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Mals de cap i maldecaps

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En català podem fer la distinció entre les sindromes doloroses que afecten el cap i el neguit i molèstia que generen les preocupacions. Mals de cap són ocasionals. Maldecaps en tè tothom.

La revista Lancet dedica un dels seus recents editorials als mals de cap de nens i adolescents:

Better evidence needed for preventing paediatric migraine

Migraines are the most common disabling type of headache among children and adolescents. Globally, of all non-communicable diseases in children aged 5–14 years, migraine ranks third for disease burden after conduct disorder and anxiety disorder. On Aug 14, the American Academy of Neurology (AAN) and the American Headache Society released new guidelines on the pharmacological prevention and acute treatment of migraine in children and adolescents. These are the first updates to AAN guidance in this area in 15 years, and outline that although there are now more evidence-based treatments for acute migraine attacks, finding the right approach for preventing migraines remains a challenge.

For relieving pain during a migraine attack, ibuprofen and paracetamol in children and adolescents, and triptans in adolescents only, are now deemed effective. By contrast, the evidence base for reducing the frequency and severity of attacks is far less robust, with the benefits of preventive medications not exceeding those of placebo in most trials to date. Topiramate is the only US Food and Drug Administration (FDA)-approved medication for migraine prevention in those aged 12–17 years, but the guideline committee noted that clinically meaningful outcomes are still in doubt. Amitriptyline in combination with cognitive behavioural therapy (CBT) appears to reduce migraine attack frequency and associated disability, but amitriptyline has an FDA black box warning regarding suicidal thoughts and behaviours.

The guidelines thus focus on behavioural and lifestyle interventions for factors that are commonly associated with migraine, including negative emotional states, overweight, low physical activity, poor sleep, and exposure to tobacco, alcohol, and caffeine. But the evidence here is also poor, making this an area for much needed research—not just into whether targeting associated factors might be effective but also into the use of CBT alone, new therapeutics, and improved trial designs. Without better-quality evidence, the prevention of migraine will remain an intractable challenge for too many children and adolescents.

https://doi.org/10.1016/S0140-6736(19)31965-8

És evident que necesitem investigacions específiques per a un problema prevalent que genera maldecaps als professionals…

X. Allué (Editor)

NOTA: Para hispanohablantes, ¿os he dicho que con el Google Translate y “corta-y-pega” se obtienen los textos con bastante precisión en cualquier idioma?
La imagen de una mujer sosteniéndose la frente que anunciaba el específico Veramón de Shering hace años que venía a ser el icono del dolor de cabeza. El Veramón era una mezcla de una pirazolona, el Piramidón, y un barbitúrico. Que luego en Madrid llamasen “Piramidón” a un nuevo gran hospital público tenía que ver a una exageración de “pirámide” por lo grande del centro. Cosas del casticismo…

 

 

Written by pedsocial

26 agosto 2019 at 6:15

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