DOCSLIB.ORG

Men, Women, and Migraine: the Role of Sex, Hormones, Obesity, and PTSD

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Men, Women, and Migraine: the Role of Sex, Hormones, Obesity, and PTSD A SUPPLEMENT TO THE JOURNAL OF FAMILY PRACTICE VOL 61, NO 4 • APRIL 2012 Men, WoMen, and MIgraIne: The role of Sex, horMoneS, obesity, and PTSd Commentary Pain—It’s not that simple The benefits of interdisciplinary pain management A SUPPLEMENT TO THE JOURNAL OF FAMILY PRACTICE For more information, visit us at chronicpainperspectives.com April 2012 CONTENTS commentary S5 | Pain—It’s not that simple Robert Bonakdar, MD FEATURE ARTIcLeS S7 | Men, women, and migraine: The role of sex, hormones, obesity, and PTSD B. Lee Peterlin, DO Anne H. Calhoun, MD Fred Balzac S12 | The benefits of S7 interdisciplinary pain management Carl Noe, MD Charles F. Williams Special thanks to our editorial consultant Kristen Georgi for her research, writing, and editing efforts. Cover illustration: Stephanie Dalton Cowan cHronIc PaIn PerSPectIVeS Please snap a picture aDVISORY BoarD with your Smartphone to see our new Web site. roBERT A. BonaKDar, mD PaUL J. cHrISto, mD, mBa Board Chairman Assistant Professor, Division of Pain Medicine, Director of Pain Management, Director, Multidisciplinary Pain Scripps Center for Integrative Fellowship Program (2003-2011), Medicine; Assistant Clinical Johns Hopkins For information about sponsorship opportunities, Professor, Department of Family University School please contact Elaine Coutsouridis at and Preventative Medicine, of Medicine, Baltimore, MD [email protected] or, 973-663-1232. University of California School of Medicine, San Diego, CA For information about submitting manuscripts, please contact Editor at [email protected]. mIcHaeL r. cLarK, mD, mPH, mBa Associate Professor and Chronic Pain Perspectives™ is a supplement to Director, Chronic Pain The Journal of Family Practice™ and a registered Treatment Program, Johns trademark of Quadrant HealthCom Inc. Hopkins University School Copyright © Quadrant HealthCom Inc. 2012 of Medicine, Baltimore, MD S4 | april 2012 • VOl 61, NO 4 • SUPPLEMENT TO THE JOUrNAL OF FaMILY PRACTiCE chroniCpaiNpErSpectives.com Commentary Pain – It’s not that simple The complex problem of pain rarely has a simple solution. Here’s why. Robert Bonakdar, MD Director of Pain Management Scripps Center for Integrative Medicine San Diego, CA; Advisory Board Chairman, Chronic Pain Perspectives L. Mencken was a 20th century journal- fact that their pain is not a discrete entity. Pain ist and critic who provided us with a is a doorway into a sequela of suffering that Hnumber of great quotes. One of my needs to be appreciated and addressed if we favorites is: have any hope of helping our patients return to functionality. “There is always an easy solution to every human problem—neat, plausible, and wrong."1 Pain does not travel alone The research guides us to understand that I like this quote because it applies to many when there is pain, there are current or emerg- aspects of pain. In this and upcoming issues ing issues with mood, energy, cognition, and of Chronic Pain Perspectives, we examine why function. Although depression is found in chronic pain needs to be viewed as a complex approximately 10% to 15% of all patients seen situation that affects the mind, body, and soul in primary care, those who have chronic pain of our patients, one in which the simple, neat have been found to present with depression as solution is often not enough. Although we may much as 58% of the time,2 making it the most wish to “tackle” pain as we would an objective common psychiatric comorbity. Conversely, in a value and reduce it with a unimodal approach, large study of primary care patients with major experience and several lines of research dem- depressive disorder, chronic pain was present onstrate that we are positioning ourselves, nearly 66% of the time.3 and our patients, for disappointment. The Beyond depression, the patient with chronic problem here is not in our