Botulinum toxin type A in prophylactic treatment of migraine headaches: a preliminary study

Abstract The purpose of this study was to determine the safety and efficacy of botulinum toxin type A (BOTOX; Allergan, Irvine, USA) in migraine prophylaxis. We performed a double-blind, randomized, 90-day placebo-controlled study that enrolled 30 adult migraineurs. Patients received 50 units botulinum toxin type A (n=15) or placebo (n=15). Outcome measures were monthly frequency and duration of migraine attacks and the number of severe attacks. Botulinum toxin type A produced significantly greater reductions in the frequency of migraine attacks of any severity at Day 90 (-3.14 vs. -0.53; p<0.05) and in the frequency of severe migraine attacks at Days 60 (-1.4 vs. -0.54; p<0.05) and 90 (-1.8 vs. -0.20; p<0.02). One patient in the botulinum toxin type A group experienced mild, transient frontalis muscle weakness lasting approximately 30 days. Botulinum toxin type A injections were well tolerated and provided effective migraine prophylaxis in these patients.     

Peripheral blood levels of progesterone in female camels during various reproductive stages

Determination of serum progesterone concentrations over a period of 2 years in female camels during various reproductive stages (estrus, pregnant, nonpregnant, and lactating) suggests that the progesterone levels exceeding 1 ng/ml are reached only if mating is fertile. A cycling camel does not have a luteal phase and mating is probably indispensable for ovulation to occur.     

Deltopectoral flap revisited: role of the extended flap in reconstruction of the head and neck.

The extended deltopectoral flap is still the best choice in selected cases. During the period 1987-2004, 34 patients required reconstruction of the head and neck using this flap. Twenty-nine had had one or more failed attempts at microsurgical reconstruction after excision of cancer. Five were treated primarily. The flap was divided at least three weeks after the primary operation. All 34 survived, and there were no donor site complications. Twenty-seven patients had an uncomplicated outcome, but the remaining seven required later closure or skin grafting, usually under local anaesthesia, for complications. The extended deltopectoral flap has been used successfully to provide stable coverage of defects in the head and neck and should remain in the armamentarium of reconstructive microsurgeons.     

Early results of arthroscopic surgery of the knee

Arthroscopic operation was performed on 105 patients and partial meniscectomy on 72 of them. The average postoperative stay in hospital was 1.4 days and the average time taken to return to work was 16 days. In 50 sportsmen the average return to strenuous sport was 33 days.     

Psychosomatic disorders in a rural family practice in Israel

A survey carried out in the Shimshon family health centre in the rural area of Jerusalem revealed that 24 per cent of new patient-doctor contacts were for psychosomatic disorders.

The three major. disorders—back pain, headache and abdominal pain—were present in almost 79 per cent of all psychosomatic contacts. Other common disorders were chest pains, palpitations, malaise and nocturnal enuresis. Classic illnesses such as peptic ulcer or asthma were less common. The incidence of peptic ulcer, asthma, atopic dermatitis and chest pains was higher among males than females; rates for headache, palpitations and malaise were higher for females than males. Back pain, headache and abdominal pains occurred differently among the five ethnic groups of the study population. Therapeutic care is carried out through assessment and study of the patient and his or her family.