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Mahood E, Shahid M, Gavin N, Rahmann A, Tadakamadla SK, Kroon J. Theories, Models, Frameworks, Guidelines, and Recommendations for Trauma-Informed Oral Healthcare Services: A Scoping Review. Trauma Violence Abuse 2024; 25:869-884. [PMID: 37083276 DOI: 10.1177/15248380231165699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Traumatic life experiences (TLE) are common and can affect a person's physical being and health-related behaviors, including those related to oral health. This scoping review aimed to identify evidence exploring the implementation and provision of trauma-informed care (TIC) in oral health services delivery. METHODS Arksey and O'Malley's framework with enhancements proposed by Levac et al. and Peters et al. was used. Studies were selected based on a preset inclusion and exclusion criteria and the population/concept/context framework. Primary charting of descriptive data was conducted, followed by thematic analysis to identify ideas common within the included literature. Searches were conducted in Medline (via Ovid), APA PsycINFO (via Ovid), Embase (Elsevier), Scopus, CINAHL (via EBSCO), and Cochrane databases. Google Scholar and ProQuest were used to identify grey literature. RESULTS The search identified 251 records, with fifteen records meeting the inclusion criteria. Limited models, frameworks, and recommendations for trauma-informed practices in oral health services were identified. Recommendations for TIC practices were identified, and clinical practice adjustments for dental practitioners were described to improve service delivery for patients who may have experienced trauma. Avenues for future research were identified. CONCLUSIONS Limited evidence exists to guide trauma-informed practice in oral health service delivery. This scoping review highlights the need for further research into approaches and practices of TIC for oral health services delivery to assess their efficacy and the need to develop evidence-based TIC frameworks to meet the unique needs of oral health service providers and populations.
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Affiliation(s)
- Emma Mahood
- Griffith University, Gold Coast, QLD, Australia
- Queensland Health, Brisbane, Australia
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Stormon N, Lawrenson P, Rahmann A, Eames S, Gavin N. Exploring strengths and weaknesses in health services research culture and capacity. AUST HEALTH REV 2024; 48:82-90. [PMID: 38219279 DOI: 10.1071/ah23241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
Objective Fostering a research culture and enhancing research capacity within the workforce is essential for any health service aiming to provide evidence-based care. This study aims to explore the research culture and capacity in a community health service setting and provide a comparison to previous published research in other health service settings. Methods Participants were invited to complete a survey consisting of demographics and the Research Capacity and Culture (RCC) tool. Median and interquartile ranges were calculated for each RCC item and compared to three Australian and one international comparison. Results A total of 73 staff members from Metro North Community and Oral Health service participated. The team-level scores for the RCC were overall the lowest. Comparison to previously published research using the RCC indicated marginally higher scores for individual-level items in our study across all domains. Individual-level items were very weak to weakly correlated with the team and organisation-level RCC items. Strong to very strong correlations were found between a majority of the team and organisation-level items. Conclusions Team-level scores were substantially lower when compared to individual and organisational levels. The item 'team leaders that support research' was positively correlated with various organisation-level items, indicating that if the respondent perceived the team leader as a low supporter of research the respondent perceived several organisation items also poorly. As an important stakeholder in enabling research in a health service, organisations should investigate the challenges experienced by team leaders in facilitating research and the support or training they may need.
