Baseline characteristics influenced by sympathetic tone such as SαA, heart rate, and cardiac output are indicative of responses to CPT. Our data supports the use of baseline values to predict blood pressure response to acute cold exposure and indicates an intrinsic difference between CPT responder phenotypes.Youssef M, Ghassemi A, Carvajal Gonczi CM, Kugathasan TA, Kilgour RD, Darlington PJ. Low baseline sympathetic tone correlates to a greater blood pressure change in the cold pressor test. Aerosp Med Hum Perform. 2018; 89(6):503-509.
Key Clinical Message
Cocaine is the second most used illicit drug; cocaine induces platelet activation and formation of thrombus. Thrombotic effects of cocaine can lead to vascular injuries, cerebrovascular accident and myocardial infarct. Less common, cocaine use disorder leads to thrombi formation in both ventricles and renal artery infarct as seen in our patient.
Miller Fisher Syndrome (MFS), a variant of Guillain Barre Syndrome (GBS), and amyotrophic lateral sclerosis (ALS) are two rare neuromuscular diseases that are usually unrelated. While ganglioside antibodies have a common relation with MFS and GBS, they have also been found in association, albeit less commonly, with ALS. A patient experiencing MFS and then ALS in tandem has never been documented. We discuss a case demonstrating these findings, with GQ1b elevated on both occasions. The pathophysiologic role of GQ1b is explored.
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