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1.
Cephalalgia ; 44(5): 3331024241248211, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38729773

RESUMO

OBJECTIVE: To investigate the role of NN414, a selective KATP channel opener for the Kir6.2/SUR1 channel subtype found in neurons and ß-pancreatic cells, in inducing migraine attacks in individuals with migraine without aura. METHODS: Thirteen participants were randomly allocated to receive NN414 and placebo on two days separated by at least one week. The primary endpoint was the difference in the incidence of migraine attacks after NN414 compared with placebo. The secondary endpoints were the difference in the area under the curve for headache intensity scores, middle cerebral artery blood flow velocity (VMCA), superficial temporal artery diameter, heart rate and mean arterial pressure. RESULTS: Twelve participants completed the study, with two (16.6%) reporting migraine attacks after NN414 compared to one (8.3%) after placebo (p = 0.53). The area under the curve for headache intensity, VMCA, superficial temporal artery diameter, heart rate and mean arterial pressure did not differ between NN414 and placebo (p > 0.05, all comparisons). CONCLUSION: The lack of migraine induction upon activation of the Kir6.2/SUR1 channel subtype suggests it may not contribute to migraine pathogenesis. Our findings point to KATP channel blockers that target the Kir6.1/SUR2B subtype, found in cerebral vasculature, as potential candidates for innovative antimigraine treatments.Registration number: NCT04744129.


Assuntos
Canais KATP , Transtornos de Enxaqueca , Humanos , Feminino , Adulto , Masculino , Canais KATP/metabolismo , Método Duplo-Cego , Transtornos de Enxaqueca/metabolismo , Adulto Jovem , Pessoa de Meia-Idade , Benzamidas/farmacologia , Benzamidas/uso terapêutico , Piridinas/farmacologia , Piperidinas
2.
Cephalalgia ; 44(8): 3331024241271976, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39161218

RESUMO

BACKGROUND: To synthesize the available epidemiologic data on short-lasting unilateral neuralgiform headache attacks (SUNHA). This, in turn, might inform diagnostic work-up and clinical decision-making. METHODS: EMBASE and PubMed were searched for observational studies reporting on the prevalence or relative frequency of SUNHA or its individual clinical features. Two investigators independently conducted title and abstract screening, full-text review, data extraction, and risk of bias assessment, and random-effects meta-analyses were performed to estimate the prevalence or relative frequency of SUNHA and its individual clinical features. RESULTS: Fifteen clinic-based studies met our eligibility criteria. Of these, five studies reported estimates on the relative frequency of SUNHA among adults evaluated for headache or facial pain, yielding a pooled relative frequency as 0.32% (95% confidence interval = 0.17-0.62; I2 = 89.9%). Most often, SUNHA presented as episodic, side-locked stabbing headache of severe pain intensity, predominantly affecting the ophthalmic and/or maxillary branch of the trigeminal nerve. The most common cranial autonomic features were lacrimation, conjunctival injection, rhinorrhea and nasal congestion. CONCLUSIONS: SUNHA is a rare headache disorder with distinct clinical features. However, our findings must be interpreted with caution as a result of between-study heterogeneity and lack of population-based studies, underscoring the need for further epidemiologic research.


Assuntos
Humanos , Prevalência
3.
Cephalalgia ; 44(1): 3331024231222916, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38181724

RESUMO

BACKGROUND: The present study aimed to investigate whether levcromakalim, a KATP channel opener, induces migraine attacks in people with migraine pre-treated with erenumab, a monoclonal CGRP receptor antibody. METHODS: In this double-blind, placebo-controlled, two-way cross-over study, adults with migraine without aura received a subcutaneous injection of 140 mg of erenumab on day 1. Subsequently, they were randomized to receive a 20-minute infusion of 0.05 mg/ml levcromakalim or placebo on two experimental days separated by at least one week (between days 8 and 21). The primary endpoint was the difference in the incidence of migraine attacks between levcromakalim and placebo during the 12-hour post-infusion period. RESULTS: In total, 16 participants completed the study. During the 12-hour observation period, 14 (88%) of 16 participants experienced migraine attacks after levcromakalim, compared to two (12%) after placebo (p < 0.001). The area under the curve for median headache intensity was greater after levcromakalim than placebo (p < 0.001). Levcromakalim elicited dilation of the superficial temporal artery during the first hour after infusion, a response absent following placebo (p < 0.001). CONCLUSIONS: The induction of migraine attacks via opening of KATP channels appears independent of CGRP receptor activation.Trial Registration: ClinicalTrials.gov, Identifier NCT05889442.


