Copper deficiency-associated myelopathy in cryptogenic hyperzincemia: A case report

Copper deficiency syndrome is an underestimated cause of posterior myelitis. We describe the case of a 41-year-old woman, who developed a subacute ataxic paraparesis associated with low back pain. Her 3T spine MRI showed a thin hyperintense FS-Echo T2 longitudinally extensive lesion involving the posterior columns of the cervical cord (from C2 to C6). An extensive diagnostic work-up excluded other causes of myelopathy and blood tests pointed out hypocupremia and mild hyperzincemia. Patients affected by this rare form of oligoelement deficiency typically develop progressive posterior column dysfunction with sensory ataxia and spasticity, sometimes associated with sensori-motor polyneuropathy. Clinical and radiological characteristics of posterior myelopathy due to copper deficiency are briefly reviewed. Physicians should be aware of this condition since a prompt introduction of copper supplementation can avoid progression of the neurological damage. (www.actabiomedica.it)

Genetics of Menstrual Migraine: The Epidemiological Evidence

Approximately one of every three to five women with migraine without aura experience migraine attacks in relation to menstruation. The International Classification of Headache Disorders, 2nd Edition provides appendix diagnoses for pure and menstrually related migraine without aura that need further validation. Probands with menstrual migraine might have more affected relatives than probands with nonmenstrual migraine. However, precise epidemiological, family, and twin data still are lacking

Italian guidelines for primary headache: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105-190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedic

Evolution of migraine-associated symptoms in menstrually related migraine following symptomatic treatment with almotriptan

In addition to headache, migraine is characterized by a series of symptoms that negatively affects the quality of life of patients. Generally, these are represented by nausea, vomiting, photophobia, phonophobia and osmophobia, with a cumulative percentage of the onset in about 90% of the patients. From this point of view, menstrually related migraine—a particularly difficult-to-treat form of primary headache—is no different from other forms of migraine. Symptomatic treatment should therefore be evaluated not only in terms of headache relief, but also by considering its effect on these migraine-associated symptoms (MAS). Starting from the data collected in a recently completed multicentre, randomized, double-blind, placebo-controlled, cross-over study with almotriptan in menstrually related migraine, an analysis of the effect of this drug on the evolution of MAS was performed. Data suggest that almotriptan shows excellent efficacy on MAS in comparison to the placebo, with a significant reduction in the percentages of suffering patients over a 2-h period of time

Study of single muons with the Large Volume Detector at Gran Sasso Laboratory

The present study is based on the sample of about 3 mln single muons observed by LVD at underground Gran Sasso Laboratory during 36500 live hours from June 1992 to February 1998. We have measured the muon intensity at slant depths from 3 km w.e. to 20 km w.e. Most events are high energy downward muons produced by meson decay in the atmosphere. The analysis of these muons has revealed the power index of pion and kaon spectrum: 2.76 \pm 0.05. The reminders are horizontal muons produced by the neutrino interactions in the rock surrounding LVD. The value of this flux is obtained. The results are compared with Monte Carlo simulations and the world data.Comment: 13 pages, 2 figures, accepted for publication in "Physics of Atomic Nuclei

Headache and migraine during pregnancy and puerperium: the MIGRA-study

There is little prospectively gathered data on the course of headaches during pregnancy and postpartum, and the influence of breastfeeding is unclear. This is a large, prospective study, which invited all pregnant women in the catchment area during a defined period. All participants (n = 2,126) filled in questionnaires concerning headache. Among these, a total of 208 women with migraine according to the International Headache Society criteria also filled in detailed headache diaries during pregnancy and the puerperal period. Freedom from earlier headaches during pregnancy was significantly more common than new onset of headache during pregnancy (p < 0.001). This was not influenced by prior use of oral contraceptives. According to the diaries, there was a gradual decrease during pregnancy in the frequency of all headaches and of self-considered migraine. There was also a significant decrease in the duration of headaches (p < 0.001) during pregnancy compared to before. Earlier parity did not influence the course. Apart from a significant increase during the first week postpartum (p < 0.01), the overall occurrence of headaches during puerperium did not differ from the pregnancy period. Compared to pregnancy, there was a postpartum increase in the mean intensity (p < 0.01) and duration (p = 0.050) of headaches, as well as in the mean number of analgesics used (p < 0.001). Breastfeeding did not influence the occurrence of headaches postpartum. These data are of practical value for informing pregnant migraineurs about the typical clinical prospects and for giving advice on breastfeeding

Muon `Depth -- Intensity' Relation Measured by LVD Underground Experiment and Cosmic-Ray Muon Spectrum at Sea Level

We present the analysis of the muon events with all muon multiplicities collected during 21804 hours of operation of the first LVD tower. The measured angular distribution of muon intensity has been converted to the `depth -- vertical intensity' relation in the depth range from 3 to 12 km w.e.. The analysis of this relation allowed to derive the power index, $\gamma$, of the primary all-nucleon spectrum: $\gamma=2.78 \pm 0.05$. The `depth -- vertical intensity' relation has been converted to standard rock and the comparison with the data of other experiments has been done. We present also the derived vertical muon spectrum at sea level.Comment: 7 pages, 3 figures, to be published on Phys. Rev.

Upper Limit on the Prompt Muon Flux Derived from the LVD Underground Experiment

We present the analysis of the muon events with all muon multiplicities collected during 21804 hours of operation of the first LVD tower. The measured depth-angular distribution of muon intensities has been used to obtain the normalization factor, A, the power index, gamma, of the primary all-nucleon spectrum and the ratio, R_c, of prompt muon flux to that of pi-mesons - the main parameters which determine the spectrum of cosmic ray muons at the sea level. The value of gamma = 2.77 +/- 0.05 (68% C.L.) and R_c < 2.0 x 10^-3 (95% C.L.) have been obtained. The upper limit to the prompt muon flux favours the models of charm production based on QGSM and the dual parton model.Comment: 10 pages, 4 figures, RevTex. To appear in Phys. Rev.

Are Menstrual and Nonmenstrual Migraine Attacks Different?

Migraine is the second most common headache condition next to tension-type headache. Up to one fourth of all women have migraine, and 20% of them experience migraine without aura attack in at least two thirds of their menstrual cycles. The current literature is analyzed in response to the question of whether menstrual and nonmenstrual migraine attacks are different. The different studies provide conflicting results, so it is not possible to answer the question firmly. Future studies should be based on the general population. Collection of both prospective and retrospective data is warranted, and headache diagnosis base on interviews by physicians with interest in headache are more precise than lay interviews or questionnaires