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1.
Neurología (Barc., Ed. impr.) ; 35(5): 291-294, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-188625

RESUMO

INTRODUCCIÓN: La infección por SARS-CoV-2y la situación de pandemia hacen necesario un cambio en nuestra práctica clínica, en relación con la adopción de nuevas estrategias que permitan la asistencia integral de los pacientes con cefalea y neuralgia. MATERIAL Y MÉTODOS: Ante la elevada capacidad de transmisión del virus, determinados procedimientos, como la infiltración de OnabotulinumtoxinA y la realización de bloqueos anestésicos, deben realizarse adoptando medidas que garanticen un nivel adecuado de seguridad. RESULTADOS: Nuestro objetivo es presentar una serie de recomendaciones basadas en las medidas establecidas por nuestro sistema sanitario para evitar el contagio. Diferenciaremos entre aquellas medidas relacionadas con el paciente y el facultativo, con la técnica, con la infraestructura (sala de espera y consulta) y con la gestión asistencial


INTRODUCTION: The COVID-19 pandemic has given rise to the need for changes in clinical practice, with new strategies to enable integrated care for patients with headache and neuralgia. METHODS: Given the high spreadability of SARS-CoV-2, new safety measures are required in such procedures as onabotulinumtoxinA infiltration and nerve blocks. RESULTS: We present a series of recommendations based on the measures implemented to prevent infection in our healthcare system. We differentiate between measures related to patients and physicians, to technique, to infrastructure (waiting room and consultation), and to healthcare managemen


Assuntos
Humanos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/normas , Toxinas Botulínicas Tipo A/administração & dosagem , Fármacos Neuromusculares/administração & dosagem , Bloqueio Nervoso/métodos , Bloqueio Nervoso/normas , Segurança do Paciente/normas , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Pandemias , Cefaleia/tratamento farmacológico , Neuralgia/tratamento farmacológico
2.
Infez Med ; 28(suppl 1): 42-45, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32532937

RESUMO

In addition to the conventional respiratory symptoms, patients with COVID-19 can exhibit neurological complications. In this concise review, we aim to report the most frequent neurologic manifestations related to Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV2) infection. SARS-CoV2 can reach the central nervous system from the bloodstream or olfactory pathway by binding ACE-2 receptor and the spike protein protease TMPRSS2. Headache is reported in more than 10% of affected patients and loss of smell and taste disturbance are reported in a slightly smaller percentage of cases. Acute cerebrovascular events are diagnosed in less than 3% of COVID-19 patients, but those with more severe manifestations have cerebrovascular events in more than 6% of the cases, as reported by two retrospective studies from Italy and China. Moreover, five cases of large-vessel stroke have been described in low-symptomatic COVID-19 patients aging less than 50 years suggesting that SARS-CoV2 can be associated with an increase of the risk of stroke in relatively young people. Peripheral nerve diseases can be observed after an apparently uneventful SARS-CoV2. Based on a literature review, nine patients experienced Guillain-Barrè syndrome (GBS) and 6 of these needed mechanical ventilation. Two more cases have been described with Miller-Fisher syndrome or polyneuritis cranialis, both had rapidly resolving symptoms. In conclusion, nervous system symptoms can be observed during SARS-CoV2 infection of which headache and smell and taste disturbance are the main symptoms reported. Cerebrovascular complications can complicate the course of COVID-19 in apparently low-risk patients. GBS is a life-threatening manifestation of COVID-19.


