bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pharmacology, toxicology, and medical treatment of sulphur mustard poisoning
Authors: Balali‐Mood Mahdi , Hefazi Mehrdad 
Published: May 2005

AbstractSulphur mustard (SM) is regarded as one of the most important agents of chemical warfare because of its simple and cheap chemical synthesis that makes it readily available for both terrorist and military use. SM acts as an alkylating agent that induces disruption of nucleic acids and proteins, impairing cell homeostasis and eventually causing cell death. It rapidly reacts with ocular, respiratory and cutaneous tissues, as well as bone marrow and the mucosal cells of the gastrointestinal tract, resulting in several devastating long‐term effects on human health, many of which are not clinically or pathologically well defined. In light of the possible threat of SM use against military and civilian populations, physicians should be aware of its grave effects and knowledgeable how to care for its victims. The pattern of immediate and long‐term toxic effects following exposure to SM is reviewed in this article with special references to the recent data available from over 100 000 chemical casualties incurred during the Iran–Iraq conflict.
The application of sample pooling methods for determining AUC, AUMC and mean residence times in pharmacokinetic studies
Authors: Cheung Belinda W.Y. , Cartier Linda L. , Russlie Henry Q. , Sawchuk Ronald J. 
Published: May 2005

AbstractFor high‐throughput screening in drug development, methods that can reduce analytical work are desirable. Pooling of plasma samples from an individual subject in the time domain to yield a single sample for analysis has been used to estimate the area under the concentration–time curve (AUC). We describe a pooling procedure for the estimation of the area under the first moment curve (AUMC). The mean residence time (MRT), and where intravenous dosing has been used, the steady‐state volume of distribution can then be determined. Plasma samples from pharmacokinetic studies in dogs and humans analyzed in our laboratory were used to validate the pooling approach. Each plasma sample containing a prokinetic macrolide and three of its metabolites was first analyzed separately, and AUCs and AUMCs were calculated using the linear trapezoidal rule. The procedures for the estimation of AUC by sample pooling have been reported by Riad et al. [Pharm. Res. (1991) vol. 8, pp. 541–543]. For the estimation of AUMC, the volume taken from each of n samples to form a pooled sample is proportional to tn(tn+1 − tn−1), except at t0 where the aliquot volume is 0 and at tlast where the aliquot volume is proportional to tlast(tlast − tlast−1). AUMC to tlast is equal to Cpooled × T2/2, where T is the overall experimental time (tlast − t0). The ratio between AUMC and AUC yields the mean residence time (MRT). Bivariate (orthogonal) regression analysis was used to assess agreement between the pooling method and the linear trapezoidal rule. Bias and root mean square error were used to validate the pooling method. Orthogonal regression analysis of the AUMC values determined by pooling (y‐axis) and those estimated by the linear trapezoidal rule (x‐axis) yielded a slope of 1.08 and r2 of 0.994 for the dog samples; slope values ranged from 0.862 to 0.928 and r2 values from 0.838 to 0.988 for the human samples. Bias, expressed as percentage, ranged from −25.1% to 14.8% with an overall average of 1.40%. The results support the use of a pooled‐sample technique in quantitating the average plasma concentration to estimate areas under the curve and areas under the first moment curve over the sampling time period. Mean residence times can then be calculated.
Justification for routine screening of pharmaceutical products in immune function tests: a review of the recommendations of Putman et al. (2003)
Authors: Ryle Peter R. 
Published: May 2005