patients, but in the pain is more likely to have coexisting anxiety,3 chronicpainperspectives.com SUPPLEMENT TO THE JOURNAL OF FAMILY PRACTICE • VOL 61, NO 4 • april 2012 | S5 panic,3 sleep dysfunction characterized by sleep this out; in a 30-year study of headache, over maintenance insomnia and fatigue,4 restless leg the course of their illness patients were found syndrome,4 and loss of gray matter density that to switch from their initial diagnosis of head- may be reversible.5,6 ache type to other headache diagnoses more This brings up the age-old intellectual ques- than 80% of the time.8 [Figure] tion, “Which came first?” What we appreciate What this creates is the awareness that we more and more—through understanding the are not really fighting a single condition, but a common pathophysiological mechanisms seen complex picture of suffering, and that we must in conditions such as migraine, depression, and take into account many layers of the patient The problem cardiovascular disease,7—is that these disor- who presents to us. In this way we can push here is not in ders are co-developing and making their way past the simple but disappointing solution to a into the chief complaint in various layers and more integrative, individualized, complex one our patients, word choices. that holds the potential for relief on multiple but in the levels. fact that their I’ll leave you with another Mencken quote pain is not Pain does not stay in the same silo that offers sage advice in this regard: a discrete As we focus more closely on pain as a foe that entity. we can subdue, we find that it exerts an influ- “The essence of science is that it is always ence on many “friends,” and that pain and its willing to abandon a given idea, however elusive friends have the ability to jump from one fundamental it may seem to be, for a bet- arena into another, sometimes making the bat- ter one.“ 9 tle feel insurmountable. Recent research points REFERENCES 1. Mencken HL. “The Divine Afflatus,” A Mencken FIGURE: Combinations of headache subtypes across 30 years Chrestomathy. Chapter 25, p. 443. 1949. among participants who met criteria for migraine or tension-type 2. Castro M, Kraychete D, Daltro C, et al. Comorbid anxi- headache (n=346) ety and depression disorders in patients with chronic pain. Arq Neuropsiquiatr. 2009;67(4):982-985. 3. Arnow BA, Hunkeler EN, Blasey CM, et al. Comorbid depression, chronic pain, and disability in primary care. Migrane Tension-type Psychosom Med. 2006;68:262-268. without aura headache 4. Alattar M, Harrington JJ, Mitchell CM, et al. Sleep problems in primary care: A North Carolina Family Practice Research Network (NC_FP_RN) study. J Am Bd Fam Med. 2007;20(4)365-374. 5. Apkarian AV, Sosa Y, Sonty S, et al. Chronic back pain is associated with decreased prefrontal and thalamic 31.5% gray matter density. J Neurosci. 2004;24(46):10410- 24.6% 10415. 36.4% 6. Seminowicz DA, Wideman TH, Naso L, et al. Effective 2.0% treatment of chronic low back pain in humans reverses 4.9% abnormal brain anatomy and function. J Neurosci. 2011;31(20)7540-7550. 0.6% 7. Park KIE, Pepine CJ. Pathophysiologic mechanisms linking impaired cardiovascular health and neuro- logic function: the year in review. Clev Clin J Med. Migrane 2010;77(suppl 3):S40-S45. with aura 8. Merikangas KR, Cui L, Kalydjian, et al. Magnitude, impact, and stability of primary headache sub- types: 30 year prospective Swiss cohort study. BMJ. Source: Adapted from Merikangas KR, et al. Magnitude, impact, and stability of primary headache 2011;343:d5706. subtypes: 30 year prospective Swiss cohort study. BMJ. 2011;343:d5706 9. Mencken HL. Minority Report, no 232. 