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At least 1,135 records · Page 63Linked to original sources
PubMed2005

Antibiotics for upper respiratory tract infections: an overview of Cochrane reviews.

OBJECTIVES: The aim of this paper is to review the four Cochrane reviews of antibiotics for upper respiratory tract infections. METHODS: Each Cochrane review was read and summarized, and results presented as odds ratios (as in the Internet version) and, where relevant, numbers needed to treat. RESULTS: The reviews of antibiotics for acute otitis media have concluded that benefit is not great with a number needed to treat for a benefit (NNTB) of 15. Recent US guidelines are recommending a delay in prescriptions in children over the age of 6 months. For streptococcal tonsillitis, the Cochrane reviewers suggest that antibiotic use seems to be discretionary rather than prohibited or mandatory. This is because the benefit in terms of symptoms is only about 16h (NNTB from 2 to 7 at day 3 for pain) compared with placebo, and that serious complications, such as rheumatic fever and glomerulonephritis, are now rare in developed countries. The reviewers do, however, suggest that antibiotics are considered in populations in whom these complications are more common. This is an area of debate, as the Infectious Disease Society of America (2002) recommends routine treatment. [Clin. Infect. Dis. 35 (2002) 113] There is good evidence and consensus that there is no indication for antibiotics for the common cold. The situation with acute purulent rhinitis is less clear, as new evidence suggests that antibiotics may be effective for acute purulent rhinitis (NNTB from 6 to 8). However, as most people with acute purulent rhinitis improve without antibiotics, giving antibiotics is not justified as an initial treatment. For acute maxillary sinusitis, the evidence suggests that antibiotics are effective for people with radiologically confirmed sinusitis. The reviewers suggest that clinicians should weigh up the modest benefits (NNTB from 3 to 6) against the potential for adverse effects. CONCLUSION: The use of antibiotics for acute otitis media, sore throat and streptococcal tonsillitis, common cold and acute purulent rhinitis, and acute maxillary sinusitis seems to be discretionary rather than prohibited or mandatory, at least for non-severe cases.

Acute Disease↗
PubMed1996

[Decongestant nasal spray. Results of a rhinomanometric double-blind study].

Between november 1993 and july 1995 60 patients with a common cold underwent randomized and double-blind testing of 3 commercial nasal sprays-benzydamine, xylometazoline combined with the secretolytic S-carboxymethylcysteine, and phenylephrine combined with the antihistaminic dimethindene maleate. After prior active rhinomanometric measurement of the untreated nose, the test substance was applied. The change of nasal patency was registered after 3 and 10 minutes and then after 2, 4, 6 and 8 hours. At the end the patient gave a subjective evaluation of the used spray. There was no change in nasal obstruction following application of NaCl or benzydamine. Xylometazoline/S-carboxymethylcysteine (+87%) or phenylephrine/ dimethindene maleate (+113%) augmented nasal patency within minutes. Using phenylephrine/dimethindene maleate the effect lasted less than 2 hours, while after xylometazoline/S-carboxymethylcysteine decongestion lasted more than 6 hours. The patients also subjectively reported an increase in nasal patency after the use of benzydamine and placebo. But only phenylephrine/ dimethindene maleate or xylometazoline/S-carboxymethylcysteine were judged good. Using benzydamine or phenylephrine + dimethindene maleate, more side-effects (mainly dryness and burning) were mentioned. Considering the subjective assessment of side-effects and duration of action, as well as objective parameters, derivatives of imidazole (oxymetazoline and xylometazoline) are first choice in treatment of the common cold.

Administration, Intranasal↗
PubMed2003

Rhinovirus and asthma.

Rhinoviruses (RVs) cause the majority of common colds, which often provoke wheezing in patients with asthma. The precise mechanisms responsible for the RV infection-induced exacerbations of bronchial asthma are still uncertain. However, several reports reveal airway hyperresponsiveness, increases in chemical mediators in airway secretions such as kinin and histamine, and airway inflammation in patients with bronchial asthma after RV infection. RV infection induces an accumulation of inflammatory cells in airway mucosa and submucosa including neutrophils, lymphocytes and eosinophils. RV affects the barrier function of airway epithelial cells, and activates the airway epithelial cells and other cells in the lung to produce pro-inflammatory cytokines, including various kinds of interleukins, GM-CSF and RANTES, and histamine. RV also stimulates the expression of intercellular adhesion molecule-1 (ICAM-1) and low-density lipoprotein receptors in the airway epithelium, receptors for major and minor RVs. On the other hand, RV infection is inhibited by treatment with soluble ICAM-1, and by reduction of ICAM-1 expression in the airway epithelial cells after treatment with erythromycin. Both soluble ICAM-1 and erythromycin were reported to reduce the frequency of common colds. Here, we review the pathogenesis and management of RV infection-induced exacerbation of bronchial asthma.

