The journal of headache and pain
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To investigate the difference in diagnostic reliability between self-instructed examiners and examiners taught in a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) course and if the reliability of self-instructed examiners improves after the course. ⋯ This study shows that the diagnostic reliability of formal DC/TMD training and calibration and DC/TMD self-instruction are similar, except for subgroups of Myalgia. Thus, self-instruction seems to be possible to use to diagnose the most common TMDs in general dental practice. The course further improves the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence.
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This study aimed to identify the systemic and cerebral hemodynamic characteristics and their roles in high-altitude headache (HAH) among young Chinese men following acute exposure. ⋯ HAH was characterized, in part, by increased systemic hemodynamics and posterior cerebral circulation, which was reflected by the BA and left VA velocities, and lower arterial resistance and compliance. Furthermore, baseline CO and V(m) in left VA or right MCA at sea level were independent predictors for HAH, whilst bilateral VA asymmetry may contribute to the development of HAH at high altitude.
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Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so that deficiencies in headache care worldwide might be recognized and rectified. These indicators themselves require evaluation and proof of fitness for purpose. This pilot study begins this process. ⋯ This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service quality evaluation was successful. The project is ready to be taken into its next stages.
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Although mostly mild in symptom severity, tension-type headache (TTH) can cause disability. However, factors associated with disability of TTH have been rarely reported. This study sought to assess the factors associated with TTH-related disability and impact. ⋯ Several headache characteristics were associated with actual disability and headache impact among TTH individuals. Our findings suggest that there needs to be consideration careful of troublesome headache characteristics for TTH individuals suffering from disability and impact.
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Premenopausal migraines frequently are associated with fluctuations of estrogen levels. Both, migraine and combined hormonal contraceptives (CHC) increase the risk of vascular events. Therefore progestagen-only contraceptives (POC) are a safer alternative. A previous short-term study demonstrated a positive impact of the oral POC desogestrel on migraine frequency. To study the effect of the POC desogestrel 75 μg on migraine frequency, intensity, use of acute medication and quality of life in a clinical setting over the period of 180 days. ⋯ Contraception with desogestrel 75 μg resulted in a significantly improved quality of life and a reduction of migraine days over the observation period of 180 days. A clinically meaningful 30% reduction in pain was observed in 25/42 (60%) participants. For counselling reasons it is of importance, that the major reduction in migraine frequency occured during the initial 90 days, however further improvement occurs with longer duration of use. Prospective studies are needed to confirm these results.