bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Human Activity on the Structure of Coastal Marine Bird Assemblages in Central Chile
Authors: Cornelius Cintia , Navarrete Sergio A. , Marquet Pablo A.
Published: August 2010

Abstract:In comparison with the effects of the collection of marine intertidal organisms by humans, the effects of human recreational activities on assemblages of marine birds have received scarce attention. We evaluated whether in central Chile the spatial and temporal variation in the composition and abundance of the avian assemblage is affected by the presence of humans on the coast. We studied a 1.5‐km stretch of rocky coast, in the center of which is a small marine reserve where no fishing or recreational activities take place. At 15 observation points, we conducted 12 monthly surveys of birds that roost in the supralittoral zone, between the high‐tide mark and the terrestrial vegetation, and/or that forage in the intertidal zone. In addition, within the reserve we conducted daily bird surveys over 2 years to evaluate whether abundance or composition changed according to the activity of people outside the reserve. We recorded 19 species of coastal marine birds. Eleven species used the supralittoral zone only for roosting (roosting assemblage), whereas the others foraged on intertidal organisms and roosted in the supralittoral zone (  foraging assemblage). Although the largest negative effect of human activity on bird abundance occurred in summer, the period of greatest recreation intensity, the presence of humans negatively affected birds year round, changing both the spatial and temporal distribution of birds along the shore. Bird abundance was higher at observation points inside the marine reserve, although the pattern was stronger for birds roosting on the supralittoral zone than for birds actively foraging in the intertidal zone. Similarly, the number of birds recorded during weekends inside the reserve was higher than during week days. Our results illustrate the important role played by this marine reserve, which offers marine birds safe roosting sites without human interference. Larger marine reserves than the one we studied are needed because the dynamics of birds inside the reserve were strongly influenced by human activities in immediately adjacent areas. Our results emphasize the need to consider human recreational activities along the coast when establishing conservation programs because harvesting refugia or “no‐take” zones will not provide protection to coastal bird assemblages unless human access is restricted.
Effects of Roads on Movements by Understory Birds in Mixed‐Species Flocks in Central Amazonian Brazil
Authors: Develey Pedro F. , Stouffer Philip C.
Published: August 2010

Abstract:Roads through tropical forest create linear disturbances that have unknown consequences for forest birds. We studied how a narrow, rarely used road through otherwise undisturbed Amazonian forest affected the movements and area requirements of understory birds that form mixed‐species flocks. Differences in road maintenance led to two distinct treatments along the same road. Trees along the “closed” road formed a partial canopy connecting the two sides of the road, although the roadway itself was kept open. The “open” road was regularly maintained, making a complete opening 10–30 m wide.We followed 15 flocks, 5 each in interior forest, along the open road, and along the closed road. These flocks were led byThamnomanesantshrikes, and each flock had a discreet, permanent territory. Flock territory size (mean = 8.5 ha) did not differ among the three locations. The open road formed the territorial boundary for all five flocks, although birds moved within a few meters of the edge of the road. The closed road was less of a barrier: 2 of 5 flocks used both sides of the closed road. Playback experiments showed that flocks readily crossed the closed road to approach agonistic vocalizations. Along the open road, even though birds responded to playback by becoming agitated and moving to the extreme edge of the roadside vegetation, they were less likely to cross the road and did so only after a longer duration of playback. Our results suggest that flocks respond to a road as they would to a long linear gap. They use the vegetation along the edges of the road, but because they are unwilling to cross the open area, it becomes a flock territory boundary. Similarly, as in forest gaps, successional change along the closed road produced suitable habitat for flocks. Although this suggests that roads are a trivial problem, we caution that this result applies only to narrow roads that are not accompanied by deforestation or other disturbance.
Avian Conservation under the Endangered Species Act: Expenditures versus Recovery Priorities
Authors: Restani Marco , Marzluff John M.
Published: August 2010

Abstract: Budget constraints require the U.S. Fish and Wildlife Service to prioritize species for recovery spending. Each listed species is ranked according to the degree of threat it faces, its recovery potential, and its taxonomic distinctness. We analyzed state and federal government expenditures for recovery of threatened and endangered birds (n = 85 species) from 1992 to 1995 to determine if the priority system was being followed. Although recovery spending correlated with priority rank, priority rank explained <5% of the variation in spending. A small number of the same moderately ranked species dominated expenditures each year (41–79% of total annual budgets). Species with wide distributions, high recovery potential, and captive breeding programs received the most funding, and more funding than their priority ranks dictated. Island species received significantly less funding than expected based on priority rank. Twelve species, 10 of which resided on islands, received <$5000 at least once from 1992 to 1995. Recovery spending was unrelated to degree of threat, taxonomic distinctness, and migratory status. There also was no relationship between land‐purchase expenditures and priority ranks. To improve the relationship between recovery spending on threatened and endangered birds and their priority rank, significant changes need to be made within the private sector ( less litigation and special‐interest lobbying  ), U.S. Congress (increased budget and reduced earmarking  ), and the U.S. Fish and Wildlife Service (restructuring of regional offices and increased accountability).
Improving Peer Review of Listings and Recovery Plans under the Endangered Species Act
Authors: Hecht Anne , Parkin Mary J.
Published: August 2010

