bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphangioma circumscriptum of the penis mimicking venereal lesions
Authors: Gupta S , Radotra B D , Javaheri S M , Kumar B 
Published: August 2003

ABSTRACTLymphangioma circumscriptum (LC) involving the penis is rare. We report two patients with penile LC. The lesions developed in early infancy in one patient, and during puberty in the other. The lesions resembled molluscum contagiosum in one and genital warts in the other. The first patient was previously treated with a diagnosis of venereal disease. A literature search found only 4 LC patients with penile lesions reported in the English literature. These cases are presented for their rarity, and to increase diagnostic vigilance and desirability of non‐intervention.
Mitochondrial DNA Variability in Bosnians and Slovenians
Authors: Malyarchuk B. A. , Grzybowski T. , Derenko M. V. , Czarny J. , Drobnič K. , Miścicka‐Śliwka D. 
Published: August 2003

SummaryMitochondrial DNA variability in two Slavonic‐speaking populations of the northwestern Balkan peninsula, Bosnians (N = 144) and Slovenians (N = 104), was studied by hypervariable segments I and II (HVS I and II) sequencing and restriction fragment‐length polymorphism (RFLP) analysis of the mtDNA coding region. The majority of the mtDNA detected in Southern Slavonic populations falls into the common West Eurasian mitochondrial haplogroups (e.g., H, pre‐V, J, T, U, K, I, W, and X). About 2% of the Bosnian mtDNAs encompass East Eurasian and African lineages (e.g., M and L1b, respectively). The distribution of mtDNA subclusters in Bosnians, Slovenians and the neighbouring European populations reveals that the common genetic substratum characteristic for Central and Eastern European populations (such as Germans, Poles, Russians and Finns) penetrates also South European territories as far as the Western Balkans. However, the observed differentiation between Bosnian and Slovenian mtDNAs suggests that at least two different migration waves of the Slavs may have reached the Balkans in the early Middle Ages.
Selective Pressure has not Acted Against Hypercoagulability Alleles in High‐Altitude Amerindians
Authors: Rupert J. L. , Monsalve M. V. , Kidd K. K. , Tan C. , Hochachka P. W. , Devine D. V. 
Published: August 2003

SummaryElevated hematocrit increases blood oxygen carrying capacity in high‐altitude populations, but blood viscosity and coaguability may increase concomitantly. Alleles of the β‐fibrinogen gene (FGB) associated with lower fibrinogen levels are more common in highland Amerindians (Quechua) than lowland Amerindians (Na‐Dene). Although genetic drift could account for this, selection may have acted against transmission of hypercoagulability alleles at high altitude. To test this hypothesis, we compared allele frequencies between Quechua and more closely related lowlanders (Maya) at loci in the genes encoding β‐fibrinogen (FGB), factors V (F5), VII (F7) and XIII (F13), α2‐integrin (ITGA2) and plasminogen activator inhibitor type 1 (PAI‐1; SERPINE1). No significant differences in allele frequencies were found except 485arg in the gene encoding factor V, which was more common in the Quechua. These data do not support the hypothesis that selection has acted to eliminate alleles associated with hypercoagulability in Andean highlanders.
Efficacy of a Fixed Combination of Indomethacin, Prochlorperazine, and Caffeine Versus Sumatriptan in Acute Treatment of Multiple Migraine Attacks: A Multicenter, Randomized, Crossover Trial
Authors: Monda Vincenzo Di , Nicolodi Maria , Aloisio Antonina , Bianco Pierluigi Del , Fonzari Marco , Grazioli Irene , Uslenghi Carla , Vecchiet Leonardo , Sicuteri Federigo 
Published: August 2003