1956. S6 | april 2012 • VOL 61, NO 4 • SUPPLEMENT TO THE JOURNAL OF FAMILY PRACTICE chronicpainperspectives.com Feature article Men, women, and migraine: the role of sex, hormones, obesity, and PtSD Links between migraine and certain comorbidities suggest new approaches to patient education, screening, and treatment. B. Lee Peterlin, DO Assistant Professor of Neurology Director, JHU Headache Research, Johns Hopkins University Baltimore, MD Anne H. Calhoun, MD Partner, Co-Founder, Carolina Headache Institute Adjunct Professor, Department of Anesthesiology; Adjunct Professor, Department of Psychiatry, University of North Carolina Chapel Hill, NC Fred Balzac Medical writer Jay, NY igraine is a common neurologic dis- much higher in females from age 12 across the order that occurs in approximately lifespan.1 In comparison, for tension-type head- 3 times as many females as males in ache the female to male ratio of occurrence is M 2 the United States. Among 30,000 respondents, 5:4, occurring only slightly more in females. the American Migraine Study II found that the The reasons for this disparity in migraine preva- prevalence of migraine was 18.2% among lence are not well understood. The dispropor- females and 6.5% among males, and was tionate number of women of reproductive age Disclosures B. Lee Peterlin, DO, has received grant/research support from GlaxoSmithKline, has served as a consultant to Nautilus, and has served on the speaker’s bureau of Zogenix. She holds a provisional patent for use of adiponectin-modulating drugs for migraine. Anne H. Calhoun, MD, has no conflicts of interest to report. Fred Balzac has no conflicts of interest to report. chronicpainperspectives.com SUPPLEMENT TO THE JOURNAL OF FAMILY PRACTICE • VOL 61, NO 4 • april 2012 | S7 with migraine suggests that hormonal factors Hormonal factors: may play a role, but the complex pathophysiol- Menstrual-related migraine ogy of migraine indicates additional factors are With migraine disproportionately affecting involved.3 women of reproductive age, as many as 70% Recent research on menstrual-related of female migraineurs are aware of a menstrual migraine and two significant comorbidities of association with their headaches.15 A menstrual migraine—obesity and posttraumatic stress migraine is defined as migraine without aura disorder (PTSD)—shed new light on the dif- that occurs during the 5-day window that begins ferences in how men and women present with 2 days before the onset of bleeding and extends As many and experience this often disabling disorder.
Load more

Recommended publications
  • Clinical Features, Anger Management and Anxiety
    Tarantino et al. The Journal of Headache and Pain 2013, 14:39 http://www.thejournalofheadacheandpain.com/content/14/1/39 RESEARCH ARTICLE Open Access Clinical features, anger management and anxiety: a possible correlation in migraine children Samuela Tarantino1, Cristiana De Ranieri2, Cecilia Dionisi3, Monica Citti1, Alessandro Capuano1, Federica Galli4, Vincenzo Guidetti3, Federico Vigevano1, Simonetta Gentile2, Fabio Presaghi3 and Massimiliano Valeriani1,5* Abstract Background: Psychological factors can increase severity and intensity of headaches. While great attention has been placed on the presence of anxiety and/or depression as a correlate to a high frequency of migraine attacks, very few studies have analyzed the management of frustration in children with headache. Aim of this study was to analyze the possible correlation between pediatric migraine severity (frequency and intensity of attacks) and the psychological profile, with particular attention to the anger management style. Methods: We studied 62 migraineurs (mean age 11.2 ± 2.1 years; 29 M and 33 F). Patients were divided into four groups according to the attack frequency (low, intermediate, high frequency, and chronic migraine). Pain intensity was rated on a 3-levels graduate scale (mild, moderate and severe pain). Psychological profile was assessed by Picture Frustration Study test for anger management and SAFA-A scale for anxiety. Results: We found a relationship between IA/OD index (tendency to inhibit anger expression) and both attack frequency (r = 0.328, p = 0.041) and intensity (r = 0.413, p = 0.010). When we analyzed the relationship between anxiety and the headache features, a negative and significant correlation emerged between separation anxiety (SAFA-A Se) and the frequency of attacks (r = −0.409, p = 0.006).
