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Migraine and headache due to weather and allied causes and its specific treatment.

Attacks of migraine resulting from climatic cold or heat-stress are a common occurrence in 20-30 per cent of a population exposed to weather changes. The electrical charges (positive ionisation and sferics) engendered by every incoming weather front produce a release of serotonin. In addition there also exists a syndrome of adrenaline deficiency, which may produce headache, while a third reaction, intermittent hyperthyreosis, plays a lesser role in evoking headache. The differential diagnosis of the various types of headache is based upon the profile of neurohormones excreted in the 24-hours urinary output, which permits a comparison between normal and weather-stress days. Such a procedure may provide an appraisal of the underlying metabolic disturbance. Consequently, appropriate treatment can be administered to the patient, and its effect controlled by analysis of any possible neurohormonal change.

Headache↗

Variegate porphyria. Twelve years' experience in Finland.

Fifty-seven patients with variegate porphyria belonging to nine families are described. The prevalence of variegate porphyria in Finland is 1.3 per 100 000. Eighteen patients had had acute attacks. During on average 5.7 years' follow-up only two of 48 patients had symptoms, which were temporary and acute. The length of life of 13 genealogically traced gene carriers who lived mostly during the 19th century did not differ from that of the general population. Skin fragility occurred in 45 per cent of the patients and was usually mild. No patients were sensitive to sunlight but seven of 14 tested reacted abnormally to artificial light. The characteristic increase in the excretion of faecal proto- and coproporphyrin was usually apparent even in the latent stage of porphyria, but increased excretion of urinary porphyrin precursors occurred only during an acute attack. However, in seven of 48 patients studied during the latent stage, faecal prophyrins were only slightly elevated or even normal, causing problems in diagnosis. Determination of faecal X-porphyrin was of no help in diagnosis. Red cell free protoporphyrin was significantly higher and serum haemopexin lower than in controls. Red cell uroporphyrinogen I synthase activity was normal in 17 of 18 patients studied. We conclude that variegate porphyria may be commoner than hiherto suspected; only half the patients in temperaure and cold climates have skin symptoms, the risk of developing an acute attack is low, and some adult patients excrete normal or only slightly abnormal amounts of porphyrin.

Acute Disease↗

Recent acute and subacute mycotoxicoses recognized in France.

Successful investigation and prevention of mycotoxic problems requires close collaboration between scientists from several disciplines ranging from agronomists and technologists required during production of food and feeds, to toxicologists and pathologists examining the effects of mycotoxins on animals and man. Zootoxic metabolites following fungal infection result from four general mechanisms: (i) secondary fungal metabolism (mycotoxins, eg, aflatoxins); (ii) bioconversion of vegetal compounds (eg, dicoumarol); (iii) plant reactions (phytoalexins, eg, coumestrol); and (iv) plant-fungus associations (endophytes, eg, Acremonium/Festuca). In reported pathologic field cases, close cooperation through a selected veterinary network has allowed diagnosis of acute and subacute mycotoxicoses in France. Natural stachybotryotoxicosis may not be limited only to cold climates, but may also occur in mild and warm ones (eg, south west of France, Morocco). A considerable variation was observed in symptoms and lesions depending on toxin levels, ranging from a poor performance in a horse race to a general haemorrhagic syndrome. Several cases of acute equine leucoencephalomalacia, characterized by pathognomonic lesions and recently supported by fumonisin analysis, have been diagnosed in the southern part of France and other countries (eg, New Caledonia and the Ivory Coast). Facial eczema in sheep is endemic in the Basque country, as a result of specific bioclimatic and zootechnic conditions. Reproductive disorders in sheep, cattle, goats and rabbits have been associated with high levels of coumestrol in alfalfa, clover and their derivatives. A few cases of fescue foot disease, associated with the endophyte Acremonium, have been diagnosed recently. In addition, several nervous disorders may be due to unknown mycotoxins. These acute or subacute mycotoxicoses suggest a potentially widespread occurrence of low level toxins and insidious asymptomatic mycotoxicoses, and justify interdisciplinary research in order to improve diagnosis and preventative measures.

Acute Disease↗

[Problem of adaptation and characteristics of the etiology of diseases in the Far North].

Extensive data covering 2086 examinees served for analysis of peripheral vascular, locomotion, neurologic disorders developing at various stages of adaptation process in workers engaged into mining in the North. Unfavorable general and local cooling resulted in overstrain of thermoregulation mechanisms, caused lower performance, difficulties in adequate occupational functioning, early formation of diseases. Association of cooling and intensive vibration with significant physical load induced neurovascular and neurodystrophic changes being a result of both local microcirculation disturbances and disordered regulation of peripheral vascular tone, higher excitability of vasoconstrictors stimulated by central mechanisms.

Adaptation, Physiological↗