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Biomedical subjects

T Catarci

Publications and source records attributed to T Catarci.

16 recordsLinked to original sources
PubMed1998

Amitriptyline is effective in chronic but not in episodic tension-type headache: pathogenetic implications.

The tricyclic antidepressant, amitriptyline, is an effective drug for the treatment of chronic tension-type headache and for other chronic pain syndromes, but it is also effective in the prophylaxis of an episodic type of headache such as migraine. However, its efficacy in episodic tension-type headache has not yet been clarified. We compared the efficacy of amitriptyline (25 mg/day) in 82 nondepressed patients with either chronic or episodic tension-type headache in an open-label study. Amitriptyline significantly reduced (P < 0.05) frequency and duration of headache as well as analgesic consumption in chronic, but not in episodic, tension-type headache. Further placebo-controlled trials, possibly with higher doses of amitriptyline, might confirm if the different pattern of response to amitriptyline can be explained in terms of different involvement of central nociception and of peripheral myofascial factors in the chronic and in the episodic forms of tension-type headache.

Adrenergic Uptake Inhibitors↗
PubMed1995

A formal model for quality assurance in coloproctologic surgery.

In the last 30 years the advanced countries experienced a large growth of financial and social resources devoted to Health Care (HC) [1] The need of better co-ordinating activities of a composite large set of specialists, and the need of avoiding further growth of financial and social resources without reducing benefits, stimulated the growth of Health Care Evaluation (HCE) and Quality Assurance (QA) studies. In this paper we show how system analysis and precise assessment of the clinical process can be largely enhanced by using formal techniques. The proposed methodology takes advantage of positive experiences in computer science. It is based on a formal model of the clinical process that provides the physicians with support for assessing diagnostic procedures in a co-operative surgical environment [7]. Diagnostic, grading, and staging procedures are integrated in a single model that can be formally expressed and analyzed. The approach is exemplified by presenting an elementary model of the diagnosis, grading and staging procedures for the colo-rectal cancer and ulcerative colitis.

Colitis, Ulcerative↗
PubMed1994

Ergotamine-induced headache can be sustained by sumatriptan daily intake.

We describe the case report of a migraine sufferer who developed ergotamine-induced headache and subsequently replaced ergotamine with daily sumatriptan (100 mg p.o.). The features of the headache were unchanged except for the presence of superimposed migraine-like headaches that occurred every 24 h.

Adult↗
PubMed1994

If migraine prophylaxis does not work, think about compliance.

Data are presented on nine patients with migraine by IHS criteria, recruited from those presenting to the clinic for treatment and needing prophylaxis. Pizotifen 0.5 mg tds was prescribed for 8 weeks and dispensed in special containers with an electronic event recorded concealed in the lid. This responded to the pressure change with each opening of the container and recorded it in real time. The information was later downloaded to a PC for analysis. At trial end, two patients had been lost to follow-up, one had not started the treatment at all, two had dropped out because of alleged side effects (drowsiness), and four patients had completed the study. For these, the quantity of tablets used as a percentage of that prescribed (i.e., compliance assessed on the basis of returned-tablet count) ranged from 62.6% to 91.9%; the percentage of days in which three doses had been taken ranged from only 15.8% to 79%; the percentage of doses taken on schedule (8 h +/- 25% after the previous dose) ranged from 21.1% to 47.3%. It is possible that all evaluations of efficacy and tolerance of migraine prophylactics reported so far have been unsoundly based.

Adult↗
PubMed1993

Cellular adaptation in migraineurs with chronic daily headache.

Ergotamine and analgesic misuse are now recognized as causes of chronic daily headache and the condition responds well to drug withdrawal with reduced headache frequency. In this study, we have investigated whether medication misuse is associated with an alteration in membrane transduction which is sensitive to drug withdrawal. This was carried out by assay of the thrombin-stimulated generation of inositol phosphates in platelets from 12 migraine patients with chronic daily headache and analgesic misuse, 7 migraine patients with chronic daily headache and ergotamine misuse and 7 control subjects. After drug withdrawal, a significant decrease in headache frequency was seen at one month in both patient groups. Withdrawal of analgesics produced a significant decrease in thrombin-stimulated inositol phosphate production at one month; this was further decreased a month later with a reduction in Bmax of 60% and no significant change in KD. A similar pattern was obtained in ergot misuse patients, with the KD value decreasing by 56% one month after drug withdrawal. These results provide evidence of an adaptation in transduction with misuse of analgesics and ergotamine which correlates with headache frequency.

