bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence for an age‐independent process in category learning
Authors: Livingston Kenneth R. , Andrews Janet K.
Published: June 2005

After learning to categorize a set of alien‐like stimuli in the context of a story, a group of 5‐year‐old children and adults judged pairs of stimuli from different categories to be less similar than did groups not learning the category distinction. In a same–different task, the learning group made more errors on pairs of non‐identical stimuli from the same category than did the other groups, suggesting increased within‐category item similarity, or compression. These expansion and compression effects add further support to the view that concept formation involves systematic changes in the metric of similarity space within which objects are represented. They also suggest that these processes do not vary with age, which is at least consistent with the hypothesis that they are fundamental to the mechanisms underlying concept formation.
Sensitivity to triadic attention in early infancy
Authors: Striano Tricia , Stahl Daniel
Published: June 2005

In Study 1, 54 3‐, 6‐ and 9‐month‐old infants interacted with an adult stranger who engaged in a face‐to‐face (dyadic) exchange. Dyadic interaction was halted when the adult turned away to look at an object. In a Joint Attention condition, the adult alternated visual attention between the infant and the object, and in a Look Away condition she looked away at the object only. Infants gazed and smiled more in the Joint Attention condition compared to in the Look Away condition. Infants’ gazing to the target object interacted with age and condition. In Study 2, 37 3‐, 6‐ and 9‐month old infants interacted with an adult who coordinated visual attention and affect, affect only, visual attention only, or ignored the infant. Infants gazed reliably more at E when she coordinated both affect and attention and smiled reliably more when the adult coordinated affect and attention or attention only. The findings show a sensitivity to triadic attention by 3 months of age.
Embedded figures detection in autism and typical development: preliminary evidence of a double dissociation in relationships with visual search
Authors: Jarrold Christopher , Gilchrist Iain D. , Bender Alison
Published: June 2005

Individuals with autism show relatively strong performance on tasks that require them to identify the constituent parts of a visual stimulus. This is assumed to be the result of a bias towards processing the local elements in a display that follows from a weakened ability to integrate information at the global level. The results of the current study showed that, among children with autism, ability to locate a figure embedded in a larger stimulus was only related to performance on visual search trials where the target was identified by a unique perceptual feature. In contrast, control children's embedded figures performance was specifically related to their performance on visual search trials where the target was defined by a conjunction of features. This double dissociation suggests that enhanced performance on perceptual tasks by children with autism is not simply a consequence of a quantitative difference in ability to engage in global processing.
Factors responsible for performance on the day–night task: response set or semantics?
Authors: Simpson Andrew , Riggs Kevin J.
Published: June 2005

In a recent study Diamond, Kirkham and Amso (2002) obtained evidence consistent with the claim that the day–night task requires inhibition because the picture and its corresponding conflicting response are semantically related. In their study children responded more accurately in a dog–pig condition (see /day picture/ say ‘dog’; see /night picture/ say ‘pig’) than the standard day–night condition (see /day picture/ say ‘night’; see /night picture/ say ‘day’). However, there is another effect that may have made the day–night condition harder than the dog–pig condition: the response set effect. In the day–night condition the names of the two stimuli (‘day’ and ‘night’) and the two corresponding conflicting responses (‘night’ and ‘day’) are from the same response set: both ‘day’ and ‘night’. In the dog–pig condition the names of the stimuli (‘day’, ‘night’) and the corresponding responses (‘dog’, ‘pig’) are from a different response set. In two experiments (Experiment 1 with 4‐year‐olds (n = 25); Experiment 2 with

, 4‐, 5‐, 7‐ and 11‐year‐olds (n = 81)) children were tested on four experimental conditions that enabled the effects of semantics and response set to be separated. Overall, our data suggest that response set is a major factor in creating the inhibitory demands of the day–night task in children of all ages. Results are discussed in relation to other inhibitory tasks.
Corporate Governance Failures: to what extent is Parmalat a particularly Italian Case?
Authors: Melis Andrea
Published: June 2005

The paper discusses to what extent Parmalat's failure can be considered a particularly Italian case. The main characteristics of Parmalat's corporate governance structure are compared and contrasted with those prevailing among Italian listed companies as well as with the highest corporate governance standards in Italy. Empirical evidence seems to confirm the lack of a monitoring structure in making corporate insiders accountable in the presence of a corporate governance system characterised by a controlling shareholder. The role of the ownership and control structure (with special regard to the controlling shareholder's role) and of the board of statutory auditors have Italian traits and might suggest that the Parmalat case is a particularly Italian scandal. However, Italian corporate governance standards were not completely at fault in the Parmalat case. Parmalat's corporate governance structure failed to comply with some of the key existing Italian corporate governance standards of best practice, such as the presence of independent directors and the composition of the internal control committee. Besides, the role of the external auditor as well as the internal control committee as non‐effective monitors seem to put Parmalat into the global argument case, not very different, mutatis mutandis, from other corporate scandals.
Behavioural Biases of Japanese Institutional Investors: fund management and corporate governance
Authors: Suto Megumi , Toshino Masashi
Published: June 2005