Abstract: We discuss several challenges encountered in peer review of Endangered Species Act listings and recovery plans, with particular attention to Meffe et al.'s (1998) statement on independent scientific review in natural resource management. First, Endangered Species Act listing documents and recovery plans pose a diverse array of scientific questions, and we suggest that overall effectiveness of peer review may be increased by segregating the critical issues and identifying specific reviewers for each issue. Some scientific reviewers may be unfamiliar with the decision standards prescribed by the Endangered Species Act and implementing policies. Unnecessary confusion could be prevented by providing reviewers with information about these standards and by requesting that reviewers clearly differentiate their assessment of decisions that must be based on available information from recommendations for future research. Short review periods constitute another constraint on careful review, but tight deadlines are fairly intractable in the context of the Endangered Species Act. We suggest that short time frames could be partially ameliorated by narrowing the scope of issues to be treated by each reviewer, and we discuss the issue of providing monetary compensation for efficient review. Finally, Endangered Species Act listing decisions and recovery planning may profit from more frequent peer review of intermediate analyses that precede publication of formal proposals or complete plans.
An Edge Effect Caused by Adult Corn‐Rootworm Beetles on Sunflowers in Tallgrass Prairie Remnants
Authors: McKone Mark J. , McLauchlan Kendra K. , Lebrun Edward G. , McCall Andrew C.
Published: August 2010

Abstract: The once‐extensive tallgrass prairie community of North America has been reduced to small remnants, many of which are surrounded by intensive corn (  Zea mays) agriculture. We investigated adult corn‐rootworm beetles (Chrysomelidae: Diabrotica spp.), important pests of corn, on sunflowers (Asteraceae: Helianthus spp.) in prairie remnants in southeast Minnesota. Large numbers of beetles invaded the prairie from surrounding corn fields in late summer. D. barberi and D. virgifera were captured on sticky traps in all locations in the prairie, but abundance was much greater near the edge adjacent to corn. We observed D. barberi ( but not D. virgifera) feeding extensively on sunflower pollen and occasionally on other flower parts, such as petals. Sunflowers located nearer corn fields sustained more floral damage than those farther from corn. To determine the effect of beetle damage on seed set, we enclosed sunflower heads in bags with either zero, two, or four D. barberi adults. Seed set was reduced in heads enclosed with D. barberi. Thus, this agricultural pest may interfere with the successful reproduction of sunflowers and possibly other prairie composites that flower in late summer. Given the small size of most prairie remnants and the abundance of this flower‐feeding beetle in landscapes dominated by corn agriculture, D. barberi may affect the sustainability of prairie plant populations.
Conservation and Community Benefits from Traditional Coral Reef Management at Ahus Island, Papua New Guinea
Authors: CINNER JOSHUA E. , MARNANE MICHAEL J. , McCLANAHAN TIM R.
Published: August 2010

Abstract:  We investigated traditional coral reef management practices at Ahus Island, Manus Province, Papua New Guinea, to evaluate their social role in the community and potential to conserve reef ecosystems. For generations, Ahus Islanders have prohibited spear and net fishing within six delineated areas of their reef lagoon. One to three times per year, fish are briefly harvested from the restricted areas to provide food for ceremonial occasions. Underwater visual censuses of fishes revealed a significantly greater biomass and average size of target species within the restricted areas (205 kg/ha ± 20 [SE]; 102 mm TL [total length]± 0.7) compared with areas without fishing restrictions (127 kg/ha ± 13 SE; 85 mm TL ± 0.7). We estimated the biomass of fish removed during one of the harvest events was 5 to 10% of the available biomass within the restricted area, and in underwater visual surveys conducted before and after a harvesting event we detected no effect of harvesting on fish stocks. Compliance with the fishing restriction is attributed to its perceived legitimacy, its ability to provide the community with direct and indirect benefits, and its reflection of local socioeconomic circumstances. Limited‐take closure systems that can serve the needs of a community may provide a viable conservation alternative in situations where compliance with fully closed protected‐area regulations is low and resources for proper enforcement are untenable.
A Multidisciplinary Approach to Assessing the Sustainability of Freshwater Crayfish Harvesting in Madagascar
Authors: JONES JULIA P. G. , ANDRIAHAJAINA FORTUNAT B. , HOCKLEY NEAL J. , BALMFORD ANDREW , RAVOAHANGIMALALA OLGA R.
Published: August 2010

Abstract:  There is growing interest among conservation decision makers in promoting harvesting of forest products as an incentive for communities to retain forest cover. Assessments of the sustainability of existing harvests are essential for implementing such policies. Madagascar's endemic freshwater crayfish, Astacoides spp., are harvested throughout their range. Despite their importance to human communities, Madagascar's crayfish, like much of the island's freshwater biodiversity, are poorly known, and there is concern that the harvest may be unsustainable. We investigated sustainability of the crayfish harvest in and around Ranomafana National Park in eastern Madagascar, focusing on the heavily harvested A. granulimanus. Several villages around the park have traditional taboos against selling crayfish, resulting in widely varying levels of crayfish exploitation. We used two approaches to assess sustainability of the harvest. First we used participatory mapping combined with a geographic information system analysis to produce a spatially accurate map of harvesting intensity. We then carried out mark‐and‐recapture sampling at 74 sites across a range of harvest intensities to test whether the level of harvesting was a significant predictor of crayfish density and structure. Second, we used size‐structured matrix population models to estimate the forest area necessary to provide the observed annual harvest from one harvesting village and compared this estimate with the area available to the harvesters. Our findings show that the crayfish harvest in Ranomafana may be sustainable under current socioeconomic conditions, suggesting that A. granulimanus is less vulnerable to overexploitation than previously thought. We emphasize the importance of a multidisciplinary approach to assessing sustainability involving both ecological information about the harvested species and socioeconomic data about the level and spatial pattern of the harvest.
A Decision Framework for the Adaptive Management of an Exploited Species with Implications for Marine Reserves
Authors: GERBER LEAH R. , WIELGUS JEFFREY , SALA ENRIC
Published: August 2010

