Fájdalomcsillapító-túlhasználathoz társuló fejfájás

Absztrakt A fájdalomcsillapító-túlhasználathoz társuló fejfájás a lakosság 1–2%-át érinti. Bármely fájdalomcsillapító rendszeres, havonta legalább 10 napon történő szedése kiválthatja, ezért minden olyan esetben gondolni kell rá, amikor korábban is panaszos betegek fejfájásának gyakorisága – nagyobb mennyiségben szedett fájdalomcsillapítók mellett – megnő. A kórkép leggyakrabban a 40–50 éves nőket érinti: kockázatát növeli a dohányzás, az elhízás, a depresszió, valamint a szorongásos zavar. Kialakulásában biológiai (genetikai megalapozottság, neurokémiai és neurofiziológiai eltérések) mellett pszichológiai, illetve életvezetési tényezők, így a fejfájásokra vonatkozó anticipátoros szorongás, a fájdalom katasztrofizálása, az ezek miatti kényszeres gyógyszerszedő magatartás is fontos szerepet játszanak. A fájdalomcsillapító-túlhasználathoz társuló fejfájás kezelésének elengedhetetlen része a kiváltó szer megvonása, a megvonási tünetek (köztük a rebound fejfájás) kezelése, a hatásos preventív terápia bevezetése, a komorbid betegségek kezelése, valamint a betegek megfelelő oktatása és pszichés támogatása. Mivel a visszaesés esélye megfelelő kezelés mellett is 30–40% lehet, alapvető fontosságú a megelőzés, amelyben az alapellátás szerepét nem lehet eléggé hangsúlyozni. Orv. Hetil., 2015, 156(30), 1195–1202

Influence of abiotic disorders on nutritional values of tomato (solanum lycopersicum

Susceptibility to abiotic disorders could play a key role in the utilization of landraces of tomato. These races have been abandoned due to non-compatibility to today’s intensive agriculture. As there is dissatisfaction on present varieties and hybrids in the context of flavor and nutritional value, landraces could be a viable alternative for the enhancement of these parameters either “per se” or as breeding background. However, frequent occurrence of abiotic disorders causes yield losses. The hypothesis of the present study is that removal of irregular fruit parts positively influences the nutritional profile of tomato in the context of investigated parameters. In the present study influence of abiotic disorders on total soluble solids (TSS), acid (TA) and lycopene content was investigated on six Hungarian tomato landraces and two commercial varieties. Abiotic disorders occurred were mainly cracking, green shoulder, sunburst and catfacing. Propagation materials were provided by Plant Biodiversity Center Tápiószele. The experiment is supported by Research Institute of Organic Agriculture, ÖMKi. Our results showed that abiotically disordered plant parts have an impact on TSS, TA and lycopene content, however, in case of investigated accessions and varieties the difference was seldom significant. Only in case of TSS a tendency can be experienced, where all samples showed lower results after the removal of abiotically disordered plant parts. In case of TA and lycopene content no tendencies could have been withdrawn

INFLUENCE OF ABIOTIC DISORDERS ON NUTRITIONAL VALUES OF TOMATO (SOLANUM LYCOPERSICUM)

Susceptibility to abiotic disorders could play a key role in the utilization of landraces of tomato. These races have been abandoned due to non-compatibility to today’s intensive agriculture. As there is dissatisfaction on present varieties and hybrids in the context of flavor and nutritional value, landraces could be a viable alternative for the enhancement of these parameters either “per se” or as breeding background. However, frequent occurrence of abiotic disorders causes yield losses. The hypothesis of the present study is that removal of irregular fruit parts positively influences the nutritional profile of tomato in the context of investigated parameters.In the present study influence of abiotic disorders on total soluble solids (TSS), acid (TA) and lycopene content was investigated on six Hungarian tomato landraces and two commercial varieties. Abiotic disorders occurred were mainly cracking, green shoulder, sunburst and catfacing. Propagation materials were provided by Plant Biodiversity Center Tápiószele. The experiment is supported by Research Institute of Organic Agriculture, ÖMKi. Our results showed that abiotically disordered plant parts have an impact on TSS, TA and lycopene content, however, in case of investigated accessions and varieties the difference was seldom significant. Only in case of TSS a tendency can be experienced, where all samples showed lower results after the removal of abiotically disordered plant parts. In case of TA and lycopene content no tendencies could have been withdrawn