    [Show full text]
  • The Beliefs, Attitudes and Views of University Students About Anger
    Educational Sciences: Theory & Practice • 14(6) • 2071-2082 ©2014 Educational Consultancy and Research Center www.edam.com.tr/estp DOI: 10.12738/estp.2014.6.2314 The Beliefs, Attitudes and Views of University Students about Anger and the Effects of Cognitive Behavioral Therapy-Oriented Anger Control and Anxiety Management Programs on Their Anger Management Skill Levels T. Fikret KARAHANa B. Murat YALÇINb Ondokuz Mayıs University Melda M. ERBAŞc Ege University Abstract This study was designed as a qualitative focus group using a randomized controlled trail with a mixed methodol- ogy. The study has dual aims. First we searched the beliefs, attitudes and views of 176 university students on how to deal with anger using eight focus discussion groups. The anxiety and anger levels of these students were investigated with the Beck Anxiety Inventory and State Trait Anger Scale, and these values were accepted as pretest scores for the participants. The 32 students with the highest scores were selected. These students were randomized into study (n = 16 students) and control groups (n = 16 students). The participants in the study group received a behavioral therapy-oriented anger management skills training program consisting of 11 sessions, 90 minutes per session. After the program was completed the Beck Anxiety Inventory and State Trait Anger Scale were re-administered to both participants in the study and control groups, giving the post-test results. The study group attended two enhancement sessions, three and six months after the termination of the program, and these tests were then reapplied to both groups of participants (1st follow-up and 2nd follow-up tests).
    [Show full text]
  • Menstrually Related and Nonmenstrual Migraines in A
    MENSTRUALLY RELATED AND NONMENSTRUAL MIGRAINES IN A FREQUENT MIGRAINE POPULATION: FEATURES, CORRELATES, AND ACUTE TREATMENT DIFFERENCES A dissertation presented to the faculty of the College of Arts and Sciences of Ohio University In partial fulfillment of the requirements for the degree Doctor of Philosophy Brenda F. Pinkerman March 2006 This dissertation entitled MENSTRUALLY RELATED AND NONMENSTRUAL MIGRAINES IN A FREQUENT MIGRAINE POPULATION: FEATURES, CORRELATES, AND ACUTE TREATMENT DIFFERENCES by BRENDA F. PINKERMAN has been approved for the Department of Psychology and the College of Arts and Sciences by Kenneth A. Holroyd Distinguished Professor of Psychology Benjamin M. Ogles Interim Dean, College of Arts and Sciences PINKERMAN, BRENDA F. Ph.D. March 2006. Clinical Psychology Menstrually Related and Nonmenstrual Migraines in a Frequent Migraine Population: Features, Correlates, and Acute Treatment Differences (307 pp.) Director of Dissertation: Kenneth A. Holroyd This research describes and compares menstrually related migraines as defined by recent proposed guidelines of the International Headache Society (IHS, 2004) to nonmenstrual migraines in a population of female migraineurs with frequent, disabling migraines. Migraines are compared by frequency per day of the menstrual cycle, headache features, use of abortive and rescue medications, and acute migraine treatment outcomes. In addition, this study explores predictors of acute treatment response and headache recurrence within 24 hours following acute migraine treatment for menstrually related migraines. Participants are 107 menstruating female migaineurs who met IHS (2004) proposed criteria for menstrually related migraines and completed headache diaries using hand-held computers. Diary data are analyzed using repeated measures logistic regression. The frequency of migraines is significantly increased during the perimenstrual period, and menstrually related migraines are of longer duration and greater frequency with longer lasting disability than nonmenstrual migraines.
