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Biomedical subjects

R Leira

Publications and source records attributed to R Leira.

53 records · Page 3Linked to original sources
PubMed1991

[Platelets and migraine. Correlation between biochemical markers of platelet aggregation and serotonin].

The correlation between the biochemical markers of platelet activation and serotonin in migraine was investigated. The beta-thromboglobulin (beta-TG), platelet factor 4 (PF-4) and serotonin levels in 105 patients with migraine were measured. The results confirmed an increase in beta-TG and PF4 levels and a reduction in serotonin levels during the migraine attacks. However, we did not find a significant correlation between these fluctuations. These findings suggest the existence of extraplatelet mechanism in the pathophysiology of migraine.

Adolescent↗
PubMed1990

[Hormonal profile and changes in platelet aggregation in menstrual migraine].

We evaluated the hormonal profile and the platelet function in a group of 20 patients with menstrual migraine and a control group of 10 healthy women. Plasma levels of estradiol, progesterone, FSH and LH, as well as betathromboglobulin, platelet factor 4 and platelet serotonin were measured in different phases of the menstrual cycle. The hormonal profile did not show significant differences between both groups. The patients with menstrual migraine had higher BTG, FP4 and serotonin levels in the premenstrual phase than the control group. The results of this study show that in premenstrual migraine a platelet hyperagregation develops during the premenstrual phase. This abnormality is not directly correlated with the hormonal fluctuations observed during the menstrual cycle.

Adult↗
PubMed1990

[Platelet function in tension headache].

The possibility of abnormal platelet function in patients with tension headache was evaluated with serial plasmatic measurements of serotonin, beta-thromboglobulin and platelet factor 4. In 40 patients with tension headache we found increased serotonin, thromboglobulin and platelet factor 4 levels during the painful phases as compared with the asymptomatic phases. These data might indicate that an increased platelet aggregation plays some role in the pathogenesis of tension headache.

Adult↗
PubMedDate not supplied

[Almotriptan in the treatment of migraine attacks in clinical practice: results of the TEA 2000 observational study].

BACKGROUND: Almotriptan, the most recent drug of the triptan family, has shown good efficacy and tolerability profile in clinical trials. OBJECTIVE: To assess almotriptan's tolerability and effectiveness in the setting of routine clinical practice. PATIENTS AND METHODS: 1,643 patients diagnosed of migraine according to IHS criteria were recruited by 317 neurologists in the TEA 2000 study. Patients were instructed to report data on migraine attacks in a diary for a three months follow-up period. Data from 4,253 migraine attacks were obtained. RESULTS: The incidence of adverse events was 0.02 per migraine attack (3,9 % of patients). Subjective clinical improvement after 30 minutes (33.2 y 37.1 %), pain improvement after 2 hours (65.5 % and 70.2 %), pain free response after 2 hours (26.6 % and 29.2 %), recurrence between 2 and 24 hours (21.2 % and 17 %) and a complete response by 24 hours (18.6 % and 22.9 %) were found. These results were obtained in both "intention to treat" and "per protocol" analyses, being even much better when only low pain intensity attacks were considered. CONCLUSIONS: The TEA 2000 study results demonstrate good effectiveness and excellent tolerability profile of almotriptan 12.5 mg in the daily clinical neurological practice. The results of this study confirm those obtained in clinical trials carried out before almotriptan was introduced into the market and that it is a good therapeutic choice for the symptomatic treatment for migraine attacks.

Adult↗
PubMedDate not supplied

[Metalloproteinases and neurovascular injury].

Matrix metalloproteinases (MMP) are a family of proteases involved in the remodelling of the extracellular matrix. In physiological conditions, the activity of MMP is regulated on several levels: gene transcription, activation of inactive precursors, and inhibition by endogenous factors. Loss of control and increased expression and activity of MMP have been implicated in various diseases (cancer, arthritis, vascular aneurysms, atherosclerosis, etc.). In the central nervous system, MMP are involved in the mechanisms associated with neuroinflammation, which is different in vascular and non-vascular diseases. MMP, especially MMP-9, have been shown to induce a high breakdown capacity, especially in the arteriolar basement membrane, leading to cerebral edema and secondary hemorrhage. In human clinical aspects, MMP are associated to intracerebral hemorrhage growth and with the development of complications in ischemic stroke. Combination therapies explicitly involving MMP inhibition could be of value in future treatment strategies.

Cerebrovascular Disorders↗
PubMedDate not supplied

[Adenine nucleotides in migraine].

Several studies have shown that migraine is associated with an abnormal platelet activation state, characterized by increased plasma levels of platelet BTG and PF4 proteins. Adenine nucleotides are contained in platelets as a part of the dense granules released during platelet activation. In the present study we evaluated the plasma levels of the adenine nucleotides AMP, ADP and ATP during asymptomatic and painful episodes in a group of 50 patients with migraine (common and classical) and a control group. During the painful phases we found a significant reduction in AMP plasma levels, and we did not find significant differences between the control group and the migraine patients in ADP and ATP levels, nor between asymptomatic and painful phases. Our results support the hypothesis that in migraine a hyposecretion of platelet dense granules is present.

Adenosine Diphosphate↗
PubMedDate not supplied

[Paramedian bithalamic infarct syndrome: report of five new cases].

