bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Typing of Helicobacter pylori by Virulence‐Gene Based Multiplex PCR and RT‐PCR Analysis
Authors: Monstein Hans‐Jürg , Ellnebo‐Svedlund Katarina 
Published: March 2003

AbstractBackground. In recent years, numerous PCR amplification typing methods have been developed for the identification of H. pylori specific virulence genes. To reduce the number of PCR amplifications needed we have previously developed virulence gene based multiplex PCR and RT‐PCR assays.Aim. The aim of the present study was to characterise Helicobacter pylori strains by means of virulence‐gene based multiplex PCR and reverse‐transcription PCR.Subjects. Helicobacter pylori clinical reference strains HP‐HJM 1–25 originally obtained from routine cultures of clinical gastric biopsy specimens from dyspeptic patients were used in the present study.Methods. Helicobacter pylori multiplex PCR and RT‐PCR assays were carried out using primer pairs targeting the cagA, vacA, ureA, ureI, hspA (hsp60), and sodB genes and their cDNA.Results. Unexpected multiplex PCR and RT‐PCR patterns were observed by ethidium bromide staining of agarose gels and Southern blot hybridisation analysis. DNA sequence analysis revealed a complex pattern of point mutations, deletions and insertions in the sodB, cagA and vacA genes, respectively. Mutations occurring in the PCR and hybridisation primer binding sites might explain some of the discrepancies previously observed in the expression of these genes. Furthermore, the present data show that coexpression of cagA and vacA transcripts of different sizes may take place in the same strain.Conclusions. The multiplex PCR and RT‐PCR assay described allows rapid characterisation of H. pylori virulence genes at the DNA and RNA (cDNA) levels. However, extensive DNA sequence analysis seems necessary if one wants to reveal details of mutations occurring in the cagA and vacA genes.
A Case of Acute Gastric Mucosal Lesions Associated with Helicobacter heilmannii Infection
Authors: Yoshimura Masaya , Isomoto Hajime , Shikuwa Saburo , Osabe Masayuki , Matsunaga Keiichiro , Omagari Katsuhisa , Mizuta Yohei , Murase Kunihiko , Murata Ikuo , Kohno Shigeru 
Published: March 2003

AbstractA 69‐year‐old‐woman presented with acute epigastric pain, nausea, vomiting and heartburn. Endoscopy disclosed acute gastric mucosal lesions including mucosal edema, erosions, and ulcers with blood crusts in the antrum. Touch cytology and histological assessment obtained from the affected mucosa revealed acute neutrophilic gastritis and single longer and more coiled organisms than Helicobacter pylori, suggesting Helicobacter heilmannii. Electron micropragh confirmed the characteristic morphology. Despite a positive rapid urease test, H. pylori was not isolated by culture or detected by histology and Gram smears. Based on these findings, a diagnosis of acute gastric mucosal lesions associated with H. heilmannii infection was established. This was successfully treated with a 2‐week triple therapy consisting of lansoprazole, clarithromycin and metronidazole with persistent endoscopic and histological remission. This is a rare case of H. heilmannii‐associated acute gastric mucosal lesions, diagnosed by morphology using touch cytology and histology. The patient might benefit from antimicrobial treatment employing the regimen effective for H. pylori.
Perceived Risk of Breast Cancer
Authors: Facione Noreen C. 
Published: March 2003

purpose: The purpose of this study was to examine the influence of heuristic reasoning on women's perceived risk for developing breast cancer, and to test for an expected bias in the direction of optimism that is predicted by recent research on human cognition.description of study: In total, 770 women recruited in community settings were surveyed regarding cancer screening behavior and their perceived risk of developing breast cancer.results: Most women perceived their risk of breast cancer to be lower than that of other women (3:1), confirming the expected bias toward optimism, and this finding was not attributable to the personality trait of optimism. Women following mammography guidelines showed greater optimism that their risk was low. Cancer knowledge and education diminished unwarranted optimism. Women with a history of benign breast disease, with a female relative with breast cancer, or both overestimated their risk. All findings suggest that heuristic thinking is being used to estimate personal cancer risk.clinical implications: Clinicians should expect women to be optimistic about their personal risk of developing breast cancer. As a result, women may put off breast cancer screening or delay the evaluation of breast symptoms that may signal breast cancer. Helping women to understand their relative risk is an essential part of a health promotion visit.
Analgesic Rebound Headache in Clinical Practice: Data From a Physician Survey
Authors: Rapoport Alan , Stang Paul , Gutterman Donna L. , Cady Roger , Markley Herbert , Weeks Randall , Saiers Jane , Fox Anthony W. 
Published: March 2003

