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Medication Causes of Headache

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181. Is Hyperpronation More Effective Than Supination for Reduction of a Radial Head Subluxation? (SRS therapy)

Is Hyperpronation More Effective Than Supination for Reduction of a Radial Head Subluxation? (SRS therapy) TAKE-HOME MESSAGE Hyperpronation has higher success rates than supination for reduction of radial head subluxation, according to low-quality evidence. Is Hyperpronation More Effective Than Supination for Reduction of a Radial Head Subluxation? EBEM Commentators Nicholas Bertucci, DO Kathleen Cowling, DO, MS Department of Emergency Medicine Central Michigan University College of Medicine (...) . The data for pain were deemedincompleteforthisreview. Commentary Radial head subluxation (nurse- maid’selbow)isacommoninjuryin pediatric patients that classically results from a sudden pull on the arm, causing the radial head to sublux from the annular ligament, which then becomes entrapped between the radial head and the capitellum. This results in pain and inabilitytomovetheaffectedarm. 1 An estimated 430,766 children younger than 5 years were treated for radial head subluxation in the United States

2018 Annals of Emergency Medicine Systematic Review Snapshots

182. CAR T-cell therapy: a summary of evidence

frameworks are in place, or under consideration, for the delivery of CAR T-cell therapy? Regulatory approvals At the time of writing, regulatory approvals of two CAR T-cell therapies have been granted by the US Food and Drug Administration (FDA), the European Medicines Agency (EMA) and Health Canada (see Appendix 5). The US was the first to approve two CAR T-cell therapies for two indications: tisagenlecleucel (Kymriah, Novartis) received FDA approval in August 2017 for adults with relapsed or refractory (...) -cell therapy 30, 31, 34, 35, 42, 47, 52 • Large number of early stage, single-arm trials in small populations, and with short follow-up • Lack of familiarity with regulatory processes for those developing the treatments (more often universities or non-commercial bodies rather than pharmaceutical companies). 32 A report by CADTH looked at all medicines approved under a number of EMA, FDA and Health Canada special designations and indicated that CAR T-cell therapies have so far been eligible

2018 Sax Institute Evidence Check

183. Guidelines for the Administration of Electroconvulsive Therapy

that electroconvulsive therapy is a continually evolving practice. Conclusion: The guidelines provide up-to-date advice for psychiatrists to promote optimal standards of electroconvul- sive therapy practice. Keywords Guidelines, electroconvulsive therapy, monitoring, depressive disorders, schizophrenia 1 School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Australia, Callaghan, NSW, Australia 2 School of Psychiatry, Faculty of Health and Medical Sciences, The University (...) be appropriate, but other options should also be considered, including adequate discussion with the anaes- thetist about minimising the dose of the induction agent, addition of an short acting narcotic agent or changing to a drug that is known to have less impact on the seizure thresh- old, that is, the ECT dose should be carefully controlled to prevent unnecessary cognitive impairment. Consideration should be given to the management of the common side-effects of ECT, including headache and nau- sea (Isuru

2019 American Psychiatric Association

184. ACR-ABS-ACNM-ASTRO-SIR-SNMMI Practice Parameters for Selective Internal Radiation Therapy (SIRT) or Radioembolization for Treatment of Liver Malignancies

]. C. Obtaining Informed Consent Consent for the interventional procedure should be obtained by the appropriate health care provider after discussing the procedure in detail with the patient or designated medical power of attorney. The risks and complications of the procedure, as well as the treatment outcomes, should be discussed in detail. The consent for radiation therapy should be obtained by the AU or his or her designee, which could include the interventional radiologist, the nuclear medicine (...) ACR-ABS-ACNM-ASTRO-SIR-SNMMI Practice Parameters for Selective Internal Radiation Therapy (SIRT) or Radioembolization for Treatment of Liver Malignancies PRACTICE PARAMETER 1 SIRT or Radioembolization The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science

