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Biomedical subjects

G Bussone

Publications and source records attributed to G Bussone.

175 records · Page 10Linked to original sources
PubMedDate not supplied

Sumatriptan in the acute treatment of migraine without aura: efficacy of 50-mg dose.

We conducted an open study on the efficacy of 50 mg of sumatriptan as an acute treatment for migraine without aura. We recruited 200 consecutive patients, with an established history of migraine without aura, presenting at a headache center. The patients were instructed to take half a 100-mg sumatriptan tablet for their next migraine attack, and to record details of their headache in a diary. The primary outcome of the study was headache relief from one migraine attack. Attacks were moderately intense (46%), moderate to severe (7%), or severe (47%). Total or partial benefit at 2 hours from the 50-mg dose was reported by 140 of 200 patients (70%). Thirty-six patients received no benefit from half a tablet, and 24 did not take sumatriptan, preferring their habitual medication. Side effects were few, mild, and short lasting. We conclude that the 50-mg oral dose is generally effective for migraine without aura attacks of both moderate and severe intensity and recommend this dose for all such patients. If, however, sumatriptan is ineffective at that dose it can be increased to a maximum of 100 mg.

Acute Disease↗
PubMedDate not supplied

Use of the Migraine Disability Assessment Questionnaire in children and adolescents with headache: an Italian pilot study.

OBJECTIVES: To determine the suitability of the Migraine Disability Assessment (MIDAS) Questionnaire for assessing disability in children and adolescents with headache and to obtain preliminary information about disability in different primary headaches. BACKGROUND: During the last decade, researchers have begun to employ standardized methodologies to investigate the global impact of primary headaches. Disease-specific instruments have been developed to measure headache-related disability. The MIDAS Questionnaire, which is the most extensively studied of these instruments, was designed to assess the overall impact of headaches over the 3 months before compilation. The MIDAS Questionnaire is an optimal tool to assess headache-related disability in adults. METHODS: Ninety-five patients aged 7 to 17 years with tension-type headache, migraine, or both completed the validated Italian form of the MIDAS questionnaire on 2 occasions. Test-retest reliability was assessed by the Spearman rank correlation test. The Cronbach alpha assessed internal consistency. The patients answered questions about the adequacy of the questionnaire. RESULTS: The Cronbach alpha was.8. Correlation coefficients were generally high for the overall MIDAS score and for the items investigating disability in school and in family/leisure activities; they were lower for the items about housework. Most patients thought that the MIDAS Questionnaire was useful (98.9%) and that it captured the impact of their headaches (58.9%); 41% thought that questions about disability in housework were useless, 44.2% suggested adding questions regarding inability to do homework. All primary headaches had a considerable impact on daily activities, but patients with migraine tended to have lower headache frequencies and lower total disability time; those with tension-type headache suffered more days in which activities, although performed, were substantially impaired. CONCLUSIONS: The MIDAS Questionnaire is useful for assessing disability in children and adolescents with different primary headaches. Minimal changes in the phrasing and content of the items would be sufficient to render the MIDAS specific for the younger population with headache.

Adolescent↗
PubMedDate not supplied

Clinical considerations on side-locked unilaterality in long-lasting primary headaches.

The relevance of side-locked unilateral pain (with no side shift) in diagnosing and differentiating primary long-lasting cephalgias such as tension headache and migraine is not clear. In the present study we have retrospectively examined the frequency of side-locked unilaterality in 1169 primary headache outpatients, whose pain duration was more than four hours. The cases were migraine (66%), tension-type headache (21%) and non-classifiable headache and atypical facial pain (not well defined headaches) (13%). The occurrence of side-locked unilateral pain was more frequent in migraine (17%) than tension headache (4%). However side-locked pain was found to be more frequent in patients with not-well-defined head pain (28%). Of the 1169 patients, 181 (15%) had side-locked unilateral pain: 70% of the 181 had migraine, 25% were not-well-defined head pain cases and 5% were tension-type headache cases. The high percentage of migraine cases in the side-locked unilateral group reflects the high proportion of migraine patients in the studied population.

Adult↗
PubMedDate not supplied

Short and medium-term influence of physical activity on immune parameters.

Physical stress induces different changes in immune parameters depending on effort schedule and/or customary physical training. The mechanisms whereby they take place and the occurrence of possible tolerance after repeated effort have not been conclusively elucidated. We studied short and medium-term exercise-induced changes in immune parameters after a standard physical effort (24' of cycle ergometer up to the 80% of maximal heart rate, daily for 5 days) in a group of healthy untrained controls. White Blood Cells, lymphocyte subsets, plasmatic catecholamine and cortisol levels, IgG and IL2receptor (IL2R) levels were determined. Most of the observed changes were strictly acute effort-related and disappeared within 3 hours (except for shifts in CD4+ CD45RA+ and CD4+ CD45RA- lymphocytes): they were concomitant to a transient sympathetic activation proved by heart rate (HR) and Norepinephrine (NE) increase. The medium-term effects of repeated daily effort included only a questionable rise in CD19+ and CD3+ CD4- CD8- cells. As far as possible tolerance mechanisms are concerned, we did not detect any change in either the direction or the entity of effort-induced changes in our controls after repeated effort. Study of strictly standardized exercise protocols is mandatory before clinical applications of physical activity in the approach to the treatment of disimmune diseases.