    [Show full text]
  • Migraine: Spectrum of Symptoms and Diagnosis
    KEY POINT: MIGRAINE: SPECTRUM A Most patients develop migraine in the first 3 OF SYMPTOMS decades of life, some in the AND DIAGNOSIS fourth and even the fifth decade. William B. Young, Stephen D. Silberstein ABSTRACT The migraine attack can be divided into four phases. Premonitory phenomena occur hours to days before headache onset and consist of psychological, neuro- logical, or general symptoms. The migraine aura is comprised of focal neurological phenomena that precede or accompany an attack. Visual and sensory auras are the most common. The migraine headache is typically unilateral, throbbing, and aggravated by routine physical activity. Cutaneous allodynia develops during un- treated migraine in 60% to 75% of cases. Migraine attacks can be accompanied by other associated symptoms, including nausea and vomiting, gastroparesis, di- arrhea, photophobia, phonophobia, osmophobia, lightheadedness and vertigo, and constitutional, mood, and mental changes. Differential diagnoses include cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoenphalopathy (CADASIL), pseudomigraine with lymphocytic pleocytosis, ophthalmoplegic mi- graine, Tolosa-Hunt syndrome, mitochondrial disorders, encephalitis, ornithine transcarbamylase deficiency, and benign idiopathic thunderclap headache. Migraine is a common episodic head- (Headache Classification Subcommittee, ache disorder with a 1-year prevalence 2004): of approximately 18% in women, 6% inmen,and4%inchildren.Attacks Recurrent attacks of headache, consist of various combinations of widely varied in intensity, fre- headache and neurological, gastrointes- quency, and duration. The attacks tinal, and autonomic symptoms. Most are commonly unilateral in onset; patients develop migraine in the first are usually associated with an- 67 3 decades of life, some in the fourth orexia and sometimes with nausea and even the fifth decade.
    [Show full text]
  • Download/Pdf/158373258.Pdf
    Adler et al. BMC Public Health (2020) 20:1168 https://doi.org/10.1186/s12889-020-09206-2 RESEARCH ARTICLE Open Access Magnitude of problematic anger and its predictors in the Millennium Cohort Amy B. Adler1, Cynthia A. LeardMann2,3*, Kimberly A. Roenfeldt3, Isabel G. Jacobson2,3, David Forbes4, for the Millennium Cohort Study Team Abstract Background: Problematic anger is intense anger associated with elevated generalized distress and that interferes with functioning. It also confers a heightened risk for the development of mental health problems. In military personnel and veterans, previous studies examining problematic anger have been constrained by sample size, cross-sectional data, and measurement limitations. Methods: The current study used Millennium Cohort survey data (N = 90,266) from two time points (2013 and 2016 surveys) to assess the association of baseline demographics, military factors, mental health, positive perspective, and self-mastery, with subsequent problematic anger. Results: Overall, 17.3% of respondents reported problematic anger. In the fully adjusted logistic regression model, greater risk of problematic anger was predicted by certain demographic characteristics as well as childhood trauma and financial problems. Service members who were in the Army or Marines, active duty (vs. reserves/national guard), and previously deployed with high levels of combat had increased risk for problematic anger. Veterans were also more likely to report problematic anger than currently serving personnel. Mental health predictors included posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and comorbid PTSD/MDD. Higher levels of positive perspective and self-mastery were associated with decreased risk of problematic anger. Conclusion: Not only did 1 in 6 respondents report problematic anger, but risk factors were significant even after adjusting for PTSD and MDD, suggesting that problematic anger is more than an expression of these mental health problems.