2019 Society of Interventional Radiology

185. British Association of Dermatologists and British photodermatology Group guidelines for topical photodynamic therapy

of post-treatment events and tolerability assessed both cumulatively over time and in intensity (including pain, irritation), and patient treat- ment preference. FRR2 Potential for combination therapy including PDT to optimize sustained response rates in BCC. FRR3 Comparison of PDT in combination with other therapies for large lesions or lesions unresponsive to monotherapy in BCC. FRR4 Comparison of conventional vs. fractionated PDT in BCC. FRR5 Comparison of the ef?cacy of conventional vs. daylight (...) Protocols for delivery of photodynamic therapy A successful PDT outcome requires the optimization of apply- ing the appropriate prodrug, drug or photosensitizer, light parameters and oxygen, thereby achieving the mechanism of action intended. The resultant photodynamic reaction at the target cell produces the therapeutic result. PDT utilizes the higher selectivity of the photosensitizer for the target tissue compared with healthy tissue. The topically applied photosen- sitizer prodrugs are converted

2019 British Association of Dermatologists

186. Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

for management of acute intermediate- and high-risk PE is rapidly evolving. Two interventional devices using pharmacomechanical means to recanalize the pulmonary arteries have recently been cleared by the US Food and Drug Administration for marketing, and several others are in various stages of development. The purpose of this document is to clarify the current state of endovascular interventional therapy for acute PE and to provide considerations for evidence development for new devices that will define (...) of complications or because hemodynamic measurements or imaging via PA catheterization reveals unexpected findings. Table 2. Risk Factors for Bleeding With and Contraindications to Use of Thrombolytic Therapy (Both Systemic and Locally Administered) Major contraindications Structural intracranial disease Previous ICH Ischemic stroke within 3 mo Active bleeding Recent brain or spinal surgery Recent head trauma with fracture or brain injury Bleeding diathesis Relative contraindications Systolic blood pressure

2019 American Heart Association

187. Headache in HIV

Headache in HIV Headache in HIV Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Headache in HIV Headache in HIV Aka: Headache in HIV (...) , Headache in AIDS II. Precautions location does not differentiate cause in HIV patients HIV patients typically present without meningeal signs despite underlying HAART has decreased of opportunistic infection causes of However HIV patients require a high level of vigilence in evaluation due to confounding factors III. Differential Diagnosis Primary HIV related s Aseptic HIV Often self-limited, presenting at any Chronic HIV Presents as persistent moderate -like symptoms Secondary HIV related s

2018 FP Notebook

188. Headache Red Flag

Asymmetric motor function Abnormal Onset recently or suddenly Onset after age 40 years Prior that is different or progressive Different location is less useful as predictor of serious cause Pain response to standard therapy is not predictive of serious cause References Dodick (2003) Adv Stud Med S550-5 VI. References Edlow and Weinstock (2013) EM:Rap 13(12): 7-8 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Headache Red Flag." Click (...) Headache Red Flag Headache Red Flag Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Headache Red Flag Headache Red Flag Aka: Headache

2018 FP Notebook

189. Headache in Children

Aka: Headache in Children , Headaches in Children , Cephalgia in Children , Pediatric Headache From Related Chapters II. Epidemiology of Age 7 years or older: 33% (frequent in 2.5%) Age 15 years or older: 50% (frequent in 15%) Gender predominance Before : Boys After : Girls s in teens presenting to Emergency Department (all serious causes had neurologic findings) Upper respiratory tract infection with fever: 55% syndrome ( or ): 18% : 7% : 2.5% Post-ictal following : 2% Postconcussive: 2 (...) % Ventricular shunt malfunction: 2% Undetermined cause: 7% III. Causes: Primary Headaches Common primary Headaches in Children See s See Uncommon primary Headaches in Children Young Children Hemiplegic Ophthalmoplegic Older Child, Adolescent and Young adult Basilar (female adolescents) Similar to without (rare in children) Occipital Neuralgia IV. Causes: Secondary Headaches Head and neck infections s Intracranial Infections Cyanotic heart disease Immunocompromised Untreated (e.g. ) Intracranial Cause

2018 FP Notebook

190. Headache in Pregnancy

Headache in Pregnancy Headache in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Headache in Pregnancy Headache (...) in Pregnancy Aka: Headache in Pregnancy , Migraine in Pregnancy , Antepartum Headache , Postpartum Headache From Related Chapters II. Types: Primary Headaches Improves with pregnancy in up to 70% of patients Some cases of first occur in first trimester Associated with aura III. Differential Diagnosis: Secondary Headaches in Antepartum Period See for other causes See s ( ) Consider after 20 weeks IV. Differential Diagnosis: Secondary Headaches in Postpartum Period (Postpartum Headache) See for other causes