AbstractIn a recent publication by Putman et al. (2003), salmeterol, morphine/methadone and buprenorphine were quoted as examples of pharmaceutical drugs whose immunotoxicity has only been revealed by conduct of specific immune function tests in non‐clinical studies. Review of the published non‐clinical data for these drugs has shown that there is no clear evidence of immunotoxicity of salmeterol in these studies, and in addition, there are no clinical issues regarding adverse immunological effects of this drug. Of the opioid drugs, only very minor evidence of immunosuppression by morphine, and marginal evidence of slight immunostimulation by buprenorphine were detected in the non‐clinical immune function assays performed at high doses. Methadone showed no effects on immune function assays in animals. As some immunomodulation by opioid drugs might have been expected based on the known pharmacological properties of this drug class, the marginal effects, or lack of effects observed in the immune function tests does raise a question about the sensitivity and specificity of the assays to detect clinically relevant changes. This review has suggested that, based on the cited examples, there is no strong case for routine non‐clinical immune function testing of all new pharmaceutical products. A more rigorous evaluation of non‐clinical immune function tests, and their ability to discriminate between clinically relevant and non‐clinically relevant immunosuppression, is needed before definitive regulatory guidance in this area can be finalized.
Calcitonin therapy in postmenopausal osteoporosis: effects on serum levels of interleukin‐1, interleukin‐6 and tumor necrosis factor‐α
Authors: ÖZORAN K. , SEÇKIN Ü. , TUTKAK H. , MERMERCI B. 
Published: May 2005

AbstractBackground:  It has been suggested that the effects of calcitonin (CT) therapy for senile and postmenopausal osteoporosis were due to its modulatory effects on bone‐related cytokines. A significantly increased release of IL‐1, IL‐6 and TNF‐α, which have bone resorptive effects, has been reported in osteoporotic patients.Aim:  In this study we investigated the effects of CT therapy on the levels of IL‐1, IL‐6 and TNF‐α.Method:  Forty postmenopausal osteoporotic women were included to the study. The first group consisting of 20 patients were given 100 IU CT subcutaneously and 1000 mg elemental calcium for 15 consecutive days. The second group or the control group also consisting of 20 patients were only given 1000 mg elemental calcium and both of the groups were not allowed to take any other medication.Results:  In the first group the mean serum TNF‐α level significantly decreased from 16.9 ± 24.2 pg/mL to 8.6 ± 13 pg/mL after 1500 IU CT therapy (P < 0.05). The control group's mean serum level of IL‐1, IL‐6 and TNF‐α did not reveal any statistically significant differences (P > 0.05).Conclusion:  Our results suggest that CT therapy for osteoporosis may partially be due to its inhibitory effects on TNF‐α, and probably IL‐1. However, further in‐vitro and ex‐vivo studies are needed to clarify this hypothesis.
Lack of association of antineutrophil cytoplasmic antibodies with joint failure as indicated by joint surgery in rheumatoid arthritis
Authors: BROADFOOT Andrew , GILLIS David , PROUDMAN Susanna 
Published: May 2005

AbstractAim:  The objective of this study was to investigate a possible association in rheumatoid arthritis (RA) of perinuclear antineutrophil cytoplasmic antibodies (pANCA) and joint failure requiring joint surgery as a well‐defined functional end point.Methods:  188 patients with RA according to the American College of Rheumatology criteria, with a mean duration of disease of 18 years, were enrolled in a cross‐sectional study. Patients were assessed for history of joint surgery, previous/current therapies, function according to the modified Health Assessment Questionnaire (mHAQ), rheumatoid factor (RF) and clinical and laboratory parameters of disease activity. ANCA were detected using indirect immunofluorescence.Results:  Overall, 36.7% of patients were pANCA positive (including atypical pANCA) and 35.1% of patients had a history of joint surgery. There was no association between the presence of pANCA and joint surgery. No association was demonstrated between ANCA status and other prognostic markers such as RF, previous or current therapies and disease activity or function.Conclusion:  No association between pANCA and joint surgery was demonstrated in this cohort of RA patients.
Up‐regulation of 5‐HT2 Serotonin Receptor: A Possible Mechanism of Transformed Migraine
Authors: Srikiatkhachorn Anan , Govitrapong Piyarat , Limthavon Chanchira 
Published: May 2005

