Better Health Through Research image
 Better Health Through Research image
      

Search Center...



SEARCH PARAMETERS
Search:
Journal: Author:
Years: through Show:  Display: 
 

  Page 1 of 100  
Therapy of : Cephalgia
Merck Online Lab
Diagnosis < Therapy > Rehabilitation Imaging Clinical Laboratory
Switching stable patients with schizophrenia from depot and oral antipsychotics to long-acting injectable risperidone: reasons for switching and safety.
Author(s): Hawley, C; Turner, M; Latif, MA; Curtis, V; Saleem, PT; Wilton, K
Journal: Hum Psychopharmacol 2010 Mar 2; Vol. 25, Issue 1; Page(s) 37-46
[Medline ID - 20041474]

OBJECTIVE: An international, non-randomised study evaluated efficacy and safety of risperidone long-acting injectable (RLAI) compared to previous treatment. To investigate generizability of the European data set to the UK subset safety and switching data are reported here. METHODS: Patients with schizophrenia or other psychotic disorder, symptomatically stable on antipsychotic medication, received intramuscular injections of RLAI 25 mg (to a maximum of 50 mg) every 2 weeks for 6 months. RESULTS: Of 182 UK patients enrolled, 79% had schizophrenia, 21% other psychotic disorders. Insufficient efficacy (43%), side effects (45%), and non-compliance (25%) were the most common reasons for switching. Sixty-nine per cent of patients completed the trial; 8% discontinued due to adverse events (AEs). Most frequent treatment-emergent AEs were headache (8.2%), relapse (7.7%) and insomnia (7.1%); 8 (4.4%) patients reported injection-related AEs. There were significant improvements in extrapyramidal symptom rating scale total and subscale (particularly Parkinsonism) scores, regardless of previous medication (total cohort, p < or = 0.0001). There was a small but significant increase in body weight at endpoint (1.2 kg, p = 0.0023). One patient suffered a myocardial infarction and died (not treatment-related). There were no substantial differences between the full data set and the UK sub-population CONCLUSION: Switch to RLAI was well-tolerated in stable patients over 6 months. The European data set is generalizable to the UK patient population.

Management of medication overuse headache.
Journal: Drug Ther Bull 2010 Apr 7; Vol. 48, Issue 1; Page(s) 2-6
[Medline ID - 20427444]

Headache is one of the most frequent reasons for medical consultation in both general practice and specialist neurology clinics.1 Prescribed and over-the-counter medications are taken to alleviate headaches, but may be used incorrectly.2 In particular, use of some drugs both frequently and regularly can have a paradoxical effect, causing headaches rather than relieving them, and leading to medication overuse headache (MOH).3 Such overuse is a common cause of frequent headache. Here we review MOH and its management.

Primary angioleiomyoma in the sellar region: a case report and literature review.
Author(s): Xu, Y; Jing, Y; Ma, S; Ma, F; Wang, Y; Ma, W; Li, Q
Journal: Clin Neuropathol 2010 Mar 20; Vol. 29, Issue 1; Page(s) 21-5
[Medline ID - 20040329]

OBJECTIVE: Angioleiomyoma (vascular leiomyomas, angiomyoma) is a rare, benign soft tissue tumor which consists of a mixture of well-differentiated smooth muscle cells and thick-walled vessels. Here we report a case of angioleiomyoma in the sellar region, which is the first case report of angioleiomyoma at this anatomical location. CLINICAL PRESENTATION: A 53-year-old man was admitted with a medical history of three months episodic headache and one month visual deterioration, both of which progressed gradually. The neurological examination showed nothing remarkable except a slightly decreased adrenocorticotrophic hormone (ACTH) level. Preoperative magnetic resonance imaging revealed a pituitary apoplexy. Gross total resection of the tumor was then performed. PATHOLOGICAL FINDINGS: Histological and immunohistochemical studies showed a typical microscopic appearance of an angioleiomyoma present in a r ather uncommon place. The pertinent literature regarding the features of this tumor was reviewed and discussed. CONCLUSIONS: Intracranial angioleiomyoma is a benign soft tissue tumor with excellent prognosis. Early diagnosis of this tumor is difficult.