2018 FP Notebook

191. Spinal Headache

Spinal Headache Spinal Headache Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Spinal Headache Spinal Headache Aka: Spinal Headache (...) Hypotension) Dural tear (typically along l spine) secondary to coughing, straining in labor Similar presentation to Spinal Headache (positional) V. Symptoms: Location Frontal, Occipital or diffuse Characteristics Severe dull or throbbing Timing Follows within 4 days May also occur spontaneously with coughing or sneezing provocative maneuvers Sitting or standing (upright ) Head-shaking ing or sneezing Straining Jugular compression palliative factors Relieved by lying supine ( improves within 30 minutes

2018 FP Notebook

192. Migraine Headache Prophylaxis

Migraine Headache Prophylaxis Migraine Headache Prophylaxis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Migraine Headache (...) Portuguese Profilaxia da enxaqueca Spanish Profilaxis de la migraña , profilaxis de la migraña (procedimiento) , profilaxis de la migraña Dutch migraine profylaxe French Prophylaxie de la migraine German Migraeneprophylaxe Derived from the NIH UMLS ( ) Related Topics in Headache Disorders About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31

2018 FP Notebook

193. Emergency Department Migraine Headache Care

Emergency Department Migraine Headache Care Emergency Department Migraine Headache Care Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration (...) 4 Emergency Department Migraine Headache Care Emergency Department Migraine Headache Care Aka: Emergency Department Migraine Headache Care , Migraine Headache Care in the Emergency Department , Status Migrainosus From Related Chapters II. Indications refractory to home care (6-72 hours) (e.g. ) III. Epidemiology is the fourth most common presentation to emergency departments in the United States IV. Causes See V. History See VI. Examination See VII. Diagnostics See See for and protocol VIII

2018 FP Notebook

194. Migraine Headache Trigger

Headache Trigger Aka: Migraine Headache Trigger , Migraine Headache Medication Causes From Related Chapters II. Causes: General Triggers Physical Exertion or Stress, worry, anxiety or mental health condition exascerbations Menstruation (see ) Pungent odors or perfumes Smoke exposure deprived, or excessive sleep Glare from the sun or fluorescent lights Weather or t changes High humidity High altitude Drinking cold water III. Causes: Medication Triggers s s IV. Causes: Food Triggers Tyramines See (...) Migraine Headache Trigger Migraine Headache Trigger Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Migraine Headache Trigger Migraine

2018 FP Notebook

195. Rebound Headache

Headache , Rebound Migraine , Analgesic Overuse Headache , Medication Overuse Headache , Analgesic Rebound Headache From Related Chapters II. Pathophysiology Excessive use of medication Use more than 15-20 days per month confers risk Butalbital (Fiorinal) >5 days/month s >8 days/month s, S, Excedrin (or other combinations) >10 days/month Drug dependent pattern of s Increasing tolerance to medication dosages Medications most prone to Rebound Headache Occurs with all medications Butalbital (e.g. Fiorinal (...) -2 weeks, then taper 500-1000mg qd for 1-3 weeks 25-30 mg tid prn for 1-2 weeks V. Prevention Limit acute abortive medications to 10 days per month or 2 days per week Long acting s may be less likely than other simple s to cause Rebound Headaches Avoid butalbital (fiorinal) for s VI. Reference Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Rebound Headache." Click on the image (or right click) to open the source website

2018 FP Notebook

196. Migraine Headache

may occur with and warrants additional evaluation XIII. Differential Diagnosis See See See Always consider for patients with frequent Conditions that may coexist with Migraine Headache Myofascial cervical Not exclusive to Present in 75% of Migraine Headache patients medications relieve and Migraine Headache criteria in 90% of XIV. Evaluation: Headache with persistent neurologic deficit See Exclude Ischemic causes Exclude structural causes Exclude Inflammatory causes Exclude Metabolic cause XV (...) . Evaluation: First or Worst severe Migraine Headache See No potent s until full evaluation Complete clinical and neurologic evaluation (or MRI Brain) Not indicated in typical Migraine Headache Use low threshold for symptoms Neurologic changes New onset Organic causes of identified by Consider for meningeal signs, fever or ill appearance XVI. Management See See in Children See XVII. Course Mild episodic s Most cases start with Migraine without Aura Relieved with OTC medications Chronic episodic Migraine