Assuntos
Infecções por Coronavirus/complicações , Doenças do Sistema Nervoso/etiologia , Pneumonia Viral/complicações , Adulto , Fatores Etários , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Síndrome de Guillain-Barré/epidemiologia , Síndrome de Guillain-Barré/etiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Incidência , Inflamação , Pessoa de Meia-Idade , Síndrome de Miller Fisher/etiologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/fisiopatologia , Neurite (Inflamação)/etiologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia
3.
J Pak Med Assoc ; 70(Suppl 3)(5): S101-S103, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32515379

RESUMO

Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has turned out to be a formidable pandemic. Upcoming evidence from confirmed cases of COVID-19 suggests an anticipated incursion of patients with neurological manifestations in the weeks to come. An expression of the angiotensin-converting enzyme 2 (ACE 2), the cellular receptor for SARS-CoV-2 over the glial cells and neurons have made the brain a potential target. Neurotoxicity may occur as a result of direct, indirect and post-infectious complications. Attention to neurological deficits in COVID-19 is fundamental to ensure appropriate, timely, beneficial management of the affected patients. Most common neurological manifestations seen include dizziness, headache, impaired consciousness, acute cerebrovascular disease, ataxia, and seizures. Anosmia and ageusia have recently been hinted as significant early symptoms in COVID-19. As cases with neurological deficits in COVID-19 emerge, the overall prognosis is yet unknown.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Cefaleia/virologia , Pandemias , Pneumonia Viral , Transtornos das Sensações/virologia , Ataxia/virologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Humanos , Mialgia/virologia , Peptidil Dipeptidase A , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Convulsões/virologia
4.
Medicine (Baltimore) ; 99(21): e20362, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481330

RESUMO

RATIONALE: Late complement deficiency increases susceptibility to meningococcal disease and recurrent infections. In Korea, 5 case reports have described meningococcal disease with complement deficiency. However, C6 deficiency has not been described previously. PATIENT CONCERNS: A 21-year-old police trainee presented with recurrent meningococcal meningitis. He was housed in communal living quarters until 20 days before the initial symptom onset. DIAGNOSIS: He was diagnosed with meningococcal meningitis with C6 deficiency. INTERVENTIONS: He was treated with intravenous ceftriaxone. An additional dose of quadrivalent meningococcal conjugate vaccine was administered after discharge. OUTCOMES: He was discharged without complications. LESSONS: Screening for complement deficiency is necessary in patients with a history of recurrent meningococcal infections to provide appropriate care and prevent recurrent infections.


Assuntos
Complemento C6/deficiência , Meningite Meningocócica/diagnóstico , Complemento C6/imunologia , Exantema/etiologia , Febre/etiologia , Cefaleia/etiologia , Humanos , Masculino , Meningite Meningocócica/tratamento farmacológico , Meningite Meningocócica/imunologia , Vacinas Meningocócicas/normas , Vacinas Meningocócicas/uso terapêutico , Recidiva , República da Coreia , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-32482781
6.
Ideggyogy Sz ; 73(05-06): 213-216, 2020 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-32579312

RESUMO

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo-gical examination excluded mycotic etiology of the aneu-rysm and "normal aneurysm wall" was described. The brain stem haemorrhage - Duret bleeding - was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.


Assuntos
Aneurisma Roto/diagnóstico por imagem , Cerebelo/irrigação sanguínea , Hematoma Subdural/etiologia , Hematoma Subdural/cirurgia , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Angiografia Cerebral , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/cirurgia , Angiografia por Tomografia Computadorizada , Feminino , Cefaleia , Humanos , Aneurisma Intracraniano/complicações , Pessoa de Meia-Idade , Resultado do Tratamento
7.
BMJ Case Rep ; 13(6)2020 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-32540882

RESUMO

A 41-year-old man with no significant medical history presented with acute behavioural disruption on the background of a 1-day history of severe headache and a 10-day history of dry cough and fever. He was sexually disinhibited with pressured speech and grandiose ideas. His behaviour worsened, necessitating heavy sedation and transfer to intensive care for mechanical ventilation despite no respiratory indication. Investigations confirmed that he was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neuroimaging and a lumbar puncture were normal. Initial screening for SARS-CoV-2 in the cerebrospinal fluid was negative although no validated assay was available. The patient's mental state remained abnormal following stepdown from intensive care. Psychiatric assessment found features consistent with acute mania, and he was detained under the Mental Health Act. This case indicates the need to consider COVID-19 in a wider series of clinical presentations and to develop a validated assay for SARS-CoV-2 in the cerebrospinal fluid.


