Headache
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Headache attributed to airplane travel is a rare form of headache that develops exclusively during airplane travel. It is characterized by occurring during takeoff, landing, or both, and improves spontaneously within 30 minutes after the ascent or descent of the airplane is completed. ⋯ This study demonstrated that headache attributed to airplane travel is not as rare as previously thought, being predominant during takeoff or landing. In addition, despite the bothersome feeling, most passengers who experienced this headache traveled normally, despite previous painful experience.
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Access to headache consultations by a headache specialist is limited. E-consultations are an efficient approach shown to reduce costs and improve continuity of care with the primary care provider. Indications, suitability, and uptake in the headache population are not well studied. ⋯ E-consultation in headache medicine could be considered if appropriately triaged. Pathways are needed to reach patients earlier in their disease course to ensure headache care meets guideline recommendations, and e-consultation is 1 option. However, better communication with primary care is required for system optimization.
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Migraine and severe headache affect approximately 1 in 6 U. S. adults and migraine is one of the most disabling disorders worldwide. Approximately 903,000 to 1.5 million African American (AA) men are affected by migraine in the United States. ⋯ Part 1 of this manuscript explores inherent and potential challenges of the equity of AA men in headache medicine including headache disparities, mistrust, understudied/lack of representation in research, cultural differences, implicit/explicit bias, and the diversity tax. Part 2 of this work offers possible solutions to achieve equity for AA men in headache including: (1) addressing head and facial pain disparities and mistrust in AA men; (2) professionalism and inclusion; (3) organizational/departmental leadership buy-in for racial diversity; (4) implicit/explicit and other bias training; (5) diversity panels with open discussion; (6) addressing diversity tax; (7) senior mentorship; (8) increased opportunities for noteworthy and important roles; (9) forming and building alliances and partnerships; (10) diversity leadership training programs; (11) headache awareness, education, and literacy with focus to underrepresented in medicine trainees and institutions; and (12) focused and supported the recruitment of AA men into headache medicine. More work is needed for equity of AA men in headache medicine.
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Observational Study
Impact of Depression and Anxiety Symptoms on Patient-Reported Outcomes in Patients With Migraine: Results From the American Registry for Migraine Research (ARMR).
The association between migraine, depression, and anxiety has been established, but the impact of these psychiatric comorbidities on functional impairment in people with migraine has been under-investigated. The purpose of this cross-sectional observational study was to investigate the relationship between anxiety and depression symptoms on migraine-related disability, pain interference, work interference, and career success in a cohort of patients with migraine. ⋯ Severity of depression symptoms in patients with migraine is associated with migraine-related disability, work interference, pain interference, and reduced career success. Patients with more severe symptoms of depression are more likely to have greater functional impairment. A management approach that addresses depression in those with migraine may lead to improvements in patient functioning.
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Randomized Controlled Trial
The Spectrum of Response to Erenumab in Patients With Episodic Migraine and Subgroup Analysis of Patients Achieving ≥50%, ≥75%, and 100% Response.
To assess the efficacy of erenumab at the ≥50%, ≥75%, and 100% reduction in monthly migraine days (MMD) response thresholds, using data from the 6-month double-blind treatment phase (DBTP) of the Study to Evaluate the Efficacy and Safety of Erenumab in Migraine Prevention (STRIVE) pivotal clinical trial. ⋯ The responses at the ≥50%, ≥75%, and 100% thresholds provide context for establishing realistic patient and physician expectations regarding the magnitude of treatment benefit that may be achieved by patients with EM responding to erenumab (STRIVE, NCT02456740).