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1.
Artigo em Inglês | MEDLINE | ID: mdl-33799926

RESUMO

There is a consensus that elderly individuals are quite vulnerable to adverse drug reactions (ADRs), and headaches are one of the most frequent clinical presentations of central nervous system problems in the general population, which can be an ADR. The purpose of our work was to analyze reports of "headache" associated ADRs in the elderly sent to the Portuguese Pharmacovigilance System (PPS), and also which drugs were more frequently associated with this adverse reaction. A retrospective analysis of suspected ADR reports involving patients aged 65 years or older received by the PPS in the last 10 years was conducted. A search of all the terms associated with the High Level Term "headache" was performed. All duplicate reports were excluded from the analysis. A total of 155 ADRs reports were included, in which 15 reported isolated "headache" as suspected ADR, while the remaining 140 ADRs reports reported "headache" together with several other adverse reactions. Most reports of "headache" ADR occurred in women (74.8%; n = 116). About half (46.5%; n = 72) of the ADR reports were considered serious. Anti-viral medication, anti-depressants, anti-dyslipidemic agents and central nervous system-acting analgesics were the most frequent drugs associated with "headache" ADR reports in this population. In elderly patients, most ADR reports involving headaches occurred in women and a high percentage (46.5%) were considered serious. Thus, it is important that healthcare professionals pay more attention to headaches reported as ADRs in the elderly and drugs suspected to cause them, in order to increase knowledge about this type of reaction and contribute towards safely using drugs in this age group.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Farmacovigilância , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Cefaleia/induzido quimicamente , Cefaleia/epidemiologia , Humanos , Estudos Retrospectivos
2.
Artigo em Inglês | MEDLINE | ID: mdl-33923935

RESUMO

Many countries introduced the requirement to wear masks in public spaces for containing SARS-CoV-2 making it commonplace in 2020. Up until now, there has been no comprehensive investigation as to the adverse health effects masks can cause. The aim was to find, test, evaluate and compile scientifically proven related side effects of wearing masks. For a quantitative evaluation, 44 mostly experimental studies were referenced, and for a substantive evaluation, 65 publications were found. The literature revealed relevant adverse effects of masks in numerous disciplines. In this paper, we refer to the psychological and physical deterioration as well as multiple symptoms described because of their consistent, recurrent and uniform presentation from different disciplines as a Mask-Induced Exhaustion Syndrome (MIES). We objectified evaluation evidenced changes in respiratory physiology of mask wearers with significant correlation of O2 drop and fatigue (p < 0.05), a clustered co-occurrence of respiratory impairment and O2 drop (67%), N95 mask and CO2 rise (82%), N95 mask and O2 drop (72%), N95 mask and headache (60%), respiratory impairment and temperature rise (88%), but also temperature rise and moisture (100%) under the masks. Extended mask-wearing by the general population could lead to relevant effects and consequences in many medical fields.


Assuntos
Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Boca , Nariz
3.
J Headache Pain ; 22(1): 19, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33794761

RESUMO

BACKGROUND: With headache experienced by up to 75% of adults worldwide in the last year, primary headache disorders constitute a major public health problem, yet they remain under-diagnosed and under-treated. Headache prevalence and burden is changing as society evolves, with headache now occurring earlier in life. Contributing factors, mostly associated with changing life style, such as stress, bad posture, physical inactivity, sleep disturbance, poor diet and excess use of digital technology may be associated with the phenomenon that could be labelled as '21st century headache'. This is especially notable in workplace and learning environments where headache impacts mental clarity and therefore cognitive performance. The headache-related impact on productivity and absenteeism negatively influences an individual's behaviour and quality of life, and is also associated with a high economic cost. Since the majority of sufferers opt to self-treat rather than seek medical advice, substantial knowledge on headache prevalence, causation and burden is unknown globally. Mapping the entire population of headache sufferers can close this knowledge gap, leading to better headache management. The broad use of digital technology to gather real world data on headache triggers, burden and management strategies, in self-treated population will allow these sufferers to access appropriate support and medication, and therefore improve quality of life. CONCLUSION: These data can yield important insights into a substantial global healthcare issue and form the basis for improved patient awareness, professional education, clinical study design and drug development.


