bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of Headache in the Medical Students of Santa Catarina's Federal University
Authors: Da Costa Marianges Zandrozny Gouvêa , Soares Cláudia Bernadet , Heinisch Liana Miriam Miranda , Heinisch Roberto Henrique 
Published: March 2003

Studies in well‐defined populations are useful in identifying factors that influence frequency and severity of headache and in understanding its impact on people.The aims of this study were to determine the frequency of headache in the medical students of Santa Catarina's Federal University, examine associated factors, verify the diagnostic impressions of the different types of headache, and describe the self‐medication level.This study included 408 medical students who were interviewed by a questionnaire from October 1997 to August 1998.The frequency of headache in this group was 33%, with women and students in the five last semesters of the medical course experiencing increased headache frequency. The diagnostic impressions of the different types of headache were migraine without aura (31.3%), migraine with aura (8.2%), episodic tension‐type headache (32.1%), chronic tension‐type headache (7.5%), and tension‐type headache combined with migraine without aura (3%). Self‐medication was reported by 51.8% of the medical students with headache; 34.4% used prescribed medications. The most common self‐help techniques used by students during a headache were to lie down or isolate themselves from their surroundings.
A Pilot Study to Measure Cognitive Efficiency During Migraine
Authors: Farmer Kathleen , Cady Roger , Bleiberg Joseph , Reeves Dennis 
Published: March 2003

Background and Objectives.—The measurement of cognitive efficiency during migraine has produced conflicting results primarily due to the types of tests used. The objectives of this pilot study were two‐fold: to measure cognitive efficiency during migraine, compared to a migraine‐free period, and to evaluate the effects of therapy with a 5‐HT1 agonist (sumatriptan injection, 6 mg) on the cognitive efficiency of migraineurs during a migraine.Method.—The Headache Care Center‐Automated Neuropsychological Assessment Metrics was administered to 10 migraineurs, three times without a migraine, once during a migraine, and three times after administration of sumatriptan injection (6 mg).Results.—The results demonstrated a significant drop in cognitive efficiency during migraine and recovery 15 minutes after therapeutic injection.Conclusions.—This pilot study is the first to document a significant drop in cognitive functioning during migraine and recovery after administration of a migraine‐specific medication.
Indirect Costs of Migraine in a Public Brazilian Hospital
Authors: Bigal Marcelo E. , Moraes Fábio A. , Fernandes Luciana C. , Bordini Carlos A. , Speciali José G. 
Published: March 2003

Objectives.—To evaluate the indirect costs of migraine affecting employees of a public Brazilian hospital.Background.—Migraine is a common primary headache which has a negative influence on the well‐being and quality of life, as well as the professional life, of affected individuals.Methods.—Our series consisted of 846 employees with migraine. The Lost Hours Equivalence Index, which considers both the hours lost due to the absence from work and reduction in productivity, was used to estimate the number of working hours lost due to migraine.Results.—Of the employees with migraine studied, 91% presented a mean 56.9% loss of productivity. The mean number of total lost working hours per month due to migraine was 6.5. The estimated total indirect cost of migraine was R $986  903.77 (US $815  622.54), implicating costs of R $241.30 (US $199.42) per employee per year.Conclusions.—Based on its impact on life and the resulting costs, migraine should be considered a public health problem and thus measures should be adopted to reduce its impact on the individual and on society.
Preference Comparison of Rizatriptan ODT 10‐mg and Sumatriptan 50‐mg Tablet in Migraine
Authors: Loder Elizabeth , Brandes Jan Lewis , Silberstein Stephen , Skobieranda Franck , Bohidar Norman , Wang Lixia , Boyle Denise , Kolodny Andrea , Guerra Filippa , Santanello Nancy , Johnson‐Pratt Lisa ,   the Rizatriptan Protocol 060 Study Group
Published: March 2003

