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Biomedical subjects

A Rigamonti

Publications and source records attributed to A Rigamonti.

At least 19 recordsLinked to original sources

Treatment of migraine with aura: comments and perspectives.

Migraine with aura (MwA) is a primary headache that affects about 30% of migraine sufferers. The main questions for the physician caring for the patient who has MwA are: when to use preventive medications, what medications to use in acute and preventive treatment, and whether the aura should be treated. The aim of this paper is to review the various therapeutic options for MwA proposed in the current literature and to evaluate their efficacy.

Adolescent↗

Quality of life and disability in primary chronic daily headaches.

We assessed functional disability and health-related quality of life (HRQOL) in Italian patients suffering from chronic migraine and medication overuse (150 subjects) or chronic cluster headache (22 subjects). We used the validated Italian versions of the Migraine Disability Assessment Score (MIDAS) and of the Short Form 36 (SF-36). Patients with both conditions were characterised by significantly lower scores on most SF-36 scales than Italian normative data (Student's t test with Bonferroni correction). MIDAS scores revealed that patients had severe limitations in their ability to function, with high proportions forced to stop work and non-work activities, or experiencing significantly reduced productivity in all activity domains. These findings show that primary chronic headaches have a marked negative influence on patients' lives, compromising their sense of well being and their ability to function in different roles. We also found that MIDAS and SF-36 were sensitive to clinical changes in a group of 84 patients with chronic migraine and medication overuse who completed the both questionnaires before and after treatment.

Activities of Daily Living↗

Treatment of chronic daily headache with medication overuse.

Clinicians long have suspected that symptomatic medications taken by those with headache can cause rebound or drug-induced headaches if overused. This problem has been considered in the classification of headache disorders made by the International Headache Society. Patients who overuse medication must be withdrawn before their headache can be treated effectively. Sustained improvement following treatment for drug-induced headache can be difficult to achieve and at the moment there is no consensus on what approach may be more effective, in particular regarding outpatient or inpatient treatment withdrawal strategy. Clinical aspects and different therapeutic strategies for chronic daily headache patients with medication overuse are considered.

Analgesics↗

Spin-freezing mechanism in underdoped superconducting cuprates.

The spin-freezing process in underdoped cuprate superconductors, observed most by NMR-NQR relaxation and muon spin rotation and sometimes interpreted as coexistence of antiferromagnetic and superconducting states, is generally thought to result from randomly distributed magnetic moments related to charge inhomogeneities (possibly stripes) which exhibit slowing down of their fluctuations on cooling below T(c). Instead, we describe the experimental findings as due to fluctuating magnetic fields caused by sliding motions of orbital currents coexisting with d-wave superconducting state. A direct explanation of the experimental results, in underdoped Y2-xCaxBa2Cu3O6.1 and La2-xSrxCuO4, is thus given in terms of freezing of orbital current fluctuations, and mean squared amplitudes of the related internal magnetic fields are estimated.

Journal Article↗

Is the CACNA1A gene involved in familial migraine with aura?

The discovery of mutations in the neural calcium channel (CACNA1A) gene in familial hemiplegic migraine (FHM), variant of migraine with aura, led to the suggestion that this gene might be involved in familial migraine with aura (FMA). We investigated whether the mutations in FHM are present in FMA patients, analyzing genomic DNA by PCR, single stranded conformation polymorphism, sequencing and restriction enzyme. No mutations were found. A known polymorphism (5682-14C>T) was found in exon 36. These findings suggest that the mutations found in FHM and the other known mutations of the CACNA1A gene are not the genetic basis of FMA. Genetic alterations in FMA patients may be localized on chromosome 19 but not in the CACNA1A exons we investigated.

Adult↗

Cerebral vein thrombosis and mild hyperhomocysteinemia: three new cases.

Mild hyperhomocysteinemia is an established risk factor for deep vein thrombosis. We report three patients with cerebral vein thrombosis (CVT) in which the only risk factor we were able to identify was increased blood homocysteine levels and the C677T polymorphism in both alleles of the methylene tetrahydrofolate reductase MTHFR gene. We suggest that hyperhomocysteinemia should also be a risk factor for CVT. Since this condition can be effectively and safely corrected by drugs, we suggest that homocysteine levels should be routinely determined in patients with idiopatic CVT, and even mildly increased levels corrected pharmacologically, in the hope of reducing the risks associated with this condition.

Adult↗

Cluster headache sine headache: two new cases in one family.

We report two cases of cluster headache sine headache occurring in a family of cluster headache sufferers. A 54-year-old female, suffered for 15 years from short-lasting, right-sided attacks of eye reddening, lacrimation, rhinorrea, palpebral oedema and miosis, seven to eight times per day, in periods of 20-30 days. She did not experience headache, either with or without these phenomena. Her son suffers from periorbital, short-lasting, right-sided painful attacks accompanied by eye reddening, lacrimation, rhinorrea and nasal stiffnesss, occurring in periods of 30-35 days. Soon after the end of the current cluster period he still had daily attacks lasting 10-15 min, with the oculo-nasal autonomic phenomena only. The occurrence of cluster headache sine headache and cluster headache in the same family strongly suggests that the first condition is related to the cluster headache syndrome. Cluster headache sine headache should be considered as a subtype of the cluster headache syndrome.

Adult↗

Health-related quality of life in patients with cluster headache during active periods.