SYNOPSISTransformation of episodic migraine to chronic daily headache (so called transformed migraine) ia now a well recognized phenomenon. Although several factors, i.e. analgesic overuse, increasing age, psychiatric disorders are reported to play some roles in this transformation, the precise cascade is still unclear. Further suppression of an already abnormal antinociceptive system with up‐regulation of post‐synaptic receptors is one of the possible explanation. In order to understand the mechanism underlying this condition, 5‐HT2 serotonin receptors on platelets were assayed by the radioligand binding technique. Six transformed migraine patients (67.67 ± 1.52 years) and seven healthy controls (72.86 ± 1.82 years) were studied. [3H]‐spiperone and ketanserin were used to determine the specific binding. We found a significant increase (P <0.05) in the maximal receptor numbers (Bmax ) on platelet membrane of the migraine patients when compared to the controls (64.31 ± 11.06 end 39.96 ± 5.42 fmol/mg protein, respectively), whereas the dissociation equilibrium constant (K D ) values remained unchanged (3.63 ± 0.78 nM and 2.84 ± 0.48 nM for the migraine patients and controls, respectively). The up‐regulation of serotonin receptors found in this study provided further support to the ”serotonergic hypofunction“ theory of migraine pathogenesis and may explain the unusual loss of episodicity seen in the transformed migraine patients.
Quantitative EEG in Children with Headache
Authors: Valdizán J.R. , Andreu C. , AImárcegui C. , Olivito A. 
Published: May 2005

SYNOPSISThe object of this work is to determine if Brain Mapping can reveal significant differences between a normal control group and e group whose members suffer from one of three types of headache: tension‐type, migraine with aura and migraine without aura. Both groups were formed by children aged between 6 and 14; the latter were undergoing no treatment and were in a headache‐free phase.Results demonstrate that there are no significant differences between the control group and the tension‐type headache group. Neither were differences found in migraine without aura group but in migraine with aura there was an increase of the theta/alpha ratio in the temporal posterior and occipital zones. This ratio could be used as a neurophysiological indicator in the evolution of the migraine with aura pathology.
Basilar Migraine With Severe EEG Abnormalities
Authors: Passier Patricia , Vredeveld Jan W. , de Krom Marc 
Published: May 2005

SYNOPSISWe report a patient suffering from a series of attacks fulfilling the criteria of basilar migraine. During the attack there was no normal EEG background pattern and the EEG showed predominantly delta activity. After the attack the EEG returned to (nearly) normal in a very short time. Up to now no such EEG findings have been reported in basilar migraine.
Evaluation and Treatment of Headache Patients in the Emergency Department: A Survey.
Authors: Barton Christopher W. 
Published: May 2005

SYNOPSISPatients with headache represent a common diagnostic and treatment challenge for health care providers in the emergency department. The therapeutic options continue to grow, yet many studies imply that narcotics continue to be a frequently chosen treatment. In this retrospective cross‐sectional survey, the evaluation and treatment patterns of patients presenting to an academic medical center emergency department with a primary diagnosis of headache were analyzed. Headache disorders accounted for 1.7% of all visits to the emergency department. Migraine headache was the most common headache diagnosis representing 60% of headache visits followed by headache of no obvious source at 25%. Narcotics were the most common treatment employed (180 patient‐visits) in all patients and non‐steroidal anti‐inflammatory agents were the second most common agent used (86 patient visits). Narcotics were also the most common therapy in migraine headache patients (152 patient‐visits) while ergotamines were used in less than one‐third of patient‐visits (36 patient‐visits). Therapy of headache patients in the emergency department continues to rely on narcotics. Methods of interrupting the dependence on narcotics need to be explored if newer non‐narcotic therapies are to be successful.
Pseudoaneurysm Within the Cavernous Sinus Presenting as Cluster Headache
Authors: Koenigsberg Adam D. , Solomon Glen D. , Kosmorsky Gregory 
Published: May 2005

SYNOPSISCluster headache and its associated signs end symptoms have been described in medical literature for years. The etiology of this condition remains unresolved. We describe a unique patient who presented with a cluster headache syndrome concurrent with new‐onset pseudoaneurysm within the cavernous sinus. Our review and analysis of this patient confirms current theories which describe the role of the cavernous sinus as a locus of pathology in cluster headache.
SUNCT Syndrome: Repetitive and Overlapping Attacks
Authors: Pareja Juan A. , Pareja Julia , Palomo Tomás , Caballero Vicente , Pamo Manuel 
Published: May 2005

