Sullivan E et al. – After menarche, women have an increased prevalence of migraine compared to men. There is significant variability in the frequency and severity of migraine throughout the menstrual cycle. Women report migraines occur more frequently during menses, and that those are more severe than other migraines. This creates a unique challenge of effectively treating menstrually related and pure menstrual migraines. As with treatment of other migraines, both abortive and prophylactic treatment regimens are used. Triptans demonstrate efficacy in the abortive management of menstrually related and pure menstrual migraines. For migraines that occur primarily during menses or that are particularly resistant to other therapies, intermittent prophylactic therapies can be used. Naproxen and estrogens have been studied for this use. More recently, triptans have been examined and have shown efficacy for intermittent prophylaxis of menstrual migraine.
Day: 09/28/2010
Urinary Antigen Testing for Community-Acquired Pneumonia
Urinary pneumococcal antigen testing should be incorporated into the standard approaches for guiding treatment in community-acquired pneumonia, an Archives of Internal Medicine study concludes.
Researchers studied some 500 cases of CAP, establishing definite or probable S. pneumoniae infection by culture or Gram stain in about one third. The urinary antigen test was found to have a sensitivity of about 70% in detecting S. pneumoniae, a specificity of about 95%, and a positive predictive value of about 90%.
The authors conclude that the test “should be incorporated into clinical guidelines at the same level as classic microbiological studies because it can supplement, but not replace, their results.”
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