Self-regulation treatment of post-polio cold limb.
Biofeedback Self Regul. 1986 Jun ;11(2):157-61. PMID: 3567235
T F Dietvorst, M K Eulberg
Decreased limb temperature in the affected limb is one of the aftereffects of poliomyelitis. The decrease in limb temperature can be painful as well as subjectively unpleasant. A search of the current literature failed to reveal a cost-effective treatment for post-polio cold limbs. Since thermal biofeedback and other physiologic self-regulatory therapies have been shown to be effective in increasing peripheral blood flow in a number of disorders, they were used in the treatment of a patient with a post-polio cold limb. The patient showed foot warming during therapy sessions. This effect generalized to situations outside the therapy environment. The patient's self-report also indicated treatment to be successful. Replication and studies of the warming and cooling mechanism are suggested.
Article Published Date : May 31, 1986
Migraine Headache Prophylaxis.
Am Fam Physician. 2019 Jan 01;99(1):17-24
Authors: Ha H, Gonzalez A
Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and headache-related distress. Preventive therapy may also improve quality of life and prevent the progression to chronic migraines. Some indications for preventive therapy include four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication-overuse headaches. Identifying and managing environmental, dietary, and behavioral triggers are useful strategies for preventing migraines. First-line medications established as effective based on clinical evidence include divalproex, topiramate, metoprolol, propranolol, and timolol. Medications such as amitriptyline, venlafaxine, atenolol, and nadolol are probably effective but should be second-line therapy. There is limited evidence for nebivolol, bisoprolol, pindolol, carbamazepine, gabapentin, fluoxetine, nicardipine, verapamil, nimodipine, nifedipine, lisinopril, and candesartan. Acebutolol, oxcarbazepine, lamotrigine, and telmisartan are ineffective. Newer agents target calcitonin gene-related peptide pain transmission in the migraine pain pathway and have recently received approval from the U.S. Food and Drug Administration; however, more studies of long-term effectiveness and adverse effects are needed. The complementary treatments petasites, feverfew, magnesium, and riboflavin are probably effective. Nonpharmacologic therapies such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic feedback, and cognitive behavior therapy also have good evidence to support their use in migraine prevention.
PMID: 30600979 [PubMed - in process]