Assuntos
Cefaleia , Qualidade de Vida , Absenteísmo , Adulto , Eficiência , Cefaleia/diagnóstico , Cefaleia/epidemiologia , Humanos , Local de Trabalho
4.
Artigo em Russo | MEDLINE | ID: mdl-33728860

RESUMO

Headache is a common symptom of acute and chronic cerebrovascular diseases. Headache can be symptomatic in patients with various forms of vascular pathology of the brain but primary headaches are much more common. Secondary headaches in acute cerebrovascular accidents may be the first symptom, and in some cases, a risk factor or complication of stroke. In chronic cerebrovascular diseases, headache may be the predominant symptom in the early stages and resolve in the later stages of the disease. At the same time, the severity, nature and course of headache cannot be considered as reliable signs of cerebrovascular disease. Meanwhile, the verification of the headache form is important from the point of view of determining the priorities of diagnosis and therapy.


Assuntos
Transtornos Cerebrovasculares , Acidente Vascular Cerebral , Transtornos Cerebrovasculares/complicações , Doença Crônica , Cefaleia/diagnóstico , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico
5.
Artigo em Russo | MEDLINE | ID: mdl-33728862

RESUMO

Anxiety and related sleep disorders are a problem in modern society. Sleep disorders cover more than 45% of the world's population and have become a global health problem in recent decades. Numerous studies have shown an association of sleep disorders with pain, depression, and anxiety, as well as a causal relationship between chronic pain and sleep deficits. Patients with headaches are at a higher risk of mood and anxiety disorders than people in the general population; these results are particularly noticeable for patients with chronic daily headache as well as medication overuse headache. This interaction between mood/anxiety problems and medication overuse may be an important factor in chronification of episodic headache. Detection and treatment of comorbid diseases will not only provide better results, but also improve the quality of life of patients. In the treatment of this category of patients, it is possible to use noofen, which improves sleep, cognitive functions, and reduces headache.


Assuntos
Transtornos da Cefaleia , Transtornos do Sono-Vigília , Transtornos de Ansiedade/epidemiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Transtornos da Cefaleia/epidemiologia , Transtornos da Cefaleia/etiologia , Humanos , Qualidade de Vida , Fatores de Risco , Transtornos do Sono-Vigília/epidemiologia
6.
Bol Med Hosp Infant Mex ; 78(1): 18-23, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33661874

RESUMO

Background: The SARS-CoV-2 virus may affect both adults and children. Although COVID-19 has a lower prevalence in infancy and has been described as mild, the clinical characteristics may vary, and there is a possibility of complications. The objectives of this study were to describe the clinical and epidemiological aspects of confirmed COVID-19 pediatric cases in the state of Sinaloa, Mexico, during the first 3 months of the pandemic, and children admitted with COVID-19 to a secondary hospital. Methods: This case series includes all patients with SARS-CoV-2 infection confirmed by PCR (polymerase chain reaction) test, identified in the state epidemiological surveillance system (SISVER) between March 1 and May 31, 2020. Confirmed patients admitted to the Sinaloa Pediatric Hospital (HPS) in the same period are also described. Results: Fifty-one children with SARS-CoV-2 were included, of which ten were admitted to the HPS. The median age was 10 years. The more frequent symptoms were fever (78%), cough (67%), and headache (57%). Most cases were mild or asymptomatic. Three patients with comorbidities died. Only four of ten patients identified in HPS were admitted with the diagnosis of possible COVID-19. Conclusions: SARS-CoV-2 infection in children was mostly mild or asymptomatic, and the clinical presentation varied. There is a possibility of complications, especially in children with comorbidities.


Assuntos
/epidemiologia , Tosse/epidemiologia , Febre/epidemiologia , Cefaleia/epidemiologia , Adolescente , Infecções Assintomáticas/epidemiologia , Criança , Pré-Escolar , Tosse/virologia , Feminino , Febre/virologia , Cefaleia/virologia , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , México , Reação em Cadeia da Polimerase , Índice de Gravidade de Doença
7.
PLoS One ; 16(2): e0246793, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33571300