Assuntos
Canais KATP , Transtornos de Enxaqueca , Adulto , Humanos , Receptores de Peptídeo Relacionado com o Gene de Calcitonina , Cromakalim , Estudos Cross-Over , Transtornos de Enxaqueca/induzido quimicamente , Anticorpos Monoclonais , Trifosfato de Adenosina
4.
Cephalalgia ; 44(1): 3331024231222915, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38215232

RESUMO

BACKGROUND: The present study investigates the wearing-off effect in adults with chronic migraine treated with erenumab or fremanezumab. METHODS: This real-world observational study was based on pre-collected headache diaries from chronic migraine patients in treatment with either monthly injections of 140 mg of erenumab or 225 mg of fremanezumab. Consistent wearing-off was defined as an increase of ≥2 weekly migraine days in the last week compared to the second week over two consecutive 4-week treatment periods. The primary endpoint was wearing-off in the total population. The secondary endpoints were difference in wearing-off in (i) a subgroup of patients treated with erenumab and fremanezumab and (ii) consistent wearing-off in patients with a ≥30% reduction in monthly migraine days, compared to baseline, in the two consecutive treatment months. RESULTS: In total, 100 patients (erenumab: n = 60, fremanezumab: n = 40) were included. Sixty-two out of 100 (62%) patients had consistent ≥30% treatment response on antibody therapy in both months (erenumab: n = 36, fremanezumab: n = 26). There was no consistent wearing-off over the two consecutive months from week 2 to week 4 (3.04%, p = 0.558). There was no wearing-off within the erenumab (p = 0.194) or the fremanezumab (p = 0.581) groups. Among the ≥30% treatment responders, there was no consistent wearing-off over the two consecutive months (2.6%, p = 0.573). CONCLUSIONS: There was no wearing-off in treatment responders, which is in alignment with premarketing data from placebo-controlled phase III studies. These data suggest that patients should be informed upfront that no wearing-off effect is expected because anxiety for attacks at the end of the month per se may generate migraine attacks.


Assuntos
Anticorpos Monoclonais Humanizados , Anticorpos Monoclonais , Transtornos de Enxaqueca , Adulto , Humanos , Resultado do Tratamento , Método Duplo-Cego , Transtornos de Enxaqueca/prevenção & controle
5.
Cephalalgia ; 44(2): 3331024231223979, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38299579

RESUMO

BACKGROUND: Estimates of proportions of people with migraine who report premonitory symptoms vary greatly among previous studies. Our aims were to establish the proportion of patients reporting premonitory symptoms and its dependency on the enquiry method. Additionally, we investigated the impact of premonitory symptoms on disease burden using Headache Impact Test (HIT-6), Migraine Disability Assessment (MIDAS) and World Health Organization Disability Assessment 2.0 (WHODAS 2.0), whilst investigating how various clinical factors influenced the likelihood of reporting premonitory symptoms. METHODS: In a cross-sectional study, premonitory symptoms were assessed among 632 patients with migraine. Unprompted enquiry was used first, followed by a list of 17 items (prompted). Additionally, we obtained clinical characteristics through a semi-structured interview. RESULTS: Prompted enquiry resulted in a greater proportion reporting premonitory symptoms than unprompted (69.9% vs. 43.0%; p < 0.001) and with higher symptom counts (medians 2, interquartile range = 0-6 vs. 1, interquartile range = 0-1; p < 0.001). The number of symptoms correlated weakly with HIT-6 (ρ = 0.14; p < 0.001) and WHODAS scores (ρ = 0.09; p = 0.041). Reporting postdromal symptoms or triggers increased the probability of reporting premonitory symptoms, whereas monthly migraine days decreased it. CONCLUSIONS: The use of a standardized and optimized method for assessing premonitory symptoms is necessary to estimate their prevalence and to understand whether and how they contribute to disease burden.


Assuntos
Transtornos de Enxaqueca , Humanos , Estudos Transversais , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia , Cefaleia , Fotofobia/epidemiologia , Prevalência
6.
Cephalalgia ; 44(6): 3331024241258734, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38859744

