摘要:

The definition of headache syndromes in the past have lacked precision, not only because different terms have been used for the same condition, but also because there is no general agreement on the essential characteristics of each. Since even minor variations will produce marked differences in case series purporting to be of the same disorder, it is important to get general agreement and to improve on previous classifications of headache.

ISSN:0251-5350    

DOI:10.1159/000110231

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Treatment of migraine attacks and prophylactic treatment of migraine are each discussed under the four headings: patient selection, trial design, evaluation of results and statistics. Checklist of problems encountered in these trials are given in the tables. The unsuitability of currently used migraine definitions for scientific investigations is stressed. Operational diagnostic criteria for common and classic migraine are given. No clear separation of common migraine attacks and interval headaches is possible, but the problem can be reduced by setting an upper limit (4–6/month) on migraine attack frequency. For the treatment of migraine attacks, the crossover design should always be used. We suggest dose-response studies to solve the problem of equipotency of doses, when 2 drugs are compared. A prophylactic drug should be studied both with the crossover design and with the less powerful group comparison design. Evaluation of results should be based on patients'' attack report forms and, in prophylactic studies, a headache diary. We suggest global rating of attack severity. A rather simple headache index (sum of severity scores for each day with migraine) and perhaps a sum of global scores should be used in prophylactic trials. Confidence limits and power should be given, particularly when statistically insignificant results are reported. Migraine frequency often decreases with time regardless of treatment, and this ''time effect'' should be separated from the therapeutic effect by appropriate statistical method

ISSN:0251-5350    

DOI:10.1159/000110232

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Treatment of migraine attacks and prophylactic treatment of migraine are each discussed under the four headings: patient selection, trial design, evaluation of results and statistics. Checklist of problems encountered in these trials are given in the tables. The unsuitability of currently used migraine definitions for scientific investigations is stressed. Operational diagnostic criteria for common and classic migraine are given. No clear separation of common migraine attacks and interval headaches is possible, but the problem can be reduced by setting an upper limit (4–6/month) on migraine attack frequency. For the treatment of migraine attacks, the crossover design should always be used. We suggest dose-response studies to solve the problem of equipotency of doses, when 2 drugs are compared. A prophylactic drug should be studied both with the crossover design and with the less powerful group comparison design. Evaluation of results should be based on patients'' attack report forms and, in prophylactic studies, a headache diary. We suggest global rating of attack severity. A rather simple headache index (sum of severity scores for each day with migraine) and perhaps a sum of global scores should be used in prophylactic trials. Confidence limits and power should be given, particularly when statistically insignificant results are reported. Migraine frequency often decreases with time regardless of treatment, and this ''time effect'' should be separated from the therapeutic effect by appropriate statistical method

ISSN:0251-5350    

DOI:10.1159/000110233

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Prior research into multiple sclerosis prognosis has produced conflicting results. This paper presents an original approach in which the disease course is described by the movements of patients through well-defined disease states. A Markov model is proposed to describe these movements and to evaluate the effect of prognostic factors on transitions from state to state. The feasibility and applicability of this model is determined using data on the course of disease in 278 diagnosed patients from Lyon. Patients with older age at onset, females, and those with monosymptomatic onset are found to be at a higher risk of transition to a worse disease state.

ISSN:0251-5350    

DOI:10.1159/000110234

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

A fatal spongiform encephalopathy of sheep and goats (scrapie) shares many characteristics with Creutzfeldt-Jakob disease (CJD), a similar dementing illness of humans. To investigate the possibility that CJD is acquired by ingestion of contaminated sheep products, we collected information on production, slaughtering practices, and marketing of sheep in Pennsylvania. The study revealed that (1) sheep were usually marketed before central nervous system signs of scrapie are expected to appear; (2) breeds known to be susceptible to the disease were the most common breeds raised in the area; (3) sheep were imported from other states including those with a high frequency of scrapie; (4) use of veterinary services on the sheep farms investigated and, hence, opportunities to detect the disease were limited; (5) sheep producers in the area knew little about scrapie despite the fact that the disease has been reported in the area, and (6) animal organs including sheep organs were sometimes included in processed food. Therefore, it was concluded that in Pennsylvania there are some ''weak links'' through which scrapie-infected animals could contaminate human food, and that consumption of these foods could perhaps account for spongiform encephalopathy in humans. The weak links observed are probably not unique to Pennsylvania.

ISSN:0251-5350    

DOI:10.1159/000110235

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110236

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110237

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110238

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110239

出版商:S. Karger AG    

年代:1985

数据来源: Karger