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Affiliation(s)
- Nicole Stormon
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Dentistry, Oral Health Centre, The University of Queensland, Herston Road, Brisbane, Qld, Australia
| | - Peter Lawrenson
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Health and Behavioural Sciences, The University of Queensland, Services Road, Brisbane, Qld, Australia
| | - Ann Rahmann
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Allied Health, Australian Catholic University, Nudgee Road, Banyo, Qld, Australia
| | - Sally Eames
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia
| | - Nicole Gavin
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Nursing and the Metro North Health Nursing and Midwifery Academy, Queensland University of Technology, Herston Road, Brisbane, Qld, Australia
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Burns CL, Cottrell M, Jones A, Foley J, Rahmann A, Young A, Cruickshank M, Pateman K. Prioritising enhancements across allied health telehealth services in a metropolitan hospital: Using a concept mapping approach. J Telemed Telecare 2022; 28:740-749. [DOI: 10.1177/1357633x221122106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction A prior study examining perceptions of Allied Health Professions (AHP) telehealth services at a metropolitan hospital highlighted multiple issues impacting service uptake, operationalisation, and delivery. Concept mapping methodology was utilised to address these issues and prioritise actionable telehealth service improvements. Methods Representatives ( n = 22) from seven AHP departments and consumers generated statements addressing the question: ‘What do we need to do to enhance and sustain telehealth services?’ Statements were synthesised and then clinicians and managers sorted them into similar groups and assigned each statement a ranking of perceived (a) importance and (b) changeability. Multivariate and multidimensional scaling was undertaken to develop a final prioritised set of goals for change. Results Ninety-six unique statements were generated as actionable goals for change. Statements were grouped into 13 clusters relating to improvements in staff support, infrastructure, consumer support and organisational processes. All clusters were rated >50% for importance (range 3.3–2.4 out of 4) and changeability (range 2.6–2.1 out of 4). Twenty-six statements were ranked highest for importance and changeability. Key prioritised areas were staff training, consumer advocacy and engagement, telehealth operations and workflow. Conclusion Concept mapping was an effective process for generating a prioritised list of actions to enhance AHP telehealth services.
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Affiliation(s)
- Clare L Burns
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Michelle Cottrell
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Amber Jones
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jasmine Foley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Ann Rahmann
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
- School of Allied Health, Australian Catholic University, Banyo, Queensland, Australia
| | - Adrienne Young
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
| | - Mark Cruickshank
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
| | - Kelsey Pateman
- Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, Queensland, Australia
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Leung FT, Mendis MD, Franettovich Smith MM, Rahmann A, Treleaven J, Hides JA. Sensorimotor system changes in adolescent rugby players post-concussion: A prospective investigation from the subacute period through to return-to-sport. Musculoskelet Sci Pract 2022; 57:102492. [PMID: 34922255 DOI: 10.1016/j.msksp.2021.102492] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/26/2021] [Accepted: 12/07/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The pathophysiology of concussion is complex. Altered sensorimotor function post-concussion may contribute to the wide range of symptoms and impairments reported. There is currently limited evidence documenting changes in sensorimotor function during the recovery period. The aim of this study was to investigate the effect of concussion on the sensorimotor system in adolescents post-concussion using a multifaceted approach. STUDY DESIGN Prospective nested case-control study. METHODS A total of 285 male adolescent rugby players underwent assessment of sensorimotor function during preseason. Players who sustained a concussion during the season and control players, matched for age and playing position, were assessed in the subacute period (3-5 days) and after return-to-sport (3 weeks). Tests of sensorimotor function included balance, cervical spine and vestibulo-ocular function, and measurement of the size and contraction of lumbopelvic muscles (ultrasound imaging). RESULTS Twenty-three players (8%) sustained a concussion. Of these, 20 players were assessed during the subacute period and 17 players following return-to-sport. The prevalence of vestibulo-ocular dysfunction increased from 38.9% to 72.2% during the subacute period and dysfunction was present in 83.3% of players after return-to-sport (p = 0.01). Changes in lumbar multifidus muscle size (p = 0.002) and thickness (p = 0.05) at the L5 vertebral level were observed. No statistically significant changes in balance, cervical spine proprioception, or contraction of lumbopelvic muscles were found (p > 0.05). CONCLUSION Changes in sensorimotor function were observed in the subacute period post-concussion, with some persisting after return-to-sport. Using symptom-based criteria for return-to-sport may not adequately reflect the sequelae of concussion on the sensorimotor system.
