bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographic and Migraine Characteristics of Adolescents With Migraine: Glaxo Wellcome Clinical Trials' Database
Authors: Winner P. , Rothner A. D. , Putnam D. G. , Asgharnejad M. 
Published: May 2003

Objective.—To describe the demographics and migraine characteristics of patients in the Glaxo Wellcome adolescent clinical trials' database.Methods.—Data from 8 sumatriptan (tablet and nasal spray) and naratriptan (tablet) trials (6 placebo controlled and 2 open label) were reviewed. Adolescents aged 12 to 17 years who had participated in migraine clinical trials and used at least 1 dose of study medication were summarized using descriptive statistics. Patient demographic (gender, age, race, height, and weight) and migraine (diagnosis, pain location and intensity, time and day of migraine onset and treatment, and associated symptoms) characteristics were examined.Results.—One thousand nine hundred thirty‐two adolescents with migraine were identified; mean age was 14.1 years (standard deviation, 1.64; range, 11 to 18) and 54% of patients were female. More males were represented in the 12‐ to 14‐year‐old group (646 [73%] of 885) than in the 15‐ to 17‐year‐old group (234 [26%] of 885). Most patients reported migraine without aura (67%, 1121 of 1672), unilateral migraine pain (58%, 458 of 787), and pulsating pain (74%, 582 of 790). Migraine was aggravated by physical activity in most of the adolescents (88%, 526 of 598). Most migraine attacks (73%, 1363 of 1858) began between 6 am and 6 pm, and proportionately more attacks occurred Monday through Wednesday. Pretreatment vomiting was experienced by 5% (97 of 1830) of patients, nausea by 53% (983 of 1849), and photophobia or phonophobia (or both) by 88% (1628 of 1858) of patients. The incidence of associated symptoms was directly related to pretreatment headache severity.Conclusions.—In this large clinical trials' database, adolescents had migraine without aura characterized by unilateral and pulsating pain and aggravated by activity. The incidence of associated symptoms was directly related to pretreatment pain intensity. More migraines occurred Monday through Wednesday during typical school hours. These data may facilitate clinicians' efforts to tailor migraine therapy to the needs of this patient population.
Cerebrovascular Reactivity in Adolescents With Migraine and Tension‐Type Headache During Headache‐Free Interval and Attack
Authors: Rosengarten Bernhard , Sperner Jürgen , Görgen‐Pauly Ute , Kaps Manfred 
Published: May 2003

Background.—Migraine is a common cause of headache in adolescents. Assuming that the cerebral vasculature is involved in the pathophysiology of migraine, we compared cerebral vasoreactivity in adolescents both during a migraine attack and a headache‐free interval.Methods.—A functional transcranial Doppler test utilizing a visual stimulation paradigm was undertaken to measure the evoked flow velocity in the posterior cerebral artery of adolescents suffering from a migraine without aura or a tension‐type headache. To serve as a control, data previously obtained from age‐matched adolescents with no primary headache disorder were used. The flow curves were evaluated by determining the maximal flow velocity increase and by modeling their time course according to a control system analysis. In that analysis, the main dynamic features of the flow response were described mathematically in terms of a control system model of low order. The parameters were time delay, gain, attenuation, rate time, and natural frequency.Results.—The attenuation parameter (P<.005), indicative of an increased tone of the vessel, and the resting absolute flow velocity (P<.01) both showed a significant increase during an attack in the adolescents with migraine; the gain parameter showed a trend towards similar increase (P  =  .07). The maximal flow velocity did not increase significantly during an attack.Conclusions.—The control system approach utilized here appears to be more sensitive for detecting migraine‐associated changes in cerebral vasoreactivity than examination of the maximal flow velocities alone.
Carnitine Palmityltransferase II (CPT2) Deficiency and Migraine Headache: Two Case Reports
Authors: Kabbouche Marielle A. , Powers Scott W. , Vockell Anna‐Liisa B. , LeCates Susan L. , Cfnp  , Hershey Andrew D. 
Published: May 2003

