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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

74 patients with arterial circulatory disorders have been treated with calcitonin in low dosages (0.25-0.5 mg s.c. or i.m. twice to three times weekly). In 3 women with Raynaud phenomenon in sclerodermia, previously refractory necroses of the finger-tips were cured. One woman with Raynaud disease became symptomfree. Marked improvements in the results of ergometric tests were observed in 8 out of 22 patients with intermittent claudication of the lower extremities. In 12 out of 31 patients with refractory angina pectoris, the attacks were practically eliminated. Remission of headaches of vascular origin was obtained in 6 out of 17 cases. Attacks of migraine were terminated in the incipient stage by treatment with 0.25 mg Cibacalcin.
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PMID:[Treatment possibilities of arterial circulatory disorders using calcitonin]. 33 77

Two cases are reported of patients who were diagnosed as having both migraine and Raynaud's disease. Because they were able to achieve effective control of both headaches and extremity temperature after undergoing a comprehensive approach--utilizing medication, biofeedback, and psychotherapy--it is suggested that both conditions are manifestations of the same disorder. It is recommended that a first step in approaching concurrent diagnoses of this type involve combined treatment as is often used in response to the singular diagnosis of migraine.
Headache 1992 Oct
PMID:"Raynaud's disease" in migraineurs: one entity or two? 144 93

Experience gained with the use of captopril has been summarized in 5 patients with sclerodermic renal crisis (true sclerodermic kidney) as well as the results of the double blind clinical trial of captopril in 16 patients with Raynaud's syndrome. Captopril given for a long time in the dose 75-150 mg to the patients with true sclerodermic kidney turned out effective which showed up by a decline and stabilization of arterial pressure, decrease of the intensity of azotemia and headaches, and stabilization of renal function. No convincing data have been obtained, that may confirm a beneficial effect of captopril on Raynaud's syndrome. The drug was applied in a dose of 37.5 mg for 2 weeks.
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PMID:[The use of Capoten in systemic scleroderma]. 145 61

The effects of 5 mg sublingual nifedipine on a standardized cold provocation test were compared with that of placebo in a double-blind, cross-over trial in 10 patients with Raynaud's disease. The percentage decrease of finger systolic pressure in the cooled finger (as compared with the contralateral control finger) was significantly lower at 10 degrees C (p less than 0.02) and 15 degrees C (p less than 0.05) after nifedipine than after placebo. These improved digital pressure values on cooling were associated with a decreased systolic blood pressure (SBP) from 131.2 (SD 10.8) to 126.2 (SD 10.1) mm Hg (p less than 0.001) and an increased heart rate (HR) from 65.5 (SD 16.1) to 69.6 (SD 16.7) beats/min (p less than 0.002) but without significant changes in diastolic blood pressure (DBP), digital blood flow (BF), or peripheral vascular resistance (PVR) in cutaneous vascular bed. Three patients experienced headache under nifedipine, but this side effect was disagreeable in only one case. These data suggest using low-dose nifedipine (5 mg sublingually) 15-30 min before predictable cold exposure and Raynaud's phenomenon. Such a procedure might be more effective and safer than chronic intake of higher doses of nifedipine, as currently recommended in Raynaud's attacks.
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PMID:Effects of low-dose nifedipine on a cold provocation test in patients with Raynaud's disease. 169 48

A total of 69 patients with primary Raynaud phenomenon were included in a multicenter, randomized, double-blind, crossover, placebo-controlled trial to assess the efficacy of nicardipine, a new calcium channel blocker. The trial data were combined with a meteorological survey. Nicardipine significantly (p = 0.02) reduced the number of crises of Raynaud phenomenon but had no significant effect on the intensity of the crises. Mean overall improvement, assessed on a linear visual analog scale, was 21% (p = 0.018), but results for the cold-reactive hyperemia test were not significantly altered after nicardipine treatment. All side effects were mild, and their frequency only differed significantly (p less than 0.05) from that of placebo for edema and headache.
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PMID:Controlled multicenter double-blind trial of nicardipine in the treatment of primary Raynaud phenomenon. French Cooperative Multicenter Group for Raynaud Phenomenon, Paris, France. 205 56

Fifteen patients with Raynaud's phenomenon [systemic lupus erythematosus (6), progressive systemic sclerosis (8) and rheumatoid arthritis (1)] and 12 patients with Raynaud's disease participated in a parallel, 4-week/arm, double blind, crossover study of nicardipine, an experimental calcium channel blocker. Nicardipine significantly improved pain (p = 0.03), decreased number of Raynaud's attacks (p less than 0.03), and was preferred over placebo (p less than 0.05) in the patients with Raynaud's disease, but showed an effect only in the number of attacks (p = 0.049) among the group with Raynaud's phenomenon. Plethysmography showed no drug effects. One patient discontinued the trial after developing headaches while taking placebo. Nonlimiting toxicity occurred more commonly with drug than placebo (15 vs 9 times, p less than 0.05). Our study demonstrated that nicardipine improves symptoms in Raynaud's disease, but is not effective in Raynaud's phenomenon.
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PMID:Nicardipine for the treatment of Raynaud's phenomena: a double blind crossover trial of a new calcium entry blocker. 331 3

