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Biomedical subjects

C Vollono

Publications and source records attributed to C Vollono.

At least 19 recordsLinked to original sources

Dysfunction of arousal systems in sleep-related migraine without aura.

Primary headaches are closely related to sleep. Modifications in the patterns of arousal during sleep have been reported in migraine, especially in the nights preceding a headache attack. We aimed at evaluating the pattern of arousal from sleep in a group of patients affected by sleep-related migraine. We enrolled 10 consecutive patients, three males and seven females, aged between 20 and 62 years, who presented frequent attacks of migraine without aura (more than five per month), closely related to sleep (more than one-half of the attacks occurred during sleep, causing an awakening). A control group was studied, matched for age and sex. Patients and controls underwent a full-night polysomnographic study, following adaptation; arousal pattern was studied by the scoring of the high-frequency EEG arousal and by the cyclic alternating pattern (CAP). Migraineurs showed a lower CAP rate in non-rapid eye movement (NREM) sleep and, in particular, a lower number of A1 phases (low-frequency, high-amplitude EEG bursts) compared with the controls. Migraineurs also showed a lower index of high-frequency EEG arousals during rapid eye movement (REM) sleep. The reduction in the CAP rate indicates a lower level of arousal fluctuation in NREM sleep. The reduced arousal index in REM suggests a dysfunction in neural structures involved in both the control of REM sleep and the pathophysiology of migraine, such as the hypothalamus and the brainstem.

Adult↗

A sleep study in cluster headache.

Cluster headache (CH) is a primary headache with a close relation to sleep. CH presents a circa-annual rhythmicity; attacks occur preferably during the night, in rapid eye movement (REM) sleep, and they are associated with autonomic and neuroendocrine modifications. The posterior hypothalamus is the key structure for the biological phenomenon of CH. Our aim is to describe a 55-year-old man presenting a typical episodic CH, in whom we performed a prolonged sleep study, consisting of a 9-week actigraphic recording and repeated polysomnography, with evaluation of both sleep macrostructure and microstructure. During the acute bout of the cluster we observed an irregular sleep-wake pattern and abnormalities of REM sleep. After the cluster phase these alterations remitted. We conclude that CH was associated, in this patient, with sleep dysregulation involving the biological clock and the arousal mechanisms, particularly in REM. All these abnormalities are consistent with posterior hypothalamic dysfunction.

Cluster Headache↗

[Long-term effects on male gonadal function of antitumoral drugs used during childhood].

The survival rate of children and adolescents with cancer has improved dramatically in the last decades so that the prospect of survival in adulthood is today a realistic expectation for about 70% of the treated patients. However, the deleterious impact that chemotherapy and radiotherapy have on the reproductive function and future fertility could compromise the quality of life of the survivors in adulthood. The interest of the scientific community on this topic is increasing and focused on a more accurate evaluation of the reproductive risk among cancer treated children and on the development of less aggressive therapies. In the present review, some information about the long-term effects on the male reproductive function, particularly vulnerable to the cancer therapies, are reported from clinical and experimental studies. Furthermore, the concern about the development of pharmacological treatments and assisted reproductive techniques that might preserve or restore the fertility potential in children being treated with gonadotoxic cancer therapy, is discussed. These new strategies are still under experimentation and deeper knowledges on the functional development of the gonads during infancy, both in human and animals models are required. On the other hand, the future clinical application of these strategies in children rise important ethical and legal problems.

Antineoplastic Agents↗

Multiple attack study on the available triptans in Italy versus placebo.

