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Biomedical subjects

G D Solomon

Publications and source records attributed to G D Solomon.

At least 37 records · Page 2Linked to original sources
PubMed1995

Quality of life assessment among migraine patients treated with sumatriptan.

PURPOSE: Quality of life evaluations can enhance traditional measures of therapeutic efficacy. The purpose of our study was to evaluate the impact of sumatriptan on the quality of life of patients with migraine headaches. PATIENTS AND METHODS: Migraine patients who were given a prescription for sumatriptan completed an SF-36 questionnaire and a nine-item pain questionnaire. Six to 9 months later, patients were mailed another copy of the SF-36 and the nine-item pain questionnaire. We compared the pretreatment and posttreatment scores for the SF-36 and for each question of the nine-item pain questionnaire. RESULTS: The pretreatment SF-36 was completed by 255 patients. The pretreatment pain questionnaire was completed by 86 of these patients. Follow-up questionnaires were returned by 147 patients (58%). Three of the eight SF-36 scales: role functioning--physical, bodily pain, and social functioning showed significant (P < 0.05) improvement with treatment. On the nine-item pain-specific questionnaire, three items--pain interference with normal work, ability to walk or move about, and enjoyment of life showed statistically significant (P < 0.05) improvement after sumatriptan treatment. CONCLUSIONS: Sumatriptan caused a significant improvement in the quality of life of patients with very severe migraine. This improvement was measurable by both the general quality of life instrument and the pain-specific questionnaire.

Health Status↗
PubMed1994

Psuedoaneurysm within the cavernous sinus presenting as cluster headache.

Cluster headache and its associated signs and symptoms have been described in medical literature for years. The etiology of this condition remains unresolved. We describe a unique patient who presented with a cluster headache syndrome concurrent with new-onset pseudoaneurysm within the cavernous sinus. Our review and analysis of this patient confirms current theories which describe the role of the cavernous sinus as a locus of pathology in cluster headache.

Angiography, Digital Subtraction↗
PubMed1994

Does quality of life differ among headache diagnoses? Analysis using the medical outcomes study instrument.

BACKGROUND: To analyze the differences in quality of life associated with headache diagnoses using the Medical Outcomes Study Short Form Health Survey (SF-20). METHODS: A patient interview survey using the SF-20 Short Form Health Survey was conducted in a headache clinic within a multi-specialty group practice. All six health components of the SF-20 were included in the study. Headache diagnoses were made using IHS criteria. RESULTS: 208 consecutive headache patients were studied. Patients with cluster headache had a significantly higher (worse) pain score (P < 0.018) and higher percentage of patients with poor health due to pain (P < 0.005) than patients with migraine headache. There were fewer cluster patients with poor health associated with physical functioning than tension-type (P < 0.020) or mixed headache (P < 0.022) patients. Poor health associated with social functioning was greater for cluster (P < 0.011) and tension-type headache (P < 0.015) than for migraine. There was a significantly higher percentage of tension-type headache patients with poor health associated with mental health (P < 0.002) than patients with migraine. CONCLUSIONS: The SF-20 is a reliable and valid measure of quality of life for patients with different headache diagnoses. Distinct headache diagnoses are marked by unique patterns of impairment and quality of life.

Adolescent↗
PubMed1994

Substance P: correlation of CSF and plasma levels.

OBJECTIVE: To determine the correlation between cerebrospinal fluid and plasma concentrations of substance P. PATIENTS: 37 patients undergoing lumbar puncture for various diagnostic purposes. MEASUREMENTS: Samples of cerebrospinal fluid and blood were obtained at the same visit. Substance P was measured by radioimmunoassay technique. At least 4 separate measurements were conducted on each sample to insure accuracy. RESULTS: The mean plasma SP level was 1.195 (+/- 1.1). The mean cerebrospinal fluid substance P level was 1.075 (+/- .07). There was a statistically significant positive correlation between substance P level in the plasma and cerebrospinal fluid. The Pearson correlation coefficient was 0.656 (P < .0001) and the Spearman correlation coefficient was 0.698 (P < .0001). CONCLUSIONS: Plasma substance P levels closely correlate with cerebrospinal fluid substance P levels. This will simplify the measurement of substance P in the evaluation of therapeutic agents for headache.

Adult↗
PubMed1994

Quality-of-life assessment in patients with headache.

Although headache is the most common pain complaint seen by primary care physicians, the measurement of quality of life in patients with headache is in its earliest stages. Most of the research has been published within the past 2 years, much of it only in abstract form. Quality-of-life data derived from the Medical Outcomes Study instrument (SF-20) demonstrate that chronic headache disorders are associated with significant limitations in all 6 health categories of patient well-being and functioning. The outcomes profile for each of the common benign headache disorders appear to be unique for the specific headache diagnosis. Migraine is primarily associated with an impairment in role (work) functioning. Chronic tension-type headache is associated with a marked impairment in mental health and a generalised impairment in functioning. Cluster headache is associated with the greatest amount of pain, but with little impairment in physical functioning. The economic toll of recurrent headache is considerable. Lost productivity in the US due to migraine is estimated at $US6.5 to 17.2 billion per year. Chronic headache disorders cause significantly more morbidity, impairment of function, and economic loss than has previously been recognised.