SYNOPSISA 79‐year‐old patient had been suffering from right orbital pain attacks since he was 77. The pain, of an “electrical” or burning character, was moderate to severe in intensity. Single attacks lasted for 30–60 seconds each and were accompanied by prominent ipsilateral conjunctival injection and tearing as well as slight rhinorrhoea. The temporal pattern of attacks was irregular with spontaneous remissions alternating with unpredictable symptomatic phases. During active periods, attacks could be triggered by several precipitants acting on trigeminal and extra‐trigeminal innervated areas. On most occasions, the patient had 2–3 attacks daily but, at worst, he might have almost continuous short‐lasting attacks in periods of 1 to 3 hours length. When attacks had such frequency they presented either as repetitive or overlapping single episodes. According to the clinical features it is concluded that the case reported is a new case of SUNCT syndrome.
The Diagnosis Of Headache in Primary Care: Factors in the Agreement of Clinical and Standardized Diagnoses
Authors: Stang Paul E. , Korff Michael Von 
Published: May 2005

SYNOPSISObjective: Comparison of clinical headache diagnoses in primary care to algorithm diagnoses from a standardized headache interview.Design: A sample of consecutive primary care headache patients (n=779) at the Group Health Cooperative of Puget Sound were interviewed and medical records abstracted.Measurements: The medical record provided ‘chart’ diagnoses while a structured interview and diagnostic algorithm yielded the ‘algorithm diagnosis’. The patients were also administered the depression sub‐scale from the SCL 90‐R, in addition to answering questions about pain intensity and disability used to rade the severity of chronic pain.Results: Among persons diagnosed by the primary care physician as having migraine, 78% received an algorithm diagnosis of migraine. However, study patients were more likely to receive a diagnosis of migraine by algorithm (57%) than by clinical diagnosis (33%). While clinicians infrequently recorded a diagnosis of migraine and tension‐type headache in the same patients, tension‐type headache was identified among half of the algorithm diagnosed migraineurs. Among patients with algorithm‐diagnosed migraine, female gender, increased isability, and the presence of aura increased the likelihood that the clinician would also diagnose migraine, Conversely, the presence of tension‐type headache features, high levels of depression, high number of headache days and age over 65 years reduced the likelihood of the clinician diagnosing migraine among algorithm‐diagnosed cases.Conclusions: The co‐occurrence of migraine and tension‐type headache symptoms are commonly reported by patients, however, primary care physicians usually recorded a single diagnosis of either migraine or tension headache. Among patients reporting migrainous features, the presence of chronic headache, emotional distress and the absence of disability reduced the likelihood that the clinician would assign a diagnosis of migraine. These results suggest the need for diagnostic and management strategies appropriate for patients whose headaches combine tension‐type and migrainous features,
Does Quality of Life Differ Among Headache Diagnoses? Analysis Using the Medical Outcomes Study Instrument
Authors: Solomon Glen D. , Skobieranda Franck G. , Gragg Lisa A. 
Published: May 2005

SYNOPSISBackground: To analyze the differences in quality of life associated with headache diagnoses using the Medical Outcomes Study Short Form Health Survey (SF‐20).Methods: A patient interview survey using the SF‐20 Short Form Health Survey was conducted in a headache clinic within a multi‐specialty group practice. All six health components of the SF‐20 were included in the study, Headache diagnoses were made using IHS criteria.Results: 208 consecutive headache patients were studied. Patients with cluster headache had a significantly higher (worse) pain score (P<0.018) and higher percentage of patients with poor health due to pain (P<0.005) than patients with migraine headache. There were fewer cluster patients with poor health associated with physical functioning than tension‐type (P<0.020) or mixed headache (P<0.022) patients. Poor health associated with social functioning was greater for cluster (P<0.011) and tension‐type headache (P<0.015) than for migraine. There was a significantly higher percentage of tension‐type headache patients with poor health associated with mental health (P<0.002) than patients with migraine.Conclusions: The SF‐20 is a reliable and valid measure of quality of life for patients with different headache diagnoses. Distinct headache diagnoses are marked by unique patterns of impairment and quality of life.
Transcranial Doppler Sonography in Headache‐Free Migraineurs
Authors: Abernathy Margaret , Donnelly Gerard , Kay Gary , Wieneke Jacqueline , Morris Sarah , Bergeson Scott , Ramos Maria , Call Diana , O'Rourke Daniel 
Published: May 2005

