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71.
目的探讨偏头痛患者同时进行脑电图、经颅多普勒超声检查的意义,以提高偏头痛的诊断率。方法选取2009年3月~2013年12月在我院神经内科门诊就诊的128例偏头痛患者为病例组,同期在我院体检的120例为对照组,两组均进行脑电图、经颅多普勒超声检查,并对检查结果进行分析。结果病例组脑电图异常率、经颅多普勒超声异常率均高于正常对照组,差异有统计学意义(P〈0.05)。结论脑电图检查虽对诊断无特异性,但有一定的定位意义,也可用于与头痛性癫痫和脑炎的鉴别诊断。经颅多普勒超声可作为偏头痛的有效诊断依据。两者结合,可以提高偏头痛的诊断率。 相似文献
72.
73.
Katherine Foxhall 《Medical history》2014,58(3):354-374
Charles Singer’s retrospective diagnosis of Hildegard of Bingen as a migraine sufferer, first made in 1913, has become commonly accepted. This article uses Hildegard as a case study to shift our focus from a polarised debate about the merits or otherwise of retrospective diagnosis, to examine instead what happens when diagnoses take on lives of their own. It argues that simply championing or rejecting retrospective diagnosis is not enough; that we need instead to appreciate how, at the moment of creation, a diagnosis reflects the significance of particular medical signs and theories in historical context and how, when and why such diagnoses can come to do meaningful work when subsequently mobilised as scientific ‘fact’. This article first traces the emergence of a new formulation of migraine in the nineteenth century, then shows how this context enabled Singer to retrospectively diagnose Hildegard’s migraine and finally examines some of the ways in which this idea has gained popular and academic currency in the second half of the twentieth century. The case of Hildegard’s migraine reminds us of the need to historicise scientific evidence just as rigorously as we historicise our other material and it exposes the cumulative methodological problems that can occur when historians use science, and scientists use history on a casual basis. 相似文献
74.
75.
Iannacchero R Cannistrà U La Vitola A Peltrone F De Caro E 《The journal of headache and pain》2005,6(4):312-314
The impact of migraine
headaches is one of the major public
health problems in several
industrialised countries, with many
patients reporting frequent and significant
disability. Previous studies
have assessed general practitioners’
(GPs) perceptions towards evidence–based medicine (EBM) and
its influence on health care decisions.
Of 500 questionnaires distributed,
responses were received
from 455 for a response rate of
91%. Respondents’ awareness of
technical terms used in EBM indicated
that only 27.2% of GPs
agreed that clinical trials are needed
to evaluate the efficacy of treatments
and this awareness was higher
in those who learned about
migraine from scientific journals or
continuing education courses and
who attended courses on epidemiology
or EBM. Training and continuing
educational programmes on
EBM and guidelines in terms of
treatments of headache for GPs are
strongly needed. 相似文献
76.
Edvinsson L 《Cephalalgia : an international journal of headache》2004,24(8):611-622
In primary headaches, there is a clear association between the headache and the release of calcitonin gene-related peptide (CGRP) but not with any of the other neuronal messengers. The purpose of this review is to describe the role of CGRP in the intracranial circulation and to elucidate a possible role for a specific CGRP receptor antagonist in the treatment of primary headaches. Acute treatment with a 5-HT(1B/1D) agonist (triptan) results in alleviation of the headache and normalization of the cranial venous CGRP levels, in part due to a presynaptic inhibitory effect on sensory nerves. The central role of CGRP in migraine and cluster headache pathophysiology has led to the search for small molecule CGRP antagonists with few cardiovascular side-effects. The initial pharmacological profile of such a group of compounds has recently been disclosed. One of these compounds has been found to be efficacious in the relief of acute attacks of migraine. 相似文献
77.
