The PACE study: past-year prevalence of tension-type headache and its subtypes in Parma's adult general population.

The mean global prevalence of tension-type headache (TTH) in adult is 42 %. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE, aimed at detecting the prevalence of primary headaches in the city of Parma's adult general population. 904 subjects representative of Parma's adult general population were interviewed face to face by a physician of our Headache Centre. Crude past-year prevalence for definite TTH was 19.4 % (95 % CI 16.8-21.9; 18.4 %, 95 % CI 14.6-22.3 in men, and 20.1 %, 95 % CI 16.6-23.6 in women), namely, 9.0 % (95 % CI 7.1-10.8) for infrequent TTH, 9.8 % (95 % CI 7.9-11.8) for frequent TTH, and 0.6 % (95 % CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3 % (95 % CI 1.3-3.3; 2 %, 95 % CI 0.6-3.4 in men, and 2.6 %, 95 % CI 1.2-3.9 in women). Our results indicate a TTH prevalence (19.4 %) at the lower limit of data ranges for Western countries, and prevalence rates for infrequent forms (9 %) do not appear different from those of frequent forms (9.8 %).

Prevalence of tension-type headache in adult general population: the PACE study and review of the literature.

The mean global prevalence of tension-type headache (TTH) in adult is 42 %. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE (PArma CEfalea, or "Headache in Parma"), aimed at detecting the prevalence and clinical features of primary headaches in the city of Parma's adult general population. Crude past-year prevalence for definite TTH was 19.4 % (95 % CI 16.8-21.9), namely 9.0 % (95 % CI 7.1-10.8) for infrequent TTH, 9.8 % (95 % CI 7.9-11.8) for frequent TTH, and 0.6 % (95 % CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3 % (95 % CI 1.3-3.3). Our study results indicate a TTH prevalence rate (19.4 %) at the lower limit of data ranges currently available for Western countries, and prevalence rates for infrequent forms (9 %) do not appear much different from those of frequent forms (9.8 %).

SPARTACUS: underdiagnosis of chronic daily headache in primary care.

Despite the burden of chronic daily headache (CDH), general practitioners' (GPs) ability to recognize it is unknown. This work is a sub-study of a population-based study investigating GPs' knowledge on their CDH patients. Patients diagnosed with CDH through the screening questionnaire were interviewed by their GPs who indicated if subjects were known as patients suffering from CDH with medication overuse (MO), CDH without MO, episodic headache (EH) or non-headache sufferers. Our study showed that 64.37 % of CDH sufferers are misdiagnosed by their GPs. However, overusers are better known to GPs.

Cough headache secondary to spontaneous intracranial hypotension complicated by cerebral venous thrombosis.

Cough headache may be the clinical manifestation, sometimes isolated, of an intracranial disease. There are several possible causes of secondary cough headache. The hypothesis that cough headache may be the expression of spontaneous intracranial hypotension has been advanced only recently. In fact, this would represent an exception to the rule that cough headache is generally secondary to conditions leading to an increase in intracranial pressure and/or volume. We report and discuss a case of cough headache secondary to spontaneous intracranial hypotension in an otherwise healthy 59-year-old man. The condition was complicated by cerebral venous thrombosis.

Population-based pace study: lifetime and past-year prevalence of headache in adults.

Primary headache prevalence in the adult Italian general population has been little studied so far. This is an observational, cross-sectional, population-based study conducted in a subject sample that was representative of the city of Parma's general population >or=age 18. The lifetime prevalence of headache was 69.1%, i.e. 75.8% in women and 60.6% in men; the past-year prevalence of headache was 42.8%, i.e. 52.0% in women and 31.1% in men. Most people suffer from one headache subtype. Headache past-year prevalence decreases with age, both in men and in women. After 60, the likelihood of suffering from headache is low. In more than 80% of cases, headache starts before age 40 and, therefore, it is not very likely for people to develop headache at an advanced age (>50 years). This is the first population-based study conducted in Italy on a sample aged >or=18 since the publication of the IHS diagnostic criteria in 1988.

Population-based pace study: headache frequency and disease perception in adult subjects with headache.

Headache is a disorder that has a very negative personal and social impact. This is an observational, cross-sectional, population-based study conducted in a subject sample (n = 904) that was representative of the town of Parma's general population aged 18 and over. The aim of this study, which is a part of a larger project, was to assess the frequency of headache and the disease perception of subjects with headache during the past year (n = 387). The average number of headache days in the past year was 34.9 days and it was comparable in men and in women: 49.9% of subjects had 1-12 days of headache in the past year, 34.9% had 1-52 days, 11.9% had 53-180 days, and 3.4% had more than 180 days. Only three subjects had headache every day during the past year. Only one-third of the subjects with headache in the past year considered themselves headache sufferers. The analysis by gender showed differences between men and women: although the average number of headache days in the past year was comparable in the male and female populations, women considered their headache a disease more often than men did. In addition, the percentage of men who considered their headache a disease did not increase with the increase in the number of headache days in the past year. More in-depth studies on this important aspect are needed.

Oral-motor skills following sensorimotor therapy in two groups of moderately dysphagic children with cerebral palsy: aspiration vs nonaspiration.

The purpose of this study was to determine the effect of oral sensorimotor treatment on oral-motor skills and measures of growth in moderately eating impaired children with cerebral palsy who were stratified by state of aspiration/nonaspiration. Twenty-seven children aged 2.5-10.0 years participated in this study (aspiration: n = 7, nonaspiration: n = 20). Weight and skinfold measures were taken. Children were observed at lunch time and six domains of feeding were examined: spoon feeding, biting, chewing, cup drinking, straw drinking, swallowing, and drooling. Children underwent 10 weeks of control and 10 weeks of sensorimotor treatment, 5-7 minutes/day, 5 days/week. Treatment compliance for the entire group was 67%. Children who aspirated had significantly poorer oral-motor skills in spoon feeding, biting, chewing, and swallowing than children who did not aspirate. There was significant improvement in eating: spoon feeding (fewer abnormal behaviors, p < 0.03), chewing (more normal behaviors, p < 0.003), and swallowing (more normal behaviors, p < 0.008). There were no significant changes in drinking skills. Children as a group maintained their pretreatment weight-age percentile but did not show any catch-up growth. Children showed adequate energy reserves as measured by skinfold thicknesses. Improvement in oral-motor skills may help these children to ingest food more competently (i.e., less spillage). However, their weight remains at the lowest level of age norms.

Effect of oral sensorimotor treatment on measures of growth, eating efficiency and aspiration in the dysphagic child with cerebral palsy.

Twenty-seven children (mean age 5.1 years) with cerebral palsy and moderate eating impairment were studied to determine frequency of aspiration and the effect of 10 and 20 weeks of oral sensorimotor therapy on eating efficiency and measures of growth (weight, skinfold thickness). The eating efficiency of the children did not change markedly in response to oral sensorimotor therapy. Children maintained their centile rank in weight-for-age and skinfold-for-age measurements. However, there was no catch-up growth. The findings suggest that eating efficiency is not a good estimator of treatment outcome, but rather a diagnostic indicator of the severity of eating impairment. Monitoring of these children's growth is essential in order to provide nutritional rehabilitation as soon as their eating skills can no longer keep up with growth demands.