Short-term frovatriptan for the prevention of difficult-to-treat menstrual migraine attacks

The efficacy of a 6-day regimen of frovatriptan for menstrual migraine (MM; attacks starting on day −2 to +3 of menses) prevention in women with difficult-to-treat MM was assessed. Women with a documented inadequate response to triptans for acute MM treatment were included in this placebo-controlled, parallel-group trial. Women were randomized to double-blind treatment for three perimenstrual periods (PMPs) with either frovatriptan 2.5 mg (q.d. or b.i.d.) or placebo initiated 2 days before anticipated MM. The efficacy analysis included 410 women with 85% completing three double-blind PMPs. The mean number of headache-free PMPs was 0.92 with frovatriptan b.i.d., 0.69 with frovatriptan q.d. and 0.42 with placebo [ P  < 0.001 (b.i.d.) and P  < 0.02 (q.d.) vs. placebo]. When migraine occurred, severity was reduced with frovatriptan q.d. ( P  < 0.001) and b.i.d. ( P  < 0.001) vs. placebo. Both frovatriptan regimens were well tolerated. In women with difficult-to-treat MM, a 6-day regimen of frovatriptan significantly reduced MM incidence and severity.     

Does persistent organic pollutant PFOS (perfluorooctane sulfonate) negative impacts on the aquatic invertebrate organism,Astacus leptodactylus [Eschscholtz, 1823]

Highly persistent perfluorooctane sulfonate (PFOS) is an industrial fluorinated organic chemical with significant bioaccumulation and biomagnification properties. The purpose of this study was to determine the toxic effects of sublethal PFOS on the aquatic invertebrate organism, narrow-clawed crayfish [Astacus leptodactylus Eschscholtz, 1823]. The 96?h LC₅₀ value was determined as 48.81?mg/L (34.19–63.68?mg/L) with probit analysis. The sublethal experimental design was formed into four groups solvent control (DMSO, dimethyl sulphoxide), non-treated control group, and 1/10 (5?mg/L) and 1/100 (0.5?mg/L) of 96?h LC₅₀ of PFOS, and crayfish were exposed for 48?h, 7?d, and 21?d under laboratory conditions. Total haemocyte counts (THCs) decreased, while the haemolymph total antioxidant status (TAS) values increased (p?<?0.05) after exposure to 0.5 and 5?mg/L PFOS for 48?h, 7?d, and 21?d. Haemolymph total oxidative stress (TOS) levels significantly increased at 5?mg/L PFOS concentration (p?<?0.05). Catalase (CAT) activities increased at both concentrations after 48?h and 7?d and then returned to control levels after 21?d; whereas superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities did not change in muscle tissue (p?>?0.05). GPX and CAT activities decreased, but SOD activity increased in hepatopancreas tissue (p?<?0.05). SOD activity at both concentrations and CAT activity at 5?mg/L PFOS exposure decreased in gill tissue, while GPX activity increased at both concentrations of 48?h and 7?d and returned to control values on day 21 of exposure. Histopathological alterations were detected in hepatopancreas and gill tissues. Lamellar deformations, epithelial hyperplasia, and haemocytic infiltrations were observed in the gill tissues, whereas tubular degeneration, tubule loss, necrosis, and lesions in the hepatopancreas tissues were the major recorded alterations. As a result, the sublethal concentrations of PFOS have toxic effects on crayfish and histologically cause tissue damage. Our findings also support a better understanding of the early toxicological effects of PFOS in freshwater ecosystems. Also, it could be concluded that A. leptodactylus is a reliable model for examining histopathological alterations and differences in enzyme activities together with the haemolymph findings in toxicology studies amid aquatic species.

     

Phantom pain: A sensitivity analysis

Purpose:?To analyse how decisions to dichotomise the frequency and impediment of phantom pain into absent and present influence the outcome of studies by performing a sensitivity analysis on an existing database.

Method:?Five hundred and thirty-six subjects were recruited from the database of an orthopaedic workshop and filled out a questionnaire in which the following items were assessed: demographics, side, date, level and reason of amputation, presence and frequency of phantom sensations, phantom pain and stump pain, and impediment due to phantom pain.

Results:?The prevalence of phantom pain ranged from 7?–?72% when different cut off points for the frequency of phantom pain were applied. The significance of the various risk factors for the prevalence of phantom pain changed when different cut off points were applied. Only stump pain and phantom sensations were significant risk factors for all cut off points. Risk factors for the impediment of phantom pain changed when different cut off points were applied and these risk factors were different from those for the prevalence of phantom pain.

Conclusion:?The choice of cut off points influences the outcome of phantom pain studies considerably. This study provides some insight into the differences in prevalence and risk factors found in literature.     

Facioscapulohumeral muscular dystrophy: epidemiological and molecular study in a north-east Italian population sample

Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant disease associated with a partial deletion on chromosome 4q35. Few relevant investigations have been reported on its epidemiology and were essentially based on clinical diagnosis, having been performed before recognition of the molecular mutation. We report an epidemiological survey on FSHD patients, in which the diagnosis was obtained by combined clinical and molecular evaluation. The survey concerned the north-east Italian province of Padova, an area of 871,190 inhabitants (1 January 2004). We identified 40 patients affected by FSHD based on clinical diagnosis. In 33 of them, the EcoRI fragment size in the 4q35 region ranged from 14 to 35 kb. Four other patients belonging to the same family harbored a 38-kb fragment. In these four cases, the relationship between the borderline deletion with the mild FSHD phenotype was corroborated by additional haplotype reconstruction and segregation analysis. Interestingly, the same mild facial-sparing clinical pattern was apparent only in one other patient with an EcoRI fragment of 32 kb, suggesting that this unusual FSHD phenotype may be due to very small 4q35 deletions. On the whole, estimating a prevalence rate of 44 × 10⁻⁶, our survey confirmed FSHD as one of the most frequent neuromuscular disorders in Western populations.