RESUMO

BACKGROUND: There is limited evidence on the clinical characteristics of SARS-CoV-2 infection in Latin America. We present findings from a nationwide study in Argentina. RESEARCH QUESTION: What is disease severity measures and risk factors are associated with admission to an intensive care unit and mortality? STUDY DESIGN AND METHODS: Data were extracted from the COVID-19 database of the Integrated Argentina Health Information System, encompassing the period of March 3rd to October 2nd, 2020, using a standardized case report form that included information on contact history, clinical signs and symptoms, and clinical diagnosis. Information was collected at the initial site of care and follow-up conducted through calls by the regional healthcare authorities. A confirmed case of COVID-19 was defined as having a positive result through sequencing or real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. RESULTS: RT-PCR testing was positive in 738,776 cases. Complete datasets were available for analysis in 207,079 cases. Mean age was 42.9±18.8 years, 50.0% were males. Frequent co-existing conditions included hypertension (19.2%), diabetes (9.7%), asthma (6.1%) and obesity (5.2%). Most common symptoms included fever (58.5%), cough (58.0%), headache (45.4%), and sore throat (42.1%). Death or ICU admission were independently associated with older age, male, coma, dyspnea or tachypnea, and seizures, with underlying co-morbidities such as immunodeficiency, chronic renal failure, and liver disease showing the strongest effects. INTERPRETATION: Most cases of COVID-19 diagnosed in Argentina were mild and had a favorable outcome, but fatality rates were relatively elevated. Risk factors for adverse outcome included older age, male sex, coma and seizures, and the concurrent presence of several morbidities. These data may be useful for healthcare providers and healthcare policy makers of low-middle income and Latin American countries to guide decisions toward optimized care during the pandemic.


Assuntos
/epidemiologia , /fisiopatologia , Adulto , Argentina/epidemiologia , Asma/epidemiologia , Asma/fisiopatologia , Comorbidade , Tosse/epidemiologia , Tosse/fisiopatologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Feminino , Febre/epidemiologia , Febre/fisiopatologia , Cefaleia/epidemiologia , Cefaleia/fisiopatologia , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
8.
Acta Neurol Scand ; 143(5): 569-574, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33559885

RESUMO

OBJECTIVE: To characterize patients with coronavirus disease 2019 (COVID-19) who presented primarily with neurologic symptoms without typical COVID-19 symptoms of fever, cough, and dyspnea. METHODS: We retrospectively identified COVID-19-positive patients 18 years and older that had neurology symptoms on presentation requiring neurology consultation between March 14, 2020 and May 18, 2020. The patients were then classified into those with typical COVID-19 symptoms and those without. Demographic, clinical symptoms, laboratory result, and clinical outcomes were collected. RESULTS: Out of 282 patients who had neurology consult during this period, we identified 56 (mean age 69.2 years, 57% women) who tested COVID-19-positive and had neurologic symptoms on initial presentation. Of these, 23 patients (mean age 65.2 years, 52% women) had no typical COVID-19 symptoms while 33 did (mean age 72.2 years, 60% woman). In both groups, impaired consciousness was the most common initial neurologic symptom, followed by stroke, unsteady gait, headache, seizure, syncopal event, acute vision changes, and intracranial hemorrhage. Out of the 23 patients without typical COVID-19 symptoms on presentation, 10 went on to develop typical symptoms with 8 needing supplemental oxygen and one requiring mechanical ventilation. CONCLUSION: Patients who have COVID-19 can present with serious neurologic symptoms such as impaired consciousness and stroke even without typical COVID-19 symptoms. Those without typical COVID-19 symptoms can later develop typical symptoms severe enough to need respiratory support.


Assuntos
/diagnóstico , Hospitalização/tendências , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Cefaleia/diagnóstico , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Centros de Atenção Terciária/tendências
9.
Rev Neurosci ; 32(3): 351-361, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33618441

RESUMO

The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected more than 27 million confirmed cases and 8,90,000 deaths all around the world. Verity of viral infections can infect the nervous system; these viral infections can present a wide range of manifestation. The aim of the current study was to systematically review the COVID-19 associated central nervous system manifestations, mental and neurological symptoms. For that we conducted a comprehensive systematic literature review of four online databases, including Web of Science, PubMed, Scopus and Embase. All relevant articles that reported psychiatric/psychological symptoms or disorders in COVID-19 without considering time and language restrictions were assessed. All the study procedures were performed based on the PRISMA criteria. Due to the screening, 14 studies were included. The current study result indicated that, the pooled prevalence of CNS or mental associated disorders with 95% CI was 50.68% (6.68-93.88). The most prevalence symptoms were hyposmia/anosmia/olfactory dysfunction (number of study: 10) with 36.20% (14.99-60.51). Only one study reported numbness/paresthesia and dysphonia. Pooled prevalence of numbness/paresthesia and dysphonia was 5.83% (2.17-12.25) and 2.39% (10.75-14.22). The pooled prevalence of depression and anxiety was 3.52% (2.62-4.54) and 13.92% (9.44-19.08). Our findings demonstrate that COVID-19 has a certain relation with neurological symptoms. The hypsomia, anosmia or olfactory dysfunction was most frequent symptom. Other symptoms were headache or dizziness, dysgeusia or ageusia, dysphonia and fatigue. Depression, anxiety, and confusion were less frequent symptoms.