Abstract:  Marine reserves have both conservation and fishery benefits. Nevertheless, there are no general criteria about when and where to establish new reserves, how to evaluate their efficacy, and how to conduct adaptive management to achieve conservation goals. We applied a decision‐theory framework to optimally allocate conservation resources between improving data on population status and establishing a reserve for species conservation. Our goal was to maximize reserve benefits given the constraints of a population growth rate that would permit sustainability of resources. We illustrate our decision framework with a retrospective analysis of a 7‐year time series on abundance of the leopard grouper (Mycteroperca rosacea) in the Sea of Cortés, Mexico. We used the lower bound of the distribution of the population growth rate (λ) as a decision rule for determining how many years of monitoring are needed to detect reserve effects. We determined the minimum time frame needed to estimate λ based on a stated level of risk tolerance for four sites. As expected, the coefficient of variation for the λ declined with the number of years of data. This increased precision with additional years of data resulted from the high degree of annual variability in the system. Where populations were slow to respond to reserves, more data were needed to detect a positive λ value. For the leopard grouper case study, confidence in the estimate of λ increased with the number of years of data. Our decision framework may be used to identify the minimum number of years of data needed before a management decision about reserve establishment could be made that is reasonably likely to meet its management objectives.
Conservation Planning in Forest Landscapes of Fennoscandia and an Approach to the Challenge of Countdown 2010
Authors: MIKUSIŃSKI G. , PRESSEY R. L. , EDENIUS L. , KUJALA H. , MOILANEN A. , NIEMELÄ J. , RANIUS T.
Published: August 2010

Abstract: Effective management of biodiversity in production landscapes requires a conservation approach that acknowledges the complexity of ecological and cultural systems in time and space. Fennoscandia has experienced major loss of forest biodiversity caused by intensive forestry. Therefore, the Countdown 2010 initiative to halt the loss of biodiversity in Europe is highly relevant to forest management in this part of the continent. As a contribution to meeting the challenge posed by Countdown 2010, we developed a spatially explicit conservation‐planning exercise that used regional knowledge on forest biodiversity to provide support for managers attempting to halt further loss of biological diversity in the region. We used current data on the distribution of 169 species (including 68 red‐listed species) representing different forest habitats and ecologies along with forest data within the frame of modern conservation software to devise a map of priority areas for conservation. The top 10% of priority areas contained over 75% of red‐listed species locations and 41% of existing protected forest areas, but only 58% of these top priorities overlapped with core areas identified previously in a regional strategy that used more qualitative methods. We argue for aggregating present and future habitat value of single management units to landscape and regional scales to identify potential bottlenecks in habitat availability linked to landscape dynamics. To address the challenge of Countdown 2010, a general framework for forest conservation planning in Fennoscandia needs to cover different conservation issues, tools, and data needs.
Patient Attitudes About Headache
Authors: Barnat Michael R. , Lake Alvin E.
Published: August 2010

SYNOPSIS

There is a growing body of literature on the psychology of headache. Little of that research effort has gone to study patient attitudes toward the disorder, for example the impact of headache on the patient's subjective quality of life. Only one study (Packard, 1979) has recently focused on differences in perception between headache patients and their physicians.

The present study was designed to help fill a gap in the existing knowledge of patient perceptions. The respondents were first visit patients in a headache treatment center. A survey form was employed and revised and in two sampling efforts the opinions of two hundred fifty two patients were obtained.

The following areas of empirical interest are described: demographic characteristics of the sample and headache characteristics, the patient's perceptions of headache causation, the relationship between headache and other life problems, patients' understanding of relief factors, their own coping strategies, emotional reactions during headache and the “social stigma” associated with headache.

