1) What was the rationale for doing the study? (2 marks) The reason for conducting this study was to investigate how efficient surgery would be for patients who are experiencing a migraine in one or several areas. 2) Briefly explain the design of the study (2 marks) Patients who endured moderate to severe migraines were interviewed a physician and had to complete a migraine diary for one month and a migraine headache information form. Patients who met the criteria were then offered to participate in the study followed by completing several questionnaires. Before undergoing the surgery, the patients were then injected botulinum toxin type A in the area where they felt the most pain from their migraine. Depending on where the patients …show more content…
(2 marks) There were 49 patients who underwent the actual surgery and 29 patients who underwent the sham surgery. 59% of the patients who underwent the actual surgery experienced migraines with no aura, 22% experienced migraines with aura and the remaining 18% experienced migraines both with and without aura. On the other side, patients who underwent the sham surgery had slightly similar results; 65% experienced migraines with no aura, 27% experienced migraines with aura and the remaining 8% experienced migraines with and without aura. 5) What did the authors find? (2 marks) The authors found that the patients who underwent the actual surgery showed a greater improvement in comparison to patients who were used as a control in the sham surgery. In the actual surgery, 57.1% of the patients reported complete elimination of their migraine, while only 3.8% reported the same for the placebo surgery. In terms of improvement, 83.7% of patients reported they were feeling significantly better, while in the sham surgery group approximately 57.7% significant …show more content…
I say this because it is unknown whether or not the patients were actually having a migraine or not. Patients could just have been saying that they are having a migraine for the purpose of being included in a study. This could possibly be a prime reason for a high percentage of patients reporting the migraine was eliminated. Also, I agree with the researchers in terms of improvement not being seen since only one main site of the brain was operated. I also feel that the study did not go in depth when finding individuals to participate. When conducting a study, you shouldn’t just be asking individuals if they are having the problem; there should be some sort of test being done to
The borders between the different forms are very fluid and the specific conditions are often misdiagnosed as a strong migraine, causing the patients to suffer significant pain before treatment is started. Which directly links to another problem: The treatment. Oxygen treatment seems promising, yet it is not readily available to the patients. Orally administered triptans are usually too weak and nasally administered triptans (e.g. ZOMIG) cannot be used in a sufficient frequency to relieve the pain during the whole day, especially in the case of Paroxysmal Hemicrania where attacks are generally of shorter duration yet of higher intensity. Therefore, patients still need to resort to taking a significant amount of painkillers which is medically problematic since an attack period can last up to several months or even years in the case of chronic conditions which 10-15% of cluster headache patients suffer from.
It is important that the patient keeps in contact with the doctor after the surgery because if the individual has any problems after the surgery, the doctor can fix it. The patient can notice that something is wrong when some of the symptoms happen. Those symptoms are numbness or weakness on the face, arm, leg, or on one side of the body, unexpected confusion which can impair the person from understanding normal conversation and be able to speak. Also, the individual may have a vision loss on either one or both eyes, individual can have loss of coordination, etc. (Beaumont, 2015). Individuals have to be careful when having those symptoms because they can be
middle of paper ... ... While there is no neurobiological or neuropathological explanation as to why CTE occurs, the majority of researchers believe the disease is strongly related to previous head injuries. An individual suffering from CTE will most likely experience changes in their mood, behavior, and cognition. Because this is a relatively new area of research, there are still a vast amount of unknowns pertaining to the disease’s symptoms, pathology, and natural course.
An essential aspect of a neurosurgeon's role is to accurately handle the documentation of data related to their patients' treatment. This data includes treatment programs and schedules, medication plans, diagnosis details, and any other analysis information related to their patients' health. Regular interaction with patients is also crucial for neurosurgeons. Supporting patients in medical decisions and informing them of all possible risks, effects, delays, results, and outcomes of their surgery is perhaps the most important responsibility a neurosurgeon can undertake. The physician must be able to discuss the patient's course of action clearly and precisely with someone they are comfortable with to ensure the best recovery.
Since the first report on the success of acupuncture anesthesia in 1970s, much attention has been attracted to the effectiveness of acupuncture therapy worldwide. Analgesia is one of the most important effects of acupuncture. Generally, mechanisms of acupuncture analgesia contain mechanisms of acupuncture anesthesia, but the latter does not represent the entirety of acupuncture analgesia. This is because acupuncture not only treats acute or transient pain, but also chronic or persistent pain resulted from inflammations or other causes. Clinically, the pain usually occurs prior to acupuncture, either needling or moxibustion can be used for treatment. For acupuncture anesthesia, an induction period of acupuncture is required prior to the surgery and only needling or acupressure may be applied. In addition, the surgical pain pertains to the category of acute pain. However, most modern studies on mechanisms of acupuncture analgesia are conducted focusing on the mechanisms of acupuncture anesthesia. In the following discussion, we will first outlook those studies on acupuncture anesthesia, then provide a complementary explanation on mechanisms of clinical acupuncture analgesia, and finally analyze their implications in improving results of clinical analgesia. Primarily, mechanisms of acupuncture anesthesia or analgesia include two closely associated aspects: neural and humoral mechanisms [27].
