Preliminary report: symptoms associated with mobile phone use.
Mobile phone use is ubiquitous, although the alleged health effects of low level radio-frequency radiation (RFR) used in transmission are contentious. Following isolated reports of headache-like symptoms arising in some users, a survey has been conducted to characterize the symptoms sometimes associated with mobile phone usage. A notice of interest in cases was placed in a major medical journal and this was publicized by the media. Respondents were interviewed by telephone using a structured questionnaire. Forty respondents from diverse occupations described unpleasant sensations such as a burning feeling or a dull ache mainly occurring in the temporal, occipital or auricular areas. The symptoms often began minutes after beginning a call, but could come on later during the day. The symptoms usually ceased within an hour after the call, but could last until evening. Symptoms did not occur when using an ordinary handset, and were different from ordinary headaches. There were several reports suggestive of intra-cranial effects. Three respondents reported local symptoms associated with wearing their mobile phone on their belts. There was one cluster of cases in a workplace. Seventy-five per cent of cases were associated with digital mobile phones. Most of the respondents obtained relief by altering their patterns of telephone usage or type of phone. Cranial and other diverse symptoms may arise associated with mobile phone usage. Physicians and users alike should be alert to this. Further work is needed to determine the range of effects, their mechanism and the possible implications for safety limits of RFR. (+info)
Antiemetic efficacy of granisetron plus dexamethasone in bone marrow transplant patients receiving chemotherapy and total body irradiation.
Few trials exist regarding the antiemetic efficacy of granisetron in bone marrow transplant (BMT) recipients conditioned with high-dose chemotherapy and total body irradiation (TBI). In this single-center, open-label, prospective, trial, the antiemetic efficacy and safety of granisetron plus dexamethasone were evaluated in 26 patients conditioned with cyclophosphamide-containing regimens (the majority receiving 60 mg/kg per day on 2 consecutive days), and TBI (12 Gy divided over 4 days). Daily intravenous doses of granisetron 1 mg plus dexamethasone 10 mg were given 30 min prior to chemotherapy or radiation, and continued for 24 h after the last conditioning treatment for a median of 6 days (range 3-9). Emetic control was defined by the number of emetic episodes occurring within a 24 h period, or the requirement for rescue medication for nausea or vomiting. A total of 25 patients completed 186 evaluable treatment days. Response (emetic control by treatment days) was complete in 50% of patients, major in 48%, minor in 2%, and there were no failures. Adverse effects were minor, with diarrhea (15%), headache (14%), and constipation (11%) reported most often. Based on these results, the antiemetic regimen of granisetron plus dexamethasone appears effective and well tolerated during BMT conditioning with high-dose cyclophosphamide and TBI. (+info)
Pain after whiplash: a prospective controlled inception cohort study.
OBJECTIVES: In Lithuania, there is little awareness of the notion that chronic symptoms may result from rear end collisions via the so-called whiplash injury. After most such collisions no contact with the health service is established. An opportunity therefore exists to study post-traumatic pain without the confounding factors present in western societies. METHODS: In a prospective, controlled inception cohort study, 210 victims of a rear end collision were consecutively identified from the daily records of the Kaunas traffic police. Neck pain and headache were evaluated by mailed questionnaires shortly after the accident, after 2 months, and after 1 year. As controls, 210 sex and age matched subjects were randomly taken from the population register of the same geographical area and evaluated for the same symptoms immediately after their identification and after 1 year. RESULTS: Initial pain was reported by 47% of accident victims; 10% had neck pain alone, 18% had neck pain together with headache, and 19% had headache alone. The median duration of the initial neck pain was 3 days and maximal duration 17 days. The median duration of headache was 4.5 hours and the maximum duration was 20 days. After 1 year, there were no significant differences between the accident victims and the control group concerning frequency and intensity of these symptoms. CONCLUSIONS: In a country were there is no preconceived notion of chronic pain arising from rear end collisions, and thus no fear of long term disability, and usually no involvement of the therapeutic community, insurance companies, or litigation, symptoms after an acute whiplash injury are self limiting, brief, and do not seem to evolve to the so-called late whiplash syndrome. (+info)
Lipoma of the corpus callosum.
Lipoma of the corpus callosum is a rare congenital condition, often asymptomatic, but which may present as epilepsy, hemiplegia, dementia, or headaches. This paper reviews the condition and reports the only two cases which are known to the Hospital for Sick Children, Great Ormond Street, London. The second case demonstrated the value of computerised axial tomography (EMI scan) in making the diagnosis and showing associated anomalies. (+info)
Headaches related to sexual activity.
