[Magnetic resonance spectroscopy (HMRS) in migraine]. / Badanie spektroskopii rezonansu magnetycznego (HMRS) w migrenie.

INTRODUCTION: There are 4 million people suffering from migraine in Poland, which account; for 10% of national population. Pathomechanism of migraine is not fully understood. In the recent years multiple studies in migraine patients revealed occurrence of metabolic disorders in nervous system tissue. MATERIAL AND METHODS: In 30 subjects with migraine diagnosis magnetic resonance spectroscopy examination was performed. Relative concentration ratio (WSS) of metabolites level to creatinine (Cr) level was measured. The obtained values were compared to findings in control groups. RESULTS: Linear correlation between increase in both WSS Lac/Cr value in left temporal lobe and WSS ml/Cr value in right frontal lobe and a number of migraine attacks per year in migraine patients was observed. It also turned out that WSS ml/Cr vox3 value depends on a total number of migraine attacks in life. A lactic acid level in left temporal lobe normalizes along with the elongation of interattack interval. There is a statistically significant difference of WSS ml/Cr value measured in left temporal lobe and right frontal lobe between migraine patients and control group. There is a statistically significant difference of WSS Cho/Cr value measured in left temporal lobe and right frontal lobe between migraine subjects and control groups.

The impact of postadmission glycemia on stroke outcome: Glucose normalisation is associated with better survival.

BACKGROUND: Hyperglycemia on admission increases the risk of death in patients with acute stroke. It remains unclear whether glucose normalisation after admission is associated with improved survival. The goal of the study was to determine the relationship between postadmission glucose levels and mortality in stroke patients with and without admission hyperglycemia. METHODS: 302 patients with first-ever ischemic stroke and without prior diagnosis of diabetes mellitus were enrolled. Random plasma glucose level was measured on admission and fasting glucose on day 1, 2, 3, 5 and 7. Hyperglycemia on admission was defined as glucose level > or = 7.8 mmol/L. Postadmission hyperglycemia was diagnosed if mean postadmission fasting glucose level was > or = 6.1 mmol/L. RESULTS: After multivariable adjustment, postadmission hyperglycemia was associated with higher risk of death regardless of admission glucose levels (HR: 1.80, 95%CI: 1.39-2.86, P<0.01). Postadmission hyperglycemia increases risk of death in both patients with admission hyperglycemia (HR: 4.83, 95%CI: 1.93-12.06, P<0.01) and those with admission normoglycemia (HR: 1.64, 95%CI: 1.06-2.54, P=0.03). In patients with admission hyperglycemia glucose normalisation after admission was associated with reduced risk of death compared to those with persistent hyperglycemia (HR: 0.21, 95%CI: 0.08-0.52). The patients who were normoglycemic on day 1 and developed hyperglycemia on next days had increased risk of death compared to persistent normoglycemic patients (HR: 1.55, 95%CI: 1.01-2.39, P=0.04). CONCLUSIONS: Postadmission, but not admission, hyperglycemia is associated with increased risk of death. Glucose normalisation after admission is associated with better survival.

[Side effects, unwanted drug interactions and the problem of cardiotoxicity]. / Dzialania niepozadane i niekorzystne interakcje leków a problem kardiotoksycznosci.

The problem of drug interactions is very important in pharmacotherapy. The interactions of some drugs (antihistamines, macrolides, fluoroquinolones, cisapride) with other can induce ventricular arrhythmias. A lot of non-antiarrhytmic drugs can prolong the QT interval, induce torsade de pointes and cardiotoxicity.