Prevalence, clinical characteristics and associated factors of cardiac cephalalgia: A prospective study.

BACKGROUND: The prevalence of cardiac cephalalgia is unknown and there is limited information about its clinical features. We aimed to assess the prevalence of cardiac cephalalgia, its clinical characteristics and associated factors. METHODS: We conducted a prospective study of patients with suspected acute coronary syndrome admitted to the Cardiology Service at Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, over a one-year period. We interviewed patients within the first 24 hours of admission using a standardized case-report form to assess the presence of headache in relation to the acute coronary syndrome and its characteristics. RESULTS: We included 438 patients, 381 with confirmed myocardial ischemia. Prevalence of cardiac cephalalgia was 14.2% (n = 54). The most common features were frontal location, pressing quality and moderate intensity. Pain referred to the jaws (aOR 2.61; 95% CI 1.33-5.12; p = 0.005), palpitations (aOR 3.65; 95% CI 1.57-8.50; p = 0.003) and circumflex coronary artery as the culprit artery for the myocardial ischemia (aOR 3.8; 95% CI 1.07-13.74; p = 0.021) were related to cardiac whereas history of hypertension was inversely associated (aOR 0.37: 95% CI 0.18-0.74; p = 0.005). CONCLUSION: The prevalence of cardiac cephalalgia was 14.2%. Our study provides valuable information about cardiac cephalalgia characteristics that suggest revision of current diagnostic criteria.

Influenza Vaccination among Multiple Sclerosis Patients during the COVID-19 Pandemic.

In the context of the COVID-19 pandemic, the co-circulation of influenza and SARS-CoV-2 viruses may have severe complications for vulnerable populations. For this reason, the World Health Organization pointed to the 2020-2021 anti-influenza campaign as being of special relevance. Our aim was to assess the 2020-2021 influenza vaccination coverage, and its associated factors, among patients in a Spanish multiple sclerosis (MS) unit. A cross-sectional study was conducted. People attending the MS unit of the Clinical Hospital of Zaragoza during 2020 were included. Variables were obtained by reviewing records. Associations with 2020-2021 influenza vaccination were analyzed using bivariate analysis and a multiple logistic regression model. A total of 302 patients were studied; 62.6% were women, whose mean age (standard deviation) was 47.3 (11.5) years. The 2020-2021 influenza vaccination coverage was 55.3% (59.8% in women and 47.8% in men). A total of 89.7% had at least one other indication for vaccination (e.g., immunosuppressive treatment in 225 patients). The variables associated with getting vaccinated were being female (adjusted odds ratio (95% confidence interval) (aOR (95%CI) = 2.12 (1.12-3.99)), having received the 2019-2020 influenza vaccine (aOR (95%CI) = 31.82 (14.71-68.86)) and being born in Spain (aOR (95%CI) = 12.91 (1.07-156.28)). Coverage is moderate compared to other countries. It is necessary to develop strategies to improve it, especially in men and those born outside Spain.

Influenza Vaccination Coverage among Multiple Sclerosis Patients: Evolution over Time and Associated Factors.

Our objective was to determine the influenza vaccination rate in a Spanish cohort of multiple sclerosis (MS) patients. A retrospective cohort study was carried out. Patients who attended the MS unit of the Lozano Blesa Hospital of Zaragoza between January 2015 and 2020 were included. The variables were obtained by reviewing the specialized and primary care records. Associations between receiving the vaccine in each flu season and the other variables were analyzed using bivariate analysis and multiple logistic regression models. A total of 260 patients were studied, with a median age of 31 years at the time of diagnosis. A total of 62.3% (162/260) were women. Vaccination coverage ranged from 20.4% in the 2015−2016 and 2016−2017 seasons to 41.5% in the 2019−2020 season (p = 0.000). Having been vaccinated in the previous season (ORa: 16.47−390.22; p = 0.000) and receiving a vaccination recommendation from the hospital vaccination unit (ORa: 2.44−3.96; p < 0.009) were associated with being vaccinated. The coverage is in an intermediate position compared to other countries. It is necessary to improve the referral system of these patients to the hospital vaccination unit because the information obtained by this service contributed to higher vaccination rates.