Objective.—To compare the efficacy of a fixed combination of indomethacin, prochlorperazine, and caffeine suppositories with sumatriptan suppositories in the treatment of 2 consecutive migraine attacks of moderate or severe intensity in a multicenter, randomized, crossover study.Background.—A fixed combination of indomethacin, prochlorperazine, and caffeine is the most commonly used drug for the acute treatment of migraine in Italy. No studies have been published comparing the efficacy of this combination with sumatriptan, the most widely prescribed of the triptans.Methods.—One hundred twelve patients with migraine with or without aura according to the diagnostic criteria of the International Headache Society were randomized to treat 2 migraine attacks with a fixed combination of indomethacin, prochlorperazine, and caffeine and 2 migraine attacks with sumatriptan. Both drugs were rectally administered in a single dose for each attack. Patients were asked to take study medication as soon as possible at the onset of a headache.Results.—Of the 112 patients, 88 were compliant to the protocol. More attacks became pain‐free at 2 hours postdose (primary end point) on the combination than on sumatriptan (49% versus 34%; P < .01), while there was no difference in the relief of headache at 2 hours postdose (71% versus 65%). The combination was statistically superior to sumatriptan in the time to a pain‐free response (a higher percentage of attacks became pain‐free from 0.5 hours postdose to 5 hours postdose), in alleviation of nausea, and in a sustained pain‐free response (pain‐free at 2 hours postdose with no use of rescue medication or relapses within 48 hours). Moreover, a significant consistent response was achieved for the combination compared with sumatriptan across (higher percentage of patients pain‐free at 2 hours postdose in the first, second, third, and fourth treated attack) and within patients (pain‐free in 2 of 2 treated attacks in 35% of patients taking the combination and 20% of patients on sumatriptan). Both drugs were well‐tolerated.Conclusions.—This study, analyzed according to the more recent guidelines for controlled trials in migraine, showed that a fixed combination of indomethacin, prochlorperazine, and caffeine is significantly more effective than sumatriptan in the acute treatment of migraine attacks. It is notable that the combination is less expensive than sumatriptan per unit dose.
Effects of Naratriptan Versus Naproxen on Daily Functioning in the Acute Treatment of Migraine: A Randomized, Double‐Blind, Double‐Dummy, Crossover Study
Authors: Stronks Dirk L. , Tulen Joke H. M. , Bussmann Hans B. J. , Mulder Laus J. M. M. , Passchier Jan 
Published: August 2003

Objective.—To evaluate the effect of acute treatment on ictal behavioral functioning of patients with migraine via ambulatory accelerometry.Background.—The inability to carry out daily activities often complicates migraine attacks. Research into the effects of pharmacological drugs on this outcome parameter in the acute treatment of migraine has been based on subjective reports only.Methods.—In a double‐blind, double‐dummy, crossover study, 12 patients with migraine treated 2 migraine attacks with the nonspecific antimigraine drug, naproxen (500‐mg capsule) or the more specific antimigraine drug, naratriptan (2.5‐mg tablet). The clinical symptoms of headache, nausea, vomiting, photophobia, and phonophobia, and the subjective symptoms reflecting mood, sleepiness, and level of functioning were measured by use of a daily log.Results.—During the first 6 hours after intake of the study medication, the objective behavioral parameters showed no significant effect of time and no significant differences between naproxen and naratriptan, but naratriptan was significantly more efficacious than naproxen in relieving headache, nausea, and vomiting; the interval between treatment and relief was significantly shorter after intake of naratriptan.Conclusions.—Consciously perceived clinical and subjective symptoms do not necessarily run in parallel with their behavioral equivalents. It, thus, may be important to assess the effects of treatment on behavioral functioning in the evaluation of the general efficacy of antimigraine drugs in the acute treatment of a migraine attack.
Botulinum Toxin Type A as an Effective Prophylactic Treatment in Primary Headache Disorders
Authors: Blumenfeld Andrew 
Published: August 2003