Assuntos
/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , /fisiopatologia , Ansiedade/psicologia , Depressão/psicologia , Disgeusia/epidemiologia , Disgeusia/fisiopatologia , Disfonia/epidemiologia , Disfonia/fisiopatologia , Fadiga/epidemiologia , Fadiga/fisiopatologia , Cefaleia/epidemiologia , Cefaleia/fisiopatologia , Humanos , Hipestesia/epidemiologia , Hipestesia/fisiopatologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/fisiopatologia , Parestesia/epidemiologia , Parestesia/fisiopatologia , Prevalência
11.
J Neurol Sci ; 423: 117283, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33636661

RESUMO

OBJECTIVE: We report the findings from the Spanish Society of Neurology's NeuroCOVID-19 Registry. METHODS: We performed a multicentre study of patients with neurological manifestations of COVID-19. Participating physicians reported demographic, clinical, and paraclinical data and judged the involvement of COVID-19 in causing neurological symptoms. RESULTS: A total of 233 cases were submitted, including 74 different combinations of manifestations. The most frequently reported were stroke (27%), neuromuscular symptoms (23.6%), altered mental status (23.6%), anosmia (17.6%), headache (12.9%), and seizures (11.6%). The mean age of patients was 61.1 years, with 42.1% being women; a higher proportion of women was recorded among patients with altered mental status, anosmia, and headache. The onset of symptoms differed within categories. Onset of anosmia occurred a mean (standard deviation) of 2.9 (2.5) days after the first general symptom, whereas neuromuscular symptoms appeared after 13.9 (10.1) days. Neurological symptoms were persistent in 33% of patients. General symptoms were present in 97.7% of patients, and results from general laboratory studies were abnormal in 99.4% of patients. Cerebrospinal fluid analysis findings were abnormal in 62.7% of the cases in which this test was performed (n = 51), but positive results for SARS-CoV-2 were only found in one case. CONCLUSIONS: The neurological manifestations of COVID-19 are diverse. Anosmia, myalgia, and headache occur earlier in the course of the disease. Altered mental status, neuromuscular symptoms, and stroke are associated with greater severity. COVID-19 must be incorporated into most clinical and radiological differential diagnoses. COVID-19 may cause persistent and disabling neurological symptoms.


Assuntos
/complicações , Doenças do Sistema Nervoso/etiologia , Adulto , Idoso , /etiologia , /epidemiologia , Doenças Cardiovasculares/epidemiologia , Causalidade , Comorbidade , Diabetes Mellitus/epidemiologia , Feminino , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Mialgia/epidemiologia , Mialgia/etiologia , Doenças do Sistema Nervoso/líquido cefalorraquidiano , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/epidemiologia , Neuroimagem , Exame Neurológico , Doenças Neuromusculares/epidemiologia , Doenças Neuromusculares/etiologia , Sistema de Registros , Espanha/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Resultado do Tratamento , Virulência
12.
Artigo em Inglês | MEDLINE | ID: mdl-33572669

