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Biomedical subjects

G D Solomon

Publications and source records attributed to G D Solomon.

At least 55 records · Page 3Linked to original sources
PubMed1987

Selection of patients--critical aspects.

Proper selection of patients is the most critical aspect in designing clinical trials in migraine research. We establish specific research diagnostic criteria for the definition of migraine. Additional factors in patient selection, migraine frequency, duration, medications and previous treatments, are reviewed. Exclusion criteria and the mixed headache syndrome patient are discussed.

Clinical Trials as Topic↗
PubMed1985

Acute colonic pseudo-obstruction: a possible role for the colocolonic reflex.

In diverse clinical settings, injury or impairment of the peripheral autonomic nervous system may cause acute colonic pseudo-obstruction. The mechanism has remained elusive since Ogilvie's original description. In classic Ogilvie's syndrome, colonic pseudo-obstruction is associated with malignant invasion of the prevertebral ganglia, and may be mediated through the colocolonic reflex, described in a guinea pig model. We have treated three patients with acute colonic pseudo-obstruction due to: 1) malignant invasion of the prevertebral plexus (classic or true Ogilvie's syndrome), 2) clonidine, and 3) herniorrhaphy under epidural anesthesia. In this paper, we discuss the possible role of the colocolonic reflex in the pathophysiology of acute colonic pseudo-obstruction, and the delineation of true Ogilvie's syndrome from the other many causes of acute colonic pseudo-obstruction.

Acute Disease↗
PubMed1983

Verapamil prophylaxis of migraine. A double-blind, placebo-controlled study.

We undertook a double-blind, placebo-controlled study to determine the effectiveness of verapamil hydrochloride for the prophylaxis of migraine. Twelve patients were given either verapamil hydrochloride, 80 mg four times daily, or placebo in random order during two consecutive three-month periods. Migraine frequency, severity, and duration were quantified by daily logs and monthly questionnaires. Ten of the 12 patients had fewer migraines during verapamil therapy. Migraine frequency decreased from 6.7 to 3.8 migraines per patient per month, for a mean decrease of 49%. Headache unit index fell from an average of 0.61 to 0.44. We conclude that verapamil is effective in the prophylaxis of migraine and that verapamil might be considered one alternative in the development of a regimen for the prophylaxis of migraine.

Clinical Trials as Topic↗
PubMedDate not supplied

Using pretreatment quality of life perceptions to predict response to sumatriptan in migraineurs.

Quality of life perceptions vary for individuals with similar medical conditions and reflect disease impact. When correlated with subsequent response to treatment, such data may contribute useful insights in understanding the determinants of therapeutic effectiveness in selected medical conditions. Two hundred thirty-five migraine patients never previously treated with injectable sumatriptan completed a Short Form-36 questionnaire before receiving a supervised test dose and a prescription for the medication. Medical records were examined to determine the number of comorbid conditions, headache characteristics (age at onset, headache frequency, duration of disease, aura, association with menses, unilaterality, and emesis), and documentation of sumatriptan's effect in relieving migraine during 12 months of follow-up. Logistic regression was used to identify patient- and disease-specific features most closely associated with the dependent variable, clinical response. One hundred eighty-four patients (78%) reported both relief of symptoms and continued usage of sumatriptan. Patients who experienced emesis with headaches (OR = 2.05 [1.07, 3.91]) and those with higher pretreatment Physical Functioning scores (OR = 3.27 [1.28, 8.37]) were more likely to respond to sumatriptan. Response to sumatriptan therapy was associated with specific pretreatment quality of life domains and headache features. These results may be useful in improving the efficiency of disease management strategies for patients with migraine.

Adult↗
PubMedDate not supplied

Quality of life and well-being of headache patients: measurement by the medical outcomes study instrument.

OBJECTIVE: To assess the reliability and validity of the Medical Outcomes Study (MOS) Short Form Health Survey as an indicator for quality of life in patients with chronic headaches. DESIGN: Patient interview survey. SETTING: A headache clinic within a multi-specialty group practice. PATIENTS: 208 consecutive patients seeking evaluation of headache at the above site. MEASUREMENTS: All six health components of the MOS Short Form Health Survey were included in the study. MAIN RESULTS: The MOS Short Form Health Survey was both reliable and valid in the group of patients with headache. Patients with headache had significantly worse physical, social, and role functioning, and worse mental health than did patients with chronic diseases (P < 0.0001). The functioning associated with chronic headaches was worse than that associated with major chronic medical conditions such as arthritis and diabetes, and was comparable to the level of functioning associated with recent myocardial infarction or congestive heart failure. CONCLUSIONS: The MOS survey is a reliable measure of quality of life for patients with chronic headaches. Chronic headache disorders cause significantly more morbidity and impairment of function than has previously been appreciated.

Adolescent↗
PubMedDate not supplied

Circadian rhythms and migraine.

To determine whether migraine exhibits a circadian rhythm or occurs randomly throughout the day, we analyzed the time of migraine onset in 15 migraine suffers (migraineurs) over 20 weeks. The patients suffered 211 migraine attacks over 20 weeks (range 3 to 30, median 13). Twelve of the 15 migraineurs had 50% or more of headache onsets during a 4-hour block of time. As a group, the migraineurs showed a circadian variation in migraine onset, with a marked increase in attacks between 6 AM and 8 AM, peak frequency of migraine onset between 8 AM and 10 AM, and a dramatic decrease in frequency between 8 PM and 4 AM. The circadian rhythm of migraine onset parallels that of myocardial infarction, platelet aggregability, plasma cortisol, and plasma catecholamines. These associations suggest that alteration of vasomotor tone may be involved in the initiation of migraine attacks.

Circadian Rhythm↗
PubMedDate not supplied

Flurbiprofen in the prophylaxis of migraine.

Flurbiprofen, a nonsteroidal anti-inflammatory drug with effects on prostaglandin synthesis, platelet serotonin release, and beta-endorphin, was studied for efficacy in migraine prophylaxis. Twenty-three patients completed the 20-week, placebo-controlled, double-blind, crossover trial. Flurbiprofen, in a dose of 100 mg twice daily, and placebo were each given for 8 weeks, with a 2-week "washout" period between the treatment periods. Flurbiprofen significantly reduced migraine intensity (P < .05), total hours with migraine (P < .015), and the dosing frequency of relief medication (P < .015). Total hours with migraine decreased by 41%, and the use of relief medication decreased by 31%. The reduction in migraine frequency did not reach statistical significance (P < .10). Adverse effects were infrequent. Based on the overall improvement in migraine parameters, flurbiprofen can be recommended for use in migraine prophylaxis.

Adult↗
PubMedDate not supplied

Advances in migraine management.

New drugs and better understanding of the pathogenesis of migraine are improving the outlook for patients with this debilitating disorder. This paper reviews recent advances and outlines our approach.

Adrenergic beta-Antagonists↗