Winter AC Hoffmann W Meisinger C Evers S Vennemann M Pfaffenrath V Fendrich K Baumeister SE Kurth T Berger K 《The journal of headache and pain》2011,12(2):147-155
Modification of lifestyle habits is a key preventive strategy for many diseases. The role of lifestyle for the onset of headache in general and for specific headache types, such as migraine and tension-type headache (TTH), has been discussed for many years. Most results, however, were inconsistent and data on the association between lifestyle factors and probable headache forms are completely lacking. We evaluated the cross-sectional association between different lifestyle factors and headache subtypes using data from three different German cohorts. Information was assessed by standardized face-to-face interviews. Lifestyle factors included alcohol consumption, smoking status, physical activity and body mass index. According to the 2004 diagnostic criteria, we distinguished the following headache types: migraine, TTH and their probable forms. Regional variations of lifestyle factors were observed. In the age- and gender-adjusted logistic regression models, none of the lifestyle factors was statistically significant associated with migraine, TTH, and their probable headache forms. In addition, we found no association between headache subtypes and the health index representing the sum of individual lifestyle factors. The lifestyle factors such as alcohol consumption, smoking, physical activity and overweight seem to be unrelated to migraine and TTH prevalence. For a judgement on their role in the onset of new or first attacks of migraine or TTH (incident cases), prospective cohort studies are required. 相似文献
78.
Yoon G Baggaley S Bacchetti P Fu YH Digre KB Ptácek LJ 《The journal of headache and pain》2005,6(5):412-416
The objective was to
evaluate the presence of a positive
family history (FH) of vascular risk
factors between patients with
migraine with aura (MA) and
migraine without aura (MO), and in
chronic migraine (CM) compared to
other headache types. As migraine
patients are typically too young to
have developed vascular events,
studying older relatives of migraine
patients may be a practical means
of evaluating associations between
vascular risk factors and migraine.
A cross–sectional study of a clinicbased
sample of adults with
migraine headache was carried out
at the University of Utah. Predictor
variables comprised first or second
degree relatives with stroke, hypertension,
diabetes or hypercholesterolaemia.
Outcome measures
comprised diagnosis of MA, MO or
CM according to the revised
International Headache Society criteria.
There was no significant difference
in FH of vascular risk factors
in MA compared to MO
(adjusted OR 1.04, 95% CI
0.61–1.78). CM was associated
with a decreased risk of FH of
stroke (OR=0.11, 95% CI
0.02–0.87, p=0.036). There was no
significant difference in FH of vascular
risk factors in MA patients
compared to MO. CM patients were
more likely to have a negative FH
of stroke compared to other
headache types, suggesting that CM
is likely a neuronal disease rather
than a vascular one. 相似文献
79.
Tom Walley 《The journal of headache and pain》2004,5(4):217-223
Abstract
Pharmacoeconomics, the application of health economics to pharmaceuticals, is an increasingly important part of the evaluation of any therapy. It is a response to limitations on the resources available for medical care, and the need to justify how we spend these resources for the public good. This review summarises some of the key issues in pharmacoeconomics, drawing examples from the literature on migraine or headaches. It describes how pharmacoeconomics is fundamentally comparative, and must be based on real world practice rather than on clinical trials. An important point is what outcomes in migraine might be used in such studies. The types of studies commonly encountered are detailed. These examples illustrate some of the limitations of the process: a risk of industry driven bias, and a draw of money into the areas evaluated (e. g., acute therapies) rather than those not considered (e. g., longterm therapies). 相似文献
80.
Migraine occurs in about 10% of the population in the United States and the United Kingdom. In the United States there seem to be more complicated patients and the expectations of the patient are higher. In the United Kingdom there is a tendency to use single rather than compound formulations, and drugs such as barbiturates cannot be prescribed for migraine. In treating migraine the first and most important thing is to get the correct diagnosis which depends on the history and the absence of abnormal physical signs. Investigations do not confirm the diagnosis of migraine, they are only necessary to exclude other causes of headaches. Most sufferers from migraine have less than four attacks a month. Attack therapy is usually all that is required, and over the past 20 years efficient attack therapy has been developed. This depends mainly on sleep, an antinauseant, analgesics, ergotamine and more recently sumatriptan. 相似文献