RESUMO

BACKGROUND: The present study aimed to investigate the predictive value of calcitonin gene-related peptide (CGRP)-induced migraine attacks for effectiveness to erenumab treatment in people with migraine. METHODS: In total, 139 participants with migraine underwent a single experimental day involving a 20-min infusion with CGRP. Following this, the participants entered a 24-week treatment period with erenumab. The primary endpoints were the predictive value of CGRP-induced migraine attacks on the effectiveness of erenumab, defined as ≥50% reduction in monthly migraine days, or ≥ 50% reduction in either monthly migraine or monthly headache days of moderate to severe intensity. RESULTS: Among participants with CGRP-induced migraine attacks, 60 of 99 (61%) achieved ≥50% reduction in monthly migraine days during weeks 13-24 with erenumab. Conversely, 13 of 25 (52%) where CGRP infusion did not induce a migraine achieved the same endpoint (p = 0.498). There were no significant differences between the ≥50% reduction in either monthly migraine or monthly headache days of moderate to severe intensity between CGRP-sensitive and non-sensitive participants (p = 0.625). CONCLUSIONS: Our findings suggest that the CGRP-provocation model cannot be used to predict erenumab's effectiveness. It remains uncertain whether this finding extends to other monoclonal antibodies targeting the CGRP ligand or to gepants.Trial Registration: The study was registered at ClinicalTrials.gov (NCT04592952).


Assuntos
Anticorpos Monoclonais Humanizados , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina , Peptídeo Relacionado com Gene de Calcitonina , Transtornos de Enxaqueca , Transtornos de Enxaqueca/prevenção & controle , Humanos , Anticorpos Monoclonais Humanizados/uso terapêutico , Masculino , Feminino , Adulto , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina/uso terapêutico , Pessoa de Meia-Idade , Biomarcadores , Método Duplo-Cego , Valor Preditivo dos Testes
7.
Headache ; 64(5): 509-515, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38646979

RESUMO

OBJECTIVE: In this retrospective cross-sectional real-world evidence study from the Danish Headache Center (DHC), a national tertiary headache center in Denmark, we sought to identify potential pharmacological agents for the treatment of new daily persistent headache (NDPH). BACKGROUND: NDPH is an enigmatic headache disorder with abrupt onset and chronic duration for which evidence-based treatments are lacking. NDPH is a diagnosis of exclusion, for which secondary headaches must be ruled out and the etiology remains idiopathic. The sparse investigations of this disorder have not yielded a pathophysiological basis and no effective treatment for NDPH has been found. METHODS: All patients with an NDPH diagnosis at the DHC were enrolled (n = 64). First, we reviewed the records of all patients with an NDPH diagnosis to evaluate whether they fulfilled the diagnostic criteria. Next, we extracted all the trialled acute and prophylactic pharmacological interventions for the included patients. Then, pharmacological interventions that had been tried in ≥ 20 patients were analyzed post hoc with efficacy as the outcome, which was stratified in five effect categories ("no effect," "partial effect," "full effect," "partial effect and cessation due to adverse events," and "full effect and cessation due to adverse events"). Descriptive statistical analysis was performed, and the results were schematically presented (see Table 2). RESULTS: Fifty-one patients out of 64 were found to fulfill NDPH criteria and were included in the study. The drugs tried by ≥ 20 patients were amitriptyline (n = 34), candesartan (n = 27), and mirtazapine (n = 20). No patients experienced a complete effect with these drugs while 9% (3/34), 26% (7/27), and 15% (3/20) experienced a partial effect with no adverse events that led to treatment discontinuation, respectively. The remaining patients experienced either no effect or a partial effect with adverse events leading to treatment discontinuation. CONCLUSION: In this study we add real-world evidence to suggest that prophylactic drugs conventionally used for treating chronic migraine and chronic tension-type headache have limited utility for treating NDPH; however, a partial response in 26% of patients using candesartan and 15% of patients using mirtazapine warrants further investigation in randomized double-blinded placebo-controlled trials.


Assuntos
Transtornos da Cefaleia , Centros de Atenção Terciária , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Transtornos da Cefaleia/tratamento farmacológico , Adulto , Estudos Transversais , Dinamarca , Idoso
8.
Headache ; 64(1): 5-15, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38205903

