The journal of headache and pain
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Comparative Study
Economic impact of primary headaches in Turkey: a university hospital based study: part II.
This study was planned to investigate the economic impact of headache on Turkish headache sufferers attending a tertiary care outpatient headache clinic. A total of 937 headache patients were included in this study and questioned using a questionnaire for the profile of patients and headache, quality of life of patients and economic impact of headache. The median total direct cost was found to be 88.0 USD and the median total cost was 160.7 USD. ⋯ The average lost and inefficient work/school days was 1.5 (0-45) and 8.4 (0-100) days for one year. It was shown that loss of productivity was higher for migraine without aura group when compared with the episodic and chronic tension-type headache groups. The results of this nationwide university hospital based study methshowed that headache, especially migraine, has considerable economic impact on patients.
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Comparative Study
The association between headache and Val158Met polymorphism in the catechol-O-methyltransferase gene: the HUNT Study.
The catechol-O-methyltransferase (COMT) gene contains a functional polymorphism, Val158Met, that has been found to influence human pain perception, and one study has found that migraine was less likely among those with the Val/Val polymorphism. In the 1995-97 Nord-Trøndelag Health (HUNT) Study, the association between the Val158Met polymorphism and headache was evaluated in a random sample of 2451 individuals. ⋯ Among women, a lower prevalence of non-migrainous headache was found among individuals with the Val/Val genotype than among those with other genotypes (26.2% vs. 33.6%, p = 0.04). That non-migrainous headache was less likely among women with the Val/Val genotype may be an incidental finding, but should be investigated in further studies.
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Comparative Study
Reliability of pain threshold measurement in young adults.
The objective was to examine reliability of pressure and thermal (cold) pain threshold assessment in persons less than 25 years of age, using intra-class correlation (ICC) and coefficients of repeatability and variability. We measured thresholds to pain from pressure algometry and ice placed at the hand and head in 10 healthy volunteers aged 18-25. Intra-rater reliability was examined with ICC. ⋯ Reliability of repeat assessments was high as assessed by ICC, although coefficients of repeatability and variation indicated considerable inter-individual variation in repeat measurements. Pressure algometry and strategically placed ice appear to be reliable techniques for assessing pain processing in young adults. Reliability studies employing ICC may benefit from complementary estimation of CR and CV.
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This overview of the published epidemiological evidence of migraine helps to identify the size of the public-health problem that migraine represents. It also highlights the need for further epidemiological studies in many parts of the world to gain full understanding of the scale of clinical, economic and humanistic burdens attributable to it. This paper presents some of the work on migraine undertaken by the World Health Organization (WHO) in the Global Burden of Disease study conducted in 2000 and reported in the World Health Report 2001. ⋯ Migraine causes a large proportion of the non-fatal disease-related burden worldwide. Our knowledge of headache related burden is incomplete and it is necessary to add to it epidemiological studies in many parts of the world and to combine this with measurements of disability using both DALYs and WHO's ICF Classification. The work described here has been the base for the Global Campaign against Headache disorders: "Lifting the Burden", launched in 2004 jointly by WHO, IHS (International Headache Society), WHA (World Headache Alliance) and EHF (European Headache Federation).