Neurology
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Review Comparative Study
Evolution of the measurement of quality of life in migraine.
Although headache is among the most common pain complaints seen by physicians, the measurement of health-related quality of life (HRQoL) in headache patients is in its earliest stages. Two types of questionnaire have been used to measure HRQoL in headache sufferers: general and disease-specific instruments. General quality-of-life (QoL) instruments use scales to assess QoL with respect to a number of activities within physical, social, psychological, and behavioral life domains. ⋯ Generic QoL instruments, such as the SF-20 or SF-36, may be more useful to define populations being studied than to measure changes in the population over time. The publication of headache-specific QoL instruments, which have been widely used in clinical trials and have been validated, is awaited. Until such time, the SF-36 will remain the standard measure of QoL in headache.
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We investigated whether moderate, transient whole-body hyperthermia (approximately 39.6 degrees C), if imposed 1 day following a brief episode of forebrain ischemia, would affect the neuropathologic outcome. Forty-two Wistar rats were subjected to either a 5- or 7-minute period of bilateral common carotid artery occlusion plus hypotension (50 mm Hg), or to the equivalent sham procedure. Twenty-four hours later, rats of one subgroup were placed into a hyperthermic chamber containing high-intensity lamps designed to elevate rectal temperature to 39 to 40 degrees C for 3 hours. ⋯ In rats with 7-minute forebrain ischemia, delayed hyperthermia increased mean numbers of ischemic neurons by 2.6- to 2.7-fold in all subsectors of area CA1 (p < 0.05, ANOVA). Delayed hyperthermia in 5-minute ischemic rats also tended to increase mean numbers of ischemic neurons (by 11-fold in lateral, 6-fold in middle, and 5-fold in medial CA1 subsectors), but these differences were not statistically significant. We conclude that moderate, transient hyperthermia, even if occurring 1 day after a 7-minute global ischemic insult, exacerbates the extent of ischemic neuronal injury.