This study examines the behavioural biases of Japanese institutional investors and discusses implications for their role in corporate governance, based on the findings of a questionnaire survey of fund managers carried out in 2003. Statistical analysis of the survey results reveals a short‐term bias in fund managers’ investment time horizons, herding and self‐marketing to improve the appearance of portfolio performance under the pressure either of customers or of institutional restraints. We conclude that institutional investors’ behaviour contradicts their role as shareholders.
How do Entrenchment and Expropriation Phenomena Affect Control Mechanisms?
Authors: De Miguel Alberto , Pindado Julio , De La Torre Chabela
Published: June 2005

This paper examines how different control mechanisms relate to one another in the Spanish corporate governance system. We propose a new empirical approach that consists of analysing control mechanisms according to the non‐linearity of the value‐ownership relation, and emphasising entrenchment and expropriation phenomena. Our evidence contributes to understanding the role played by several control mechanisms in the Spanish corporate governance system, which largely differs from the US one. Our results show that control mechanisms (especially insider ownership, debt and dividends) are used in a complementary way by Spanish firms. Additionally, this complementarity is only observed when the interests of managers and owners converge, but not when there are controlling owners whose interests need not coincide with those of minority shareholders. Therefore, entrenchment and expropriation effects do influence the relationship among control mechanisms.
The Corporate Governance of Professional Football Clubs in England
Authors: Michie Jonathan , Oughton Christine
Published: June 2005

We analyse the corporate governance of professional football clubs operating in England's Premier and Football Leagues. Good corporate governance is essential if clubs are to be managed effectively and to survive in the difficult economic circumstances surrounding the football industry. The past couple of years have been especially testing, as Football League clubs have had to deal with the aftermath of the collapse of the ITV digital contract. Our analysis reveals that while there are some noticeable improvements in governance standards, many clubs would benefit from following best practice guidelines on information disclosure, the appointment of directors, board composition, induction and training of directors, risk management and consultation with stakeholders. Despite improvement in some areas over the past three years, standards of corporate governance in football clubs are significantly below those of listed companies as a whole and there is thus considerable need for improvement.

Corporate governance in the UK is regulated by Company Law and by codes of corporate governance such as The Combined Code (CC) and The OECD Principles. Whereas compliance with company law is obligatory, compliance with best practice codes of corporate governance, such as the CC, is voluntary in the sense that companies listed on the London Stock Exchange must either comply with the code or else explain any instance of non‐compliance in their Annual Report. The rationale for this self‐regulatory process is that good corporate governance brings benefits to companies in terms of engendering the trust of investors and improving corporate performance. Firms will therefore find it in their own best interests to comply with the code unless there is a good reason not to do so which can be explained to shareholders in the company's statement of compliance. Since the CC was first introduced, the degree of compliance, as measured by the proportion of companies adopting best practice, has increased considerably, representing a welcome improvement in governance standards.

In this paper we present results from our annual survey of FA Premier and Football League clubs, and our analysis of corporate governance statements published by listed clubs, to provide an assessment of the state of corporate governance of professional football clubs. On the basis of this analysis we make a number of recommendations for how the corporate governance of professional football clubs might be improved in the future.
The Financial Sector and Corporate Governance: the UK case
Authors: Mallin Chris , Mullineux Andy , Wihlborg Clas
Published: June 2005

Post 1992 Cadbury Committee report developments in UK corporate governance provisions are reviewed. The role of institutional investors, and the financial sector as a whole, in corporate governance is considered. Practices in “Continental Europe”, the UK and the US are contrasted, along with the roles of banks, strategic investors (“insiders”), institutional investors (“outsiders”) and capital markets. To be effective, capital markets must be efficient and competitive and auditing must be reliable. Current EU and US reform proposals are compared and prospects for convergence in corporate governance procedures assessed.
Childhood granulomatous periorificial dermatitis: lupus miliaris disseminatus faciei in children?
Authors: Misago N , Nakafusa J , Narisawa Y
Published: June 2005

Background  Childhood granulomatous periorificial dermatitis (CGPD) is a granulomatous disease characterized by monomorphous, small papular eruptions around the mouse, nose and eyes, and is thought to be closely related to perioral dermatitis. This condition has always been believed to occur more commonly in dark‐skinned patients; however, recent observations have revealed CGPD to occur also in white patients.

Observation  We report an 11‐year‐old Japanese boy with the characteristic features of CGPD. Although sarcoidosis and acne/granulomatous rosacea could be differentiated from CGPD, we could find no essential differences between CGPD and lupus miliaris disseminatus faciei (LMDF). The cases of LMDF in children, which were recorded in the Japanese literature, had highly similar clinicopathological features to those of CGPD. This case responded dramatically to topical tacrolimus in combination with the oral administration of minocycline.

Conclusions  The entity ‘facial idiopathic granulomas with regressive evolution’ is considered to include LMDF (a common adult form), CGPD (a rare childhood form) and perioral dermatitis (a peculiar form exacerbated by topical corticosteroids). Topical tacrolimus may be recommended as one of the therapies for LMDF as well as CGPD.
Degos disease with an inconspicuous clinical course
Authors: Loewe R , Palatin M , Petzelbauer P
Published: June 2005

Background  Degos disease is a rare systemic disorder with involvement of the skin and visceral organs, leading to death in about 50% of cases within 1 or 2 years. In recent years, several cases with cutaneous lesions only have been recognized.