RESUMO

OBJECTIVE: To assess the prevalence or relative frequency of paroxysmal hemicrania and its clinical features in the adult general population and among adult patients evaluated for headache in tertiary care. BACKGROUND: Paroxysmal hemicrania is a rare trigeminal autonomic cephalalgia with characteristic attacks of headache, associated cranial autonomic symptoms and signs, and an absolute response to indomethacin. Its epidemiological burden remains unknown in both the adult general population and among adult patients evaluated for headache in a tertiary care setting. Moreover, the frequencies of the clinical features associated with paroxysmal hemicrania have not been well established. METHODS: A literature search of PubMed and Embase was conducted from January 1, 1988, to January 20, 2023. Eligible for inclusion were observational studies reporting the point prevalence or relative frequency of paroxysmal hemicrania or its clinical features in the adult general population or among adult patients evaluated for headache in tertiary care. Two independent investigators (M.J.H. and J.G.L.) performed the title, abstract, and full-text article screening. Each included study's risk of bias was critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Estimates of prevalence or relative frequency were calculated using a random-effects meta-analysis. The between-study heterogeneity was assessed using the I2 statistic and further explored with meta-regression. This study was pre-registered on PROSPERO (identifier: CRD42023391127). RESULTS: A total of 17 clinic-based studies and one population-based study met the eligibility criteria. Importantly, an overall high risk of bias was observed across the eligible studies. The relative frequency of paroxysmal hemicrania was estimated to be 0.3% (95% CI, 0.2%-0.5%) among adult patients evaluated for headache in tertiary care with considerable heterogeneity (I2 = 76.4%). No cases with paroxysmal hemicrania were identified among 1,838 participants in a population-based sample. Moreover, the most prevalent cranial autonomic symptoms were lacrimation (77.3% [95% Cl, 62.7%-87.3%]), conjunctival injection (75.0% [95% Cl, 60.3%-85.6%]), and nasal congestion (47.7% [95% Cl, 33.6%-62.3%]). CONCLUSIONS: Our findings suggest that paroxysmal hemicrania is a rare disorder among adults evaluated for headache in tertiary care, while its prevalence in the general population remains unknown. Further studies focusing on the clinical features of paroxysmal hemicrania are warranted.


Assuntos
Hemicrania Paroxística , Humanos , Cefaleia , Indometacina , Hemicrania Paroxística/diagnóstico , Hemicrania Paroxística/tratamento farmacológico , Hemicrania Paroxística/epidemiologia
9.
Mol Biol Rep ; 51(1): 501, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38598057

RESUMO

BACKGROUND: Dendrocalamus strictus (Roxb.) Nees, generally referred to as 'Male bamboo,' is a globally prevalent and highly significant species of bamboo. It is a versatile species and possesses notable industrial significance. However, despite its numerous applications, the production of this plant is insufficient to fulfill the worldwide demand. The challenges that impede the dissemination of D. strictus encompass the unpredictable blooming pattern (30-70 years), low seed production, and limited seed viability. Therefore, tissue culture presents a reliable and effective option for the mass production of standardized planting material. METHODOLOGY AND RESULTS: This study investigated the effects of silver nanoparticles (AgNPs) at a concentration of 6.0 mg L- 1 in the Murashige and Skoog (MS) nutrient medium fortified with pre-optimized plant growth regulators (3.0 mg L- 1 6-benzylaminopurine + 0.5 mg L- 1 α-naphthalene acetic acid) on the induction of flowering in a controlled environment in D. strictus. The use of AgNPs in the media induced a maximum of 14 inflorescences per culture vessel, 9 flowers per inflorescence, and improved the performance of the micropropagated plantlets during acclimatization in the greenhouse and field. The ISSR and SCoT amplified polymorphic DNA analysis of the regenerants resulted in the formation of 49 bands (300 to 2000 bp size) and 36 scorable bands (350 to 2000 bp) respectively. All the PCR amplicons produced by SCoT and ISSR were monomorphic confirming the genetic uniformity of the tissue cultured plants of D. strictus with the mother plant. CONCLUSIONS: It can be inferred that the incorporation of AgNPs during the shoot proliferation phase has the potential to stimulate in vitro flowering in D. strictus. This finding could provide valuable insights into innovative strategies for enhancing crop productivity and genetic manipulation for accelerated breeding and agricultural advancement.


Assuntos
Nanopartículas Metálicas , Prata/farmacologia , Melhoramento Vegetal , Biomarcadores , Aclimatação
10.
J Headache Pain ; 25(1): 22, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38350851

RESUMO

BACKGROUND: About one-third of persons with migraine experience transient neurologic symptoms, referred to as aura. Despite its widespread prevalence, comprehensive clinical descriptions of migraine with aura remain sparse. Therefore, we aimed to provide an in-depth phenotypic analysis of aura symptoms and characteristics in a cross-sectional study of a large sample of adults diagnosed with migraine with aura. METHODS: Data were extracted from the baseline characteristics of participants in the Registry for Migraine (REFORM) study - a single-center, prospective, longitudinal cohort study. Participants were adults diagnosed with migraine aura, reporting ≥ 4 monthly migraine days in the preceding 3 months. Trained personnel conducted in-person semi-structured interviews, capturing details on the nature, duration, localization, and progression of individual aura symptoms. RESULTS: Of the 227 enrolled participants with migraine with aura, the mean age was 41.1 years, with a predominant female representation (n = 205 [90.3%]). Visual aura was present in 215 (94.7%) participants, somatosensory aura in 81 (35.7%), and speech and/or language aura in 31 (13.7%). A single type of aura was observed in 148 (65.2%) participants, whilst 79 (34.8%) reported multiple aura types. Most participants (n = 220 [96.9%]) described their aura symptoms as positive or gradually spreading. Headache in relation to aura was noted by 218 (96.0%) participants, with 177 (80.8%) stating that the onset of aura symptoms preceded the onset of headache. CONCLUSIONS: This study offers a detailed clinical depiction of persons with migraine with aura, who were predominantly enrolled from a tertiary care unit. The findings highlight potential gaps in the available literature on migraine with aura and should bolster clinicians' acumen in diagnosing migraine with aura in clinical settings.


