It is necessary to expand the guidance and support of breastfeeding for nursing mothers in the early postpartum period.
To compare the preventive treatment benefits of amitriptyline and aerobic exercise or amitriptyline alone in patients with chronic migraine. Method: Sixty patients, both genders, aged between 18 and 50 years, with a diagnosis of chronic migraine, were randomized in groups called amitriptyline and aerobic exercise or amitriptyline alone. The following parameters were evaluated: headache frequency, intensity and duration of headache, days of the analgesic medication use, body mass index (BMI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores. Results: In the evaluated parameters, was observed decrease in headache frequency (p=0.001), moderate intensity (p=0.048), in headache duration (p=0.001), the body mass index (p=0.001), Beck Depression Inventory (p=0.001) and Beck Anxiety Inventory scores (p=0.001), when groups were compared in the end of third month. Conclusion: In this study, the amitriptyline was an effective treatment for chronic migraine, but its efficacy was increased when combined with aerobic exercise.
The aim of this study was to evaluate the visual attention of children with migraine and compare it with a control group. Thirty migrainous children and 30 controls without headache were subjected to a visual attention assessment with Trail Making Tests (TMT) A/B, Letter Cancellation Test, and the Brazilian computerized test Visual Attention Test, third edition. The migraine group was evaluated after 2 days without headache. The migraine group had an inferior performance compared with the control group on TMT A (P = 0.03) and B (P = 0.001), and more errors on tasks 1 (P = 0.032) and 2 (P = 0.015) of the Visual Attention Test, presenting difficulty with selective and alternate attention. Attention is a neurological function that depends on structures such as the brainstem, cerebral cortex and the limbic system and on neurotransmitters such as dopamine and noradrenaline. The neurochemical aspects involved in the physiopathology of migraine and attention mechanisms probably predispose these children to visual attention deficits.
Chronic migraine is a condition with significant prevalence all around the world and high socioeconomic impact, and its handling has been challenging neurologists. Developments for understanding its mechanisms and associated conditions, as well as that of new therapies, have been quick and important, a fact which has motivated the Latin American and Brazilian Headache Societies to prepare the present consensus. The treatment of chronic migraine should always be preceded by a careful diagnosis review; the detection of possible worsening factors and associated conditions; the stratification of seriousness/impossibility to treat; and monitoring establishment, with a pain diary. The present consensus deals with pharmacological and nonpharmacological forms of treatment to be used in chronic migraine.
-Objective: To analyze the demographic features of the population sample, the time of headache complaint until first consultation and the diagnosis of primary and secondary headaches. Method: 3 3 2 8 patients were analyzed re t rospectively and divided according to gender, age, race, school instruction, onset of headache until first consultation and diagnosis (ICHD-II, 2004). Results: Sex ratio (Female/Male) was 4:1, and the mean age was 40.7±15 years, without statistical diff e rences between sexes. Appro x i m a t e l y 65% of the patients were white and 55% had less than eight years of school instruction. Headache complaint until first consultation ranged from 1 to 5 years in 32.99% patients. The most prevalent diagnosis w e re migraine (37.98%), tension-type headache-TTH (22.65%) and cluster headache (2. 73%). C o n c l u s i o n :T h e re are few data on epidemiological features of headache clinic populations, mainly in developing countries. According to the literature, migraine was more frequent than TTH. It is noteworthy the low school instruction of this sample and time patient spent to seek for specialized attention. Hypnic headache syndrome was seen with an unusual frequency.KEY WORDS: headache, clinic-based study, epidemiology.Epidemiologia das cefaléias primárias e secundárias em um serviço terciário brasileiro. RESUMO -Objetivo:Analisar os aspectos demográficos da população em estudo, o tempo decorrido desde o início da queixa de cefaléia até a busca pelo serviço, assim como o diagnóstico das cefaléias primárias e secundárias. Método: 3328 pacientes foram analisados re t rospectivamente de acordo com sexo, idade, raça, escolaridade, tempo decorrido entre o início da cefaléia e a busca ao médico e diagnóstico (ICHD-II, 2 0 0 4 ) . Resultados: A razão Mulher/Homem foi 4:1, ambos com média de idade 40,7±15anos, não havendo diferença significativa entre os sexos. Aproximadamente 65% dos pacientes eram brancos e 55% tinha menos de 8 anos de escolaridade. A duração da queixa de cefaléia até a primeira consulta foi de 1 a 5 anos em 32,99% dos pacientes. Os diagnósticos mais prevalentes foram: migrânea (37,98%), cefaléia do tipo tensional-CTT (22,65%) e cefaléia em salvas (2,73%). Conclusão: Existem poucos dados epidemiológicos de pacientes atendidos em serviços terciários, principalmente em países subdesenvolvidos. De acordo com a literatura, a migrânea foi mais prevalente que a CTT. Também é relevante observar a baixa escolaridade da população, assim como o grande tempo de espera até a primeira consulta. Um número incomum de pacientes com síndrome de cefaléia hípnica foi observado na amostra.
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