Assuntos
Sintomas Afetivos , Betacoronavirus/isolamento & purificação , Clonazepam/administração & dosagem , Infecções por Coronavirus , Olanzapina/administração & dosagem , Pandemias , Pneumonia Viral , Agitação Psicomotora , Transtornos Psicóticos/diagnóstico , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/tratamento farmacológico , Sintomas Afetivos/etiologia , Betacoronavirus/patogenicidade , Líquido Cefalorraquidiano/virologia , Infecções por Coronavirus/líquido cefalorraquidiano , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Serviços Médicos de Emergência/métodos , Cefaleia/etiologia , Cefaleia/virologia , Humanos , Masculino , Neuroimagem/métodos , Pneumonia Viral/líquido cefalorraquidiano , Pneumonia Viral/diagnóstico , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Escalas de Graduação Psiquiátrica , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/tratamento farmacológico , Agitação Psicomotora/etiologia , Psicotrópicos/administração & dosagem , Resultado do Tratamento
8.
Ideggyogy Sz ; 73(3-4): 135-139, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32364341

RESUMO

The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HaNDL) is a rare entity. This disease has been related to migrainous headaches. It is a benign, self-limited disorder, which is characterized by fluctuating neurological symptoms and cerebrospinal fluid lymphocytosis. We describe a case of a 47 years old man with acute onset of headache and aphasia. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis (25 cells/µl, 100% lymphocytes). Electroencephalogram showed moderate slow rhythm in the left hemisphere, with temporoparietal predominance, and without epileptiform activity. His blood tests as well as magnetic resonance imaging (MRI) results were normal. With the diagnosis of HaNDL syndrome the patient was accepted in the Department of Neurology and discharged with full recovery.


Assuntos
Encéfalo/patologia , Líquido Cefalorraquidiano/química , Cefaleia/diagnóstico , Linfocitose/líquido cefalorraquidiano , Doenças do Sistema Nervoso/diagnóstico , Afasia , Eletroencefalografia , Cefaleia/líquido cefalorraquidiano , Cefaleia/complicações , Humanos , Linfocitose/diagnóstico , Masculino , Pessoa de Meia-Idade , Síndrome
9.
Neurotox Res ; 38(1): 1-7, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32399719

RESUMO

As a severe and highly contagious infectious disease, coronavirus disease 2019 (COVID-19) has caused a global pandemic. Several case reports have demonstrated that the respiratory system is the main target in patients with COVID-19, but the disease is not limited to the respiratory system. Case analysis indicated that the nervous system can be invaded by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that 36.4% of COVID-19 patients had neurological symptoms. Importantly, the involvement of the CNS may be associated with poor prognosis and disease worsening. Here, we discussed the symptoms and evidence of nervous system involvement (directly and indirectly) caused by SARS-CoV-2 infection and possible mechanisms. CNS symptoms could be a potential indicator of poor prognosis; therefore, the prevention and treatment of CNS symptoms are also crucial for the recovery of COVID-19 patients.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Doenças do Sistema Nervoso/etiologia , Pneumonia Viral/complicações , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/etiologia , Terapia Combinada , Transtornos da Consciência/epidemiologia , Transtornos da Consciência/etiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Tontura/epidemiologia , Tontura/etiologia , Encefalite Viral/epidemiologia , Encefalite Viral/etiologia , Células Endoteliais/metabolismo , Células Endoteliais/virologia , Fadiga/epidemiologia , Fadiga/etiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Hipertensão Intracraniana/epidemiologia , Hipertensão Intracraniana/etiologia , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Transtornos Mentais/terapia , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Transtornos do Humor/terapia , Doenças do Sistema Nervoso/epidemiologia , Neurônios/metabolismo , Neurônios/virologia , Nervo Olfatório/virologia , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Prevalência , Prognóstico , Psicoterapia , Psicotrópicos/uso terapêutico , Receptores Virais/metabolismo , Estudos Retrospectivos , Transtornos das Sensações/epidemiologia , Transtornos das Sensações/etiologia , Glicoproteína da Espícula de Coronavírus/metabolismo
10.
Medicine (Baltimore) ; 99(20): e20337, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443385