A triciklusos antidepresszívumok helye a fejfájások kezelésében

The two most important representatives of the primary headaches are migraine and tension-type headache. More than 10% of the population suffer from migraine and even a greater part, approximately 30-40% from tension-type headache. These two headache types have a great effect both on the individual and on the society. There are two types of therapeutic approaches to headaches: the abortive and the prophylactic therapy. Prophylactic treatment is used for frequent and/or difficult-to-treat headache attacks. Although both migraine and tension-type headache are often associated with depression, for their treatment - in contrast to the widespread medical opinion - not all antidepressants were found to be effective. Amitriptyline, which is a tricyclic antidepressant, is used as a prophylactic therapy for headache since 1968. Its efficacy has been demonstrated in several double-blind, placebo-controlled studies. Although the newer types of antidepressant, such as selective serotonin reuptake inhibitors and selective serotonin-norepinephrine reuptake inhibitor, have a more favorable side-effect profile than tricyclic antidepressants, their headache prophylactic effect has not been proven yet

Antioxidant profile of tomato landraces for fresh consumption

Tomato is one of the most important and frequently consumed vegetable species in Hungary, as well as a significant vitamin source throughout the year. Due to its antioxidant content, tomato consumption is related to the reduced occurrence of cardiovascular diseases and certain cancer types. In our study, four Hungarian tomato accessions [RCAT030275 (Cegléd), RCAT031012 (Veresegyház), RCAT031095 (Cigánd), RCAT054422 (Jánoshalma)] and a commercial cultivar (Hellfrucht) were investigated according to antioxidant capacity [ferric reducing power (FRAP), total phenol content (TPC) and radical scavenging activity (DPPH)], lycopene and ascorbic acid content. A two year (2013-2014) open field trial was carried out in the certified organic area of SZIE Soroksár Experimental and Educational Station. Our results showed that no significant differences were between the landraces and the variety in DPPH values, while TPC values were higher in both years in the landraces, especially in RCAT031095, and RCAT054422. The lycopene content of RCAT031012, RCAT031095 and RCAT054422 was also higher in both years than those of Hellfrucht. The results demonstrate that small-scale production of the investigated landraces could be marketable

A Cross-Sectional Study on the Quality of Life in Migraine and Medication Overuse Headache in a Hungarian Sample: Understanding the Effect of Headache Characteristics

Háttér és célkitûzés – Általános és betegségspecifikus életminőség-kérdőívet használó vizsgálatok eredményei alapján mind migrénben, mind fájdalomcsillapító-túlfogyasztáshoz társuló fejfájásban (FTTF) szenvedő betegek esetében alacsonyabb életminôség-értékeket mértek a kontrollrésztvevőkhöz hasonlítva. Vizsgálatunk célja egyrészt a migrénben és FTTF-ben szenvedő betegek életminőségének, valamint a fejfájás-karakterisztika (fejfájós évek száma, auratünetek, triptánhasználat, fejfájássúlyosság és fejfájás-gyakoriság) életminőségre gyakorolt hatásának vizsgálata volt. Módszerek – Keresztmetszeti vizsgálatunkban 334 beteg vett részt (248 beteg fejfájás-ambulanciánkról, valamint 86 beteg hirdetés útján). A résztvevők életminőségének értékeléséhez az Átfogó Fejfájással Kapcsolatos Életminőség kérdőívet (CHQQ) használtuk. Adataink normáleloszlást mutattak, így χ2-próba mellett parametrikus teszte ket alkalmaztunk (például független mintás t-próba), a szignifikanciaszintet p < 0,05-ban határoztuk meg. A nem, életkor, beválogatási kritériumok, fejfájástípus, valamint fejfájás-karakterisztika (auratünetek megléte, fejfájós évek száma, fejfájás súlyossága, fejfájás gyakorisága, triptánhasználat) életminőségre gyakorolt hatásának vizsgálatához lineáris regressziós modelleket használtunk mind a három CHQQ-alskála és az összpontszám tekintetében is. Az utóbbi esetében az I. típusú hiba elkerülésének érdekében a szignifikanciaszintet p<=0,0125 (0,05/4) értékben határoztuk meg. Eredmények – A fejfájástípust önmagában vizsgálva az FTTF-ben szenvedő betegek a szociális alskála kivételével szignifikánsan alacsonyabb CHQQ-értékeket értek el, mint a migrénes betegek. A többi változó bevonásával elvégzett regressziós elemzések alapján a triptánhasználat mutatott fordított összefüggést az összes CHQQ-alskálaértékkel (p < 0,0125). A vizsgált fejfájás-karakterisztikák közül a fejfájás súlyossága mutatott szignifikáns kapcsolatot az alacsonyabb fizikaialskála-értékekkel (p = 0,001), valamint az alacsonyabb CHQQ-összpontszámmal (p = 0,002). Következtetés – Eredményeink azt mutatják, hogy a fejfájás-karakterisztika (és nem a fejfájás típusa önmagában) összefüggést mutat a fejfájós betegek alacsonyabb életminôségével. Az életminőség-változást előidézô faktorok meghatározása fontos a különböző betegpopulációk adekvát kezelésének, valamint az egészségügyi szolgáltatások igénybevételével és az egészségügyi költségekkel kapcsolatos népegészségügyi intézkedéseknek a megtervezése érdekében

