bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastric Mucosal Blood Flow Changes in Helicobacter pylori Infection and NSAID‐Induced Gastric Injury
Authors: Elizalde J. Ignasi , Mendez Asuncion , Gomez Julia , Del Rivero Maria , Gironella Meritxell , Closa Daniel , Quintero Enrique , Pique Josep M. 
Published: December 2004

abstractBackground. The impact of H. pylori infection on gastric mucosal blood flow and NSAID‐induced gastric damage is unclear.Aim. To study the effects of H. pylori infection on gastric mucosal blood flow, both at basal conditions and after NSAID exposure, and its relation with mucosal damage and nitric oxide production.Methods. Gastric mucosal blood flow, nitric oxide production and gastric damage were assessed in time after H. pylori SS1 or E. coli inoculation in mice. Experiments were conducted in basal conditions or after oral exposure to indomethacin (20 mg/kg).Results. H. pylori infected mice exhibited a significant increase in gastric blood flow and gastric nitric oxide production 1 week after infection, but those parameters returned to basal levels by 4 weeks. NSAID challenge elicited a similar reduction in gastric blood flow [25–35%] in H. pylori‐infected and control animals. However, only 1 week H. pylori‐infected mice, which exhibited a significant baseline hyperemia, were able to maintain gastric blood flow values within the normal range after NSAID exposure. NSAID‐induced gastric damage was increased in H. pylori‐infected mice by 4 weeks, but not 1 week after infection.Conclusions. Underlying H. pylori infection aggravates acute NSAID‐induced gastric damage. However, at early phases, gastric hyperemia associated with increased nitric oxide production may exert some protective role.
Histology of Gastritis and Helicobacter pylori Infection in Thailand: a Nationwide Study of 3776 Cases
Authors: Atisook Kanit , Kachinthorn Udom , Luengrojanakul Pairoj , Tanwandee Tawesak , Pakdirat Puripakorn , Puapairoj Anucha 
Published: December 2004

abstractBackground. Dyspepsia is a very common problem in Thailand. Etiology of gastritis, incidence of Helicobacter pylori and mode of transmission of Helicobacter pylori infection in the country was proposed.Methods. A nation‐wide study of gastric biopsy in 3776 dyspeptic patients from six different geographic regions for incidence of gastritis, type of gastritis, incidence of H. pylori infection, gastric atrophic change and intestinal metaplasia in three age‐groups of each region was done.Results. 58.7% of dyspeptic patients had histological gastritis. Pangastritis was the most common type (77.3%) with mostly mild active inflammation (60.6%) and was found most commonly in the age group 31–60 years. Incidence of gastritis was slightly lower in the coastal and peninsular community compared with the mountain, jungle, semiarid plateau and fertile plain communities. Geographic factor, socioeconomic status and dietary habit were proposed to be important factors in inducing gastritis. H. pylori infection was found in 48.2% of dyspeptic patients with high incidence in the age‐group 31–60 years (63.7%) and 98.2% of H. pylori infection was found to be associated with gastritis. Semi‐arid plateau, mountain, jungle and fertile plain communities had high incidences of H. pylori infection varying from 54.0 to 67.1% while the coastal and peninsular communities had low incidences of 32%. Oral to oral spread is proposed to be the mode of bacterial transmission. Incidences of gastric atrophic change and intestinal metaplasia were low in this country and were found in 11.6% and 8.2% of subjects, respectively, with no significantly different distribution in geographic regions. Type I or intestinal type was found to be the most common type of intestinal metaplasia.
Cost‐Effectiveness of Antiepileptic Drugs in Migraine Prophylaxis
Authors: Adelman James U. , Adelman Leon C. , Von Seggern Randal 
Published: December 2004