Assuntos
Epilepsia , Transtornos de Enxaqueca , Enxaqueca com Aura , Adulto , Humanos , Feminino , Enxaqueca com Aura/diagnóstico , Enxaqueca com Aura/epidemiologia , Estudos Transversais , Estudos Prospectivos , Estudos Longitudinais , Cefaleia/epidemiologia , Sistema de Registros
11.
Heliyon ; 10(9): e29822, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38699045

RESUMO

We propose a single material microstructured optical fiber with more than five octave spanning supercontinuum generation. Due to using single material, compatibility checking between core and cladding material need not required. Moreover, the material is such chosen that optical transmission range is quite high in comparison to others. The fiber is designed in COMSOL platform and according to finite element method (FEM), numerical analysis is accomplished. Dispersion, confinement loss, nonlinearity etc. are investigated and exposed for a wavelength range of 2000-3000 nm. The proposed fiber reveals zero dispersion at 2200 nm, nonlinearity of 14,370 W-1km-1 and confinement loss around 10-9 order in dB/m. Finally, supercontinuum generation has been investigated inside the structure and obtained high coherence that span (from 1500 nm to 34,500 nm) over five octave. The generated spectrum fulfills the requirements for being applicable in frequency metrology, fiber laser and biophotonics. With the best of our knowing, such coherent and widened supercontinuua for single material fiber is yet to be proposed.

12.
Plant Physiol Biochem ; 212: 108722, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38761543

RESUMO

The escalating influence of environmental changes has heightened the physiological challenges faced by plants, with drought stress increasingly recognized as a critical global issue significantly impeding affecting the crop productivity. This study investigates the effectiveness of metal nano particles such as zinc oxide nanoparticles (ZnO NPs) and silver nanoparticles (Ag NPs) in mitigating drought stress in Solanum lycopersicum. The foliar application of ZnO NPs (500 ppm) and/or Ag NPs (500 ppm), individually or in combination, significantly alleviated drought stress-induced. This mitigation was evidenced by enhanced antioxidant enzymes activity viz., catalase (64%), peroxidase (76%), superoxide dismutase (78%), chlorophyll content (31%) & photosynthesis (37%), and protein levels (15%). Furthermore, ZnO NPs and Ag NPs effectively mitigated oxidative stress and lipid peroxidation, as evidence by reduced accumulation of malondialdehyde (11%). Remarkably, the combined application of ZnO NPs and Ag NPs expedited the water-splitting capacity and facilitated electron exchange through redox reactions under drought stress. Consequently, these enhancements positively influenced the morpho-physiological characteristics such as height (28%), fresh weight (31%), dry weight (29%) and net photosynthetic rate (37%) of S. lycopersicum. These findings underscore the promising potential of metal NPs, such as ZnO NPs and Ag NPs, in mitigating drought stress, offering valuable insights for sustainable crop production amidst evolving environmental challenges.


Assuntos
Secas , Nanopartículas Metálicas , Estresse Oxidativo , Prata , Solanum lycopersicum , Óxido de Zinco , Óxido de Zinco/farmacologia , Óxido de Zinco/química , Prata/farmacologia , Solanum lycopersicum/efeitos dos fármacos , Solanum lycopersicum/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Nanopartículas Metálicas/química , Fotossíntese/efeitos dos fármacos , Antioxidantes/metabolismo , Clorofila/metabolismo , Superóxido Dismutase/metabolismo
13.
Sci Rep ; 14(1): 18068, 2024 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-39103416

RESUMO

Physical activity can worsen migraine, leading to reduced activity levels in adults with chronic migraine. This study investigated the change in average steps per day, as a surrogate marker of physical activity, in adults with chronic migraine successfully treated with monoclonal antibodies against calcitonin gene-related peptide or its receptor. Data were obtained from adults with chronic migraine, who were classified as responders to preventive treatment with monoclonal antibodies. The primary endpoint was the difference in a mean number of steps per day between the 3 months prior to treatment initiation and the first 3 months after treatment initiation. The secondary endpoint was the correlation between the change in steps per day and the change in monthly migraine days. Twenty-two (20 females) participants with a median age of 48.5 years were enrolled. The median number of steps per day increased from 4421 at baseline to 5241 after treatment (P = 0.039). We found a positive correlation between the increase in steps per day and the treatment response (P = 0.013). In conclusion, an increase in physical activity, based on steps per day, positively correlated with treatment response to monoclonal antibodies. Automatically registered daily step count data might be used to monitor physical activity as a response to preventive treatment in adults with chronic migraine.


