The prevalence of migraine (IHS categories 1.1 and 1.2) in France is 7.9%, and that of total migraine is 17.0%; this does not seem to have evolved over the past 10 years.

The objective of this study was to describe the epidemiology, clinical presentation and consequences of chronic daily headache (CDH) in France. A representative nation-wide sample of the general population was identified using a stratified sampling method. Ten thousand five hundred and eight-five subjects were screened in face-to-face interviews, and data collected using a standard questionnaire. An overall point prevalence of CDH in the general population of 2.98% was observed. Two-thirds of these subjects presented migraine-like features. Severity, functional impact and healthcare consumption were higher than in subjects reporting episodic migraine in the same sample. Of the subjects, 28.2% reported the most severe migraine disability assessment scores (Grades 3 and 4), compared to 12% of episodic migraineurs. A qualité de vie et migraine score of 68.4 was observed, indicating severely attenuated quality of life. Only 6.6% of subjects were taking prophylactic treatment, whilst 88% were using non-specific acute headache treatments. The frequency of physician consultations and laboratory examinations was significantly higher than in individuals with episodic headache. CDH is thus a relatively prevalent condition in the general French population, associated with an important burden of suffering and with considerable expenditure in the health service. Management of this condition is generally inappropriate.

Clinical benefits achieved during the present study included significant improvements in conjunctivitis symptoms and prevention of asthma symptoms. The overall safety profile of the active treatment (drops or tablets) was good.

The direct healthcare costs of migraine do not seem to have risen significantly over the past decade. A small minority of individuals with more severe headaches consume most of the healthcare resources devoted to migraine, while most individuals generate relatively low direct costs. The total annual direct costs in France for migraine are almost 10-fold higher than those of other episodic headache.

The relationship between asthma and gastro-oesophageal reflux (GER) is controversial. In an allergy department, GER prevalence was evaluated in asthmatics, with a view to judging the potential influence of GER on asthma.One hundred and five asthmatics were recruited and co-investigated for GER and lung function. Descriptive analysis was performed, patients with (GER+) and without (GER-) GER were then compared, and finally, stepwise regression analysis was used. GER prevalence was 32%.Lung parameters did not differ between GER+ and GER-patients. When restricting analysis to GER+ patients, bronchial reactivity was closely correlated to the number of reflux episodes (NRE) (r=0.983; p=0.001). When comparing patients with more than 15 reflux episodes·day -1 (n=50), with those having less (n=43), no differences were found in lung function and GER parameters. However, there was a positive correlation between the provocative dose of methacholine causing forced expiration volume to fall 20% from the baseline and NRE in patients with NRE>15 (r=0.561; p=0.05).In conclusion, gastro-oesophageal reflux was observed in a third of the asthma patients studied. These data do not support a firm aetiological relationship between gastro-oesophageal reflux and asthma, but do suggest an association between the number of reflux episodes and bronchial hyperresponsiveness. Eur Respir J 1997; 10: 2255-2259 Asthma is a bronchial disease characterized by an inflammatory process [1]. Gastro-oesophageal reflux (GER) has been suspected as a causal factor, but the relationship between GER and asthma remains controversial.The physiopathological mechanisms involved in this potential relationship are still hypothetical [2-4], although two main mechanisms are usually accepted, reflex [5][6][7] or acid inhalation [8][9][10]. A possible relationship between the severity of GER and that of asthma has not been investigated previously.GER prevalence is not precisely known in asthmatics; it has been estimated at levels of 20 to even 80% [11]. Finally, it is not known which groups of asthma patients in particular should be investigated for GER.This controversy induced us to conduct a prospective assessment of GER prevalence in a population of 105 consecutively admitted asthmatic out-patients and to search for a relationship between the development of asthma and that of GER. Materials and methods PatientsOne hundred and five consecutively admitted asthmatic out-patients were investigated. Asthma was diagnosed according to international consensus guidelines [12]. Besides clinical data, airway obstruction was measured and its reversibility was defined as a 20% improvement in forced expiratory volume in one second (FEV1) after bronchodilator administration, or a 20% decrease in FEV1 after methacholine bronchoprovocation. FEV1 was measured with a pocket-sized spirometer (Spirobank®; Isotec, Saint-Quentin, France). Results were expressed in real values and as the percentage of standard values for age, gender and height [13]. Bronchoprovocation tests w...