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Biomedical subjects

A Prusiński

Publications and source records attributed to A Prusiński.

At least 19 recordsLinked to original sources
PubMed1999

[Feverfew as a prophylactic treatment of migraine].

Feverfew has been used in traditional medicine in the treatment of migraine for a long time. In 1985 E.S. Johnson et al. and later J.J. Murphy et al., 1988 and B.K. Vogler et al., 1994 published positive results of prophylactic use of this herb in migraine. Since 1994 through 1996 we studied in our Centre of Migraine Therapy the efficacy of feverfew in migraine treatment. We had 24 patients (women 19-61 years old) in our group. The drug was administered once daily (5 ml of the sap) for 30-60 days. We observed significant reduction of Migraine Index in 8 patients, less significant in additional 5. Our results confirm that feverfew may be beneficial in migraine prophylaxis as an additive drug. Further controlled studies need to be done, especially to establish the optimal dose of the drug.

Adolescent↗
PubMed1999

[Selected problems for discussion of procedures in epilepsy].

In neurological practice epilepsy treatment has a special place. Among the problems encountered by us in this connection every day the following are worth mentioning: Differential diagnosis of epileptic seizure against psychogenic fits and fainting. Management of the first seizure /treatment starting?/. How EEG tracings should be related to clinical status? Should imaging examination be suggested? Treatment programme /doses, mono- or polytherapy, new generation drugs/ Can anticonvulsants worsen epilepsy? Indications to surgical treatment. Whether and when anticonvulsants should be withdrawn in case of remission? Should treatment be given prophylactically after injury or stroke? How to deal with late onset epilepsy? What is the significance of concomitant diseases? The purpose of this lecture is to incite personal consideration of these matters and discussion on these problems in which it is difficult to take optimal decision.

Adult↗
PubMed1999

[Drug rebound headaches].

The term "drug rebound headache" refers to headaches occurring every day in patients with migraine and tension headaches as a consequence of taking analgesics or ergotamine every day. Their cause is a vicious circle mechanism. This form of headache has been discovered in recent years and it is supposed that about 20% of patients with chronic headaches belong to that category. The only way to disrupt this vicious circle is immediate complete abandoning of these drugs. The abstinence period with associated troublesome symptoms lasts several to up to 20 days. Antidepressants are given for their alleviation. The author prescribes opipramol /Pramolan/ which is taken by increments from half tablet up to three in 6 days and the treatment is then continued for 4-6 weeks. From the 6th day on the patient should completely discontinue taking of analgesics. The material observed by the author comprises 47 patients /45 women/ aged 19-57 years, mean age 41 years, with these headaches continuing since 1-12 years /mean 3.0 years/. The above described method gave good results in 32 cases. In 10 cases complete withdrawal of analgesics was not possible by this method was abandoned accepting that their headaches were not due to drug abuse.

Adult↗
PubMed1999

[Emergency treatment of migraine attacks with particular reference to agonists of 5-HT1B/1D receptor].

The author discusses the modern methods of emergency controlling of migraine attacks, especially the recently introduced drugs agonists of the 5-HT 1B/1D receptor /Sumatriptan, Zolmitriptan/ and prophylactic treatment. In light and moderately severe attacks analgesics are usually effective as well as non-steroid antiinflammatory drugs /paracetamol, acetylsalicylic acid, naproxen, diclofenac, ibuprofen, ketoprofen etc./ with or without addition of caffeine and codeine, and metoclopramide /for suppression of nausea and vomiting/ or Torecan. Ergotamine is still in use, although it can produce serious adverse effects. An essential advance in the treatment of more severe attacks was achieved with the introduction of Sumatriptan, a selective 5-HT1D receptor agonist in 1988. In pursuing this direction further indole derivatives /so called triptans/ were introduced. Zolmitriptan introduced in 1994 is an agonists of 5-HT 1B/1D receptor, is active both peripherally and centrally, is well absorbed from the digestive tract and has a good bioavailability index /40%/. In 2.5 mg doses it causes regression or marked alleviation of migraine attack within 2 hours in 70% of cases. Administration of a second dose after that time increases the percentage of successes. Adverse effects are usually mild, coronary complication have not yet been described. Prophylactic treatment is given to patients with attack frequency over 2 in a month. For that treatment usually dihydroergotamine, pisotifen, propranolol, metoprolol, flunarizin, valproic acid, iprasochrom and oxetoron are given.

Analgesics↗
PubMed1999

[Insomnia and its treatment].

Insomnia is a very frequent complaint /periodically or permanently it affects about 35% of the population/ and is a serious sociological problem. This term covers at least four types of sleep disorders: difficult falling asleep, frequent awakening, too early awakening and impairment of sleep quality--sleep quantitatively sufficient but failing to produce a feeling of rest. Insomnia may be sporadic, short-lasting and chronic. The last type requires particularly medical assistance since impairment of sleep quality can lead to drug dependence. In every case of insomnia it should be tried to explain its cause /neurosis, depression, somatic diseases with symptoms leading to sleep disturbances, toxic factors such as alcohol, drugs, inappropriate sleep hygiene etc./. In the treatment the basic role is played by removal of causes and better observation of sleep hygiene. Hypnotic drugs are indicated in sporadic and short-lasting insomnia, but in chronic insomnia they should be used cautiously and not continuously. Barbiturates have been abandoned recently and benzodiazepines have replaced them. They are, however, fraught with numerous faults. Cyclopyrolones /Zolpidem, Zopiklon/ are the new generation of hypnotic drugs in which the negative features of benzodiazepines have been partly excluded. Their half-life is short, they cause no rebound effect, adverse effects are better tolerated and are less frequent, drug dependence is not produced.