The validation of the Hungarian version of the ID-migraine questionnaire

Despite its high prevalence, migraine remains underdiagnosed and undertreated. ID-Migraine is a short, self-administrated questionnaire, originally developed in English by Lipton et al. and later validated in several languages. Our goal was to validate the Hungarian version of the ID-Migraine Questionnaire.Patients visiting two headache specialty services were enrolled. Diagnoses were made by headache specialists according to the ICHD-3beta diagnostic criteria. There were 309 clinically diagnosed migraineurs among the 380 patients. Among the 309 migraineurs, 190 patients had only migraine, and 119 patients had other headache beside migraine, namely: 111 patients had tension type headache, 3 patients had cluster headache, 4 patients had medication overuse headache and one patient had headache associated with sexual activity also. Among the 380 patients, 257 had only a single type headache whereas 123 patients had multiple types of headache. Test-retest reliability of the ID-Migraine Questionnaire was studied in 40 patients.The validity features of the Hungarian version of the ID-Migraine questionnaire were the following: sensitivity 0.95 (95% CI, 0.92-0.97), specificity 0.42 (95% CI, 0.31-0.55), positive predictive value 0.88 (95% CI, 0.84-0.91), negative predictive value 0.65 (95% CI, 0.5-0.78), missclassification error 0.15 (95% CI, 0.12-0.19). The kappa coefficient of the questionnaire was 0.77.The Hungarian version of the ID-Migraine Questionnaire had adequate sensitivity, positive predictive value and misclassification error, but a low specificity and somewhat low negative predictive value

Medicinal Chemistry of Antimigraine Drugs.

Migraine is one of the most frequent neurological disorder with high impact on the quality of life. Primary headaches such as migraine are pathophysiologically complex disorders. The concept of the trigeminovascular system dysfunction in migraine has led to a number of drug discoveries dramatically changing the treatment options. Acute and prophylactic therapy targeting either the trigeminovascular system or central structures involve several groups of drugs with peculiar medicinal chemistry. In the proposed review up to date concept of treatment strategy, medicinal chemistry data of the drugs used will be summarized. The present review gives detailed information on drugs effective in aborting migraine attacks (by inhibiting prostanoid synthesis, are agonists of serotonin 5-HT1B/D receptors, on the recently introduced CGRP-receptor antagonists) and the drugs recommended for prophylactic treatment (selected beta-adrenergic receptor antagonists, Ca-channel inhibitors, antiepileptics, antidepressants). The pharmacokinetics, fate in the body (absorption, distribution, metabolism, excretion) and significant pharmacological effects as well as the recent bioanalytical methods for their determination are presented

Psychometric properties of the Headache Under-Response to Treatment (HURT) questionnaire and the Migraine Disability Assessment Test (MIDAS) translated to Serbian

© 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Background/Aim. The Headache Under-Response to Treatment (HURT) questionnaire and the Migraine Disability Assessment Test (MIDAS), which are intended for assessing the headache-related disability, impact (MIDAS) and management (HURT), were not yet translated to Serbian and validated in the population of Serbia. The aim of this study was to translate the HURT and MIDAS from English to Serbian, to make necessary cultural adaptations and to test their psychometric properties in a sample of outpatients with the headache. Methods. The HURT and MIDAS questionnaires were translated and adapted according to the internationally accepted guidelines, and then tested on a sample of Serbian patients with various headache types. Internal consistency was checked through the calculation of Cronbach’s alpha for the questionnaires, and by correlation of each question with the corrected total score. The criterion validity of the translation was tested by correlating scores of individual items, domains and whole questionnaire with the headache characteristics (severity, duration, frequency), and convergent validity was tested by correlating the abovementioned scores with results of an instrument for measurement of headache-related quality of life. Results. There were 171 (79.2%) females and 45 (20.8%) male study participants. The mean age of the patients was 42.3 years, (standard deviation – SD 13.35; range 18–75); 27 (12.5%) suffered from a migraine and 189 (87.5%) from the episodic tension-type headache (TTH). The Serbian translation of HURT and MIDAS questionneires showed excellent internal consistency, with high values of the Cronbach’s alpha: 0.764 and 0.731, respectively. The validity of the instruments in all aspects (criterion, convergent and discriminant validity) was also excellent for the whole sample and for the subgroup of patients with TTH, while the results for the patients with the migraine were less favorable. The factor analysis suggested the existence of one domain of MIDAS and two domains of HURT questionneires. Conclusion. The Serbian translations of HURT and MIDAS could be used as the reliable and valid specific instruments for measuring a headache-related disability, impact (MIDAS) and management (HURT) in the patients with TTH and probably in the patients with the migraine