Clinical and experimental neurology
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Chronic rheumatic pain syndromes such as the fibrositis syndrome, 'whiplash' syndrome, low back pain syndrome and regional pain syndrome are common clinical disorders of unknown cause. The presence of tender points in predictable anatomical locations is essential to their diagnosis. Exaggerated dermatographia or flare response to mechanical stimulation is also a commonly observed physical finding. ⋯ Patients with chronic rheumatic pain syndromes had a lower threshold for capsaicin-induced flare responses compared with controls. They also had larger flares at capsaicin concentrations of 0.02 and 0.033 mg/mL (p less than 0.05) applied as 20 microL aliquots over 30 minutes. It is concluded that neurogenic flare responses are increased in patients with chronic rheumatic pain syndromes.
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A community-based register of cases of acute cerebrovascular disease in a representative segment of the city of Perth, Western Australia, has been developed. Stroke attack rates, pathological diagnoses and site of care of the cases, as revealed by the register, are analysed.
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One hundred and twenty-nine patients notified to the Perth Community Stroke Study in whom the final diagnosis was cerebrovascular disease were matched with controls of the same sex and 5-year age group drawn from the records of the usual general practitioner of each index case. The control subjects were interviewed and examined briefly at home, following the same protocol as that used for assessment of cases. ⋯ Being married (0.6) and history of migraine (0.4) were significant protective factors. There was no association between a history of hypertension and cerebrovascular disease in this series.