Headache
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The search for rationality in health expenses in developing countries collides with the lack of effectively conducted epidemiologic studies. ⋯ Migraine seems to pose a huge burden on the Brazilian public health system. The implementation of a stratified care model of treatment that would include specific acute migraine therapies could result in a dramatic increase in the quality of migraine care and a significant reduction in cost.
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To determine the feasibility of developing a headache management program and to assess the outcomes of patients referred to the program for treatment of chronic headache. ⋯ A headache management program was successfully established. Patients referred to the program experienced significant improvement in headache-related disability and functional health status and reported greater satisfaction with care. Even so, these results were obtained at one site and in a small sample that was not randomized. We currently are conducting a randomized controlled trial to better evaluate the clinical and financial impact of a headache management program for patients with chronic headache.
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To examine factors associated with social, occupational, and psychological burden of common primary headache (migraine and tension-type headache). ⋯ The number of days per month with headache is a key determinant of headache-related burden in those attending specialty clinics. Frequent (chronic) headache is associated with significantly higher psychopathology scores and general social impairment, but the direction of this relationship is not clear. Those with migraine and chronicity are the most impaired.
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Comparative Study
Naratriptan in the preventive treatment of refractory chronic migraine: a review of 27 cases.
To review the efficacy of naratriptan as preventive treatment in 27 patients with chronic migraine refractory to other commonly used preventive therapies. ⋯ Naratriptan may have a role in the preventive treatment of intractable chronic migraine. Prospective, controlled studies should be considered.