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

Sumatriptan nasal spray safety and effectiveness in migraine with aura adolescents

Background and aims Migraine is a common cause of headache among late childhood and adolescence and is the most common cause of severe, recurrent headaches up in 15–19 ys, with a great impairment on quality of life, sociality and school performances. In 2004, Italian Health Ministry rules triptans use in adolescent age. Aims study is assessing safety and effectiveness of Sumatriptan nasal spray in Migraine with Aura adolescent. Methods According to IHS 2004 criteria, 24 migraine with Aura (MA) patients (M/F 13/11) aged 12–17 ys (mean 13.4 SD±1.48), were selected in Headache Centre of Child and Adolescents Neuropsychiatry Department in Naples, between February 2003 and September 2004. Monthly frequency migraine attacks were 3 to 7. All patients were non responders at analgesics and NSAIDs. Standard neurological and clinical laboratory tests, EEG wake and sleep recordings, electrocardiograms, and nasal examinations were performed at first clinic visit. Patients presented visual aura in 42.85%, limbs parestesia 28.57%, and arms hyposthenia 28.57%. Before and after treatment of each migraine, patients scored pain on a four-point scale (0=none; 1=mild; 2=moderate; 3=severe). Results The success of individual Sumatriptan clinical administration appears related to time to treatment, with resolution pain time in 10 minutes for 64.58% and in 30 minutes for 35.42%. Overall, triptan tolerability in adolescents is similar to that reported in adults. The most common specific drug-related adverse event was unpleasant taste, which was reported in 37.58% of patients and epistaxis in 12.52%. Mean scored value pain after treatment with Sumatriptan was 0.75 (SD±0.8) vs 2.89 (SD±1.24) (p=0.000). Conclusions Triptans (selective 5-hydroxytryptamine1B/1D serotonin agonists) are a new class of agents used in the treatment of migraine. Study results suggest that Sumatripatn nasal spray may effectively alleviate migraine in adolescents MA patients