Cluster Headache Features and Therapeutic Options

A review article titled “Cluster Headache: Clinical Features and Therapeutic Options” written by Charly Gaul, Hans-Christoph Diener, and Oliver M. Muller published in Deutsches Ärzteblatt International (vol. 108, issue 33, pages 543-549, 2011) provides an interesting look on new options for those with a chronic refractory cluster headache. The article discusses how 120,000 people in Germany are affected by cluster headache. The attacks are in the periorbital area on one side and last 90 minutes on average. The attacks often posses a circadian and seasonal rhythm. The author lists the diagnostic criteria for cluster headache as from the International Classification of Headache Disorders (ICHD-II). First line drugs for treatment include verapamil and cortisione or lithium and topirmate. In addition, short term relief can be obtained by local anesthetics and steroids along the course of the greater occipital nerve. I have … Read more

Evidence Base for Oral and Maxillofacial Surgery Journals

An interesting articled titled “The evidence base for oral and maxillofacial surgery: 10-year analysis of two journals,” appeared in the January 2012 edition of the British Journal of Oral and Maxillofacial Surgery (vol. 50, issue 1, pages 45-48) wirrten by Amandip Sandhu. The author opens by discussing an editorial in the Lancet in 1996 which discussed how there is a lack of scientific rigor in surgical research. The author states “There is a well established hierarchy of levels of evidence, and the medical community considers that meta-analyses and randomised controlled trials (RCTs) are the most scientifically stringent means of investigating the efficacy of one intervention against another. Other grades of evidence (in increasing weakness of level of evidence) are case controlled studies, comparative studies, case series, correlation studies and expert committee reports, and the clinical experiences of respected authorities.” The … Read more

Evidence Based Medicine

I found a good website discussing some of the benefits of evidence based medicine. It explains what it is, what a systematic review is, and what this means to you. The information is from The Informed Health Online/Gesundheitsinformation.de Team: IQWiG. My favorite paragraph is talking about what to do when there is no clear answer for your medical treatment. It is important to remember, too, that just because there is no clear answer now, it does not mean that there is nothing a patient can do and that someone should take over for them. If there is no conclusive evidence about a treatment, patients need the best description possible of the potential advantages and disadvantages of the alternatives they face so that they can choose what they want to do. A variety of medical and personal issues can influence this … Read more