New uses of the Migraine Screen Questionnaire (MS-Q): validation in the Primary Care setting and ability to detect hidden migraine. MS-Q in Primary Care

<p>Abstract</p> <p>Background</p> <p>PC plays an important role in early diagnosis of health disorders, particularly migraine, due to the financial impact of this disease for the society and its impact on patients' quality of life. The aim of the study was to validate the self-administered MS-Q questionnaire for detection of hidden migraine in the field of primary care (PC), and to explore its use in this setting.</p> <p>Methods</p> <p>Cross-sectional, observational, and multicentre study in subjects above 18 years of age patients attending PC centers (regardless of the reason for consultation). A MS-Q score ≥ 4 was considered possible migraine. Level of agreement with IHS criteria clinical diagnosis (kappa coefficient), and instrument's validity properties: sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were determined. The ability of the instrument to identify possible new cases of migraine was calculated, as well as the ratio of hidden disease compared to the ratio obtained by IHS criteria.</p> <p>Results</p> <p>A total of 9,670 patients were included [48.9 ± 17.2 years (mean ± SD); 61.9% women], from 410 PC centers representative of the whole national territory. The clinical prevalence of migraine according to the IHS criteria was 24.7%, and 20.4% according to MS-Q: Kappa index of agreement 0.82 (p < 0.05). MS-Q sensitivity was 0.82 (95% CI, 0.81 - 0.84), specificity 0.97 (95% CI, 0.98 - 0.99), PPV 0.95 (95% CI, 0.94 - 0.96), and NPV 0.94 (95% CI, 0.93 - 0.95). No statistically significant differences were found in the percentages of patients with <it>de novo </it>and hidden migraine identified by MS-Q and by IHS criteria: 5.7% vs. 6.1% and 26.6% vs. 24.1%, respectively.</p> <p>Conclusions</p> <p>The results of the present study confirm the usefulness of the MS-Q questionnaire for the early detection and assessment of migraine in PC settings, and its ability to detect hidden migraine.</p

Migraine and psychiatric comorbidity: a review of clinical findings

Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder

A molecular mechanism for eflornithine resistance in African trypanosomes

Human African trypanosomiasis, endemic to sub-Saharan Africa, is invariably fatal if untreated. Its causative agent is the protozoan parasite Trypanosoma brucei. Eflornithine is used as a first line treatment for human African trypanosomiasis, but there is a risk that resistance could thwart its use, even when used in combination therapy with nifurtimox. Eflornithine resistant trypanosomes were selected in vitro and subjected to biochemical and genetic analysis. The resistance phenotype was verified in vivo. Here we report the molecular basis of resistance. While the drug's target, ornithine decarboxylase, was unaltered in resistant cells and changes to levels of metabolites in the targeted polyamine pathway were not apparent, the accumulation of eflornithine was shown to be diminished in resistant lines. An amino acid transporter gene, TbAAT6 (Tb927.8.5450), was found to be deleted in two lines independently selected for resistance. Ablating expression of this gene in wildtype cells using RNA interference led to acquisition of resistance while expression of an ectopic copy of the gene introduced into the resistant deletion lines restored sensitivity, confirming the role of TbAAT6 in eflornithine action. Eflornithine resistance is easy to select through loss of a putative amino acid transporter, TbAAT6. The loss of this transporter will be easily identified in the field using a simple PCR test, enabling more appropriate chemotherapy to be administered

Efficacy of Citrus sinensis essential oils in the control of Pseudomonas syringae pv. tomato and Fusarium oxysporum f.sp. radicis lycopersici

Essential oils represent a promising option for pathogen control due to their natural antimicrobial properties. This study evaluated the antibacterial and antifungal activity, against phytopathogenic species, of two varieties of essential oils extracted from Citrus sinensis peel: C. sinensis “Navel Orange” and C. sinensis “Tarocco”. As regards antibacterial activity, after determining the minimum inhibitory concentration, equal to 5% (w/w), against Pseudomonas syringae pv. tomato, the causative agent of bacterial spot on tomatoes, curative efficacy tests were conducted. The inoculated plastic surfaces were treated with essential oils and subsequently analyzed to verify the presence of the pathogen by plating on selective media and specific polymerase chain reaction. The antifungal activity of the same essential oils was studied against Fusarium oxysporum f.sp. radicis lycopersici, the agent responsible for root rot in tomatoes. Tomato seeds were exposed during germination to different concentrations of suspended essential oils. After a few days, blackening of the roots, if present, was observed as an indicator of disease. The results highlighted the significant effectiveness of essential oils in both assays, suggesting their potential use as sustainable tools for the management of fungal infections in agriculture and for the disinfection of surfaces promoting the reuse of agricultural artifacts with a view to circular economy

Potential of Salvia extracts as natural insecticides against the tomato leaf miner, Tuta absoluta

The tomato leaf miner, Tuta absoluta, is a major threat to solanaceous crops, particularly tomatoes, and can cause yield losses of up to 100%. The rapid spread of the pest and increasing resistance to conventional insecticides highlight the need for alternative control methods [1,2]. Considering these challenges, we evaluated the insecticidal and antifeedant activities of dichloromethane surface ex- tracts from four Salvia species (S. buchanani, S. corrugata, S. discolor, and S. namaensis) against T. absoluta larvae using a leaf-dip bioassay protocol (IRAC susceptibility test method) with few modifi- cations. LC-MS analysis revealed that the extracts were rich in abietane-type diterpenes and highly methoxylated flavonoids, which are known for their bioactive properties. Preliminary screening at a concentration of 2.5 mg/mL revealed S. discolor to be the most effective, demonstrating statistically higher larval mortality than the commercial insecticide Spinosad. Encouraged by these findings, we further evaluated the effects of the species at varying concentrations (0.16, 0.31, 0.62, 1.25, and 5.0 mg/mL). S. discolor demonstrated remarkable potency, with an LC50 of 0.013 mg/mL. Additionally S. discolor consistently induced strong feeding inhibition across all tested concentrations, suggesting its potential as a possible natural alternative to synthetic insecticides. Future studies will be carried out to investigate the compounds responsible for these effects