RESUMO

Currently, SARS-CoV-2 is the primary pathogen worldwide, disrupting most of our everyday activities. The study aim was to evaluate its impact on the Polish dental community, standards of care, health, and welfare. METHODS: A Google Forms survey was conducted among 303 dental practitioners. RESULTS: Of respondents, 54.93% curbed the number of patients in the last six months, 34.21% declared no changes, and 10.86% reported an increase; whereas 70.7% of the respondents reported a treatment price increase within the same period (27.96% and 1.32% reported no changes and a decrease, respectively). Of the respondents, 15.5% did not close their businesses during the first wave of the pandemic. Most declared 1 or 2 month break, 30.7% and 34.7%, respectively. Some reported 3, 4, or 5 month breaks (15.84%, 1.32%, and 0.99%, respectively), and only two respondents (0.66%) did not admit patients at all. Headache episodes were more frequent among female dentists before the pandemic; after the pandemic, headache frequency increased among both sexes. Temporomandibular disorders (TMDs) were more frequent among women (p = 0.017). CONCLUSIONS: Most Polish dentists followed SARS-CoV-2 recommendations and restricted their practices to admitting only patients with pain or incomplete treatment. Decreased sleep parameters, head, back, and neck pain, were observed. This situation may affect dental health conditions in Polish society over time.


Assuntos
Odontologia/tendências , Odontólogos , Padrão de Cuidado , Odontologia/normas , Feminino , Cefaleia/epidemiologia , Humanos , Masculino , Polônia/epidemiologia , Papel Profissional , Estudos Retrospectivos , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/epidemiologia
13.
ABCS health sci ; 46: e021207, 09 fev. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1152228

RESUMO

INTRODUCTION: Primary headaches, defined as disorders in themselves caused by independent pathomechanisms and not by other disorders, are prevalent in university students and considered one important health problems in the world. OBJECTIVE: To investigate the prevalence of primary headaches and analyze associations with sociodemographic characteristics and the use of electronic devices by university students. METHODS: A cross-sectional observational study analysis was carried out with a sample of 1,143 students of both genders who responded to the questionnaire on demographic, socioeconomic aspects, use of electronic devices, and on the primary headaches. Descriptive analysis, bivariate analysis, and Poisson regression were performed. RESULTS: The overall prevalence of primary headache of 60.7%, being that, in relation to the type, 33.2% presented tension-type headache, 54.3% migraine, and 12.3% other types of headache. Regression analysis showed that female gender and income of up to two minimum wages were associated with primary headache and migraine type. The primary headache was associated with subjects of the white race; watching television and playing video games for more than 3 hours per day, for example. The sitting posture, semi-lying down, and distance from the eyes to the mobile phone and tablet longer than 20 cm were associated with primary headache and the three types of headaches. CONCLUSION: The results allow us to conclude that there is a high prevalence of primary headaches in college students and that socioeconomic factors related to the use of electronic devices are associated with the presence of primary headaches.


INTRODUÇÃO: As dores de cabeça primárias, definidas como perturbações em si mesmas, causadas por patomecanismos independentes e não por outras perturbações, são prevalentes em universitários e considerada um importante problema de saúde mundial. OBJETIVO: Investigar a prevalência de cefaleia primária e analisar associações com características sociodemográficas e uso de dispositivos eletrônicos em estudantes universitários. MÉTODOS: Foi realizado um estudo observacional transversal com uma amostra de 1143 estudantes de ambos os sexos, que responderam ao questionário sobre aspectos demográficos, socioeconômicos, uso de dispositivos eletrônicos e cefaleia primária. Foram realizadas análises descritivas, análises bivariadas e regressão de Poisson. RESULTADOS: A prevalência geral de cefaleia primária de 60,7%, sendo que, em relação ao tipo, 33,2% apresentavam cefaleia tensional, 54,3% enxaqueca e 12,3% outros tipos de cefaleia. A análise de regressão mostrou que o sexo feminino e a renda de até dois salários-mínimos estavam associados à cefaleia primária e a enxaqueca; a cefaleia primária está associada a indivíduos da raça branca; assistir televisão e jogar videogame por mais de 3 horas por dia foi associado ao tipo tensional, a enxaqueca e cefaleia primária; a postura sentada, semideitada e distância dos olhos ao telefone celular e tablet com mais de 20 cm com a cefaleia primária e aos três tipos específicos. CONCLUSÃO: Os resultados permitem concluir que existe alta prevalência de cefaleia primária em estudantes universitários e que fatores socioeconômicos e relacionados ao uso de dispositivos eletrônicos estão associados à presença de cefaleia primária.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes , Universidades , Fatores de Risco , Transtornos da Cefaleia Primários/epidemiologia , Cefaleia/epidemiologia , Televisão , Microcomputadores , Demografia , Estudos Transversais , Telefone Celular
14.
Neurology ; 96(11): e1527-e1538, 2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-33443111