Although the data base describing clinical outcome following biofeedback/relaxation training is accumulating, there have been relatively few attempts to predict short-term outcome, and even fewer for long-term outcome. Significant short-term outcome predictors have been identified, and they often allude to the level of psychological distress as a major factor affecting outcome. To investigate further the role of psychological variables in outcome prediction, this project presents preliminary findings that demonstrate the relationship involving interpersonal psychological stress, interpersonal style of behavior, and outcome. With a very heterogeneous group of patients (N = 39), measures of interpersonal style of behavior were used to discriminate correctly 80% of cases by outcome at the 3-month postadmission evaluation. With a more homogeneous group having somatic disorders alone (headache, Raynaud's, etc.), the accuracy of prediction at 3 months was 90%. No measures were capable of predicting long-term outcome with accuracies even moderately greater than chance. The results indicate that style of interpersonal behavior (e.g., managerial, dependent) and, to a lesser extent, interpersonal stress is predictive of short-term outcome following biofeedback/relaxation training. Individuals who tend to like responsibility and who are more executive and independent generally benefited more than doubtful, obedient, and depressed individuals. While the resulting prediction rates were only slightly more accurate than MMPI D and Pt subscales alone, the procedures provide additional information regarding the personality characteristics of successful and unsuccessful biofeedback clients, and may also provide the clinician with information regarding treatment choice if biofeedback is provided as an adjunct to psychotherapy.
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PMID:Interpersonal stress and style as predictors of biofeedback/relaxation training outcome: preliminary findings. 391 13

Clinical evidence for the long-term effectiveness of biofeedback related relaxation training is accumulating. The purpose of this report is to describe the population, self-regulation procedure, outcome criteria, and final outcome for patients who received Quieting Response (QR) training. Data from 340 patients who completed at least the first follow-up at 3 months is presented. Primary presenting symptoms were headaches, 72%; primary and secondary Raynaud's, 14%; hypertension, 4%; irritable colon, 4%; and miscellaneous, 6%. QR training integrated EMG and thermal feedback with deep breathing, progressive relaxation, and autogenic exercises presented on cassette tapes. Eight 1-hour weekly sessions were given, with emphasis on daily home exercises. Follow-up evaluations were at 3 months, 6 months, 1 year, and 2 years. Outcome was based on change in frequency, severity, and duration of symptoms; changes in medication; and secondary benefits. Quieting Response training was found to be most beneficial for patients with primary Raynaud's disease (18 of 23 patients, or 78% successful), classic migraines (9 of 13, or 69%), and common migraines (20 of 32, or 62%), followed by mixed headaches (79 of 131, or 60%), Raynaud's plus other symptoms (9 of 15, or 60%), and the irritable colon syndrome (7 of 13, or 54%). Less successful were patients with headaches plus other symptoms (16 of 37, or 43%), muscle contraction headaches (13 of 33, or 39%), secondary Raynaud's phenomenon (4 of 10, or 40%), and essential hypertension (5 of 15, or 33%). Speculations about the differing outcomes across symptom groups were made.
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PMID:Quieting response training: long-term evaluation of a clinical biofeedback practice. 635 89

Extensive personality, demographic, and symptom-related information from a heterogeneous group of more than 300 patients was examined for patterns that would discriminate between successful and unsuccessful outcomes in patients undergoing Quieting Response (QR) training, an 8-week program that integrated EMG and thermal biofeedback with a variety of relaxation exercises. Follow-up evaluations were at 3, 6, 12 and 24 months. Agreement between expected (from stepwise discriminant analyses) and observed outcomes was 65% (whole sample), 62% (headache only), and 70% (Raynaud's only). Unimproved patient MMPI scales D, Sc, F, Hy, and Pt were significantly elevated. A variety of additional measures used indicated elevated levels of psychological stress among unsuccessful patients. While stereotypical descriptions of successful and unsuccessful patients are proposed, patterns from outcome groups were more similar than dissimilar, and no combination of factors was identified that had sufficient predictive power for use with future patients. No statistical grounds for exclusion were found among patterns of responses to the measures employed. Factors contributing to the inaccuracy of outcome prediction are discussed.
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PMID:Quieting response training: predictors of long-term outcome. 636 35

In a single-blind trial 25 patients with progressive scleroderma and Raynaud's phenomenon intravenous infusions of iloprost, a prostacyclin derivative (carbaprostacyclin), were given daily for five hours during a six-day hospital stay, after a comparable initial single placebo infusion. Duration, frequency and intensity of Raynaud symptoms improved in more than 75% of the patients. This improvement was objectified by telethermometry which demonstrated acral hyperthermia and significantly briefer rewarming after standardized cooling of the hands. In addition, there was more rapid healing of ulcerations and necroses of the digital pulp. A significant inhibition of ADP- and collagen-dependent platelet aggregation was demonstrated during the iloprost infusion. Side effects, such as headache, nausea and tiredness occurred only transitorily during the infusion, were individually highly variable, and then only at higher concentrations. A dosage of 2 ng/kg X min was tolerated by all patients.
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PMID:[Treatment of Raynaud's phenomenon in scleroderma with a new stable prostacyclin derivative]. 638 60


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