A comparison of pharmacological (amitriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches

Forty-one recurrent tension headache sufferers were randomly assigned to either cognitive-behavioral therapy (administered in a primarily home-based treatment protocol) or to amitriptyline therapy (with dosage individualized at 25, 50, or 75 mg/day). Cognitive-behavioral therapy and amitriptyline each yielded clinically significant improvements in headache activity, both when improvement was assessed with patient daily recordings (56% and 27% reduction in headache index, respectively), and when improvement was assessed with neurologist ratings of clinical improvement (94% and 69% of patients rated at least moderately improved, respectively). In instances where differences in treatment effectiveness were observed (headache index, somatic complaints, perceptions of control of headache activity), cognitive-behavioral therapy yielded somewhat more positive outcomes than did amitriptyline. Neither treatment, however, eliminated headache problems.     

Body Mass Index,Body Esteem,and Unprotected Receptive Anal Intercourse Among Young Men Who Have Sex with Men Who Seek Partners Online

Research examining the relationship between body mass index (BMI) and sexual risk outcomes among men who have sex with men (MSM) has yielded inconsistent results. Using a web-based survey, single-identified (e.g., not in a relationship) young MSM (N = 431) between the ages of 18 and 24 years who sought romantic partners online were asked to respond to items regarding their BMI, body image (e.g., attribution, dissatisfaction, and pride), and sexual risk behaviors. We used Poisson regressions to examine the relationships between BMI, body image, and the number of unprotected receptive anal intercourse (URAI) occasions and partners in the past 2 months. We found a curvilinear relationship between BMI and URAI occasions, and a linear relationship between BMI and URAI partners. These relationships persisted after accounting for body image. Further, we found that body attribution served as a protective factor whereas body pride served as a risk factor. We discuss the implications of our findings for sexual health education and HIV prevention.     

The effect of acute exercise on collagen turnover in human tendons: influence of prior immobilization period

Mechanical loading of human tendon stimulates collagen synthesis, but the relationship between acute loading responses and training status of the tendon is not clear. We tested the effect of prolonged load deprivation on the acute loading-induced collagen turnover in human tendons, by applying the same absolute load to a relative untrained Achilles tendon (2-week immobilization period prior to acute loading) and a habitually loaded contra-lateral Achilles tendon, respectively, within the same individuals. Eight untrained, healthy males had one lower limb totally immobilized for 2 weeks, whereas the contra-lateral leg was used habitually. Following the procedure both Achilles tendons and calf muscles were loaded with the same absolute load during a 1-h treadmill run. Tissue collagen turnover was measured by microdialysis performed post-immobilization but pre-exercise around both Achilles tendons and compared to values obtained by 72-h post-exercise. Power Doppler was used to monitor alterations in intratendinous blood flow velocity of the Achilles tendon and MRI used to quantitate changes in tendon cross-section area. Acute loading resulted in an increased collagen synthesis 72 h after the run in both Achilles tendons (p < 0.05) with no significant difference. No signs of acute tendon overloading were demonstrated by Power Doppler, and tendon cross-section area did not change as a result of immobilization and reloading. The present study indicates that 2 weeks of tendon load deprivation is not sufficient to affect the normal adaptive response to loading determined as increased collagen synthesis of peritendinous Achilles tendon tissue in humans.     

Percutaneous posterior stabilisation of L1 to L5 with microsurgical decompression of L3/4, and percutaneous L3 biopsy,in a spinal metastasis

European Spine Journal -     

Vertebral body replacement in the thoracolumbar spine via a mini-open,thoracoscopically assisted transthoracic approach

European Spine Journal -     

Enhanced alveolar bone loss in a model of non-invasive periodontitis in rice rats

Oral Diseases (2012) 18 , 459–468 Objective: The rice rat (Oryzomys palustris) develops periodontitis‐like lesions when fed a diet rich in sucrose and casein (H‐SC). We aimed to establish whether this model can accurately mimic the development of human periodontitis. Materials and Methods: For this purpose, 28‐day‐old rice rats (15/group) were assigned to standard (STD) or H‐SC diets and sacrificed after 6, 12, and 18 weeks. Jaws were processed for morphometric, histometric, histologic, histomorphometric, and micro‐CT analyses. Results: We found a progressive increase in horizontal alveolar bone loss (ABL) with age in maxillae of rats fed the STD diet as determined by morphometry. The H‐SC diet exacerbated horizontal ABL at the palatal surface at 12 and 18 weeks. Furthermore, increased vertical ABL was detected in mandibles and maxillae of rats fed the H‐SC diet for 12 and/or 18 weeks by histometry and micro‐CT. Remarkably, the H‐SC diet significantly increased bone remodeling at the interproximal alveolar bone of mandibles from rats fed for 6 weeks, but not in those fed for longer periods. Conclusions: These findings indicate that the H‐SC diet induced a transient increase in alveolar bone remodeling, which is followed by ABL characteristic of moderate periodontitis.     

Enhancing the Effectiveness of Abortive Therapy: A Controlled Evaluation of Self-Management Training

Research suggests that approximately one half of recurrent headache sufferers fail to adhere properly to drug treatment regimens with as many as two thirds of patients failing to make optimal use of abortive medications such as ergotamine. In spite of these findings there are no controlled studies that have attempted to evaluate methods for improving adherence to drug regimens for the treatment of chronic headache disorders. In an initial effort to address this adherence problem thirty-four recurrent migraine sufferers were randomized to abortive therapy with ergotamine tartrate plus caffeine (standard abortive therapy) or to standard abortive therapy accompanied by a brief educational intervention designed to facilitate the migraine sufferer's effective use of ergotamine. Patients who received the adjunctive educational intervention attempted to abort a greater percentage of their migraine attacks (70% vs 40%) and showed larger reduction in headache activity (e.g., 40% vs 26% reduction in month two of treatment). However, patients in both treatment groups used similar amounts of abortive medication when attempting to abort a migraine attack and showed similar reductions in analgesic medication use with abortive therapy. There results suggest that brief educational interventions designed to address the problem of patient adherence may yield significant improvements in standard therapies. We argue that such educational interventions deserve more attention in the headache treatment literature than they have received to date.     

The influence of training status on the drop in muscle strength after acute exercise

Skeletal muscles fatigue after exercise, and reductions in maximal force appear. A difference in training status between the legs was introduced by unilateral immobilization of the calf muscles for 2 weeks in young men, who were randomly assigned to two groups, either a RUN group (n = 8) that was exposed to prolonged exercise (1-h running: individual pace) or a REST group (n = 12) that did no exercise after immobilization. Cross-sectional area (CSA) of the triceps-surae muscles was calculated by magnetic resonance imaging (MRI), and maximal voluntary contraction (MVC) force of the plantar flexors was measured before and after immobilization and after the running protocol. The CSA of triceps-surae muscles decreased significantly with a 7% reduction in both groups. A significant drop in the MVC of the triceps-surae muscle (10%; P < 0.05) was observed in response to immobilization. When subjected to running exercise immediately after immobilization, the muscle strength of the triceps-surae muscles dropped even further, but just in the immobilized leg (41%; P < 0.05). The present study highlights the importance of determining the muscle endurance when evaluating the effect of immobilization on muscle parameters.