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Chronic headaches are difficult to treat and represent the biggest challenge in headache centres. Mirtazapine has a prophylactic and ibuprofen an acute effect in tension-type headache. Combination therapy may increase efficacy and lower side effects. We aimed to evaluate the prophylactic effect of a combination of low-dose mirtazapine and ibuprofen in chronic tension-type headache. Ninety-three patients were included in the double-blind, placebo-controlled, parallel trial. Following a 4-week run-in period they were randomized to four groups for treatment with a combination of mirtazapine 4.5 mg and ibuprofen 400 mg, placebo, mirtazapine 4.5 mg or ibuprofen 400 mg daily for 8 weeks. Eighty-four patients completed the study. The primary efficacy parameter, change in area under the headache curve from run-in to the last 4 weeks of treatment, did not differ between combination therapy (190) and placebo (219), P = 0.85. Explanatory analyses revealed worsening of headache already in the third week of treatment with ibuprofen alone. In conclusion, the combination of low-dose mirtazapine and ibuprofen is not effective for the treatment of chronic tension-type headache. Moreover, the study suggests that daily intake of ibuprofen worsens headache already after few weeks in chronic tension-type headache. 相似文献
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Renal complications of lipodystrophy: A closer look at the natural history of kidney disease
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Baris Akinci Sadiye Mehtat Unlu Ali Celik Ilgin Yildirim Simsir Sait Sen Banu Nur Fatma Ela Keskin Basak Ozgen Saydam Nilufer Kutbay Ozdemir Banu Sarer Yurekli Bekir Ugur Ergur Melda Sonmez Tahir Atik Atakan Arslan Tevfik Demir Canan Altay Ulku Aybuke Tunc Tugba Arkan Ramazan Gen Erdal Eren Gulcin Akinci Aslihan Arasli Yilmaz Habib Bilen Samim Ozen Aygul Celtik Senay Savas Erdeve Semra Cetinkaya Huseyin Onay Sulen Sarioglu Elif Arioglu Oral 《Clinical endocrinology》2018,89(1):65-75
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Sait Demirkol M.D. Ugur Kucuk M.D. Oben Baysan M.D. Sevket Balta M.D. Turgay Celik M.D. Ibrahim Halil Kurt M.D. Hilal Olgun Kucuk M.D. Uygar Cagdas Yuksel M.D. Murat Unlu M.D. Mehmet Yokusoglu M.D. 《Echocardiography (Mount Kisco, N.Y.)》2012,29(9):1064-1070
Aims: The aim of this study is to investigate the effect of mitral stenosis (MS) on left atrial (LA) function using two‐dimensional speckle tracking echocardiography (2DSTE). Methods and Results: The study subjects consisted of 52 patients with asymptomatic MS and 52 control subjects. LA function was assessed using prototype speckle tracking software and manual tracking method. Maximal LA volume (LAVmax) and minimal LA volume (LAVmin) and LA volume before atrial contraction (LAVpre‐a) were measured. Using these volumes, LA reservoir, conduit and booster pump fuction parameters were calculated. Indexed LAVmax, LAVmin, and LAVpre‐a measurements via speckle tracking were highly correlated with manual tracing methods in both groups. Expansion index (67.8 ± 36.4 vs. 148.3 ± 44.2), diastolic emptying index (37.7 ± 12.9 vs. 58.0 ± 8.5), passive emptying (37.3 ± 14.1 vs. 70.4 ± 10.4) and passive emptying index (13.3 ± 6.3 vs. 41.3 ± 10.6) were decreased significantly in MS patients (P < 0.001). In contrast active emptying index (62.6 ± 4.1 vs. 29.5 ± 10.1) increased in MS group (P < 0.001) while active emptying (28.1 ± 13.0 vs. 28.3 ± 6.9) remained same among both groups. Conclusions: This is the first study relating LA volumes and function assessed by 2DSTE to MS. 2D speckle tracking analysis of LA volume is relatively easy and provides more detailed information regarding the changes in LA volumes during the cardiac cycle. 相似文献
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Henrik W. Schytz Faisal M. Amin Rigmor H. Jensen Louise Carlsen Stine Maarbjerg Nunu Lund Karen Aegidius Lise L. Thomsen Flemming W. Bach Dagmar Beier Hanne Johansen Jakob M. Hansen Helge Kasch Signe B. Munksgaard Lars Poulsen Per Schmidt Srensen Peter T. Schmidt-Hansen Vlasta V. Cvetkovic Messoud Ashina Lars Bendtsen 《The journal of headache and pain》2021,22(1)
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Anne?Luise?Vollesen Silvia?Benemei Francesca?Cortese Alejandro?Labastida-Ramírez Francesca?Marchese Lanfranco?Pellesi Michele?Romoli Messoud?Ashina Christian?Lampl 《The journal of headache and pain》2018,19(1):89
Although clinically distinguishable, migraine and cluster headache share prominent features such as unilateral pain, common pharmacological triggers such glyceryl trinitrate, histamine, calcitonin gene-related peptide (CGRP) and response to triptans and neuromodulation. Recent data also suggest efficacy of anti CGRP monoclonal antibodies in both migraine and cluster headache. While exact mechanisms behind both disorders remain to be fully understood, the trigeminovascular system represents one possible common pathophysiological pathway and network of both disorders. Here, we review past and current literature shedding light on similarities and differences in phenotype, heritability, pathophysiology, imaging findings and treatment options of migraine and cluster headache. A continued focus on their shared pathophysiological pathways may be important in paving future treatment avenues that could benefit both migraine and cluster headache patients. 相似文献