also reported that in patients with thyroid autoimmunity, normalization of hypercortisolism exacerbates selleck chem inhibitor autoimmune phenomenon and leads to thyroid diseases [13]. We found similar frequencies of PTD in patients with or without systemic corticosteroid therapy and we observed that corticosteroids did not effect thyroid autoimmunity and lower doses of corticosteroids did not increase occurrence of thyroid diseases [8, 12, 13]. Firooz et al. reported that the frequency of thyroid diseases had a threefold increase in the first-degree relatives of PV patients and suggested that genetic susceptibility is responsible for the occurrence of more than one autoimmune disease in an individual [4]. Bartalena et al. claimed that the high frequency of HLA DR3 and HLA D4 both in PV and Graves’ disease emphasizes the role of genetic predisposition in these two diseases [8].

As a conclusion, even though the exact causes remain unidentified, the results of our study showed that PV could accompany thyroid autoimmunity and primary thyroid diseases especially Hashimoto thyroiditis. We recommend laboratory testing for thyroid autoantibodies and thyroid function tests in patients with PV even if they do not have a clinical indication of thyroid disease.
A single-channel functional electrical stimulation (FES) system was first introduced fifty years ago by Liberson and colleagues to assist patients with hemiplegia demonstrating foot drop [1]. Since then, numerous studies have verified the benefits of peroneal stimulation for ameliorating foot drop and promoting motor recovery and locomotion [2�C6].

These studies have demonstrated that peroneal FES significantly decreases fall incidence [4], increases walking speed [2�C6], and improves gait rhythmicity and steadiness [4�C6]. The results also suggest that the use of FES may potentially increase community participation and physical functioning [6]. Long-lasting therapeutic effects of FES for foot drop, which are maintained even when FES is not being delivered, have been demonstrated in the literature as well [2, 6].However, many patients with hemiplegia and dorsiflexors inadequacy also demonstrate insufficient control of the knee flexors and extensors, which is essential for normal gait by providing shock absorption, assisting with foot clearance and balance control [7]. In fact, there is a moderate to strong significant relation between Carfilzomib the strength of the knee extensors and flexors of the paretic limb and gait performance [8]. Consequently, FES to the thigh muscles may further enhance gait in patients with hemiparesis. Furthermore, as FES can be set individuality for each patient, it may address the variability in knee control deficits in patients with hemiparesis [9, 10].