions in the internal watershed distribution of right internal carotid artery (ICA). Carotid artery dissection was diagnosed using DSA and T1 FAT-SAT sequences for the depiction of intramural hematoma. The patient was placed under oral anticoagulation and remained asymptomatic during a follow-up period of 6 months. The present case report highlights that cervicocephalic artery dissection is a condition that should be looked for in women with persisting or remitting unilateral headache following childbirth.
Subject(s)
Carotid Artery, Internal, Dissection/complications , Headache/etiology , Postpartum Period , Adult , Angiography, Digital Subtraction , Carotid Artery, Internal, Dissection/diagnostic imaging , Female , Headache/diagnostic imaging , Humans , Magnetic Resonance Imaging , RecurrenceABSTRACT
OBJECTIVE: Using intracoronary ultrasound we studied the anatomical characteristics and the pulsatile changes of the coronary arterial wall of ectatic coronary arteries in patients with atherosclerotic coronary artery disease who underwent percutaneous transluminal coronary angioplasty. METHODS AND RESULTS: Three study groups were formed according to the characteristics of the coronary segments, (a) group CES, coronary segments with ectasia, n = 10, (b) group NES, normal coronary segments adjacent to ectatic sites, n = 10 and (c) group NAS, normal coronary segments adjacent to atherosclerotic sites, n = 30. Pulsatile changes was defined as CSLA(syst)-CSLA(dia)/CSLA(dia) x 100. Coronary segments with ectasia (CES group) had significantly thinner media than the NAS group. Furthermore, increased vessel wall pulsatile changes were found in the ectatic segments. CONCLUSIONS: Atherosclerotic ectatic coronary segments reveal diminished media thickness and increased coronary arterial wall pulsatile changes, which may be indicative of a mechanically and structurally weak artery prone to aneurysm formation.
