Medication overuse headache, addiction and personality pathology: a controlled study by SWAP-200

Background: Medication Overuse Headache (MOH) is a type of chronic headache, whose mechanisms are still unknown. Some empirical investigations examining the addiction-like behaviors and processes, as well as personality characteristics underlying MOH development, reached contrasting findings. This study aimed at detecting personality and its disorders (PDs) in MOH patients, with a specific attention to the features of addiction. Methods: Eighty-eight MOH patients have been compared with two clinical populations including 99 patients with Substance Use Disorder (SUD) and 91 with PDs using the Shedler-Westen Assessment Procedure-200 (SWAP-200). MANCOVAs were performed to evaluate personality differences among MOH, SUD and PD groups, controlling for age and gender. Results: MOH patients showed lower traits of the SWAP-200’s clusters A and B disorders than SUD and PD patients, whom presented more severe levels of personality impairment. No differences in the SWAP-200’s cluster C have been found, indicating common personality features in these populations. At levels of specific PDs, MOH patients presented higher obsessive and dysphoric traits, as well as better overall psychological functioning than SUD and PD patients. Conclusions: The study supported the presence of a specific pattern of personality in MOH patients including obsessive (perfectionist) and dysphoric characteristics, as well as good enough psychological resources. No similarities with drug addicted and personality-disordered patients were found. Practitioners’ careful understanding of the personality of MOH patients may be useful to provide more effective treatment strategies and patient-tailored intervention programs

Migraine-specific quality of life questionnaire and relapse on medication overuse headache

Background: The management of Medication overuse headache (MOH) represents a difficult challenge for clinicians and headache experts, particularly for the responder rate after a successful withdrawal treatment. The purpose of this study was to investigate the role of demographic and clinical characteristics as well as the score of Migraine-Specific Quality of Life Questionnaire (MSQ), Migraine Disability Questionnaire and Leeds Dependence Questionnaire in predicting a response after a successful withdrawal treatment in patients with MOH. Methods: This ancillary study is part of a randomized trial that demonstrated the safety and the efficacy of a 3-month treatment with sodium valproate (VPA) (800 mg/day vs placebo) in MOH. Demographic and clinical characteristics and questionnaire results were obtained from the entire sample. Results: A significant correlation was found only between MOH relapse and the total MSQ score, the Role Preventive sub-scale and the Emotional Function sub-scale, suggesting a poorer quality of life in non responders. Conclusion: A high MSQ score could be associated with a poor short-term outcome in MOH patients after a successful treatment with detoxification followed by a new treatment

One more proof of the Abhyankar-Moh-Suzuki theorem

We extract the Abhyankar-Moh-Suzuki theorem from the Lin-Zaidenberg theorem.Comment: 4 page

The journey from genetic predisposition to medication overuse headache to its acquisition as sequela of chronic migraine

Migraine remains one of the biggest clinical case to be solved among the non-communicable diseases, second to low back pain for disability caused as reported by the Global Burden of Disease Study 2016. Despite this, its genetics roots are still unknown. Its evolution in chronic forms hits 2-4% of the population and causes a form so far defined Medication Overuse Headache (MOH), whose pathophysiological basis have not been explained by many dedicated studies. The Global Burden of Disease Study 2016 has not recognized MOH as independent entity, but as a sequela of Chronic Migraine. This concept, already reported in previous studies, has been confirmed by the efficacy of OnabotulinumtoxinA in Chronic Migraine independently from the presence of MOH. The consistency of the current definitions of both Medication Overuse Headache and Chronic Migraine itself might be re-read on the basis of new evidences

Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru.