    [Show full text]
  • Hormonal Contraceptive Treatment May Reduce the Risk of Fibromyalgia in Women with Dysmenorrhea: a Cohort Study
    Journal of Personalized Medicine Article Hormonal Contraceptive Treatment May Reduce the Risk of Fibromyalgia in Women with Dysmenorrhea: A Cohort Study Cheng-Hao Tu 1,* , Cheng-Li Lin 2, Su-Tso Yang 3,4, Wei-Chih Shen 5,6 and Yi-Hung Chen 1,7,8,* 1 Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan 2 Management Office for Health Data, China Medical University Hospital, Taichung 404332, Taiwan; [email protected] 3 Department of Medical Imaging, China Medical University Hospital, Taichung 404332, Taiwan; [email protected] 4 School of Chinese Medicine, China Medical University, Taichung 404333, Taiwan 5 Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404332, Taiwan; [email protected] 6 Department of Computer Science and Information Engineering, Asia University, Taichung 413305, Taiwan 7 Traditional Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan 8 Department of Photonics and Communication Engineering, Asia University, Taichung 41354, Taiwan * Correspondence: [email protected] (C.-H.T.); [email protected] (Y.-H.C.); Tel.: +886-4-22053366 (C.-H.T.) (ext. 3336) Received: 17 November 2020; Accepted: 11 December 2020; Published: 14 December 2020 Abstract: Dysmenorrhea is the most common gynecological disorder for women in the reproductive age. Study has indicated that dysmenorrhea might be a general risk factor of chronic pelvic pain and even chronic non-pelvic pain, such as fibromyalgia. We used the Longitudinal Health Insurance Database 2000 from the Taiwan National Health Research Institutes Database to investigate whether women with dysmenorrhea have a higher risk of fibromyalgia and whether treatment of dysmenorrhea reduced the risk of fibromyalgia.
    [Show full text]
  • Mindfulness-Based and Cognitive-Behavior Therapy for Anger-Management : an Integrated Approach Jeffrey R
    Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Psychology Dissertations Student Dissertations, Theses and Papers 2007 Mindfulness-based and Cognitive-behavior Therapy for Anger-management : an Integrated Approach Jeffrey R. Kelly Philadelphia College of Osteopathic Medicine, [email protected] Follow this and additional works at: http://digitalcommons.pcom.edu/psychology_dissertations Part of the School Psychology Commons Recommended Citation Kelly, Jeffrey R., "Mindfulness-based and Cognitive-behavior Therapy for Anger-management : an Integrated Approach" (2007). PCOM Psychology Dissertations. Paper 68. This Dissertation is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been accepted for inclusion in PCOM Psychology Dissertations by an authorized administrator of DigitalCommons@PCOM. For more information, please contact [email protected]. PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE DEPARTMENT OF PSYCHOLOGY Dissertation Approval This is to certify that the thesis presented to us by Jeffrey Kelly on the 30th day of May, 2006, in partial fulfillment of the requirements for the degree of Doctor of Psychology, has been examined and is acceptable in both scholarship and literary quality. Committee Members' Signatures: Diane Smallwood, Psy.D. , Chairperson George McCloskey, Ph.D. Vincent R. Stranges, Ph.D Robert A. DiTomasso, Ph.D., ABPP, Chair, Department of Psychology 111 Acknowledgements I would like to express my gratitude and appreciation to Dr. Diane Smallwood for her encouragement, guidance, and time with this dissertation project. The interest and enthusiasm she had for this project was the catalyst that kept this work moving forward. I would like to thank Dr. George McCloskey for the guidance, insight, and time he dedicated to this dissertation project.