The aim of the study is to evaluate the efficacy and tolerability of the five triptans that are commercially available in Italy (zolmitriptan 2.5 mg, rizatriptan 10 mg, sumatriptan 100 mg, almotriptan 12.5 mg and eletriptan 40 mg). The study was conducted in single-blind versus placebo and its duration was 18 months. At the Headache Centre of the 'Agostino Gemelli' Hospital in Rome we selected 42 patients, suffering from headache with and without aura (International Headache Society Committee on Headache Classification, 1988 Cephalalgia 8:1-96), whose headache frequency ranged between 1- and 4-monthly crises. For a total of 25 crises, for every five consecutive crises, a different triptan was taken. The end-points of the study were as follows: response at 2 h, 'pain free' at 2 h and 'sustained pain free' (at 24 h). The intra-patient consistency and the tolerability were also evaluated. Thirty patients completed the study and the statistical analysis was only applied to these patients. No substantial difference in terms of the efficacy of the triptans was noted; all triptans were well tolerated. These results suggest the possibility of testing different triptans in the same patient in order to identify the ideal drug for every patient.

Adult↗

Topiramate in migraine prophylaxis: a randomised double-blind versus placebo study.

The objectives of this paper are to evaluate the efficacy and tolerability of topiramate, given at the dose of 100 mg/day, in the prophylactic treatment of migraine. The hypothesis that migraine is the result of a condition of neuronal hyperexcitability and the quest for drugs that are able to limit the number of crises justifies the attempt to utilise the new antiepileptic drugs in the prophylaxis of this pathology, which is so important due to its high prevalence and due to the high disability it causes. The study was randomised double-blind versus placebo, lasting 16 weeks, and was preceded by a run-in period of 4 weeks. One hundred and fifteen patients were randomly allocated to treatment with topiramate (TPM) or placebo: 35 patients completed the study in the TPM group and 37 patients in the placebo group. At the end of the double-blind phase of study, in the TPM group, we recorded a significant reduction in the frequency of migraine crises (from 5.26 at baseline to 2.60 in the last 4 weeks), a significant reduction in the quantity of symptomatic drugs taken as compared to the placebo control group (from 6.17+/-1.80 SD to 2.57+/-0.80) and a significant downward trend in the number of days of disability over the 16-week period of therapy. In the TPM group, side effects were transient and well tolerated. TPM has thus proven its efficacy and tolerability in the prophylaxis of migraine.

Adult↗

Beliefs and attitudes towards the consumption of sugar-free products in a sample of Italian adolescents.

OBJECTIVE: The objective of this study was to investigate beliefs and attitudes towards sugar-free products in a sample of Italian teenagers. DESIGN: A total of 10 secondary public schools in the county of Rome were randomly selected. The probability of being extracted was set proportional to the number of students. A random sample of teenagers was selected from the schools for participating in a food consumption survey. SUBJECTS: The sample included 233 adolescents, aged 15-21 y. A total of 224 adolescents agreed to participate in the study aimed at assessing beliefs and attitudes. INTERVENTIONS: Two questionnaires were completed at the first day of the last period of the 4-day food survey. The first questionnaire contained questions on attitudes and beliefs toward a healthy diet. The second questionnaire, aimed at assessing adolescents' attitudes towards the consumption of sugar-free products, was based in part on the social-psychological model of the Theory of Planned Behaviour. RESULTS: In general, the adolescents of this sample seemed to be quite uncertain in their responses. On average, they did not express an emphatic point of view with regard to the act of eating sugar-free products. The results of the assessment of relationships between the variables of the theoretical model revealed the lack of causal links among beliefs, attitudes, intention and consumption of sugar-free products. Perceived behavioural control was not a significant predictor of intention. CONCLUSIONS: The target of further studies aimed at investigating attitudes towards sugar-free products should be tailored according to the quantity of consumption of such products in order to represent a sample of frequent and high consumers of sugar-free products. SPONSORSHIP: European Commission Quality of Life and Management of Living Resources Fifth framework Programme. QLRT-1999-00155.

Adolescent↗

Influence of cholinergic circuitries in generation of high-frequency somatosensory evoked potentials.