Objective.—To analyze the cost‐effectiveness of antiepileptics in migraine prophylaxis.Methods.—A cost‐effectiveness analysis was performed using efficacy data from three recent, double‐blind, placebo‐controlled, clinical trials of antiepileptic drugs studied for migraine prevention and cost data. Two measures of cost‐effectiveness were used: cost per headache prevented and the cost‐equivalent number.Results.—In the double‐blind, placebo‐controlled, clinical trials evaluated, three antiepileptic drugs were shown to be effective in migraine prevention. All three antiepileptic drugs had high costs per migraine reduced. Gabapentin was the most costly at $138.00 per migraine prevented, whereas the cost per migraine prevented with topiramate was $114.80 and with divalproex sodium was $48.00. For migraine prevention divalproex sodium became cost‐effective with 10 migraines per month, whereas gabapentin and topiramate required considerably more migraines per month to be cost‐effective.Conclusions.—Antiepileptic drugs have proven effectiveness in migraine prophylaxis. However, in patients responsive to their acute care medications, the antiepileptic drugs are only cost‐effective for those patients with a high frequency of migraines and those with comorbid diseases. Future studies should be done with antiepileptic drugs in patients exhibiting a migraine frequency of 10 or more headaches per month.
Reliability and Validity of the Migraine Therapy Assessment Questionnaire
Authors: Chatterton Mary Lou , Lofland Jennifer H. , Shechter Aaron , Curtice Walter Scott , Hu X. Henry , Lenow Jeffrey , Smullens Stanton N. , Nash David B. , Silberstein Stephen D. 
Published: December 2004

Objective.—To determine the reliability and validity of the Migraine Therapy Assessment Questionnaire (MTAQ).Design/Methods.—Eligible patients between ages 18 and 65 with at least one migraine per month, a physician visit in the preceding 6 months, and a migraine diagnosis were recruited from physician offices in the Philadelphia area. Participants completed the MTAQ, Short Form‐36 (SF‐36), the Migraine Disability Assessment Score (MIDAS), the Beck Depression Inventory, a demographic questionnaire, and a medication use survey. The first 100 participants completed a second MTAQ approximately 2 weeks later. The test‐retest reliability, construct, and predictive validity of the MTAQ were assessed.Results.—Two hundred fifty‐one patients were recruited; 243 patients were assessable. All MTAQ questions had a kappa statistic of .5 or higher and an agreement of at least 76%. There was a significant level of agreement (.71) for the MTAQ summary score. MTAQ items regarding control, frequency, work loss, resource use, and satisfaction were associated with significant differences in SF‐36 scores. MTAQ items related to work loss, emergency department use, headache frequency, and control were associated with days missed from work and degree of disability as measured by MIDAS. Suboptimal migraine management was significantly associated with MTAQ items indicating three or more headaches per month, missing time from work or school, taking daily medication for headaches, and having an emergency department visit in the last 6 months.Conclusion.—MTAQ is a reliable and valid questionnaire to identify migraineurs whose migraine management may be suboptimal in a primary care setting.
Relief of Tension‐type Headache Symptoms in Subjects with Temporomandibular Disorders Treated with Botulinum Toxin‐A
Authors: Freund Brian J. , Schwartz Marvin 
Published: December 2004

Background.—Temporomandibular disorder (TMD) and chronic tension headaches clinically coexist in many individuals. Generally considered as separate pathological entities, they have been clinically treated by different means.Objective.—To determine the utility of treatement with botulinum toxin for patients with coexisting TMD and chronic tension type headache.Methods.—In this open‐label study of 60 subjects with chronic TMD, 46 subjects also met the diagnostic criteria for chronic tension headache. All 60 subjects were treated with 150 units of botulinum toxin‐A injected into the masticatory muscles, specifically 50 units into each masseter and 25 units into each temporalis muscle.Results.—Thirty‐eight of 60 subjects (63%) reported a 50% improvement in their facial pain during the follow‐up period. The subset of 46 subjects with chronic tension headache and TMD symptoms reported a 50% or greater improvement in headache pain as well. The number of headache free days also improved postinjection.Conclusion.—These results suggest that the masticatory muscles, specifically the temporalis, may be involved in the pathogenesis of this form of chronic tension headache found in association with TMD.
Efficacy, Safety, and Tolerability of Oral Eletriptan for Treatment of Acute Migraine: A Multicenter, Double‐Blind, Placebo‐Controlled Study Conducted in the United States
Authors: Sheftell Fred , Ryan Robert , Pitman Verne , For The Eletriptan Steering Committee  
Published: December 2004