Patients frequently have concerns about where their case fits in to the whole spectrum of headache suffering. The data above, taking into account the fact that samples will differ from setting to setting, can be helpful in educating both patients and their physicians about this complex disorder.
Recurrent VI Nerve Palsy in Cluster Headache
Authors: Peatfield R.C.
Published: August 2010

SYNOPSIS

A patient is reported who has had 4 bouts of typical left‐sided cluster headache, each lasting for about 6 weeks. In the last 3 of these he developed a right lateral rectus palsy, which persisted unchanged throughout each cluster and settled about a week after the pain subsided. No alternative cause for the palsy could be identified and its mechanism remains obscure, though it may be in some way related to ophthalmoplegic migraine.
Child, Parent, and Physician Reports of a Child's Headache Pain: Relationships Prior to and Following Treatment
Authors: Andrasik Frank , Burke Edmund J. , Attanasio Virginia , Rosenblum Edwin L.
Published: August 2010

SYNOPSIS

While headache represents one of the most common medical complaints of children, very little is known about its phenomenology. In the two studies currently reported, children's headache complaints were assessed in several ways. In Study 1, 53 children and their parents provided estimates of 3 parameters of headache during separate interviews and then engaged in 4 continuous weeks of daily record keeping, all of which occurred prior to participating in a behavioral treatment program. In Study 2, 37 of the children who had completed treatment and their parents participated in the same type of assessment to determine correspondence between various ways to gauge improvement. Additional estimates of improvement were collected by administering visual analog scales to children, parents, and a pediatric neurologist (upon completion of his independent interview). Although child and parent estimates of headache activity obtained at the initial interview were highly consistent, these estimates greatly overstated the values recorded by the children in their daily diaries. Interview estimates overstated diary values by from 56% to 112%. The interview estimation biases were greatly reduced by treatment's end, however, and were no longer significant for all but 1 measure. Parent and child diaries revealed high levels of agreement for headache intensity both prior to and following treatment. Signficant disagreement occurred prior to treatment for headache frequency, but this did not continue following completion of treatment. Visual analog estimates of improvement were not statistically different from improvement measured by diary report, although children, parents, and neurologist underestimated actual improvement by 5%, 10%, and 20%, respectively.
Sumatriptan for the Range of Headaches in Migraine Sufferers: Results of the Spectrum Study
Authors: Lipton Richard B. , Stewart Walter F. , Cady Roger , Hall Charles , O'Quinn Stephen , Kuhn Timothy , Gutterman Donna
Published: August 2010

Background.—Migraineurs experience a spectrum of headaches: migraine, migrainous, and episodic tension‐type as defined by the International Headache Society (IHS).

Objective.—To evaluate the effectiveness of sumatriptan, 50‐mg tablets, in treating the spectrum of headaches in IHS‐diagnosed migraineurs.

Design/Methods.—Migraineurs with severe disability (Headache Impact Questionnaire score 250 or greater) were enrolled in a randomized, double‐blind, placebo‐controlled, crossover study. Patients treated up to 10 headaches with sumatriptan, 50 mg, or placebo (4:1). Headache features, recorded prior to treatment, were used to classify each headache using IHS criteria. Headache response (moderate or severe pain reduced to mild or no pain) and pain‐free response were recorded at 2 and 4 hours postdose (primary endpoint). Because patients treated multiple attacks, statistical methods controlling for within‐subject correlation were used.

Results.—Two hundred forty‐nine migraineurs treated 1576 moderate or severe headaches: migraine (n = 1110), migrainous (n = 103), and tension‐type (n = 363). Sumatriptan was superior to placebo for headache response 4 hours postdose (primary endpoint) across all headache types (migraine, 66% versus 48%; P<.001; migrainous, 71% versus 39%; P<.01; tension‐type, 78% versus 50%, P<.001). Sumatriptan was also superior to placebo for pain‐free response 4 hours postdose for migraine (41% versus 24%, P<.001) and tension‐type headaches (56% versus 36%, P = .001). Sumatriptan provided superior pain‐free response 2 hours postdose for migraine (18% versus 7%, P<.0001) and tension‐type headache (28% versus 14%, P = .0005) compared with placebo.

Conclusion.—Sumatriptan, 50‐mg tablets, are effective for the full spectrum of headaches experienced by patients with disabling migraine due to a sumatriptan‐responsive mechanism.
Comorbidity of Depressive and Anxiety Disorders in Chronic Daily Headache and Its Subtypes
Authors: Juang Kai‐Dih , Wang Shuu‐Jiun , Fuh Jong‐Ling , Lu Shiang‐Ru , Su Tung‐Ping
Published: August 2010

Objective.—To investigate the frequency of depressive and anxiety disorders in patients with chronic daily headache.

Background.—There is a lack of data in the literature on the extent of psychiatric comorbidity in patients with different subtypes of chronic daily headache.

Methods.—We recruited consecutive patients with chronic daily headache seen in a headache clinic from November 1998 to December 1999. The subtypes of chronic daily headache were classified according to the criteria proposed by Silberstein et al. A psychiatrist evaluated the patients according to the structured Mini‐International Neuropsychiatric Interview to assess the comorbidity of depressive and anxiety disorders.

Results.—Two hundred sixty‐one patients with chronic daily headache were recruited. The mean age was 46 years, and 80% were women. Transformed migraine was diagnosed in 152 patients (58%) and chronic tension‐type headache in 92 patients (35%). Seventy‐eight percent of patients with transformed migraine had psychiatric comorbidity, including major depression (57%), dysthymia (11%), panic disorder (30%), and generalized anxiety disorder (8%). Sixty‐four percent of patients with chronic tension‐type headache had psychiatric diagnoses, including major depression (51%), dysthymia (8%), panic disorder (22%), and generalized anxiety disorder (1%). The frequency of anxiety disorders was significantly higher in patients with transformed migraine after controlling for age and sex (P = .02). Both depressive and anxiety disorders were significantly more frequent in women.

