The results of inspiratory muscle training on cardiac, respiratory, musculoskeletal, and psychological status in patients with stable angina: a randomized controlled trial.

PURPOSE: To determine the effect of inspiratory muscle training (IMT) on respiratory and peripheral muscle strength, functional exercise capacity, health-related quality of life (HRQoL), fatigue, depression, and cardiac functions in patients with stable angina. METHODS: A randomized, controlled, single-blinded study. Twenty patients (59.95 ± 7.35 y, LVEF = 58.77 ± 7.49) with stable angina received IMT at the lowest load (10 cmH2O), and 20 patients (55.85 ± 7.60 y, LVEF = 62.26 ± 7.75) received training at 30% of maximal inspiratory pressure (MIP) seven days/8 weeks. Respiratory muscle strength (MIP; maximal expiratory pressure, MEP), peripheral muscle strength, pulmonary functions, functional exercise capacity (6-min walking test; exercise test), fatigue, HRQoL, depression, and cardiac functions were evaluated before and after. RESULTS: A statistical difference was found between groups in terms of respiratory and peripheral muscle strength, pulmonary functions, functional exercise capacity (p < 0.05). The results of fatigue, depression, HRQoL, and cardiac functions were similar between the groups (p > 0.05). CONCLUSIONS: This study is the first to demonstrate the positive effects of IMT in patients with stable angina. IMT is a safe and effective method and is recommended to be added to cardiopulmonary rehabilitation programs and guidelines, as it results in increased peripheral muscle strength and functional exercise capacity in stable angina patients.Implications for rehabilitationInspiratory muscle training (IMT) is a safe and effective method for coronary artery disease (CAD) patients with stable angina.IMT improved respiratory and peripheral muscle strength, functional exercise capacity, pulmonary functions, and health-related quality of life in CAD patients with stable angina.Perception of depression and fatigue were decreased with IMT in CAD patients with stable angina.

[Decreased Heart Rate Variability in Sickle Cell Anemia as Effect of Pulmonary Arterial Hypertension].

Decreased heart rate variability (HRV) is associated with increased mortality risk in various diseases. The objective of this investigation:to study HRV in patients with sickle cell anemia (SCA) and to assess the effect of pulmonary arterial hypertension (PAH) on HRV in these patients. Materials and methods. HRV registration and Doppler echocardiographic assessment of systolic pulmonary arterial pressure (PAP) was carried out in 61 stable patients with SCA and 24 healthy subjects. Results. Low frequency power (LFP) and high frequency power (HFP) were decreased in SCA patients compared to healthy subjects. Among SCA patients, PAH patients had lower  LFP and HFP than patients without PAH. In SCA patients, systolic PAP showed significant negative correlation with LFP and HFP. Conclusion. HRV is significantly decreased in SCA patients, especially in those with PAH. HRV may be particularly useful in early detection of PAH patients who may have worse prognosis and higher mortality risk.

Primary tubercular chorioretinitis.

The aim of this report is to emphasize that corticosteroids should not be prescribed when the etiological factors remain unidentified. A 34-year-old male visited our ophthalmology clinic suffering from blurred vision. Behçet's disease had been diagnosed 5 years prior, and the patient was taking an oral immunosuppressant and a systemic corticosteroid. Vitreous cell count and foci of chorioretinitis (apparently confined to the ocular fundus) were evident. A vitreous sample was subjected to polymerase chain reaction, which resulted in the identification of and Mycobacterium tuberculosis. Treatment with a combination of four anti-tuberculosis drugs was commenced. During the follow-up, the vitritis disappeared, and the foci of active chorioretinitis improved. Systemic and Sub-Tenon corticosteroid treatment should not be prescribed until vitreous and anterior chamber fluid samples have been evaluated in patients with uveitis. Some microbes are not detected on routine examination.

Optimal wrist position for long and short axis ultrasound guided radial artery cannulation.