Methods  We report on a young male patient presenting with single inconspicuous papules with bluish/black centres on the trunk and the upper limbs that, upon healing turn white. These lesions recurred on different locations over the past 6 years, and were never more than two to three at one time.

Results  Histopathological examinations revealed archetypal features for Degos disease. The patient had no other complaints, neither visceral organs nor the central nerve system were involved. Laboratory examinations were within normal range.

Conclusions  This case increases the number of reports on a benign course of Degos disease. It raises the question if the ‘malignant’ and the ‘benign’ course of the disease represent two distinct diseases or variants of a systemic vasculitis with unknown cause.
A new case of semicircular lipoatrophy associated with repeated external microtraumas and review of the literature
Authors: Gómez‐Espejo C , Pérez‐Bernal A , Camacho‐Martínez F
Published: June 2005

We present a new case of semicircular lipoatrophy whose lesions disappeared after 2 months of avoiding a repeated trauma in that area. It seems that this is the only associated aetiological factor, and this entity is perhaps a consequence of certain postural habits. The repeated microtraumas would damage the fatty tissue giving rise to the histopathological findings described, which are compatible with traumatic panniculitis. In conclusion, repeated microtraumas may be the aetiological factor in these cutaneous lesions. Other data in favour of this hypothesis are the disappearance of the lesions after avoiding the mechanical trauma, the fact that there were other affected people at work, and that this factor has also been identified in the majority of cases reported previously.
Tumorous variant of scleromyxedema. Successful therapy with intravenous immunoglobulins
Authors: Wojas‐Pelc A , Błaszczyk M , Glińska M , Jabłońska S
Published: June 2005

We present an unusual tumorous variety of scleromyxedema mimicking facies leonina in lymphoma. In spite of pronounced and widespread cutaneous changes, hypergammaglobulinaemia and paraproteinaemia, the general condition of the patient was satisfactory, there was no internal involvement and no symptoms of any malignancy. Initially, melphalan and corticosteroids were applied but were not effective. High‐dose intravenous immunoglobulin (IVIG) therapy had dramatic effect, and after five 5‐day monthly courses the tumours almost regressed and the skin became less hard. After a further five courses in the following year there was complete clearance, which was sustained without any therapy for 1 year (until now). IVIG appears to be the therapy of choice for scleromyxedema. We stress, however, that at the start of therapy, IVIG applications should be supplemented with small doses of melphalan and/or corticosteroids.
Vesiculous prurigo pigmentosa in a 13‐year‐old girl: good response to isotretinoin
Authors: Requena Caballero C , Nagore E , Sanmartín O , Botella‐Estrada R , Serra C , Guillén C
Published: June 2005

Prurigo pigmentosa is a rare inflammatory disease of unknown origin, first reported from Japan, with only 33 cases described in non‐Japanese patients. We describe a 13‐year‐old girl with a pruriginous symmetrical eruption of papules and vesicles affecting her back, neck and chest of 1 month duration. She remembered a similar, but lighter eruption, 2 months before. As the initial diagnosis was of a vesiculobullous form of Darier disease, treatment with isotretinoin 40 mg/day was started with good response. Histological study showed a superficial perivascular and interstitial dermatitis composed predominantly of lymphocytes. The epidermis was spongiotic, with exocytosis of lymphocytes and some neutrophils and necrotic keratinocytes. All these findings were consistent with prurigo pigmentosa. The lesions resolved leaving a light brown reticulate hyperpigmentation. Prurigo pigmentosa has never been reported in prepubescent patients, the vesiculobullous forms are unusual, and the only treatments used previously are sulphonamides, tetracyclines and macrolides. We report a 13‐year‐old Caucasian girl with vesiculobullous prurigo pigmentosa successfully treated with isotretinoin.
Adamantiades–Behçet's disease, deep venous thrombosis and anticardiolipin antibodies: report of two cases
Authors: Kandolf‐Sekulovic L , Pavlovic MD , Glisic B , Petronijevic M , Ristic G , Mijuškovic Ž , Zecevic RD , Stefanovic D
Published: June 2005

Vascular thrombosis was found in different proportions of patients with Adamantiades–Behçet's disease (ABD), depending on the ethnicity of the population under study. Various thrombophilic factors, including the levels of anticardiolipin antibodies (ACA), were investigated for their role in the thrombotic process with conflicting results. The prevalence of ACA varies considerably in different studies, but their presence has not been associated with increased risk for vascular thrombosis. We present two cases with ABD, deep venous thrombosis (DVT) and elevated levels of ACA that fulfil the criteria for both ABD and antiphospholipid syndrome (APS).
α1‐Antitrypsin deficiency‐associated panniculitis: case report and review of treatment options
Authors: Ortiz PG , Skov BG , Benfeldt E
Published: June 2005

α1‐Antitrypsin deficiency, a relatively frequent mutation in the population, is associated with the development of panlobular emphysema and liver cirrhosis. The deficiency is in rare cases associated with the development of panniculitis, and very differentiated clinical courses have been reported in the literature. We report a case of panniculitis in a patient with α1‐antitrypsin deficiency and describe briefly the pathophysiology of the disease and current treatment possibilities.
Circumscribed palmar hypokeratosis: clinical evolution and ultrastructural study after prolonged treatment with topical calcipotriol
Authors: Urbina F , Misad C , González S
Published: June 2005