Adult↗
PubMed1995

Viral upper respiratory infections.

Viral upper respiratory infections, otherwise known as the common cold, are the most common diseases among humans. The self-limited, and often self-diagnosed, acute mild catarrhal illness is usually a nasopharyngitis of 5 to 7 days duration. The major virus groups causing colds are the Picornaviridae, Coronaviridae, Paramyxoviridae, Orthomyxoviridae, and Adenoviridae families. This review will emphasize the basic virology, pathogenesis, and immunology of these infections, and will conclude with present-day and future modalities for treatment and prevention.

Adenovirus Infections, Human↗
PubMed2001

Cross-sectional study on cytokine polymorphisms, cytokine production after T-cell stimulation and clinical parameters in a random sample of a German population.

We investigated, in a random sample of a German population, the association of polymorphisms in the genes encoding the cytokines interleukin 2 (IL-2), interleukin 4 receptor (IL-4R), interleukin 6 (IL-6), interleukin 10, interferon gamma (IFNG), tumor necrosis factor (TNF) and intercellular adhesion molecule 1 (ICAM-1) with (1) secreted levels of the respective proteins after T-cell stimulation and (2) data on selected diseases obtained from a questionnaire. The scope of this investigation was to further the understanding of the genetic background of allergies and common colds and the observed heterogeneity of many immune responses in the human population. In contrast to previous reports that showed associations of promoter polymorphisms of cytokine genes with the production of the corresponding protein, we did not find associations with protein release after T-cell stimulation in vitro. Among the correlations with the clinical parameters, we observed an increased risk of allergies (odds ratio, OR= 4.1; confidence interval, CI: 1.6-10.4), particularly hay fever (OR=5.6, CI: 1.8-17.1) in individuals homozygous for IFNG 13 CA-repeats. In combination with the TNF wildtype, the risk for hay fever increased to OR=8.4 (CI: 2.7-25.6). Furthermore, individuals with a combination of IL2, IL6 and ICAM-1 polymorphisms tended to have higher frequencies of reported common colds than individuals with the alternate genotypes. As these are results of an explorative investigation, these findings require confirmation in material from a different source. If confirmed, these relationships could contribute to a better characterisation of the genetic component of allergies.

Aged↗
PubMed2004

Vitamin E and respiratory infection in the elderly.

Respiratory infections are prevalent in the elderly, resulting in increased morbidity, mortality, and utilization of health care services. Contributing to the increased incidence of infection with age is the well-described decline in immune response, which has been correlated with patterns of illness in the elderly. For example, there are higher morbidity and mortality from cancer, pneumonia, and post-operative complications in those who have diminished, delayed-type hypersensitivity skin test responses. Nutritional status is an important determinant of immune function. We have shown in double-blind, placebo-controlled trials that vitamin E supplementation significantly improved immune response, including DTH and response to vaccines. Furthermore, subjects receiving vitamin E in the 6-month trial had a 30% lower incidence of infectious diseases. That study, however, was not powered to demonstrate statistical significance, and the infections were self-reported. To overcome these limitations, we conducted a double-blind, placebo-controlled trial to determine the effect of one-year supplementation with 200 IU/day vitamin E on the incidence and duration of respiratory infections in 617 elderly nursing home residents. The results of this clinical trial show that vitamin E supplementation significantly reduces the incidence rate of common colds and the number of subjects who acquire a cold among elderly nursing home residents. A nonsignificant reduction in the duration of colds was also observed. Because of the high rate and more severe morbidity associated with common colds in this age group, these findings have important implications for the well being of the elderly as well as for the economic burden associated with their care.

Aged↗
PubMed2005

Open trial to assess aspects of safety and efficacy of a combined herbal cough syrup with ivy and thyme.

