Rehabilitation hospital staff knowledge and attitudes regarding pain.

No published studies exist that document pain-related knowledge, attitudes, or educational needs of clinical staff in a rehabilitation hospital; the purpose of this study was to obtain such information to aid in the development of an institutional pain care improvement project. A survey regarding knowledge and attitudes about pain and perceived areas of educational need was administered to all staff with inpatient care responsibilities. Results show that rehabilitation hospital staff hold generally progressive attitudes toward the treatment of pain but with a substantial degree of ambivalence about the use of opioids in the treatment of pain.

Prophylaxis of menstrual migraine with triptans: problems and possibilities.

Menstruation is a prominent, predictable attack trigger for many women with migraine. If abortive therapy of menstrual attacks is ineffective, prophylactic therapy is used to prevent attacks or render them shorter and less resistant to acute therapy. Interest is increasing in the use of triptan medications for the prophylaxis of menstrual migraine, and clinical trials to evaluate this approach are underway.

Safety of sumatriptan in pregnancy: a review of the data so far.

The high prevalence of migraine in women during their reproductive years means that new drug treatments for migraine, such as the serotonin 5-HT(1B/1D) receptor agonists (the 'triptans'), are likely to be widely used by women of childbearing potential. Scrutiny of these agents in an effort to detect any signal of teratogenicity is thus important. A systematic review of the medical literature was conducted to identify information regarding the safety of sumatriptan during pregnancy.

Volume and nature of telephone calls in a specialty headache practice.

Background: No information exists regarding the contribution of patient-related telephone calls to the burden of headache practice.

Objective: To identify the nature and volume of patient-related telephone calls to a specialty headache practice over a 1-month period.

Design And Methods: The characteristics of all patient-related calls to a single headache practitioner occurring during July 2001 were documented.

Women and headache: a treatment approach based on life stages.

Effective headache management in women requires an understanding of the unique epidemiologic and pathophysiologic factors affecting women. We present preventive, abortive, and nonpharmacologic approaches to headache treatment that vary with the chronologic and hormonal stages of a woman's life, with special attention to headache during pregnancy and later in life.

Naratriptan in the prophylaxis of cluster headache.

A 36-year-old man with cluster headache refractory to trials of standard prophylactic treatment and only partially responsive to parenteral sumatriptan and inhaled oxygen was admitted to an inpatient pain unit. The diagnosis of cluster headache was confirmed by direct observation of a typical attack. Despite efforts at prophylaxis, the patient continued to experience three to four severe headaches per day.

Menstrual Migraine.

Slightly less than half of women with migraine report that menstruation is an important trigger of headache episodes. However, it is rare that menstruation is the only trigger for a patient and its importance as a trigger may be over- emphasized. Accurate diagnosis requires a prospectively kept diary of information showing a consistent and mechanistically valid temporal correlation between migraine attacks and menstrual periods.