Objective.—To compare the proportion of patients who prefer rizatriptan orally disintegrating tablet (ODT) 10‐mg to sumatriptan 50‐mg tablet.Background.—Migraineurs express treatment preference based on a variety of attributes including the speed of pain relief and medication formulation. Rizatriptan ODT is an orally disintegrating formulation of rizatriptan, a selective 5‐HT1B/1D receptor agonist. This study was conducted to determine patient preference between rizatriptan ODT 10‐mg and sumatriptan 50‐mg tablet for the acute treatment of migraine.Methods.—This was a multicenter, randomized, open‐label, two‐period crossover study conducted in the United States with 524 enrolled patients. Patients treated a single moderate or severe headache in each treatment period. Patients treated one migraine with either rizatriptan ODT 10‐mg or sumatriptan 50‐mg tablet, then treated a second migraine with the alternate therapy. Patients completed diary assessments at baseline, and 30, 45, 60, 90, and 120 minutes postdose and rated headache severity on a 4‐point scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe). At the final study visit following treatment of their second migraine, patients expressed preference for one of the two study medications by completing an interviewer‐administered Global Preference Question and then responded to a self‐administered series of questions to capture their most important reason for preferring one study medication over the other. Safety measurements were recorded through standard adverse experience reporting.Results.—Three hundred eighty‐six patients treated two migraine attacks. For those patients who expressed a preference for either rizatriptan ODT or sumatriptan (n = 374), the percentage of patients who preferred rizatriptan ODT 10‐mg (57%, n = 213) was significantly greater than those who preferred sumatriptan 50‐mg tablet (43%, n = 161) (P<.01). For those patients who treated two migraine attacks and had drug severity measures for both attacks (n = 384), a significantly greater percentage of patients reported pain relief after taking rizatriptan ODT than sumatriptan at the 45‐ and 60‐minute time points (38% versus 29% and 58% versus 49%, respectively) (P<.01). In addition, a significantly greater percentage of patients taking rizatriptan ODT reported a pain‐free status at the 60‐ and 120‐minute time points (23% versus 17%[P<.05] and 60% versus 52%[P<.01], respectively). Both rizatriptan ODT and sumatriptan were well tolerated.Conclusions.—A significantly greater proportion of patients preferred rizatriptan ODT 10‐mg to sumatriptan 50‐mg tablet for the acute treatment of migraine. Efficacy and safety data are consistent with the preference findings.
Statuslike SUNCT in Two Young Women
Authors: Montes Enrique , Alberca Román , Lozano Pilar , Franco Emilio , Martínez‐Fernández Eva , Mir Pablo 
Published: March 2003

Objective.—To describe the statuslike pattern of SUNCT (short‐lasting unilateral neuralgiform pain with conjunctival injection and tearing) in two young women.Background.—SUNCT syndrome is a rare condition characterized by a short‐lasting periocular pain associated with marked autonomic symptoms. Twenty‐five cases have been reported in the literature with a high preponderance of males and a mean age of 51 years. The frequency of episodes shows a wide variability, not just among individuals but also in the same patient, and a statuslike pattern of almost continuous attacks has been described.Methods.—We report the cases of two young women (aged 26 and 23 years) with typical SUNCT features who suffered bouts of up to 60 paroxysms of pain per hour. Paraclinical investigations showed no abnormalities.Conclusions.—Although unusual, paroxysms in SUNCT may overlap into a clinical status. A strong relationship with hormonal changes was noted in one patient. In both cases, the pain was refractory to treatment with indomethacin, carbamazepine, and hypnotics, and only intravenous methylprednisolone with oral carbamazepine may have been partially effective in one case.
Effectiveness of Nasal Sumatriptan in 5‐ to 12‐Year‐Old Children
Authors: Hershey Andrew D. , Powers Scott W. , LeCates Susan , Bentti Anna‐Liisa 
Published: March 2003

Objective.—To assess the tolerability and effectiveness of nasal sumatriptan in the treatment of migraine in 5‐ to 12‐year‐old children.Background.—Although headaches are a common disorder and occur in up to 10.6% of children, many of the new migraine abortive agents have not been well evaluated in this population. It has recently been reported that nasal sumatriptan is effective in the treatment of migraine in adolescents. In younger children, it is yet to be characterized. In addition, many children have significant amounts of vomiting with their migraines, limiting their use of oral medications.Design and Methods.—Children with headache were evaluated by a child neurologist, child psychologist, and pediatric nurse practitioner. Clinical and International Headache Society diagnoses were established for each child. Patients with headaches that were either unresponsive to oral medications or had significant vomiting were treated with nasal sumatriptan. Initial administration and tolerability were performed in the Headache Center at Cincinnati's Children's Hospital Medical Center. Patients or their parents were contacted to assess the overall effectiveness of nasal sumatriptan after home administration.Results.—Ten patients aged between 5 and 12 years (mean, 9.9 years) received either a 5‐mg (n = 2) or 20‐mg (n = 8) dose of sumatriptan. All 10 patients had a clinical diagnosis of migraine; 7 met the International Headache Society criteria for migraine. The mean age of headache onset was 6.6 years. A total of 57 headaches were treated; 47 (82.5%) responded to sumatriptan. Of the patients who treated headaches, the mean number of headaches treated was 5.2, while the mean number of responsive headaches was 4.3. One patient had no response, 2 patients had a 50% response, and 6 patients had 100% response to the nasal sumatriptan. Three patients reported persistent “bad taste.”Conclusions.—This report demonstrates that nasal sumatriptan may be effective in aborting migraine in young children (aged 5 to 12 years). It also suggests that there may be subgroups for which it works well. This information suggests that double‐blind, placebo‐controlled studies are necessary to determine the overall effectiveness of nasal sumatriptan in this age group.
Gender Differences in Treatment‐Seeking Chronic Headache Sufferers
Authors: Marcus Dawn A. 
Published: March 2003