of a blind or control group can affect the documenting of these types of coincidental effects and the belief of their cause. Thus people who know they are taking placebos will assume that their headache or other unpleasant symptom is not due to anything they are taking and may fail to report it. Those who know they are receiving real treatment are more likely to believe the causality are more likely to report it. The "blind" control group helps to balance the effects of incidental timing
Migraine headaches affect an estimated 36 million Americans, or about 12% of the population, surpassing asthma at 8.3% (25 million) and diabetes at 7.8% (23.6 million). Migraines are much more common in women than in men--about 3 times more common. Nearly 30% of women will experience at least one episode of migraine headaches in their lifetime, most commonly in the third and sixth decades of life. However, migraines can affect anyone at any age and from any ethnic group. In addition to indirect expenses like missed work/school and lost productivity, the American Migraine Foundation estimates that migraines cost Americans more than $20 billion annually. Migraine sufferers are also more likely to experience anxiety, depression, sleep disorders, fatigue, and other pain conditions, and those who experience visual disturbances called “auras” associated with migraines are at an increased risk of heart attack and stroke. Unfortunately, there is no cure for migraines. The best treatment options available only to seek to reduce frequency of attacks or treat an attack once one has begun, and medication use is often limited by side effects and difficulty of administration. The American Migraine Foundation itself labels current treatment options “far from perfect” and concludes, “Undoubtedly, better treatments are needed.” Filling this therapeutic void is the primary objective of NuPathe Inc. (very recently acquired by Teva Pharmaceutical Industries Ltd.) with Zecuity®, a sumatriptan iontophoretic transdermal system.
The case is about one Arturo Iturralde who was diagnosed with degenerative spondylolisthesis L4-5 with stenosis. The condition is treated by way of surgery. The surgery was carried out at Hilo Medical Center (HMC). It involved implanting titanium rods in the spine forming a bilateral fixation. During surgery, the titanium rods were missing from the surgery room and Dr. Robert Ricketson decided to make do by use of a stainless steel screwdriver.
Jane did explain that since the history of migraine headache had been going on for years it was going to take a while prior to seen any results but it was going to take some lifestyle changes other than the acupuncture to achieve the goal. The author left the office in a great note. Unable to gauge the results of the treatment yet but with a hopeful outlook for the future.
Over time the occurrences of surgical Never Events has decreased with the help of checklists and other procedures implemented in the work place.
Our patient Ms. Blum is a 28-year-old white female who presents with symptoms of a migraine, such as waking up by a severe headache that she states is often made worse when she turns on the light. In addition, Ms. Blum presents with several factors that can trigger her migraines including her lack of sleep, her stressful life as concluded by her statement that this has been a difficult period in her life and her approaching deadline to turn in her dissertation, her weekend alcohol consumption, her menstrual cycle since she notices that a couple of days before her period starts she experiences these headaches, also she states that food doesn’t seem to appeal to her and it takes her effort to eat a meal, and her diagnosis of major depressive disorder.
Keep in mind that the migraine sufferer does not have to have any of these conditions to take them to prevent their migraines.
This type of pain is classified as nociceptive pain or the normal pain process. It involves four processes that occur continuously: transduction, transmission, perception, and modulation. Neuropathic pain is not as easily understood because it involves damage and dysfunction of nerve cells in the peripheral nervous system (PNS) and/or the central nervous system (CNS) (Ignatavicius & Workman, 2016). Most patients describe neuropathic type pain as burning, stabbing, shooting, and/or a feeling pins and needles (Ignatavicius & Workman, 2016). This type of pain is hard to treat because of the subjective nature of pain and not all the causes of neuropathic pain are understood. This paper is a review of pharmacological and non-pharmacological management of neuropathic pain management. Three articles were found on this subject and summarized to inform its readers on recent research conducted within the last five years. The first article reviewed was a research study to determine strategies patient’s implemented in order to cope with
My mom became a victim to this illness after she had my youngest sibling. She has now lived with primary migraines for about seven years and the cause of her condition is unknown. The possible factors that can lead to migraines include, hormones, caffeine, stress, anxiety, and many others. Similarly, the journal “Providing Care for Patients with Chronic Migraine: Diagnosis, Treatment, and Management”, by Stephen D. Silberstein states, “Other comorbid factors should be addressed, including sleep disorders, neck pain, fibromyalgia, and obesity” (Silberstein). My mother has gone through many things in her life which relate to many of these factors. Therefore, doctors have not been able to determine the cause of her
Introduction Clinical trials are a gateway to proven practical medical treatment, so it requires accuracy and validity of the outcomes. Placebo control trials are therefore employed in clinical trials as nearly half of academic physicians have answered in a questionnaire that they had used a placebo in their clinical trials (Sherman and Hickner, 2007). To have the higher scientific validity of results on the clinical trials requires that prospective, carefully selected subjects and endpoints, a control group, randomly allocated subjects into a treatment group and a control group, blinded both subject groups and investigators, sufficient sample size, and an approved independent ethics committee and monitoring by data safety and monitoring board to have stronger the scientific validity on the clinical trials (Brody, 1997). The use of placebos will enable more scientifically reliable outcomes. However, unnecessarily or ineffectiveness of placebo use is also claimed, therefore considering appropriate conditions and suitable cases would be needed for placebo use. .