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Affiliation(s)
- Felix T Leung
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, 4111, Australia.
| | - M Dilani Mendis
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, 4111, Australia
| | | | - Ann Rahmann
- School of Allied Health, Australian Catholic University, Banyo, QLD, 4014, Australia
| | - Julia Treleaven
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD, 4072, Australia
| | - Julie A Hides
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, 4111, Australia; Mater Back Stability Research Clinic, Mater Health Services, South Brisbane, QLD, 4101, Australia
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Cottrell M, Burns CL, Jones A, Rahmann A, Young A, Sam S, Cruickshank M, Pateman K. Sustaining allied health telehealth services beyond the rapid response to COVID-19: Learning from patient and staff experiences at a large quaternary hospital. J Telemed Telecare 2021; 27:615-624. [PMID: 34726993 PMCID: PMC8564219 DOI: 10.1177/1357633x211041517] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The patient, clinician and administration staff perspectives of telehealth (specifically videoconferencing) services provided by Allied Health Professions (AHP) at a large quaternary hospital were explored. The purpose was to understand stakeholders' perceptions of the service during initial COVID-19 restrictions and examine factors that influenced the implementation and sustained use of telehealth. A sequential mixed-methods approach was undertaken. Stage 1 involved surveys completed by patients (n = 109) and clinicians (n = 66) who received and provided care via telehealth, respectively, across six AHP departments. Stage 2 involved focus groups with clinicians (n = 24) and administrative staff (n = 13) to further examine implementation and sustainability factors.All participant groups confirmed that telehealth was a valid service model and valued the benefits it afforded, particularly during COVID-19 restrictions. Both patients and clinicians reported that not all AHP services could be delivered via telehealth and preferred a blended model of telehealth and in-person care. Increased administrative staff assistance was needed to support growing telehealth demand. Main factors to address are the need to expand AHP telehealth models and workforce/patient training, improve workflow processes and enhance technical support.Despite rapid implementation, telehealth experiences were overall positive. Study findings are being used to generate solutions to enhance and sustain AHP telehealth services.
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Affiliation(s)
- Michelle Cottrell
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia.,School of Health and Rehabilitation Sciences, 1974University of Queensland, Australia
| | - Clare L Burns
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia.,School of Health and Rehabilitation Sciences, 1974University of Queensland, Australia
| | - Amber Jones
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia
| | - Ann Rahmann
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia.,School of Allied Health, 95583Australian Catholic University, Australia
| | - Adrienne Young
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia
| | - Sonia Sam
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia
| | - Mark Cruickshank
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia
| | - Kelsey Pateman
- 3883Royal Brisbane and Women's Hospital, Metro North Health, Australia
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Heywood S, McClelland J, Geigle P, Rahmann A, Villalta E, Mentiplay B, Clark R. Force during functional exercises on land and in water in older adults with and without knee osteoarthritis: Implications for rehabilitation. Knee 2019; 26:61-72. [PMID: 30611642 DOI: 10.1016/j.knee.2018.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/31/2018] [Accepted: 11/03/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Closed kinetic chain and plyometric exercises are commonly used in aquatic rehabilitation because they are believed to reduce joint loading whilst replicating functional tasks. However, the forces and relationship to land-based functional movement is unknown. This study aims to compare vertical ground reaction force during squats, calf raises and jumping in older adults with and without knee osteoarthritis on land and in water. METHODS Forty one participants (Healthy n = 21; Knee osteoarthritis n = 20; Age 68.5 (4.4) years) completed squats and calf raises at slow, medium and maximal speeds and jumping at maximal speed on land and in waist and chest depth water. Vertical ground reaction force and pain rating was measured in each environment. RESULTS Force in all exercises was significantly greater on land than in chest depth water (p < 0.005). Peak force was significantly greater at maximal speed compared to slow speed (p < 0.001). The pattern of force in squats at slow speed in water was different to on land, with force highest at the start and end of the exercise and decreasing in the central phase. Pain ratings were significantly lower (p < 0.001) in water compared to on land in squats. CONCLUSIONS Closed kinetic chain exercises offer inherently different loading in an aquatic environment. Body weight squats and calf raises in water could be defined as either neuromotor or low load, high velocity training. Maximal speed exercise in water produces higher relative load compared to slow speed and minimal pain providing an opportunity for clinicians to use greater speed to address power deficits.