2018 FP Notebook

197. Chronic Progressive Headache

be attributed to a variety of causes including BRAIN VASCULAR DISORDERS; WOUNDS AND INJURIES; INFECTION; drug use or its withdrawal. Concepts Disease or Syndrome ( T047 ) MSH Swedish Huvudvärksproblem, sekundära Finnish Sekundaariset päänsäryt Russian GOLOVNAIA BOL', VYZVANNAIA CHREZMERNYM PRIMENENIEM ANAL'GETIKOV , GOLOVNOI BOLI SINDROMY VTORICHNYE , ГОЛОВНАЯ БОЛЬ, ВЫЗВАННАЯ ЧРЕЗМЕРНЫМ ПРИМЕНЕНИЕМ АНАЛЬГЕТИКОВ , ГОЛОВНОЙ БОЛИ СИНДРОМЫ ВТОРИЧНЫЕ English Headache Disorders, Secondary [Disease/Finding (...) Chronic Progressive Headache Chronic Progressive Headache Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Chronic Progressive Headache

2018 FP Notebook

198. Cluster Headache

. Management: Nonpharmacologic measures s Cognitive-behavior therapy Treat comorbid s cessation XII. Management: Abortive Treatment for Acute Cluster Headache See Treatment First line agents Agents ( ) Intranasal 20 mg (may repeat once in 24 hours) Subcutaneous: 6 mg SC (may repeat once after 1 hour) Significant pain relief with 6 mg dose in 75% of patients by 15 minutes (NNT 2.4) Higher dose (12 mg) adds adverse effects without additional benefit Oral: 5 mg orally (may repeat once in 24 hours) Intranasal (...) ) Definition (MSH) A primary headache disorder that is characterized by severe, strictly unilateral PAIN which is orbital, supraorbital, temporal or in any combination of these sites, lasting 15-180 min. occurring 1 to 8 times a day. The attacks are associated with one or more of the following, all of which are ipsilateral: conjunctival injection, lacrimation, nasal congestion, rhinorrhea, facial SWEATING, eyelid EDEMA, and miosis. (International Classification of Headache Disorders, 2nd ed. Cephalalgia

2018 FP Notebook

199. Tension Headache

(MSH) A common primary headache disorder, characterized by a dull, non-pulsatile, diffuse, band-like (or vice-like) PAIN of mild to moderate intensity in the HEAD; SCALP; or NECK. The subtypes are classified by frequency and severity of symptoms. There is no clear cause even though it has been associated with MUSCLE CONTRACTION and stress. (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1) Definition (MSHCZE) Problém s běžnou základní bolestí hlavy (...) Headache , Occipital Headache From Related Chapters II. Pathophysiology Pain associated with myofascial (muscular) cause III. Causes Stress or worry Anxiety Overwork Lack of sleep Incorrect Marital and family dysfunction Post- (<3 months) Conversion IV. Types Acute Tension Headache Chronic Tension Headache See Present at least half the days of the month Persists for 6 months or more V. Symptoms Characteristics Pressing, tightening or vice-like gripping Location Band of pain extending from forehead back

2018 FP Notebook

200. Acute Recurrent Headache

Acute Recurrent Headache Acute Recurrent Headache Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Acute Recurrent Headache Acute (...) Recurrent Headache Aka: Acute Recurrent Headache , Recurrent Headache From Related Chapters II. Causes: Children (52%) Chronic (21%) References III. Causes: General Complicated Hemiplegic (young child) Ophthalmologic (young child) Basilar (adolescent girls) (rare in children) equivalent Cyclic Acute confusional state Transient global amnesia IV. Evaluation See See See See V. Management Reassurance Nonpharmacologic Treatment Specific Pharmacologic Treatment See specific types Images: Related links

2018 FP Notebook

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