RESUMO

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is protean in its manifestations, affecting nearly every organ system. However, nervous system involvement and its effect on disease outcome are poorly characterized. The objective of this study was to determine whether neurologic syndromes are associated with increased risk of inpatient mortality. METHODS: A total of 581 hospitalized patients with confirmed SARS-CoV-2 infection, neurologic involvement, and brain imaging were compared to hospitalized non-neurologic patients with coronavirus disease 2019 (COVID-19). Four patterns of neurologic manifestations were identified: acute stroke, new or recrudescent seizures, altered mentation with normal imaging, and neuro-COVID-19 complex. Factors present on admission were analyzed as potential predictors of in-hospital mortality, including sociodemographic variables, preexisting comorbidities, vital signs, laboratory values, and pattern of neurologic manifestations. Significant predictors were incorporated into a disease severity score. Patients with neurologic manifestations were matched with patients of the same age and disease severity to assess the risk of death. RESULTS: A total of 4,711 patients with confirmed SARS-CoV-2 infection were admitted to one medical system in New York City during a 6-week period. Of these, 581 (12%) had neurologic issues of sufficient concern to warrant neuroimaging. These patients were compared to 1,743 non-neurologic patients with COVID-19 matched for age and disease severity admitted during the same period. Patients with altered mentation (n = 258, p = 0.04, odds ratio [OR] 1.39, confidence interval [CI] 1.04-1.86) or radiologically confirmed stroke (n = 55, p = 0.001, OR 3.1, CI 1.65-5.92) had a higher risk of mortality than age- and severity-matched controls. CONCLUSIONS: The incidence of altered mentation or stroke on admission predicts a modest but significantly higher risk of in-hospital mortality independent of disease severity. While other biomarker factors also predict mortality, measures to identify and treat such patients may be important in reducing overall mortality of COVID-19.


Assuntos
/mortalidade , Confusão/fisiopatologia , Transtornos da Consciência/fisiopatologia , Mortalidade Hospitalar , Acidente Vascular Cerebral/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Ageusia/epidemiologia , Ageusia/fisiopatologia , /fisiopatologia , Ataxia/epidemiologia , Ataxia/fisiopatologia , Confusão/epidemiologia , Transtornos da Consciência/epidemiologia , Doenças dos Nervos Cranianos/epidemiologia , Doenças dos Nervos Cranianos/fisiopatologia , Delírio/epidemiologia , Delírio/fisiopatologia , Feminino , Cefaleia/epidemiologia , Cefaleia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Parestesia/epidemiologia , Parestesia/fisiopatologia , Disautonomias Primárias/epidemiologia , Disautonomias Primárias/fisiopatologia , Recidiva , Convulsões/epidemiologia , Convulsões/fisiopatologia , Acidente Vascular Cerebral/epidemiologia , Vertigem/epidemiologia , Vertigem/fisiopatologia
15.
Neurol Sci ; 42(4): 1267-1276, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33502666

RESUMO

BACKGROUND: SARS-CoV-2 is a novel infectious agent causing coronavirus disease 2019, which has been declared as pandemic in March 2020. Personal protective equipment has been mandatory for healthcare workers in order to contain the outbreak of pandemic disease. Mild neurological disturbances such as headache have been related to the extensive utilization of facemask. This study aims to examine headache variations related to the intensive utilization of facemask among a cohort of healthcare professionals in a setting of low-medium risk of exposure to SARS-CoV-2. METHODS: This is a cross-sectional study among healthcare providers from different hospital and clinics in Italy. Each participant completed a specifically designed self-administered questionnaire. Headache features and outcome measures' change from baseline were evaluated over a 4-month period, in which wearing facemask has become mandatory for Italian healthcare workers. RESULTS: A total of 400 healthcare providers completed the questionnaire, 383 of them met the inclusion criteria. The majority were doctors, with a mean age of 33.4 ± 9.2 years old. Among 166/383 subjects, who were headache free at baseline, 44 (26.5%) developed de novo headache. Furthermore, 217/383 reported a previous diagnosis of primary headache disorder: 137 were affected by migraine and 80 had tension-type headache. A proportion (31.3%) of these primary headache sufferers experienced worsening of their pre-existing headache disorder, mainly for migraine frequency and attack mean duration. CONCLUSIONS: Our data showed the appearance of de novo associated facemask headache in previous headache-free subjects and an exacerbation of pre-existing primary headache disorders, mostly experienced by people with migraine disease.


