Alexithymic features in migraine patients

Abstract. The aims of the present study were 1) to investigate the alexithymic features in migraine patients and, 2) if alexithymia has any relation with the results of other psychological scales that are widely used in clinical practice to describe the psychopathologies, such as depression and anxiety. Demographic and clinical data of 50 cases with migraine without aura and 50 normal volunteers were supplied. All cases completed the Beck Depression Inventory, Hamilton Depression Rating Scale, State and Trait Anxiety Inventory and Toronto Alexithymia Scale. Migraine patients were significantly more depressive, anxious and alexithymic than the control group; there was no correlation between TAS scores and demographic variables; not depression but anxiety was significantly correlated with alexithymia in the migraine group, whereas none of the scores were found to be related to alexithymia in controls. According to our results, alexithymia is a frequent finding in migraine patients and is associated with anxiety to a considerable extent but not with depression.     

Economic impact of primary headaches in Turkey: a university hospital based study: part II

This study was planned to investigate the economic impact of headache on Turkish headache sufferers attending a tertiary care outpatient headache clinic. A total of 937 headache patients were included in this study and questioned using a questionnaire for the profile of patients and headache, quality of life of patients and economic impact of headache. The median total direct cost was found to be 88.0 USD and the median total cost was 160.7 USD. The drug treatment cost was the highest item followed by the specialist outpatient care cost. The average lost and inefficient work/school days was 1.5 (0–45) and 8.4 (0–100) days for one year. It was shown that loss of productivity was higher for migraine without aura group when compared with the episodic and chronic tension–type headache groups. The results of this nationwide university hospital based study methshowed that headache, especially migraine, has considerable economic impact on patients.     

Plasma nitrite levels,total antioxidant status,total oxidant status,and oxidative stress index in patients with tension-type headache and fibromyalgia

Objectives

Tension-type headache (TTH) and fibromyalgia syndrome (FM) are worldwide seen chronic pain syndromes of unknown etiology. Despite the growing body of data on pathophysiology and generation mechanisms of pain; our knowledge on pain mechanisms in both FM and TTH is yet to be limited.

Patients and methods

We investigated the plasma nitrite levels, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) in 35 TTH, 33 FM patients and 31 healthy controls.

Results

The mean plasma nitrite levels and TAS levels were significantly low and OSI was found to be significantly high in TTH and FM groups compared to the control group (p = 0.001, p = 0.001, p = 0.001 and p = 0.001, respectively). The mean serum TOS levels were also significantly higher in FM group according to the control group (p = 0.034), but there was not a significant difference between TTH and control groups (p = 0.066).

Conclusion

These results indicated that; FM and TTH patients revealed higher oxidative stress index and lower total nitrite levels than healthy controls. We conclude that oxidative stress may have a role in the pathophysiological mechanisms of TTH and FM, although, whether it is the cause or the consequence, is not clear.     

TNF-α promoter polymorphisms in multiple sclerosis: no association with −308 and −238 alleles,but the −857 alleles in associated with the disease in Turkish patients

Dysregulation in the expression of pro- and anti-inflammatory cytokines is one of the milestones in multiple sclerosis (MS) development and progression. Tumour necrosis factor (TNF-α), a proinflammatory cytokine is believed to play an important role in MS pathogenesis. The objective of this study is to investigate the association between TNF-α promoter region (TNF-α−238, −308 and −857) and susceptibility to MS and clinical course of the disease. Eighty-six relapsing remitting MS patients and 150 sex-, age- and ethnic-matched controls were enrolled in the study. Genotyping was performed by PCR-RFLP method. We observed a statistically significant increase in TNF-α 857 CC genotype in MS patients than controls (P < 0.001) while TNF-α 857 CT genotype showed a significant negative correlation with MS patients (P = 0.033). No differences in the distribution of the TNF-α−238 and −308 alleles were observed. None of the three polymorphisms (−238, −308 and −857) did not show relation with disease duration, Expanded Disability Status Scale or age of onset. On the other hand, significant difference of TNF −857 CC genotype was identified with the low disease index (P = 0.025). Although the study group is small, the results indicate that TNF-α 857 CC genotype may cause susceptibility to MS in the Turkish population.     

