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OBJECTIVES: Stroke risk is increased in migraine, the basis of which remains to be established. C-reactive protein (CRP) is a marker of cerebrovascular disease, suggesting in part an inflammatory mechanism. Because attacks of migraine may involve repeated sterile vascular inflammation, we measured CRP in migraine patients. METHODS: Retrospective review was conducted of 60 randomly sampled charts of patients with the diagnosis of migraine without aura (MwoA, n = 29) and migraine with aura (MwA, n = 31), in which CRP was recorded as part of the differential diagnostic evaluation. CRP was measured by standard commercial laboratory methods; high sensitivity CRP (hs-CRP) values above 3mg/L were considered abnormal. RESULTS: Elevated hs-CRP was found in 43% of all patients (26 of 60). In MwoA, of 29 subjects, abnormal hs-CRP was recorded in 16; in 10 no other conditions were found to explain the abnormality. In MwA, of 31 subjects, abnormal CRP was recorded in 10; in 5 no other condition could explain the abnormality. No associations were found between other demographic or clinical features. CONCLUSIONS: CRP may be abnormal in MwoA and MwA patients who present with atypical, severe, or complex clinical features that require extensive differential diagnostic investigation.  相似文献   

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Diagnosing ingested dental prostheses can be difficult and delays in treatment may result in serious complications. Patients often present with a vague history and very few reliable clinical signs. In addition, the fact that dental plates are often radiolucent may lead to the diagnosis being overlooked with disastrous consequences. A case of successful diagnosis and treatment is presented, and the importance of a high index of clinical suspicion to avoid the morbidity and mortality associated with missed impacted dentures is discussed.  相似文献   

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The use of ultrasonography for the investigation of pneumomediastinum is limited by the presence of air artifacts. Air accumulation in the mediastinum obscures the heart, sometimes leading to misinterpretation as lung tissue. We found that cardiac apical swinging during the heart cycle, however, can create a uniquely characteristic squeezing of mediastinal free air, producing a sonographic B-line that flashes in and out. We named this dynamic finding, the “disco spotlight” sign. This finding may be useful to confirm the diagnosis of pneumomediastinum.  相似文献   

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Sexually abused girls are at risk for premature motherhood. The adolescents who become mothers often do not breastfeed. This review examines the literature and discusses the mental health consequences of childhood sexual abuse that may influence the feeding decisions of adolescent mothers. Adolescents may be reluctant to breastfeed because it may trigger anxiety and lead to discomfort with intimacy, and emotional distancing from their infants. Nurses need to be sensitive to potential sexual abuse histories among adolescent mothers. They should provide balanced and unbiased information to their adolescent patients about feeding methods and encourage adolescents to select the methods best for them.  相似文献   

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Liu Z  Chi B  Takahashi K  Mishiro S 《Intervirology》2003,46(4):252-256
We sequenced the RNA genome of hepatitis E virus (HEV) recovered from an acute hepatitis patient living in Changchun, China. The HEV-CCC220 isolate thus obtained was 7,193 nt in length and contained ORF1 (5121 nt, 1706 aa), ORF2 (2025 nt, 674 aa), and ORF3 (345 nt, 114 aa) plus uncompleted 5' and 3' untranslated regions. When compared with full-genome isolates so far reported, the CCC220 isolate segregated to genotype IV although the nucleotide similarity to the previous genotype IV isolates was only 83.9-85.6%. Comparison of a partial sequence (300 nt) within the ORF2 between the genotype IV isolates from China, Taiwan and Japan also indicated the phylogenetic uniqueness of the CCC220 isolate: even the highest homology was less than 90%. These findings suggest that the CCC220 isolate might represent HEV strains that are indigenous to Changchun, China.  相似文献   

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