What do we know about chronic tension-type headache?
Author(s): Fern; ández-de-Las-Peñas, C
Journal: Discov Med 2010 May 21; Vol. 8, Issue 43; Page(s) 232-6
[Medline ID - 20040276]

In the past few years there has been an increasing body of knowledge about etiological mechanisms of chronic tension type headache (CTTH), permitting a better understanding of this syndrome. It seems that CTTH diagnostic criteria should be modified to improve its differential diagnosis against migraine, since CTTH is a syndrome of "featureless" headaches characterized by nothing but pain in the head. It has been demonstrated that pressure pain hypersensitivity and pericranial muscle tenderness are both consequence and not causative factors of CTTH. An updated pain model has suggested that CTTH can be explained by referred pain from trigger points (TrPs) in the cranio-cervical muscles, mediated through the spinal cord and the trigeminal nerve nucleus caudalis. Different therapeutic strategies (pharmacological and non-pharmacological) are generally used for the management of these patients. CTTH is generally treated with non-steroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, and physical therapy, although the therapeutic efficacy of these approaches is controversial.

Headache: what do children and mothers expect from pediatricians?
Author(s): Raieli, V; Compagno, A; Pandolfi, E; La Vecchia, M; Puma, D; La Franca, G; Ragusa, D
Journal: Headache 2010 Aug 19; Vol. 50, Issue 2; Page(s) 290-300
[Medline ID - 20039963]

BACKGROUND: Headache is a frequent occurrence among children and adolescents, and one of the most common causes of medical consultation. While serious conditions presenting headache as the chief complaint are not common in the pediatric population, enormous sums are invested to perform very expensive and often unnecessary diagnostic investigations. Pediatricians should adopt a flexible and diversified diagnostic/therapeutic approach and, at the same time, should not forget to take into consideration the demands, expectations, and worries of children and their parents. OBJECTIVE: The aim of this study was to assess simultaneously children's and mothers' expectations from the pediatric consultation concerning headache, and pediatricians' opinions about said expectations. In addition, we attempted to investigate mothers', children's, and pediatricians' opinions about symptomatic and prophylactic treatment of headache. METHOD: A total of 100 young headache sufferers, 50 were male and 50 were female, from 10 to 16 years of age, were enrolled in this study. Two diversified, self-administered, ad hoc questionnaires about their expectations from the pediatric treatment of headache and about symptomatic and prophylactic treatment were delivered to each patient and their mother, to which they responded separately. A third self-administered questionnaire was delivered to a sample of 50 pediatricians. RESULTS: Our study showed that children and their mothers sometimes have different expectations about the consultation of the pediatrician and of the headache specialist. Frequency of pain was the main reason for pediatric consultation for 70% of mothers, whereas only 2% of them (as opposed to what pediatricians believed) consulted the pediatrician because they were worried about a tumor. Moreover, a high percentage of children and mothers expected from the pediatric consultation to be reassured that it is not a serious illness and to find out the causes of headache (60% and 47%, and 45% and 62%, respectively). A total of 26% of children wanted to know the progression of headache in the future, but only 3% of mothers shared the same demand. With regard to their expectations, pediatricians agree only in part with children and their mothers. On the contrary, the majority of children (68%), mothers (49%), and pediatricians (90%) agree that a symptomatic treatment was necessary in the presence of a severe pain. In addition, 61% of children, 37% of mothers, and 74% of pediatricians believed that a prophylactic treatment was necessary when the pain is severe and long-lasting. CONCLUSION: Pediatricians sometimes do not consider sufficiently children's and mothers' wishes and expectations and, consequently, could limit the outcome of their diagnostic-therapeutic approach. This is particularly important because, in the developmental age, an accurate recognition of patients' and parents' expectations represents an essential requirement for a favorable outcome of the consultation.

The "repeater" phenomenon in migraine patients: a clinical and psychometric study.
Author(s): Villani, V; Di Stani, F; Vanacore, N; Scattoni, L; Cerbo, R; Bruti, G
Journal: Headache 2010 Aug 19; Vol. 50, Issue 3; Page(s) 348-56
[Medline ID - 20039961]