Background.—Migraine headache is common and has multiple etiologies. A number of mitochondrial anomalies have been described for migraine, and mitochondrial dysfunction has been implicated as one potential pathophysiological mechanism. Carnitine is used by mitochondria for fatty acid transportation; its deficiency, however, has not been implicated in migraine pathophysiology.Methods and Results.—Two adolescent girls presented to the Headache Center at Cincinnati Children's Hospital Medical Center with frequent headaches and were diagnosed with migraine by the International Headache Society (IHS) criteria. Both girls had a history of recurrent fatigue, muscle cramps, and multiple side effects from their prophylactic treatment. Carnitine levels were measured and found to be low. Carnitine supplementation was initiated. Both patients had a reduction in headache frequency, as well as an improvement in their associated symptoms and other complaints. A skin and muscle biopsy obtained from one patient revealed a partial carnitine palmityltransferase II deficiency in the muscle only.Conclusion.—Carnitine palmityltransferase II deficiency may represent another etiology for migraine headache, and may be useful in further defining the pathophysiology of migraine. When properly recognized, supplementation with carnitine may improve the outcome of the migraine as well as the carnitine‐associated symptoms.
A Prospective Study of the Requirement for and the Provision of Epilepsy Surgery in the United Kingdom
Authors: Lhatoo Samden D. , Solomon Juliet K. , McEvoy Andrew W. , Kitchen Neil D. , Shorvon Simon D. , Sander Josemir W. 
Published: May 2003

Summary:  Purpose: Of the 30,000 persons in whom epilepsy develops annually in the United Kingdom, in ∼6000 (20%), intractability develops. Some of these patients will be appropriate for epilepsy surgery. We aimed to estimate the number of patients who should be considered surgical candidates, by extrapolation from a population‐based study of prognosis and the number who are receiving epilepsy surgery, by a survey of U.K. neurosurgeons.Methods: We identified the number of patients who may eventually require surgery from a prospective cohort of patients with newly diagnosed epilepsy. We identified all U.K. neurosurgeons who had performed any epilepsy surgery in the past year. Each identified surgeon prospectively recorded the number and types of operations carried out for 6 months.Results: Of newly diagnosed patients each year, 450 (1.5%) may eventually require surgery. Thirty‐two respondents (22% of all U.K. neurosurgeons) reported that they performed epilepsy surgery. The 211 operations were carried out in the 6 months surveyed (422 operations annually or 13 per surgeon per year). Temporal lobe resection (77%) was the most common procedure.Conclusions: Based on a prevalence of 5/1,000 persons with epilepsy, ≤4,500 patients in the U.K. require epilepsy surgery. Every year, 450 patients with newly diagnosed epilepsy who may eventually require surgery are added to this “surgical pool.” At the current annual rate of operations, a large number of refractory patients remain untreated. This is probably partly because many patients are not referred for specialist care and therefore remain underinvestigated.
Statistical Mapping of Scalp‐Recorded Ictal EEG Records Using Wavelet Analysis
Authors: Battiston John J. , Darcey Terrance M. , Siegel Adrian M. , Williamson Peter D. , Barkan Helen I. , Akay Metin , Thadani Vijay M. , Roberts David W. 
Published: May 2003

Summary:  Purpose: The wavelet transform (WT) is well suited for the analysis of signals whose characteristics vary rapidly over time. We devised a computerized method for objective scoring of scalp‐recorded seizures that takes advantage of the WT.Methods: Using wavelet coefficients as a metric, we devised a statistical scoring method aimed at detecting significant and sustained rhythmic buildup. The approach was used to create spatiotemporal significance maps for each seizure. Each seizure was also independently analyzed by computer and an expert reader not involved in the clinical workup or computer analysis of these patients. Hierarchical decision rules for determining seizure lateralization and localization were established from a training set of seizures and subsequently tested on those from an independent test set of seizures. The test dataset included a total of 57 scalp‐recorded seizures from 18 patients, each with a ≥12‐month seizure‐free surgical outcome.Results: Validation was determined by the site of surgical resection. Of the 57 seizure records in the test dataset, the computerized approach resulted in 48 correctly lateralized seizures as compared to 34 for the expert reader. Further, the computer correctly localized 41 seizures to the expert's 31.Conclusions: The method presented appears to provide an objective basis for the intrachannel scoring of ictal EEGs with minimal interference from artifacts and intermittent discharges. Although the approach has so far shown a substantial improvement over expert scoring in estimating the lateralization and locus of seizure onset, further testing is required to fully evaluate fully its diagnostic accuracy.
Surgical Treatment of Multifocal Epilepsy Involving Eloquent Cortex
Authors: Devinsky Orrin , Romanelli Pantaleo , Orbach Darren , Pacia Steven , Doyle Werner 
Published: May 2003