BACKGROUND AND OBJECTIVES: Changes in the symptoms of cough after treatment with a combined herbal preparation containing dry ivy leaf extract as main active ingredient, decoction of thyme and aniseed, and mucilage of marshmallow root (Weleda Hustenelixier, new formulation) and its tolerability were investigated in an open clinical trial ('Anwendungsbeleg'). PATIENTS AND METHODS: Between January and March 2004, 13 general practitioners recruited and treated 62 patients with a mean age of 50 years (range 16-89). The patients had irritating cough in consequence of common cold (n = 29), bronchitis (n = 20) or respiratory tract diseases with formation of viscous mucus (n = 15). The mean daily intake was 10 ml (range 7.5-15) of syrup, and the mean duration of treatment was 12 days (range 3-23 days). Treatment results were assessed on the basis of changes in the symptom scores for cough and expectoration. Safety was evaluated by means of an analysis of adverse events. In addition, efficacy and tolerability were analyzed from the judgments of the doctors and patients. RESULTS: At the final visit, all symptom scores showed an improvement as compared to baseline. Doctors and patients assessed efficacy as good or very good in 86% and 90% of the cases, respectively. Tolerability was assessed as good or very good by 97% of the doctors and patients. Only one adverse event was reported. However, a relation to the medication was classified to be unlikely. CONCLUSION: Considering the traditional use of ivy leaves, thyme herb, aniseed and marshmallow root in preparations for cough, the reduction in the symptom score as well as the good tolerability the investigated combined herbal cough syrup seems to alleviate cough in consequence of common cold, bronchitis or respiratory tract diseases with formation of mucus.

Adolescent↗
PubMed1999

An update on the pathophysiology of rhinovirus upper respiratory tract infections.

Upper respiratory tract infections are one of the most common infectious diseases in man and are characterized by relatively mild symptoms. However, complications of bacterial super-infection or asthma exacerbations are not seldomly seen. Most upper respiratory tract infections are caused by rhinoviruses. The rhinovirus is a non-enveloped 30 nm RNA-virus with over 100 serotypes that belongs to the Picornaviridae family and only replicates in primates. It is characterized by a single positive stranded genome acting not only as a template for RNA synthesis, but also encoding for a single polypeptide necessary for viral replication. The viral capsid has an icosahedral symmetry and demonstrates deep canyons, with a receptor-binding domain. Rhinoviruses are transmitted mainly via direct- or indirect contact with infected secretions and invade their host by binding to the ICAM-1 receptor on the nasal epithelium. Typical for rhinovirus upper respiratory tract infections are isolated scattered foci of infected epithelium, not showing any striking damage or cytopathic alterations, between large areas of normal epithelium. Today there is still little detailed knowledge on the pathophysiology of common cold, especially on the aspect of cellular migration and defense. A better understanding in mechanisms underlying this cellular response would not only have therapeutical consequences, but may also explain the relationship between viral infectious rhinitis and asthma or atopy. During a rhinovirus infection, a selective neutrophil and monocyte recruitment is observed. In vitro and in vivo data have demonstrated a time-limited, rhinovirus-induced increase in bradykinin, cytokine, chemokine and sICAM-1 concentrations. Epithelial derived proinflammatory cytokines initiate an adhesion cascade and activate T lymphocytes that create a TH1-type cytokine environment within the infected tissue, necessary to eradicate the virus infection. The selective recruitment of neutrophils seems linked to increased concentrations of the chemokine IL-8 and common cold symptoms. It is doubtful that the cytokine-regulated-production of specific neutralising immunoglobulins is necessary for recovery from viral illnesses and presumably only contributes to a late and temporary protection against rhinovirus reinfection. These observations confirm the crucial role that cytokines and mediators play in the pathogenesis of a rhinovirus infection by mediating chemotaxis, transmigration and activation of inflammatory- and immunocompetent cells.

Animals↗
PubMed1992

Nasal airflow asymmetry and the effects of a topical nasal decongestant.

