Alcohol as a dietary trigger of primary headaches: what triggering site could be compatible?

Alcoholic drinks (AD) have been known as migraine triggers in about one-third of migraine patients in retrospective studies. We have reviewed the studies concerning the role of AD in triggering the various types of primary headaches published after the International Headache Society classification of 1988. There are many studies showing that AD are triggers of migraine without aura (MO), migraine with aura (MA), cluster headache (CH) and tension-type headache (TH). About one-third of MO and half of CH patients reported AD as trigger factors. Some studies show that AD are triggers in MA and TH in a similar percentage to that found in MO, but there are also discordant findings. There are sparse reports that AD are also triggers of less frequent types of primary headache such as familial hemiplegic migraine, hemicrania continua and paroxysmal hemicrania. The mechanism of alcohol-provoking headache is debated and should be compatible with the principal pathogenetic theories of primary headaches. If AD are capable of triggering practically all primary headaches, they should act at a common pathogenetic level. Vasodilatation is unlikely to be compatible as common mechanism. An action at cortical or more likely at subcortical level is plausible.

Influence of the application renewal of glutamate and tartrate on Cd, Cu, Pb and Zn distribution between contaminated soil and Paulownia tomentosa in a pilot-scale assisted phytoremediation study.

The influence of repeated applications of tartrate (TAR) and glutamate (GLU) at 50-mmol kg(-1) of soil on Cd, Cu, Pb, and Zn distribution between a contaminated soil and Paulownia tomentosa was investigated. TAR and GLU were applied by a single or a double dosage, the latter carried out with an interval between the two applications of thirty days. The comparison of the differences in mean amounts of metals accumulated in the whole plant at the end of single and double TAR and GLU application experiments indicated the positive effect of repeated GLU applications on the accumulation of Cu, Pb, and Zn by Paulownia tomentosa as compared to untreated controls. A similar effect was not observed for the TAR treatments. When soil treated with either TAR or GLU was compared with untreated controls, no significant effect on heavy-metal concentrations in the soil solution was observed 30 days after treatment, suggesting the absence of an increase of the long-term leaching risk of heavy metals in aquifers and surface waters due to the ligand application. A cost analysis of the treatment is also reported.

Spatiotemporal dynamics of the electrical network activity in the root apex.

The study of electrical network systems, integrated with chemical signaling networks, is becoming a common trend in contemporary biology. Classical techniques are limited to the assessment of signals from doublets or triplets of cells at a fixed temporal bin width. At present, full characteristics of the electrical network distribution and dynamics in plant cells and tissues has not been established. Here, a 60-channels multielectrode array (MEA) is applied to study spatiotemporal characteristics of the electrical network activity of the root apex. Both intense spontaneous electrical activities and stimulation-elicited bursts of locally propagating electrical signals have been observed. Propagation of the spikes indicates the existence of excitable traveling waves in plants, similar to those observed in non-nerve electrogenic tissues of animals. Obtained data reveal synchronous electric activities of root cells emerging in a specific root apex region. The dynamic electrochemical activity of root apex cells is proposed to continuously integrate internal and external signaling for developmental adaptations in a changing environment.

Heavy metal distribution between contaminated soil and Paulownia tomentosa, in a pilot-scale assisted phytoremediation study: influence of different complexing agents.

The distribution of Cd, Cu, Pb and Zn between a contaminated soil and the tree species Paulownia tomentosa was investigated in a pilot-scale assisted phytoremediation study. The influence of the addition of EDTA, tartrate and glutamate at 1, 5 and 10mM concentrations on metal accumulation by the plant and on metal mobilization in soil was evaluated. Root/shoot metal concentration ratios were in the range of 3-5 for Zn, 7-17 for Cu, 9-18 for Cd and 11-39 for Pb, depending on the type and concentration of complexing agent. A significant enhancement of metal uptake in response to complexing agent application was mainly obtained in roots for Pb (i.e. 359 mg kg(-1) for EDTA 10mM and 128 mg kg(-1) for the control), Cu (i.e. 594 mg kg(-1) for glutamate 10mM and 146 mg kg(-1) for the control) and, with the exception of glutamate, also for Zn (i.e. 670 mg kg(-1) for tartrate 10mM and 237 mg kg(-1) for the control). Despite its higher metal mobilization capacity, EDTA produced a metal accumulation in plants quite similar to those obtained with tartrate and glutamate. Consequently the concentration gradient between soil pore water and plant tissues does not seem to be the predominant mechanism for metal accumulation in Paulownia tomentosa and a role of the plant should be invoked in the selection of the chemical species taken up. Metal bioavailability in soil at the end of the experiment was higher in the trials treated with EDTA than in those treated with tartrate and glutamate, the latter not being significantly different from the control. These findings indicated the persistence of a leaching risk associated to the use of this chelator, while an increase of the environmental impact is not expected when glutamate and tartrate are applied.