Summary:  Purpose: This report describes our long‐term follow‐up for combined resective surgery and multiple subpial transections (MSTs) in patients with refractory epilepsy involving eloquent and noneloquent cortex in multiple lobes. Multiple independent seizure foci made these patients poor candidates for conventional surgery.Methods: MST and resective surgery were used in 13 patients to treat localization‐related refractory epilepsy involving eloquent and noneloquent cortex of two or more lobes. Preoperative investigation was followed by invasive monitoring.Results: Eleven patients had MST plus resection involving two different lobes, and two patients had MST plus resection involving three different lobes. MSTs were performed on the primary sensorimotor cortex (eight patients), temporal language area (two patients), Broca's area (one patient), and on both frontal motor and temporal language areas (two patients). Nine patients had a two‐stage procedure, and four patients had a three‐stage procedure (two consecutive subdural grid studies followed by resections). Average follow‐up was 59.2 months (range, 42–98 months). With a modified Engel Outcome Scale, four patients (31%) had a class I outcome; three (23%), class II; three (23%), class III; and three (23%), class IV. Ten (77%) patients had a >50% reduction of seizure burden.Conclusions: Combined MST and resection can meaningfully improve seizure control in patients with multifocal epilepsy involving eloquent cortex. Prospective randomized studies are needed.
The Influence of Obesity on the Frequency and Distribution of Medication
Authors: Dzien A. , Pfeiffer K. P. , Dzien‐Bischinger Christine , Hoppichler F. , Lechleitner Monika 
Published: May 2003

Summary: Obesity is a serious health problem in industrialized countries and is associated with a significant increase in total health care costs. Only few data are available about the costs of drug therapies in patients with an increased body weight treated under clinical routine procedures. Such data could support efforts to intensify obesity prevention and treatment programmes in order to reduce comorbidities and costs.We have evaluated body mass index (BMI), diagnosis, and medication in 3360 outpatients (2175 women and 1185 men; mean age: 56.7 ± 17.5 years). All patients underwent physical examinations, including BMI determination, and provided a detailed record concerning medication. In 1809 patients, the percentage of body fat content was measured with a bioimpedance method (OMRON BF 302 body fat monitor). Continuous variables were compared using the t‐test or Wilcoxon U‐test. Frequency distributions were compared using chi‐squared tests.With respect to BMI, most of the patients (n = 1793; 53 %) were overweight or obese, 1349 (40 %) showed a normal BMI and 218 (7 %) a low BMI. The majority of cardiovascular (61 %), rheumatological (61.1 %) and metabolic (60.4 %) medication was administered to overweight and obese patients. Parallel findings could be obtained by analysing the percentage of body fat and the frequency of medication. Overall, 82.5 % of all medication was given to patients with a body fat content >20 %.Our results support the importance of weight‐reduction programmes in order to prevent an overall increase in the costs of medication as a consequence of overweight and obesity.
Advice Against Smoking is not Effective in Patients with Graves’ Ophthalmopathy
Authors: Karadimas P. , Bouzas E. A. , Mastorakos G. 
Published: May 2003