Assuntos
Cefaleia/etiologia , Pessoal de Saúde , Máscaras/efeitos adversos , Pandemias , Equipamento de Proteção Individual/efeitos adversos , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Cefaleia/epidemiologia , Transtornos da Cefaleia/epidemiologia , Transtornos da Cefaleia/etiologia , Humanos , Hiperalgesia/epidemiologia , Hiperalgesia/etiologia , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/etiologia , Médicos , Inquéritos e Questionários
16.
J Med Virol ; 93(5): 2925-2931, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33463731

RESUMO

A nested longitudinal study within theAsymptomatic novel CORonavirus iNFfection study followed participants with positive nasopharyngeal swab to query for development of symptoms and assess duration of positive reverse transcription-polymerase chain reaction (RT-PCR) test results. Of the 91 participants initially testing positive, 86 participated in follow-up approximately 14 days after study enrollment; of those 86 participants, 19 (22.1%) developed at least one symptom at any time after the initial positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result. The median number of days to symptom development after their initial positive test result was 6 (range 1-29 days). No participants reported a SARS-CoV-2-related hospitalization. The most frequently reported symptoms were fatigue or muscle aches (10.5%), headache (9.3%), fever (5.8%), and shortness of breath (5.8%). Of the 78 participants who submitted a nasopharyngeal swab for repeat RT-PCR testing, 17 (21.8%) remained positive at Day 14, 4 of which continued to test positive at Day 28. These findings reinforce the probable role of silent SARS-CoV-2 infections in community transmission, and that reliance on symptom development will miss a large proportion of infections. Broad testing programs not limited to individuals presenting with symptoms are critical for identifying persons with SARS-CoV-2 infection and ultimately slowing transmission.


Assuntos
Infecções Assintomáticas/epidemiologia , /epidemiologia , /isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dispneia/epidemiologia , Fadiga/epidemiologia , Feminino , Febre/epidemiologia , Seguimentos , Cefaleia/epidemiologia , Hospitalização , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Prevalência , Manejo de Espécimes , Carga Viral , Adulto Jovem
17.
West Afr J Med ; 38(1): 54-58, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33463708

RESUMO

BACKGROUND: The SARS-CoV-2 infection continues to ravage the global community since it was declared a pandemic. The socio-demographic and clinical characteristics defining the disease are mainly from Europe and Asia. The disease symptomatology is similar to the prevalent diseases in our environment, this could result in the delay in prompt identification and appropriate management of suspected cases toward combating community transmission. This study evaluates the prevalence, socio-demographic and clinical characteristics of positive cases of COVID -19. METHODS: This was a retrospective cohort study. Data on the socio-demographic, clinical characteristics and the results of the SARS-CoV-2 test of participants at the Nigerian Institute of Medical Research [NIMR] Modified Drive-through Centre for COVID-19 test sample collection over two months [24th February 2020- 27th April 2020] were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. RESULTS: A total number of 481 clients were evaluated in this review. The prevalence of SARS-CoV-2 infection in the population was 14.6%. The mean age of the positive cases was 42.2 [±15.9] years. The common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%) and running nose (15.7%). Fever depicted statistical significance with positive cases with the majority being of mild to moderate clinical severity. CONCLUSION: The prevalence of SARS-CoV-2 infection among this cohort was 14.6% with a male preponderance. Fever and sore throat were the variables that predicted SARS CoV-2 infection among our cohort.


Assuntos
/epidemiologia , Pandemias , Adolescente , Tosse/epidemiologia , Tosse/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Febre/epidemiologia , Febre/etiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Masculino , Nigéria/epidemiologia , Faringite/epidemiologia , Faringite/etiologia , Prevalência , Estudos Retrospectivos
18.
Headache ; 61(1): 60-68, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33349955