RESUMO

To investigate the potential relationship between septal deviation (SD) and headache using nationwide representative cohort sample data.This study used a nationwide cohort sample from the Korean National Health Insurance Service database. The cohort sample was composed of 1 million patients, which is obtained by propensity score matching from 2002 to 2013. There were 9171 individuals in the SD group and 28243 in the control or no SD group. The Kaplan-Meier survival analysis, the log-rank test, and Cox proportional hazard regression analysis were used to calculate the incidence, survival curve, and hazard ratio of headache for each group.There were no statistically significant differences in sex (P = .7708), age (P = .991), residential area (P = .9626), or socioeconomic status (P = .9982) between the 2 groups. The survival curve between SD and control or no SD showed a statistically significant difference. The adjusted hazard ratio for headache incidence during the 10-year follow-up period of the SD group was 1.37 (95% CI: 1.31-1.43).This cohort study suggests that SD is associated with headache. Therefore, these findings suggest that septoplasty can be considered as 1 of the treatment option in SD patients with headache.


Assuntos
Cefaleia/epidemiologia , Septo Nasal/patologia , Adulto , Feminino , Seguimentos , Humanos , Revisão da Utilização de Seguros , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Características de Residência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
11.
J Neurovirol ; 26(2): 143-148, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32447630

RESUMO

A pandemic due to novel coronavirus arose in mid-December 2019 in Wuhan, China, and in 3 months' time swept the world. The disease has been referred to as COVID-19, and the causative agent has been labelled SARS-CoV-2 due to its genetic similarities to the virus (SARS-CoV-1) responsible for the severe acute respiratory syndrome (SARS) epidemic nearly 20 years earlier. The spike proteins of both viruses dictate tissue tropism using the angiotensin-converting enzyme type 2 (ACE-2) receptor to bind to cells. The ACE-2 receptor can be found in nervous system tissue and endothelial cells among the tissues of many other organs.Neurological complications have been observed with COVID-19. Myalgia and headache are relatively common, but serious neurological disease appears to be rare. No part of the neuraxis is spared. The neurological disorders occurring with COVID-19 may have many pathophysiological underpinnings. Some appear to be the consequence of direct viral invasion of the nervous system tissue, others arise as a postviral autoimmune process, and still others are the result of metabolic and systemic complications due to the associated critical illness. This review addresses the preliminary observations regarding the neurological disorders reported with COVID-19 to date and describes some of the disorders that are anticipated from prior experience with similar coronaviruses.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Encefalite Viral/epidemiologia , Meningite/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Betacoronavirus/genética , Betacoronavirus/metabolismo , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Encefalite Viral/complicações , Encefalite Viral/diagnóstico , Encefalite Viral/virologia , Cefaleia/complicações , Cefaleia/diagnóstico , Cefaleia/epidemiologia , Cefaleia/virologia , Interações Hospedeiro-Patógeno/genética , Humanos , Meningite/complicações , Meningite/diagnóstico , Meningite/virologia , Mialgia/complicações , Mialgia/diagnóstico , Mialgia/epidemiologia , Mialgia/virologia , Miosite/complicações , Miosite/diagnóstico , Miosite/epidemiologia , Miosite/virologia , Sistema Nervoso/patologia , Sistema Nervoso/virologia , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Ligação Proteica , Receptores Virais/genética , Receptores Virais/metabolismo , Glicoproteína da Espícula de Coronavírus/genética , Glicoproteína da Espícula de Coronavírus/metabolismo , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/virologia , Internalização do Vírus
12.
Virulence ; 11(1): 482-485, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32441574