Background: Frequent, excessive use of over‐the‐counter or prescription analgesics may lead to analgesic rebound headache. Little is known about the magnitude of the health problem posed by analgesic rebound headache, its epidemiology, the characteristics of analgesic rebound headache sufferers, or about physicians’ approaches to treatment.Methods: Four hundred seventy‐three practitioners, who had previously expressed an interest in the treatment of headache, were mailed a questionnaire designed to capture information about the frequency and management of analgesic rebound headache and about the characteristics of analgesic rebound headache sufferers.Results: Completed questionnaires were returned by 174 practitioners (37%) from 40 states, the District of Columbia, and Puerto Rico. More than 40% of respondents indicated that analgesic rebound headache was present in at least 20% of their patients. On average, the physicians reported that 73% of patients with analgesic rebound headache were women. Analgesic rebound headache was most likely to occur in patients aged 31 to 40 years. No one analgesic was consistently identified as causative, although acetaminophen, butalbital + aspirin + caffeine, and aspirin were commonly used by patients. Eighty percent of respondents indicated that depression was commonly observed in analgesic rebound headache sufferers; 77% indicated that physical conditions (especially gastrointestinal symptoms) were commonly observed. A variety of therapeutic strategies, including pharmacotherapy, were used in the management of analgesic rebound headache.Conclusion: Analgesic rebound headache was recognized as a distinct entity and a substantive component in more than 40% of the practices of 174 surveyed practitioners. Genera practitioners, who see a wide variety of patient types with a spectrum of complaints, need to be able to diagnose analgesic rebound headache by taking a good history.
Use of High Sumatriptan Dosages During Episodic Cluster Headache: Three Clinical Cases
Authors: Centonze V. , Polito B.M. , Attolini E. , Cassiano M.A. , Sabbà C. , Ricchetti G. , Bassi A. , Cavazzuti L. , Albano O. 
Published: March 2003

The authors describe three patients with episodic cluster headache whose attacks were all treated with subcutaneous sumatriptan.The patients described had a high frequency of attacks (more than two per day); therefore, far higher dosage of the drug was taken than commonly used in cluster headache. The patients did not experience any particular side effects, neither during the treatment period nor on abrupt withdrawal of the drug. Moreover, neither tachyphylaxis nor addiction were observed.The authors point out both the efficacy of sumatriptan, confirmed in all the treated attacks, and its safety even at higher dosages than recommended.
Analgesic Drug Taking: Beliefs and Behavior Among Headache Patients
Authors: Ferrari Anna , Stefani Marina , Sternieri Sabina , Bertolotti Marco , Sternieri Emilio 
Published: March 2003

Objective. —To explore beliefs and behavior with respect to analgesic drug taking in headache patients. To compare episodic headache to chronic headache sufferers.Methods. —A consecutive series of 280 headache patients, newly admitted to the Headache Center of the University of Modena, all referred by their general practitioner, were asked to fill out a brief questionnaire, specially compiled for this survey. The questionnaire invited patients to indicate how they themselves thought they should best cope with their headache, and how they actually did so in practice.Results. —The majority of our patients had a positive attitude towards over‐the‐counter analgesics, which they believed to be more adequate than prescription drugs for acute treatment of their headache. They handled analgesics very carefully, believing it correct to take the drug only when the pain became unbearable, if it was not possible for them to stop work. Chronic headache patients tended to consume more prescription drugs than episodic headache sufferers. Furthermore, the majority of chronic sufferers, as opposed to episodic sufferers, took the analgesic even when not at work.Conclusions. —The use of over‐the‐counter drugs is considered the best way to treat acute headache even by subjects suffering from severe idiopathic headache and seeking professional care in specialized clinics. Prescribed analgesics are underused by patients with serious episodic headache, which is precisely the group for which they are principally intended.
Continuous Intravenous Dihydroergotamine in the Treatment of Intractable Headache
Authors: Ford Robert G. , Ford Kay T. 
Published: March 2003