Twenty-one patients experienced headache related to sexual activity. Two varieties of headache could be distinguished from the clinical histories. The first, developing as sexual excitement mount, had the characteristics of muscle contraction headache. The second, severe, throbbing or 'explosive' in character, occurring at the time of orgasm, was presumably of vascular origin associated with a hyperdynamic circulatory state. Two of the patients with the latter type of headache had each experienced episodes of cerebral vascular insufficiency on one occasion which subsequently resolved. A third patient in this category had a past history of drop attacks. No evidence of any structural lesion was obtained on clinical examination or investigation, including cerebral angiography in seven patients. Eighteen patients have been followed up for periods of two to seven years without any serious intracranial disorder becoming apparent. While the possibility of intracranial vascular or other lesions must always be borne in mind, there appears to be a syndrome of headache associated with sexual excitement where no organic change can be demonstrated, analogous to benign cough headache and benign exertional headache. (+info)
Assessing introduction of spinal anaesthesia for obstetric procedures.
To assess the impact of introducing spinal anaesthesia for obstetric operative procedures on use of general anaesthesia and quality of regional anaesthesia in a unit with an established epidural service a retrospective analysis of routinely collected data on method of anaesthesia, efficacy, and complications was carried out. Data were collected from 1988 to 1991 on 1670 obstetric patients requiring an operative procedure. The introduction of spinal anaesthesia in 1989 significantly reduced the proportion of operative procedures performed under general anaesthesia, from 60% (234/390) in 1988 to 30% (124/414) in 1991. The decrease was most pronounced for manual removal of the placenta (88%, 48/55 v 9%, 3/34) and emergency caesarean section (67%, 129/193) v 38%, 87/229). Epidural anaesthesia decreased in use most significantly for elective caesarean section (65%, 77/118 v 3% 3/113; x2=139, p<0.0001). The incidence of severe pain and need for conversion to general anaesthesia was significantly less with spinal anaesthesia (0%, 0/207 v 3%, 5/156; p<0.05). Hypotension was not a problem, and the incidence of headache after spinal anaesthetic decreased over the period studied. Introducing spinal anaesthesia therefore reduced the need for general anaesthesia and improved the quality of regional anaesthesia. (+info)
Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients.
Motivation for starting treatment and satisfaction with treatment results were evaluated on the basis of replies to a 14-item questionnaire and clinical examination of 28 orthognathic patients from 6 months to 2 years after treatment. The most common reasons for seeking professional help were problems in biting and chewing (68 per cent). Another major reason was dissatisfaction with facial appearance (36 per cent). Many patients also complained of temporomandibular joint symptoms (32 per cent) and headache (32 per cent). Women (8/19) were more often dissatisfied with their facial appearance than men (2/9), but the difference was not statistically significant. In agreement with earlier studies, the results of orthognathic treatment fulfilled the expectations of almost every patient. Nearly 100 per cent of the patients (27/28) were satisfied with treatment results, although 40 per cent experienced some degree of numbness in the lips and/or jaw 1 year post-operatively. The most satisfied patients were those who stated temporomandibular disorders as the main reason for seeking treatment and whose PAR-index had improved greatly. The majority of the patients experienced the orthodontic treatment as painful and as the most unpleasant part of the whole treatment, but all the patients were satisfied with the pre-treatment information they were given on orthodontics. Orthodontic-surgical therapy should be of a high professional standard technically, but the psychological aspects are equally important in the treatment protocol. The professionals should make efforts to understand the patient's motivations for and expectations of treatment. Patients should be well prepared for surgery and supported for a long time after to help them to adjust to post-surgical changes. (+info)
Elementary visual hallucinations, blindness, and headache in idiopathic occipital epilepsy: differentiation from migraine.
This is a qualitative and chronological analysis of ictal and postictal symptoms, frequency of seizures, family history, response to treatment, and prognosis in nine patients with idiopathic occipital epilepsy and visual seizures. Ictal elementary visual hallucinations are stereotyped for each patient, usually lasting for seconds. They consist of mainly multiple, bright coloured, small circular spots, circles, or balls. Mostly, they appear in a temporal hemifield often moving contralaterally or in the centre where they may be flashing. They may multiply and increase in size in the course of the seizure and may progress to other non-visual occipital seizure symptoms and more rarely to extra-occipital manifestations and convulsions. Blindness occurs usually from the beginning and postictal headache, often indistinguishable from migraine, is common. It is concluded that elementary visual hallucinations in occipital seizures are entirely different from visual aura of migraine when individual elements of colour, shape, size, location, movement, speed of development, duration, and progress are synthesised together. Postictal headache does not show preference for those with a family history of migraine. Most of the patients are misdiagnosed as having migraine with aura, basilar migraine, acephalgic migraine, or migralepsy simply because physicians are not properly informed of differential diagnostic criteria. As a result, treatment may be delayed for years. Response to carbamazepine is excellent and seizures may remit. (+info)