Conclusion.—Psychiatric comorbidity, especially major depression and panic disorders, was highly prevalent in patients with chronic daily headache seen in a headache clinic. These results demonstrate that women and patients with transformed migraine are at higher risk of psychiatric comorbidity.
Chronic Bilateral Headache Responding to Indomethacin
Authors: Hannerz Jan
Published: August 2010

Three patients with bilateral chronic tension‐type headache (meeting IHS diagnostic criteria) responded with complete control of the headache during the more than 2 years they were treated with indomethacin. The headache recurred within 12 to 26 hours after indomethacin was stopped. Fifty milligrams of intravenous indomethacin resulted in complete relief of headache for 6.5 to 25 hours, similar to results found earlier in patients with hemicrania continua. It is concluded that there may be a subgroup of patients with bilateral chronic headache who respond to indomethacin in the group of patients otherwise diagnosed as having chronic tension‐type headache.
Clinical Utility of an Instrument Assessing Migraine Disability: The Migraine Disability Assessment (MIDAS) Questionnaire
Authors: Lipton R.B. , Stewart W.F. , Sawyer J. , Edmeads J.G.
Published: August 2010

Objective.—We evaluated the agreement between Migraine Disability Assessment (MIDAS) scores and independent physician judgments about pain, disability, and treatment needs based on patient medical histories.

Background.—The MIDAS questionnaire measures headache‐related disability as lost time due to headache from paid work or school, household work, and nonwork activities.

Methods.—Twelve histories from patients with migraine were presented to 49 primary and specialty care physicians unaware of the MIDAS scores. Physicians graded each patient for pain level (mild, moderate, or severe), level of disability (none, mild, moderate, or severe), and need for medical care (from 0 [lowest] to 100 [highest]). Physicians also identified MIDAS scores they associated with different degrees of disability and with the urgency to prescribe an effective treatment during the first consultation.

Results.—The physicians' perceptions of the need for medical care based on medical histories correlated with the MIDAS score (r = .69). Estimates of pain and disability by physicians were directly correlated with increasing MIDAS scores. Using the physicians' clinical judgments, the overall MIDAS score was categorized into four grades of increasing severity.

Conclusions.—Scores on the MIDAS are highly correlated with physician judgments regarding patients' pain, disability, and need for medical care. These findings support the potential utility of the MIDAS questionnaire in clinical practice.
Headaches and Sinus Disease
Authors: Blumenthal Harvey J.
Published: August 2010

Modern diagnostic tools like fiberoptic nasal endoscopy and CT imaging of the sinuses are very sensitive in helping clinicians diagnose sinus disease; we may now reevaluate the symptoms and signs most useful in making a clinical diagnosis of rhinosinusitis. Two major systems of classification and diagnostic criteria relating headaches and sinus disease have achieved currency—that of the International Headache Society (IHS) (1988) and the more recent task force recommendations of the American Academy of Otolaryngology‐Head and Neck Surgery (AAO‐HNS) (1997). This report compares and contrasts the different starting points, certain assumptions, and conflicting conclusions of these two classification systems and recommends a cooperative alliance of the IHS and AAO‐HNS when these diagnostic criteria are revised.
Hypoglycemia Rebound Migraine
Authors: Jacome Daniel E.
Published: August 2010

Objective.—To describe a patient with specific hypoglycemia rebound migraine.

Background.—There is an increased prevalence of headache in persons with diabetes. Although hypoglycemia may precipitate headache in some diabetic (and nondiabetic) patients, it is not a universal pathogenetic mechanism responsible for headache in those individuals or in normal fasting subjects.

Methods.—Clinical history, review of past medical records, neurologic examination, follow‐up evaluation, electroencephalogram, and computerized tomography of the head.

Results.—A 56‐year‐old man with unstable diabetes mellitus had recurrent monthly episodes of profound hypoglycemia for 40 years. These episodes were followed by severe, global, pulsatile headache after glycemia became normal subsequent to intravenous infusion of glucose and the patient was no longer confused and lethargic. He had no headache preceding or throughout the actual hypoglycemic phase. His neurologic examination was normal when asymptomatic. His baseline electroencephalogram was normal, but showed mild slowing of the background in the immediate posthypoglycemic state. Computerized tomography of the head demonstrated mild atrophic changes. His severe bouts of hypoglycemia and migraine were ameliorated by prophylactic treatment with valproic acid.

Conclusion.—Posthypoglycemic migraine may occur exceptionally in patients with unstable diabetes as a rebound phenomenon, caused by an unidentified mechanism.
Migraine MLT‐Down: An Unusual Presentation of Migraine in Patients With Aspartame‐Triggered Headaches
Authors: Newman Lawrence C. , Lipton Richard B.
Published: August 2010

Aspartame, an artificial sweetener added to many foods and beverages, may trigger headaches in susceptible individuals. We report two patients with aspartame‐triggered attacks in whom the use of an aspartame‐containing acute medication (Maxalt‐MLT) worsened an ongoing attack of migraine.
Behavioral Facilitation of Medical Treatment for Headache—Part I: Review of Headache Treatment Compliance
Authors: Rains Jeanetta C. , Lipchik Gay L. , Penzien Donald B.
Published: August 2010

