Approach to Headache

2021 ◽  
Vol 41 (06) ◽  
pp. 633-643
Author(s):  
Sarah M. Bobker ◽  
Joseph E. Safdieh
Keyword(s):  
United States ◽  
Systematic Approach ◽  
Correct Diagnosis ◽  
The United States ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Fluid Analysis ◽  
High Prevalence ◽  
Inpatient Settings ◽  
Very High

AbstractThere is a very high prevalence of headache in both outpatient and inpatient settings, in the United States and worldwide, due to an abundance of possible causes. Having a practical and systematic approach to evaluating and treating headache is, therefore, key to making the correct diagnosis, or possibly overlapping diagnoses. Taking a thorough and methodical headache history is the mainstay for diagnosis of both primary and secondary headache disorders. Evaluation and workup should include a complete neurological examination, consideration of neuroimaging in specific limited situations, and serum or spinal fluid analysis if indicated. Adopting a diagnostic approach to headache ensures that cannot-miss, or potentially fatal, headache syndromes are not overlooked, while resource-intensive tests are performed only on an as-needed basis.

scholarly journals A Comparison of Mental Health Outcomes in the United States and Italy at Different Levels of Cumulative COVID-19 Prevalence

2021 ◽  
Author(s):  
Anthony D Mancini ◽  
Gabriele Prati
Keyword(s):  
Mental Health ◽  
United States ◽  
New York ◽  
San Francisco ◽  
The United States ◽  
Ptsd Symptoms ◽  
General Distress ◽  
High Prevalence ◽  
Low Prevalence ◽  
Different Levels

How does the prevalence of COVID-19 impact people’s mental health? In a preregistered study (N = 857), we sought to answer this question by comparing demographically matched samples in four regions in the United States and Italy with different levels of cumulative COVID-19 prevalence. No main effect of prevalence emerged. Rather, prevalence region had opposite effects, depending on the country. New York City participants (high prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than San Francisco (low prevalence). Conversely, Campania participants (low prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than Lombardy (high prevalence). Consistent with these patterns, COVID-19 worry was more strongly linked with general distress and PTSD symptoms in New York than San Francisco, whereas COVID-19 worry was more strongly linked with PTSD in Campania than Lombardy. In exploratory analyses, media exposure predicted and mapped on to geographic variation in mental health outcomes.

scholarly journals Aetiological Factors of Osteoarthritis: A Review Update

2015 ◽  
Vol 2 (1) ◽  
pp. 18-23
Author(s):  
M. Jahidul Islam ◽  
M. Shahadat Hossain ◽  
M. Ruhul Amin ◽  
Monzur Ahmed
Keyword(s):  
United States ◽  
Joint Damage ◽  
The Elderly ◽  
The United States ◽  
Common Type ◽  
High Rate ◽  
Lumbosacral Spine ◽  
First Metatarsal ◽  
High Prevalence ◽  
Wear And Tear

Osteoarthritis (OA) is no longer considered ‘degenerative’ or ‘wear and tear’ arthritis; rather involves dynamic biomechanical, biochemical and cellular process. Indeed, the joint damage that occurs in OA is the result of active remodeling involving all the joint structures. Although articular cartilage is at the center of change, OA is viewed as a disease of the entire joint. Traditionally, OA has been viewed as an inevitable degenerative condition of the cartilage. It is currently viewed as a biomechanical and biochemical inflammatory disease of the entire joints. Osteoarthritis (OA) is the most common type of arthritis. Its high prevalence, especially in the elderly, and the high rate of disability related to disease make it a leading cause of disability in the elderly. Because of the aging of Western populations and because obesity, a major risk factor, are increasing in prevalence, the occurrence of osteoarthritis is on the rise. In the United States, osteoarthritis prevalence will increase from 66–100% by the year 2020. OA affects certain joints, yet spares others. Commonly affected joints include the cervical and lumbosacral spine, hip, knee, and first metatarsal phalangeal joint (MTP). In the hands, the distal and proximal inter-phalangeal joints and the base of the thumb are often affected. Usually spared are the wrist, elbow, and ankle.Journal of Current and Advance Medical Research 2015;2(1):18-23DOI: http://dx.doi.org/10.3329/jcamr.v2i1.22584

scholarly journals Implications for Europe of high prevalence of HIV drug resistance in the United States

2002 ◽  
Vol 6 (2) ◽  
Author(s):  
D Pillay
Keyword(s):  
United States ◽  
Drug Resistance ◽  
Disease Progression ◽  
Successful Treatment ◽  
Virological Failure ◽  
The United States ◽  
Viral Rna ◽  
Viral Rebound ◽  
Drug Compliance ◽  
High Prevalence