Nasal airway resistance (NAR) is normally asymmetrical due to the nasal cycle. The aims of this study were to determine the degree of this asymmetry in healthy subjects and those with acute rhinitis associated with common cold, and to investigate how the administration of a topical nasal decongestant (xylometazoline) influenced the asymmetry in NAR. Unilateral NAR was measured by active anterior rhinomanometry, and was shown to be asymmetrical in both healthy subjects and those suffering with acute rhinitis. The asymmetry in NAR was greater in those with acute rhinitis than in the healthy group, with a ratio between "high" and "low" sides of 2.3:1 in the rhinitis group compared to a ratio of 1.7:1 in the healthy subjects. Administration of a topical nasal decongestant caused a significant decrease in total NAR in both groups and abolished the asymmetry in NAR in the healthy subjects (ratio is 1:1 after decongestion). However, significant asymmetry of NAR was still present in the group with acute rhinitis following the administration of decongestant (ratio is 1.5:1 after decongestion). These findings show that the normal asymmetry in NAR was increased during acute rhinitis associated with common cold, and that in healthy subjects (but not in those with rhinitis) the asymmetry was abolished by administration of a topical decongestant. The results are discussed in relation to nasal sympathetic tone and nasal blood flow.

Acute Disease↗
PubMed2005

A novel sham moxibustion device: a randomized, placebo-controlled trial.

OBJECTIVES: (1) Develop a sham moxibustion device; (2) determine whether volunteer participants and practitioners can distinguish the sham procedure from real moxibustion during treatment for prevention of the common cold; and (3) assess the feasibility of conducting a larger clinical trial of the device. DESIGN: Double-blinded, randomized, placebo-controlled clinical trial. SETTING: A community outpatient health station in Chaoyang district, Beijing, China, from early November through late December 2003. METHODS: Sham and real moxibustion pillars were made by affixing moxa cones onto special collar bases. These pillars resemble each other in appearance, burning procedure and residue, but the base of the sham pillar isolates the moxa-produced heat and smoke and prevents them from radiating to the skin. These devices were tested in a pilot clinical trial in which patients received moxibustion at Zusanli (ST 36) for prevention of the common cold. Volunteers (n = 71) aged 55-75 years were given pre-treatment questionnaires to assess their knowledge of moxibustion and their expectations and motives for participating in the trial, randomized into treatment (n = 36) and placebo-controlled (n = 35) groups, and treated once every 2 days for 1 month. Questionnaires assessing the effectiveness of the blinding were given to the volunteers at the end of the trial and to practitioners after each treatment session. RESULT: There were no significant differences between the two groups of patients in past moxibustion experience, knowledge of moxibustion, expectations and motivation. The number of volunteers in the treatment group and the placebo group who believed they received: (1) real moxibustion; (2) sham moxibustion; and (3) were uncertain as to which they received is 30, 0, 5; 29, 0, 4, respectively. The results show no significant statistical differences (P = 1.000). The number of volunteers in the treatment group and the placebo group who were believed, by the two practitioners who provided the treatments, to have received: (1) real moxibustion; (2) sham moxibustion; and (3) and an undisclosed treatment were 10, 6, 19; 9, 4, 20 and 11, 7, 17; 12, 5, 16, respectively. There were no statistically significant differences between the practitioners (P = 0.811 and 0.840). CONCLUSION: The sham moxibustion device was successfully validated in the present study. The results demonstrate that these specially designed real and sham moxibustion pillars can be used together to provide an effective placebo-control in moxibustion research and can successfully fulfill the double blinding protocol in moxibustion clinical trials.

Aged↗
PubMed1996

Effects of viral and bacterial infection on nasal and sinus mucosa.

There is still controversy over the role of viruses and bacteria in rhinologic infections, especially in sinusitis. Until recently it was not fully known whether the sinuses do in fact take part in the infectious process of a common cold (viral rhinitis). CT scans show that in the vast majority of otherwise healthy volunteers with a common cold, and without a previous history of recurrent or chronic sinusitis, the sinuses are involved; there was, however, in these individuals no typical symptomatology of acute sinusitis. A viral rhinitis alone does not seem to be able to elicit a "clinical" acute otitis. Bacteria determine the clinical picture and outcome of sinusitis. There is not much controversy about the role of bacteria in acute sinusitis, S. pneumoniae, H. influenzae, and M. catarrhalis being the most frequently involved. Much more conflicting reports are published about the normal flora of the sinuses, the role of anaerobes and the microbiology of chronic sinusitis. In this paper the mechanisms of viral and bacterial infection of the nasal and sinusal mucosa are described and the results of microbiological studies in sinusitis reported by other authors and our own group are discussed. It is postulated that, although bacteria are very important in acute sinusitis, their role in chronic sinusitis is minimal, the bacteria being opportunistic colonisers.