Circumscribed palmar hypokeratosis is a recently described condition that consists of a solitary area of depressed skin affecting the palm (or sole). Its histopathological features include a thinned horny layer, a slightly diminished granular cell layer, and intraepidermal vacuolated cells. Prolonged treatment with topical calcipotriol resulted in complete recovery of the affected zone in the case reported here. A second biopsy of the lesion taken at around the fourth year of therapy showed a normalization of the granular layer, a reduction in the intraepidermal vacuolated cells, and a somewhat thicker horny layer. An ultrastructural study carried out at the same time showed a reduction in keratin bundles and keratohyalin granules, and an increase in lipid droplets up to the horny layer. These findings and the therapeutic response to topical calcipotriol support the concept that circumscribed palmar hypokeratosis is a focalized abnormal keratinization defect morphologically expressed at the granular and horny layers.
Recommendations for the topical treatment of psoriasis
Authors: Van De Kerkhof PCM , Kragballe K
Published: June 2005

Several topical treatments are available for patients with psoriasis. Although individualization of the treatment remains important, there is a need for treatment recommendations to identify the best treatment out of the available treatments and to help with improvement in treatment compliance. In this communication we give our views on the assessment of severity of psoriasis. We provide recommendations for selection of treatments, reconciling the clearance phase and the long‐term management. Finally, we provide recommendations for the treatment of particular localizations: the scalp and psoriasis at sensitive sites.
Effect of psoriasis treatment on plasma concentrations of metalloproteinase‐1 and tissue inhibitor of metalloproteinases‐1
Authors: Flisiak I , Myśliwiec H , Chodynicka B
Published: June 2005

Aim  The aim of this study was to evaluate the effect of psoriasis treatment on plasma concentrations of metalloproteinase‐1 (MMP‐1) and tissue inhibitor of metalloproteinases‐1 (TIMP‐1) with respect to disease severity.

Methods  MMP‐1 and TIMP‐1 were measured using an enzyme immunoassay in plasma of 32 patients before and after topical treatment. Data were analysed with respect to baseline values of the Psoriasis Area and Severity Index (PASI).

Results  Baseline plasma concentrations of both TIMP‐1 and MMP‐1 (1487 ± 102 and 21.0 ± 2.5 ng/mL, respectively) were significantly higher (P = 0.02 and 0.03, respectively) than normal. Both TIMP‐1 and MMP‐1 decreased significantly after completion of treatment to values similar to normal (1112 ± 127 and 11.3 ± 1.3 ng/mL, respectively). There was a significant positive correlation (r = 0.522) between baseline PASI and TIMP‐1 values. Significant differences were observed between baseline TIMP‐1 concentrations in groups with PASI < 15 and PASI > 20. Baseline values (1697 ± 162 ng/mL) in patients with severe course of the disease (PASI > 20) were significantly elevated in comparison to normal values. Treatment caused a decrease in TIMP‐1 plasma concentrations in all groups, but a significant difference was noted only in patients with pretreatment PASI > 20. Baseline MMP‐1 concentrations exceeded significantly normal values only in patients with PASI < 15 (27.2 ± 6.3 ng/mL) and 15–20 (18.4 ± 1.4 ng/mL). Treatment caused a significant decrease in MMP‐1‐values in all groups to levels similar to normal.

Conclusions  Our results confirm the role of TIMP‐1 and MMP‐1 in the pathogenesis of psoriasis. Pretreatment plasma TIMP‐1 increased whereas MMP‐1 decreased in patients with a more severe course of the disease. However, successful treatment causes normalization of these plasma protein concentrations irrespective of psoriasis baseline activity.
A phase I/II randomized, double‐blind, placebo‐controlled, dose‐ranging study evaluating the efficacy, safety and pharmacokinetics of ravuconazole in the treatment of onychomycosis
Authors: Gupta AK , Leonardi C , Stoltz RR , Pierce PF , Conetta B ,   the Ravuconazole onychomycosis group
Published: June 2005

Objective  To determine the effectiveness and safety of ravuconazole in the treatment of toenail onychomycosis.

Design  A phase I/II randomized, double‐blind, double‐dummy, placebo‐controlled, dose‐ranging study. Four 12‐week dosing regimens were used: 200 mg/day; 100 mg/week; 400 mg/week and placebo. Subjects returned at weeks 2, 4, 6, 8, 10, 12, 14, 16, 24, 36 and 48 for assessment. Subjects were enrolled at 10 dermatology practices (seven in the United States, one in Canada, two in France).

Subjects  Adults with distal subungual onychomycosis of one great (hallux) toenail (minimum area of 25%), and at least 2 mm of proximal nail clear of disease were selected. Onychomycosis was confirmed by direct microscopy and/or fungal culture. Subjects with conditions known to produce abnormal‐appearing nails were excluded. One hundred and fifty‐one subjects were randomized in a 2 : 2 : 2 : 1 ratio to the treatments above.

Main Outcome Measures  Primary efficacy was the effective cure rate at week 48 (mycological cure, and clinical cure or > 30% improvement).