RESUMO

Since its outbreak in Wuhan, Hubei Province China, 2019-coronavirus infected disease (COVID-19) had been widely spread all over the world, the control of which calls for a better understanding of its epidemiology and clinical characteristics. We included 12 confirmed cases of COVID-19 in First Affiliated Hospital of Jilin University from 23 January 2020 to 11 February 2020, which were retrospectively analyzed for epidemiological, demographic, clinical, laboratory, and radiological features. All the patients were confirmed by nucleic acid detection, the average age of whom was 45.25 years (range, 23-79 years). Most patients had a history of Wuhan traveling or had contact with Wuhan travelers or infected cases. Obvious family cluster was observed. Clinical manifestations included fever (12/12), fatigue (10/12), cough (6/12), sore throat (4/12), headache (3/12), and diarrhea (2/12). Only three out of eight patients had pneumonia manifestation on radiography. Most patients had a normal white blood cell (WBC) count and normal or reduced lymphocyte (LY) count. Pneumonia changes were observed in all the four patients who underwent a chest CT scan. Only one elderly patient developed severe pneumonia, while all the rest were mild disease and had a self-limiting course.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Adulto , Idoso , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/virologia , Tosse/etiologia , Diarreia/etiologia , Fadiga/etiologia , Feminino , Febre/etiologia , Cefaleia/etiologia , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Faringite/etiologia , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
13.
Acta Neurol Taiwan ; 29(1): 18-23, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32285430

RESUMO

BACKGROUND: Failure to recognize a carotid-cavernous fistula (CCF) promptly may lead to worse prognosis due to a setback in providing proper treatment. To promote early diagnosis of non-traumatic CCF, we report a case with classic clinical symptoms and signs that was diagnosed and followed up with carotid Doppler sonography (CDS) and transcranial color-coded duplex (TCD). CASE REPORT: A 45-year-old woman developed an intermittent headache, pulsatile tinnitus, and double vision sequentially within ten days. Progressive left retro-orbital pain, continuous ringing in the left ear, sensory impairment of trigeminal nerve and abducens nerve palsy were also noted on examination. Despite insignificant findings on computed tomography (CT) of the brain, TCD revealed an aberrant flow pattern with high velocity and low resistance at the left carotid siphon. Digital subtraction angiography (DSA) later confirmed a left direct type CCF by illustrating a quick opacification of left cavernous sinus via the internal carotid artery. CONCLUSION: In addition to invasive DSA, non-invasive CDS and TCD may serve as useful apparatus during the initial evaluation and subsequent follow-ups. The positive sonographic clues, including abnormal turbulent and hemodynamic parameters, are quite exhibitive in the existence of CCFs.


Assuntos
Fístula Carotidocavernosa , Embolização Terapêutica , Angiografia Digital , Artéria Carótida Interna , Feminino , Cefaleia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
14.
Headache ; 60(5): 864-877, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32232837