Bacteria, Anaerobic↗
PubMed1999

Antibiotic usage in primary care units in Taiwan.

To understand the situation of antibiotic usage in primary care units in Taiwan, we collected all prescriptions over a 1 week period during March 2 to March 7, 1992, December 2 to December 7, 1992, and January 14 to January 19, 1994 from out-patient clinics of public health stations located in various parts of Taiwan. In the first time period 60 health stations were sampled, 18,350 patient-visits made and 23,674 diagnoses recorded. In the second time period 168 health stations were sampled, 84,143 patient-visits made and 96,528 diagnoses recorded. In the third time period 173 health stations were sampled with 85,623 patient-visits and 105,132 diagnoses recorded. The percentages of total patient-visits that resulted in antibiotic treatment were 16.7, 13.5 and 12.4% in the three time periods, respectively. The patient group under the age of 11 received the highest percentage of antibiotic treatment. The percentage of patient-visits that resulted in treatment with two or more types of antibiotics decreased from 25.4% in March, 1992 to 13.2% in January, 1994. Common cold was the most frequent diagnosis in patients receiving antibiotic therapy during the three time periods and accounted for 36.9% of total antibiotic prescriptions. Of the patients with the diagnosis of common cold, 29.7% received antibiotic treatment, of whom the largest group were paediatric patients (< 16 years). Penicillins, macrolides and cephalosporins were the most commonly prescribed antibiotics and accounted for 34.0, 21.8 and 21.3% of all prescribed antibiotics in the three study periods.

Adolescent↗
PubMed2005

Antibiotic prescribing by ambulatory care physicians for adults with nasopharyngitis, URIs, and acute bronchitis in Taiwan: a multi-level modeling approach.

BACKGROUND: Imprudent prescribing of antibiotics in ambulatory care in Asia is of great concern. However, an adequate understanding of factors associated with antibiotic prescribing patterns in Asia has not been achieved. OBJECTIVE: Our aim was to identify patient and physician characteristics that influence antibiotic prescribing for adults with nasopharyngitis (common colds), upper respiratory tract infections (URIs) or bronchitis in Taiwan. METHODS: Generalized Estimating Equations (GEE) were used to analyze all 128,260 episodes of common colds, URIs and bronchitis generated by a random sample of 137,935 adult National Health Insurance (NHI) beneficiaries (> or = 18 years old) in Taiwan in 2000. RESULTS: Multivariate analysis results revealed substantial variations across different physician groups. Physician age and accreditation level of the physician's practice setting were the characteristics most associated with prescribing of antibiotics at the initial encounters for these episodes of care. Urban practising physicians (adjusted OR 1.69, 95% CI 1.29-2.21) and those who were self-dispensing or with on-site pharmacists (adjusted OR 1.32, 95% CI 1.19-1.46) were also higher prescribers of antibiotics for adults. Other significant physician predictors included physician specialty, patient volume, and ownership of practice setting. CONCLUSIONS: Results suggest that both accessibility to updated medical information and economic incentives of the attending physician may shape prescribing of antibiotics in ambulatory care in Taiwan. Interventions should be developed to influence these modifiable factors to reduce antibiotic prescriptions of questionable value.

Adult↗
PubMed1981

Penicillin in acute otitis media: a double-blind placebo-controlled trial.

The effect of peroral penicillin-V (55 mg/kg/day in 7 days) on acute otitis media was studied in 149 children between the ages of 1 and 10 years in a double-blind, placebo-controlled investigation. The parameters of the disease employed were symptom scores for earache, fever and common cold, the use of analgetics, otoscopy, as well as tympanometry. The children were followed-up for 3 months. Penicillin had no effect on fever and common cold, but earache was significantly reduced on the 2nd day of treatment. The acute course of the disease was satisfactory in 69% of the children in the placebo group and in 86% in the penicillin group. In patients with pneumococci or haemolytic streptococci in the nasopharynx, the pain disappeared after 1-2 doses of penicillin, whereas the treatment had no effect in children with Haemophilus influenzae. There was no difference between the penicillin and the placebo groups with regard to the results of otoscopy and tympanometry after 1 week, 1 month and 3 months. No serious complications were observed. It is concluded that an attitude of "masterly inactivity" with regard to the treatment of acute otitis media is justifiable, provided sufficient analgesic treatment is given and also that the patient can be closely followed. As there are still many unanswered questions more controlled investigations are warranted.