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Affiliation(s)
- Sophie Heywood
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
| | | | - Paula Geigle
- School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Ann Rahmann
- School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia
| | - Elizabeth Villalta
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Benjamin Mentiplay
- Latrobe University, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Ross Clark
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Leung F, Mendis D, Franettovich Smith M, Rahmann A, Hides J. Sensorimotor system changes in adolescent Rugby players post-concussion. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Heywood S, Pua YH, McClelland J, Geigle P, Rahmann A, Bower K, Clark R. Low-cost electromyography – Validation against a commercial system using both manual and automated activation timing thresholds. J Electromyogr Kinesiol 2018; 42:74-80. [DOI: 10.1016/j.jelekin.2018.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/11/2018] [Accepted: 05/25/2018] [Indexed: 10/14/2022] Open
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Leung FT, Franettovich Smith MM, Brown M, Rahmann A, Mendis MD, Hides JA. Epidemiology of injuries in Australian school level rugby union. J Sci Med Sport 2017; 20:740-744. [DOI: 10.1016/j.jsams.2017.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/10/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
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Heywood S, McClelland J, Mentiplay B, Geigle P, Rahmann A, Clark R. Effectiveness of Aquatic Exercise in Improving Lower Limb Strength in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2017; 98:173-186. [DOI: 10.1016/j.apmr.2016.08.472] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 07/28/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
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Abstract
The aim of this study was to provide data on the prognosis and treatment options of headache associated with sexual activity (HSA). Sixty patients diagnosed with HSA between 1996 and 2004 were followed up between 2003 and 2006 at least 12 months after the first interview. The further course of the disease and their contentedness with therapy were requested. On average, the second interview was performed 35.9 months after the first examination. Of the 45 patients who had suffered from single attacks or bouts prior to baseline examination, 37 had no further attacks. Seven patients suffered from at least one further bout with an average duration of 2.1 months. One patient developed a chronic course of the disease after an episodic start. Of the 15 patients with chronic disease at the first examination, seven were in remission and five had ongoing attacks at follow-up. Ten patients received indomethacin for preemptive therapy, with good results in nine patients. Eighteen patients received β-blockers for prophylaxis, with good results in 15 patients. Episodic HSA occurs in approximately three-quarters and chronic HSA in approximately one-quarter of patients. Even in chronic HAS, the prognosis is favourable, with remission rates of 69% during an observation period of 3 years. For patients with longer-lasting bouts or with chronic HSA, prophylactic treatment with β-blockers or preemptive therapy with indomethacin are often successful.