Results  Effective cure was found in 56% of subjects using 200 mg/day. Effective cure was 10% in subjects receiving 100 mg/week, 8% of subjects using 400 mg/week, and 15% of subjects using placebo. Mycological cure was seen in 59% of subjects in the 200‐mg/day group, which was significantly higher than the rates found in the other groups. Drug‐related adverse events were infrequent in all treatment arms. Headache was the most frequently reported event. Abnormal laboratory tests were infrequent over the 12 weeks of dosing. Abnormal laboratory findings with increases beyond normal of Grade 2, 3 or 4 were found in 8/148 subjects (5.4%). Only the 200 mg daily regimen had a mean plasma steady state concentration of ravuconazole exceeding the MIC90 adjusted for 98% protein binding (3000 ng/mL).

Conclusions  For the treatment of onychomycosis, ravuconazole 200 mg/day for 12 weeks is the most effective of the regimens investigated. The safety of all regimens was acceptable. The concentrations of ravuconazole in the plasma compared to the adjusted MIC90 may be useful in predicting the clinical and mycologic response of therapy.
Reactivity to euro coins and sensitization thresholds in nickel‐sensitive subjects
Authors: Seidenari S , Giusti F , Pellacani G , Antelmi AR , Foti C , Bonamonte D , Ayala F , Balato G , Cristaudo A , Stingeni L , Lisi P
Published: June 2005

Background  The 1‐ and the 2‐euro coins consist of nickel alloys, which release nickel. The nickel released by far exceeds the amount allowed by the European Union Nickel Directive referring to products intended to come into direct and prolonged contact with the skin. As there is only temporary contact with the skin, the clinical relevance of nickel‐containing coins with regard to nickel dermatitis is a matter of debate, although there is evidence that the nickel released from the coins affects some nickel‐sensitive subjects through occupational exposure.

Objectives  Our aim was to study skin reactivity to euro coins, and to correlate the frequency and intensity of coin patch test responses to sensitization thresholds to nickel.

Patients and methods  Sixty‐four nickel‐sensitized and 30 non‐nickel‐sensitized subjects were patch tested with serial dilutions of nickel sulfate (5, 1, 0.5, 0.1, 0.05, 0.01 and 0.005% in distilled water) and with coins. Italian coins (500, 200, 100 and 50 lira) and euro coins (2 and 1 euros, 20 and 5 euro cents) were used for patch testing and compared.

Results  The application of 1‐ and 2‐euro coins to the skin induced eczematous reactions, being more frequent and intense in comparison with those provoked by other coins. A correlation between intensity of responses to coin patch tests and sensitization threshold to nickel was observed. Patients with the strongest reactions to 1‐ and 2‐euro coins showed positive responses to the lowest nickel concentrations.

Conclusions  The nickel content in euro coins represents a possible health hazard, especially for highly nickel‐sensitive subjects. We recommend that nickel sulfate patch tests should be performed at different concentrations to determine sensitization thresholds at least in individuals with occupational exposure to coins.
Prevalence of Migraine and Cluster Headache in Swedish Men of 18
Authors: Ekbom Karl , Ahlborg Björn , Schéle Rickard
Published: June 2005

SYNOPSIS

The prevalence of migraine and cluster headache was investigated in a well‐defined homogeneous non‐hospital population of 9,803 18‐year‐old men from east central Sweden. The occurrence of headache was recorded by means of a questionnaire technique which proved to have a high degree of reliability as shown in personal interviews with a randomly chosen series of more than one‐fifth of the subjects. Personal interviews were held in all subjects. Personal interviews were held in all suspected cases of cluster headache. Recurrent headache occurred in 4.4% of the cases: migraine in 1.7%; cluster headache in 0.09%; other, non‐migrainous headache (MNH) in 2.6%. The majority of subjects had relatively frequent headaches, but only 43% of the migraine and 32% of the MNH subjects had sought medical advice for their complaint. Daily or almost daily consumption of analgetics was reported by 14% of the migraine and 11% of the NMH subjects. Ergotamine tartrate had been used by 15% of those suffering from migraine.Only 4 of the 9 subjects with cluster headache had been to a doctor on account of their headache, and only in one of them had a correct diagnosis been made. One subject had primary chronic symptoms, the remainder suffered periodically from cluster headache. Three subjects had symptoms since the age of 8‐9 years.
A Double Blind Trial of Acebutolol For Migraine Prophylaxis
Authors: Nanda R.N. , Johnson R.H. , Gray Janet , Keogh H.J. , Melville I.D.
Published: June 2005

SYNOPSIS

Drugs which block adrenergic receptors have previously been used in the prophylactic treatment ofmigraine with varying success. We report a double blind crossover trial with the ß‐blocker acebutolol(Sectral, May & Baker Ltd) in which 43 patients took part. The number, frequency, duration and intensity of the headaches were recorded by the patients and results were analysed for the 33 patients who completed the trial. Plasma levels of acebutolol were measured during the trial. There was good patient compliance but here was no obvious correlation found between any of the parameters measured and the concentration of the drug. Although there was a general reduction in frequency with intensity of migraine during treatment when compared with a pre‐trial period, there was also a large placebo effect which made it difficult to separate the true effect of the ß‐blocking drug. 13 patients, however, said that they felt better during the period of the trial when they were receiving acebutolol and continued on this treatment when the trial finished. The value of acebutolol therefore requires further evaluation in such patients.
Plasma 18 Hydroxy‐ II ‐ Deoxycorticosterone In Dialysis Patients With Headache
Authors: Bana Dhirendra S. , Graham John R.
Published: June 2005