BACKGROUND: Headache is one of the most common symptoms in an emergency department (ED), while migraine is the most frequently observed headache in this setting. The aim of our study was to evaluate the influence of clinical and psychometric variables on the repeater phenomenon, ie, patients who make at least 3 visits to the ED at least 1 week apart during a 6-month period. METHODS: According to the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, we consecutively recruited Italian-speaking migraine subjects who came to the ED or outpatient service. All the patients underwent the Migraine Disability Assessment Scale for the evaluation of migraine disability. We also administered the Beck Depression Inventory, State and Trait Anxiety Inventory, and Toronto Alexithymia Scale-20 for the evaluation of depressive, anxiety, and alexithymic symptoms, respectively. A personality profile was also obtained by means of the Tridimensional Personality Questionnaire (TPQ). RESULTS: We consecutively enrolled 465 migraine patients, diagnosed according to the ICHD-II criteria. Seventy (15%) of these patients met the repeater definition. The repeater group had more severe disability and was affected to a greater degree by chronic migraine, regardless of symptomatic drug overuse, than the non-repeater group. As regards the psychometric variables, repeaters were more alexithymic, anxious, and depressed than non-repeaters. The personality profile, as measured by the TPQ, revealed that the repeater patients scored higher on the harm avoidance scale and their subscales than the non-repeater patients. CONCLUSIONS: According to the findings of our study, the repeater migraineur is typically triptan-na ïve, more alexithymic, and more depressed than the non-repeater migraineur. A clinical and psychometric evaluation of repeater patients who go to the ED because of migraine attacks may help to understand this epidemiological and clinical phenomenon. From a clinical point of view, these psychometric findings may not only shed light on the epidemiology of migraine in the ED, but may also help to design a specific therapeutic protocol for this subgroup of migraine patients.

Resolution of menstrually related migraine following aggressive treatment for breast cancer.
Author(s): Smitherman, TA; Kolivas, ED
Journal: Headache 2010 Aug 19; Vol. 50, Issue 3; Page(s) 485-8
[Medline ID - 20039954]

Hormonal influences associated with the female menstrual cycle play strong roles in both migraine and particular types of breast cancer, but there is limited literature on the effects of breast cancer treatment regimens in women with migraine. The present case describes resolution of menstrually related migraine following aggressive treatment for infiltrating ductal carcinoma (neoadjuvant chemotherapy, single radical mastectomy, and locoregional radiation therapy) that was maintained with supplemental treatment using tamoxifen, an anti-estrogenic agent. This novel case is presented to stimulate further research into the hormonal mechanisms underlying migraine.

Triptan use as a function of cardiovascular risk. A population-based study.
Author(s): Bigal, ME; Golden, W; Buse, D; Chen, YT; Lipton, RB
Journal: Headache 2010 Aug 19; Vol. 50, Issue 2; Page(s) 256-63
[Medline ID - 20039953]

AIM: To estimate the proportion of individuals with migraine using triptan therapy as a function of their cardiovascular (CV) profile and disease severity. METHODS: As a part of the American Migraine Prevalence and Prevention study, we identified migraineurs representative of the U.S. adult population. Triptan use was estimated as a function of presence of CV disease (CVD), of CV risk factors, and by level of migraine-related disability. RESULTS: Our sample consists of 6102 individuals with migraine. Compared with migraineurs without risk factors for CVD, triptans were significantly less likely to be used in individuals with diabetes (11.5% vs 18.3%, OR = 0.6, 95% CI = 0.5-0.7), hypertension (14.8%, OR = 0.8, 0.7-0.9) and by smokers (12.9%, OR = 0.7, 0.6-0.8). Similar findings were seen for individuals with established CVD. As contrasted to individuals without CVD, those with myocardial infarct (8.5% vs 18.5%, OR = 0.4, 0.3-0.7), stroke (7%, OR = 0.6, 0.3-0.9) and heart surgery (9.3%, OR = 0.5, 0.4-0.7) were less likely to use triptans. Use of triptan increased as a function of disability regardless of CVD status or presence of CV risk factors. CONCLUSION: Triptan use is lower in those with vs without CV risk, suggesting that doctors and/or patients fear using triptans in individuals at risk to CVD. Furthermore, triptan use in those with established CVD increases with headache-related disability, suggesting that patients and providers balance risks and benefits. Additional and analytical data are needed on the safety of triptans in the setting of CVD risk. This study has not assessed adequacy of care.

