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In this review, we discussed how homocysteinemia can induce migraine. Vascular and neurogenic mechanisms of migraine-onset, such as the classical 'triggers', were examined. Favourable effects induced on the syndrome by folate supplementation were also illustrated. However, it was recently shown that hyper-homocysteinemia can favor migraine by the production of homocysteic acid.This acts as an agonist of the N-acetyl-aspartame-D receptor, and is a potent neurotoxic stimulus causing migraine. Its detrimental effects seem to be antagonized by N-acetyl-cysteine, calcium chelators, a naturally-occurring dipeptide widely distribuited in the muscular and nervous systems. This compound showed positive results in animal models. Elevated homocysteic acid levels secondary to hyper-homocysteinemia could sensitize the dura mater and cerebral arteries and favor the activation of the trigeminovascular system, predisposing to migraine attacks. However, other experimental and human studies are requested to ratify the negative effect of homocysteic acid on migraine and the positive results obtaining with of its antagonists. [ABSTRACT FROM AUTHOR]

In 44 patients affected by systemic lupus erythematosus (SLE) without any clinical signs of heart disease (group I) the myocardial performance index (MPI) was calculated to investigate left ventricular function. The index, as the sum of isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) divided by ejection time (ET), was measured by tissue Doppler echocardiography (TDE). Results achieved show a prolonged MPI with respect to the values recorded in healthy controls (group II). Its prolongation is due to a significant increase of IRT, whereas ICT and ET were within the normal limits. In patients with SLE without an evident cardiac engagement, this outcome seems to depend on a prevalent diastolic left ventricular dysfunction, perhaps due to a subclinical myocarditis. TDE is more precise than the conventional Doppler method in evaluating MPI and single time intervals, because their measurements are accomplished in concomitance of left ventricular wall motion rather than the flow movement. (ECHOCARDIOGRAPHY, Volume 22, April 2005) [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about the relation between aging and diabetes.