Headache disorders as risk factors for sleep disturbances in school aged children.

Several epidemiological studies have shown the presence of comorbidity between various types of sleep disorders and different headache subtypes. Migraine without aura is a sensitive risk factor for disorders of initiating and maintaining sleep (odds ratio (OR) 8.2500), and chronic tension-type headache for sleep breathing disorders (OR 15.231), but headache disorder is a cumulative risk factor for disorders of excessive somnolence (OR 15.061). This result has not been reported in the clinical literature. © Springer-Verlag Italia 2005

The added value of whole-body magnetic resonance imaging in the management of patients with advanced breast cancer

This study investigates the impact of whole-body MRI (WB-MRI) in addition to CT of chest-abdomen-pelvis (CT-CAP) and 18F-FDG PET/CT (PET/CT) on systemic treatment decisions in standard clinical practice for patients with advanced breast cancer (ABC). WB-MRI examinations in ABC patients were extracted from our WB-MRI registry (2009-2017). Patients under systemic treatment who underwent WB-MRI and a control examination (CT-CAP or PET/CT) were included. Data regarding progressive disease (PD) reported either on WB-MRI or on the control examinations were collected. Data regarding eventual change in treatment after the imaging evaluation were collected. It was finally evaluated whether the detection of PD by any of the two modalities had induced a change in treatment. Among 910 WB-MRI examinations in ABC patients, 58 had a paired control examination (16 CT-CAP and 42 PET/CT) and were analysed. In 23/58 paired examinations, additional sites of disease were reported only on WB-MRI and not on the control examination. In 17/28 paired examinations, PD was reported only on WB-MRI and not on the control examination. In 14 out of the 28 pairs of examinations that were followed by a change in treatment, PD had been reported only on WBMRI (14/28; 50%), while stable disease had been reported on the control examination

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Melatonin, 3 mg, is effective for migraine prevention also in school-aged patients

Hypothalamic dysfunction may be present in migraine and in circadian periodicity of headache attacks, more specifically, the suprachiasmatic nucleus and melatonin have been suggested to play a role in the pathogenesis [1]. Altered melatonin levels have been found in cluster headache, migraine with and without aura, menstrual migraine, and chronic migraine. Melatonin may have many metabolic effects, such as anti-inflammatory effects (melatonin and indomethacin share similar chemical structure), reducing the up-regulation of proinflammatory cytokines, and inhibiting nitric oxide synthase activity and dopamine release. Melatonin administration is thus a possible candidate for migraine prevention [2]. Objective The aim of this open trial was to test the hypothesis of the potential effectiveness of melatonin for migraine prophylaxis also in school-aged children. Patients and methods We performed an open-label trial of melatonin, 3 mg, for migraine prevention. Twenty-three patients (11 M, 12 F) aged 6–15 years (mean 12.8 years, SD±1.38) with episodic migraine with or without aura according to ICHD-II 2004 criteria, were screened for the baseline period. All patients started prophylactic treatment with melatonin, 3 mg, 10 minutes before bedtime for 3 months. A complete clinical interview and examination as well neurophysiological recordings (wake and sleep EEG) were performed for each patient. Study participants experienced between two and six attacks per month. Exclusion criteria included the presence of sleep disorders, as confirmed by the mothers of all subjects who filled out the Sleep Disturbances Scale for Children [SDSC]. The SDSC is a sleep questionnaire that consists of 26 items subdivided into 6 sleep disorder subscales according to American Sleep Disorders Association criteria: DIMS (disorders in initiating and maintaining sleep), SDB (sleep disordered breathing), DA (disorders of arousal), SWTD (sleep-wake transition disorders), DES (disorders of excessive somnolence), SHY (sleep hyperhydrosis). Results Twenty out of 23 patients completed the study (86.95%). That patients (85%, 17/20) who completed the study had at least a 50% reduction in intensity and frequency of headache attacks. Nobody reported an increase in headache frequency. Complete (100%) response was achieved in 12 patients (60%) and no adverse effects were recorded. Conclusions There is increasing evidence to indicate that the hypothalamus plays a major role in the pathophysiology of several of the primary headache disorders, such as migraine, and hypnic headache [1, 2]. Melatonin, an indole compound derived from serotonin, was reported safe and effective in adult patients [2], but no data were available for school-aged children. This is an original study to assess melatonin, 3 mg, for prophylactic treatment of headache also in childhood

Headache disorders as risk factors for sleep disturbances in school-aged children.

Several epidemiological studies have shown the presence of comorbidity between various types of sleep disorders and different headache subtypes. Migraine without aura is a sensitive risk factor for disorders of initiating and maintaining sleep (odds ratio (OR) 8.2500), and chronic tension-type headache for sleep breathing disorders (OR 15.231), but headache disorder is a cumulative risk factor for disorders of excessive somnolence (OR 15.061). This result has not been reported in the clinical literature. © Springer-Verlag Italia 2005

Headache disorders as risk factors for sleep disturbances in school aged children

Several epidemiological studies have shown the presence of comorbidity between various types of sleep disorders and different headache subtypes. Migraine without aura is a sensitive risk factor for disorders of initiating and maintaining sleep (odds ratio (OR) 8.2500), and chronic tension-type headache for sleep breathing disorders (OR 15.231), but headache disorder is a cumulative risk factor for disorders of excessive somnolence (OR 15.061). This result has not been reported in the clinical literature