Objective.—To measure the effect of botulinum toxin type A (Botox, Allergan, Inc, Irvine, CA) treatment in 271 patients diagnosed with headache in accordance with International Headache Society (IHS) criteria.Background.—Botulinum toxin type A has shown promise for the treatment of headache in several clinical trials, but uncertainty remains as to how botulinum toxin type A optimally should be used for treating headache and which patients are best suited for this treatment.Methods.—This was a retrospective chart review of all patients who received botulinum toxin type A for the treatment of headache from January 1999 to February 2002. Patients were injected with an average dose of 63.2 U (SD, 14.5) of botulinum toxin type A on 2 or more visits, with treatments involving a “fixed‐site” or a “follow‐the‐pain” (or a combination of both) approach. In the fixed‐site approach, botulinum toxin type A was injected into the procerus, corrugator, frontalis, and temporalis muscles. In the follow‐the‐pain approach, botulinum toxin type A was injected into a combination of the procerus, corrugator, frontalis, temporalis, occipitalis, trapezius, and/or semispinalis capitis muscles. The primary outcomes for the trial were the reduction in headache days per month or headache intensity (0 to 3 scale) (or both) from baseline. Patients were diagnosed according to IHS criteria and subsequently classified into the following categories: chronic daily headache (more than 15 headache days per month), episodic tension‐type headache, episodic migraine, and “mixed” HA (less than 15 headache days per month, combination of migraine and tension‐type headache).Results.—Treatment period was an average of 8.6 months (SD, 6.4); patients received an average of 3.4 doses (SD, 1.6) 3 months apart. Of the 271 patients, 29 (10.7%) had episodic migraine, 17 (6.3%) had episodic tension‐type headache, 71 (26.2%) had mixed headache, and 154 (56.8%) had chronic daily headache. Two‐hundred fifty‐six patients had data for the number of headache days per month, 117 had data for headache intensity, and all 271 had data for headache days or headache intensity. Botulinum toxin type A treatment significantly reduced the number of headache days per month from 18.9 (SD, 10.3) to 8.3 (SD, 8.9) (n = 256, P < .001)—a 56% reduction. Headache intensity decreased from 2.4 points (SD, 0.6) to 1.8 points (SD, 0.8) (n = 117, P < .001)—a 25% reduction. Of 263 patients surveyed, 225 (85.6%) reported improvement in headache frequency and intensity. There was no correlation of effect/lack of effect with reason for treatment, duration/number of treatments, injection technique, mean/total dose, age, gender, or comorbidity. Approximately 95% of patients did not experience medication side effects.Conclusion.—These results suggest that botulinum toxin type A may be an effective and safe prophylactic treatment for a variety of moderate to severe chronic headache types.
Electrocardiographic Changes During Migraine Attacks
Authors: Aygun D. , Altintop L. , Doganay Z. , Guven H. , Baydin A. 
Published: August 2003

Objectives.—To clarify whether electrocardiographic (ECG) changes can be identified during a migraine attack and to determine whether there are ECG differences between periods with and without headache.Background.—The clinical signs and symptoms of migraine point to involvement of the autonomic nervous system, and especially to disrupted regulation of the circulatory system and autonomic balance. This disruption may be more marked during a migraine attack. During a migraine attack, autonomic imbalance within the heart and its vessels conceivably may result in ECG abnormalities.Methods.—In 30 patients with migraine, the ECG variables of heart rate, abnormalities of rhythm, PR interval, QRS duration, corrected QT interval, T inversion, and ST‐segment changes were recorded during migraine attacks and pain‐free periods.Results.—Of the 30 patients studied during a migraine attack, 9 (30%) had one or more abnormalities of rhythm (including sinus arrhythmia, atrial premature contraction, and ventricular premature contraction), 20% had PR intervals greater than 0.20 seconds, 40% had corrected QT intervals greater than 0.44 seconds, 66% had T inversion, and 40% had ST‐segment abnormalities. No patient had arrhythmia, PR intervals greater than 0.20 seconds, or corrected QT intervals greater than 0.44 seconds during a pain‐free period. No differences were noted for ST‐segment changes, T inversion, and total ECG changes between periods with and without headache, but both PR and corrected QT intervals were significantly longer during migraine attacks than during pain‐free periods.Conclusions.—We conclude that ECG abnormalities often are present during a migraine attack, and for most of these, particularly PR and corrected QT interval lengthening, these abnormalities will be absent or less prominent during pain‐free intervals.
Confirmation of the Distinction Between Chronic Migraine and Chronic Tension‐type Headache by the McGill Pain Questionnaire
Authors: Mongini Franco , Deregibus Andrea , Raviola Fabio , Mongini Tullia 
Published: August 2003

