The role of headache chronicity among predictors contributing to quality of life in patients with migraine: a hospital-based study

Background

Headache chronicity has been known to elicit deleterious effects on quality of life (QOL). We evaluated the contribution of headache chronicity to QOL in relation to clinical, psychiatric, and psychosocial variables in patients with migraine.

Methods

Subjects were recruited from a headache clinic and completed self-report questionnaires including the Migraine Disability Assessment (MIDAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Migraine-Specific Quality of Life (MSQoL). We obtained predictors of MSQoL by multiple regression analyses. A path analysis model was constructed to analyze interrelationships between the variables.

Results

Among 251 eligible patients, 183 (72.9%) had episodic migraine (EM) and 68 (27.1%) had chronic migraine (CM). Patients with CM had more serious clinical, psychiatric, and poor QOL than did patients with EM. The strongest predictor of the MSQoL score in all patients with migraine was the BDI score (β = -0.373, p < 0.001), followed by the MIDAS score (β = -0.223, p < 0.001), female gender (β = -0.192, p < 0.001), attack duration (β = -0.159, p = 0.001), and headache chronicity (β = -0.130, p = 0.012). Headache chronicity had a direct effect on the MSQoL score and exerted an indirect effect on the MSQoL score through the MIDAS and the BDI scores.

Conclusions

Chronic migraine appears to impair QOL directly as well as indirectly by provoking disability and depression.     

The impact of depression and ghrelin on body weight in migraineurs

Background

Comorbidity of migraine with anxiety and depression may play a role in the link between migraine and obesity. We examined the moderating and mediating roles of ghrelin in the relationship between depression (and anxiety) and body weight in newly diagnosed migraineurs.

Methods

Participants were 63 newly diagnosed migraine patients (using the ICHD-II criteria) and 42 healthy volunteers. Body mass index (BMI) was calculated by measuring height and weight. Ghrelin was assessed at fasting. Depression was assessed with the Hamilton Depression scale, and anxiety with the Hamilton Anxiety scale.

Results

The data did not support the mediating role of ghrelin in the relationship between depression (or anxiety) and BMI for either the migraine or the control group. The interaction between ghrelin and depression as well as anxiety was significant for the migraine group, but not for the control group. Depressed (or anxious) migraineurs had a positive association between ghrelin and BMI, whereas for the non-depressed (or non-anxious) migraineurs this association was negative.

Conclusions

Depression and anxiety moderated the effect of ghrelin on BMI for migraineurs. Management of anxiety and depression might be regarded as part of migraine treatment.     

运动疗法在维持性血液透析患者中的应用效果评价

目的:探讨运动疗法对维持性血液透析(MHD)患者睡眠质量、抑郁情绪和生活质量的影响。方法:将46例MHD患者随机等分为对照组和观察组,对照组采用常规护理,并嘱患者维持原生活方式和运动状态不变,观察组在常规护理的基础上给予运动疗法,干预6个月后评价两组的干预效果。结果:观察组患者干预6个月后的睡眠质量得分、SDS评分低于对照组(P0.05),生理功能、生理职能、活力和生理健康总评均高于对照组(P0.05)。结论:运动疗法可改善维持性血液透析患者睡眠质量,消除抑郁情绪,提高生活质量。     

慢性乙型肝炎患者外周血抗原特异性CD8~+T细胞功能的初步分析

目的评价慢性乙型肝炎(CHB)患者外周血抗原特异性CD8+T细胞的功能及与临床相关指标的关系。方法采用主要组织相容性复合物(MHC)-抗原肽四聚体标记技术检测CHB患者外周血乙型肝炎病毒(HBV)抗原特异性CD8+T细胞,并对其细胞因子分泌能力进行检测,分析其与临床生化和病毒学指标的关系。结果 35例人类白细胞相关抗原(HLA)-A基因型为A02或A24的患者中有9例患者至少检出1种被四聚体识别的HBV抗原特异性CD8+T细胞,其白细胞介素2(IL-2)和γ干扰素(IFN-γ)的分泌能力明显低于其自身的外周血总CD8+T细胞。检出抗原特异性CD8+T细胞患者的血清丙氨酸氨基转移酶(ALT)水平明显高于阴性患者,而HBV DNA水平低于阴性患者。结论 CHB患者外周血抗原特异性CD8+T细胞存在明显的功能缺陷,可能因病毒抗原持续刺激造成功能耗竭,但外周血出现抗原特异性CD8+T细胞仍表明患者体内出现较强抗病毒免疫反应。     