Cost of Illness↗
PubMed1993

Therapeutic advances in migraine.

Migraine is a common and debilitating disorder of uncertain pathogenesis. Recent research into the pathophysiology of migraine and serotonin receptors has revolutionized the approach to pharmacotherapy. New medications, such as sumatriptan, and new dosage forms of older medications, including dihydroergotamine, NSAIDs, and phenothiazines are available to treat acute attacks. New prophylactic approaches include the use of calcium-channel blockers, NSAIDs, fluoxetine, and valproate. The addition of several new agents for the acute and prophylactic therapy of migraine has improved the outlook for this disabling disorder.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

Treatment considerations in headache and associated medical disorders.

As more headache sufferers seek medical care for their headaches, it is incumbent on physicians to consider all of a patient's medical illnesses in choosing therapy. The availability of new medications for headache will facilitate the tailoring of treatment to specific patient needs. The physician who treats patients with headache and concomitant medical problems must be knowledgeable about the pharmacology and adverse effects of these agents. This will permit the practitioner to use specific therapy, limit the number of medications prescribed, and prevent an exacerbation of either the medical condition or the headaches.

Adrenergic beta-Antagonists↗
PubMed1991

Concomitant medical disease and headache.

The treatment of headache disorders in patients with concomitant medical illness constitutes one of the more challenging areas of headache therapy. As new agents are added to our pharmacologic armamentarium, it will become easier to tailor therapy to our patients. The physician who treats the headache patient with concomitant medical illness must be particularly aware of drug side effects and pharmacology in order to prevent a worsening of underlying medical conditions or an exacerbation of headaches.

Asthma↗
PubMed1990

Demographics of headache in elderly patients.

This study seeks to define the types of headache and the sex and age distribution, of headache patients aged 65 and older. A computer search was performed of outpatients with a diagnosis of headache or temporal arteritis seen during 1988 at the Cleveland Clinic Foundation. Of over 120,000 outpatients treated at the clinic 9,950 had a diagnosis of headache; of these, 359 were 65 or older. We found that, compared with younger patients, older headache patients had more tension headache and less migraine headache. In our population, temporal arteritis occurred with the same frequency as migraine, and in patients with a similar demographic profile.

Aged↗
PubMed1990

Pharmacology and use of headache medications.

Treatment of headache disorders is most likely to be successful when the pathophysiology of the disease is correlated with the pharmacologic actions of the available drugs. Beta blockers generally are considered first-line therapy for migraine prophylaxis, but calcium blockers also are appropriate for some patients. Antidepressants are the primary modality for treatment of tension type headaches, although they are also used for migraine prophylaxis. Mixed headache, which has features of both migraine and tension-type headache, usually requires treatment with more than one drug. Habituation to analgesics is common among patients with mixed headache.

Headache↗
PubMed1989

Management of the headache patient with medical illness.

The recent development of new drug therapies for headache disorders has allowed for the tailoring of treatment to specific patient needs. This paper reviews the pharmacologic management of patients with both headache and concomitant medical illness. The discussion specifically includes the treatment of hypertension, coronary artery disease, mitral valve prolapse, asthma, peptic ulcer disease, obesity, and chronic Epstein-Barr virus infection, occurring concomitantly in patients with headache. Medications that can exacerbate either the headache or concurrent medical condition are noted, and alternative therapies are advised.

Headache↗
PubMed1989

Verapamil in migraine prophylaxis--a five-year review.

Verapamil is a papaverine derivative calcium channel blocking drug that has been effectively utilized in the prophylaxis of migraine. This paper reviews the clinical pharmacology as it applied to headache and the current research on the clinical use of verapamil in migraine prophylaxis. Included are three double-blind, placebo-controlled studies. Ten of 12 patients, eight of 14 patients, and 20 of 23 patients showed improvement, with all studies finding verapamil significantly more effective than placebo in migraine prophylaxis. Research comparing 240 mg/day with 320 mg/day dosing found 320 mg/day significantly more effective in reducing migraine frequency. Review of 133 refractory headache-clinic patients, treated with verapamil and additional drugs reported excellent (100% improvement) or good results (greater than 50% reduction in migraine frequency) in 5% and 40% of patients, respectively. Fair response (less than 50% improvement) was observed in 50% of patients, and poor response was seen in 5% of patients. Analysis of this information reveals that verapamil is a safe, well-tolerated and effective agent for migraine prophylaxis.

Clinical Trials as Topic↗
PubMed1987

Migraine headache. Working for the best outcome.

Migraine is a common hereditary disorder manifested by episodic headache, irritability, and gastrointestinal upset. The condition may be triggered by dietary, environmental, psychological, or pharmacologic factors. With proper diagnosis and judicious use of abortive and prophylactic therapy, patients often obtain excellent results.

Adolescent↗