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

Bromocriptine, an ergot alkaloid dopamine agonist, is a recent common treatment for suppression of lactation in postpartum women. A case is presented of a postpartum woman prescribed bromocriptine for suppression of lactation who developed hypertension, headaches, blurry vision, seizures, and pituitary hemorrhage. Differential diagnosis and a literature review are considered.
Gen Hosp Psychiatry 1991 Jul
PMID:Bromocriptine associated with postpartum hypertension, seizures, and pituitary hemorrhage. 187 30

The DSM-III-R criteria for uncomplicated alcohol withdrawal require the presence of coarse tremor of the hands, tongue, or eyelids plus one of a number of other clinical features. We examined the validity and other characteristics of these items in 137 patients in pure alcohol withdrawal using the reliable and valid Clinical Institute Withdrawal Assessment for Alcohol. The DSM-III-R items of hand tremor amplitude, nausea or vomiting, headache, transient hallucinations, autonomic hyperactivity (increased pulse or sweating), and anxiety correlated significantly with total score and significantly indicated clinical severity. Addition of an "agitation" item improved the correlation. The diagnostic accuracy is greater than 95% if any two or more items are present. The number of positive items, of which tremor can be one, to grade clinical severity shows that a score of 2 indicates "very mild"; 3, "mild"; 4, "moderate"; and 5, "severe.". We propose that an Alcohol Withdrawal Diagnostic Inventory and a DSM-III-R-compatible brief Clinical Institute Withdrawal Assessment for Alcohol are useful for clinical research, where graded symptom characterization is needed. Our data may be helpful in the development of criteria for DSM-IV.
Arch Gen Psychiatry 1991 May
PMID:Characterization of DSM-III-R criteria for uncomplicated alcohol withdrawal provides an empirical basis for DSM-IV. 202 Dec 96

A study was undertaken whereby a set of standardized (simulated) patients visited general practitioners without being detected, in a health care system where doctors had fixed patient lists. Thirty nine general practitioners were each visited during normal surgery hours by four standardized patients who were designed to be indistinguishable from real patients. The objective of the study was to see whether the actual performance of general practitioners, as assessed by standardized patients, met predetermined consensus standards of care for actual practice. The patients presented standardized accounts of headache, diarrhoea, shoulder pain and diabetes. The mean group scores of the doctors on the predefined standards of care for the different complaints ranged from 33 to 68%. The results show that standardized patients may be the method of choice in the assessment of the quality of actual care of doctors. It is hypothesized that the substandard scores of the doctors do not reflect inadequate competence, but are a result of the difference between competence and performance.
Br J Gen Pract 1991 Mar
PMID:Assessment of the performance of general practitioners by the use of standardized (simulated) patients. 193 Dec 15

Twenty-two coffee drinkers (three to seven cups per day) underwent repeated double-blind trials to test for caffeine self-administration, withdrawal, and adverse effects. Each trial consisted first of a randomized crossover period of 1 day of decaffeinated coffee and 1 day of caffeinated coffee (100 mg) to assess withdrawal and adverse effects of caffeine. Next, subjects were given 2 days of concurrent access to the two coffees. The relative use of the two coffees was used to assess caffeine self-administration. Reliable caffeine self-administration occurred in three of 10 subjects in study 1 and seven of 12 subjects in study 2. Withdrawal symptoms were headaches, drowsiness, and fatigue. The major adverse effect from self-administration was tremulousness. The occurrence of headaches on substitution of decaffeinated coffee prospectively predicted subsequent self-administration of caffeine. These results indicate that some coffee drinkers exhibit signs of a caffeine dependence, ie, they self-administer coffee for the effects of caffeine, have withdrawal symptoms on cessation, and experience adverse effects.
Arch Gen Psychiatry 1991 Jul
PMID:Caffeine self-administration, withdrawal, and adverse effects among coffee drinkers. 206 91

A sample of 56 general practitioners were asked to rate, on a percentage scale, 23 words or phrases which denote frequency or likelihood. The hypothetical context of the exercise was that of communicating to patients the probability of a side-effect (headache) arising from an unspecified prescription medicine. Median phrase ratings ranged from 'never' at 0% to 'certain' at 95% with a 50% rating given to the phrase 'reasonable chance'. Despite relatively large variance in ratings between respondents, the median ratings of a number of phrases were similar, and some identical, to other studies from different medical professionals. Although the clinical context in which a given expression of probability is used may affect its meaning, the results are encouraging and suggest that phrases denoting likelihood might be systematically codified to enhance communication between doctor and patient. To move towards this objective more research is needed to evaluate how patients interpret expressions of probability, and the relative effectiveness of different modes of communicating likelihood.
J R Coll Gen Pract 1989 Mar
PMID:Words or numbers? The evaluation of probability expressions in general practice. 255 4