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Affiliation(s)
- A Frese
- Department of Neurology, University of Münster, Münster, Germany
| | - A Rahmann
- Department of Neurology, University of Münster, Münster, Germany
| | - N Gregor
- Department of Neurology, University of Münster, Münster, Germany
| | - K Biehl
- Department of Neurology, University of Münster, Münster, Germany
| | - I-W Husstedt
- Department of Neurology, University of Münster, Münster, Germany
| | - S Evers
- Department of Neurology, University of Münster, Münster, Germany
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Barker A, Talevski J, Morello R, Brand C, Rahmann A, Urquhart D. Effectiveness of aquatic exercise for musculoskeletal conditions: a meta-analysis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lindenberg K, Nitz JC, Rahmann A, Bew P. Predictors of Discharge Destination in a Geriatric Population After Undergoing Rehabilitation. J Geriatr Phys Ther 2014; 37:92-8. [DOI: 10.1519/jpt.0b013e3182abe79e] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Stellos K, Rahmann A, Kilias A, Ruf M, Sopova K, Stamatelopoulos K, Jorbenadze R, Weretka S, Geisler T, Gawaz M, Weig HJ, Bigalke B. Expression of platelet-bound stromal cell-derived factor-1 in patients with non-valvular atrial fibrillation and ischemic heart disease. J Thromb Haemost 2012; 10:49-55. [PMID: 22044645 DOI: 10.1111/j.1538-7836.2011.04547.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Blood cell infiltration and inflammation are involved in atrial remodelling during atrial fibrillation (AF) although the exact mechanisms of inflammatory cell recruitment remain poorly understood. Platelet-bound stromal cell-derived factor-1 (SDF-1) is increased in cases of ischemic myocardium and regulates recruitment of CXCR4(+) cells on the vascular wall. Whether platelet-bound SDF-1 expression is differentially influenced by non-valvular paroxysmal or permanent atrial fibrillation (AF) in patients with stable angina pectoris (SAP) or acute coronary syndrome (ACS) has not been reported so far. METHODS AND RESULTS A total of 1291 consecutive patients with coronary artery disease (CAD) undergoing coronary angiography were recruited. Among the patients with SAP, platelet-bound-SDF-1 is increased in patients with paroxysmal AF compared with SR or to persistent/permanent AF (P < 0.05 for both). Platelet-bound SDF-1 correlated with plasma SDF-1 (r = 0.488, P = 0.013) in patients with AF and ACS, which was more pronounced among patients with persistent AF (r = 0.842, P = 0.009). Plasma SDF-1 was increased in persistent/permanent AF compared with SR. Patients with ACS presented with enhanced platelet-bound-SDF-1 compared with SAP. Interestingly, among patients with ACS, patients with paroxysmal or persistent/permanent AF presented with an impaired platelet-bound SDF-1 expression compared with patients with SR. CONCLUSIONS Differential expression of platelet-bound and plasma SDF-1 was observed in patients with AF compared with SR which may be involved in progenitor cell mobilization and inflammatory cell recruitment in patients with AF and ischemic heart disease. Further in vivo studies are required to elucidate the role of SDF-1 in atrial remodeling and the atrial fibrillation course.
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Affiliation(s)
- Konstantinos Stellos
- Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard Karls-Universität Tübingen, Tübingen, Germany.
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Rahmann A, Wienecke T, Hansen JM, Fahrenkrug J, Olesen J, Ashina M. Vasoactive Intestinal Peptide Causes Marked Cephalic Vasodilation, but does not Induce Migraine. Cephalalgia 2008; 28:226-36. [DOI: 10.1111/j.1468-2982.2007.01497.x] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We hypothesized that intravenous infusion of the parasympathetic transmitter, vasoactive intestinal peptide (VIP), might induce migraine attacks in migraineurs. Twelve patients with migraine without aura were allocated to receive 8 pmol kg-1 min-1 VIP or placebo in a randomized, double-blind crossover study. Headache was scored on a verbal rating scale (VRS), mean blood flow velocity in the middle cerebral artery ( Vmean mca) was measured by transcranial Doppler ultrasonography, and diameter of the superficial temporal artery (STA) by high-frequency ultrasound. None of the subjects reported a migraine attack after VIP infusion. VIP induced a mild immediate headache (maximum 2 on VRS) compared with placebo ( P = 0.005). Three patients reported delayed headache (3-11 h after infusion) after VIP and two after placebo ( P = 0.89). Vmean mca decreased (16.3 ± 5.9%) and diameter of STA increased significantly after VIP (45.9 ± 13.9%). VIP mediates a marked dilation of cranial arteries, but does not trigger migraine attacks in migraineurs. These data provide further evidence against a purely vascular origin of migraine.
