National Migraine Centre

Migraine is among the top 20 most disabling diseases 1. Despite the significant progress in pain management, migraine‐cause is still not understood. Most research is focused on pain, making it difficult to see the cause of migraine. How nutrition affects ionic channels and electrolyte homeostasis have not yet been connected to migraines.Migraine is caused by channelopathy 2 the following way: hyper‐sensory brain 3; increased sensory‐neuron connections 4; extra voltage used by extra connections 5, 6; extra voltage uses more sodium 7; glucose entering cells causes sodium efflux 8; kidneys waste potassium 9, 10 and water to spare sodium; reduced sodium in circulation triggers increased aldosterone, cortisol, and adrenaline 11; cortisol and adrenaline increase glucose in the blood 12; glucose entering cells causes sodium and water efflux (as noted earlier), initiating the previous steps with adrenaline and cortisol 8. This cycle leads to migraine.In this presentation, I derive the migraine‐process, forming a coherent picture and show how the proper nutrition may prevent migraines. There is a considerable interplay between nutrition high in carbohydrates, low in salt, and migraines. Carbohydrates have a detrimental effect on electrolytes, which may be the most important factor in migraine cause.Support or Funding InformationStanton Migraine Protocol Inc.,

ObjectiveTo assess the effects of migraine on important life domains and compare differences between respondents with episodic and chronic migraine and between sexes.BackgroundMigraine is associated with a substantial personal and societal burden and can also affect the interpersonal dynamics, psychological health and well‐being, and financial stability of the entire family of the person with migraine.MethodsThe Chronic Migraine Epidemiology and Outcomes (CaMEO) Study is a prospective, longitudinal, Web‐based survey study undertaken between September 2012 and November 2013 in a systematic U.S. sample of people meeting modified International Classification of Headache Disorders, 3rd edition migraine criteria: 19,891 respondents were invited to complete the Family Burden Module, which assessed the perceived impact of migraine on family relationships and life, career and finances, and overall health. Respondents were stratified by episodic migraine (<15 headache days/month) and chronic migraine (≥15 headache days/month) and sex for comparisons.ResultsA total of 13,064 respondents (episodic migraine: 11,944 [91.4%]; chronic migraine: 1120 [8.6%]) provided valid data. Approximately 16.8% of respondents not currently in a romantic relationship (n = 536 of 3189) and 17.8% of those in a relationship but not living together (n = 236 of 1323) indicated that headaches had contributed to relationship problems. Of those in a relationship and living together (n = 8154), 3.2% reported that they chose not to have children, delayed having children or had fewer children because of migraine (n = 260; episodic migraine: n = 193 of 7446 [2.6%]; chronic migraine: n = 67 of 708 [9.5%]; P < .001). Of individuals responding to career/finance items (n = 13,061/13,036), 32.7% indicated that headaches negatively affected ≥1 career area (n = 4271; episodic migraine: n = 3617 of 11,942 [30.3%]; chronic migraine: n = 654 of 1119 [58.4%]), and 32.1% endorsed worry about long‐term financial security due to migraine (n = 4180; episodic migraine: n = 3539 of 11,920 [29.7%]; chronic migraine: n = 641 of 1116 [57.4%]).ConclusionsMigraine can negatively affect many important aspects of life including marital, parenting, romantic and family relationships, career/financial achievement and stability, and overall health. Reported burden was consistently greater among those with chronic migraine than among people with episodic migraine; however, few differences were seen between the sexes.

Interorganizational collaboration management theory contends that cooperation between distinct but related organizations can yield innovation and competitive advantage to the participating organization. Yet, it is unclear if a multi-institutional collaborative can improve quality outcomes across communities. We developed a large regional collaborative network of 15 hospitals and 24 emergency medical service agencies surrounding Dallas, Texas, and collected patient-level data on treatment times for acute myocardial infarctions. Using a pre-/posttest research design, we applied median tests of differences to explore outcome changes between groups and over the 6-year period, using data extracted from participating hospital electronic health records. We analyzed temporal trends and changes in treatment times for 2302 patients with ST-elevation myocardial infarction between the pre- and posttest groups. We found a statistically significant 19-minute median reduction in the key outcome metric (total ischemic time, the time difference between the patient's first reported symptoms and the definitive opening of the artery). This represents a 10.8% community-wide improvement over time. Interorganizational collaboration focused on quality improvement can impact population health across a community. This study provides a basis for broader understanding and participation by health care organizations in multi-institutional community change efforts.

