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Biomedical subjects

R D'Alessandro

Publications and source records attributed to R D'Alessandro.

At least 109 records · Page 6Linked to original sources

Analysis of outcome predictors of migraine towards chronicity.

Long-term migraine evolution is still undefined. The poorest outcome is the transformation from episodic attacks to a pattern of daily attacks or continuous headache with intermittent attacks. We called these cases "chronic migraine". The aim of our study was to investigate whether some clinical variables contributed to migraine chronicity. We interviewed 50 patients with chronic migraine from 2 to 15 years and 90 patients with episodic migraine matched for sex and age as a control group. Univariate analysis revealed two correlations with a chronic outcome: (1) In the control group a significantly higher number of women took oral contraceptives. (2) In the group who developed chronic migraine, there were a greater number of smokers, without reaching statistical significance. The stepwise multiple logistic regression method showed that these two variables influence the prognosis with a maximum likelihood estimate of 65%, hence not much higher than random probability.

Adolescent↗

Drop attacks: an ominous change in the evolution of partial epilepsy.

We studied 16 patients with partial epilepsy and drop attacks. The drop attacks appeared 1 to 29 years after onset of epilepsy; 15 patients had these attacks weekly or daily, despite therapy. After the appearance of drop attacks, 6 patients had severe mental disorders, and social life was disrupted in 13. There was a high rate of adversive seizures, atypical absences, and diffuse spike-wave discharges in the EEG, electroclinical features that suggest a frontal origin of epilepsy. Drop attacks are ominous because they occur so frequently, resist therapy, are physically dangerous, and portend personality change.

Adolescent↗

[Plasma variations of pituitary hormones during extracorporeal circulation].

In this research we have determined the behaviour of hypophisary hormones determined by radioimmunoassay. We have noted a constant increase of GH and HPrL. In one case we have seen also the decrease of LH and FSH. This changes are determined by the large dose of heparin necessary during C.E.C.

Extracorporeal Circulation↗

Late seizures in patients with internal carotid and middle cerebral artery occlusive disease following ischaemic events.

The occurrence of post-infarction epilepsy was investigated in 68 patients with angiographically proven internal carotid artery occlusion and in 56 patients with middle cerebral artery occlusion. Epileptic seizures occurred during follow-up in 9% of the carotid artery group and in 21.4% of the middle cerebral artery group. The different incidence of seizures in the two groups was statistically significant. The physiopathological mechanism of the late post-infarction epilepsy is discussed.

Adult↗

Phenytoin-induced increase in growth hormone response to levodopa in adult males.

Growth hormone and prolactin response to levodopa were evaluated before and after long-term phenytoin treatment in five men with previously untreated partial epilepsy. After phenytoin treatment, growth hormone response to levodopa increased. There was a close relationship between growth hormone response to levodopa and plasma phenytoin concentrations. These findings suggest a phenytoin-induced dopaminergic activity at the hypothalamic-pituitary level in adult males.

Adult↗

Antiviral therapy in HBsAg-positive chronic liver disease (HBsAg+ve CLD): how many patients really need it?

One hundred and seventy-one consecutive patients with HBsAg+ve CLD were investigated in order to assess whether they were actively replicating the hepatitis B virus, and therefore eligible for antiviral therapy. Our results show that only 5.8% of patients were actively replicating B virus and therefore antiviral therapy, when available, could be used only for a small subgroup of patients suffering from CLD due to hepatitis B virus chronic infection.

Adult↗

Propranolol and acetylsalicylic acid in migraine prophylaxis. Double-blind crossover study.

The aim of this double-blind crossover study was to compare the prophylactic effect of acetylsalicylic acid (ASA) with that of propranolol (PRP) in the treatment of migraine. Plasma concentrations of the two drugs were measured in order to investigate a possible relationship to the clinical effect. Compared to the pretreatment period, PRP and ASA reduced migraine index, frequency, duration, severity of attacks and headache days. Due to the limited number of patients, our results should be cautiously interpreted, however relevant the clinical improvement seemed. Improvement of migraine index was not related to different plasma levels of the two drugs.

Adolescent↗

Menstrual migraine: intermittent prophylaxis with a timed-release pharmacological formulation of dihydroergotamine.

An open study was performed on 20 women between 20 and 40 years of age in order to assess the effectiveness of a slow-release pharmacological formulation of dihydroergotamine in the prevention of menstrual migraine. Therapy was started two days prior to the expected date of menstruation and continued for five days after the onset of menstrual flow. Trial lasted for five months, four patients suspended the treatment: one because of side effects and three because of "ineffectiveness of drug". In the 16 patients who completed the study, there was a significant reduction both in intensity and duration of migraine compared to the month prior to treatment.

Adult↗

Systemic arterial pressure and heart rate changes during migraine and cluster headaches: preliminary study.

In a case of common migraine and in two cases of cluster headache we monitored the arterial pressure and the heart rate by means of polygraphic recordings before, during and after headache attacks. During migraine attacks the arterial pressure did not show significant changes; the heart rate increased. During cluster attacks the arterial pressure increased with frequent hypertensive peaks; the heart rate on average slowed down and showed marked irregularities.

Adult↗