Background:Headache patients frequently complain about difficulties in attention and concentration, even when they are headache free, and psychometric studies concerning attentional deficits in migraine patients between attacks are scarce.Objective:To evaluate selective attention of migraine patients interictally and compare them with healthy volunteers.Patients and Methods:We performed, between February 2011 and July 2011, a case-control study including 45 university students suffering from migraine matched with 45 healthy students as controls. Migraine patients were evaluated in an interictal state. Subjects with another headache type, history of brain injury, epilepsy and visual disturbances were excluded. Mood disorders were assessed using the Hospital Anxiety and Depression (HAD) questionnaire. Selective attention was evaluated using the Delis–Kaplan Executive Functions System (D-KEFS) colour-word interference test.Results:Mean age of patients was 23.29±2.55 years, versus 22.89±2.04 years for controls (p=0.2). The selective attention score was −4.04±7.08 for patients, versus −1.31±7.73 for controls (p=0.02). The mean mental flexibility score was lower in migraine patients compared with controls (36.67±6.79 versus 41.33±6.23; p=0.01). Gender, anxiety, depression scores and migraine characteristics had no correlation with the selective attention score.Conclusion:Selective attention and mental flexibility capacities are significantly reduced in migraine patients during the interictal period. These abnormalities probably contribute to frequent attentional complaints among these patients.
Background: Lipoprotein(a) levels are associated with coronary artery disease (CAD) and aortic valve calcification. This study aimed to determine the correlation between Lp(a) levels and coronary artery calcium (CAC) scores in patients who underwent coronary computed tomography angiography (CCTA).Methods: This was a single-center observational study. The patients had not been previously diagnosed with CAD and underwent CCTA and Lp(a) measurement within a three-month interval. Coronary angiography and further management were performed according to the physicians decision. Among 252 patients, 81 and 171 patients underwent coronary revascularization and received medical treatment, respectively. To examine the relationship between Lp(a) and CAC score and between Lp(a) and CAD, we divided the patients by Lp(a) level (50 mg/dL) and CAC score (400). Results:No relationship was observed between Lp(a) and CAD and other risk factors for that. There were no differences in the ratio of patients who underwent coronary revascularization and the CAC score according to an Lp(a) level of 50 ml/dL. There was no difference in Lp(a) level at a CAC level of 400. The proportion of patients who underwent coronary intervention was high in the high CAC score group (50.6% vs. 23.7%, p = 0.000). No association was observed between Lp(a) and CAC in the Pearson correlation (0.000, p < 0.998). Conclusion:Correlations between Lp(a) and CAC and between Lp(a) and CAD were not observed in Korean patients. However, a high CAC score was correlated with coronary revascularization.
Background: Biermer disease is a megaloblastic disease caused by vitamin B12 deficiency. It is a rare clinical entity especially in subsahara Africa. Case presentation: We report the case of a 45 years old female patient who consulted for a one month history of generalised muscle cramps, weakness and numbness of all four limbs. Physical examination was relevant for a poor gait, poor coordination of both upper and lower limbs, a positive Romberg sign, normal muscle tone in all four limbs, reduced pallesthesia and deep tendon reflexes, abolished plantar reflexes. Paraclinical investigations revealed macrocytosis without anemia, a low cyanocobalamin (vitamin B 12 ) level with a normal folic acid level, an atrophic corporeofundic mucosa which upon pathological analysis revealed a chronic atrophic gastritis with no Helicobacter pylori infection. Anti-intrinsic factor antibodies were positive while anti parietal cells antibodies were negative. The diagnosis of Biermer disease was considered and the patient did well on vitamin B 12 supplementation. Conclusion: Though a rare disease, Biermer disease should be considered in a patient who consults for polyneuropathy even in the absence of anemia.
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