A novel type of influenza vaccine: safety and immunogenicity of replication-deficient influenza virus created by deletion of the interferon antagonist NS1.
Author(s): Wacheck, V; Egorov, A; Groiss, F; Pfeiffer, A; Fuereder, T; Hoeflmayer, D; Kundi, M; Popow-Kraupp, T; Redlberger-Fritz, M; Mueller, CA; Cinatl, J; Michaelis, M; Geiler, J; Bergmann, M; Romanova, J; Roethl, E; Morokutti, A; Wolschek, M; Ferko, B; Seipelt, J; Dick-Gudenus, R; Muster, T
Journal: J Infect Dis 2010 Jan 28; Vol. 201, Issue 3; Page(s) 354-62
[Medline ID - 20039806]

BACKGROUND. The nonstructural protein NS1 of influenza virus counteracts the interferon-mediated immune response of the host. By deleting the open reading frame of NS1, we have generated a novel type of influenza vaccine. We studied the safety and immunogenicity of an influenza strain lacking the NS1 gene (DeltaNS1-H1N1) in healthy volunteers. METHODS. Healthy seronegative adult volunteers were randomized to receive either a single intranasal dose of the DeltaNS1-H1N1 A/New Caledonia vaccine at 1 of 5 dose levels (6.4, 6.7, 7.0, 7.4, and 7.7 log(10) median tissue culture infective dose) (n = 36 recipients) or placebo (n = 12 recipients). RESULTS. Intranasal vaccination with the replication-deficient DeltaNS1-H1N1 vaccine was well tolerated. Rhinitis-like symptoms and headache were the most common adverse events identified during the 28-day observation period. Adverse events were similarly distributed between the treatment and placebo groups. Vaccine-specific local and serum antibodies were induced in a dose-dependent manner. In the highest dose group, vaccine-specific antibodies were detected in 10 of 12 volunteers. Importantly, the vaccine also induced neutralizing antibodies against heterologous drift variants. CONCLUSIONS. We show that vaccination with an influenza virus strain lacking the viral interferon antagonist NS1 induces statistically significant levels of strain-specific and cross-neutralizing antibodies despite the highly attenuated replication-deficient phenotype. Further studies are warranted to determine whether these results translate into protection from influenza virus infection. TRIAL REGISTRATION. ClinicalTrials.gov identifier: NCT00724997 .

Ultrasound-guided epidural blood patch.
Author(s): Gnaho, A; Nguyen, V; des D; éserts, MD; Bonnet, F
Journal: Eur J Anaesthesiol 2010 Mar 31; Vol. 27, Issue 2; Page(s) 221-2
[Medline ID - 20038838]

ABSTRACT NOT AVAILABLE
  Page 1 of 100  




 



Resource Center

 - Merck Manual

 - Lab Test On-Line

 - MeSH Search



Clinical Conditions

 - A/C Degeneration

 - Adolescent Low Back

 - Ankle Sprain

 - Ankylosing Spondylitis

 - Arthritides

 - Brachial Plexus Neuritis

 - Carpal Tunnel Syndrome

 - Headache/Cephalgia

 - Cervical Disc Degen

 - Cervical Sprain

 - Cervical Strain

 - Cervical Osteoarthritis

 - Cervical Radiculopathy

 - Cervical Spine Instability

 - Cervical Spondylosis

 - Cervical Torticollis

 - Chronic Low Back Pain

 - Chronic Pain

 - Disc Displacement

 - Facet Arthropathy

 - Facet Capsulitis

 - Failed Back

 - Fibromyalgia

 - Frozen Shoulder

 - Knee Sprain

 - Lateral Epicondylitis

 - Low Back Pain

 - Lumbar Disc Degen

 - Lumbar Stenosis

 - Metatarsalgia

 - Psoriatic Arthritis

 - Reactive Arthritis

 - Rheumatoid Arthritis

 - Rotator Cuff Syndrome

 - SI Dysfunction

 - Sciatica

 - Scoliosis

 - Shoulder Bursitis

 - Spondylolisthesis

 - Stroke

 - Tarsal Tunnel Syndrome

 - TMD

 - Tendinopathy

 - Thoracic Outlet Syn

 - Ulnar Nerve Entrapment

 - Whiplash Injuries

 - Wrist Sprain



Resources

 - Chiropractic Organizations

 - State Associations

 - Schools & Institutions

 - NIH Grants Feed

 - HRSA Grants Feed

 - Evidence-Based Resource

 - Journal Links


Bookmark and Share

|  Home  |


 Copyright © 2007 - | DCConsult.com | All Rights Reserved.


the primary url for this site ( "DCConsult" ) is http://DCConsult.com




Category : Topics




Support for DCConsult provided by :