Objective.—To investigate if the McGill Pain Questionnaire confirms the distinction between chronic migraine and chronic tension‐type headache.Background.—It has been suggested that different categories of chronic daily headache should be distinguished; in particular, chronic migraine and chronic tension‐type headache.Methods.—The McGill Pain Questionnaire and a visual analog scale were administered to 40 patients with chronic daily headache, 85 patients with migraine, and 47 patients with episodic tension‐type headache. The patients with chronic daily headache were subdivided, according to criteria described by other authors, into those with chronic migraine (n = 29) and those with chronic tension‐type headache (n = 11). Weighted McGill Pain Questionnaire item scores, subscales, total pain rating indexes, and choice frequency of the descriptors were calculated. The data of chronic migraine and chronic tension‐type headache were compared and tested for significant differences (Student t test). The same was done for migraine and episodic tension‐type headache. Data were also processed through the Self‐organizing Map, a system based on a counter‐propagation neural network.Results.—In the chronic migraine group, compared with the chronic tension‐type headache group, scores were higher in 17 of 20 McGill Pain Questionnaire items (significantly in 5) and for the sensory and affective subscales (significantly). In the migraine group, compared with the episodic tension‐type headache group, scores were higher for 18 McGill Pain Questionnaire items (significantly in 7), and for the sensory, affective, and mixed affective‐evaluative subscales, total pain‐rating index, and visual analog scale (all significantly). The coincidence of descriptors of first choice was low between chronic migraine and chronic tension‐type headache, but it was high between chronic migraine and migraine and between chronic tension‐type headache and episodic tension‐type headache. After Self‐organizing Map analysis, chronic migraine and chronic tension‐type headache were prevalently distributed in 2 different areas of the map.Conclusions.—In the disorders characterized by a daily and near‐daily headache, the McGill Pain Questionnaire consistently can discriminate between those evolving from migraine and those evolving from tension‐type headache, indirectly confirming the validity of a distinction between these 2 clinical conditions. The differences are similar to those observed between patients with migraine and patients with episodic tension‐type headache. This seems to be independent of the pain level since the difference of the total pain‐rating index and the visual analog scale between chronic migraine and chronic tension‐type headache was not statistically significant.
Relationship of Locus of Control in Women With Migraine and Healthy Volunteers
Authors: Lampl Christian , Heuberger Barbara , Haas Selina , Yazdi Kambiz , Buzath Andrea , Kemetzhofer Peter 
Published: August 2003

Objective.—To investigate potential differences in various aspects of personality in women with migraine with aura, without aura, and in healthy volunteers.Methods.—The following instruments were used to evaluate a sample of 35 women with migraine with aura, 35 women with migraine without aura, and 35 healthy women: Locus of Control and Competence Questionnaire, Health Locus of Control Questionnaire, Trait scale of the State‐Trait Anxiety Inventory, and the depression scale by von Zerssen.Results.—There were no significant differences in generalized locus of control beliefs among the 3 groups. Migraineurs with aura were found to score very low on the social locus of control scale. Statistically significant differences were found regarding anxiety in migraineurs with aura as opposed to migraineurs without aura and healthy control subjects. As for depression, migraineurs with aura were significantly more likely to indicate feelings of worthlessness and lack of self‐confidence.Conclusions.—Our results suggest that migraineurs with aura differ from migraineurs without aura and healthy control subjects in terms of anxiety and depression. With regard to health‐related locus of control, there was no correlation among mean number of migraine attacks per year, duration of disease, time of last migraine attack, and number of aura symptoms.
Pseudomigraine With Lymphocytic Pleocytosis: A Calcium Channelopathy? Clinical Description of 10 Cases and Genetic Analysis of the Familial Hemiplegic Migraine Gene CACNA1A
Authors: Chapman Kristine M. , Szczygielski Blazej I. , Toth Cory , Woolfenden Andrew , Robinson Gordon , Snutch Terrance P. , Spacey Siân D. 
Published: August 2003