Researchers initiated a randomized double blind crossover trial as part of a community based postal survey of menstrual patterns of 68 women in England. Each woman jotted down daily the severity of symptoms (e.g., depression, headache, etc.). After this 1st study cycle and being randomly assigned to the pyridoxine or placebo group, they either took 50 mg/day of pyridoxine or placebo tablets for 3 months. At the end of 3 months, they followed the other treatment. 37 women completed 6 months and only 32 completed the full 7 months. The results of the study show pyridoxine to significantly affect emotional type symptoms (depression, irritability, and tiredness [p.05]), but not somatic (headache, breast discomfort, swollen abdomen, swollen hands or feet) or menstrual (stomach cramps, backache, other) symptoms. Women who took oral contraceptives (OCs) had nonsignificant higher adjusted premenstrual symptom scores, particularly for emotional type symptoms, during both pyridoxine and placebo months that did those who did not take OCs. This study was complicated by a placebo effect. It revealed a significant decrease in the level of all symptom scores from the 1st month to the 4th month by a mean of 57% (p=.001) when the women took the placebo initially. Emotional type symptoms decreased by 69% (p.05), somatic type by 52% (p.05), and menstrual type nonsignificantly by 15%. On the other hand, when women took the placebo after taking pyridoxine for a month, the combined level of all symptom scores only increased 37% on average (nonsignificant). Based on the results of this study, pyridoxine appears to alleviate premenstrual depression. Further research is needed to confirm the results of this and other similar studies.
J R Coll Gen Pract 1989 Sep
PMID:Pyridoxine (vitamin B6) and the premenstrual syndrome: a randomized crossover trial. 255 86

Headache is a common symptom in primary care about which surprisingly little is known. Over a 14-month period 3847 patients making 4940 consecutive visits for headache to 38 primary care practices in the USA and Canada were studied. The clinical characteristics of patients, as well as the diagnostic and therapeutic strategies employed by their doctors, were examined. Visits for headache represented 1.5% of all visits during this period. Most patients (72.0%) made only one visit, and nearly half of the headaches reported were new. Only a small number of patients (3.0%) received a computerized tomographic scan; other investigations were used sparingly, as were referrals to consultants (5.0%) and hospitalizations (2.2%). Drugs (75.2%) and advice (64.5%) were commonly employed, although formal psychotherapy was recommended infrequently (4.5%). It is concluded from this large series that most patients with headache visit primary care practitioners only once; their headaches frequently defy usual diagnostic categorization and often change in character from visit to visit. Moreover, headaches in this series were frequently associated with a variety of causes not often included in discussions of headache aetiology. These findings suggest that the strategies which doctors in primary care devise to diagnose, investigate and manage this common symptom, require further study.
J R Coll Gen Pract 1987 Sep
PMID:A study of headache in North American primary care. Report from the Ambulatory Sentinel Practice Network. 345 Aug 66

The concept of psychogenic pain is discussed and reviewed from multiple theoretical perspectives. The validity of psychogenic pain disorder as a clinical diagnosis is also examined, as are regional pain syndromes such as psychogenic abdominal, facial, pelvic, chest, and headache pain. The term "psychogenic pain" is considered to have limited clinical or diagnostic usefulness and the preferred term "idiopathic pain syndrome" used in DSM-III-R is advocated.
Gen Hosp Psychiatry 1987 Mar
PMID:Psychogenic/idiopathic pain syndromes. 355 78

This paper describes the case of a 14-year-old boy who presented to his general practitioner with a history of headaches and visual problems. Investigations subsequently revealed that he had a pineal tumour. The management of the patient is described and this rare condition discussed.
J R Coll Gen Pract 1986 Sep
PMID:Once in a lifetime: a case of a pineal tumour. 380 90

The relationship between psychiatric impairment and disability due to somatic complaints was studied in 859 women adopted at an early age by nonrelatives in Sweden. The clinical data were derived from the comprehensive registrations for all medical treatment and sick-leave compensation that are kept about Swedish residents by the National Health Insurance Board. The adoptees were compared with nonadopted controls who were individually matched for social and demographic variables. We identified a somatization syndrome that is consistently associated with psychiatric impairment and repeated brief periods of disability with chief complaints of headache, backache, and abdominal distress on different occasions. A method for clinically distinguishing "somatizers" from other women was derived in one sample and was shown to have a classification accuracy of 97% in a replication sample. Somatizers accounted for 36% of all cases of psychiatric disability and 48% of all sick-leave occasions in adopted women. Compared with nonadoptees, there was an excess of somatizers in adoptees, a population known to have an excess of biological parents who are criminal and/or alcoholic.
Arch Gen Psychiatry 1984 Sep
PMID:An adoption study of somatoform disorders. I. The relationship of somatization to psychiatric disability. 646 44


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