Five patients were examined suffering from bilateral paramedian thalamic infarction, caused by occlusion of the posterior paramedian thalamo-subthalamic arteries, when they begin from one single pedicle. All cases began with obnubilation or transitory coma, followed by hypersomnia. Four patients showed vertical gaze paralysis, and the fifth vertical nystagmus. In three cases, nuclear lesion of the III cranial nerve was observed along with alteration of the photomotor reflexes, and there was miosis in one case. All were suffering from weakness in one or another limb or facial paresis and generalised acute hypotonia: only one patient had hemihypostesia. All five had dysarthria, ataxy and dysmetria, one had asterixis and two spasmodic crying. Between 5 and 12 months later, one had akinetic mutism and vertical gaze paralysis as the most noteworthy signs. The neuroradiological images show a bilateral ischemic lesion in the paramedian thalamic region, which extends in some cases to the anterior nucleus and in one case to the pulvinars; the lesion continues through the subthalamic regions and the medial part of the mesencephalic tegmentum, with a clear extension to the medial region of the cerebral peduncles in three cases and to the tectum in one case.

Adult↗
PubMedDate not supplied

[A headache and ischemic infarction of middle cerebral artery: a prospective study of 100 patient].

The frequency and clinical characteristics of headache were assessed in a prospective study carried out among 100 patients suffering from ischaemic infarct in the area of the middle cerebral artery. Headache was found in 28 out of the 100 patients studied and proved to be significantly more frequent in those infarcts located in the superficial branches (p < 0.001) and in the dominant hemisphere (p < 0.05). We found no relationship between the existence of headache and the type of infarct, its extension or level of neurological affectation. Severe headache preceded stroke in 28.5% of cases, was simultaneous in 57.1% and followed in 14.2%. The average intensity of headache was 2.14 +/- 1.69 headache units. It was bilateral in 46.4% of patients, generalized in 14.2%, unilateral on the side of the infarct in 28.5% and counterlateral in the remaining 10.7%.

Adult↗
PubMedDate not supplied

[Subcutaneous sumatriptan in the treatment of migraine attacks. An analysis of its long term efficaciousness and tolerance].

We present the results of treatment with subcutaneous sumatriptan in migraine attacks. The study comprised forty-two patients suffering from migraine both with and without aura, with migraine attacks not susceptible to analgesics, non-steroid anti-inflammatory drugs (NSAID), ergotics or else intolerance to the same. Two groups were independently analyzed, one consisting of ten patients who had menstrual migraine continually for twelve months, the other consisting of thirty-two patients suffering from migraine with and without aura for six months. We assessed the effectiveness of the drug (reduction in the intensity and duration of the attack, action, speed, recurrence) and tolerance (adverse effects). The effectiveness of sumatriptan in relieving headache was 75.9% (80% in the case of the menstrual migraine group and 71.8% in the case of the migraine with and without aura group). This effectiveness was maintained in a similar fashion by analyzing independently the first and last months of treatment. Adverse effects were noted in 38.7% of patients treated (40% for the menstrual migraine group, 37.5% for those with migraine with and without aura). The most frequent effects were pain at the point of injection, a feeling of general tiredness, nausea and a sensation of tension in the neck or chest. These effects were largely slight and short lived. No serious adverse effects were reported. A long term analysis carried out on the menstrual migraine group shows the efficacy of sumatriptan is kept up, with improved tolerance of the drug and a decrease in the number of negative side effects noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Spanish study of quality of life in migraine (I). Profile of the patient with migraine attending neurology clinics].

BACKGROUND: Migraine is the main reason for neurological consultation. OBJECTIVES: To analyse the profile of the patient with migraine attending the Neurological Services of our country. PATIENTS AND METHODS: Neurologists from 7 hospitals in different spanish regions interviewed 305 patients (at least 40 per hospital) who met migraine diagnostic criteria. They used an ad hoc questionnaire in which detailed demographic and migraine clinical data were included. Patients with transformed migraine or tension-type headache more than two days per week were excluded. RESULTS: The majority (82%), were women, with no other diseases, with an average social (88%) and cultural (41%) level. The mean age at consultation was 38 +/- 11 years, while the mean duration of migraine history was 18 +/- 13 years; 78% met criteria of migraine without aura, 15% of migraine with aura and the remaining (8%) both migraine with and without aura criteria. Main subjective precipitating factors were: stress (80%), foods (68%), drugs (34%), alcohol (20%) and menstruation (8%). Migraine pain was referred to as mild by 4% of cases, as moderate by 59% and as severe in the remaining 37%. The usual duration of migraine attacks ranged from 12 to 24 h in 35% of cases, from 24 to 48 h in 25%, from 4 to 12 h in 23% and was longer than 48 h in the remaining 17%. More than half (53%) had more than 3 attacks per month. The pain was unilateral in 70% of cases, and more than half had vomiting (57%) and sono and/or photophobia (97%). CONCLUSIONS: The typical profile of the migraine patient attending the Neurology Services in Spain is that of a woman aged from 20-50, with a long personal history of migraine, otherwise healthy and with an average socioeconomic and cultural level. Our data confirm that migraine attacks are incapacitating in a relevant number of these patients.

Adolescent↗