Objective.—To identify gender differences within a group of patients seeking treatment for chronic headache. Previous studies of the general population have reported differences in headache symptoms, frequency, disability, and psychological distress, with women affected with more severe and disabling symptoms than men. This study evaluated these features in a population seeking treatment.Methods.—Two hundred fifty‐eight consecutive patients with headache attending a university headache clinic were evaluated with questionnaires about headache symptoms and psychological distress. Comparisons between men and women were made for headache symptoms, severity, frequency, trigger factors, comorbid depression and anxiety, and response to treatment.Results.—There were no gender differences in headache symptoms, frequency, severity, and duration. Headache triggers were gender‐specific, with men more likely to endorse exercise and women more likely to endorse stress and exposure to odors. Psychological comorbidity was similar among men and women seeking treatment, with a mean Beck Depression Inventory score of 10 and a mean Spielberger trait anxiety score of 39 for both men and women. Disability was greater in men, with 46% reporting restrictions in activities more than 3 days per week because of headache compared with 29% of women. In addition, men were more likely to contribute headache control to external figures than women.Conclusions.—Patients seeking treatment for chronic headache do not have the same gender‐specific differences that have been reported in general population surveys. Men who seek treatment for headache are more likely to have significant disability, and are equally likely to have symptoms of depression and anxiety as women who seek treatment. Clinical and research investigations of headache triggers need to be gender‐specific.
The Occurrence of Recall Bias in Pediatric Headache: A Comparison of Questionnaire and Diary Data
Authors: Van Den Brink M. , Bandell‐Hoekstra E.N.G. , Abu‐Saad H. Huijer 
Published: March 2003

Objective.—To investigate whether children and adolescents can recall prior headache complaints accurately and to study whether age, gender, headache severity, preferred coping strategies, depression, somatization, and trait anxiety are related to recall errors, causing recall bias.Methods.—A retrospective headache questionnaire and a prospective 4‐week headache diary were filled out by 181 children aged 9 to 16 years who experienced headache at least weekly. In addition, several other questionnaires were administered, measuring coping strategies, depression, somatization, and trait anxiety. Headache frequency, intensity, and duration, as scored on the questionnaire and the diary, were compared using Wilcoxon tests. Regression analyses were performed to study whether age, gender, headache severity, preferred coping strategies, depression, somatization, and trait anxiety can predict the size of differences between the diary and the questionnaire.Results.—Compared with the diary, headache intensity and headache duration were overestimated on the questionnaire. At group level, median headache frequency as measured by the diary and the questionnaire was equal. Regarding headache frequency and headache intensity, age and headache severity were statistically related to errors in recall. For headache frequency, depression was also predictive of the size of recall error.Conclusions.—Recall errors occur when children are asked to report their headaches on a retrospective questionnaire. As compared to a prospective diary, pain complaints are evaluated more negatively on a questionnaire. Other factors such as age, depression, and headache severity influence the way children and adolescents recall their headaches. To minimize bias, the use of a diary when studying recurrent headache complaints in children is recommended.
Sumatriptan Scavenges Superoxide, Hydroxyl, and Nitric Oxide Radicals: In Vitro Electron Spin Resonance Study
Authors: Ikeda Yukio , Jimbo Hiroyuki , Shimazu Motohiko , Satoh Kazue 
Published: March 2003