BACKGROUND: The radial artery is the most common site for arterial cannulation. Procedures for improving radial artery cannulation have involved direct visualization of the vessel with ultrasonography (US). The aim of this study evaluate the short axis and long axis radial artery measurements at 0º, 45º, 60º wrist joint angle and find out the optimal wrist joint angle for long and short axis US guided radial artery cannulation. MATERIALS AND METHODS: This study was approved by the Institutional Ethical Committee and the study was performed in accordance with the ethical principles for human investigations, as outlined by the Second Declaration of Helsinki. One hundred fifty-two (90 men and 62 women, 18-48 years of age, mean age: 32.9 ± 6.1) healthy volunteers were recruited. The radial artery distance between skin and height, width, area in short axis and radial artery distance between skin and height was measured in long axis at 0º, 45º, 60º wrist joint angle were measured. Results. Short axis radial artery distance between skin, width, height, area and long axis radial artery distance between skin, height were statistically significantly different among 0º, 45º, 60º (p< 0.05; for all comparisons). Short axis width was statistically significantly increased at 45º compared to at 0º (p< 0.001;). Short axis radial artery distance between skin and height at 45º were statistically significantly decreased than at 0º (p< 0.001; for all comparisons) and long axis skin distance and height at 45º were also statistically significantly decreased than at 0º (p< 0.001; for both comparisons). Short axis radial artery skin distance and area at 60º is statistically significantly decreased than at 45º (p< 0.001; for both comparisons) and also long axis height of radial artery at 60º is statistically significantly decreased than at 45º (p< 0.001;). CONCLUSIONS: Angle increment up to 45º might help clinicians for radial artery cannulation in short axis plane whereas this angle increment maneuver decreased the arterial height in long axis which might be a potential disadvantage for cannulation.

Evaluation of ceruloplasmin levels in patients with pulmonary cystic echinococcus.

AIM: In this study, we aimed to evaluate serum CP levels in the serum samples before and after the surgical interventions in patients with pulmonary cystic echinococcus (CE). MATERIALS AND METHODS: Forty-eight patients with pulmonary CE who underwent surgery and 48 healthy individuals were enrolled to the study. Patients were divided in two groups; group 1 (n=48) consisted of patients with pulmonary CE, and group 2 (n=48) consisted of healthy subjects. Before and after surgical interventions serum CP levels were measured. RESULTS: Compared to group 2, group 1 had significantly higher CP levels at baseline (p <0.001). In group 1, CP levels were significantly decreased after the surgical intervention (p <0.001). CONCLUSIONS: The present study showed that CP levels increased in patients with pulmonary CE; chronic inflammation may cause these rises, and may be an immune response of the host, and these levels decreased after the surgical intervention.

Kidney transplantation in immunologically high-risk patients.

An increased number of sensitized patients await kidney transplantation (KTx). Sensitization has a major impact on patient mortality and morbidity due to prolonged waiting time and may preclude live donor transplantation. However, recent reports have shown that KTx can be performed successfully using novel immunosuppressive protocols. This study presents our experience with patients displaying donor-specific antibody (DSA) (+). We enrolled 5 lymphocyte cross-match (LCM) negative (complement-dependent cytotoxicity) and panel-reactive antibody (PRA) plus DSA-positive patients mean fluorescein intensity [MFI] > 1000) who underwent living kidney donor procedures. All subjects were females and their mean age was 36.7 years. In our protocol, we started mycophenolate mofetil (2 g/d), tacrolimus (0.01 mg/kg) and prednisolone (0.5 mg/kg) on day -6. We performed 2 sessions of total plasma exchange (TPE) with albumin replacement and administered 2 doses of IVIG (5 g/d). On day -1, we added rituximab (200 mg). On the operation day and on day +4, the patients received doses of basiliximab. Serum samples were taken on days -6, 0, and 30 as well as at 1 year after transplantation. All patients displayed immediate graft function. Mean basal DSA titer was 5624 MFI. After desensitization, the MFI titers decreased at the time of transplantation to 2753 MFI, and were 2564 MFI at the 1st month and 802 MFI at 1st year. Three patients experienced acute rejection episodes (60%). After treatment for rejection, the average follow-up was 17 months and last creatinine levels were 0.6-0.8 mg/dL (minimum-maximum). In conclusion, KTx can be succesfully performed in sensitized patients displaying DSA. However, there seems to be a greater acute rejection risk. There is no consensus regarding adequate doses of IVIG or plasmapheresis treatments; furthermore, more studies are needed to clarify the safe MFI titer of the DSA.

Evaluation of pre- and post-surgical oxidative stress parameters in patients with pulmonary cystic echinococcus.