Noncompliance or nonadherence with medical regimens represents a major challenge to the practice of medicine including the treatment of headache. Indeed, medication use patterns are particularly relevant to headache because of the potential for headache therapies to induce medication‐overuse headache. Previous research has demonstrated that adherence to long‐term medication therapy for various chronic illnesses averages only about 50%. The rate of adherence among headache patients has been found to be similarly poor. Misuse or overuse of symptomatic medication has been demonstrated to contribute to treatment failure, and one‐fourth to one‐half of patients are noncompliant with prophylactic headache medications and at least 40% nonadherent with appointment‐keeping. Adherence declines with more frequent and complex dosing regimens, side effects, and costs, and is subject to a wide range of psychosocial influences. Subjective reports of adherence are likely not only to overestimate but also to be discordant with more objective measurements. As the first of 2 articles, this paper describes the problem of noncompliance in medical practice and reviews literature addressing compliance specific to headache management. A companion paper (Behavioral Facilitation of Medical Treatment for Headache—Part II: Theoretical Models and Behavioral Strategies for Improving Adherence) summarizes social learning models proposed to characterize the multiple determinants of adherence and guide behavioral adherence‐enhancing interventions, and then presents cognitive and behavioral strategies that may facilitate treatment adherence with headache patients.
Headache and Psychological Functioning in Children and Adolescents
Authors: Powers Scott W. , Gilman Deborah Kruglak , Hershey Andrew D.
Published: August 2010

Headache can affect all aspects of a child's functioning, leading to negative affective states (eg, anxiety, depression, anger) and increased psychosocial problems (for instance, school absences, problematic social interactions). For children and adolescents who experience frequent headache problems, comorbid psychological issues are a well‐recognized, but poorly understood, clinical phenomenon. The confusion surrounding the relationship between pediatric headache and psychopathology exists for several reasons. First, in some cases, headache has been inappropriately attributed to psychological or personality features based on anecdotal observations or interpretations that go beyond the available data. Additionally, measures of psychopathology have not always adhered to the American Psychiatric Association's diagnostic criteria, thus reducing the reliability of diagnostic judgments. Furthermore, the diagnosis of headache has not always followed standard criteria, and has been complicated by the emergence of new terms and evolving measures. Finally, methodological shortcomings, such as incomplete descriptions of the procedures and criteria used for the study, inadequate descriptions of headache severity, lack of a control group for comparison with individuals without headaches, reliance primarily on cross‐sectional research designs that are often discussed with inferences to causal hypotheses, and the use of unstandardized assessment measures, have significantly limited the validity of research findings. The goal of the current review is to examine the extant literature to provide the most up‐to‐date picture on what the research has made available about the magnitude, specificity, and causes of psychopathology in children and adolescents with headache, in an effort to further elucidate their relationship and prompt a more methodologically rigorous study of these issues.
Intracranial Hypotension Following Chiropractic Spinal Manipulation
Authors: Prasad Sashank , El‐Haddad Ghassan , Zhuang Hongming , Khella Sami
Published: August 2010

We report a case of intracranial hypotension caused by chiropractic manipulation which, in contrast to previously reported cases, documents the location of the cerebrospinal fluid leak by radionuclide cisternography. Cervical spinal manipulation produced a remote lumbar dural tear in our patient. Spinal magnetic resonance imaging may falsely localize the dural tear in this condition. Although conservative management is often sufficient, precise localization is required for more invasive therapies.
Hemicrania Continua Secondary to an Ipsilateral Brainstem Lesion
Authors: Valença Marcelo M. , Andrade‐Valença Luciana P. A. , Da Silva Wilson Farias , Dodick David W.
Published: August 2010

We describe a 47‐year‐old woman with a 3‐year history of a continuum mild‐moderate right‐side headache, with exacerbations, associated with stabbing volleys of pain on right orbit‐temporal region (10/10) and right eye ptosis and lacrimation with conjunctival injection. The pain was completely abolished with indomethacin (100 mg per day). The diagnosis of hemicrania continua was made according to the International Headache Society (IHS) criteria. The headache presentation was precipitated by a stroke and a right‐side brainstem lesion was present at magnetic resonance imaging. This case report shows anatomoclinical evidence of the involvement of brainstem structures on the pathophysiology of hemicrania continua.
Validation of a German Language Questionnaire for Screening for Migraine, Tension‐Type Headache, and Trigeminal Autonomic Cephalgias
Authors: Fritsche Guenther , Hueppe Michael , Kukava M. , Dzagnidze A. , Schuerks Markus , Yoon M.‐S. , Diener Hans‐Christoph , Katsarava Zaza
Published: August 2010

Background.—To develop a German language questionnaire for screening for migraine, tension‐type headache, and trigeminal autonomic cephalgias.

Objective.—Aim of the study was to develop a German language self‐administered headache questionnaire for screening for migraine (MIG), tension‐type headache (TTH), and trigeminal‐autonomic cephalgias (TAC).

Methods.—Questionnaire‐based diagnoses were blindly compared with those of headache experts.

