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F Titus

Publications and source records attributed to F Titus.

At least 19 recordsLinked to original sources
PubMed2004

Placebo-controlled comparison of effervescent acetylsalicylic acid, sumatriptan and ibuprofen in the treatment of migraine attacks.

Acetylsalicylic acid (ASA) in combination with metoclopramide has been frequently used in clinical trials in the acute treatment of migraine attacks. Recently the efficacy of a new high buffered formulation of 1000 mg effervescent ASA without metoclopramide compared to placebo has been shown. To further confirm the efficacy of this new formulation in comparison with a triptan and a nonsteroidal anti-inflammatory drug (ibuprofen) a three-fold crossover, double-blind, randomized trial with 312 patients was conducted in Germany, Italy and Spain. Effervescent ASA (1000 mg) was compared to encapsulated sumatriptan (50 mg), ibuprofen (400 mg) and placebo. The percentage of patients with reduction in headache severity from moderate or severe to mild or no pain (primary endpoint) was 52.5% for ASA, 60.2% for ibuprofen, 55.8% for sumatriptan and 30.6% for placebo. All active treatments were superior to placebo (P < 0.0001), whereas active treatments were not statistically different. The number of patients who were pain-free at 2 h was 27.1%, 33.2%, 37.1% and 12.6% for those treated with ASA, ibuprofen, sumatriptan or placebo, respectively. The difference between ASA and sumatriptan was statistically significant (P = 0.025). With respect to other secondary efficacy criteria and accompanying symptoms no statistically significant differences between ASA and ibuprofen or sumatriptan were found. Drug-related adverse events were reported in 4.1%, 5.7%, 6.6% and 4.5% of patients treated with ASA, ibuprofen sumatriptan or placebo. This study showed that 1000 mg effervescent ASA is as effective as 50 mg sumatriptan and 400 mg ibuprofen in the treatment of migraine attacks regarding headache relief from moderate/severe to mild/no pain at 2 h. Regarding pain-free at 2 h sumatriptan was most effective.

Adult↗
PubMed2001

Efficacy and safety of metamizol vs. acetylsalicylic acid in patients with moderate episodic tension-type headache: a randomized, double-blind, placebo- and active-controlled, multicentre study.

We assessed the efficacy and safety of oral single doses of 0.5 and 1 g metamizol vs. 1 g acetylsalicylic acid (ASA) in 417 patients with moderate episodic tension-type headache included in a randomized, double-blind, placebo- and active-controlled, parallel, multicentre trial. Eligibility criteria included 18-65 years of age, history of at least two episodes of tension-type headache per month in the 3 months prior to enrollment, and successful previous pain relief with a non-opioid analgesic. Treatment arms were metamizol 0.5 g (n = 102), metamizol 1 g (n = 108), ASA 1 g (n = 102) and placebo (n = 105). The analgesic efficacy of 0.5 and 1 g metamizol vs. placebo was highly statistically significant (alpha: 0.025; one-sided) for sum of pain intensity differences, maximum pain intensity difference, number of patients with at least 50% pain reduction, time to 50% pain reduction, maximum pain relief and total pain relief. A trend towards an earlier onset of a more profound pain relief of 0.5 and 1 g metamizol over 1 g ASA was noticed. All medications including placebo were almost equally safe and well tolerated.

Adolescent↗
PubMed1999

[Spanish study of quality of life in migraine (II). Profile of medication consumption and subjective efficacy].

OBJECTIVES: The response to the different antimigraine medications is variable. In this study we have analysed the profile of prescription of these antimigraine medications, both preventive and symptomatic, by a group of spanish neurologists and examined the subjective efficacy of these compounds. PATIENTS AND METHODS: Neurologists from 7 hospitals in different spanish regions interviewed 305 patients (at least 40 per hospital) who met migraine diagnostic criteria. They used an ad hoc questionnaire in which the antimigraine medications, both symptomatic and preventive, taken by the patients, as well as their subjective response were registered. Patients with transformed migraine or tension-type headache more than 2 days per week were excluded. RESULTS: Analgesics, non-steroidal anti-inflammatory drugs, ergotics and sumatriptan had been taken by 99, 69, 54 and 40% of the 305 interviewed patients, respectively. A subjective good response was refered to by 9% of patients who had taken analgesics, 23% of patients who had taken non-steroidal anti-inflammatory drugs, 39% of those who had taken ergotics and 63% of patients with sumatriptan. The current symptomatic treatment was: analgesics 34% of cases, non-steroidal anti-inflamatory drugs 26%, ergotics 13% and sumatriptan 63%. Regarding preventive treatments, 108 patients (35%) had been treated with calcium-antagonists, 87 (29%) with beta-blockers, 55 (18%) with amitriptyline and only 7 (2.2%) with valproic acid. The percentages of good responses to these drugs were: 55% for beta-blockers, 42% for calcium-antagonists and 31% for amitriptyline. CONCLUSIONS: Our data confirm that analgesics are not efficacious in the majority of migraine patients and that the advent of sumatriptan has clearly improved the quality of migrane symptomatic treatment, even though about one-third of migraine patients do not respond to this drug. This study confirm that calcium-antagonists are the antimigraine preventive treatment most frequently prescribed in our country, even though their subjective efficacy is lower than that of beta-blockers.