Corpus callosum atrophy is associated with gait disorders in patients with leukoaraiosis.

Cognitive impairment and gait disturbances are the most frequent clinical findings in patients with leukoaraiosis (LA). Corpus callosum (CC) atrophy has been associated with dementia in patients with LA, as well as with gait disturbances in patients with normal pressure hydrocephalus. We investigated, in patients with LA, the possible association between gait impairment and CC atrophy, taking into account cognitive deficits and the other brain lesions commonly present in these patients. Thirty patients (M:F=21:9; mean age 72.5+/-6.3 years) with gait disturbances and brain CT images consistent with LA underwent an assessment of gait and a cognitive assessment of global and selective functions. Magnetic resonance imaging (MRI) was used to measure thickness and area of the CC, total LA volume, lacunar infarcts and size of lateral ventricles. We examined the effect of every MRI change on each performance measure. Reduction of CC thickness, particularly that of the anterior segment, had a significant effect on severity of gait impairment, as measured using the gait scale's score. It was independent of any other brain changes revealed by MRI, including LA. An independent, significant association was also found between CC area and the Left Hand Praxis test results. In patients with LA, CC atrophy is associated with gait impairment independently of LA and other brain abnormalities usually present in these patients.

Validity of different linguistic versions of the Alzheimer's Disease Assessment Scale in an international multicentre Alzheimer's disease trial.

Owing to the involvement of Italian Centres in a multicentre, German-Italian therapeutical trial with Alzheimer's dementia patients, to be assessed with the Alzheimer's Disease Assessment Scale (ADAS), it was decided that the Italian centres would use an Italian version of the scale, derived from that used by the German centres. However, the lists of words for exploring verbal memory are not merely translated from the German version, but are composed of selective Italian words chosen according to linguistic criteria. This Italian version was validated following the same procedure adopted for validating the German version. We submitted this Italian version to an interrater reliability, test-retest reliability, concurrent validity, internal consistency and sensitivity evaluation, using demented patients. Based on the results of these tests this Italian version of the ADAS proved valid and reliable. Moreover, the results were strikingly comparable to those from the validation of the German version. Our work supports the validity, reliability and transnational comparability of national versions of the ADAS constructed following definite linguistic criteria.

Sex-related differences in human cerebral hemodynamics.

OBJECTIVES: To identify possible inter-hemispheric sex-related cerebral hemodynamic differences at rest, in healthy subjects by transcranial Doppler (TCD). SUBJECTS AND METHODS: Mean flow velocity (MV) was recorded by TCD in 96 (48 males, 48 females) right-handed volunteers. Mean age was similar in males and females, distribution of age-groups by sex was similar, too. RESULTS: Examining by sex MV values in each basal artery, left middle cerebral artery (MCA) showed a statistically significant difference (53.5+/-8.2 cm x s(-1) in males versus 58.5+/-10.4 cm x s(-1) in females, P=0.005, one-way ANOVA). Multiple regression models show a significant correlation between age and MV on each side, while sex correlates with MV on the left side. CONCLUSION: A sex-dependent hemispheric difference in MV in the left MCA at rest (females>males) in the younger population subgroup was identified. These data support recent observations on anatomical differences between sexes, referring a proportionally larger Broca area in females compared to males.

Ionophore A23187-induced leukotriene biosynthesis in equine granulocytes-neutrophils, but not eosinophils require exogenous arachidonic acid.