Cutaneous leishmaniasis is endemic to South America where diagnosis is most commonly conducted via microscopy. Patients with suspected leishmaniasis were referred for enrollment by the Ministry of Health (MoH) in Lima, Iquitos, Puerto Maldonado, and several rural areas of Peru. A 43-question survey requesting age, gender, occupation, characterization of the lesion(s), history of leishmaniasis, and insect-deterrent behaviors was administered. Polymerase chain reaction (PCR) was conducted on lesion materials at the Naval Medical Research Unit No. 6 in Lima, and the results were compared with those obtained by the MoH using microscopy. Factors associated with negative microscopy and positive PCR results were identified using

Tanzania Joint Health Technical Review 2002:final report HIV/AIDS

\ud Tanzania has a HIV epidemic at an estimated range of approximately 12% of the adult population (15-49 years) being infected. The epidemic is still increasing and there are few signs that the epidemic will level off in the near future. Until 2000 the response to the epidemic was the responsibility of NACP, the National AIDS Control Programme, within the MoH. As the epidemic and the insight of the impact of the epidemic on society progressed the health approach changed to a multi-sectoral response – still led by the MoH. However, as in other countries with a significant HIV epidemic it was decided to move the response of the epidemic to the highest level of government. The multi-sectoral approach thus underwent a transformation from a strategy of the MoH to a strategy of GOT by placing the responsibility under the Prime Ministers’ Office. In this transition the TACAIDS was formed to provide the leadership of GOT’s fight on HIV/AIDS in 2001. TACAIDS is placed within the PM’s Office and has slowly started to become operational. In January 2002 the commissioners were appointed and the first meeting will take place in February. The NACP is undergoing a transformation from being the body for the national response of all sectors in society to be part of the response from the MoH. The new role of NACP is still being developed, but it has been decided that the NACP in the future will operate under the authority of the CMO in the MoH. The task within the health sector is huge since the health sector is the first to be impacted by the epidemic and many of the cost-effective preventive measures to combat the epidemic, such as STI treatment, and the care of an increasing number of people being sick and dying from HIV/AIDS, fall on this sector to be appropriately dealt with in partnership with civil society and other stakeholders. The timing of the mission is appropriate as far as HIV/AIDS is concerned. Great expectations are attached to TACAIDS to ensure leadership and the MoH can now concentrate on improving the provision of services in the health sector where it has a comparative advantage. At the same time new money are being made available from the donors in the basket fund for district health services and new resources are soon going to be available for HIV/AIDS activities: the Global Fund for AIDS, the HIPC money, and the TMAP – perhaps effective from 2003. The opportunity to consolidate the achievements in the health sector has never been greater. It is the objectives of the review to assess the performance of the health sector’s response to HIV/AIDS; main challenges regarding the consequences and combat of HIV/AIDS; and based on this recommend actions in the short and medium term. The scope of work includes a review the performance of the National Aids Control Programme \ud and the opportunities lying ahead for TACAIDS. Further the review on HIV/AIDS will assess constraints and opportunities within the health sector with regard to both preventive and care interventions including MTCT and HAART treatment. The response is assessed with regard to the capacity of the health care sector. In all these areas the following should be considered: Experience within Tanzania with a view to possible best practices and lessons learned. Cost implications should be considered, with a particular view to opportunity cost in areas where there would be a choice. Private sector possible contribution and specific problems The team, Adeline Kimambo, medical doctor and Anita Alban, health economist, hold international and national experience in the field of HIV/AIDS. The team carried out a review of \ud existing documentation, including policies and guidelines, and interviews were carried out with key people within MOH, PORALG, TACAIDS and civil society (NGOs for PLWHA). Further a field trip was undertaken to a district that is part of the health sector reform process. For the Health District Reform to succeed it needs an effective facilitated response from the MoH and cooperation from all stakeholders in the process – not least PRORALG. The report reflects this approach by reviewing and assessing both the new opportunities and obstacles of the MoH in the transition from a multi-sectoral response to a consolidated health sector response and the progress of the decentralisation process at district level. Further the team has made a strategic choice in focusing on the HIV/AIDS interventions that can make a significant difference if scaled up. In the time available for the team a choice also had to be made between assessing MTCT interventions and the introduction of anti-retroviral drugs into the care agenda. We chose the latter since it is the greatest investment challenge to the MoH.\u