We reviewed data on 171 patients with refractory headache treated by continuous intravenous dihydroergotamine mesylate (IV DHE 45 ÒÒ ) and repetitive IV DHE and compared the efficacy of continuous IV DHE to repetitive IV DHE. One hundred (58.5%) patients had refractory chronic daily headache. Seventy‐one (42%) had drug rebound headache. One hundred thirty‐eight (81%) had refractory migraine without aura, and 28 (16%) had migraine with aura. Treatment consisted of either continuous IV DHE by infusion pump or repetitive IV DHE and withdrawal of excessively used analgesics, analgesic narcotics, ergotamines, or benzodiazepines. Eighty‐nine (92.5%) patients treated with continuous IV DHE became headache‐free; the majority, 62 (64.5%), within 3 days. Sixty‐five (86.5%) patients treated by repetitive IV DHE became headache‐free, 50 (66.5%) within three days. The average hospital stay for both treatment groups was 4 days. Twelve (12.5%) of the continuous group and 12 (16%) of the repetitive group were headache‐free within 24 hours. The average length of time to become headache‐free was similar for the two groups, 3.06 days for continuous IV DHE and 2.94 days for repetitive IV DHE. The most common side effect was nausea, followed by diarrhea, vomiting, and leg cramps.We conclude that DHE can be accurately and easily administered by continuous IV infusion pump, and that continuous IV DHE is a safe and efficacious mode of treatment producing results similar to repetitive IV DHE.
Psychophysical Precedents of Migraine in Relation to the Time of Onset of the Headache: The Migraine Time Line
Authors: Spierings Egilius L.H. , Sorbi Marjolijn , Maassen Gerard H. , Honkoop Peter C. 
Published: March 2003

We conducted a prospective study of 19 female migraine patients who kept a diary four times per day at 8 AM, I PM, 6 PM, and 11 PM for 10 consecutive weeks. In the diary, the patients recorded the occurrence as well as the features and associated symptoms of their headaches. They also rated five mood states: alertness, tension, irritability, depression, and fatigue, as well as the quality of sleep and the incidence and stressfulness of daily hassles as measurements of stress. They quantified the variables through the use of 100‐mm visual analog scales.In the diaries, we identified 68 migraine headaches of which 23 developed during the night, 19 during the morning, 16 during the afternoon, and 10 during the evening. The headaches which developed during the evening or night were preceded by an increased incidence of daily hassles during the afternoon. The headaches which developed during the morning or afternoon were preceded by increased tension the previous days.The day before the headaches which developed during the morning, the incidence of daily hassles was increased during the morning, afternoon, and evening. The increased tension at I PM was followed by increased fatigue at 6 PM, which was still present at 8 AM of the morning during which the headaches developed. The day before the headaches which developed during the afternoon, the increased tension at 6 PM was followed by increased alertness at 11 PM. The next morning, the stressfulness of daily hassles was increased at 8 AM, followed by increased tension and irritability at 1 PM.We conclude that there are three different sequences of events with regard to the psychophysical precedents of migraine, depending on the time of onset of the headache: the migraine time line.
Clinical and Demographic Characteristics of Migraine in Urban Children
Authors: Lee Lai H. , Olness Karen N. 
Published: March 2003