Background.—The molecular mechanisms of migraine have not yet been clarified. Oxygen free radicals have been implicated in the genesis of many pathological processes, including migraine. Sumatriptan succinate is known to be a very effective drug for acute relief of migraine attack. Objective.—To investigate the direct scavenging activities of sumatriptan for superoxide, hydroxyl, and nitric oxide (NO) radicals using electron spin resonance (ESR) spectroscopy. Methods.—Measurement of superoxide and hydroxyl radical scavenging activities was performed by ESR using 5,5‐dimethyl‐1‐pyrroline‐N‐oxide as a spin trap. NO was generated from 1‐hydroxy‐2‐oxo‐3‐(N‐3‐methyl‐3‐aminopropyl)‐3‐methyl‐1‐triazene and analyzed by 2‐(4‐carboxyphenyl)‐4,4,5,5‐tetramethylimidazoline‐1‐oxyl produced from the reaction between 2‐(4‐carboxyphenyl)‐4,4,5,5‐tetramethylimidazoline‐1‐oxyl‐3‐oxide and NO. Results.—The ESR study demonstrated that sumatriptan scavenged superoxide, hydroxyl, and NO in a dose‐dependent manner. Conclusion.—Sumatriptan has direct scavenging activity on free radicals and NO. Acute migraine drugs with antioxidant properties may provide heretofore unheralded benefits via this mechanism.
In Vivo Evidence for P‐Glycoprotein–Mediated Transport of Phenytoin at the Blood–Brain Barrier of Rats
Authors: Potschka Heidrun , Löscher Wolfgang 
Published: March 2003

Summary:  Purpose: The multidrug transporter P‐glycoprotein (P‐gp) is expressed at high levels in a variety of tissues such as the endothelial cells of the blood–brain barrier (BBB) capillaries, where it is thought to be involved in the exclusion of various drugs from the capillary endothelial cells, blocking their entry into brain. It was previously shown that pharmacoresistant partial epilepsy is associated with an increased expression of P‐gp in brain capillary endothelium and astrocytes, leading to the hypothesis that increased P‐gp expression may be involved in medically intractable epilepsy. However, it is not known whether the distribution of antiepileptic drugs (AEDs) into the brain is limited by P‐gp. We used in vivo microdialysis in freely moving rats to study whether the concentration of the major AED phenytoin (PHT) in the extra‐cellular fluid (ECF) of the cerebral cortex can be enhanced by inhibition of P‐gp.Methods: Three different P‐gp inhibitors, sodium cyanide, verapamil, and PSC 833, were used. These drugs were given via the microdialysis probe in the right frontal cortex, while a probe in the left cortex served as vehicle control side. Perfusion with the inhibitor started 15–60 min before systemic (i.p.) administration of PHT, 50 mg/kg.Results: PHT rapidly entered the brain ECF compartment, but ECF plasma ratios at time of maximal ECF levels were only ∼0.04. All P‐gp inhibitors significantly increased the ECF concentrations of PHT after local administration, indicating that P‐gp in the BBB normally limits the distribution of PHT into the brain parenchyma. Cremorphor EL, the vehicle used to administer PSC, also was able to increase ECF PHT, which is explained by the previously reported inhibitory effect of cremophor on P‐gp.Conclusions: Provided that multidrug transporters such as P‐gp also are involved in the BBB outward transport of other AEDs, increased expression of multidrug transporters, leading to inadequate accumulation of AEDs in the brain, would be a likely explanation for pharmacoresistant epilepsy.
Thyroid Function in Men Taking Carbamazepine, Oxcarbazepine, or Valproate for Epilepsy
Authors: Isojärvi Jouko I. T. , Turkka Jukka , Pakarinen Arto J. , Kotila Mervi , Rättyä Johanna , Myllylä Vilho V. 
Published: March 2003

