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1.
Abstract The pain of cluster headache attacks is severe, excruciating and selectively responsive to subcutaneous sumatriptan. Serious
cardiovascular events attributed to sumatriptan are extremely rare and have most often been reported in patients at significant
cardiovascular risk, or in overt cardiovascular disease. They also have occurred, however, in patients without evidence of
cardiovascular disease. We describe a 42-year-old man with episodic cluster headache without history of coronary artery disease
who was admitted to our coronary care unit for acute myocardial infarction after 3 h of subcutaneous injection of sumatriptan.
During hospitalisation cluster headache attacks were successfully treated with e.v. indomethacin. 相似文献
2.
J. de Pedro-Cuesta V. Abraira G.-X. Jiang G. Solders S. Fredrikson 《Acta neurologica Scandinavica》1996,93(2-3):175-183
Using hierarchical cluster analysis, applied to 47 cases of Guillain-Barre Syndrome (GBS) incident in South-West Stockholm (SWS) during the period from January 1973 to June 1992, we identified three major clinicoepidemiological subgroups. The first subgroup, 25.5% of the cases (26.7 ± 6.7 years), recorded a peak incidence at ages 20–29 years and presented significant differences from other subgroups, a high proportion of cases with onset at low age preceded by respiratory infection (83.3%) and with normal motor conduction velocity (50.0%). Also found, were less affected biological parameters, a rapidly progressive course and independence in gait at one month after onset. A second subgroup, 27.7% of cases, was severely affected, clinically and functionally. It consisted predominantly of young individuals (22.7 ± 11.1 years), with a high incidence (69.2% of cases) in autumn. A third subgroup, comprising 40.47; of cases, was older (61.1 ± 11.0 years) and, in general, also severely affected. The incidence of this form appeared to be invariant with time. 相似文献
3.
Data from a 1988 national drinking survey was cluster analysedto identify different types of male drinkers, to assist in thetargeting of health promotion strategies. Of the five segmentsgenerated by the clustering, one labelled Young Heavy DrinkingMales was identified as the most appropriate target segment,because although they were the segment reporting the highestlevel of alcohol-related problems they were also the segmentmost likely to feel they were drinking too much They were thereforethe segment most likely to be responsive to advertising thatsought to support people who wanted to change their drinkinghabits. They were also the most appropriate target for the longer-termgoal of changing the climate of opinion regarding the acceptabilityof more moderate drinking. Comparisons with two previous clusteranalyses showed a high degree of similarity, suggesting thatclustering is a reliable vehicle for identifying drinker types. 相似文献
4.
《Headache》1993,33(2):98-104
SYNOPSIS
Respiratory sinus arrhythmia is regarded as indicative of cardiac vagal integrity. A ratio of the longest R-R interval to the shortest R-R interval during deep breathing test (E:I ratio) was calculated in controls (n=49), cluster headache (n=33) and CPH (n=4) patients, E:I ratio decreased with age but was not dependent upon sex or upon smoking habits. Furthermore, there were no significant differences as regards E:I ratio between cluster headache patients in and outside a bout, or between patients with right-sided and left-sided headache. However, the E:I ratio was found to be significantly lower in the cluster headache group as such, when compared with controls, but the number of patients disclosing pathological or borderline results was small, 2 and 2, respectively. This may indicate that a putative vagal dysfunction in cluster headache is usually less marked than in patients with e.g. diabetic autonomic neuropathy. Significant attack-related change in the E:I ratio were detected in all individual patients though these changes were not of a uniform nature from individual to individual. E:I ratios were rather high in 3 out of 4 CPH patients examined. However, the number of patients in this group is too small to allow definite statements about the difference between CPH end cluster headache with regard to E:I ratios. There was no significant difference between E:I ratios outside and during a mild, short, mechanically precipitated attack in a single CPH patient. 相似文献
Respiratory sinus arrhythmia is regarded as indicative of cardiac vagal integrity. A ratio of the longest R-R interval to the shortest R-R interval during deep breathing test (E:I ratio) was calculated in controls (n=49), cluster headache (n=33) and CPH (n=4) patients, E:I ratio decreased with age but was not dependent upon sex or upon smoking habits. Furthermore, there were no significant differences as regards E:I ratio between cluster headache patients in and outside a bout, or between patients with right-sided and left-sided headache. However, the E:I ratio was found to be significantly lower in the cluster headache group as such, when compared with controls, but the number of patients disclosing pathological or borderline results was small, 2 and 2, respectively. This may indicate that a putative vagal dysfunction in cluster headache is usually less marked than in patients with e.g. diabetic autonomic neuropathy. Significant attack-related change in the E:I ratio were detected in all individual patients though these changes were not of a uniform nature from individual to individual. E:I ratios were rather high in 3 out of 4 CPH patients examined. However, the number of patients in this group is too small to allow definite statements about the difference between CPH end cluster headache with regard to E:I ratios. There was no significant difference between E:I ratios outside and during a mild, short, mechanically precipitated attack in a single CPH patient. 相似文献
5.
6.
