Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
Neurogastroenterol Motil ; 20(4): 269-84, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18371009

ABSTRACT

Cyclic vomiting syndrome (CVS) was initially described in children but can occur in all age groups. Cyclic vomiting syndrome is increasingly recognized in adults. However, the lack of awareness of CVS in adults has led to small numbers of diagnosed patients and a paucity of published data on the causes, diagnosis and management of CVS in adults. This article is a state-of-knowledge overview on CVS in adults and is intended to provide a framework for management and further investigations into CVS in adults.


Subject(s)
Vomiting/diagnosis , Vomiting/physiopathology , Vomiting/therapy , Adult , Child , Humans , Syndrome
2.
Neurology ; 65(12): 1941-9, 2005 Dec 27.
Article in English | MEDLINE | ID: mdl-16380617

ABSTRACT

OBJECTIVE: To test the hypothesis that atomoxetine does not significantly worsen tic severity relative to placebo in children and adolescents with attention deficit/hyperactivity disorder (ADHD) and comorbid tic disorders. METHODS: Study subjects were 7 to 17 years old, met Diagnostic and Statistical Manual of Mental Disorders-IV criteria for ADHD, and had concurrent Tourette syndrome or chronic motor tic disorder. Patients were randomly assigned to double-blind treatment with placebo (n = 72) or atomoxetine (0.5 to 1.5 mg/kg/day, n = 76) for up to 18 weeks. RESULTS: Atomoxetine treatment was associated with greater reduction of tic severity at endpoint relative to placebo, approaching significance on the Yale Global Tic Severity Scale total score (-5.5 +/- 6.9 vs -3.0 +/- 8.7, p = 0.063) and Tic Symptom Self-Report total score (-4.7 +/- 6.5 vs -2.9 +/- 5.2, p = 0.095) and achieving significance on the Clinical Global Impressions (CGI) tic/neurologic severity scale score (-0.7 +/- 1.2 vs -0.1 +/- 1.0, p = 0.002). Atomoxetine patients also showed greater improvement on the ADHD Rating Scale total score (-10.9 +/- 10.9 vs -4.9 +/- 10.3, p < 0.001) and CGI severity of ADHD/psychiatric symptoms scale score (-0.8 +/- 1.1 vs -0.3 +/- 1.0, p = 0.015). Discontinuation rates were not significantly different between treatment groups. Atomoxetine patients had greater increases in heart rate and decreases of body weight, and rates of treatment-emergent decreased appetite and nausea were higher. No other clinically relevant treatment differences were seen in any other vital sign, adverse event, or electrocardiographic or laboratory measures. CONCLUSIONS: Atomoxetine did not exacerbate tic symptoms. Rather, there was some evidence of reduction in tic severity with a significant reduction of attention deficit/hyperactivity disorder symptoms. Atomoxetine treatment appeared safe and well tolerated.


Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Propylamines/administration & dosage , Tic Disorders/drug therapy , Adolescent , Adrenergic Agonists/administration & dosage , Adrenergic Agonists/adverse effects , Atomoxetine Hydrochloride , Body Weight/drug effects , Child , Comorbidity , Double-Blind Method , Female , Heart Rate/drug effects , Humans , Male , Placebo Effect , Propylamines/adverse effects , Tachycardia/chemically induced , Treatment Outcome
3.
Med Clin North Am ; 85(4): 1037-53, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11480257

ABSTRACT

Headaches are frequent in children and adolescents and at times can be extremely disabling. Disability scales, such as the MIDAS scale, have been useful in helping follow adult patients. Modifications of this scale have been helpful in following pediatric and adolescent patients. Greater attention has been paid to epidemiology and classification of headache in children. Studies are being done on serotonin 1B/1D agonist for treating acute migraine, and this agent has been found to be efficacious despite a high placebo response. It is anticipated that FDA approval of sumatriptan nasal spray in adolescents is forthcoming. Despite advancements, there is no wonder drug. There continues to be a need for studying preventive therapies in a double-blind, placebo-controlled environment, and plans are under way for such studies. Many adult patients with chronic daily headaches report that their headaches began in childhood and adolescence. A better understanding of diagnostic criteria, early diagnosis, and more effective treatment may be the key to influencing the prevalence of headaches in adults. Continued research is the only answer to the questions raised by the most recent studies in this population.


Subject(s)
Headache/etiology , Adolescent , Analgesics/administration & dosage , Analgesics/adverse effects , Central Nervous System Agents/administration & dosage , Central Nervous System Agents/adverse effects , Child , Chronic Disease , Combined Modality Therapy , Female , Headache/drug therapy , Humans , Male , Migraine Disorders/drug therapy , Migraine Disorders/etiology , Risk Factors
4.
Semin Pediatr Neurol ; 8(1): 34-9, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11332864

ABSTRACT

Chronic nonprogressive headaches (CNPHA) are common in children and increase in frequency in adolescents. Features are usually, but not always, distinct from those of migraine. CNPHA have also been called chronic daily headaches, tension-type headaches, muscle contraction headaches, and psychogenic headaches. These headaches represent a diagnostic and therapeutic challenge to family physicians, pediatricians, and pediatric neurologists. The evaluation is time-consuming and the treatment frustrating and often unsuccessful. They are a significant cause of school absences. This review addresses the epidemiology classification, pathogenesis, clinical characteristics, evaluation, and treatment of this disorder.