Objective.—To investigate the efficacy, consistency, safety, and tolerability of oral eletriptan in the acute treatment of three migraine attacks.Background.—Eletriptan is a selective 5‐HT1B/1D agonist member of a class of agents known to be effective in the acute treatment of migraine.Methods.—Thirteen hundred thirty‐four patients were randomized to 20 mg, 40 mg, or 80 mg of eletriptan, or placebo and could treat up to three attacks. The primary efficacy endpoint was 2‐hour headache response for the first attack. Secondary endpoints included associated symptom relief, and pain‐free, sustained pain‐free, and consistency of response.Results.—Eletriptan 20 mg, 40 mg, and 80 mg achieved significantly (P  <  .0001) better headache response rates than placebo at 2 hours (47%, 62%, and 59%, respectively, versus 22%) and 4 hours (64%, 76%, and 79%, respectively, versus 25%). Headache response was observed to be rapid, showing improvement at 0.5 hour and 1 hour. Two‐hour pain‐free response rates for eletriptan 20 mg, 40 mg, and 80 mg were 14%, 27%, and 27%, respectively, compared with 4% for placebo. Sustained pain‐free response rates were significantly (P  <  .001) better for eletriptan 20 mg (10%), 40 mg (20%), and 80 mg (18%) compared with placebo (3%). Eletriptan had a higher consistency of intrapatient response than placebo in two of three (68% to 82%) and three of three attacks (32% to 60%) versus 16% and 8%, respectively. All eletriptan doses yielded significant functional improvement at 2 hours. Adverse events were generally mild or moderate and transient, with eletriptan 20 mg having an adverse event profile comparable to placebo.Conclusions.—Eletriptan is efficacious, displaying high consistency of response over multiple attacks, and is well tolerated for the acute treatment of migraine.
Real‐World Experiences in Migraine Therapy With Rizatriptan
Authors: Jamieson Dara , Cutrer F. Michael , Goldstein Jerome , Dayno Jeffrey , Hu X. Henry , On Behalf Of The USMAP Investigators  
Published: December 2004

Objective.—To evaluate the effectiveness of rizatriptan for acute migraine treatment and patient satisfaction with the drug in usual clinical practice settings.Background.—Although rizatriptan has been shown to effectively relieve migraine symptoms in clinical trials, we wished to assess its utility in typical patient care settings.Design.—Multicenter, open‐label design involving the patients of practicing clinicians.Methods.—Adult migraineurs treated two migraine attacks with either rizatriptan 10‐mg standard tablets or rizatriptan 10‐mg orally disintegrating tablets in a crossover manner. Participants had not taken rizatriptan previously and chose which formulation to take first. Patients reported their treatment experiences via an interactive voice response system approximately 24 hours after treatment. Prior migraine treatment experiences were reported by patients on a baseline questionnaire completed at participating clinics. We used conditional logistic regression analysis adjusted for treatment sequences to test the statistical significance of comparisons with results recorded on the baseline questionnaire.Results.—Of the 5388 patients enrolled, 3953 (73%) completed at least one follow‐up and 3183 (59%) completed two follow‐up reports. Patients reported the following outcomes for attacks treated with the rizatriptan tablet and orally disintegrating tablet formulations, respectively, compared with their prior responses to oral usual care medications (P  <  .05 in all comparisons with baseline data): onset of pain relief within 30 minutes postdose: 18% and 23% versus 16%; no or mild headache 2 hours postdose: 66% and 67% versus 37%; largely symptom‐free within 2 hours postdose: 52% and 54% versus 35%; return to usual activities within 2 hours postdose: 50% and 51% versus 31%; and very or somewhat satisfied with treatment: 72% and 74% versus 53%.Conclusions.—In this “real‐world” setting involving a patient population selected by clinicians, rizatriptan appeared to offer better treatment outcomes than those from prior treatments with other oral migraine medications.
Biofeedback‐Assisted Relaxation in Migraine Headache: Relationship to Cerebral Blood Flow Velocity in the Middle Cerebral Artery
Authors: Vasudeva Sachinder , Claggett Alice L. , Tietjen Gretchen E. , McGrady Angele V. 
Published: December 2004