Cluster headache is characterized by excruciatingly painful headaches which occur one or several times during the day. Little is known about the functional consequences of this severe headache form. We assessed health-related quality of life in 56 consecutive patients, 34 of whom were episodic cluster headache patients during an active period, and 22 had chronic cluster headache. All patients completed the Short Form-36 (SF-36). We found lower scores in the studied patients than in those reported in the general population for all SF-36 domains. For most scales the difference was significant (P < 0.0001, Student's t-test, Bonferroni correction). Our findings suggest that cluster headache has marked functional consequences even when appropriate treatments are used.

Activities of Daily Living↗

Increased familial risk of cluster headache.

The authors studied the occurrence of cluster headache in the families of 220 Italian patients with cluster headache. A positive family history was found in 20% (44/220) of the families. Compared with the general population, first-degree relatives had a 39-fold significantly increased risk of cluster headache. Second-degree relatives had an eightfold significantly increased risk. The increased familial risk strongly supports the hypothesis that cluster headache has a genetic component in some families.

Adult↗

Spin dynamics and magnetic correlation length in two-dimensional quantum heisenberg antiferromagnets

The correlated spin dynamics and temperature dependence of the correlation length xi(T) in two-dimensional quantum (S = 1/2) Heisenberg antiferromagnets (2DQHAF) on a square lattice are discussed in light of experimental results of proton spin lattice relaxation in copper formiate tetradeuterate. In this compound the exchange constant is much smaller than the one in recently studied 2DQHAF, such as La2CuO4 and Sr2CuO2Cl2. Thus the spin dynamics can be probed in detail over a wider temperature range. The NMR relaxation rates turn out to be in excellent agreement with a theoretical mode-coupling calculation. The deduced temperature behavior of xi(T) is in agreement with high-temperature expansions, quantum Monte Carlo simulations, and the pure quantum self-consistent harmonic approximation. Contrary to the predictions of the theories based on the nonlinear sigma model, no evidence of crossover between different quantum regimes is observed.

Journal Article↗

Cervical plexus anesthesia for carotid endarterectomy: comparison of ropivacaine and mepivacaine.

PURPOSE: To evaluate the effectiveness of cervical plexus block performed with ropivacaine 0.75% or 1%, or mepivacaine 2%. METHODS: In a prospective, randomized, double-blind study, 60 patients received deep cervical plexus block with 0.2 ml x kg(-1) divided among C2-C4 injections using ropivacaine 0.75% and 1% or mepivacaine 2%. A blinded observer recorded loss of pin-prick sensation every minute in the C2-C4 dermatomes until readiness for surgery. Then, a superficial cervical block was performed with 0.15 ml x kg(-1) lidocaine 1%. The need for intraoperative supplemental analgesia and degree of pain and time of first postoperative pain medication were also recorded. RESULTS: General anesthesia was not required to complete surgery in any case. No differences in the need for intraoperative supplemental analgesia was observed (7, 6, and 9 patients with ropivacaine 0.75% and 1% or mepivacaine 2%, respectively). Readiness to surgery required 15 (10-25) min with ropivacaine 0.75%, 18 (8-20) min with ropivacaine 1%, and 15 (5-20) min with mepivacaine 2% (P = NS); while patients asked for first postoperative pain medication after 10 (4-13) hr and 9 (6.5 - 11) hr with ropivacaine 0.75% and 1% compared with 5 (0-8) hr with mepivacaine 2% (P<0.05). CONCLUSION: Ropivacaine 0.75% or 1% are appropriate choices when performing cervical plexus anesthesia for carotid endarterectomy, providing nerve block characteristics similar to those of mepivacaine 2%, but with the advantage of longer postoperative pain relief.

Aged↗

Two new SUNCT cases responsive to lamotrigine.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare and debilitating headache form generally unresponsive to treatment. Following a recent report of a SUNCT patient who responded to lamotrigine, we tried this drug in two new SUNCT patients, reported here. In both cases prophylaxis was successful, suggesting lamotrigine might be the first effective treatment for this rare and debilitating headache syndrome.

Aged↗

Sixteen weeks of hexarelin therapy in aged dogs: effects on the somatotropic axis, muscle morphology, and bone metabolism.

Hexarelin (HEXA; 500 micrograms/kg/die, s.c.) was administered for 16 weeks to six old beagle dogs. The treatment consisted of three on-drug periods spaced by two off-drug periods. During each on period, the growth hormone (GH) peak response to HEXA initially increased and then dropped to pretreatment values. Each time, a wash-out interval restored the same pattern of GH responsiveness. HEXA significantly augmented the indices of spontaneous pulsatility of GH, but plasma insulin-like growth factor I levels did not change during treatment. HEXA apparently reduced bone resorption since it significantly decreased the urinary concentration of lysylpyridinoline, a bone matrix component. Bone formation apparently was not affected since unchanged levels of alkaline phosphatase were recorded. In three of six old dogs, HEXA induced an improvement of some morphological and biochemical muscular indices, evaluated in muscle specimens that, instead, remained unchanged in a group of young untreated controls. These findings indicate that HEXA effectively releases GH and primes the pituitary of old dogs, and strengthen the view that in aging, GH secretion may be restored by pharmacological means. It would also appear that HEXA-induced GH release improves some indices of body composition in old dogs.

Animals↗