This double-blind, placebo-controlled, multicenter, parallel-group study assessed whether subcutaneous sumatriptan administered during the migraine aura would prolong or modify the aura and prevent or delay development of the headache. One hundred seventy-one patients (88 receiving 6 mg sumatriptan, 83 receiving placebo) treated a single attack of migraine with typical aura at home, by self-injection. The median duration of aura following the first injection was 25 minutes for the sumatriptan group and 30 minutes for the placebo group (NS). The aura symptom profile was similar for the two treatment groups. The proportion of patients who developed a moderate or severe headache within 6 hours after dose administration was similar in the two groups--68% among those receiving sumatriptan and 75% among those receiving placebo (NS). Sumatriptan given during the aura did not prolong or alter the nature of the migraine aura and did not prevent or significantly delay headache development.

Two double-blind, placebo-controlled, randomised, multicentre, multinational, parallel-group studies were carried out to identify the optimum dose of intranasal sumatriptan for the acute treatment of migraine. Study medication was taken as a single dose through one nostril in the first study, and as a divided dose through two nostrils in the second study. Totals of 245 and 210 patients with a history of migraine were recruited into the one- and two-nostril studies, respectively. In both studies, headache severity had significantly improved at 120 min after doses of 10-40 mg sumatriptan compared to placebo (P < 0.05) and the greatest efficacy rates were obtained with 20 mg sumatriptan. With 20 mg sumatriptan 78% and 74% of patients experienced headache relief in one- and two-nostril studies respectively. Sumatriptan was generally well tolerated, the most frequently reported event being taste disturbance. The results of the two studies are similar and indicate that administering sumatriptan as a divided dose via two nostrils confers no significant advantage over single-nostril administration.

It is becoming more common for people with disabilities to procure service dogs as a form of assistive technology (AT). However, there is little qualitative research examining the impact of service dogs on engagement in valued daily activities (occupations) among persons with mobility impairments. This study used a qualitative descriptive methodology to learn about the experiences of four female service dog owners with mobility impairments, with a focus on the impact of service dog use on the performance of daily occupations and participation in social activities, and their experiences utilizing a service dog as a form of AT. Data analysis indicated that each participant’s service dog made a significant impact on their everyday lives and their ability to independently perform everyday activities; however, there are also unique challenges associated with service dog ownership that must be considered when evaluating benefits of service dog partnership. Overall, the positive outcomes reported by participants indicate that service dogs can be considered a beneficial, adaptable form of AT for some persons with mobility impairments.

Patients undergoing sedation in emergency departments (EDs) must be monitored carefully to ensure that, when they are being transferred to different departments, they are safe and that information about them is accurate. However, sedation scoring, for which several tools are available, should not be confused with assessment of consciousness, which is undertaken using the Glasgow Coma Scale. This article considers the validity and reliability of sedation scoring tools, and discusses how ED staff can choose and integrate them into patient care pathways.

Pediatricians are the primary care providers for most children and adolescents in the United States, so they need to feel comfortable caring for children and teens with depression. This topic is an extremely important one because the top three reasons teens die or get injured are related to accidents (3.7 per 100,000 for those ages 5-14 years and 28.5 per 100,000 for those ages 15-24 years), suicide (1 per 100,000 in the younger age group, and 12.5 deaths per 100,000 in those ages 5-14 years), and homicide (0.7 per 100,000 in those age 5-14 years, and 10.8 per 100,000 in those age 15-24 years). Each year, 21% of children ages 9 to 17 years are diagnosed with a mental or addictive disorder associated with at least minimum impairment, with 11% of these children having significant functional impairment and another 5% demonstrating extreme functional impairment. We know that one-half of all lifetime cases of mental health disorders start by age 14 years. This includes serious adult psychiatric illnesses such as major depressive disorder, anxiety disorders, and substance abuse. Three-quarters are present by age 24 years; therefore, interventions aimed at prevention or early treatment need to focus on youth. [Pediatr Ann. 2018;47(7):e261-e265.].