Equine granulocyte suspensions, mainly consisting of neutrophils, failed to produce detectable amounts of leukotrienes when stimulated with calcium ionophore A23187 alone, whereas leukotrienes were dose-dependently formed in control incubations with human granulocytes. In contrast, ionophore A23187 initiated synthesis of leukotrienes B4 and C4 in equine granulocytes when added in combination with low concentrations of exogenous arachidonic acid. Similarly, ionophore A23187 provoked leukotriene biosynthesis when added alone to human whole blood, whereas addition of exogenous arachidonic acid was a prerequisite for ionophore A23187-induced leukotriene formation in equine whole blood. Leukotriene biosynthesis was provoked by A23187 alone after addition of homologous platelets to equine granulocyte suspensions. After separation of equine neutrophils and eosinophils, purified eosinophil suspensions produced LTC4 after stimulation with ionophore A23187 alone, whereas exogenous arachidonic acid was required for ionophore-induced LTB4 formation in purified neutrophil suspensions. Leukotriene synthesis in both eosinophils and neutrophils was suppressed by the 5-lipoxygenase activating protein (FLAP) inhibitor, MK-886. Exogenous arachidonic acid was needed for ionophore-induced leukotriene synthesis also in bovine granulocytes, but was not a prerequisite for the production of leukotrienes in porcine granulocytes or in rat and rabbit white blood cell suspensions. The results indicate differences in the mechanisms regulating leukotriene synthesis in equine neutrophils, as compared to human granulocytes or equine eosinophils, and suggest that elevation of intracellular calcium is an insufficient stimulus to provoke utilisation of endogenous arachidonic acid for leukotriene synthesis in equine neutrophils.

MRI and MR angiography of vertebral artery dissection.

A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3-20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients.

Influence of interleukin 1alpha on superoxide anion, platelet activating factor release and phospholipase A2 activity of naive and sensitized guinea-pig alveolar macrophages.

1. We studied the effect exerted by hr-interleukin-1alpha (IL-1alpha) on responsiveness of alveolar macrophages (AM) from naive and sensitized guinea-pigs, through O2.- production (by ferricytochrome C reduction), platelet-activating factor (PAF) release (by platelet aggregation), prostaglandin E2 (PGE2) release (by a radioimmunoassay), and cytosolic phospholipase A2 (cPLA2) activity (by hydrolysis of radioactive substrate). 2. In naive guinea-pig AM, 0.06 nM hr-IL-1alpha pretreatment decreased by 65% O2.- release stimulated with 10 nM fMLP. In contrast, O2.- production was not affected in sensitized guinea-pig AM. 3. O2.- release elicited by fMLP stimulation in both cell groups was affected by PLA2 inhibitors (10 microM bromophenacyl bromide, BPB or 10 microM methylprednisolone, MP). In contrast, 10 microM arachidonyl trifluoromethyl ketone (AACOCF3), a cPLA2 inhibitor, was ineffective. 4. In naive AM, PAF release was elicited by hr-IL-1alpha pretreatment and by separate fMLP-stimulation, but when the stimulus was added to hr-IL-1alpha-pretreated cells inhibition of PAF release was observed. In sensitized AM, PAF release was lower than that found in naive guinea-pig AM in both hr-IL-1alpha-pretreated and fMLP-stimulated cells. 5. PGE2 release was unaffected by hr-IL-1alpha pretreatment and it was decreased by fMLP in both naive and sensitized AMs. The latter released less PGE2 than naive cells in basal conditions and after fMLP treatment. 6. Sensitized AM showed a greater cPLA2 activity in all experimental conditions in comparison to naive cells. cPLA2 activity assayed in the cytosolic fraction was found to be enhanced by hr-IL-1alpha pretreatment and by fMLP stimulation in naive but not in sensitized AM. However, when the stimulus was added to hr-IL-1alpha-pretreated cells we observed a decrease in cPLA2 activity in the cytosol and an increase in the membranes, thus suggesting a translocation of enzymatic activity. 7. In conclusion, hr-IL-1alpha can modulate the responsiveness of AM from naive and sensitized guinea-pigs, as suggested by changes found in the release of PAF and O2.- and in cPLA2 activity; therefore, sensitization itself may affect cellular responsiveness.

Hemoglobin affects lipid peroxidation and prostaglandin E2 formation in rat corticocerebral tissues in vitro.