Results.—Overall 278 headache patients (MIG = 97, TTH = 60, TAC = 98, MIG plus TTH = 23) as well as 42 patients with low back pain without headache and 47 healthy subjects were studied. The Cohen's kappa for 7 headache syndromes including all combination diagnoses was 0.64 (95% CI 0.58‐0.70). Sensitivity and specificity for migraine were 0.73 and 0.96, for TTH 0.85 and 0.98, for TAC 0.63 and 0.99, and for MIG plus TTH 0.62 and 0.97, respectively. Ignoring all combination diagnoses, the kappa‐coefficient for the monodiagnoses MIG, TTH, and TAC (193 out of 278 patients) was 0.93 (CI 0.83‐1.0). The retest‐reliability (4 weeks later) was 0.95.

Conclusion.—We present the first questionnaire in German language including 3 most common primary headaches for use in epidemiological research.
Screening and Behavioral Management: Obesity and Weight Management
Authors: Nicholson Robert , Bigal Marcelo
Published: August 2010

Individuals with migraine headaches who are obese or overweight may be at elevated risk for experiencing more frequent migraines and for developing chronic migraine. This makes it imperative that clinicians consider including weight management as part of a migraine treatment plan in situations where the patient is overweight or obese. Weight loss and weight maintenance therapy should employ a combination of behavioral strategies, in particular nutritional education, dietary intervention, and exercise counseling, as a first line intervention. Weight loss medications are considered a secondary treatment; however, when weight loss medications are used, it is vital to monitor the influence of the medication on headache. Similarly, a clinician considering migraine prophylaxis needs to consider whether the pharmacologic agent being considered influences weight gain or loss.
Familial Occurrence of Spontaneous Spinal CSF Leaks: Underlying Connective Tissue Disorder (CME)
Authors: Mokri Bahram
Published: August 2010

Two sisters developed spontaneous cerebrospinal fluid (CSF) leaks from meningeal diverticula. Both had recurrences from non diverticular sites. Both patients, a sister, and their mother had joint hypermobility and there was a strong family history of thoracic and abdominal aorta aneurysms. To my knowledge, this is the first report of familial occurrence of CSF leaks. It also points to the role of a pre‐existing dural weakness, likely related to a disorder of connective tissue matrix.
Donitriptan, a Unique High‐Efficacy 5‐HT1B/1DAgonist: Key Features and Acute Antimigraine Potential
Authors: John Gareth W. , Perez Michel , Pauwels Petrus J. , Le Grand Bruno , Verscheure Yvan , Colpaert Francis C.
Published: August 2010

We hypothesized that the limited acute therapeutic effectiveness of tryptamine derivatives in alleviating migraine headache could be explained by the relatively low intrinsic activity of these agents at 5‐HT1B/1Dreceptors. Donitriptan is a novel arylpiperazide 5‐hydroxytryptamine (5‐HT) derivative which was designed to exploit the higher potency and efficacy properties of 5‐HT compared to tryptamine at 5‐HT1B/1Dreceptors.

In vitro, donitriptan has subnanomolar affinity for nonhuman and human 5‐HT1B/1Dreceptors and micromolar affinity for the 5‐HTip subtype. Donitritpan potently inhibited forskolin‐induced cAMP formation and enhanced specific GTP35γS specific binding to a greater extent than tryptamine derivatives and equivalent to 5‐HT in C6 cells expressing human 5‐HT1Bor 5‐HT1Dreceptors. Donitriptan produced more potent and larger amplitude increases in hyperpolarizing Ca2+‐dependent K+current than sumatriptan in guinea pig isolated trigeminal ganglion neurons, and was more potent than tryptamine derivatives in eliciting contractile responses in rabbit isolated saphenous vein rings.

In vivo, donitriptan evoked more potent, longer‐lasting and greater amplitude carotid vasoconstrictor responses than tryptamine derivatives in anesthetized pigs; and in contrast to sumatriptan, naratriptan or zolmitriptan, produced long‐lasting, dose‐dependent decreases in unilateral carotid blood flow in conscious dogs at doses from 0.63 mg/kg p.o. without affecting heart rate or behavior. Oral donitriptan also evoked hypothermic responses in guinea pigs suggesting that the compound gains access to the brain.

Donitriptan is thus a selective, potent 5‐HT1B/1Dreceptor agonist which can be distinguished from tryptamine derivatives in consistently exerting high intrinsic activity at these receptors in a series of vascular and neuronal models relevant to migraine. Advantages in terms of therapeutic effectiveness in the acute relief of migraine headache over currently available triptans can be expected to include greater response rates and consistency of pain relief, a lower incidence of migraine recurrence and better tolerability. The acute anti‐migraine potential of the first high efficacy 5‐HT1B/1Dagonist of its kind, donitriptan, is currently being investigated in man.
The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders
Authors: MacQueen Glenda , Born Leslie , Steiner Meir
Published: August 2010

