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Biomedical subjects

G Zanchin

Publications and source records attributed to G Zanchin.

At least 19 recordsLinked to original sources

Sympathy for Pontius Pilate. Hemicrania in M. A. Bulgakov's The Master and Margarita.

The aim of this study was to explore the description of the migraine attack of Pontius Pilate (a character in the novel The Master and Margarita by M. A. Bulgakov). Some of its features are analysed in light of current migraine literature. It is hypothesized that, at least in part, this description is based on the personal experience of the novel's author. We studied and analysed the text of the novel, other works by Bulgakov, his biography, including his medical training and practice, and the recently published diaries of Bulgakov and his wife E. S. Bulgakova. The novel contains a comprehensive description of a migraine attack. It includes a prodrome/aura of osmophobia. Olfactory perception during or shortly before the migraine attack is altered to the point where neutral or even pleasant odours become unbearable. Bulgakov's extensive history of migraines is seen in his diary, the diary of his wife, letters and other literary works. This is one of the most detailed and extensive depictions of a migraine attack in literature, with osmophobia described with great emphasis. It is likely that Pilate's migraine is described based on the personal history of the novel's author.

Authorship↗

Clinical-biochemical correlates of migraine attacks in rizatriptan responders and non-responders.

The present study was aimed at verifying the clinical characteristics of a typical attack in 20 migraine patients, 10 responders and 10 non-responders to rizatriptan, and at investigating any differences in the levels of neuropeptides of the trigeminovascular or parasympathetic systems [calcitonin gene-related peptide (CGRP), neurokinin A (NKA) and vasoactive intestinal peptide (VIP) measured by radioimmunoassay methods in external jugular blood] between responders and non-responders. In all responders to rizatriptan, pain was unilateral, severe, and pulsating, and in five of them at least one sign suggestive of parasympathetic system activation was recorded. Five patients who were non-responders to rizatriptan referred bilateral and non-pulsating pain, even though severe in most of them. CGRP and NKA levels measured before rizatriptan administration were significantly higher in responders than in non-responders (P < 0.0001 and P < 0.002, respectively). In the five patients with autonomic signs among rizatriptan responders, detectable VIP levels were found at baseline. One hour after rizatriptan administration, a decrease in CGRP and NKA levels was evident in the external jugular venous blood of rizatriptan responders, and this corresponded to a significant pain relief and alleviation of accompanying symptoms. VIP levels were also significantly reduced at the same time in the five patients with autonomic signs. After rizatriptan administration, CGRP and NKA levels in non-responder patients showed less significant variations at all time points after rizatriptan administration compared with rizatriptan responders. The present study, although carried out on a limited number of patients, supports recent clinical evidence of increased trigeminal activation associated with a better triptan response in migraine patients accompanied by parasympathetic activation in a subgroup of patients with autonomic signs. In contrast, the poor response seems to be correlated with a lesser degree of trigeminal activation, lower variations of trigeminal neuropeptides after triptan administration, and no evidence of parasympathetic activation at baseline.

Calcitonin Gene-Related Peptide↗

[Takayasu's arteritis. A concise review and some observations on a putative case reported by Giovanni Battista Morgagni (1761)].

The discovery of Takayasu's arteritis is likely to date back as far as 1830, owing to the first description of the Japanese Rokushu Yamamoto. Thereafter, several authors from certain geographical areas and in various historical periods described such a vascular disorder, by introducing a quantity of definitions. At present, it is defined as an eponymic disease, namely Takayasu's arteritis, since Makito Takayasu, a Japanese ophtalmologist, reported in 1908 the clinical history of a woman showing some particular retinal anastomotic shunts of arterioles and venules. In the present study the description of an about 40 year-old woman suffering from a pulseless disease, as reported by Giovanni Battista Morgagni in 1761, is summarized. Such a description could be the first case report of Takayasu's arteritis, according to some previous literature data and our critical analysis.

History, 18th Century↗

Chronic paroxysmal hemicrania, hemicrania continua and SUNCT syndrome in association with other pathologies: a review.

We present a review of 22 cases of headache mimicking chronic paroxysmal hemicrania (CPH) (17 female and five male; F : M ratio 3.4), nine cases mimicking hemicrania continua (HC) (seven female and two male) and seven cases mimicking SUNCT syndrome (five male and two female) found in association with other pathologies published from 1980 up to the present. All case reports were discussed with respect to diagnostic criteria proposed by International Headache Society (IHS) for CPH, by Goadsby and Lipton for HC and SUNCT, and evaluated to identify a possible causal relationship between the pathology and the onset of headache. The aim of the present review was to evaluate if the presence of associated lesions and their location could help elucidate the pathogenesis of trigeminal autonomic cephalalgias (TACs).

Adolescent↗

Spontaneous carotid artery dissection with cluster-like headache.

A case of carotid artery dissection in a 41-year-old-woman is described whose main symptom was cluster-like pain. The case is interesting for its atypical presentation with only two other like cases in the literature, and the site of dissection, localized in the intrapetrous curvature of the carotid artery. The case highlights the need for active co-operation between clinician and neuroradiologist during neuroimaging assessment which must be focused on the clinical evaluation of the individual patient so as to avoid error, particularly in atypical cases.

Adult↗

Self-administered pain-relieving manoeuvres in primary headaches.

We investigated the use of self-administered pain-relieving manoeuvres on a sample of 400 patients with primary headaches--represented by an even distribution of migraine without aura (MO), migraine with aura (MA), episodic tension-type headache (TH), and cluster headache (CH)--consecutively seen at Padua and Parma Headache Centres. Manoeuvres on various regions of the head were used by 258 patients (65% of the cases). The most applied procedures were: compression (114 out of 382 manoeuvres; 30%), application of cold (27%), massage (25%) and application of heat (8%). A significant (P < 0.001) relationship was found between headache diagnoses and type of manoeuvre. In MO patients the application of cold (38% of the manoeuvres) and compression (36%), used mainly on the forehead and temples, prevailed; compression, mainly on the temples, was the most frequent procedure (44%) in MA patients. Massage on the temples and nape was the predominant manoeuvre (43%) in TH patients, whereas in the CH group, which more often required heterogeneous procedures, none of the above-mentioned manoeuvres was prevalent. Compression, as a diagnostic criterion for MO, had a sensitivity of 33% and a specificity of 86%; for the application of cold the figures were 36% and 84%, respectively. Massage had a sensitivity of 33% and a specificity of 80% for TH. The efficacy of the self-administered manoeuvres in reducing pain was scarce. Only 8% of the manoeuvres, in fact, resulted in a good or excellent pain control. Moreover, the efficacy of the manoeuvre was often momentary, wearing off when the manoeuvre stopped. In spite of this, 46% of the subjects used the manoeuvres constantly, at each attack.

Adolescent↗

Headaches in Domestic Medicine by William Buchan.

In this paper, we consider the chapter on headaches contained in William Buchan's Domestic Medicine, a book that enjoyed great success during the second half of the eighteenth and the beginning of the nineteenth centuries, and belongs to the series of public education treatises that began with the publication of Avis au Peuple sur la Sante by Simon Andrè Tissot. In line with the ideals of the Enlightenment, Buchan's aim was to satisfy the needs of people who had no opportunity of consulting a physician by providing them with information about the symptoms and treatment of the most common diseases. One of the distinguishing characteristics of the book is the space dedicated to preventive medicine. In the chapter on headaches, as well as dealing extensively with their etiology, pathogenesis, clinical characteristics and treatment within the conceptual context of humoral medicine, the author also proposed a number of preventive measures that can still be considered fully acceptable today.

Headache↗