RESUMO

BACKGROUND AND OBJECTIVES: Accurate, up-to-date estimates of the burden of migraine and severe headache are important for evidence-based decision-making about workforce needs and the distribution of health resources. We used data from US government health surveys to report the prevalence, trends, and impact of this condition by age, sex, and poverty status. METHODS: We identified the most recent, publicly available summary statistics from the National Hospital Ambulatory Medical Care Survey, the National Ambulatory Medical Care Survey, and the National Health Interview Survey. We extracted and compiled relevant information from each study, with an emphasis on sex, age, and economic-related statistics. RESULTS: The age-adjusted prevalence of migraine and severe headache in the United States has remained stable over many years. In 2018, the age-adjusted prevalence was 15.9% across all adults. The sex ratio also remains stable, with 21% of women and 10.7% of men affected. Migraine continues to be an important public health problem, accounting for roughly 4 million emergency department (ED) visits in 2016, when headache was the fifth most common reason for an ED visit overall and the third most common reason for ED visits in females 15-64. Migraine also accounted for over 4.3 million office visits. Many adults with migraine or severe headaches are disadvantaged. In 2018, for example, roughly 40% of US adults with migraine were unemployed, and a similar proportion were classified as poor or "near poor." Roughly one in five had no health insurance and about a third had a high school education or less. CONCLUSIONS: Migraine and severe headaches are a serious public health issue in the United States, with the highest impact in women of childbearing age and those of lower socioeconomic status. Socioeconomic disadvantages also are highly prevalent among those with headaches. The economic consequences of the current coronavirus pandemic are likely to exacerbate all of these inequities. Increased attention to this high impact chronic pain condition, and improved funding for treatment provision and research, are warranted to reduce the future burden of disease.


Assuntos
/complicações , Efeitos Psicossociais da Doença , Disparidades nos Níveis de Saúde , Transtornos de Enxaqueca/epidemiologia , Adolescente , Adulto , Criança , Feminino , Cefaleia/epidemiologia , Pesquisas sobre Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
19.
J Med Virol ; 93(5): 2683-2693, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33325107

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is currently not under control. We aimed to assess whether there are differences in clinical manifestations between COVID-19 patients from the East (East and South-East Asian countries including China, South Korea, and Thailand) and the West (North American, European, and Middle East countries, including the United States, Italy, France, and Iran). For this meta-analysis, we searched for eligible studies about COVID-19 in three databases: PubMed, EMBASE, and the Cochrane Library. Studies were divided into two cohorts for analysis: the East and the West. Stata 13.1 software was used for the meta-analysis. Of the 1527 studies initially identified by the literature search, 169 full-text articles were retrieved and screened for eligibility. Fifty-seven of these, describing 19,353 patients, were deemed eligible for inclusion. Of these, 45 studies with 8416 patients were from the East while 12 studies with 10,937 patients were from the West. The results indicated that the incidences of cough, headache, dizziness, nasal congestion, and digestive symptoms in COVID-19 patients from the East were lower than those in the West. The laboratory data showed that there were no significant differences in the levels of lymphocytes, leukocytes, C-reactive protein, and platelet counts between the two groups. In addition, our results also showed that the incidence of cardiac and kidney injury, as well as increased levels of creatinine, alanine transaminase, and aspartate transaminase, were significantly higher in patients from the West than from the East. Our meta-analysis indicated that there are differences in the clinical manifestations of COVID-19 in patients from the East and the West. COVID-19 patients from the West appear to suffer more severe liver, kidney, and heart damage due to SARS-CoV-2.


Assuntos
/complicações , /fisiopatologia , Proteína C-Reativa , China , Tosse/epidemiologia , Bases de Dados Factuais , Tontura/epidemiologia , França , Cefaleia/epidemiologia , Humanos , Irã (Geográfico) , Itália , Oriente Médio , Pandemias , República da Coreia , Tailândia , Estados Unidos
20.
Rev Saude Publica ; 54: 133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33331527

RESUMO

OBJECTIVE: To explore the association of occupational pesticide exposure with acute and mental health symptoms. METHODS: Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios. RESULTS: Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment. CONCLUSIONS: Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.


Assuntos
Depressão/induzido quimicamente , Fazendeiros , Cefaleia/induzido quimicamente , Exposição Ocupacional/estatística & dados numéricos , Praguicidas/envenenamento , Praguicidas/toxicidade , Envenenamento/epidemiologia , Doenças Respiratórias/induzido quimicamente , Taquicardia/induzido quimicamente , Adolescente , Adulto , Agricultura , Brasil/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Família , Feminino , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Prevalência , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/epidemiologia , Taquicardia/epidemiologia , Adulto Jovem
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