OBJECTIVE: High-frequency oscillations (HFOs) evoked by upper limb stimulation reflect highly synchronised spikes generated in the somatosensory human system. Since acetylcholine produces differential modulation in subgroups of neurons, we would determine whether cholinergic drive influences HFOs. METHODS: We recorded somatosensory evoked potentials (SEPs) from 31 scalp electrodes in 7 healthy volunteers, before and after single administration of rivastigmine, an inhibitor of central acetylcholinesterase. Right median nerve SEPs have been analysed after digital narrow bandpass filtering (500-700 Hz). Raw data were further submitted to Brain Electrical Source analysis (BESA) to evaluate the respective contribution of lemniscal, thalamic and cortical sources. Lastly, we analysed by Fast Fourier transform spectral changes after drug administration in the 10-30 ms latency range. RESULTS: Rivastigmine administration caused a significant increase of HFOs in the 18-28 ms latency range. Wavelets occurring before the onset latency of the conventional N20 SEP did not show any significant change. A similar increase concerned the strength of cortical dipolar sources in our BESA model. Lastly, we found a significant power increase of the frequency peak at about 600 Hz in P3-F3 traces after drug intake. CONCLUSIONS: Our findings demonstrate that the cortical component of HFOs is significantly enhanced by cholinergic activation. Pyramidal chattering cells, which are capable to discharge high-frequency bursts, are mainly modulated by cholinergic inputs; by contrast, acetylcholine does not modify the firing rate of fast-spiking GABAergic interneurons. We thus discuss the hypothesis that cortical HFOs are mainly generated by specialised pyramidal cells.

Acetylcholine↗

Molecular analysis of arterial stenosis in rat carotids.

A new model of surgical injury for the induction and development of stenosis in common rat carotids is described. This model differs from balloon angioplasty or vein graft systems currently applied on animals to develop stenosis, since it involves the entire vessel wall layers and mimics the injury occurring during arterial grafts, endarterectomy or organ transplantation. At different times following arterial damage, the pattern of expression of genes already known to be involved in the proliferation, differentiation, and apoptosis of smooth muscle cells (c-myc, Angiotensin II receptor 1, Bcl-2 and Bax alpha), as well as of Rb and Rb2 genes, whose pattern of expression after arterial injury has not yet been reported, was analyzed by semi-quantitative reverse transcription-polymerase chain reaction technique. Histological and histochemical analysis on carotid sections shows the morphological changes which occurred 30 days after surgical injury in the vessel wall. Molecular and histological data demonstrate that this model of surgical injury induces neointimal proliferation in about 30% of rats. In about 70% of the remaining rats, it induces the processes responsible for negative remodelling, namely the significant accumulation of extracellular matrix and fibers and disorganization of arterial tunics. This model is therefore available for further studies on the expression of genes involved in the arterial stenotic process, as well as for testing drugs aimed at limiting this recurrent pathophysiological phenomenon.

Animals↗

[Risk perception and self-assessment of exposure to antineoplastic agents in a group of nurses and pharmacists].

Many antineoplastic drugs have shown to be carcinogenic, teratogenic and mutagenic to humans and exposure and absorption have been showed to occur during the preparation and administration in health care practise. More recently, in many countries, national health authorities concern has been focused on promoting actions aimed to protect health of the personnel handling these drugs. The present study reports the results of a survey carried out through a questionnaire among the pharmacists and nurses working in the health care settings located in the province of Rome (Italy), with the aim to survey: occupational risk perception of health care workers; their confidence in the safety measures adopted in the work practice; their knowledge of risk factor and the kind of training received regarding these specific agents. Among the respondents, most of the pharmacists (80%) and nurses (90.4%) show a high concern about antineoplastic drugs dangerousness. At the same time, they state not to have a satisfactory level of knowledge regarding the risk factor and, also that their main information source on occupational risk connected to antineoplastic drugs exposure is not the health care structure, where they are employed. Besides, they do not show a high level of confidence in the safety measures adopted in the health care structures with the aim to protect workers' health. The study results suggest the necessity to promote the development of preventive actions aimed to minimise occupational exposure to these substances through the implementation of procedures and controls in the hospitals, as well as the use of work practice and protective equipment, reinforced by workers education and training.

Antineoplastic Agents↗