急诊非器质性呼吸困难患者焦虑抑郁状态分析

目的 探讨急诊非器质性呼吸困难患者焦虑抑郁状态及相关影响因素.方法 连续人选中国医科大学北京顺义区医院急诊科与首都医科大学附属北京朝阳医院急诊科2014年1月1日至2014年5月30日急诊就诊的主诉呼吸困难患者,经过诊疗以后最终诊断为非器质性呼吸困难患者80例,其中68例同意进行心理测评.采用综合医院焦虑抑郁评分量表对68例非器质性呼吸困难患者行心理测评,评价焦虑和抑郁的发生率,对性别、年龄、受教育程度、情绪波动等影响因素进行分析.结果 68例患者中,焦虑患者22例,占32.4％,抑郁患者14例,占20.6％.女性、中学以下学历、就诊前情绪波动以及非本地居民来源者焦虑抑郁发生率更高(P＜0.05).Logistic回归分析结果显示中学以下学历、就诊前情绪波动和非本地居民来源均是发生焦虑、抑郁的主要影响因素.结论 对于急诊非器质性呼吸困难患者,在进行急诊常规诊疗的同时,应重视患者心理因素,必要时应该建议患者求助心理干预.     

针药结合治疗肾虚肝郁型围绝经期综合征的临床疗效分析

目的:观察中药内服配合针刺治疗围绝经期综合征的临床疗效。方法:肾虚肝郁型围绝经期综合征患者67例,随机分为两组。治疗组33例以补肾调肝汤配合针刺治疗,对照组34例口服补肾调肝汤治疗。结果:治疗组有效率90.91%,对照组有效率70.59%,两组比较有显著性差异(P<0.05)。治疗后Kupperman绝经指数评分治疗组为(6.09±3.59)分,对照组为(10.79±6.73)分,两组比较有显著性差异(P<0.05)。结论:针药结合治疗肾虚肝郁型围绝经期综合征疗效肯定,能改善或消除围绝经期诸多症状。     

成都市城乡居民抑郁现状调查及其影响因素分析

目的调查成都地区城乡社区居民的抑郁现状,并探讨其影响因素。方法采取多阶段分层整群抽样方法于2010年2~10月选取成都市城区和农村4个社区的35~70岁居民进行入户调查。调查用表为患者健康问卷PHQ-2抑郁筛查量表。统计分析采用SPSS18.0软件并用logistic回归模型对主要影响因素进行多因素分析。结果共调查2 027人,其中城区1 015人(女性616人,男性399人,平均年龄58.90±9.48岁),农村1 012人(女性582人、男性430人,平均年龄54.94±9.64岁)。调查结果显示,成都市35~70岁抑郁患病率为2.91%(59/2 027),其中城区为4.33%(44/1 015),农村为1.48%(15/1 012);城区明显高于农村,其差异有统计学意义(χ2=13.296,P<0.001)。多因素分析结果显示,不同婚姻状况人群之间抑郁患病率差异有统计学意义,离婚人群抑郁患病较多;而职业、教育程度和家庭人均月收入状况与抑郁的相关性无统计学意义。结论成都市城乡社区居民抑郁筛查患病率较高,离婚人群是防治抑郁的重点人群。     

帕罗西汀联合丁螺环酮治疗抑郁症对照研究

目的：探讨帕罗西汀联合丁螺环酮治疗抑郁症的临床疗效和安全性。方法将80例抑郁症患者随机分为两组,每组40例,两组均口服帕罗西汀治疗,研究组联合丁螺环酮治疗,观察6周。于治疗前后采用汉密顿抑郁量表、汉密顿焦虑量表评定临床疗效,副反应量表评定不良反应。结果治疗6周末研究组显效率为70．0％、有效率为90．0％,对照组分别为42．5％、85．0％,研究组显效率显著高于对照组（χ2＝6．15,P＜0．05）。两组不良反应较轻微,同期副反应量表评分比较差异无显著性（P＞0．05）。结论帕罗西汀联合丁螺环酮治疗抑郁症具有增效作用,疗效显著,起效快,且不增加不良反应,显著优于单用帕罗西汀治疗。     

T2* magnetic resonance imaging of the liver in thalassemic patients in Iran

AIM: To investigate the accuracy of T2*-weighted magnetic resonance imaging (MRI T2*) in the evaluation of iron overload in beta-thalassemia major patients. METHODS: In this cross-sectional study, 210 patients with beta-thalassemia major having regular blood transfusions were consecutively enrolled. Serum ferritin levels were measured, and all patients underwent MRI T2* of the liver. Liver biopsy was performed in 53 patients at an interval of no longer than 3 mo after the MRIT2* in each patient. The amount ...