SYNOPSIS

In previous studies, we reported chronic hemodialysis patients who suffer with headaches to have low renin, low aldosterone, and high blood pressure. We report the role of plasma 18 Hydroxy‐II‐deoxycorticosterone 18 OHDOC as another mineralocorticoid responsible for such biochemical change. Plasma 18 OHDOC level was found to be low in these patients.
Mast Cells and Headache in Crohn's Disease
Authors: Atkinson Ruth , Appenzeller Otto
Published: June 2005

SYNOPSIS

Four patients with vascular headaches of remarkable severity and chronicity not responding to usual therapies brought attention to their families in which at least two members each also have Crohn's disease. Hitherto an association of Crohn's disease with vascular headache of the migrainous type has not been recognized.One patient suffered bouts of extreme constipation at age four years. When eight years old he developed “screaming, pounding headaches”. During headaches, intermittent crampy periumbilical pain and diarrhea appeared. Subsequent radiologic and surgical evidence resulted in a diagnosis of Crohn's disease. His 11‐year‐old brother was seen for headaches which were intractable over a period of at least six months, but bowel symptoms has not appeared as yet. Their father has Crohn's disease.A 19‐year‐old woman with Crohn's disease presented with headaches of the migrainous type of eight months duration, resistent to all therapies. Her mother has Crohn's disease and migraine and a sister has peptic ulcers, “gaseous colon” and migraine.Resected bowel of three of these patients showed large numbers of mast cells. We suggest that vasoactive substances, including histamine released from mast cells, could cause headache. Moreover, impaired sulfate conjugation of monamines, or decreased monoamine oxidase in diseased bowel could facilitate the absorption and increase the circulation of vasoactive substances causing headache.
Rhinologic Causes of Facial Pain and Headache
Authors: Ryan Robert E. , Kern Eugene B.
Published: June 2005

SYNOPSIS

Facial pain and headache are common and difficult problems encountered by physicians. A rather common cause, frequently overlooked, is rhinologic. Structural or nasal mucosal (or both) disorders are capable of producing facial pain or headache. In addition, either benign or malignant lesions of the nose and or paranasal sinuses can cause facial pain and headache. An outline of the various rhinologic causes for facial pain and headache is offered. Speculations and correlations with various experimental studies are included in an attempt to explain some of the mechanisms of referred pain from the nose and sinuses to the head and face.
Response of Cluster Headache Attacks to Oxygen Inhalation
Authors: Kudrow Lee
Published: June 2005

SYNOPSIS

Fifty‐two randomly selected patients diagnosed as having either active episodic or chronic cluster headaches were evaluated for symptomatic response to oxygen inhalation. At the onset of attacks, 100% oxygen was administered through a facial mask at a rate of 7 liters per minute, for 15 minutes. Each patient self‐treated ten attacks, and timed the rated reduction of pain. A successful treatment result required complete or almost complete reduction of pain in seven of ten attacks, within 15 minutes.In a second (crossover) trial involving an additional 50 patients, sublingual ergotamine tartrate (ErgomarÒ) was compared to oxygen inhalation for symptomatic relief of cluster attacks. Each patient treated ten attacks with either preparation in accordance with the crossover design. Oxygen was administered as described above. Sublingual ergotamine was used every five minutes, to a maximum of three tablets, if necessary.In the first trial 3952 (75%) of patients obtained significant relief from cluster pain. The greatest benefit (92.9%) was found among episodic patients under 50 years of age. The least benefit (57%), was found among chronic patients over 49 years of age. In the second trial, results among oxygen users were better (82%) than those of ergotamine users (70%), but not significantly. Rapidity of relief was similar in both groups.The results of both series indicate that oxygen inhalation is an efficacious symptomatic treatment for cluster attacks. It is superior to ergotamine since there are neither complications nor contraindications to its use. Ergotamine, however, has the advantage of convenience.
5‐Hydroxytryptamine in Platelets of Patients with Muscle Contraction Headache
Authors: Rolf L.H. , Wiele G. , Brune G.G.
Published: June 2005

SYNOPSIS

5‐Hydroxytryptamine (5‐HT) was determined in platelets of 23 patients with muscle contraction headache and the results were compared to those obtained in a control group of 20 healthy persons. 5‐HT was observed to be significantly lower in patients with muscle contraction headache as compared to the control group. It is concluded that 5‐HT may be involved in peripheral andor central pain mechanisms of muscle contraction headache.
EMG Biofeedback During Dynamic Movement as a Treatment for Tension Headache
Authors: Ahles Tim A. , King Abby , Martin John E.
Published: June 2005