Objective.‐To establish the frequency, symptoms, duration, and treatment methods of childhood migraine in an urban area.Design.‐Self‐administered questionnaire survey. The questionnaire was designed according to criteria suggested by the International Headache Society (IHS).Participants.‐In 1994, with the help of school officials in 41 elementary and middle schools in the Greater Cleveland Area, 18000 questionnaires were distributed to the parents of schoolchildren who ranged in age from 5 to 13 years.Results.‐Of the total 2572 respondents, 222 children (8.6%) met the IHS criteria for migraine. Male to female ratio was 1:1.2 (99:120), 65.8% had a positive family history of migraine, 30.6% had onset of migraine at 4 to 5 years of age, and 54.1% reported having an aura (71% of these were visual aura). The headaches were mostly pulsating, poorly localized, lasted about 2 to 12 hours, and were aggravated by motion, noise, and bright light. The associated symptoms were nausea, vomiting, photophobia, and phonophobia. During the attack, 43% of the migraineurs had to stay in bed, and 27% were unable to attend school. Only 19.8% of the migraineurs were diagnosed to have migraine by their physicians, and most of these had not received treatment.Conclusion.‐This study in an urban area indicates that childhood migraine is a common, often underdiagnosed disorder that causes significant suffering for children and their families.
Pericranial Muscle Tenderness and Exteroceptive Suppression of Temporalis Muscle Activity: A Blind Study of Chronic Tension‐Type Headache
Authors: Lipchik Gay L. , Holroyd Kenneth A. , Talbot France , Greer Michelle 
Published: March 2003

The aim of the present study was to examine the ability of pericranial muscle tenderness and the second exteroceptive suppression period to distinguish chronic tension‐type headache sufferers, migraine sufferers, and controls in a young adult population utilizing a blind design. The second exteroceptive suppression periods were assessed using the methodology recommended by the European Headache Federation and were scored with an automatec computer software program designed in our laboratory to provide reliable, standardized, and precise quantification of exteroceptive suppression periods and eliminate any influence of experimenter bias that may occur with manual scoring.Our sample consisted of 45 subjects diagnosed according to IHS criteria: 25 with chronic tension‐type headache and 20 with migraine without aura. Twenty‐three headache‐free controls were recruited. Consistent with our previous findings, abnormalities in pericranial muscle‐tenderness, but not in the second exteroceptive suppression period distinguished chronic tension‐type headache sufferers from controls. The chronic tension headache sufferers exhibited the highest pericranial muscle tenderness and the control group exhibited the lowest tenderness (p<.001). Pericranial muscle tenderness was quite successful in distinguishing recurrent headache sufferers from controls, but failed to distinguish chronic tension‐type headache sufferers from migraineurs. Our findings raise the possibility that pericranial muscle tenderness is present early in the development of chronic tension‐type headache and migraine without aura, and thus might contribute to the etiology of headache disorders. Our findings also indicate that a shortened second exteroceptive suppression period is not a reliable marker for chronic tension‐type headache in young adults.
Potential Neurogenic and Vascular Roles of Nitric Oxide in Migraine Headache and Aura
Authors: Myers Daniel E. 
Published: March 2003

It has long been known that nitrate and nitrite medications consistently cause significant headache as a side effect. Classical research has shown that cerebral vasodilation accompanies the use of these medications. More modern studies suggest that these vasodilators exert their action on blood vessels via nitric oxide and its second messenger, cyclic guanosine monophosphate. This paper reviews research studies and theoretical articles which address the concept that nitric oxide plays a major role in the vasodilation associated with the headache phase of migraine with aura. A brief discussion of nitric oxide biochemistry and pharmacology follows.In addition, there is a review of evidence examining the possible contributions of nitric oxide to the neurogenic and vascular events associated with spreading cortical depression, an animal model of migraine aura. The paradoxical hypotheses that nitric oxide may contribute to both the propagation of spreading cortical depression and its limitation are presented. Finally, a rationale for the experimental use of nitric oxide agonists and antagonists in the abortion of migraine aura is introduced.
Epidemiology of Chronic Daily Headache in the General Population
Authors: Castillo Jesús , Muñoz Pedro , Guitera Victoria , Pascual Julio 
Published: March 2003