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease of pandemic proportions. Healthcare workers in Singapore working in high-risk areas were mandated to wear personal protective equipment (PPE) such as N95 face mask and protective eyewear while attending to patients. OBJECTIVES: We sought to determine the risk factors associated with the development of de novo PPE-associated headaches as well as the perceived impact of these headaches on their personal health and work performance. The impact of COVID-19 on pre-existing headache disorders was also investigated. METHODS: This is a cross-sectional study among healthcare workers at our tertiary institution who were working in high-risk hospital areas during COVID-19. All respondents completed a self-administered questionnaire. RESULTS: A total of 158 healthcare workers participated in the study. Majority [126/158 (77.8%)] were aged 21-35 years. Participants included nurses [102/158 (64.6%)], doctors [51/158 (32.3%)], and paramedical staff [5/158 (3.2%)]. Pre-existing primary headache diagnosis was present in about a third [46/158 (29.1%)] of respondents. Those based at the emergency department had higher average daily duration of combined PPE exposure compared to those working in isolation wards [7.0 (SD 2.2) vs 5.2 (SD 2.4) hours, P < .0001] or medical ICU [7.0 (SD 2.2) vs 2.2 (SD 0.41) hours, P < .0001]. Out of 158 respondents, 128 (81.0%) respondents developed de novo PPE-associated headaches. A pre-existing primary headache diagnosis (OR = 4.20, 95% CI 1.48-15.40; P = .030) and combined PPE usage for >4 hours per day (OR 3.91, 95% CI 1.35-11.31; P = .012) were independently associated with de novo PPE-associated headaches. Since COVID-19 outbreak, 42/46 (91.3%) of respondents with pre-existing headache diagnosis either "agreed" or "strongly agreed" that the increased PPE usage had affected the control of their background headaches, which affected their level of work performance. CONCLUSION: Most healthcare workers develop de novo PPE-associated headaches or exacerbation of their pre-existing headache disorders.


Assuntos
Infecções por Coronavirus/prevenção & controle , Cefaleia/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Pneumonia Viral/prevenção & controle , Adulto , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pneumonia Viral/epidemiologia , Singapura/epidemiologia , Inquéritos e Questionários , Adulto Jovem
15.
J Headache Pain ; 21(1): 38, 2020 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-32334535

RESUMO

The world is currently dominated by the Corona Virus Disease 2019 (COVID-19) pandemic. Besides the obvious concerns about limitation of virus spread and providing the best possible care to infected patients, a concomitant concern has now arisen in view of a putative link between the use of certain drugs, such as Renin-Angiotensin System (RAS) inhibitors and ibuprofen, and an increased risk for COVID-19 infection. We here discuss this concern in relation to headache treatment and conclude that, based on current evidence, there is no reason to abandon treatment of headache patients with RAS inhibitors or ibuprofen.


Assuntos
Antagonistas de Receptores de Angiotensina/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Infecções por Coronavirus/patologia , Cefaleia/tratamento farmacológico , Ibuprofeno/efeitos adversos , Pneumonia Viral/patologia , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Betacoronavirus , Humanos , Ibuprofeno/uso terapêutico , Pandemias , Peptidil Dipeptidase A/metabolismo , Sistema Renina-Angiotensina , Fatores de Risco , Regulação para Cima/efeitos dos fármacos
16.
Emerg Med Clin North Am ; 38(2): 523-537, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32336338

RESUMO

A careful history and thorough physical examination are necessary in patients presenting with acute neurologic dysfunction. Patients presenting with headache should be screened for red-flag criteria that suggest a dangerous secondary cause warranting imaging and further diagnostic workup. Dizziness is a vague complaint; focusing on timing, triggers, and examination findings can help reduce diagnostic error. Most patients presenting with back pain do not require emergent imaging, but those with new neurologic deficits or signs/symptoms concerning for acute infection or cord compression warrant MRI. Delay to diagnosis and treatment of acute ischemic stroke is a frequent reason for medical malpractice claims.


Assuntos
Serviço Hospitalar de Emergência , Doenças do Sistema Nervoso/diagnóstico , Dor nas Costas/diagnóstico , Dor nas Costas/etiologia , Dor nas Costas/terapia , Tontura/diagnóstico , Tontura/etiologia , Tontura/terapia , Cefaleia/diagnóstico , Cefaleia/etiologia , Cefaleia/terapia , Humanos , Imperícia , Doenças do Sistema Nervoso/terapia , Gestão de Riscos , Convulsões/diagnóstico , Convulsões/etiologia , Convulsões/terapia
17.
JMIR Public Health Surveill ; 6(2): e18576, 2020 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-32319956