BACKGROUND: Hydatid cyst secretes numerous immunomodulatory molecules to the host, and the host reacts these molecules by activating immune response. It is also known that, immune cells generally produce more oxidative products. AIM: In this study, we aimed to evaluate the antioxidant enzyme using catalase (CAT) and oxidant enzyme using lipid hydroperoxide (LOOH) levels in the serum samples before and after the surgical interventions in patients with pulmonary cystic echinococcus (CE). PATIENTS AND METHODS: Forty patients with pulmonary CE who underwent surgery and 40 healthy individuals were enrolled to the study. Patients were divided in two groups; group 1 (n=40) consisted of patients with pulmonary CE, and group 2 (n=40) consisted of healthy subjects. Before and after surgical interventions serum CAT and LOOH levels were measured. RESULTS: Compared to group 2, group 1 had significantly lower CAT and higher LOOH levels before surgery (both p < 0.001). In group 1; CAT levels were significantly increased and LOOH levels significantly increased after the surgical intervention (both p < 0.001). CONCLUSIONS: The present study showed that oxidative stress increased in patients with pulmonary CE, may be consequence of immune response of the host, and these levels decreased after the surgical intervention.

Contractility evaluation by 2 dimensional echocardiography and gated SPECT myocardial perfusion scintigraphy in hypertensive patients with clinical presentation of atypical chest pain.

BACKGROUND: Hypertension (HT) is a growing health problem in the population and associated with increased cardiovascular event risk and mortality. In hypertensive patients, progressive left ventricular (LV) contractility deterioration is detectable by gated single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy9. We planned this study to explore the agreement in ejection fraction (EF) determination between 2 dimensional echocardiography and gated SPECT analysis in selected group of patients with hypertension. PATIENTS AND METHODS: We studied 26 consecutive patients (mean age 56.5 ± 8.8 years; 6 men) with hypertension. Quantitative contractility analysis by both echocardiography and SPECT at rest was performed to investigate the agreement between two diagnostic tests. RESULTS: EF at rest was greater than 55 % in all patients. All patients had a clinical presentation of atypical chest pain. Therefore, in addition to quantitative contractility analysis at rest by echocardiography and myocardial SPECT perfusion scintigraphy, we examined ischemia by stress induction and determined that 10 patients had ischemic finding (38.4 %). The mean value of EF calculated by echocardiography was 67.5 ± 5.7 %, while EF by gated SPECT was 72.8 ± 8.5 %. We documented an acceptable agreement in EF determination between these 2 diagnostic tests by meaningful correlation (r = 0.556, p = 0.003). There was no regional contractility deterioration despite existence of ischemia in 10 patients of the study group. CONCLUSIONS: We observed that both echocardiography and gated SPECT can be used for quantification of EF in the hypertensive patients with an acceptable agreement.

Assessment of the relationship between coronary artery ectasia and erectile function score.

The relation between coronary artery ectasia (CAE) and erectile dysfunction (ED) has not been studied so far. Hence, we decided to investigate the erectile function score in patients with CAE. We investigated the international index of erectile function (IIEF)-5 score in 34 men with CAE, 38 men with coronary artery disease (CAD), and 30 male controls with normal coronary arteries whose mean ages were 53.2 ± 5.6, 51.4 ± 7.8, and 49.6 ± 8.6 years, respectively. Erectile function was evaluated by the five-item version of the IIEF-5. Each question is scored from 0 to 5. CAE was defined as being without any stenotic lesions with a visual assessment of the coronary arteries showing a luminal dilatation 1.5-fold or more of the adjacent normal coronary segments. IIEF-5 scores in CAE group were found statistically significantly lower than the control group (P<0.001). There were no statistically significant differences in IIEF-5 scores between CAE and CAD groups (P=0.13). We have shown for the first time that patients with CAE have lower IIEF-5 scores compared with controls with normal coronary angiograms. Many studies reported that endothelial dysfunction in patients with CAE was more dominant than those with CAD. This study suggests that ED and CAE may be different manifestations of a common underlying vascular pathology and vasculogenic ED is frequently seen in CAE at least as much as in CAD.

Left ventricular wall function abnormalities in patients with ankylosing spondylitis evaluated by gated myocardial perfusion scintigraphy.