Analgesics, Non-Narcotic↗
PubMed1996

Recurrent paroxysmal headache associated with facial ecchymosis.

The case of a 58-year-old man with chronic paroxysmal headache and facial ecchymosis is described. The headache was pulsating, of short duration, without nausea or vomiting, and occasionally associated with flashing lights. Ecchymoses were mainly located in the middle forehead region and their appearance was associated with a reduction in intensity of the headache. Blood coagulation tests were within normal limits, and a skin biopsy of the ecchymotic lesion ruled out an underlying vasculitis. These attacks were difficult to include in any particular type of headache, although some aspects were similar to migraine headache. The possible mechanism of hemorrhages is discussed.

Basilar Artery↗
PubMed1994

[Mortality in the acute phase of cerebrovascular disease: the registry of La Alianza-Hospital Central of Barcelona].

BACKGROUND: Few studies have been performed on mortality from acute cerebrovascular disease (ACVD) during hospital admission, particularly in Spain. METHODS: A prospective clinical analysis was performed in 1,356 consecutive patients with ACVD included in the Registry of Cerebrovascular Disease of the Central La Alianza-Hospital in Barcelona (1986-1992) with the aim of analyzing the causes of mortality during the acute phase of the disease and the time of hospital survival. RESULTS: The mortality of the series was 16% (13% from cerebral infarction and 29% from cerebral hemorrhage; p < 0.0001). The causes of mortality were not neurologic in 49%, neurologic in 42% and of unknown cause in 9%. The principal causes of death were: transtentorial herniation/compression of the cerebral trunk (TH/CCT) 34%, pneumonia 14%, sepsis 14% and heart disease 11%. TH/CCT was more frequent on hemorrhage than on cerebral infarction (50% vs 27%; p < 0.001) while heart diseases were more frequent in cerebral infarction (14% vs 3%, p < 0.03). TH/CCT was the most common cause of death during the first seven days, with the pneumonia-sepsis-pulmonary thromboembolism being the most common after the third week. On the other hand, heart disease and sudden death showed homogeneous presentation with regard to frequency. CONCLUSIONS: The causes of death during the acute phase of acute cerebrovascular disease are principally non neurologic (49%) being potentially preventable with the most frequent causes of death being from pneumonia, sepsis and pulmonary thromboembolism. Mortality of these patients may be decreased on correct diagnosis and treatment.

Acute Disease↗
PubMed1994

Headache in acute cerebrovascular disease: a prospective clinical study in 240 patients.

To evaluate the clinical features of headache in stroke, a prospective study was carried out in 240 consecutive patients with acute stroke who had intact expressive function. Headache occurred in 38%: 32% of 195 patients with ischemic stroke and 64.5% of 45 patients with hemorrhagic stroke (p < 0.0001). Headache patients were younger (mean age 62 +/- 15 vs 67 +/- 11.5 years) than non-headache patients (p < 0.01). A history of previous vascular or tension-type headache was found in 40.5% of the headache group, but in only 23.5% of the non-headache group (p < 0.01). In ischemic stroke, headache was observed in 41% of thrombotic infarcts, in 39% of cardioembolic infarcts, in 23% of lacunar infarcts and in 26% of TIA. Headache was significantly more common in thrombotic than lacunar infarcts (p < 0.05). In hemorrhagic stroke, headache was observed in all subarachnoid hemorrhages and in 58% of intraparenchymal hemorrhages. In ischemic stroke, the mean duration of the headache was 25 +/- 28 h and in hemorrhagic stroke 64.5 +/- 36.5 h (p < 0.00001). In ischemic stroke the headache was focal in 74% and mild or moderate in intensity in 74%. In hemorrhagic stroke, it was diffuse in 52% and the pain intensity was incapacitating in 70%. Headache was more common in vertebrobasilar stroke (59%), in comparison with carotid stroke (26%) or stroke of unclear vascular topography (33%) (p < 0.00001). Fifty-six and a half percent of patients with cortical stroke had headaches, as opposed to only 26.5% of patients with subcortical stroke (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1993

[An analysis of 1000 consecutive patients with acute cerebrovascular disease. The registry of cerebrovascular disease of La Alianza-Hospital Central of Barcelona].

