Risk factors for development of personal protective equipment induced headache: e-survey of medical staff in Baltic states.

BACKGROUND: The COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic. METHODS: From January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states. RESULTS: In total, 2132 individuals participated. 52.3% experienced a PPE-induced headache. Usual onset time was between 2-3 h, lasting up to 1 h after PPE removal. The most common localization was in temporal and frontal regions. Headache usually occurred 2 to 3 days per week with an average pain score of 5.04 ± 1.80 points. Higher risk was associated with discomfort/pressure OR = 11.55, heat stress OR = 2.228, skin conditions OR = 1.784, long PPE use (duration 10-12 h) OR = 2,18, headache history prior PPE use OR = 1.207. Out of 52.3% respondents with PPE-induced headache, 45.5% developed de novo headache, whereas 54.5% had headache history. Statistically significant differences of PPE-induced headache between respective groups included severity (4.73 vs 5.29), duration (≥ 6 h 6.7% vs 8.2%), accompanying symptoms (nausea (19.3% vs 25.7%), photophobia (19.1% vs 25.7%), phonophobia (15.8% vs 23.5%), osmophobia (5.3% vs 12.0%)) and painkiller use (43.0% vs 61.7%). CONCLUSIONS: Over half of the medical personnel reported headache while using PPE. The risk was higher in individuals with headache history, increased duration of PPE use and discomfort while using PPE. Predisposed individuals reported PPE-induced headache which persisted longer, was more intense and debilitating than in the respondents with de novo headache.

Clinical and neurophysiological spectrum of polyneuropathies in children.

Peripheral neuropathy is a disorder of the peripheral nerves and results from a disturbance of structure and/or function of the peripheral sensory, motor and/or autonomic neurons. The possible aetiology of peripheral neuropathies is diverse, but inflammatory and hereditary diseases of the peripheral nerves predominate in childhood. The aim of this study was to determine the clinical and electrophysiological profile of large nerve fibre neuropathy detected by nerve conduction studies (NCS) in children over a 10-year period at the Children's Clinical University Hospital in Latvia. Based on NCS findings, 165 children between 2008 and 2018 were diagnosed with polyneuropathy. In our study, the majority of children had peripheral neuropathy due to acquired causes, mostly due to diabetes mellitus; roughly one in five of the patients had hereditary neuropathy. Almost half of the patients had motor deficits, which were more prevalent in toxic and inflammatory neuropathies. A little less than a third of patients complained of pain as well as presenting with autonomic dysfunction symptoms. The NCS demonstrated a demyelinating neuropathy in 52 cases (31%), an axonal neuropathy in 34 cases (21%), and mixed polyneuropathy in 79 cases (48%). Our study investigated the clinical and electrophysiological characteristics of polyneuropathies diagnosed with NCS in children. Most of the polyneuropathies in our study were hereditary and diabetic neuropathies with combined (myelin and axon) damage to nerve fibres. Almost all clinical symptoms of polyneuropathy were present in all aetiological groups.