SYNOPSIS

Recent attempts to identify EMG elevations in patients with tension headaches have produced contradictory results. In the present case study, a 36‐year‐old male with a 17 year history of tension headaches was treated with trapezius EMG biofeedback while walking on a treadmill. The results demonstrated that: (1) EMG elevations could be identified during dynamic movement but not while in a static position and (2) EMG biofeedback during dynamic movement was effective in reducing EMG levels and headache activity. The results are discussed in terms of the potential importance of assessing and modifying patterns of elevated EMG activity which contribute to headaches during naturalistic activities such as walking.
Exteroceptive Suppression of Temporalis Muscle Activity in Patients with Chronic Headache and in Normal Volunteers: Methodology, Clinical and Pathophysiological Relevance
Authors: Schoenen J.
Published: June 2005

SYNOPSIS

Exteroceptive suppression of temporalis muscle activity was studied in patients with chronic headache and in healthy controls. Among different methods of recording, averaging 10 full‐wave rectified EMG responses produces results with acceptable variability and discomfort. The late temporalis exteroceptive suppression period (ES2) is reduced on average in patients with chronic tension‐type headache; this finding has been reproduced by several independent laboratories. Mean duration of temporalis ES2 is also diminished, but to a lesser degree, in daily drug abuse headache and, as shown by others, in episodic tension‐type headache. It is normal in migraine between attacks, cluster headache and various types of symptomatic headaches. Temporalis ES2 may be decreased in untreated patients with major depression.

In healthy volunteers, temporalis ES2 duration is reduced by a short‐lasting painful stimulus to peripheral limbs after a delay of 50 to 60 ms, and by a sub‐motor threshold electromagnetic stimulation to the contralateral cerebral cortex after a delay of 20 to 30 ms. In contrast, long‐lasting trains of peripheral painful stimuli have no effect. Various pharmacological agents are able to modify temporalis ES2. Its duration is increased by 5‐HT antagonists, but decreased by 5‐HT uptake blockers. Pharmacological effects may differ between controls and patients. Considering these results and available data on the anatomo‐functional organization of masticatory reflexes, we postulate that temporalis ES2 is a marker of the excitability of interneuronal nets in the ponto‐medullary reticular formation. In chronic tension‐type headache, excitability of these interneurons is decreased because of inadequate control by the serotonergic raphe magnus nucleus and the periaqueductal gray matter. Dysfunctioning of the latter structures might be caused by abnormal limbic inputs to the brain stem. Some steps of this pathophysiological hypothesis can be verified by modern neurophysiological techniques.
Head Band for Migraine Headache Relief
Authors: Vijayan N.
Published: June 2005

SYNOPSIS

Application of an ice pack and local scalp pressure are the most commonly used non‐pharmacological methods for temporary relief of migraine headache pain. An elastic band secured around the head with Velcro(r) and firm rubber discs inserted under the band was used to apply local pressure over the area of maximum pain in 25 patients with migraine headache. Three headaches were studied in each patient. Two patients dropped out because of local tenderness which prevented them from using the band. The 23 remaining patients used the band in a total of 69 headaches. Pain relief was monitored for 30 minutes at 10 minute intervals. Sixty headaches (87%) were relieved. Nine headaches (13%) were not improved. Sixty‐seven percent of those who improved (40 headaches) had relief of over 80%, twenty‐five percent (15 headaches) improved between 50–60% and eight percent (5 headaches) had less than 50% improvement. Pain severity steadily increased when the band was released. Temporary relief of pain from mechanical compression of the scalp supports the possibility that at least part of the pain in migraine headache originates from dilated blood vessels in the scalp.
Failure to Mourn as a Possible Contributory Factor to Headache Onset in Adolescence
Authors: Kaiser Ronald S. , Primavera Joseph P.
Published: June 2005

SYNOPSIS

Patients who have suffered from chronic headaches frequently are unable to identify a triggering physical or emotional event that precipitated the headache process. This study examined the headachehistories of teenage headache patients, the majority of whom were found to be depressed, and found that personal loss occurred within 12 months of headache onset in 11 of 15 cases. Among the losses that were identified were those involving terminal illness and death of family members, separation and/or divorce in the family, or change of residence from a familiar area.

It is recommended that opportunities for dealing with feelings about their losses should be presented to patients, whether or not the patients express a need for this. Furthermore, it is recommended that patients of any age who cannot identify a triggering event prior to the onset of their headache histories should be questioned in detail about the possible correlation with personal loss.
Sometimes Jello Helps: Perceptions of Headache Etiology, Triggers and Treatment in Literature
Authors: Patterson Stephanie , Silberstein Stephen D.
Published: June 2005

SYNOPSIS

Throughout history writers have attempted to describe the symptoms and evoke the misery of “a dismal headache.”Writers from Plato to Stephen King have used the phenomenology of headache to illustrate their work. Lewis Carroll, for example, vividly describes the central scotoma, tunnel vision, phonophobia, vertigo, distortions in body image, dementia and visual hallucinations that often accompany migraine.

Although many authors have discussed the topic seriously, others have addressed the issue in a dismissive and even contemptuous manner, relegating this very real disorder to the status of a medical stepchild. We will examine headache etiology, triggers and treatment and explore the attitudes toward headache and headache sufferers found in literature.