Adult↗
PubMed1993

5HT in migraine patients with medication-induced headache.

Whole blood 5HT levels were measured in seven female migraine sufferers with chronic daily headache due to medication abuse, before and after abrupt medication withdrawal. A statistically significant increase in 5HT levels, from mean 4.89 mumol/l to mean 6.59 mumol/l (p < 0.05, Wilcoxon signed rank test), occurred after 4 weeks of withdrawal. We conclude from this pilot study that 5HT may be important in the physiopathogenesis of chronic daily headache. Alternatively, reduced 5HT may be the result of chronic daily headache or else an epiphenomenon.

Adult↗
PubMed1993

Prolonged muscular flaccidity: frequency and association with unilateral spatial neglect after stroke.

The frequency of prolonged muscular flaccidity (PMF) was examined in a series of stroke patients in chronic phase suffering from hemiplegia with minimal spontaneous recovery (MSR). The results indicated that in such a population with poor motor recovery, PMF was significantly more frequent than spasticity. PMF was found to be associated with left-sided hemiplegia and unilateral spatial neglect. The minimal spontaneous recovery of the series of stroke patients we studied could be dependent on the interaction of three negative prognostic factors: left sided hemiplegia, unilateral spatial neglect and prolonged muscular flaccidity.

Aged↗
PubMed1992

Migraine and heredity.

Since the time of Liveing and Gowers in the nineteenth century, migraine has been thought to be inherited, although family history has been widely studied, nearly all the reports are not scientifically based and studies on twins have never shown 100% concordance in monozygotic (MZ) pairs, indicating that migraine cannot be inherited by a single gene. Furthermore, the criteria for a polygenic trait are not fulfilled by migraine patients. The only two syndromes with a strong genetic basis of inheritance are familial hemiplegic migraine and migraine occurring in Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episodes (MELAS). It is the predisposition to headache that is likely to be inherited; this is supported by the induction of migraine-like headaches with either m-chlorophenyl-piperazine (m-CPP) or nitroglycerin in normal subjects with a positive family history for migraine.

Family↗
PubMed1991

Nimodipine in migraine: clinical efficacy and endocrinological effects.

Serum prolactin is increased during chronic flunarizine treatment of patients suffering from migraine. In order to clarify the role of calcium in control of the secretion of anterior pituitary hormones, a study has now been made of the effects of chronic nimodipine and propranolol treatment of migraine patients on prolactin (PRL), luteinizing hormone (LH) and growth hormone (GH) levels. 11 patients were treated with nimodipine and 8 with propranolol for four months. A statistically significant reduction in the frequency of the attacks was demonstrated in both groups. No significant change was found in the hormones levels during nimodipine treatment.

Adult↗
PubMed1990

Cluster-like headache and head injury: case report.

This appears to be the first report of cluster-like headache secondary to post-traumatic subdural hematoma. A 39 year old man consulted us for cluster-like headáche on the right side following an injury to the right frontotemporal region some 45 days before. A CT scan revealed a chronic subdural hematoma in the right frontotemporal region. We discuss the possible relationship between the head injury and the headache and suggest the value of CT scanning in patients with cluster headache.

Administration, Rectal↗
PubMedDate not supplied

Empty sella and headache.

Empty sella is an anatomical condition caused by herniation of the subarachnoid space into the pituitary fossa through an incompetent sellar diaphragm. Headache seems to be one of the most frequently reported symptoms. We studied 13 headache patients (12 females, 1 male) presenting with primary empty sella (PES) on CT scan. The characteristics of the headache were analyzed and plasma levels of pituitary hormones or cortisol assessed. We confirmed the nonspecific nature of the headache in PES even though the majority of our patients complained of daily headache, mostly localized anteriorly. Hormone plasma levels were within normal range in all the patients assessed. However, four patients reported earlier endocrine disorders and more than half of the patients presented with obesity. In our opinion, PES should be suspected in middle-aged overweight women with daily headache even in the absence of endocrine symptomatology.

Adolescent↗
PubMedDate not supplied

Handedness in musicians.

In order to study the prevalence of left- or mixed-handedness in musicians, we decided to examine a population of professional musicians. We assessed the handedness pattern of 382 members of 7 orchestras. The prevalence of non-right-handedness in musicians was found to be much the same as in the general population. Similar results emerged from a study of young music school pupils. We conclude that brain structural tomographic imaging should ideally be performed, and the pattern of cerebral asymmetry analysed in order to assess cerebral lateralization in musicians.

Brain↗