BACKGROUND: Ankylosing spondilitis (AS) is a chronic inflammatory disease with prominent inflammation in joints and extraarticular organs. AS patients have approximately two times more risk of mortality than the normal population. One reason for this increase in mortality is increased cardiovascular risk. In this study, we have aimed to evaluate myocardial perfusion and left ventricular function using (99m)Tc-MIBI gated myocardial perfusion single photon emission computed tomography (SPECT). MATERIAL AND METHODS: The study group consisted of 28 AS patients (19 men, 9 women), and mean age 39.46±10.98 years. All patients underwent (99m)Tc-MIBI gated myocardial perfusion SPECT with the same day protocol. RESULTS: We detected various risk factors including smoking habits in 12, family history of cardiovascular disease in 12, hypertension in 3, hyperlipidemia in 9 patients. We performed a myocardial perfusion SPECT for each patient and found normal perfusion pattern in SPECT images. Out of 28 patients, eight patients had normal perfusion but wall motion abnormalities. CONCLUSION: We detected that myocardial perfusion is preserved in the patients with AS. However, left ventricular wall motion abnormalities are seen. We concluded that ankylosing spondylitis may be associated with microvascular dysfunction and gated myocardial perfusion scintigraphy could be valuable in AS patients for the evaluation of LV function even if the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score are low and the disease duration shorter.

Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients.

Excessive sympathetic activity and stress-induced left ventricular (LV) hypercontractility have been described in hypertensive LV hypertrophy. Recent quantitative data have shown that hypertensive LV hypertrophy is associated with preserved global LV function. However, progression of uncontrolled hypertension have detrimental effects on both the ejection fraction (EF) and LV contractile response to stress. Hypertensive LV hypertrophy has some common characteristics, including preserved global LV systolic function and LV volume with heart failure with preserved EF (HFPEF), which makes it difficult to differentiate between the two conditions at rest. Studies suggest that adopting an efficient antihypertensive therapy regimen may positively effect on the LV contractile capability in patients with long-standing hypertension. Evaluation of quantitative LV contractility under stress may be beneficial to differentiate between the hypertensive LV hypertrophy and HFPEF. It may also assist in developing a more effective modality in medical management of patients with hypertensive heart disease.

Myocardial perfusion is preserved in patients with psoriasis without clinically evident cardiovascular disease.

BACKGROUND: Psoriasis is associated with a premature atherosclerosis due to the chronic inflammatory process. To evaluate the effect of disease process on myocardial perfusion, we planned to perform 99mTc-MIBI myocardial perfusion single photon emission computed tomography (SPECT) in patients with psoriasis. METHODS: The study group consisted of 28 psoriasis patients (17 men, 11 women), aged 18-76 years, and mean age 41.2 +/- 14.1 years. The patients were selected among those who were older than 18 years and longer than 10 years of disease duration with more than two times of systemic treatment. All patients underwent 99mTc-MIBI myocardial perfusion SPECT with the same day protocol. RESULTS: We detected various risk factors including smoking habits in 7, family history of cardiovascular disease in 4, hypertension in 1, hyperlipidemia in 9 patients. We completed myocardial perfusion SPECT for each patient and found normal perfusion pattern in SPECT images. CONCLUSION: We detected that myocardial perfusion is preserved in the patients with psoriasis. The majority of acute heart attacks are caused by noncritical coronary stenosis and this may be an explanation for increased cardiovascular risk in these patients despite normal coronary perfusion.

Is androgenetic alopecia a risk for atherosclerosis?

BACKGROUND: Several studies have demonstrated the presence of an association between androgenetic alopecia (AGA) and cardiovascular disease. The aim of this study was to evaluate subclinical atherosclerosis in patients with AGA and healthy controls by the incorporation of carotid intima-media thickness (IMT) and high-sensitive C-reactive protein (hs-CRP) along with echocardiography (ECHO) and exercise electrocardiography (ExECG). METHODS: We performed a case-control study in 50 male patients with AGA and 31 age-matched healthy male controls with normal hair status. Both the AGA patients and controls with a history of diabetes mellitus, cigarette smoking, hypertension, cardiovascular or cerebrovascular disease, and renal failure were excluded. AGA was classified according to the Hamilton-Norwood scale. Serum lipids, serum hs-CRP, total testosterone, and dehydroepiandrosterone sulphate were examined in all study subjects. Carotid ultrasonography was used to measure the IMT of the common carotid arteries (CCA). ECHO and ExECG were performed in all subjects. RESULTS: IMT of the CCA was found to be significantly higher in patients with severe vertex pattern AGA when compared to patients with other patterns of AGA and healthy controls (P < 0.05). Hs-CRP in patients with any group of AGA was not significantly different from those healthy controls (P > 0.05). ECHO showed that cardiac structural and functional measures were in normal ranges. ExECG was also normal in all subjects. CONCLUSION: Severe vertex pattern AGA should be considered to have an increased risk of subclinical atherosclerosis. For this reason, CCA IMT measurement can be recommended as a non-invasive and early diagnostic method.

Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis.

BACKGROUND: Psoriasis is associated with an increased risk of atherosclerosis. This study compared subclinical atherosclerosis of the carotid and brachial arteries in psoriasis vulgaris patients and healthy controls using high-resolution ultrasonography. METHODS: We studied 43 psoriasis patients and 43 healthy controls matched for age and sex. Flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NTD) of the brachial artery and intima-media thickness (IMT) of the common carotid arteries (CCA) were measured ultrasonographically. Diabetes mellitus, hypertension, renal failure, a history of cardiovascular or cerebrovascular disease were exclusion criteria. Subjects who were receiving lipid-lowering therapy, antihypertensive or anti-aggregant drugs, nitrates or long-term systemic steroids were also excluded. RESULTS: The mean IMT values of the right, left and averaged CCA of the psoriasis patients were significantly higher, compared with the controls (0.607+/-0.144 mm vs. 0.532+/-0.101 mm, 0.611+/-0.157 mm vs. 0.521+/-0.117 mm, and 0.609+/-0.146 mm vs. 0.526+/-0.104 mm; P=0.006, P=0.003 and P=0.003, respectively). The mean FMD and NTD values of the psoriasis patients were significantly lower, compared with the controls (13.36+/-6.39 mm vs. 19.60+/-11.23 mm and 21.08+/-8.38 mm vs. 26.85+/-12.38 mm; P=0.002 and P=0.013, respectively). Multiple linear regression analysis revealed a significant association between psoriasis and the IMT, FMD and NTD. Moreover, the FMD in psoriasis patients was associated with disease duration. CONCLUSION: Psoriasis patients had impaired endothelial function and thicker IMT of the CCA, compared with the healthy control subjects. The presence of psoriasis was an independent risk factor for subclinical atherosclerosis.

Association of left ventricular diastolic function abnormalities with aortic elastic properties in asymptomatic patients with type 2 diabetes mellitus. A tissue doppler echocardiographic study.

BACKGROUND: The aim of this study was to investigate the association between the aortic elastic properties and the left ventricular diastolic function measured by tissue Doppler echocardiography (TDE) in asymptomatic type 2 diabetes mellitus. METHODS: Fifty-seven asymptomatic patients with type 2 diabetes (33 women, mean age: 49 +/- 6 years) and 25 healthy control subjects (19 women, mean age: 46 +/- 7 years) were included in the present study. Diastolic filling indices were measured by conventional (CE) and tissue Doppler echocardiography. The aortic elastic properties [Aortic stiffness index (ASI), aortic distensibility and strain] were measured as previous definition. RESULTS: Compared with control subjects, the ratio of LV diastolic abnormalities measured by CE and TDE were found higher in patients with type 2 diabetes (36% and 73.6%, p = 0.001, respectively, and 52% and 89.4%, p < 0.001, for septal annulus; 48% and 89.4%, p < 0.001 for septal basal respectively). The ASI was significantly higher (p < 0.001), aortic distensibility and aortic strain were also significantly lower in patients with type 2 diabetes than control subjects (p < 0.001 and p < 0.001 respectively). In the regression analysis, Ao distensibility was correlated to age (beta = -0.299, p = 0.004), septal basal Em/Am ratio (beta =0.543, p < 0.001) and HDL-cholesterol (beta = 0.192, p = 0.039). ASI was also correlated only to age (beta = 0.255, p = 0.044), the presence of diabetes mellitus (beta = 0.304, p = 0.009), mitral A wave (beta = 0.322, p = 0.013) and mitral annulus Em wave (beta = -0.505, p < 0.001). CONCLUSION: The aortic elastic function is impaired in asymptomatic patients with type 2 diabetes. Increased ASI and decreased Ao distensibility are closely associated with diastolic filling indices measured by CE and TDE.

Effect of dobutamine stress on basal septal tissue dynamics in hypertensive patients with basal septal hypertrophy.