Assuntos
Anticorpos Monoclonais , Peptídeo Relacionado com Gene de Calcitonina , Transtornos de Enxaqueca , Humanos , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/imunologia , Feminino , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Peptídeo Relacionado com Gene de Calcitonina/imunologia , Adulto , Anticorpos Monoclonais/uso terapêutico , Doença Crônica , Resultado do Tratamento , Biomarcadores , Exercício Físico
14.
Pain ; 165(6): 1289-1303, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38127692

RESUMO

ABSTRACT: Activation of adenosine triphosphate-sensitive potassium (K ATP ) channels has been implicated in triggering migraine attacks. However, whether the opening of these channels provoke cluster headache attacks remains undetermined. The hallmark of cluster headache is a distinct cyclical pattern of recurrent, severe headache episodes, succeeded by intervals of remission where no symptoms are present. In our study, we enrolled 41 participants: 10 with episodic cluster headaches during a bout, 15 in the attack-free remission period, and 17 diagnosed with chronic cluster headaches. Over 2 distinct experimental days, participants underwent a continuous 20-minute infusion of levcromakalim, a K ATP channel opener, or a placebo (isotonic saline), followed by a 90-minute observational period. The primary outcome was comparing the incidence of cluster headache attacks within the postinfusion observation period between the levcromakalim and placebo groups. Six of 10 participants (60%) with episodic cluster headaches in bout experienced attacks after levcromakalim infusion, vs just 1 of 10 (10%) with placebo ( P = 0.037). Among those in the remission phase, 1 of 15 participants (7%) reported attacks after levcromakalim, whereas none did postplacebo ( P = 0.50). In addition, 5 of 17 participants (29%) with chronic cluster headache had attacks after levcromakalim, in contrast to none after placebo ( P = 0.037). These findings demonstrate that K ATP channel activation can induce cluster headache attacks in participants with episodic cluster headaches in bout and chronic cluster headache, but not in those in the remission period. Our results underscore the potential utility of K ATP channel inhibitors as therapeutic agents for cluster headaches.


Assuntos
Cefaleia Histamínica , Cromakalim , Canais KATP , Humanos , Cefaleia Histamínica/tratamento farmacológico , Masculino , Adulto , Feminino , Cromakalim/uso terapêutico , Pessoa de Meia-Idade , Canais KATP/metabolismo , Método Duplo-Cego , Adulto Jovem
15.
Neurology ; 102(9): e209305, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38630960

RESUMO

BACKGROUND AND OBJECTIVES: Structural imaging can offer insights into the cortical morphometry of migraine, which might reflect adaptations to recurring nociceptive messaging. This study compares cortical morphometry between a large sample of people with migraine and healthy controls, as well as across migraine subtypes. METHODS: Adult participants with migraine and age-matched and sex-matched healthy controls attended a single MRI session with magnetization-prepared rapid acquisition gradient echo and fluid-attenuated inversion recovery sequences at 3T. Cortical surface area, thickness, and volume were compared between participants with migraine (including subgroups) and healthy controls across the whole cortex within FreeSurfer and reported according to the Desikan-Killiany atlas. The analysis used cluster-determining thresholds of p < 0.0001 and cluster-wise thresholds of p < 0.05, adjusted for age, sex, and total intracranial volume. RESULTS: A total of 296 participants with migraine (mean age 41.6 years ± 12.4 SD, 261 women) and 155 healthy controls (mean age 41.1 years ± 11.7 SD, 133 women) were included. Among the participants with migraine, 180 (63.5%) had chronic migraine, 103 (34.8%) had migraine with aura, and 88 (29.7%) experienced a migraine headache during the scan. The total cohort of participants with migraine had reduced cortical surface area in the left insula, compared with controls (p < 0.0001). Furthermore, participants with chronic migraine (n = 180) exhibited reduced surface area in the left insula (p < 0.0001) and increased surface area in the right caudal anterior cingulate cortex (p < 0.0001), compared with controls. We found no differences specific to participants with aura or ongoing migraine headache. Post hoc tests revealed a positive correlation between monthly headache days and surface area within the identified anterior cingulate cluster (p = 0.014). DISCUSSION: The identified cortical changes in migraine were limited to specific pain processing regions, including the insula and caudal anterior cingulate gyrus, and were most notable in participants with chronic migraine. These findings suggest persistent cortical changes associated with migraine. TRIAL REGISTRATION INFORMATION: The REFORM study (clinicaltrials.gov identifier: NCT04674020).