The primary care physician's role in preventing vision loss and blindness in patients with diabetes

While not trained to specifically diagnose or treat ophthalmic conditions, primary care physicians can play a significant role in the visual health of their patients, specifically those with diabetes. Diabetic retinopathy is a leading cause of vision loss and blindness in the United States and because of its asymptomatic nature, patients often do not seek eye care until they notice changes in their vision. Patients with diabetes look to their physicians for guidance in managing all aspects of the disease, and research has shown people are more likely to have their eyes examined if their physician suggests it. Physicians should discuss visual health with patients and make referrals for annual comprehensive dilated eye examinations. Vision loss and blindness from diabetes can often be prevented through early detection and timely treatment; however, many patients seek eye care at a stage too late for treatment to be effective.     

Effect of glutathione on brain nitric oxide levels in an exerimental epilepsy mouse model

BACKGROUND： Oxidative stress plays an important role in the pathophysiology of epilepsy. Glutathione, known as one of the compounds of antioxidant defense, has been shown to inhibit convulsions. Nitric oxide has a proconvulsant effect on a pentylenetetrazole-induced animal model. OBJECTIVE： To evaluate the effects of glutathione administration on nitric oxide levels in brain regions of convulsive and kindling pentylenetetrazole-induced seizure models. DESIGN, TIME, AND SETTING： A randomized, controlled, animal experiment. The study was performed at the Department of Physiology, Gaziantep University and Department of Chemistry-Biochemistry,Kahramamaras Sutcu Imam University in 2006. MATERIALS： Pentylenetetrazole and glutathione were purchased from Sigma, USA. METHODS： A total of 80 mice were assigned to 8 groups （n = 10）： normal control, saline control （1 mL normal saline）, convulsive pentylenetetrazole （single intraperitoneal administration of pentylenetetrazole, 60 mg/kg）, convulsive pentylenetrazole plus glutathione （single administration of 60 mg/kg pentylenetetrazole and 200 mg/kg glutathione）, five-dose glutathione （intraperitoneal injection of 200 mg/kg glutathione respectively at 1, 3, 5, 7, and 10 days）, single-dose glutathione （single administration of 200 mg/kg glutathione）, pentylenetetrazole kindling （intraperitoneal administration of pentylenetetrazole of 40 mg/kg at 1,3, 5, 7, and 10 days）, and pentylenetetrazole kindling plus glutathione group （intraperitoneal injection of 40 mg/kg pentylenetetrazole and 200 mg/kg glutathione respectively at 1, 3, 5, 7, and 10 days）. MAIN OUTCOME MEASURES： All mice were sacrificed 1 hour after the last administration. Brain nitric oxide levels were determined by spectrophotometry. RESULTS： There were no significant differences in nitric oxide levels between the normal control, saline control, five-dose glutathione, and single-dose glutathione groups （P 〉 0.05）. Nitric oxide levels in the cerebral hemisphere and cerebellum were significantly less in the convulsive pentylenetetrazole group, compared with the convulsive pentylenetetrazole plus glutathione group （P 〈 0.01）, and levels in the pentylenetetrazole kindling group were remarkably greater than the remaining groups （P 〈 0.01 ）. Brain nitric oxide levels in all groups gradually decreased from the right brain stem to the left brain stem, cerebellum, left cerebral hemisphere, and right cerebral hemisphere. CONCLUSION： Glutathione regulated nitric oxide levels in various brain regions of pentylenetetrazole-induced kindling models, and did not affect nitric oxide levels in the control mice. These results indicated that glutathione played a role when nitric oxide was over-produced. In addition, the brain stem exhibited the highest levels of nitric oxide in both control mice and pentylenetetrazole-induced kindling models.     

A transdisciplinary approach to improve health literacy and reduce disparities

A challenge to public health professionals, health care providers, and consumers is to come together to improve the quality of health care and to eliminate disparities. Improving health literacy skills along with a transdisciplinary approach to care contributes to effective patient-provider communication. This article addresses a team approach to health care, a community health center experience, self-management skills, patient education, and cultural competency training. In addition, the authors provide concepts that can be incorporated in health care settings to eliminate health disparities and improve health literacy.