We have recently seen a growing understanding of the physiological basis of headaches. However, this knowledge has not yet reached the level of literature or popular culture. In an age when it seems every Sunday night brings a new “disease of the week” movie, and every human ill is subjected to often intense and numbing scrutiny by the media, the anguish of a chronic migraine sufferer will probably remain unexplored ‐ unless she kills her husband and children during an attack.
Roentgenographic Findings of the Cervical Spine in Tension‐Type Headache
Authors: Nagasawa Arata , Sakakibara Toshimasa , Takahashi Akira
Published: June 2005

SYNOPSIS

Roentgenographic studies were carried out on 372 patients with tension‐type headache and 225 normal control subjects to determine relationships between straightened cervical spines, low‐set shoulders, and cervical spine instability. A great majority of the patients with tension‐type headache were found also to have straightened cervical spine. Patients with tension‐type headache may have a restricted progression of the cervical spinal Iordosis, which results in a straightened cervical spine. The flexor muscles of the head and neck prevent physiological Iordosis of the cervical spine, and their sustained chronic contraction may be a principal cause of a straightened neck. The low‐set shoulder was frequently seen in patients with tension‐type headache, and it may result in traction of the brachial plexus, which gives rise to pain in the neck and shoulders. Cervical spine instability, on the other hand, was rather infrequent in patients with tension‐type headache. Its relationship to tension‐type headache is unclear and warrants further study. Our results suggest that both a straightened cervical spine and low‐set shoulders may play an important role in the pathogenesis of tension‐type headache and its accessory symptoms.
Respiratory Sinus Arrhythmia in Cluster Headache Syndrome
Authors: Kruszewski Piotr
Published: June 2005

SYNOPSIS

Respiratory sinus arrhythmia is regarded as indicative of cardiac vagal integrity. A ratio of the longest R‐R interval to the shortest R‐R interval during deep breathing test (E:I ratio) was calculated in controls (n=49), cluster headache (n=33) and CPH (n=4) patients, E:I ratio decreased with age but was not dependent upon sex or upon smoking habits. Furthermore, there were no significant differences as regards E:I ratio between cluster headache patients in and outside a bout, or between patients with right‐sided and left‐sided headache. However, the E:I ratio was found to be significantly lower in the cluster headache group as such, when compared with controls, but the number of patients disclosing pathological or borderline results was small, 2 and 2, respectively. This may indicate that a putative vagal dysfunction in cluster headache is usually less marked than in patients with e.g. diabetic autonomic neuropathy. Significant attack‐related change in the E:I ratio were detected in all individual patients though these changes were not of a uniform nature from individual to individual. E:I ratios were rather high in 3 out of 4 CPH patients examined. However, the number of patients in this group is too small to allow definite statements about the difference between CPH end cluster headache with regard to E:I ratios. There was no significant difference between E:I ratios outside and during a mild, short, mechanically precipitated attack in a single CPH patient.
Migraine: An Alternative in the Diagnosis of Unclassified Vertigo
Authors: Aragones J.M. , Fortes‐Rego J. , Fuste J. , Cardozo A.
Published: June 2005

SYNOPSIS

Vertigo and unsteadiness are frequent reasons for medical consultation. In some cases, these symptoms remain unclassified. The association of equilibrium disorders with migraine is often mentioned in literature.

Seventy‐two cases of unclassified vertigo were studied in order to ascertain the prevalence of migraine in patients affected by recurring episodes of vertigo from undetermined causes, and attempting to establish a possible relationship with migraine. Characteristics of the vertigo and the headache, were evaluated by clinical history and examination, electronystagmogram (ENG), electroencephalogram (EEG), computerized tomography scanning (CT) and/or magnetic resonance imaging (MRI). In the group of patients studied 50% suffered from headache, and 32.8% fulfilled the diagnostic criteria of migraine. Results suggest that only a thorough clinical history would be able to give enough information to establish the diagnosis of migraine in these patients.

These observations imply an alternative diagnosis to be taken into account when a case of unclassified vertigo is evaluated.
Posttraumatic Headache: Determining Chronicity
Authors: Packard Russell C. , Ham Lesley P.
Published: June 2005

SYNOPSIS

In the headache literature, there exists a great deal of discrepancy regarding when posttraumatic headache (PTH) may be classified as chronic. Although chronic pain is usually described as pain persisting for longer than six months, many view chronic posttraumatic headache as persisting for more than two months, including the International Headache Society criteria. Observations made by Brenner and Friedman in 1944 have been repeatedly cited for this determination. Surprisingly, a review of this original source revealed that the term “chronic“ was never used when discussing posttraumatic headache over two months duration. The authors, in fact, suggested two months as an “arbitrary” dividing line. Recent studies suggest that many patients with PTH continue to improve or change over the first six months but start to plateau after that time. We feel six months serves as a better time indicator for defining chronicity in cases of posttraumatic headache. This would be more consistent with the current literature concerning chronic pain and the International Headache Society criteria for chronic tension headache.
Value of MRI in Pediatric Migraine
Authors: McAbee Gary N. , Siegel Sheryl E. , Kadakia Satish , Cantos Eric
Published: June 2005

SYNOPSIS

Twenty four pediatric migraineurs were prospectively evaluated to determine if white matter hyperi ntensities were presenton magnetic resonance imaging (MRI). None had white matter findings or brain abnormalities. Five had mucoperiosteal thickening of the paranasal sinuses, which were unrelated to the patients' clinical course. MRI white matter findings are probably not a common occurrence in pediatric migraineurs. In addition, MRI sinus findings are not necessarily related to a child's headache complaints.