SYNOPSISWe used transcranial Doppler ultrasonography to determine whether intracranial blood velocities in 182 headache‐free migraineurs (60 with aura, 122 without aura) differed from velocities in 38 nonheadache prone control subjects. During the headache‐free period, migraineurs with and without aura had significantly elevated mean velocities in all intracranial arteries except the right internal carotid artery at the level of the siphon. Velocities in migraineurs with aura did not differ significantly from velocities in those without aura.Markedly increased velocities were noted in a subset of interictal migraineurs. Two explanations are possible: 1) Blood flow velocities may increase in response to a decrease in the cross sectional area of a vessel st or near the point of insonation. 2) Alterations at the level of the cerebral arteriole may affect regional cerebral blood flow, thereby changing blood flow velocities at the point of insonation. Transcranial Doppler sonography alone cannot sort out which process is responsible for the vascular response.This work may have therapeutic as well as diagnostic implications. When interictal flow velocities are markedly increased, it is possible that therapeutic agents with vasoconstrictor action might cause an excessive response. Further study is needed to clarify the sites of vasoreactivity as well as the magnitude of drug‐induced vasoconstrictor response.
The Relationship Between Locus of Control, Amount of Pre‐Admission Analgesic/Ergot Overuse, and Length of Stay for Patients Admitted for Inpatient Treatment of Chronic Headache
Authors: Primavera J.P. , Kaiser R.S. 
Published: May 2005

SYNOPSISThis study was undertaken to assess the relationship between locus of control, medication overuse, end length of hospitalization for patients admitted for inpatient treatment of chronic headache with drug rebound. Thirty patients admitted for treatment using repetitive IV DHE were administered the Health Attribution Test (HAT). Two‐thirds of these patients had profile score representative of good health attitudes associated with favorable rehabilitation outcomes. There was a trend in the direction of predicting shorter lengths of hospital stay for those patients with “good” profiles, although the correlation did not reach statistical significance. The statistical relationship (r = .25; P = .09) found between the HAT's “Powerful Others” scale and preadmission levels of medication use was consistent with previously published control theory findings regarding high external locus of control in drug and alcohol abusers.The findings of this study suggest that analgesic/ergot abusing chronic headache patients may differ from street drug abusers. This may account, in part, for the high levels of success for these patients at two year follow‐up after hospital discharge.
Precipitating Factors in Migraine: A Retrospective Review of 494 Patients
Authors: Robbins Lawrence 
Published: May 2005

SYNOPSISThe predominance of certain triggers for migraine was assessed in 494 migraine patients. Stress (62%) was the most frequently cited precipitant. Weather changes (43%), missing a meal (40%), and bright sunlight (38%) were also prominent factors. Sexual activity (5%) was the precipitant cited by the least number of patients. Significant differences were found between men and women in their responses to weather changes, perfumes, cigarette smoke, missing a meal, and sexual activity.Spring was cited by 14% of patients as a time for increased migraine attacks, followed by fall (13%), summer (11%), and winter (7%).
SUNCT Syndrome in the Female
Authors: Pareja Juan A. , Sjaastad Ottar 
Published: May 2005

SYNOPSISTwo female patients suffering from SUNCT syndrome are presented. They are the first female SUNCT cases reported (of a total of 16 cases hitherto seen by us, reported to us, or published). Also some minor modifications of the hitherto known clinical symptomatology of SUNCT syndrome have been observed.Attacks could be triggered in a variety of ways. A short latency between the application of a precipitating stimulus and the onset of pain was noted. An occasional inability of a given precipitating maneuver to activate the pain was also noted. The temporal pattern of pain was partly characterized by the typical, "plateau‐like" pattern, but with ultrashort exacerbations. In part, the pain attacks were characterized by steeple or spike‐like pain waves, that did not quite subside to the baseline (“repetitive pattern”). Autonomic signs such as lacrimation and conjunctival injection were rather marked, as is generally the case in SUNCT syndrome. Rhinorrhea was present in both patients, and in one patient the rhinorrhea was unusually marked. Carbamazepine treatment seemingly brought about a slight decrease in the frequency of attacks.