ABSTRACT
Diagnosing a non-epileptic seizure is difficult in the absence of a video electroencephalogram. The expert commission of the international league against epilepsy proposes a diagnostic approach allowing the diagnosis to be made according to a degree of certainty with or in the absence of a video electroencephalogram. Our objective was to determine the hospital frequency of psychogenic non-epileptic seizures in the absence of video-electroencephalogram. Using the outpatient registry, we identified patients followed for epilepsy with two normal interictal electroencephalographies, between January 2020 and October 2021. A review of the patients' medical records and an assessment of the validity of the diagnosis were carried out. Out of 64 patients evaluated with normal interictal electroencephalogram, 19 were included as suffering from psychogenic non-epileptic seizures, i.e. 26.68%. The average age was 23.94 +/- 9.4 years. Women represented 68.4%. Patients followed in neurology represented 84%. A history of childhood trauma was found in (47.4%). The first crisis was preceded by stressful events in 47.36%. Post-traumatic stress disorder was the most represented with 73.7% of cases. The average age was 20.95 +/- 9.8 years for the first crisis and the average duration of evolution of the crises was 3 years +/- 2 years. This study illustrates the possibility of making a presumptive diagnosis of psychogenic non-epileptic seizure in the absence of video-electroencephalogram.
Subject(s)
Electroencephalography , Seizures , Humans , Female , Male , Seizures/diagnosis , Seizures/epidemiology , Adult , Electroencephalography/methods , Young Adult , Adolescent , Mali , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/diagnosis , Retrospective Studies , Middle AgedABSTRACT
Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors, morbidity and mortality with respect to their distributions associated with demographic, socioeconomic, environmental, health behavior, and genetic risk factors, and time-varying changes. In the Letter to Editor, we had a brief description of the practice for the mortality and the space-time patterns of John Snow's map of cholera epidemic in London, United Kingdom in 1854. This map is one of the earliest public heath practices of developing and applying spatial epidemiology. In the early history, spatial epidemiology was predominantly applied in infectious disease and risk factor studies. However, since the recent decades, noncommunicable diseases have become the leading cause of death in both developing and developed countries, spatial epidemiology has been used in the study of noncommunicable disease. In the Letter, we addressed two examples that applied spatial epidemiology to cluster and identify stroke belt and diabetes belt across the states and counties in the United States. Similar to any other epidemiological study design and analysis approaches, spatial epidemiology has its limitations. We should keep in mind when applying spatial epidemiology in research and in public health practice.
ABSTRACT
Se realizó un estudio observacional y descriptivo de 32 pacientes con esteatosis hepática no alcohólica, diagnosticados en el Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, de enero de 2011 a junio de 2013, a fin de caracterizarles epidemiológica, clínica e histomorfológicamente. En la investigación se obtuvo un incremento de la esteatosis hepática no alcohólica entre las hepatopatías crónicas, con predominio en personas de los grupos etarios de 35-44 y 45-54 años y del sexo masculino, y una mayor asociación a la hipertrigliceridemia y la hipertransaminasemia; igualmente, la dislipidemia y el sobrepeso -- según índice de masa corporal -- representaron los factores de riesgo más frecuentes en los afectados. No se encontró significación estadística al correlacionar los hallazgos ecográficos con los obtenidos por biopsia, de manera que quedó reafirmado que la laparoscopia constituye el medio de mayor sensibilidad y especificidad para diagnosticar la enfermedad en cuestión(AU)
An observational and descriptive study of 32 patients with hepatic alcoholic steatosis, diagnosed in Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba was carried out from January, 2011 to June, 2013, in order to characterize them epidemiologically, clinically and hystomorphologically. In the investigation an increment of the non alcoholic hepatic steatosis was obtained among the chronic hepatopathies, with prevalence in people of the age groups 35-44 and 45-54 years and of the male sex, and a higher association to hypertriglyceridemia and hypertransaminasemia; equally, the dyslipidemia and overweight -- according to index of body mass -- represented the most frequent risk factors in those affected. There was no statistical significance when correlating the echographical with the biopsy findings, so that it was reaffirmed that laparoscopy constitutes the most sensitive and specific mean to diagnose the disease(AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Fatty Liver , Biopsy , Secondary Care , Histology , Cell Nucleus Shape , Epidemiology, Descriptive , Observational Studies as TopicABSTRACT
Se realizó un estudio observacional y descriptivo de 32 pacientes con esteatosis hepática no alcohólica, diagnosticados en el Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, de enero de 2011 a junio de 2013, a fin de caracterizarles epidemiológica, clínica e histomorfológicamente. En la investigación se obtuvo un incremento de la esteatosis hepática no alcohólica entre las hepatopatías crónicas, con predominio en personas de los grupos etarios de 35-44 y 45-54 años y del sexo masculino, y una mayor asociación a la hipertrigliceridemia y la hipertransaminasemia; igualmente, la dislipidemia y el sobrepeso -- según índice de masa corporal -- representaron los factores de riesgo más frecuentes en los afectados. No se encontró significación estadística al correlacionar los hallazgos ecográficos con los obtenidos por biopsia, de manera que quedó reafirmado que la laparoscopia constituye el medio de mayor sensibilidad y especificidad para diagnosticar la enfermedad en cuestión.
An observational and descriptive study of 32 patients with hepatic alcoholic steatosis, diagnosed in "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba was carried out from January, 2011 to June, 2013, in order to characterize them epidemiologically, clinically and hystomorphologically. In the investigation an increment of the non alcoholic hepatic steatosis was obtained among the chronic hepatopathies, with prevalence in people of the age groups 35-44 and 45-54 years and of the male sex, and a higher association to hypertriglyceridemia and hypertransaminasemia; equally, the dyslipidemia and overweight -- according to index of body mass -- represented the most frequent risk factors in those affected. There was no statistical significance when correlating the echographical with the biopsy findings, so that it was reaffirmed that laparoscopy constitutes the most sensitive and specific mean to diagnose the disease.