Adult↗
PubMedDate not supplied

Cluster headache: lack of central modulation?

Activation of the SPergic pathway may be responsible for the starting of both painful and autonomic symptoms during a typical cluster headache (CH) attack. We utilized Brainstem Auditory Evoked Potentials (BAEPs) and Visual Evoked Potentials (VEPs) to evaluate the possibility of underlying asymmetries in central functions in CH attacks. We studied 14 CH (7 right and 7 left cluster) and 14 normal subjects. All the CH patients showed a significant VEP asymmetry; the mean P 100 amplitude was significantly reduced on the side of the pain and I-V latency of BAEP was increased on the symptomatic side. No check was made for any significant variation underlying asymmetries in the normal subjects. We postulate that such an asymmetry in VEP and BAEP responses could suggest a neurotransmitters disorder with a different manifestation in each hemisphere.

Adult↗
PubMedDate not supplied

Pharmacologic evaluation of cardiovascular reflex responses in migraine patients: lack of central sympathetic modulation?

To characterize autonomic imbalance in migraine, we compared the cardiovascular reflex responses of 10 migraineurs and 10 healthy subjects after pharmacological noradrenergic stimulation or inhibition. A battery of 5 autonomic tests was administered on basal conditions as well as after pretreatment with drugs acting at different levels on the noradrenergic pathway: pseudoephedrine, clonidine, guanethidine, indenolol, prazosin. Our data confirm a predominantly sympathetic hypofunction in migraine and provide evidence for an impairment of the central autonomic control.

Adult↗
PubMedDate not supplied

Monoamine oxidase activities in patients with migraine or with cluster headache during the acute phases and after treatment with L-5-hydroxytryptophan.

The results of a study of the activity of platelet monoamine oxidase (MAO) in patients with migraine or with "Cluster headache" during the acute phases and after treatment with L-5-hydroxytryptophan are presented. MAO levels are higher in migraine subjects than in normals. There is, also, a clear difference between basal MAO levels in migraine sufferers and in Cluster Headache sufferers. The treatment with L-5-hydroxytryptophan tend to normalize MAO activity in the migraine patients, but does not change the MAO activity in cluster headache patients.

5-Hydroxytryptophan↗
PubMedDate not supplied

Cardiovascular reflex responses in cluster headache patients: basal autonomic alterations.

To investigate the involvement of the autonomic nervous system in Cluster Headache (CH) patients, we compared the cardiovascular reflex responses in a group of CH subjects and a group of controls. We considered five tests: 1) deep breathing test (DB); 2) lying to standing test; 3) heart rate response to Valsalva manoeuvre; 4) blood pressure response to standing; 5) blood pressure response to sustained handgrip. Our data confirm an autonomic dysfunction in CH, particularly regarding the parasympathetic system. Alternative interpretations of these results are discussed.

Adult↗
PubMedDate not supplied

Five cases of Creutzfeldt-Jakob disease: a clinical-pathological contribution.

Clinico-pathological features are reported in five cases of Creutzfeldt-Jakob disease. In three cases only the brain was examined while in the other two a complete autopsy was performed. In one case a brain biopsy was performed and in other two a piece of cerebral cortex was taken within three hours after death; the brain material was frozen and sent for inoculation in monkeys to Dr. Gajdusek of NINDS-Bethesda, with positive results in two. From the clinical point of view our cases may be classified as follows: two as "classic" type; one as "amaurotic" type; and the last two as "ataxic-amyotrophic" forms according to Alemà and Brion (see text). All five patients were females from 56 to 73 years of age. The duration of the disease ranged from 3 to 7 months. From the histological point of view, in the two "classic" cases the outstanding features was the neuronal loss in all cortical mantle, mainly in the fronto-parietal cortex; furthermore in one there was severe and diffuse spongiform state. In the "amaurotic" case the three types of lesion were mainly localized in the occipital cortex. In the two "ataxic-amyotrophic" forms the neuronal loss was particularly evident in the cerebellar cortex and especially in the granular layer. The Kuru plaques were seen especially in the cerebellum in four of the five cases examined. The aim of our study is to contribute to the epidemiology of this disease.

Aged↗
PubMedDate not supplied

[Tiapride in the treatment of chronic headache (author's transl)].

The therapeutic efficacy of tiapride in chronic headache (300 mg/day orally during 30 days) was studied in a doubleblind trial in a group of 50 patients, 40 of them with so-called "mixed headache", and 10 with classical migraine. The results were subjected to statistical analysis. 65% of treated patients had clinical benefit in the intensity and frequency of headaches. The mode of action of this drug is discussed, together with the involvement of several monoaminergic systems in the genesis of headache. The action of tiapride appears to be indirectly dopaminomimetic as it operates by a blockade of dopaminergic inhibitors receptors.

Benzamides↗