Background and Objectives.—Although chronic daily headache, mainly transformed migraine, is an important reason for consultation in headache clinics, its actual prevalence is unknown. This study analyzes the prevalence of the different types of chronic daily headache in an unselected population.Methods.—A questionnaire exploring headache frequency was distributed to 2252 unselected subjects. Those having headache 10 or more days per month were given a headache diary and were seen by a neurologist who classified their headaches. The varieties of chronic daily headache were classified according to the second revision of IHS criteria proposed by Silberstein et al published in Neurology 1996;47:871.Results.—The questionnaire was returned by 1883 subjects (83.5%). One hundred thirty‐five admitted to headache 10 or more days per month. Chronic daily headache criteria were fulfilled by 89 individuals (4.7%). Eighty were women. Forty‐two (47.2% of subjects with chronic daily headache and 2.2% of all subjects) had chronic tension‐type headache. Analgesic overuse was found in 8 (17%). Transformed migraine was diagnosed in 45 (50.6% of subjects with chronic daily headache and 2.4% of all subjects). Fourteen (31.1%) individuals with this form of chronic daily headache overused ergots or analgesics. The remaining 2 cases in this series met the criteria of new daily persistent headache. No one was diagnosed as having hemicrania continua.Conclusions.—Almost 5% of the general population (9% of women) suffers from chronic daily headache, the proportion of chronic tension‐type headache and transformed migraine being quite similar. Less than one third overuse analgesics. The prevalence of chronic daily headache subtypes shown here differs from data obtained from headache clinics, emphasizing that caution is needed in extrapolating data from specialized units to the general population.
The Occipital Cortex Is Hyperexcitable in Migraine: Experimental Evidence
Authors: Aurora SK. , Cao Y. , Bowyer SM. , Welch K.M.A. 
Published: March 2003

Objectives.—Threshold for generation of magnetophosphenes has been reported to be lower in migraine. We compared the threshold for eliciting phosphenes by transcranial magnetic stimulation and the ability to visually trigger headache in a select group of individuals with migraine with and without aura to normal controls.Methods.—Transcranial magnetic stimulation was performed using the Cadwell MES‐10 stimulator. A circular coil, 9.5 cm in diameter, was applied to the occipital scalp (7 cm above the inion). Stimulator intensity was increased in 10% increments until subjects reported visual phenomena or 100% intensity was reached. Stimulator intensity was then fine‐tuned to determine the threshold at which phosphenes were seen. In the same subjects, visual stimulation was given in 3.0 T MRI and if a headache occurred the response was recorded.Results.—Fifteen subjects with migraine were compared to 8 controls. A significant proportion of the migraineurs (86.7%) developed phosphenes compared to the controls (25%) (P=.006). The probability of triggering a headache was also higher in the migraineurs (53%); no headache was triggered in the controls (P=.019). A significant correlation was found between the threshold for phosphenes on transcranial magnetic stimulation and visually triggered headache (P=.002). When only migraine was considered, there was again a significant trend (P=.O84).Conclusions.—There is a difference in threshold for excitability of occipital cortex in migraineurs and controls.The hyperexcitable visual cortex in migraine is predisposed to visually triggered headache.
Baclofen in Cluster Headache
Authors: Hering‐Hanit R. , Gadoth N. 
Published: March 2003

Cluster headache is a rare, severe, clinically well‐characterized disorder that occurs in both episodic and chronic forms. The painful short‐lived attacks occur unilaterally and are associated with signs and symptoms of autonomic involvement. They are difficult to treat, and reported prophylactic therapies include ergotamine, steroids, methysergide, lithium carbonate, verapamil, valproate, capsaicin, leuprolide, clonidine, methylergonovine maleate, and melatonin.Baclofen, an antispastic agent, has been shown to have an antinociceptive action. Its efficacy in the treatment of neuralgias, central pain following spinal lesions or painful strokes, migraine, and medication misuse chronic daily headache suggested that it may prevent cluster headache attacks. Nine cluster headache patients received baclofen, 15 to 30 mg, in three divided doses. Within a week, six of nine patients reported the cessation of attacks. One was substantially better and became attack free by the end of the following week. In the remaining two patients, the attacks worsened and corticosteroids were prescribed. In this pilot study, baclofen seemed to be effective and well tolerated for the prevention of cluster headache.