Summary: Advice against smoking is one of the means frequently used in the management of patients with Graves’ ophthalmopathy (GO). The objective of this study was to prospectively evaluate the efficacy of such advice. The study was performed at a referral centre. Eighty‐five smokers out of 102 consecutive patients with GO, who were examined during a 1‐year period, were included in the study. Severity of the disease, smoking history, and the results from a patients’ self‐assessment questionnaire were recorded.The behavioural intervention consisted in a standardized 2‐min message from the attending ophthalmologist strongly advising each patient to quit. The main outcome measure was smoking cessation during the 1‐year follow‐up period. None of the 85 smokers reported smoking cessation either during the follow‐up visits or at the end point of the study.The results of our study show that advice against smoking is not effective among patients with GO. Specifically designed intervention programmes may be necessary and should be evaluated in a controlled trial.
Inferences from DNA Data: Population Histories, Evolutionary Processes and Forensic Match Probabilities
Authors: Wilson Ian J. , Weale Michael E. , Balding David J. 
Published: May 2003

SummaryWe develop a flexible class of Metropolis–Hastings algorithms for drawing inferences about population histories and mutation rates from deoxyribonucleic acid (DNA) sequence data. Match probabilities for use in forensic identification are also obtained, which is particularly useful for mitochondrial DNA profiles. Our data augmentation approach, in which the ancestral DNA data are inferred at each node of the genealogical tree, simplifies likelihood calculations and permits a wide class of mutation models to be employed, so that many different types of DNA sequence data can be analysed within our framework. Moreover, simpler likelihood calculations imply greater freedom for generating tree proposals, so that algorithms with good mixing properties can be implemented. We incorporate the effects of demography by means of simple mechanisms for changes in population size and structure, and we estimate the corresponding demographic parameters, but we do not here allow for the effects of either recombination or selection. We illustrate our methods by application to four human DNA data sets, consisting of DNA sequences, short tandem repeat loci, single-nucleotide polymorphism sites and insertion sites. Two of the data sets are drawn from the male-specific Y-chromosome, one from maternally inherited mitochondrial DNA and one from the β-globin locus on chromosome 11.
Human Immunodeficiency Virus Risk: Is it Possible to Dissuade People from Having Unsafe Sex?
Authors: Richens John , Imrie John , Weiss Helen 
Published: May 2003

SummaryThe cumulative number of human immunodeficiency virus (HIV) infections worldwide has reached 60 million in little over 30 years. HIV continues to spread despite a detailed understanding of the manner in which it spreads and measures which can prevent spread. Some governments have been highly successful in containing the spread of HIV through blood products and from mother to child and among injecting drug users. Lack of political will, lack of resources or challenges to widely accepted scientific evidence have held back similar interventions in other countries. It has proved much more difficult to reduce the sexual transmission of HIV in both high and low income countries. A wide range of strategies has been identified but it remains unclear which strategies deserve priority and what methods of promoting them have the greatest effect. There is ample evidence that awareness of HIV and changes in sexual behaviour have occurred widely but the penetration of information remains poor in some vulnerable groups especially adolescents and women in poorer countries. Further obstacles face those who have information about the risk. The subordinate position of women and a desire for large families are important obstacles to condom negotiation and use. Urbanization, poverty, conflict and declining public services all exacerbate unsafe sexual behaviour. We argue that so-called ‘structural’ interventions directed at these wider contexts of unsafe behaviour merit greater attention. Such approaches have the added benefit of being less susceptible to ‘risk compensation’ which has the potential to undermine strategies directed at reducing the transmission efficiency of HIV.
Communicating Risk—Coronary Risk Scores
Authors: Graham Ian M. , Clavel Elizabeth 
Published: May 2003