Subject(s)
Headache/diagnosis , Tension-Type Headache/diagnosis , Absenteeism , Adolescent , Child , Chronic Disease , Cross-Sectional Studies , Diagnosis, Differential , Headache/classification , Headache/epidemiology , Humans , Migraine Disorders/classification , Migraine Disorders/diagnosis , Migraine Disorders/epidemiology , Tension-Type Headache/classification , Tension-Type Headache/epidemiology , United States
5.
Int J Clin Pract ; 54(7): 466-9, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11070573

ABSTRACT

Data from a subgroup of adolescents (12-17 years) entered into a one-year open-label phase of a large international study were analysed to evaluate response rates and tolerability of zolmitriptan for the acute treatment of migraine. In the open-label phase of this study, the first two migraine attacks were treated with zolmitriptan 2.5 mg and subsequent attacks with zolmitriptan 2.5 mg or 5 mg, at the patient's discretion, for up to 12 months. Two-hour headache and pain-free responses were evaluated and adverse events were recorded. Thirty-eight adolescents treated 276 migraine attacks of any intensity. The overall headache response at 2 hours was 80% (88% and 70% with zolmitriptan 2.5 mg and 5 mg, respectively), and the pain-free response was 66% (76% and 52% for zolmitriptan 2.5 mg and 5 mg, respectively). Response rates were independent of whether or not migraine was associated with aura or menses. During prolonged use, patients learned to adjust the dose of zolmitriptan to effectively manage their migraine. Treatment was well tolerated. In conclusion, preliminary data indicate that zolmitriptan is effective in the acute treatment of migraine in adolescents and is well tolerated.


Subject(s)
Migraine Disorders/drug therapy , Oxazolidinones/therapeutic use , Serotonin Receptor Agonists/therapeutic use , Acute Disease , Adolescent , Child , Dose-Response Relationship, Drug , Female , Humans , Male , Pain Measurement , Treatment Outcome , Tryptamines
6.
Headache ; 36(7): 419-22, 1996.
Article in English | MEDLINE | ID: mdl-8783473

ABSTRACT

An open prospective study was undertaken to assess the efficacy and safety of subcutaneous sumatriptan in 50 consecutive children ages 6 to 18 years with severe migraine. There were 28 females and 22 males. The dose of sumatriptan was 0.06 mg/kg. Parameters included overall efficacy, time to relief, recurrence rate, adverse events, and objective global rating. Overall efficacy, defined by headache reduction from severe or moderate to mild or none, was 78%. Twenty-six percent responded within 30 minutes, 46% responded in 60 minutes, and 6% responded between 1 to 2 hours. Twenty-two percent had no response or a suboptimal response. Recurrence rate was only 6%. There was a difference in efficacy between male and female, as 91% of the males responded, while only 68% of the females responded. The males had more migraine alone while the females had migraine often with a coexistent tension-type headache. Eighty percent of all the patients had some adverse event which was usually mild and transient; however, one patient developed a transitory confusional state which resolved in 2 hours. Eighty-four percent reported a global rating of good to excellent, while 16% rated the treatment only fair to poor. These findings suggest that subcutaneous sumatriptan can be both effective and safe in childhood migraine, especially in dealing with migraine alone.


Subject(s)
Ambulatory Care , Migraine Disorders/drug therapy , Sumatriptan/therapeutic use , Vasoconstrictor Agents/therapeutic use , Acute Disease , Adolescent , Child , Female , Humans , Injections, Subcutaneous , Male , Migraine Disorders/complications , Neurology , Pediatrics , Prospective Studies , Sumatriptan/administration & dosage , Tension-Type Headache/complications , Vasoconstrictor Agents/administration & dosage
7.
Headache ; 34(10): 578-80, 1994.
Article in English | MEDLINE | ID: mdl-7843951

ABSTRACT

This study was undertaken to determine whether pediatric patients with migraine without aura who have failed standard outpatient regimens including intravenous dihydroergotamine mesylate (DHE) in conjunction with oral metoclopramide would respond to an inpatient treatment protocol of intravenous DHE and oral metoclopramide. Thirty patients were evaluated in this study which was an open label, retrospective review of treatment. Independent of the duration of the refractory migraine, 80% of the patients responded to the protocol with only minimal side effect. The dose of DHE mesylate ranged from 0.1 to 0.5 mg. The dose of DHE is lower than is typically utilized in standard adult protocols. The patients received an average of five doses of DHE.


Subject(s)
Dihydroergotamine/therapeutic use , Headache/drug therapy , Adolescent , Child , Drug Therapy, Combination , Female , Humans , Inpatients , Male , Metoclopramide/therapeutic use , Retrospective Studies
8.
Appl Opt ; 6(7): 1201-4, 1967 Jul 01.
Article in English | MEDLINE | ID: mdl-20062163

ABSTRACT

This paper delineates a method of determining the design criteria for narrow optical passband filters used in the reception of nonparallel modulated monochromatic radiation. The analysis results in straightforward mathematical expressions for calculating the filter width and design center wavelength which maximize the signal-to-noise ratio. Two cases are considered: (a) the filter is designed to have a maximum transmission (for normal incidence) at the incident wavelength, but with the spectral width optimized, and (b) both the design wavelength and the spectral width are optimized. It is shown that the voltage signal-to-noise ratio for case (b) is 2((1/2)) that of case (a). Numerical examples are calculated.

SELECTION OF CITATIONS
SEARCH DETAIL
...