RESUMO

BACKGROUND: The recent outbreak of the coronavirus disease (COVID-19) has become an international pandemic. So far, little is known about the role of an internet approach in COVID-19 participatory surveillance. OBJECTIVE: The aim of this study is to investigate whether an online survey can provide population-level information for observing prevalence trends during the early phase of an outbreak and identifying potential risk factors of COVID-19 infection. METHODS: A 10-item online questionnaire was developed according to medical guidelines and relevant publications. It was distributed between January 24 and February 17, 2020. The characteristics of respondents and temporal changes of various questionnaire-derived indicators were analyzed. RESULTS: A total of 18,161 questionnaires were returned, including 6.45% (n=1171) from Wuhan City. Geographical distributions of the respondents were consistent with the population per province (R2=0.61, P<.001). History of contact significantly decreased with time, both outside Wuhan City (R2=0.35, P=.002) and outside Hubei Province (R2=0.42, P<.001). The percentage of respondents reporting a fever peaked around February 8 (R2=0.57, P<.001) and increased with a history of contact in the areas outside Wuhan City (risk ratio 1.31, 95% CI 1.13-1.52, P<.001). Male sex, advanced age, and lung diseases were associated with a higher risk of fever in the general population with a history of contact. CONCLUSIONS: This study shows the usefulness of an online questionnaire for the surveillance of outbreaks like COVID-19 by providing information about trends of the disease and aiding the identification of potential risk factors.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Coronavirus , Surtos de Doenças/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , China/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Infecções por Coronavirus/prevenção & controle , Tosse/etiologia , Feminino , Febre/etiologia , Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Vigilância da População , Prevalência
18.
Euro Surveill ; 25(16)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32347200

RESUMO

Healthcare workers (n = 803) with mild symptoms were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 90 positive) and asked to complete a symptom questionnaire. Anosmia, muscle ache, ocular pain, general malaise, headache, extreme tiredness and fever were associated with positivity. A predictive model based on these symptoms showed moderate discriminative value (sensitivity: 91.2%; specificity: 55.6%). While our models would not justify presumptive SARS-CoV-2 diagnosis without molecular confirmation, it can contribute to targeted screening strategies.


Assuntos
Infecções por Coronavirus , Pessoal de Saúde , Pandemias , Recursos Humanos em Hospital , Pneumonia Viral , Adulto , Idoso , Betacoronavirus , Estudos de Coortes , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Tosse/etiologia , Dor Ocular/etiologia , Fadiga/etiologia , Febre/etiologia , Cefaleia/etiologia , Política de Saúde , Humanos , Pessoa de Meia-Idade , Mialgia/etiologia , Países Baixos , Isolamento de Pacientes , Faringite/etiologia , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Valor Preditivo dos Testes , Adulto Jovem
19.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(3. Vyp. 2): 13-15, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32307424

RESUMO

The aspects of disruption of venous blood outflow from face region into skull are well-known; they can occur at any age - from neonatal to old age, however, the possible compensation mechanisms for such disorders are usually difficult to identify. A description is given of a unique case of unilateral epistaxis and a homolateral (right-sided) headache that developed much later. Examination revealed hypoplasia of the left sigmoid sinus and blood overflow of the right sigmoid sinus. After prescription of betahistine in a dose of 24 mg before bedtime and after awakening the headache and nosebleeds disappeared on the second day. The effect was persistent. The case demonstrates previously unknown compensation mechanisms for venous outflow - a retrograde outflow from the skull to the face region.


Assuntos
Face/irrigação sanguínea , Crânio/irrigação sanguínea , Veias/fisiologia , beta-Histina/uso terapêutico , Cavidades Cranianas/patologia , Cavidades Cranianas/fisiopatologia , Epistaxe/tratamento farmacológico , Epistaxe/fisiopatologia , Face/patologia , Cefaleia/tratamento farmacológico , Cefaleia/patologia , Cefaleia/fisiopatologia , Humanos , Crânio/patologia
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