    [Show full text]
  • Anger and PTSD
    VOLUME 31/NO. 3 • ISSN: 1050-1835 • 2020 Research Quarterly advancing science and promoting understanding of traumatic stress Leslie Morland, PhD, PsyD Published by: VA Health Care System, San Diego, CA National Center for PTSD National Center for PTSD Pacific Islands Division, Honolulu, HI VA Medical Center (116D) University of California, San Diego, CA 215 North Main Street White River Junction Eric Elbogen, PhD, ABPP (Forensic) Vermont 05009-0001 USA Anger and PTSD VA National Center on Homelessness among Veterans (802) 296-5132 Duke University Medical Center, Durham, NC FAX (802) 296-5135 Email: [email protected] Kirsten Dillon, PhD Duke University Medical Center, Durham, NC All issues of the PTSD Research Durham VA Health Center, Durham, NC Quarterly are available online at: www.ptsd.va.gov Dysregulated anger and heightened levels of recent research on assessing anger and aggression are prominent among Veterans and aggression. We will then discuss treatments for Editorial Members: civilians with posttraumatic stress disorder (PTSD). PTSD and anger, and their effects on reducing Editorial Director Two decades of research with Veterans have found a anger outcomes, followed by a brief review of Matthew J. Friedman, MD, PhD robust relationship between the incidence of PTSD some recent studies using technology and novel Bibliographic Editor and elevated rates of anger, aggression, and approaches to target anger. We will end with some David Kruidenier, MLS violence. When considering anger in the context of conclusions and suggestions for future research. Managing Editor PTSD it is important to note that previously the Heather Smith, BA Ed fourth edition of the Diagnostic and Statistical Impact of Anger Manual of Mental Disorders (DSM-IV) combined the Anger has been found to contribute to a range of National Center Divisions: behavioral and emotional aspects of anger in Executive difficulties among individuals with PTSD, including Criterion D3.
    [Show full text]
  • Medical Treatment Guidelines (MTG)
    Post-Traumatic Stress Disorder and Acute Stress Disorder Effective: November 1, 2021 Adapted by NYS Workers’ Compensation Board (“WCB”) from MDGuidelines® with permission of Reed Group, Ltd. (“ReedGroup”), which is not responsible for WCB’s modifications. MDGuidelines® are Copyright 2019 Reed Group, Ltd. All Rights Reserved. No part of this publication may be reproduced, displayed, disseminated, modified, or incorporated in any form without prior written permission from ReedGroup and WCB. Notwithstanding the foregoing, this publication may be viewed and printed solely for internal use as a reference, including to assist in compliance with WCL Sec. 13-0 and 12 NYCRR Part 44[0], provided that (i) users shall not sell or distribute, display, or otherwise provide such copies to others or otherwise commercially exploit the material. Commercial licenses, which provide access to the online text-searchable version of MDGuidelines®, are available from ReedGroup at www.mdguidelines.com. Contributors The NYS Workers’ Compensation Board would like to thank the members of the New York Workers’ Compensation Board Medical Advisory Committee (MAC). The MAC served as the Board’s advisory body to adapt the American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines to a New York version of the Medical Treatment Guidelines (MTG). In this capacity, the MAC provided valuable input and made recommendations to help guide the final version of these Guidelines. With full consensus reached on many topics, and a careful review of any dissenting opinions on others, the Board established the final product. New York State Workers’ Compensation Board Medical Advisory Committee Christopher A. Burke, MD , FAPM Attending Physician, Long Island Jewish Medical Center, Northwell Health Assistant Clinical Professor, Hofstra Medical School Joseph Canovas, Esq.
    [Show full text]
  • Migraine Headache Prophylaxis Hien Ha, Pharmd, and Annika Gonzalez, MD, Christus Santa Rosa Family Medicine Residency Program, San Antonio, Texas
    Migraine Headache Prophylaxis Hien Ha, PharmD, and Annika Gonzalez, MD, Christus Santa Rosa Family Medicine Residency Program, San Antonio, Texas Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and headache-related distress. Preventive therapy may also improve quality of life and prevent the progression to chronic migraines. Some indications for preventive therapy include four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication- overuse headaches. Identifying and managing environmental, dietary, and behavioral triggers are useful strategies for preventing migraines. First-line med- ications established as effective based on clinical evidence include divalproex, topiramate, metoprolol, propranolol, and timolol. Medications such as ami- triptyline, venlafaxine, atenolol, and nadolol are probably effective but should be second-line therapy. There is limited evidence for nebivolol, bisoprolol, pindolol, carbamazepine, gabapentin, fluoxetine, nicardipine, verapamil, nimodipine, nifedipine, lisinopril, and candesartan. Acebutolol, oxcarbazepine, lamotrigine, and telmisartan are ineffective. Newer agents target calcitonin gene-related peptide pain transmission in the migraine pain pathway and have recently received approval from the U.S. Food and Drug Administration; ​​​how- ever, more studies of long-term effectiveness and adverse effects are needed. The complementary treatments petasites, feverfew, magnesium, and riboflavin are probably effective. Nonpharmacologic therapies such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic feedback, and cognitive behavior therapy also have good evidence to support their use in migraine prevention. (Am Fam Physician. 2019; 99(1):17-24.