Assuntos
Transtornos de Enxaqueca , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Giro do Cíngulo , Cefaleia , Imageamento por Ressonância Magnética/métodos , Sistema de Registros
16.
Int J Immunopathol Pharmacol ; 38: 3946320231220178, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38233742

RESUMO

OBJECTIVES: Crocin, the principal water-soluble active constituent of saffron, possesses numerous pharmacological activities. The present investigation examined the potential antidiabetic and antioxidant characteristics of Crocin in rats with type-2 diabetes by administering it orally and intraperitoneally (i.p.). METHODS: After 2 weeks of a high-fat diet, streptozotocin (STZ) (i.p., 40 mg/kg) was administered to male adult rats to induce type-2 diabetes mellitus. Body weight and fasting blood glucose (FBG) were measured on days zero, weeks 1, and 2. At the end of 2 weeks of drug administration in their respective groups, fasting insulin and glucose levels were estimated, and insulin resistance (HOMA-IR) was determined. Intraperitoneal glucose (IPGTT) and insulin tolerance tests (ITT) were carried out. Histopathological investigation and biochemical parameters were estimated in pancreatic tissues. RESULTS: The Crocin (100 mg/kg) treatment has significantly improved body weight, abatement of FBG, fasting insulin, and HOMA-IR. Likewise, Crocin treatment significantly improved the glucose and insulin challenges. We observed a significantly marked elevation in endogenous antioxidant enzymes in Crocin-treated groups. Similarly, Crocin treatment reversed the histopathological changes and restored the normal integrity and function of the pancreas. CONCLUSION: The overall finding indicates that intraperitoneal administration of Crocin demonstrated better control of glycemic level and body weight. Further, it has improved insulin levels in the serum and potentiated antioxidant properties.


Assuntos
Carotenoides , Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Ratos , Animais , Masculino , Antioxidantes/farmacologia , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Estreptozocina , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/tratamento farmacológico , Ratos Wistar , Dieta Hiperlipídica/efeitos adversos , Diabetes Mellitus Tipo 2/induzido quimicamente , Diabetes Mellitus Tipo 2/tratamento farmacológico , Insulina , Glucose , Peso Corporal , Glicemia
17.
Biol. Res ; 49: 1-13, 2016. ilus, graf
Artigo em Inglês | LILACS | ID: biblio-950847

RESUMO

BACKGROUND: Despite manifold benefits of nanoparticles (NPs), less information on the risks of NPs to human health and environment has been studied. Cobalt oxide nanoparticles (Co3O4-NPs) have been reported to cause toxicity in several organisms. In this study, we have investigated the role of Co3O4-NPs in inducing phytotoxicity, cellular DNA damage and apoptosis in eggplant (Solanum melongena L. cv. Violetta lunga 2). To the best of our knowledge, this is the first report on Co3O4-NPs showing phytotoxicity in eggplant. RESULTS: The data revealed that eggplant seeds treated with Co3O4-NPs for 2 h at a concentration of 1.0 mg/ml retarded root length by 81.5 % upon 7 days incubation in a moist chamber. Ultrastructural analysis by transmission electron microscopy (TEM) demonstrated the uptake and translocation of Co3O4-NPs into the cytoplasm. Intracellular presence of Co3O4-NPs triggered subcellular changes such as degeneration of mitochondrial cristae, abundance of peroxisomes and excessive vacuolization. Flow cytometric analysis of Co3O4-NPs (1.0 mg/ml) treated root protoplasts revealed 157, 282 and 178 % increase in reactive oxygen species (ROS), membrane potential (APm) and nitric oxide (NO), respectively. Besides, the esterase activity in treated protoplasts was also found compromised. About 2.4-fold greater level of DNA damage, as compared to untreated control was observed in Comet assay, and 73.2 % of Co3O4-NPs treated cells appeared apoptotic in flow cytometry based cell cycle analysis. CONCLUSION: This study demonstrate the phytotoxic potential of Co3O4-NPs in terms of reduction in seed germination, root growth, greater level of DNA and mitochondrial damage, oxidative stress and cell death in eggplant. The data generated from this study will provide a strong background to draw attention on Co3O4-NPs environmental hazards to vegetable crops.