Objective.—To report the clinical findings of 10 patients diagnosed with pseudomigraine with lymphocytic pleocytosis and the results of mutational analysis of the CACNA1A gene in 8 of these patients.Background.—Pseudomigraine with lymphocytic pleocytosis, also referred to as headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HaNDL), is characterized by episodic transient neurologic dysfunction associated with moderate to severe headache and cerebrospinal fluid lymphocytic pleocytosis. Episodes are recurrent and the condition is self‐limiting. The etiology of this sporadic condition remains unknown, but the episodic nature and its ability to be triggered by angiography is somewhat reminiscent of the phenotypic features of familial hemiplegic migraine, a condition caused by mutations in the CACNA1A gene.Design/Methods.—Utilizing retrospective chart review, we describe the clinical features of pseudomigraine with lymphocytic pleocytosis in 10 patients. Whole blood was taken from 8 patients (2 were lost to follow‐up) and used for DNA testing. The CACNA1A gene was screened for mutations using heteroduplex analysis and direct DNA sequencing.Results.—Clinical features of pseudomigraine with lymphocytic pleocytosis included transient episodes of weakness, sensory and visual symptoms, aphasia, and confusion lasting minutes up to 4 hours. Sensory symptoms, typically affecting the face and arm, were the most common presentation. Localization of symptoms did not conform to vascular territories. Headache was typically throbbing and most often bilateral. Genetic analysis did not identify any mutations in the CACNA1A gene.Conclusions.—Similarities between familial hemiplegic migraine and pseudomigraine with lymphocytic pleocytosis include recurrent headache with reversible neurologic deficit, cerebrospinal fluid lymphocytic pleocytosis, and triggers such as angiography. Even so, heteroduplex analysis and DNA sequencing failed to identify any sporadic mutations or shared polymorphisms in the exons or the intron/exon boundaries of the CACNA1A gene. These results do not support a role of the CACNA1A gene in the etiology of pseudomigraine with lymphocytic pleocytosis.
Oral Phenobarbital Loading: A Safe and Effective Method of Withdrawing Patients With Headache From Butalbital Compounds
Authors: Loder Elizabeth , Biondi David 
Published: August 2003

Background.—The overuse of short‐acting barbiturate medications for the acute treatment of headache is a common problem in the United States. Most experts agree that withdrawal from these medications is necessary for subsequent headache treatment to be successful, yet there are few published articles outlining effective methods of drug withdrawal.Objective.—To evaluate the safety and effectiveness of phenobarbital loading for withdrawal from overuse of short‐acting barbiturate compounds in inpatients with headache.Design and Methods.—We performed a retrospective chart review of 18 consecutive patients in an inpatient pain rehabilitation program who were withdrawn from overuse of butalbital‐combination medications using a phenobarbital‐loading protocol.Results.—Eighteen patients with headache hospitalized in an inpatient pain unit for withdrawal from overuse of combination butalbital preparations underwent a phenobarbital‐loading protocol. Short‐acting barbiturate medications were discontinued, and patients received 120 mg of oral phenobarbital until their score on a predetermined scale reached target levels, and the drug was then discontinued. All patients were effectively treated with no serious adverse events. The median number of doses required varied significantly, and could not be predicted by the patient's prior intake.Conclusions.—Management of butalbital withdrawal can be simplified by using a phenobarbital‐loading protocol, taking advantage of the natural tapering afforded by the drug's long half‐life. This method possesses most of the characteristics of an ideal drug withdrawal program for patients with headache who are overusing medications.
Isolation and biochemical characterization of LEAP‐2, a novel blood peptide expressed in the liver
Authors: Krause Alexander , Sillard Rannar , Kleemeier Burkhard , Klüver Enno , Maronde Erik , Conejo‐García José Ramon , Forssmann Wolf Georg , Schulz‐Knappe Peter , Nehls Michael C. , Wattler Frank , Wattler Sigrid , Adermann Knut 
Published: August 2003

AbstractThe human genome contains numerous genes whose protein products are unknown in terms of structure, interaction partner, expression, and function. To unravel the function of these orphan genes, it is of particular value to isolate native forms of protein and peptide products derived from these genes. From human blood ultrafiltrate, we characterized a novel gene‐encoded, cysteine‐rich, and cationic peptide that we termed liver‐expressed antimicrobial peptide 2 (LEAP‐2). We identified several circulating forms of LEAP‐2 differing in their amino‐terminal length, all containing a core structure with two disulfide bonds formed by cysteine residues in relative 1–3 and 2–4 positions. Molecular cloning of the cDNA showed that LEAP‐2 is synthesized as a 77‐residue precursor, which is predominantly expressed in the liver and highly conserved among mammals. This makes it a unique peptide that does not exhibit similarity with any known human peptide regarding its primary structure, disulfide motif, and expression. Analysis of the LEAP‐2 gene resulted in the identification of an alternative promoter and at least four different splicing variants, with the two dominating transcripts being tissue‐specifically expressed. The largest native LEAP‐2 form of 40 amino acid residues is generated from the precursor at a putative cleavage site for a furin‐like endoprotease. In contrast to smaller LEAP‐2 variants, this peptide exhibited dose‐dependent antimicrobial activity against selected microbial model organisms. LEAP‐2 shares some characteristic properties with classic peptide hormones and it is expected that the isolation of this novel peptide will help to unravel its physiological role.