Left ventricular outflow tract (LVOT) obstruction has been classically observed in hypertrophic cardiomyopathy in which the LVOT obstruction is associated with asymmetric septal hypertrophy producing a systolic pressure gradient across the LVOT. Basal septal hypertrophy (BSH) with hypertension may result in dynamic LVOT obstruction as well. It was suggested that regional hypertrophy may be related to enhanced ventricular dynamics.

QTc dispersion and P-wave dispersion during migraine attacks.

The aim of this study was to investigate increase of QTc dispersion and P-wave dispersion during migraine attacks. Fifty-five patients (16-65 years of age, 49 women, six men) with migraine were included in our study. Heart rate, QTc interval, maximum and minimum QTc interval, QTc dispersion, maximum and minimum P-wave duration and P-wave dispersion were measured from 12-lead ECG recording during migraine attacks and pain-free periods. ECGs were transferred to a personal computer via a scanner and then used for magnification of x400 by Adobe Photoshop software. Maximum QTc interval (454 +/- 24 ms vs. 429 +/- 23 ms, P < 0.001), QTc interval (443 +/- 26 ms vs. 408 +/- 22 ms, P < 0.001) and QTc dispersion (63 +/- 18 ms vs. 43 +/- 14 ms, P < 0.001) were found significantly higher during migraine attacks compared with pain-free periods. Maximum P-wave duration (107 +/- 11 ms vs. 100 +/- 11 ms, P < 0.001) and P-wave dispersion (45 +/- 13 ms vs. 35 +/- 13 ms, P < 0.001) were found higher during migraine attacks than pain-free periods. We concluded that migraine attacks are associated with increased QTc and P-wave dispersion compared with pain-free periods.

Effect of obesity on P-wave dispersion and QT dispersion in women.

OBJECTIVE: The aim of this study was to investigate the effect of obesity on dispersion of P-wave duration and QTc interval in obese women. METHODS: Forty-two obese women (Body mass index (BMI)=40+/-3 kg/m(2), mean age 45+/-9 years) and compared age-matched (BMI=22+/-1 kg/m(2), mean age 41+/-6 years) twenty-five non-obese women were included in our study. Maximum and minimum P-wave duration, P-wave dispersion (difference between the maximum and the minimum P-wave duration), maximum and minimum QTc interval, and QTc dispersion (the difference between the maximum and the minimum QTc interval) were measured from 12-lead ECG. ECG's were transferred to a personal computer via a scanner and then used for magnification of 400 times by Adobe Photoshop software. RESULTS: There was significant difference in BMI (40+/-3 vs 22+/-1 kg/m(2), P<0.001, respectively) between obese and non-obese women. Obese women had higher Max. P-wave duration (116+/-11 vs 94+/-14 ms, P<0.001), P-wave dispersion (51+/-15 vs 26+/-11 ms, P<0.001), Max. QTc interval (449+/-38 vs 419+/-30 ms, P<0.001) and QTc dispersion (57+/-23 vs 38+/-15 ms, P<0.001) compared to non-obese women. A significant correlation was found between BMI and Max. P-wave duration (r=0.584, P<0.001), P-wave dispersion (r=0.621, P<0.001), Max. QTc interval (r=0.410, P<0.001), and QTc dispersion (r=0.429, P<0.001). In the linear regression analysis, compared to co-morbidity factors such as age, hypertension, diabetes mellitus and smoking, there was significant association between only BMI and electrocardiographic values (P-wave and QTc dispersion). CONCLUSION: We concluded that obesity caused significant increase in P-wave and QTc dispersion. Therefore, obese women may not only be under the risk of ventricular arrhythmias, but also they may under the risk of atrial arrhythmias.

The relationship between migraine and atopic disorders-the contribution of pulmonary function tests and immunological screening.

This cross-sectional clinical study was conducted in order to explore the relationship between atopic disorders and migraine. We evaluated 186 consecutive patients with migraine. Patients with a history of atopic disorders were compared with the others during headache-free intervals, for their headache characteristics, pulmonary test (PFT) performances and immunological screenings, through appropriate statistical methods. Of the patients with migraine, 77 (41.4%) reported at least one atopic disorder. PFT screening showed a general decreased pulmonary capacity and an important correlation between a positive history of atopic disorders and both increased eosinophil and IgE levels in headache-free periods. It should be discussed whether screening with PFT or immunological tests helps in early detection of progressive lung disease which might develop in these patients.