RESUMO
BACKGROUND: Evidence is accumulating that venous thromboembolism is not limited to coagulation system and immune system seems to be involved in formation and resolution of thrombus. Some studies have demonstrated the role of inflammatory factors in deep venous thrombosis (DVT) of limbs; however, there has not been such study in the patients with cerebral venous sinus thrombosis (CVST). The purpose of this study was to evaluate inflammatory cytokines including interleukin-6 (IL-6), IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α) in the patients with the history of CVST. METHODS: In a cross-sectional study, 20 patients with the first episode of CVST and 20 age- and sex-matched healthy controls were included. The patients were seen only after anticoagulant treatment had been discontinued for at least 3 months. IL-6, IL-8, IL-10, TNF-α levels, and erythrocyte sedimentation rate (ESR) were measured in two groups. RESULTS: The median age of patients was 37.0 [interquartile range (IQR) = 31.75-42.75] and in control group was 42.0 (IQR = 38.0-40.6) (P = 0.18). In patients group, 14 (70%) were females and in control group, also, 14 (70%) subjects were female (P = 0.01). It is significant that the level of IL-6 was significantly higher in the control group [patients: median: 9.75, IQR: 8.98-10.65; controls: median: 11.45, IQR: 10.28-13.10; P = 0.01]; however, the ESR level was higher in the patients. On the subject of IL-8, IL-10, and TNF-α, no significant difference was detected. CONCLUSION: We did not find higher concentrations of inflammatory ILs in the patients with the history of CVST that is contradictory with some findings in venous thrombosis of the extremities; however, the studies with larger sample size may be required.
RESUMO
BACKGROUND: Migraine is a prevalent disease which is classified into two groups of migraine with aura and without aura. Eighteen percent of women and 6.5 percent of men in United States have migraine headache. Migraine headache is prevalent in all age groups but it usually subsides in adults above fifty. Migraine has many risk factors such as stress, light, tiredness, special foods and beverages. The aim of this study was the evaluation of the effects of body mass index (BMI) on the treatment of migraine headaches. METHODS: All patients assigned to four groups according to their BMI. Patients with more than three attacks per month received nortriptyline and propranolol for eight weeks. The frequency, duration and severity of pain were measured by visual analogue scale (VAS) and behavioral rating scale (BRS-6) in regular intervals. RESULTS: 203 patients completed the study. 153(75%) subjects were women and 50(25%) were men. Mean age of patients was 30.5 ± 7.1 years. Mean weight was 80.4 ± 14.1 kg and mean height was 1.67 ± 0.07 m. Pain frequency and duration showed statistically significant differences among four groups with better response in patients with lower BMI (P < 0.0001). VAS and BRS-6 scales showed statistically significant differences among four groups in favor of patients with lower BMI (P < 0.0001). CONCLUSION: This study showed that obesity has a direct influence on the treatment of migraine headaches. It could be recommended to patients to reduce their weight for better response to treatment. In addition, care should be taken about migraine drugs which make a tendency for increased appetite.