Variations of lipid peroxidation and arachidonic acid (AA) metabolism products were found when experimental subarachnoid hemorrhage or ischemia and reperfusion were performed in an animal brain model. In a previous study, we showed that hemoglobin (Hb) produces prostaglandins when incubated in AA. To elucidate how Hb affects lipid peroxidation and AA metabolism in the CNS, we measured lipid hydroperoxides (LOOH), PGE2 and thiobarbituric acid reactant substances (TBARS) in corticocerebral homogenates and slices of rats (normal rats) after incubation with different concentrations (10(-9) to 10(-5) M) of Hb. In addition, brain cortices of indomethacin-treated (40 mg/Kg) rats (IN-treated rat) were incubated in the presence of 10(-5) M indomethacin (IN) to exclude the interference of prostaglandin enzyme synthetase. Hb was able to affect LOOH, PGE2, and TBARS production in both normal and IN-treated rat brain cortex homogenates and slices. In all cases, we found an increase in prostaglandin when 10(-8) M Hb was used, whereas no effect was noticed with 10(-9) M. On the other hand, with higher Hb concentrations (10(-6)-10(-5) M), the LOOH and PGE2 values did not reach statistical significance, and TBARS significantly increased. In all cases, when 10(-4) M scavenger or metal-chelating compounds were added to an incubation mixture with 10(-8) M Hb, PGE2 formation was inhibited, whereas no variation occurred when 10(-4) M IN was further added to IN-treated rat corticocerebral homogenate or slices. We hypothesize that in in vivo experimental neuropathologies, Hb must attain the 10(-8) M concentration in the reaction cellular microenvironment to stimulate PGE2 production, and that an evaluable part of this PGE2 production may be directly ascribable to the iron-heme oxy-redoxy activity of Hb.

GABA-mediated inhibition of the anaphylactic response in the guinea-pig trachea.

1. In sensitized guinea-pigs, the effects of gamma-aminobutyric acid (GABA) and GABAmimetic drugs have been investigated on tracheal segments contracted by cumulative application of an allergen (ovoalbumin, OA) and on serosal mast cells. The same drugs have also been tested on activation of alveolar macrophages isolated from unsensitized guinea-pigs. 2. Superfusion with GABA (1-1000 microM) reduced the contraction intensity of tracheal strips. The effect of GABA (100 microM) was not affected by the carrier blockers, nipecotic acid and beta-alanine (300 microM each). It was mimicked by the GABAB agonist (-)-baclofen (100 microM) but not 3-aminopropanephosphinic acid (100 microM, 3-APA). The GABAA agonist, isoguvacine (100 microM) did not exert any effect. GABA (10 microM)-induced inhibition of tracheal contractions was reduced by the GABAB antagonist, 2-hydroxysaclofen (100 microM, 2-HS), but not by the GABAA antagonist, bicuculline (30 microM). 3. The reduction in contraction intensity induced by GABA (100 microM) was prevented by a 40 min preincubation of tracheal strips with capsaicin (10 microM), but not tetrodotoxin (TTX, 0.3 microM). The effect of GABA (1000 microM) was absent after preincubation with indomethacin (2.8 microM) but unmodified when nordihydroguaiaretic acid (NDGA, 3.3 microM) was used. Finally, removal of the epithelium prevented the GABA effect. 4. Anaphylactic histamine release from serosal mast cells isolated from sensitized animals was not affected either by GABA (10-1000 microM) or the selective receptor agonists (-)-baclofen (0.1-1000 microM) and isoguvacine (10-1000 microM). The release of platelet-activating factor (PAF) from alveolar macrophages stimulated by formyl-Met-Leu-Phe (FMLP; 1 microM) was modified neither by GABA (100 microM)nor by (-)-baclofen (100microM).5. In conclusion, these data show that GABA can inhibit allergic phenomena in the guinea-pig airways through activation of GABAB receptors. An involvement of neuropeptidergic sensory structures is suggested but a role for epithelial cells and arachidonate metabolites is not definitely proved.

Salmeterol inhibits anaphylactic histamine release from guinea-pig isolated mast cells.

Salmeterol (1 nM-100 microM) showed an inhibitory action on anaphylactic histamine release from mast cells, isolated from pleural and peritoneal cavities of actively sensitized guinea-pigs and stimulated by incubation with allergen. The effect is concentration-dependent and is reduced by the beta-adrenoceptor antagonist propranolol (1 microM). This study supports the hypothesis of an anti-inflammatory property of salmeterol, which concerns cells involved in the early phases of asthma.

Leishmaniasis in Tuscany (Italy): VIII. Human population response to leishmanin in the focus of Monte Argentario (Grosseto) and epidemiological evaluation.

A skin test survey carried out in the towns of Porto St. Stefano and Porto Ercole showed a total positivity rate of 15.3%. The progressive increase of positivity according to age was not uniform but similar for the two towns since the values concerning the last two age groups did not follow the general trend of the graph but were lower than expected. The possible causes of this phenomenon have been discussed. The absence of overt visceral leishmaniasis cases in recent years and the concomitant high prevalence of canine leishmaniasis have been considered in the light of the occurrence of infectious diseases and the increase of the nutritional levels in the local human population.