Bruce H. Peters

Comparison of 650 mg aspirin and 1,000 mg acetaminophen with each other, and with placebo in moderately severe headache

Two-hundred-sixty-nine otherwise healthy persons experiencing periodic, moderately severe headache of a type that had previously responded to nonprescription medications completed this randomized, parallel, double-blind study. The three demographically similar subgroups took either 1,000 mg acetaminophen, 650 mg aspirin, or an identical placebo, for headache. Headache intensity and relief scores over the following six hours were obtained and assessed by sums of pain intensity difference and values of pain relief scores analyses. Responses for the group, and for the subgroup with tension headaches (107 persons) showed no differences between the effects of the active medications. The effects of each medication were strongly superior to placebo. There were no differences in side effects among the three treatment modalities. In persons experiencing tension-vascular headaches (162), only aspirin, at two hours, was superior to placebo, but direct comparison with acetaminophen suggested no real difference. Acetaminophen (1,000 mg) and aspirin (650 mg) are clinically similar in treating the headaches for which they are commonly taken. Recommendations for their use in treating headache should be based on individual patient suitability and on cost factors.

Neurologic and psychologic manifestations of decompression illness in divers

It has been widely accepted that the neurologic sequelae of decompression illness are confined to the spinal cord. Of 10 divers who gave a history of an episode of decompression illness involving the central nervous system, we found that eight had unequivocal neurologic deficits implicating multiple supraspinal lesions. Seven of these neurologically impaired divers completed a battery of neuropsychologic tests that revealed severe deficits in all cases. The findings show that diffuse and multiple central nervous system lesions result from decompression illness and demonstrate the importance and close correlation of thorough neurologic and neuropsychologic tests in assessment following diving accidents.

Platelet antagonists in migraine prophylaxis. A clinical trial using aspirin and dipyridamole.

SYNOPSIS

Early concepts of anterograde and retrograde amnesia

The series of studies published by Korsakoff between 1887 and 1900 stirred widespread interest in the amnesic disorders. This development stands in marked contrast to the sparse literature on memory disorders published prior to the 19th century. Korsakoff (1889) attributed the paucity of early descriptions of amnesia to its occurrence as a sequel or as a finding incidental to diseases which primarily occupied the attention of physicians. In comparison with aphasia, the more subtle presentation of memory deficit often requires repeated observations to differentiate it from global dementia. Although the physicians of antiquity must have observed disorders of memory, their recorded impressions were based on short term observations. They lacked both a scientific approach and the facilities and interest for sustained followup of their patients. These problems persistently hampered advances in the clinical assessment of memory deficit until two developments in the 19th century. The first development was the emergence of detailed case studies of cognitively disordered patients as exemplified by a report in 1845 from the English surgeon Robert Dunn. The second was the application of the scientific method to the study of memory by Hermann Ebbinghaus (1850-1909) as reviewed by Boring (1957). The traditions of careful observation and the scientific approach laid the groundwork for modern contributions to the study of amne-