In her 1994 essay ‘Ireland and the Iconography of Rape’, Sabine Sharkey analyses the texts of Edward Spenser and Sir William Petty to identify their deployment of the language of rape and husbandry to describe the process of colonising Ireland.1 As she points out, this metaphoric use of language is not limited to Ireland but is part of the colonial reporting and conceptualisation of the period: John Donne addresses his mistress as ‘my America, my New-Found-Land’, and George Chapman imagines Guyana as a virgin and the English ‘industrious knight, soule of this exploit’ as her bridegroom. This metaphor persists in cartoons, travelogues, histories, and literature from at least the sixteenth to the early twentieth centuries, and examples can be found in imperial and postcolonial theatre and drama in Ireland, the United Kingdom, Canada and Australia, amongst others. Sharkey draws on the work of Stallybrass and Kosofsky-Sedgwick to investigation the use of rape to construct narratives that promote colonial agency, arguing that the ideological discourses of the sixteenth and seventeenth centuries define women as valued male property and commodities for exchange between men,2 so easing the conflation of woman and nation. Thus Ireland in Luke Gernon’s seventeenth-century text is described as ‘at all points like a young wench that hath the green sickness for want of occupying’. She lies open and receptive to potential husbands: ‘betwixt her legs (for Ireland is full of havens) she hath open harbor, but not much frequented’.3 The land is ripe for the rape or seduction that constitutes the first step, the invasion; the second step is the development of a constant relationship expressed in terms of sexual union. The metaphor persists so that Victorian iconography such as the Punch cartoons by John Tenniel and others depicts a delicately feminine Hibernia clinging to either her tall strong sister Britannia (often drawn in armour), or to John Bull, with Hibernia now in a family relationship as sister, daughter, or occasionally wife.4 Colonisation and colonial domination is thus naturalised as a sexual or familial relationship with Ireland as the female (dependent, subordinate) partner.

We report a conjugate between carbon quantum dots and a NO photoreleaser able to photogenerate the anticancer NO radical via an energy transfer mechanism. This nanohybrid proved toxic to cancer cells in vitro and significantly reduced tumor volume in mice bearing human xenograft BxPC-3 pancreatic tumors upon two-photon excitation with the highly biocompatible 800 nm light.

Luminescent sensors and switches continue to play a key role in shaping our understanding of key biochemical processes, assist in the diagnosis of disease and contribute to the design of new drugs and therapies. Similarly, their contribution to the environment cannot be understated as they offer a portable means to undertake field testing for hazardous chemicals and pollutants such as heavy metals. From a physiological perspective, the Group I and II metal ions are among the most important in the periodic table with blood plasma levels of H(+), Na(+) and Ca(2+) being indicators of several possible disease states. In this review, we examine the progress that has been made in the development of luminescent probes for Group I and Group II ions as well as protons. The potential applications of these probes and the mechanism involved in controlling their luminescent response upon analyte binding will also be discussed.

Chronic Migraine (CM) was first defined in 2004. The definition was revised in 2006[1]. The definition allows occurence of both migraine and tension-type headache (TTH). This study analyses the Introduction of the new diagnosis of CM in one neurologist's practice. A patient database for all patients seen in consultation has been maintained since 1994. Total patient numbers are currently over 22,000. Data are collected and recorded at the time of first consultation and updated when the patient is reviewed. All relevant diagnoses are recorded; patients often have more than one diagnosis. Before the definition of CM, patients with other primary headache, and medication overuse headache (MOH), were diagnosed with both the primary headache, and MOH, when appropriate. This practice continued when coding for CM, despite the IHS definition excluding CM in MOH patients. A steady rise in CM since 2004 has peaked at about 150 cases a year. This is mirrored by a fall in diagnosis of TTH to single figures annually. It is likely that patients with chronic headache,formerly diagnosed as both TTH and migraine, can now receive a single diagnosis of CM. CM has proved common in this practice and has largely superceded the diagnosis of TTH.

Implantable peripheral neurostimulation was introduced in 1969 as a potential treatment for certain neuropathic pain syndromes, primarily involving the limbs. While a few early studies included implants for occipital neuralgia, serious interest in its potential as a treatment for head pain came only after our 1999 report of positive findings in a series of patients with occipital neuralgia. Subsequent investigators confirmed these initial findings, and then extended the application to patients with various primary headache disorders, including migraine. While most found a therapeutic response, the degree of that response varied significantly, and analysis suggests that the issue of paresthesia concordancy may be central, both in explaining the data, as well as providing direction for future endeavors. Therefore, while at present peripheral neurostimulation is gaining increasing acceptance as a treatment for chronic headaches, the precise clinical indications and procedures, as well as the underlying neurophysiological mechanisms, are still being worked out.