Using pupillometry and sympathetic skin responses we compared the changes in local and systemic autonomic function within
one week of a migraine attack. We investigated whether the measurement of the pupillary light reflex provides further information
on the pathophysiology of migraine.
Forty-two migraine patients and forty-two healthy age-matched controls were included. The parameters that were measured were
the amplitude of the pupillary light reflex, the pupil size at the beginning of the measurement, the latency, the velocity
of constriction and the velocity at the end of the dilatation.
The average pupil size was 6.43 mm in the migraine group and 6.7 mm in the control group (p < 0.01). Reduced velocity of
constriction and smaller amplitude of constriction in migraine patients within two days of an attack were signs of a parasympathetic
dysfunction (p < 0.05). The sympathetic skin response did not differ significantly between migraine sufferers and controls.
These findings indicate that both parasympathetic and sympathetic nerves supplying the eye are involved in migraine headache
presumably due to effects on the pericarotid sympathetic fibers and involvement of trigeminal-parasympathetic reflexes.
Received: 24 July 2001, Accepted: 16 July 2002
Correspondence to K. Schepelmann, M. D. 相似文献
OBJECTIVE: Although somatoform disorders are assumed to be chronic clinical conditions, epidemiological knowledge on their natural course based on representative samples is not available. METHOD: Data come from a prospective epidemiologic study of adolescents and young adults in Munich, Germany. Respondents' diagnoses (N = 2548) at baseline and follow-up on average 42 months later are considered. The follow-up incidence, stability as well as selected baseline risk factors (sociodemographics, psychopathology, trauma exposure) for the incidence and stability of somatoform disorders and syndromes are prospectively examined. Diagnostic information was assessed by using the standardized Munich-Composite International Diagnostic Interview (M-CIDI). RESULTS: Over the follow-up period, incidence rate for any of the covered somatoform diagnoses was 25.7%. Stability for the overall group of any somatoform disorder/syndrome was 48%. Female gender, lower social class, the experience of any substance use, anxiety and affective disorder as well as the experience of traumatic sexual and physical threat events predicted new onsets of somatoform conditions, while stability was predicted by being female, prior existing substance use, affective and eating disorders as well as the experience of a serious accident. CONCLUSIONS: At least for a substantial proportion of individuals, the overall picture of somatization seems to be relatively stable, but with fluctuation in the symptom picture over time. Being female, the experience of substance use as well as anxiety disorder seem to constitute risk factors for the onset of new somatoform conditions as well as for a stable course over time. 相似文献
Repression is commonly assumed to be a major characteristic of the cancer-prone personality. Main supporting evidence includes studies showing that cancer patients are low in emotional expression and that repressives have shorter survival. The evidence did not seem compelling, mainly because of contrary findings, overlooking the age factor and the assessment instruments. Thus, we examined whether repression is a response to the threat posed by the cancer diagnosis and whether cancer patients are more repressive, using a new assessment method combining anxiety and defensiveness scores and controlling age. The subjects were 98 women comprising three groups comparable in demographic characteristics: (a) breast biopsy showed they were healthy (n = 40), (b) biopsy showed they had breast cancer (n = 32), and (c) underwent surgery unrelated to cancer (n = 26). Only post-surgery groups a and b knew the diagnosis. Questionnaires of information and repression were administered to all women pre- and post-surgery. Before surgery, the groups did not differ in repression, anxiety and defensiveness. Post-surgery, there were no differences in anxiety but MANOVA and X2 analyses showed that, in the malignancy group, defensiveness and the number of repressors increased more than in the other groups. The results indicate that repression could be a response to the threat posed by the cancer diagnosis and a means for keeping anxiety at a tolerable level rather than a personality trait of cancer patients. 相似文献
Zusammenfassung
Die Typ I-Allergien gegen Latex sind in den vergangenen Jahren zu einem zunehmenden berufsdermatologischen Problem geworden,
zumal mindestens 10% der Angestellten im Gesundheitswesen betroffen sind. In der Dermatologischen Klinik der Universit?t Erlangen-Nürnberg
stieg die Anzahl der j?hrlich diagnostizierten Patienten mit Latexallergien von 1989 bis 1995 auf das 12fache, wobei der Anteil
der schweren, generalisierten Formen der Erkrankung von 10,7% (1989/1990) auf 44% (1994/1995) zunahm.Unter den m?glichen Ausl?sern der Latexallergie (wasserl?sliche Proteine mit Molekulargewichten von 2 bis 200 kD) sind mindestens
5 Hauptproteine mit bereits bekannter Prim?rstruktur zu berücksichtigen. Zus?tzlich gibt es Hinweise für Markerproteine, die
in bestimmten Risikogruppen geh?uft zur Ausl?sung spezifischer IgE-Antik?rper führen (z.B. 46 kD-Protein in medizinischen
Berufen, 14,6 kD- und 27 kD-Proteine bei Kindern mit Spina bifida). Das Vorkommen von Kreuzreaktionen zwischen Latex und unterschiedlichen
Früchten (besonders Avocado, Kiwi, Banane, E?kastanie) bei 60 bis 70% der Latexallergiker ist bei der allergologischen Abkl?rung
und Beratung dieser Patienten zu beachten. Wesentliche Aspekte der Prophylaxe umfassen die konsequente Umstellung medizinischer
Einrichtungen auf ungepuderte Latexhandschuhe mit niedrigem Proteingehalt. Eine Zusammenstellung von OP- und Untersuchungshandschuhen,
welche Angaben über die von uns ermittelten Proteinkonzentrationen (modifizierte Lowry-Methode und Hochdruck-Flüssigkeits-Chromatographie,
HPLC) enth?lt, soll ein Leitfaden bei der Auswahl allergologisch geeigneter Handschuhe sein.
Eingegangen am 10. August 1996 Angenommen am 21. August 1996 相似文献
Intramolecular Aminoalkylation of Amidoximes 2-tertiary aminobenzamidoximes 2 react with mercury edta by intramolecular aminoalkylation and oxidation to anellated quinazolinone-oximes 5 ; their configuration is not changed. 相似文献
The acute psychological reactions of 101 train drivers to on-the-track accidents were studied by means of clinical interviews and questionnaires (Impact of Event Scale, GHQ-20 and a questionnaire addressing stress symptoms, pre-accident expectancies and worries). More than half of the train drivers reported moderate to high intrusive distress (mean 11.3) within hours to days after the accident but only 1/3 reported symptoms of acute psychophysiological arousal. Intrusive symptoms related to visual impressions were most frequently reported. Avoidance was less prevalent (mean 8.8).
Clinical interviews, relationship between pre-accident worries and severity of the acute responses and positive correlation between GHQ-scores relating to the fortnight preceding the accident and IES-intrusion scores, suggest that premorbid variables may influence the stress response. Involvement in more than two previous accidents invoked a feeling of vulnerability and produced stronger acute responses. Post-accident experiences involving various personal contacts did not correlate with the stress responses in this study and only a few drivers experienced such events in a negative way. Denial of the possibility of being involved in accidents was not associated with increased risk of strong acute responses, indicating that denial does not predict poor outcome in healthy persons exposed to situations where possibility of avoiding the event is outside the control of the person. 相似文献