The naphthylamine derivative sertraline is a potent and selective inhibitor of serotonin reuptake into presynaptic terminals. Sertraline has a linear pharmacokinetic profile and a half‐life of about 26 h. Its major metabolite, desmethylsertraline does not appear to inhibit serotonin reuptake. Sertraline mildly inhibits the CYP2D6 isoform of the cytochrome P450 system but has little effect on CYP1A2, CYP3A3/4, CYP2C9, or CYP2C19. It is, however, highly protein bound and may alter blood levels of other highly protein bound agents. Sertraline is a widely used serotonin reuptake inhibitor that has been shown to have both antidepressant and antianxiety effects. Many clinical trials have demonstrated its efficacy in depression compared with both placebo and other antidepressant drugs. Its efficacy has also been demonstrated in randomized, controlled trials of patients with obsessive‐compulsive disorder, panic disorder, social phobia, and premenstrual dysphoric disorder. In short‐term, open‐label studies it has appeared efficacious and tolerable in children and adolescents and in the elderly, and data are positive for its use in pregnant or lactating women. Typical side effects include gastrointestinal and central nervous system effects as well as treatment‐emergent sexual dysfunction; withdrawal reactions may be associated with abrupt discontinuation of the agent. The safety profile of sertraline in overdose is very favorable. Sertraline's efficacy for both mood and anxiety disorders, relatively weak effect on the cytochrome P450 system, and tolerability profile and safety in overdose are factors that contribute to make it a first‐line agent for treatment in both primary and tertiary care settings.

Sertraline is a potent and specific serotonin uptake inhibitor with efficacy in mood and anxiety disorders. Its therapeutic value in major depression, dysthymia, OCD, social phobia, panic disorder, and PMDD has been established. In addition, recent data support its relative safety for use in pregnant and breast‐feeding women. It has relatively weak effects on the cytochrome P450 system, a tolerability profile that is positive compared with antidepressants of other classes, and it is relatively safe in overdose. These findings contribute to sertraline being the first‐line agent for the treatment of several psychiatric disorders.
Gacyclidine: A New Neuroprotective Agent Acting at the N‐Methyl‐D‐Aspartate Receptor
Authors: Hirbec Hélène , Gaviria Manuel , Vignon Jacques
Published: August 2010

Gacyclidine is a new phencyclidine derivative with neuroprotective properties. Tritiated gacyclidine and its enantiomers bind to NMDA receptors with binding parameters similar to those of other non‐competitive NMDA receptor antagonists. The (‐)enantiomer, (‐)GK11, exhibits an affinity (2.5 nM) similar to that of dizocilpine (MK‐801), while the (+)enantiomer, (+)GK11, has a 10 times lower affinity. When its interaction with NMDA receptors is prevented, gacyclidine binds also to “non‐NMDA” binding sites which are mainly located in the molecular layer of the cerebellum on the dendritic tree of Purkinje cells. These binding sites do not appear to be related to any known neuro transmitters.

In primary cortical cultures, gacyclidine and its enantiomers, at 0.1 to 5.0 μ, prevent glutamate‐induced neuronal death. In rats,in vivoneurotoxicity of gacyclidine is far low than that of MK‐801. No necrotic neurons were detected in animals sacrificed at 18 or 96 h after treatment with gacyclidine (1, 5, 10 or 20 mg/kg i.v.). At the highest (20 mg/kg) but not the lower doses (1–100 mg/kg) electron microscopy revealed the presence of few cytoplasmic or intramitochondrial vacuoles. In soman‐treated monkeys gacyclidine enhanced neuroprotective activity of “three drugs cocktail” (atropine + di‐azepam + pralidoxime). Moreover, in rats, gacyclidine exerts a dose‐ and time‐dependent neuroprotection in three models of spinal cord lesion. Beneficial effects of gacyclidine include reduction of lesion size and improvement of functional parameters after injury. In traumatic brain injury models gacyclidine improves also behavioral parameters and neuronal survival. Optimal protection is obtained when gacyclidine is administered at 0 to 30 min after injury. It is, therefore, concluded that gacyclidine exhibits neuroprotective effects similar to those of other NMDA receptor antagonists, with the advantage of being substantially less neurotoxic maybe due to its interaction with “non‐NMDA” binding sites.
A Review of the Pharmacological and Clinical Profile of Mirtazapine
Authors: Anttila Sami A. K. , Leinonen Esa V. J.
Published: August 2010

The novel antidepressant mirtazapine has a dual mode of action. It is a noradrenergic and specific serotonergic antidepressant (NaSSA) that acts by antagonizing the adrenergic α2‐autoreceptors and α2‐heteroreceptors as well as by blocking 5‐HT2and 5‐HT3receptors. It enhances, therefore, the release of norepinephrine and 5‐HT1A‐mediated serotonergic transmission. This dual mode of action may conceivably be responsible for mirtazapine's rapid onset of action.

Mirtazapine is extensively metabolized in the liver. The cytochrome (CYP) P450 isoenzymes CYP1A2, CYP2D6, and CYP3A4 are mainly responsible for its metabolism. Using once daily dosing, steady‐state concentrations are reached after 4 days in adults and 6 days in the elderly.In vitrostudies suggest that mirtazapine is unlikely to cause clinically significant drug‐drug interactions. Dry mouth, sedation, and increases in appetite and body weight are the most common adverse effects. In contrast to selective serotonin reuptake inhibitors (SSRIs), mirtazapine has no sexual side effects.

The antidepressant efficacy of mirtazapine was established in several placebo‐controlled trials. In major depression, its efficacy is comparable to that of amitriptyline, clomipramine, doxepin, fluoxetine, paroxetine, citalopram, or venlafaxine. Mirtazapine also appears to be useful in patients suffering from depression comorbid with anxiety symptoms and sleep disturbance. It seems to be safe and effective during long‐term use.