SummaryCardiovascular disease, particularly heart attack and stroke, is the major cause of death in adults in Europe. The underlying atherosclerosis which causes cardiovascular disease is difficult to treat or reverse, and this has led to intense interest in strategies to prevent its development. The major causes of cardiovascular disease—a high fat diet, tobacco smoking and high blood pressure—are now well known. Control of these risk factors has been shown to reduce the risk of heart attack or stroke. It is now possible with simple information (age, sex, blood pressure level, cholesterol level and information on smoking) to predict the risk of heart attack or stroke fairly accurately. The challenge for the future is to make the information available on risk prediction and on how to reduce risk accessible to lay people, so that they may choose, if they wish, to adopt a life style that will reduce their risk. Such a life style involves healthy food choices, avoidance of overweight, the promotion of leisure exercise and complete avoidance of tobacco. Drug treatments can be extremely effective in controlling both blood pressure and cholesterol levels, but they should be seen as an adjunct to life style measures rather than a primary means of achieving prevention. Practical prevention will only be achieved through dynamic partnerships between the medical profession, Government, voluntary bodies, teaching institutions, insurance companies and paramedical bodies. An outline about how cardiac societies can participate in this process is appended.
Tobacco—The Importance of Relevant Information on Risk
Authors: Darby Sarah C. 
Published: May 2003

SummaryAlthough it has been widely accepted since the 1960s that smoking cigarettes carries a substantial health risk, worldwide mortality from tobacco-related diseases is increasing rapidly at the beginning of the 21st century. To provide the motivation to control this epidemic there is a continuing and pressing need for information on the risks of tobacco consumption that is accurate, up to date, locally relevant and imaginatively presented.
Tobacco: Public Perceptions and the Role of the Industry
Authors: Simpson David , Lee Sue 
Published: May 2003

SummaryThe paper briefly examines the substantial risks of smoking, and how people's perception of them may be influenced by tobacco control policy and by the activities of the tobacco industry. The comparative lack of effectiveness of the self-regulation system of implementing tobacco control policy is noted, illustrated by the example of cigarette pack health warnings, from the first examples under the voluntary system to the significantly more robust and effective pictorial warnings system pioneered by Canada and implemented by legislation, similar to measures recently approved by the European Union. Other aspects of tobacco control policy are discussed, including health education, restricting the promotion of tobacco and changing the social acceptability of smoking. Three areas of success in the UK—taxation, the leadership of doctors and sustained media advocacy—are described; and the paper concludes by looking at prospects for the future, with the forthcoming ban on most forms of tobacco promotion and the challenge of responding to growing demands to protect non-smokers from exposure to other people's tobacco smoke in the workplace and in public places.
Communication of Risk: Health Hazards from Mobile Phones
Authors: Cox D. R. 
Published: May 2003

SummaryPossible health hazards from mobile phones arise from the use of the phones themselves and via the base stations that relay signals. Except for an increase in traffic accidents induced by the use of mobile phones in cars the evidence for a health hazard is at most indirect, but it cannot be entirely dismissed; the phones have not been widely used for sufficiently long for direct epidemiological studies to have high sensitivity for detecting any induced incidence of cancer, for example. The background and evidence are briefly reviewed and the steps taken in the UK to make information widely available described.
Crime Victimization: Its Extent and Communication
Authors: Wiles Paul , Simmons Jon , Pease Ken 
Published: May 2003

Summary
The criminal justice contexts are identified in which understanding and communicating risks are important. The paper is thereafter exclusively concerned with the probability of crime victimization classified by person and location. Examples of crime risks derived from the British Crime Survey are provided, with instances of where concern about crime diverges from risks of crime. Caution is advocated about seeking to reduce the fear of crime by reassurance. The high levels of concentration of crime by location are noted, together with the fact that particular individuals and households are repeatedly victimized, enabling the prioritization of crime-reductive resources after a crime has taken place. The paper concludes that an emphasis on how the supply of criminal opportunities may be regulated heralds a more systematic approach to the distribution of unavoidable hazard among citizens.
Accidental Fatalities in Transport
Authors: Evans Andrew W. 
Published: May 2003

SummaryThe paper considers accidents on the different modes of transport. Accidents have many kinds of unwanted effects, though the paper focuses on just one: accidental fatalities. The paper reviews the main official sources of accident data and considers the use of past accident data. It then offers data and discussion on the numbers of accidental fatalities per year, passenger fatality rates, major accidents and the fatalities imposed by transport on third parties. The paper concludes with a brief discussion of communicating these results.