Summary:  Purpose: Antiepileptic drugs (AEDs) may affect serum thyroid hormone concentrations. This study aimed to evaluate thyroid function in men taking carbamazepine (CBZ), oxcarbazepine (OCBZ), or valproate (VPA) for epilepsy.Methods: Ninety men with epilepsy (40 taking CBZ, 29 taking OCBZ, and 21 taking VPA monotherapy) and 25 control subjects participated in the study. After clinical examination, a blood sample for hormone, γ‐glutamyl‐transferase (GGT) and antibody (ab) assays was obtained.Results: Serum thyroxine (T4) and free thyroxine (FT4) concentrations were low in men taking CBZ or OCBZ. Forty‐five percent of men taking CBZ and 24% of men taking OCBZ had serum T4 and/or FT4 levels below the reference range. However, no correlations were found between T4 or FT4 and GGT concentrations in men taking CBZ or OCBZ. Thirteen percent of men taking CBZ, 17% of men taking OCBZ, and 6% of control men had increased levels of thyroid peroxidase (TPO)‐ab and/or thyroglobulin (TG)‐ab, but these were not associated with altered serum thyroid hormone concentrations. Serum triiodothyronine and thyrotropin levels in men taking CBZ or OCBZ were normal. In men taking VPA, the concentrations of thyroid hormones, thyrotropin, and antithyroid ab were normal.Conclusions: Serum thyroid hormone concentrations are low in CBZ‐ or OCBZ‐treated men. However, these low levels do not seem to be due to liver enzyme induction or activation of immunologic mechanisms. Therefore, interference with hypothalamic regulation of thyroid function by CBZ and OCBZ seems possible. VPA does not have any significant effects on thyroid function.
Incidence of Epilepsies and Epileptic Syndromes in Children and Adolescents: A Population‐Based Prospective Study in Germany
Authors: Freitag Christine M. , May Theodor W. , Pfäfflin Margarete , König Stephan , Rating Dietz 
Published: March 2003

Summary:  Purpose: To estimate the incidence rate of epilepsies and epileptic syndromes in German children and adolescents aged 1 month to <15 years, and to provide data on their classification.Methods: A population‐based prospective study was performed between July 1, 1999, and June 30, 2000. All children aged 1 month to <15 years with a newly diagnosed epilepsy or epileptic syndrome were recorded by private pediatricians, EEG laboratories, and the two University Children's Hospitals in the neighboring cities of Heidelberg and Mannheim. The diagnoses were classified according to the International Classification of Epilepsies and Epileptic Syndromes of the International League Against Epilepsy (ILAE).Results: The total age‐adjusted annual incidence rate was 60/100,000 (95% confidence interval, 42–84), with the highest incidence in the first year of life (146/100,000). Focal epilepsies or epileptic syndromes (58%; incidence rate, 35/100,000) were more common than were generalized ones (39%; incidence rate, 24/100,000), and 3% (incidence rate, 2/100,000) of the epilepsies or epileptic syndromes were undetermined. The rate of idiopathic (47%; incidence rate, 29/100,000) and symptomatic or cryptogenic epilepsies (50%; incidence rate, 30/100,000) was equal. No significant difference in incidence between boys and girls was found.Conclusions: Incidence rates for epilepsy in German children aged 1 month to <15 years are about equal to those of other countries in Europe and North America. In accordance with studies from the United States and from many European countries, incidence was highest in the first year of life, and no difference in the incidence between girls and boys was found. In Germany as throughout Europe, idiopathic generalized epileptic syndromes are more often diagnosed than in the United States.
Comparison of the Anticonvulsant Efficacies and Neurotoxic Effects of Valproic Acid, Phenytoin, and the Ketogenic Diet
Authors: Bough Kristopher J. , Eagles Douglas A. 
Published: March 2003

Summary: Purpose:The purpose of this study was to measure quantitatively the effectiveness of the ketogenic diet (KD) in comparison to two clinically important anticonvulsant drugs (AEDs), valproic acid (VPA) and phenytoin (PHT), and to evaluate possible associated neurotoxicity.Methods:Rats were maintained on either a calorie‐restricted, KD or calorie‐restricted, rodent‐chow diet for 3–5 weeks, after which neurobehavioral and seizure testing was completed. AEDs (either VPA or PHT) were injected acutely at the time to peak effect before neurotoxic and seizure assessment. Seizures were induced by timed infusion of pentylenetetrazole (PTZ) and maximal electroshock (MES).Results:VPA protected from both MES‐ and PTZ‐induced seizures, whereas the KD only elevated PTZ seizure threshold; PHT only attenuated MES‐induced seizures. The KD was as effective as a high dose of VPA (i.e., 300 mg/kg) and combined treatment (i.e., KD + VPA) showed an additive increase in PTZ seizure threshold. No observed neurobehavioral deficits were associated with either diet treatment; however, drug‐related side effects were noted with high doses of either VPA or PHT.Conclusions:These data suggest that the KD ranks among VPA and PHT as an effective treatment for seizures, without observed drug‐associated neurobehavioral contraindications. In combination with AEDs, our results indicate that the KD plus VPA work synergistically to increase seizure threshold, whereas the KD plus PHT may be complementary, elevating seizure threshold (KD) and reducing seizure severity (PHT). These findings may provide insights into future directions for rational polytherapy; however, it is important to be aware that the KD has been shown to elevate VPA‐induced hepatotoxicity.