Assuntos
Óxidos/toxicidade , Dano ao DNA/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Cobalto/toxicidade , Solanum melongena/efeitos dos fármacos , Nanopartículas/toxicidade , Dilatação Mitocondrial/efeitos dos fármacos , Óxido Nítrico/metabolismo , Óxidos/metabolismo , Análise de Variância , Espécies Reativas de Oxigênio/metabolismo , Cobalto/metabolismo , Ensaio Cometa , Solanum melongena/metabolismo , Microscopia Eletrônica de Transmissão , Nanopartículas/metabolismo , Citometria de Fluxo , Dilatação Mitocondrial/fisiologia
18.
Colomb. med ; 37(2,supl.1): 6-14, abr.-jun. 2006. tab
Artigo em Espanhol | LILACS | ID: lil-585777

RESUMO

Objetivo: Describir el nivel de predicción de las complicaciones obstétricas y perinatales mediante la evaluación periódica del riesgo biopsicosocial prenatal (RBP) durante el control prenatal en mujeres asiáticas. Materiales y métodos: Durante el 2002 se evaluaron en Shanghai, China y Dhaka, Bangalesh 565 primigrávidas sanas con evaluaciones periódicas del RBP (primera: semana 14-27, segunda: semana 28-32, tercera: semana 33-42) con evaluación prospectiva del resultado materno y perinatal. Resultados: La edad promedio fue 25.1±6.4 años en su mayoría de nivel socioeconómico medio, con formación universitaria y residencia urbana. Se observaron 135 (23.9%) complicaciones obstétricas, 57 (10.1%) recién nacidos con bajo peso y 41 (7.3%) muertes perinatales. El alto riesgo biopsicosocial prenatal se asoció con las complicaciones obstétricas (área bajo la curva ROC) 0.80 IC 95% 0.71-0.89 con el parto prematuro (área bajo la curva ROC) 0.79, IC 95% 0.68-0.90) y con el bajo peso al nacer (área bajo la curva ROC) 0.85, IC 95% 0.77-0.93. El período con mayor efectividad predictiva fue el último (33-42 semanas) tanto para las complicaciones obstétricas (sensibilidad: 84.4%, especificidad: 69.3%), como para el parto prematuro (sensibilidad: 79.2%, especificidad: 67.1%) como para el bajo peso al nacer (sensibilidad: 88% especificidad: 77.3%). A pesar de las diferencias basales sociodemográficas, nutricionales, étnicas, culturales y religiosas de los dos países el efecto predictivo del instrumento fue similar. Conclusión: La evaluación del riesgo biopsicosocial prenatal fue clínicamente válida para predecir complicaciones obstétricas, parto prematuro y bajo peso al nacer en los países asiáticos comparable a los resultados en Latino-América.


Objective: To determine the effect of the periodical use of the prenatal biopsychosocial risk assessment (PBR) to predict obstetric and perinatal complications in pregnant women in Asian countries. Materials and methods: In Shanghai, China, and Dhaka, Bangladesh, 565 healthy primigravids were evaluated with PBR at inclusion (14-27 weeks), in a second time (28-32 weeks) and in a third time (33-42 weeks) with assessment of the perinatal outcome. Results: The average age was 25.1±6.4 years old. Most of the women were from middle socioeconomic level, with university academic degree and urban residence. There were 129 (25.6%) obstetric complications, 54 (10.1%) low birth weight babies and 41 (7.3%) perinatal deaths. The ROC analysis showed that the high PBR score was associated with obstetric complications (area under ROC Curves) 0.80 CI 95% 0.71-0.89, preterm birth (area under ROC curves) 0.79, CI 95% 0.68-0.90, low birth weight (area under ROC curves) 0.85, CI 95% 0.77-0.93. The best predictive period was the last (33-42 weeks) to obstetric complications (sensibility: 84.4%, specificity: 69.3%), preterm delivery (sensibility 79.2%, specificity 67.1%) and to low birth weight (sensibility 88%, specificity 77.3%). The baseline sociodemographic and nutritional characteristics and the perinatal outcome were different between the countries, however, the predictive effect of the instrument was similar. Conclusion: The prenatal biopsychosocial risk assessment was clinically valid to predict obstetric complications, preterm birth and low birth weight in two Asian countries when compared to results in Latin-American countries.


Assuntos
Feminino , Peso ao Nascer , Técnicas de Diagnóstico Obstétrico e Ginecológico , Enfermagem Neonatal , Complicações na Gravidez , Mulheres , Ásia
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