Objective.—To determine if migraineurs with aura respond differently to biofeedback/relaxation than those without aura and, if so, whether the variability in outcome can be explained by blood flow velocity.Background.—The relationship between cerebral blood flow velocity and treatment response to biofeedback/relaxation in migraine with and without aura is uncertain.Method.—Twenty migraineurs underwent 12 sessions of biofeedback/relaxation therapy, while 20 controls simply were told to relax on their own. Cerebral blood flow velocity was measured bilaterally in the middle cerebral artery with transcranial Doppler.Results.—The biofeedback group showed significant (P  <  .05) reductions in pain, depression, and anxiety compared to the control group. Patients with and without aura did equally well. There were significant (P  <  .05) left to right blood flow velocity differences only in the migraine with aura group. Maximum blood flow velocities were significantly higher (P  <  .05) in the migraine with aura group than in the cohort without aura. There was an inverse correlation between indicators of anxiety and blood flow velocity, perhaps related to hyperventilation‐induced constriction in the small vessels distal to the middle cerebral artery.Conclusion.—The positive treatment response to biofeedback/relaxation in migraine headache is not related to presence of aura, nor to changes in blood flow velocity, but may be associated with reduction in anxiety and depression.
Migraine Disability Assessment (MIDAS) Score: Relation to Headache Frequency, Pain Intensity, and Headache Symptoms
Authors: Stewart Walter F. , Lipton Richard B. , Kolodner Ken 
Published: December 2004

Objective.—To determine the extent to which variation in the Migraine Disability Assessment (MIDAS) score is associated with headache frequency, pain intensity, headache symptoms, gender, and employment status.Background.—The MIDAS questionnaire is a 7‐item questionnaire (with 5 scored items) designed to measure headache‐related disability, to improve physician‐patient communication, and to identify patients with high treatment needs.Methods.—Data from 3 population‐based studies (total sample, n  =  397) conducted in the United States and the United Kingdom were used to evaluate the relationship between headache features (attack frequency, pain intensity, pain quality, and associated symptoms) and MIDAS score. Data on headache features were collected by telephone using a standardized interview. The MIDAS questionnaire was completed shortly after the telephone interview. General linear models were used to determine the extent to which population variation in the MIDAS score was explained by headache features.Results.—Using linear regression, variables for all headache features (ie, headache frequency, pain intensity, pain quality, and associated symptoms) and demographic characteristics explained only 22% of the variation in MIDAS scores. Almost all (19.9%) the explained variance was accounted for by average pain intensity (12.0%), number of headache days (6.1%), and exacerbation of pain with movement (1.8%). When pain intensity and headache frequency were included in the model, no statistically significant differences in MIDAS scores were observed by gender or employment status. Although explaining only 2.1% of the variance, age was significantly associated with MIDAS scores, with those under 25 years demonstrating higher MIDAS scores than other age groups. No other variables (ie, frequency of occurrence of associated symptoms and other measures of quality of pain) were associated with MIDAS scores.Conclusions.—Challenges to the utility of the MIDAS as a measure include whether headache‐related disability is largely a function of other routine headache features and whether MIDAS is inherently biased based on work status and gender. While the MIDAS score was associated with headache frequency and average pain score, these two headache features explain only a modest proportion of the variation in MIDAS scores. Additionally, gender and work status were not related to MIDAS scores. These findings suggest that the MIDAS score captures information about disability that is not inherent to other headache features and is independent of gender and work status.
Academic Headache Medicine in America: Report of Academic Membership Survey of the American Headache Society Special Interest Section on Academic Affairs
Authors: Finkel Alan G. 
Published: December 2004

Background.—What constitutes the typical clinical experience of an academic headache specialist in America is unknown.Purpose.—To clarify this issue, we undertook a survey of academic headache specialists who are members of the American Headache Society.Methods.—In June 2000, 181 surveys including questions regarding academic rank, departmental and institutional affiliation, and time distribution were sent to members drawn from the 1999‐2000 Membership Directory of the American Headache Society whose primary addresses were recognized academic institutions or who, by reputation, had extensive academic affiliation. Additional questions about headache teaching, research, and practice were included.Results.—Seventy‐two (39.7%) of the surveys were returned. Forty‐nine (40%) of the 122 American medical schools were represented. The most prevalent academic rank was professor (38%). Included were 2 departmental chairs, 1 division chief, 1 vice dean, and 1 residency training director. The majority (70.8%) were neurologists. Seventy‐two percent of respondents spent at least 50% of their time in a clinic, 79% spent 25% or less of their time on research, and 78% spent 25% or less time in teaching. The average number of new patients seen per week was 9.0  ±  7.6, with each visit lasting 62.4  ±  20.8 minutes. Clinicians saw 22.7  ±  14.6 patients for follow‐up per week, with the average visit lasting 24.7  ±  6.8 minutes. Although it appears that at least informal instruction in headache is provided to medical students, interns, and residents, 19.7% (12 of 61) of respondents reported that no formal medical school lecture on the topic of headache was offered at their institutions.Conclusion.—This preliminary survey offers some insight into the clinical experience of academic headache specialists in the American medical system. Suggestions for future studies are discussed.
Electrophysiological evidence for trigeminal neuron sensitization in patients with migraine.
Authors: Sandrini G , Proietti Cecchini A , Milanov I , Tassorelli C , Buzzi MG , Nappi G 
Published: December 2004

