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Excruciating cluster headaches often misdiagnosed

Excruciating cluster headaches often misdiagnosed

By Angela Betsaida B. Laguipo, BSNJun 4 2020

A headache is a painful sensation in any part of the head and can have a multitude of causes that are not necessarily due to underlying illness. They result from signals interacting among the brain, surrounding nerves, and blood vessels.

The most excruciating and painful type of headache is a cluster headache. The condition is more than just a headache, but a severe neurological condition. Some patients may have suicidal thoughts that accompany their attacks, hence the name “suicide headache.”

In a study published in the British Journal of General Practice, a team of researchers from the University of York, King’s College London, Ghent University and Keele University found that many patients are forced to wait a long time to have their cluster headache correctly diagnosed and treated.

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Shrinking Door-to-Needle Time in Stroke Proves Its Worth

Shorter times to thrombolytic therapy in acute stroke led to better long-term survival and lower readmission risk, an analysis of Medicare patients showed.

One year later, ischemic stroke patients treated with intravenous tissue plasminogen activator (tPA) who had door-to-needle times longer than 45 minutes had higher all-cause mortality (35.0% vs 30.8%) and higher all-cause hospital readmission (40.8% vs 38.4%) than patients with shorter times to treatment, reported Gregg Fonarow, MD, of the University of California Los Angeles, and colleagues.

Within a 90-minute window after hospital arrival, every 15-minute increase in door-to-needle time upped the risk of 1-year all-cause death (HR 1.04) or readmission (HR 1.02), they wrote in JAMA.

"Faster treatment translates into better long-term outcomes in patients with stroke," Fonarow said.

"For every 15 minutes improvement in treatment time, improvements in 1-year outcomes were observed," he told MedPage Today.

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Zoloft Shortage; Google's Anxiety Self-Screening

The antidepressant sertraline (Zoloft) was added to the FDA's shortage list due to increased demand amid the pandemic. (Bloomberg Law)

As the pandemic pushed the field toward telehealth, researchers of a JAMA Psychiatry viewpoint said the post-COVID-19 world "could usher in a golden era for technology in psychiatry in which we are able to harmonize the benefits of telepsychiatry and virtual care while maintaining the core of our treatment: that of human connectedness."

In partnership with the National Alliance on Mental Illness, Google added a clinically validated anxiety self-assessment tool to its search engine. (CNET)

When added to usual care, adjunctive treatment with the anti-inflammatory drugs minocycline (Minocin), celecoxib (Celebrex), or both was not superior to placebo for improving symptoms of bipolar depression. (Lancet Psychiatry)

Compared to their heterosexual counterparts, higher rates of substance abuse were found among middle-age and older folks in the LGBTQ community, according to a new study. "Similar to LGBTQ adolescents and young adults, such prevalence may be related to stressors like discrimination and stigma based on sexual orientation in addition to stressors related to aging, including social isolation and age-related stigma," lead author Benjamin Han, MD, MPH, of NYU Langone Health in New York City, said in a statement. (Journal of General Internal Medicine)

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