    [Show full text]
  • Assessment and Treatment of Posttraumatic Anger and Aggression: a Review
    Volume 49, Number 5, 2012 JRRDJRRD Pages 777–788 Assessment and treatment of posttraumatic anger and aggression: A review Casey T. Taft, PhD;1–2* Suzannah K. Creech, PhD;1,3 Lorig Kachadourian, PhD1–2 1National Center for PTSD, Department of Veterans Affairs (VA) Boston Healthcare System, Boston, MA; 2Boston Uni- versity School of Medicine, Boston, MA; 3Providence VA Medical Center, Providence, RI; and Warren Alpert Medical School of Brown University, Providence, RI Abstract—The Department of Veterans Affairs (VA) and hyperarousal and are increasingly being viewed as a Department of Defense’s (DOD) recently published and updated defining feature of patients’ clinical presentations. Department of Veterans Affairs/Department of Defense VA/ DOD Clinical Practice Guideline for Management of Post- Traumatic Stress includes irritability, severe agitation, and METHODS anger as specific symptoms that frequently co-occur with PTSD. For the first time, the guideline includes nine specific We begin by reviewing literature on the associations recommendations for the assessment and treatment of PTSD- related anger, irritability, and agitation. This article will review between PTSD and both anger and aggression. The the literature on PTSD and its association with anger and review that occurred for the update in the 2010 VA/DOD aggression. We highlight explanatory models for these associa- PTSD clinical practice guideline and additional relevant tions, factors that contribute to the occurrence of anger and literature published since that guideline review is aggression in PTSD, assessment of anger and aggression, and included. We then discuss theoretical models that have effective anger management interventions and strategies. been proposed to explain these associations.
    [Show full text]
  • Effects of the Menstrual Cycle on Medical Disorders
    REVIEW ARTICLE Effects of the Menstrual Cycle on Medical Disorders Allison M. Case, MD; Robert L. Reid, MD xacerbation of certain medical conditions at specific phases of the menstrual cycle is a well-recognized phenomenon. We review the effects of the menstrual cycle on medical conditions, including menstrual migraine, epilepsy, asthma, rheumatoid arthritis, irritable bowel syndrome, and diabetes. We discuss the role of medical suppression of ovulationE using gonadotropin-releasing hormone agonists in the evaluation and treatment of these disorders. Peer-reviewed publications from English-language literature were located via MEDLINE or from bibliographies of relevant articles. We reviewed all review articles, case reports and series, and therapeutic trials. Emphasis was placed on diagnosis and therapy of menstrual cycle– related exacerbations of disease processes. Abrupt changes in the concentrations of circulating ovar- ian steroids at ovulation and premenstrually may account for menstrual cycle–related changes in these chronic conditions. Accurate documentation of symptoms on a menstrual calendar allows identification of women with cyclic alterations in disease activity. Medical suppression of ovula- tion using gonadotropin-releasing hormone agonists can be useful for both diagnosis and treat- ment of any severe, recurrent menstrual cycle–related disease exacerbations. Arch Intern Med. 1998;158:1405-1412 The menstrual cycle, an event that punctu- Several theories have been proposed to ates the lives of most women, may be asso- explain these menstrual cycle–related effects ciated with diverse physical, psychological, on existing disease processes, including fluc- and behavioral changes. Not surprisingly, it tuations in levels of sex steroids, cyclic alter- plays a significant role in women’s health and ations in the immune system, and changing disease.
    [Show full text]