Current pain and headache reports
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Growth hormone is essential for normal linear growth and the attainment of an adult mature height. It also plays an important role in cartilage growth and the attainment of normal bone mass. ⋯ However, there is increasing appreciation that suboptimal growth hormone secretion, leading to a state of adult growth hormone deficiency, may occur in the setting of chronic inflammatory disease, chronic corticosteroid use, and fibromyalgia. Therefore, the evaluation and effective management of growth hormone oversecretion and undersecretion is relevant to practicing rheumatologists.
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Curr Pain Headache Rep · Oct 2005
ReviewManagement of migraine in children and adolescents in the emergency department and inpatient setting.
Migraine is a chronic disorder that can be debilitating, especially when the attacks are severe and frequent. Children and adolescents are significantly affected. The prevalence of migraine in this age group is higher than predicted due to more recognition of the disease in this population throughout the past century. ⋯ Multiple medications are used to break an acute attack. Most approaches are based on outpatient treatments and include the use of over-the-counter medications and triptans and narcotics. This manuscript reviews most of the available therapies for acute treatment of primary headache that did not respond to outpatient management.
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Curr Pain Headache Rep · Oct 2005
Review Case ReportsReview of the Chinese medical approach to the management of fibromyalgia.
Traditional Chinese medicine (TCM) has a long history of efficacy in treating chronic illness. TCM views fibromyalgia and related conditions as disorders in the movement of energy (Qi) and body fluids (including blood) in the body and gets excellent treatment results using acupuncture, herbal medicine, massage, diet, and exercise to restore the proper flow of Qi and fluids. This article briefly introduces the TCM model of human physiology and TCM diagnostics and describes the TCM pathophysiology and treatment models for fibromyalgia.
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The American Academy of Neurology recently has published two practice parameters pertaining to children and adolescents with headache. The first focuses attention on the appropriate evaluation of the child with recurrent headache and reviews the data regarding laboratory investigation, electroencephalography (EEG), and neuroimaging. ⋯ If there are abnormalities on the neurologic examination (eg, focal findings, signs of increased intracranial pressure, significant alteration of consciousness) or the coexistence of seizures, then neuroimaging is recommended. The second parameter evaluates relevant data regarding the acute and preventive therapies for pediatric migraine.
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Persistent myalgia following whiplash is commonly considered the result of poor psychosocial status, illness behavior, or failing coping skills. However, there is much evidence that persistent myalgia may be due to neurophysiologic mechanisms involving peripheral and central sensitization. ⋯ Recent research suggests that the chemical environment of myofascial trigger points is an important factor. Several consequences are reviewed when central pain mechanisms and myofascial trigger points are included in the differential diagnosis and in the management of patients with persistent pain following whiplash.