Linda R White Lars Jacob Stovner Maurice B Vincent Ole Petter Løbben Yara D Fragoso Kristian S Bjerve Ottar Sjaastad 《Cephalalgia : an international journal of headache》1992,12(2):107-110
Our group has previously reported significant changes in the incorporation of precursors into glycerophospholipids, particularly phosphatidylserine, in polymorphonuclear cells obtained from the peripheral blood of cluster headache patients, when compared with controls. The potential of these results led to further work using both the previous methodology and a modified isolation technique to obtain polymorphonuclear cells in as pure a state as possible. Neither the new results obtained using the original technique, nor the results with high purity polymorphonuclear cells from controls and cluster headache patients, confirm the marked changes in precursor uptake into glycerophospholipids originally reported. 相似文献
7.
Leukemia clusters around nuclear facilities in Britain 总被引:1,自引:0,他引:1
Brian McMahon 《Cancer causes & control : CCC》1992,3(3):283-288
He bas been retained for the defense by British Nuclear Fuelsplc in two suits in which leukemia and non-Hodgkin's lymphoma have been alleged to result from radiation exposures due to the operation of the nuclear reprocessing plant at Sellafield. This paper has been sent to the senior authors of the papers reporting clusters of leukemia or other malignancy in the vicinity of nuclear facilities in Britain and their comments invited. Subject to considerations of space and CCC style, these comments will be published as submited. 相似文献
8.
How Cluster Headache is Explained as an Intracavernous Inflammatory Process Lesioning Sympathetic Fibers 总被引:2,自引:0,他引:2
SYNOPSIS
A large body of evidence points to an inflammatory process in the cavernous sinus and tributary veins as being primarily responsible for cluster headaches. The inflammation obliterates the venous outflow from the cavernous sinus on one side and injures the through-running sympathetic fibers to the eye, upper eye lid, forehead skin, and the intracranial internal carotid artery and its branches. The active period ends when the inflammation is suppressed and the sympathetic fibers partially or fully recover. Evidence is presented that the symptoms suggestive of an enhanced parasympathetic activity during attacks may alternatively be explained as local pain fiber activation or a stasis in the outflow from the cavernous sinus. Vasodilator agents like nitroglycerin induce an attack by enhancing the venous load on the cavernous sinus. Constriction of the proximal intracranial internal carotid artery, spontaneously induced by tressful pain activation of the perivascular sympathetic nerves, or by exogenous administration of serotonin 1 D-like receptor agonists or oxygen, terminates the venous load and thus the pain and associated symptoms. 相似文献
A large body of evidence points to an inflammatory process in the cavernous sinus and tributary veins as being primarily responsible for cluster headaches. The inflammation obliterates the venous outflow from the cavernous sinus on one side and injures the through-running sympathetic fibers to the eye, upper eye lid, forehead skin, and the intracranial internal carotid artery and its branches. The active period ends when the inflammation is suppressed and the sympathetic fibers partially or fully recover. Evidence is presented that the symptoms suggestive of an enhanced parasympathetic activity during attacks may alternatively be explained as local pain fiber activation or a stasis in the outflow from the cavernous sinus. Vasodilator agents like nitroglycerin induce an attack by enhancing the venous load on the cavernous sinus. Constriction of the proximal intracranial internal carotid artery, spontaneously induced by tressful pain activation of the perivascular sympathetic nerves, or by exogenous administration of serotonin 1 D-like receptor agonists or oxygen, terminates the venous load and thus the pain and associated symptoms. 相似文献
9.
支气管扩张症辨证模式初探 总被引:4,自引:0,他引:4
目的:探讨支气管扩张症的中医辨证分型规律及证候特点.方法:通过对563例支气管扩张症的临床流行病学调查,采集以症状、体征、舌、脉及相关理化检测为变量的基本信息,以频数分析、聚类分析、方差分析等方法,提炼支气管扩张症的证候分布规律及证候特点.结果:临床上支气管扩张症多见4种证候类型,分别为痰热壅肺证(45.65%)、肝火犯肺证(24.51%)、肺脾气虚证(22.38%)、气阴两虚证(7.46%).结论:较大样本的临床流行病学调查为研究支气管扩张症辨证分型规律提供了科学依据,并可以通过主症判别分析法建立证候识别模式,为临床实践提供依据. 相似文献
10.
Boiardi A. Gemma M. Porta E. Peccarisi C. Bussone G. 《The Italian Journal of Neurological Sciences》1986,7(5):531-534
15 chronic cluster headache patients in whom pain was induced by nitroglycerin received acute intravenous treatment with a
calcium entry blocker. At the time of peak pain we noted a sudden decrease after the Verapamil injection. The mechanism by
which the calcium entry blocker afforded relief is unlikely to have been vasodilatation in patients whose blood vessels had
just been dilated by nitroglycerin. A more probable mechanism is blockade of the release of the pain-inducing neurotransmitters.
The vasodilatation phase is not a primary factor in the onset of pain.
Sommario Sono stati studiati 15 soggetti affetti da Cluster cronica inducendo loro la crisi dolorosa con Trinitrina, trattandoli poi con calcio antagonista (Verapamil) per via endovenosa. Al momento dell'apice del dolore, valutato dal paziente con un analogo visivo, la somministrazione di Verapamil endovena, determina una rapida estinzione del dolore. L'azione efficace del Ca-antagonista non può sicuramente essere rapportata alla vasodilatazione poiché la crisi dolorosa insorge già in una fase di vasodilatazione per l'azione della Trinitina. Il meccanismo d'azione più probabile è il blocco del release di neurotrasmettitori inducenti l'attacco doloroso. Si sottolinea che la vasodilatazione non è il fattore primario dell'induzione del dolore.相似文献