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Affiliation(s)
- A Rahmann
- Danish Headache Centre, Department of Neurology, Glostrup Hospital
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - T Wienecke
- Danish Headache Centre, Department of Neurology, Glostrup Hospital
| | - JM Hansen
- Danish Headache Centre, Department of Neurology, Glostrup Hospital
| | - J Fahrenkrug
- Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - J Olesen
- Danish Headache Centre, Department of Neurology, Glostrup Hospital
| | - M Ashina
- Danish Headache Centre, Department of Neurology, Glostrup Hospital
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Abstract
The authors conducted a double-blind, placebo-controlled, crossover study to investigate the efficacy of oral zolmitriptan in the treatment of migraine in children and adolescents. Patients (n = 32) received placebo, zolmitriptan 2.5 mg, and ibuprofen 200 to 400 mg to treat three consecutive migraine attacks. Pain relief rates after 2 hours were 28% for placebo, 62% for zolmitriptan, and 69% for ibuprofen (p < 0.05). Both drugs are well tolerated with only mild side effects.
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Affiliation(s)
- S Evers
- Department of Neurology, University of Münster, Germany.
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Allroggen A, Frese A, Rahmann A, Gaubitz M, Husstedt IW, Evers S. HIV associated arthritis: case report and review of the literature. Eur J Med Res 2005; 10:305-8. [PMID: 16055402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
HIV infection can be associated with different types of arthropathies which are often underdiagnosed. We present the case of a 52 year old HIV positive man on highly active antiretroviral therapy including indinavir who developed an acute painful oligoarthritis. We present this case on HIV associated arthritis and include a review on other HIV specific types of arthritis (acute symmetric arthritis and painful articular syndrome) which are assumed as entities exclusively apparent in HIV patients. The pathophysiology of arthritis in HIV infected patients is not yet completely understood but a direct role of the HIV on the initiation of synovitis is suspected in some of them. Additionally, there is evidence that antiretroviral drugs, in particular the protease inhibitor indinavir, can lead to arthritic complications as well.
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Affiliation(s)
- A Allroggen
- Department of Neurology, University of Münster, Albert-Schweitzer-Str. 33, D-48129 Münster, Germany
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Heuschmann PU, Kolominsky-Rabas PL, Nolte CH, Hünermund G, Ruf HU, Laumeier I, Meyrer R, Alberti T, Rahmann A, Kurth T, Berger K. Untersuchung der Reliabilität der deutschen Version des Barthel-Index sowie Entwicklung einer postalischen und telefonischen Fassung für den Einsatz bei Schlaganfall-Patienten. Fortschr Neurol Psychiatr 2005; 73:74-82. [PMID: 15685491 DOI: 10.1055/s-2004-830172] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSES Aim of the study was to translate the original version of the Barthel-Index (BI) into German and to investigate the reliability of the German version. In addition, a German version of the BI for postal and telephone use was developed. METHODS Data were collected in four neurological hospitals in Germany. The translation of the BI followed the protocol of the Medical Outcomes Trust. The interrater reliability of the German version of the BI was investigated in 72 patients after acute stroke. The reliability of the postal and telephone version of the BI was compared with face-to-face interview in 147 patients three months after stroke. Reliability was assessed using simple weighted kappa-statistics. RESULTS The interrater reliability of the German version of the BI was excellent (mean kappa 0.93). The mean kappa coefficient was 0.79 for the postal version of the BI and 0.80 for the telephone version. Thus, the agreement between the postal and the telephone administration of the BI compared to the face-to-face interview was substantial to excellent. CONCLUSIONS Our study published the first German version of the BI which was investigated for interrater reliability in a standardized way. The development of a postal and a telephone version allows the widespread use of the German BI for the follow up of stroke patients in different access paths.
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Affiliation(s)
- P U Heuschmann
- Institut für Epidemiologie und Sozialmedizin, Universität Münster.