Acute Disease↗
PubMed1998

[Evaluation of efficacy and tolerance sumatriptan at a dose of 50 mg in treatment of migraine attack].

Sumatriptan has been used successfully in the acute treatment of migraine since 1991. Most patients (70-80%) experience pain relief 2-4 hours after receiving 100 mg sumatriptan orally. During last few years efficacy of lower doses has been studied. Many authors proved that 50 mg of sumatriptan may be as effective as 100 mg. Our study confirmed that 50 mg oral dose of sumatriptan is sufficient in many patients. Headache relief was achieved in 58% of treated patients after single dose. The second dose of sumatriptan was effective in next 14% of patients. Totally headache relief after two doses of sumatriptan was achieved in 72% of patients. The sumatriptan 50 mg was well tolerated; only 10% of patients reported adverse events, which were minor and transient.

Administration, Oral↗
PubMed1994

[Present problems of migraine and similar headaches].

Headaches belong to the most frequent sufferings. According to certain most modern epidemiological studies about 20% of adults have recurrent headaches, among them particularly migraine and tension headache. In recent years the interest in these conditions had increased resulting in a great number of research works. A great role is played by the International Headache Society, and the newly formed European Federation of Headaches. In 1988 a universally accepted classification, and diagnostic criterias were elaborated and have been accepted by the Polish neurologists. Tens or research centres are studying the problems in this field. The main directions of studies are-the role of neurotransmitters, the vascular system of the head, the mechanisms of autonomic regulation, the role of neurogenic bland inflammation in the generation of pain, and the psycho-emotional factors. A number of new clinical forms of headache have been described. Therapeutic possibilities have also increased (beta-blockers, calcium blockers, serotonin receptor drugs, eg. sumatriptan, microsurgery of neuralgias etc). This opens a new period for satisfactory advances in that rather marginal, as yet, area.

Brain↗
PubMed1994

[Studies of heart rhythm variability in migraine. Preliminary communication].

Spectral analysis of hart rhythm variability makes possible assessment of the state (power) of autonomic innervation of the heart. The reported study was carried out in 40 patients (22 women) with migraine. The studies were done in times between migraine attacks. The control group comprised 62 clinically healthy subjects. In most patients (over 61%) the sympathetic and parasympathetic innervation of the heart was weaker than in healthy subjects and the index of automatic equilibrium in the sinus node was lower than in controls.

Adult↗
PubMed1992

[Sumatriptan and its use in treatment of migraine and cluster headaches].

The methods used presently for abortion of the attacks of migraine and cluster headache are not fully satisfactory which causes that the search for new therapies is continuing. Although the mechanism of migraine attacks remains unexplained, it is thought that an important role in it is played by serotonin receptors, vasodilation in certain regions and opening of arteriovenous communications in the head. Sumatriptan is an agonist of 5-HT1 -like receptors and exerts a selective vasoconstricting effect on the arteries of the head, particularly in the rami of the carotid artery. In 1988 the first reports appeared on the effectiveness of the drug in migraine attacks. In the following years extensive, multicentre and international studies of the drug were carried out on over 600 healthy volunteers and nearly 6000 patients with migraine. The studies demonstrated that Sumatriptan was effective in abortion of migraine attacks. After oral administration of 100 mg or subcutaneous injection of 6 mg in nearly 70% of cases the attack regressed or was greatly alleviated, similarly as other symptoms accompanying the headache such as photophobia, nausea, vomiting. Studies were undertaken also on the effectiveness of Sumatriptan in emergency treatment of cluster headache, and good results were again achieved. The tolerance of the drug is good, although in some cases side effects develop, usually transient and mild, among them tingling, feeling of pressure, heat or heaviness of the head or chest, taste change and burning sensation at the site of injection. Sumatriptan, similarly as all novel drugs, requires caution in its use, particularly in patients with coronary heart disease and hypertension, and also in old patients. As yet, the use of the drug in paediatric migraine or in pregnancy is not recommended.

Cluster Headache↗
PubMed1989

[So-called cervicogenic headache].

After a description of the clinical pattern of the newly isolated by Sjaastad et al. from of headaches, that is cervicogenic headache the authors report two own cases in women aged 37 and 57 years. The cases agreed completely with the description of Sjaastad et al. and other authors, and they enrich the number of case reports on this disease.

Adult↗
PubMed1987

Monotherapy or polytherapy in migraine.

The majority of current therapeutic papers concerns the prophylactic therapy of migraine using only one drug, very few advocating the simultaneous use of two drugs. The theoretical usefulness of polytherapy in migraine is examined with examples from personal experience, and found justified.

Barbiturates↗