Acta neurologica Scandinavica
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Acta Neurol. Scand. · Jul 2018
Painful musculosceletal disorders and depression among working aged migraineurs.
Musculoskeletal disorders and depression are common among migraineurs. The aim of our study was to evaluate the occurrence of these disorders among working aged migraineurs. ⋯ Recognition of comorbid musculoskeletal disorders and mood disorders among migraineurs needs targeted outreach in working aged population. The acute and preventive treatments to control for neuronal sensitization in migraine and comorbid pain disorders may benefit of individual treatment plan and tailored use of antidepressants.
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Botulinum toxin serotype A (BoNT/A) was originally used in neurology for the treatment of dystonia and blepharospasms, but is now clinically used worldwide for the treatment of chronic migraine. Still, the possible mode of action of BoNT/A in migraine is not fully known. However, the mode of action of BoNT/A has been investigated in experimental pain as well as migraine models, which may elucidate the underlying mechanisms in migraine. ⋯ The mechanisms behind the effect of BoNT/A in chronic migraine may also include modulation of neurotransmitter release, changes in surface expression of receptors and cytokines as well as enhancement of opioidergic transmission. Clinical and experimental studies with botulinum toxin in the last decade have advanced our understanding of headache and other pain states. More research into botulinum toxin as treatment for headache is warranted as it can be an attractive alternative for patients who do not respond positively to other drugs.
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Acta Neurol. Scand. · May 2018
Observational StudyA shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service.
We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. ⋯ Patients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.
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Acta Neurol. Scand. · Jan 2018
Midazolam vs diazepam in prolonged seizures in children: A pharmacoeconomic approach.
A previous European cost-utility study reported that use of buccal midazolam in the community setting for the treatment of prolonged seizures (ie, seizures lasting ≥5 minutes) in children was associated with an overall €12 507 399 reduction in annual costs charged to the Italian national health service compared with rectal diazepam. We re-evaluated these findings by applying a more conservative approach. ⋯ In this more conservative revised analysis, the high cost of buccal midazolam is still counteracted by greater cost savings compared with rectal diazepam, but cost reduction was less than previously estimated.
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The impact of electrolyte imbalance on clinical outcomes after acute ischemic stroke (AIS) is still not understood. We investigated the association between hypochloremia and hyponatremia upon hospital admission and in-hospital mortality in AIS patients. ⋯ Hypochloremia at admission was independently associated with in-hospital mortality in AIS patients.