Acoustic Impedance Tests↗
PubMed1998

Olfactory function in acute rhinitis.

This study was performed to investigate the effects of the common cold on olfactory function, which was assessed using chemosensory event-related potentials (CSERP, in response to both olfactory [H2S] and trigeminal [CO2] stimuli) and psychophysical measures (intensity ratings, odor discrimination, butanol threshold); nasal volume was assessed by means of acoustic rhinometry. The investigation was performed in 36 subjects (18 women, 18 men). After onset of the rhinitis (day 0) measurements were performed on days 2, 4, 6 and 35. The cold produced a decrease of the volume of the anterior nasal cavity accompanied by an increase of mucus secretion, an increase of olfactory thresholds, a decrease of intensity ratings and a decrease of N1 CSERP amplitudes to olfactory and trigeminal stimuli. When mucus secretion of the contralateral nasal cavity was controlled with oxymetazoline, N1 amplitudes to olfactory stimuli were still affected by the cold as indicated by the significant increase of amplitudes as subjects recovered; this phenomenenon was not found for responses to trigeminal stimuli. This indicates that the common cold has a small effect on olfactory function which may be independent of nasal congestion.

Acute Disease↗
PubMed2004

Controversies about the decubitus ulcer.

Knowledge of the decubitus ulcer has made great progress in recent decades. No longer is the diagnosis of a bedsore, as it was in the iron lung days, almost a death warrant. One cannot cause to heal a patient who is in organ failure, nor can one necessarily prevent ulcers in a new spinal cord-injured patient. Reflecting on the common cold, one realizes that prevention is limited to covering the face when sneezing, and treatment is symptomatic. There is no way of eradicating the virus of the common cold, nor is there an appropriate treatment. The decubitus ulcer should be conceived of in a similar vein, until understanding is more complete and specific treatments are available.

Aged↗
PubMedDate not supplied

Household firewood use and the health of children and women of Indian communities in Chiapas, Mexico.

A follow-up study in two rural communities in the state of Chiapas, Mexico, compared families that used an improved stove for cooking with those that used traditional open-fire stoves, to assess the risks of respiratory symptoms in children and women exposed to wood smoke. 16-hour measurements showed that the concentration of particles less than 10 microm in diameter was significantly lower in households with the better stoves in the kitchen area, where children usually play, i.e., 158 microg/m3 vs 305 microg/m3 (p = 0.03). Multivariate models showed that using the better stove tended to protect against symptoms such as the common cold in children (RR 0.24; 9.5% CI 0.05, 1.02). Use of more firewood was linked to greater risks of experiencing difficulty breathing (RR 1.15; 95% CI 1.04, 1.27) and the common cold (RR 1.09; 95% CI 1.01, 1.18) in women. The use of stoves that require less wood for cooking reduces the risks of respiratory symptoms that may contribute to complicated respiratory diseases and mortality.

Adolescent↗
PubMed2000

Prevalence of migraine, tension-type headache, and other headaches in Hong Kong.

OBJECTIVE: To assess the prevalence of migraine and other headaches in Hong Kong in 1998. BACKGROUND: A community-based prevalence survey of headache was carried out from July 1992 to March 1993, and the prevalence rates were 1% for migraine, 2% for tension-type headache, and 1% for other headaches. A similar survey was carried out in May and June 1998 to interview individuals aged 15 years or older. Recurrent headache was defined as having two or more headaches unrelated either to influenza or a common cold within the past 12 months. METHODS: Respondents with recurrent headache were offered a personal interview for clinical validation. Of 3156 randomly selected individuals, 1436 responded. RESULTS: Headache was due to influenza or a common cold in 270 (18.8%) respondents; recurrent headache affected 533 (37.1%) respondents. The overall prevalence rates were 4.7% for migraine, 26.9% for tension-type headache, and 5.5% for other headaches. Clinical validation was available for 72 respondents. After adjustment for possible misclassification, the estimated prevalence rates became 12.5% for migraine, 18.7% for tension-type headache, and 6.0% for other headaches. There was a female preponderance for all types of headache with a peak in the 25- to 34-year-age group for tension-type headache. CONCLUSIONS: All types of headache were more common in the 1998 study, and the prevalence rates were closer to those of Western communities.

Adolescent↗