BACKGROUND: Registries of cerebral vascular disease (CVD) are useful in the study of the natural history of acute cerebrovascular disease (ACBD). Nonetheless there are few series which analyze the different stroke subtypes (SS) of CVD. METHODS: A descriptive and comparative clinical analysis was performed of the different SS of CVD from the registry of CVD of the La Alianza-Central Hospital of Barcelona (Spain). A prospective study of 1,000 consecutive patients with ACVD admitted in the Neurology Department from 1986-1991 was carried out. The registry recommended by the Study Group of Cerebrovascular Diseases of the Sociedad Española de Neurología (SEN) were used and the stroke subtypes classified in agreement with the Glossary of Neurology of the SEN. RESULTS: The mean age of the series was of 71 +/- 13 years with 537 patients being males. The frequency of the stroke subtypes in focal cerebral ischemia (FCI) was: thrombotic infarction 26%, lacunar infarction 16.9%, essential infarction 14.8%, cardioembolic infarction 12.4%, transient ischemic attacks 9% and infarction of unusual cause 3.5%. The frequency of the SS in cerebral hemorrhage (CH) was: intraparenchymatous hemorrhage 14.1%, subarachnoid hemorrhage 2.0%, subdural hematoma 1.2% and epidural hematoma 0.1%. Mortality of the series was 16.7% predominating in CH (28%) versus FCI (14%) (p < 0.00001). This was found to be greatest in cases of intraparenchymatous hemorrhage (31%) and in the cardioembolic infarction (28%) and lowest in the lacunar infarctions (0.6%). CONCLUSIONS: The most common stroke subtypes were those of thrombotic infarctions, lacunar infarctions and intraparenchymal hemorrhages. Essential infarctions constitute 14.8% of acute cerebral vascular disease. The classification of cerebral vascular disease in its different subtypes is recommendable since this has prognostic and therapeutic implications.

Acute Disease↗
PubMed1993

[Headache in acute cerebrovascular ischemic disease: a prospective clinical study of 195 patients].

BACKGROUND: Headache is a little known aspect in the study of acute ischemic cerebrovascular disease (AICVD). METHODS: To contribute to the knowledge of the clinical characteristics of headache in the different nosologic entities of AICVD a prospective study was performed in 195 patients consecutively studied by CT scan and/or cerebral MRI. RESULTS: There was headache in 32% of the total and in 41% of the thrombotic infarctions, 39% of the cardioembolisms, 26% of the transient ischemic attacks (TIA) and 23% of the lacunar infarcts. The mean duration was 25 +/- 28 hours. Headache was focal in 74% of the cases and of slight or moderate intensity in 74%. Headache was significantly more common in thrombotic infarctions than in lacunar ones (p < 0.05). It was more frequent when the topography is vertebrobasilar (57.5%), in comparison with carotid (21%) or undetermined (17.5%) (p < 0.0001). Headache was more common when topography was cortical (56.5%) in comparison with subcortical (26.5%) (p < 0.005). Eight per cent of the patients presented sentinel headache: 22% of the cardioembolic infarctions, 7% of the lacunars, 6.5% of the TIA and 5.5% of the thrombotic. CONCLUSIONS: Headache in acute ischemic cerebrovascular disease is not uncommon predominating in thrombotic infarctions and cardioembolisms of cortical topography and of vertebrobasilar vascular territory.

Acute Disease↗
PubMed1993

[Migraine-infarct in patients treated with beta-blockers].

Migraine in itself is a potential cause of cerebral infarct in young adults. However the mechanism of migrainous ictus is open to discussion. Some drugs (oral anticonceptives, ergotaminics) could favor its appearance. Three cases has described in the medical literature of migraine patients in whom betablockers administration has been related with onset of an ischemic ictus. We present two new cases of this association. Nonselective betablockers provoke an increase in platelet activity by stimulation of platelet alpha-2 receptors; this together with their vasoconstrictor effect could favor the apparition of cerebral infarction in patients with migraine. We suggest, following other authors, to include non selective betablockers in the group of drugs which have to be carefully managed in the patients with migraine, especially in those with the classical type (migraine with aura) in whom an initial vasoconstriction has been suggested.

Acute Disease↗
PubMed1993

[Pure motor hemiparesis secondary to chronic subdural hematoma with total recovery through medical treatment].

We discuss in this paper the cases of two patients with pure motor hemiparesis which were secondary to chronic subdural hematoma who evolved satisfactorily only with medical treatment. Of 1,000 consecutive patients with cerebro-vascular pathology admitted in our Neurology Department in the last 5 years, said two patients were the only ones (0.2%) in whom the lacunar syndrome "pure motor hemiparesis" was secondary to a chronic subdural hematoma. Such cases show that a subdural hematoma can manifest itself as a lacunar syndrome and that in selected cases the medical treatment of chronic subdural hematoma can yield goods results.

Aged↗