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Evers S, Vollmer-Haase J, Schwaag S, Rahmann A, Husstedt IW, Frese A. Botulinum toxin A in the prophylactic treatment of migraine--a randomized, double-blind, placebo-controlled study. Cephalalgia 2004; 24:838-43. [PMID: 15377314 DOI: 10.1111/j.1468-2982.2004.00754.x] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Botulinum toxin A has been suggested to be effective in the prophylactic treatment of migraine. However, only very few randomized, double-blind, placebo-controlled studies are available. We designed such a study with a specific focus on different injection sites. Sixty patients with a migraine according to the criteria of the International Headache Society were randomly assigned to receive either placebo in the frontal and neck muscles, or to receive 16 U botulinum toxin A in the frontal muscles and placebo in the neck muscles, or to receive in total 100 U botulinum toxin A in the frontal and neck muscles. The observation period was 3 months. In both treatment groups, 30% of patients showed a reduction of migraine frequency in month 3 by at least 50% compared with baseline, in the placebo group 25% of the patients showed such a reduction (P = 0.921). There were no significant differences between the three study groups with respect to reduction of migraine frequency, number of days with migraine, and the number of total single doses to treat a migraine attack. In the post hoc analysis, the reduction of all accompanying symptoms was significantly higher in the 16 U treatment group compared with the placebo group. In the 100 U treatment group significantly more adverse events occurred compared with the placebo group. All adverse events were mild and transient. Our study did not show any efficacy of botulinum toxin A in the prophylactic treatment of migraine. Only accompanying symptoms were significantly reduced in the 16 U but not in the 100 U treatment group. Future studies should focus on the efficacy of botulinum toxin A in specific subgroups of patients, on the efficacy of repetitive injections, and on other injection sites.
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Affiliation(s)
- S Evers
- Department of Neurology, University of Münster, Germany.
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Abstract
We report the first four German cases of hypnic headache according to the criteria suggested in the literature. Furthermore, we present the results of polysomnography in two theses cases with hypnic headache occurring during REM sleep. In one case, hypnic headache was also associated with periodic limb movements. Although mean nocturnal oxygen saturation was decreased in another patient, nightly oxygen inhalation did not result in an improvement of the headache.
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Affiliation(s)
- S Evers
- Department of Neurology, University of Münster, Germany.
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Abstract
The aim of this review is to evaluate the studies available from reference systems and published congress contributions on the prophylactic treatment of idiopathic and cervicogenic headache with botulinum toxin A, and to classify these studies according to evidence-based medicine (EBM) criteria. The studies were analysed with respect to the study design, the number of patients enrolled, the efficacy parameters, and the significance of results. We used the following classification of EBM. I: randomized, controlled study with sufficient number of patients; II: well-designed, controlled study (or randomized, controlled study with insufficient number of patients, no exact diagnosis, missing data of botulinum toxin A dose); III: well-designed, descriptive study; IV: case reports, opinions of experts. For tension-type headache, two studies were found with negative evidence of I with respect to the primary endpoint. There are about as many positive as negative studies with evidence of II or III. For the therapy of migraine, one study with both negative and positive evidence of I, one in part positive study of II, and three positive studies classified as III are available. Two studies on cervicogenic headache with evidence of II and III are contradictory. In addition, we found several positive case reports. For patients with cluster headache, there are positive and negative case reports. We found one positive case report for the treatment of chronic paroxysmal hemicrania. As a result of this analysis, we consider no sufficient positive evidence for a general treatment of idiopathic and cervicogenic headaches with botulinum toxin A to date. Further studies are needed for a definite evaluation of subgroups with benefit from such treatment.
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Affiliation(s)
- S Evers
- Department of Neurology, University of Münster, Münster, Germany.
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Sethi KK, Rahmann A, Brandis H. Maintenance of Fc receptors in hybrid cell lines obtained by fusing mouse splenic macrophages with mouse myeloma cells. Eur J Cell Biol 1979; 19:216-21. [PMID: 226369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Mouse splenic macrophages were fused with cells of the mouse myeloma line P3-X63-Ag8 in the presence of inactivated Sendai virus. Two continuously growing hybrid cell lines were established from fusion mixtures. These hybrid cell lines exhibited macrophage-like morphology and continued to express macrophage derived Fc receptor activity even after prolonged culture in vitro.
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