ABSTRACT
To verify the effect of piroxicam-beta-cyclodextrin (P-B-CD), a novel non-steroidal anti-inflammatory compound, on regional cerebral blood flow (rCBF) during migraine attacks, 7 female patients (mean age: 37.4 years), suffering from migraine without aura, were studied. The patients, after induction of a migraine-like attack with sublingual nitroglycerin (NTG), underwent a rCBF evaluation using Single Photon Emission Computerized Tomography (SPECT) and Tc-99m examethyl-propylene-amino-oxyma split-dose method before and after oral administration of P-B-CD (20 mg). In addition, a spontaneous migraine attack and NTG test in 7 control subjects were investigated. All patients observed relief of pain, evaluated by direct and indirect parameters (Pain Intensity; Pain Intensity Difference; Sum of Pain Intensity Difference). SPECT revealed a uniform and symmetrical distribution of the radiocompound in 5 out of 8 patients, while in the remaining 3 symmetrical parietal or parieto-occipital areas of decreased tracer uptake were detected. In these cases, the intake of P-B-CD cancelled out the cerebral perfusion abnormality.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Brain/blood supply , Cyclodextrins/therapeutic use , Migraine Disorders/drug therapy , Piroxicam/therapeutic use , Tomography, Emission-Computed, Single-Photon , beta-Cyclodextrins , Adolescent , Adult , Blood Flow Velocity/drug effects , Drug Combinations , Female , Humans , Middle Aged , Migraine Disorders/diagnostic imaging , Nitroglycerin , Organotechnetium Compounds , Oximes , Pain Measurement , Regional Blood Flow/drug effects , Technetium Tc 99m ExametazimeABSTRACT
Surgical treatment of multinodular goiter is still now discussed: total versus subtotal thyroidectomy. Advantages of partial thyroidectomy are the low incidence of laryngeal nerve injury and the low risk of hypoparathyroidism. Disadvantages are the increased recurrent disease, the risk of carcinoma, the elevated possibility of laryngeal nerve lesions and permanent hypoparathyroidism after reoperations. Own experience regarding 401 thyroid operations is reported; 60 patients were operated for multinodular goiter; 48 subtotal and 12 total thyroidectomy were performed. Among those 1 (1.65%) inferior laryngeal lesion and 1 (1.65%) permanent hypoparathyroidism occurred. Anatomic knowledge and correct surgical procedure give a reduction in the mobility of total thyroidectomy which in selective case can be considered the treatment of choice.