Neurosci Lett. 2002 Jan 14;317(3):135‐138The electrically elicited corneal reflex is a useful tool for exploring the trigeminal system in humans and it may provide additional evidence pointing to a dysfunction of this system in migrainous patients. Tactile perception, corneal reflex and pain thresholds were studied in 48 migraine without aura patients during pain‐free periods and compared with those observed in 24 controls. Twenty‐eight of the patients had strictly unilateral headache, while the other 20 had bilateral or side‐shifting pain during attacks. Both migraine subgroups (bilateral and unilateral) showed significantly lower thresholds compared with controls. The lowest values were observed on the symptomatic side of unilateral migraine patients. These findings suggest that sensorimotor mechanisms and/or pain control systems at the trigeminal level are impaired in migraine. The bilateral location of these abnormalities seems to point to a centrally located dysfunction.Comment: This is an important paper which describes a noninvasive method of studying sensorimotor/pain control mechanism in humans. This approach may help in the development of potential prophylactic agents, to establish likely clinically effective doses and duration of treatments in small‐scale phase II trials, before exposing larger numbers of subjects to potentially ineffective doses in phase III trials. DSM
Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache.
Authors: Heinrichs L 
Published: December 2004

Am J Obstet Gynecol. 2002 May;185(5 Suppl Understanding):S215‐S219Objective: The experience of women was sought about nausea and vomiting, its relation to olfaction, its occurrence among pregnant women with anosmia, and the potential association of hyperemesis gravidarum and migraine headache.Methods: We performed a community‐based study with a physician/patient‐directed questionnaire, and a retrospective analysis of hospital records.Results: Nearly all women (n  =  163 parous women) experience nausea (98%) and vomiting (97%). The highest frequency causes of nausea and vomiting were “food poisoning” (65%), “flu” (58%), pregnancy (54%), and offensive odors (52%); vomiting occurred as frequently as nausea for the first 2 causes, and one half as often for the latter causes. Most women reported that the pain experienced during vomiting exceeded that of parturition. Among 9 women with hypogonadotropic anosmia with advanced reproductive technology‐induced pregnancies, 2 experienced nausea and vomiting, one from “food poisoning.” Among 37 women with migraine headache, 10 (27%) had experienced hyperemesis gravidarum, and among 16 who experienced hyperemesis gravidarum, 5 (37%) had migraine headaches.Conclusions: The frequency of nausea and vomiting, caused most often by nonpregnancy‐related triggers, is high among women. In a small sample of women with congenital anosmia, nausea and vomiting of pregnancy occurred in only 1 pregnancy, suggesting that olfaction is a highly selected trigger for nausea and vomiting of pregnancy. The shared nausea and vomiting experience of hyperemesis gravidarum and migraine headache among women suggests a common mechanism, possibly based on allelic variations within the DRD2 (dopaminergic receptor) gene. Because olfactory receptors, odor types, and MHC antigens are closely integrated, and because olfactory stimuli often incite episodes of pregnancy, nausea, and vomiting, hyperemesis gravidarum, and migraine headache, these genes and their products invite further scrutiny. The pregnancy‐conserving effect of PNV and the MHC antigen overlap in couples with recurrent abortion are important clues possibly relating olfaction, MHC antigens, and reproductive success or failure.Comment: Dr Stephen Peroutka described a group of patients with migraine with DRD2 gene abnormalities that he thought might predict for antidopamine medication efficacy in treating their migraines. He felt these patients had prominent dopaminergic manifestations in their migraine presentations: yawning and severe nausea and vomiting. (Peroutka SJ. Dopamine and migraine. Neurology. 1997;49:650‐656). The current study suggests that we may be able to look for other comorbid illnesses, such as hyperemesis gravidarum, to find patients with “dopaminergic migraine,” if this entity exists. SJT