Over 16 drugs are now available for use against HIV, broadly comprising three classes of agent. Their use, in combination, has had a dramatic impact in reducing disease progression. Successful treatment is increasingly defined as the maintenance of plasma viral RNA load at undetectable levels. Reasons for ‘virological failure’ (viral rebound) on treatment are many, but perhaps the single most important factor is suboptimal drug compliance.

scholarly journals The Management of Hyponatremia

2015 ◽  
Vol 1 (1) ◽  
pp. napoc.2015.1473
Author(s):  
Norbert Lameire
Keyword(s):  
United States ◽  
Risk Factors ◽  
Correct Diagnosis ◽  
The United States ◽  
Plasma Sodium ◽  
Therapeutic Action ◽  
Electrolyte Disturbances ◽  
Present On Admission ◽  
Key Questions

A case of hyponatremia in a previously healthy 76-year-old woman is described with discussion revolving around key questions: 1. Is hyponatremia really hypotonic? 2. Is there an emergency present on admission necessitating acute therapeutic action to improve the electrolyte disturbances? 3. What is the best approach to obtaining a correct diagnosis? 4. What is the best approach to raise serum Na? 5. What are the risk factors, symptoms and pathophysiology of thiazide-induced hyponatremia? 6. What is the role of hypokalemia in the pathophysiology of hyponatremia? 7. What are the options for therapy to raise the plasma sodium in this patient? 8. How should the concomitant hypokalemia be treated, and is it an additional danger in the treatment of the hyponatremia? 9. What are the lessons from this case for the management of chronic “asymptomatic” or mildly symptomatic hyponatremic patients? 10. Would this patient be approached differently in Europe and the United States?

Handguns: Risks versus Benefits

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 781-782
Author(s):  
KATHERINE K. CHRISTOFFEL ◽  
TOM CHRISTOFFEL
Keyword(s):  
United States ◽  
New York ◽  
New York Times ◽  
The United States ◽  
Gun Control ◽  
Second Amendment ◽  
High Prevalence ◽  
The Us ◽  
Us Supreme Court ◽  
P 16

THE ISSUE There are an estimated 40 to 50 million handguns in the United States, with approximately 2 million more being manufactured annually1 (The New York Times, July 9, 1985, p 16). The high prevalence of handgun injury in the United States is unique in all the world and is increasing. Children are among the growing legions of US citizens harmed by the handgun epidemic.2 The effort to control handguns is focussed on developing laws to control their manufacture, importation, purchase, possession, and use. Opponents of these legal approaches claim that gun control endangers constitutional freedoms. When asked, the US Supreme court has consistently rejected that position in favor of the view that the Second Amendment protects a collective, not a personal, right to bear arms.3,4

Salmonella enterica Serovar Diversity, Distribution, and Prevalence in Public Access Waters from a Central California Coastal Leafy Green Growing Region during 2011 - 2016

2021 ◽  
Author(s):  
Lisa Gorski ◽  
Anita S. Liang ◽  
Samarpita Walker ◽  
Diana Carychao ◽  
Ashley Aviles Noriega ◽  
...  
Keyword(s):  
United States ◽  
Salmonella Enterica ◽  
The United States ◽  
Public Access ◽  
Bias Analysis ◽  
Central California ◽  
High Prevalence ◽  
Human Salmonellosis ◽  
Rain Events ◽  
Growing Region

Prevalence and serovar diversity of Salmonella enterica was measured during a five-year survey of surface waters in a 500 mi^2 agricultural region of the Central California Coast. Rivers, streams, lakes, and ponds were sampled bimonthly resulting in 2,979 samples. Overall prevalence was 56.4% with higher levels detected in Spring than in Fall. Small, but significant, differences in prevalence were detected based on sample locations. Detection of Salmonella was correlated positively with both significant rain events and, in some environments, levels of generic Escherichia coli . Analysis of 1,936 isolates revealed significant serovar diversity, with 91 different serovars detected. The most common isolated serovars were S. enterica subsp. enterica serovars I 6,8:d:- (406 isolates, 21.0%, and potentially monophasic Salmonella Muenchen), Give (334 isolates, 17.3%), Muenchen (158 isolates, 8.2%), Typhimurium (227 isolates, 11.7%), Oranienburg (106 isolates, 5.5%), and Montevideo (78 isolates, 4%). Sixteen of the 24 most common serovars detected in the region are among the serovars reported to cause the most human salmonellosis in the United States. Some of the serovars were associated with location and seasonal bias. Analysis of Xba I Pulsed Field Gel Electrophoresis (PFGE) patterns of strains of serovars Typhimurium, Oranienburg, and Montevideo showed significant intra-serovar diversity. PFGE pulsotypes were identified in the region for multiple years of the survey, indicating persistence or regular re-introduction to the region. Importance Non-typhoidal Salmonella is the among the leading causes of bacterial foodborne illness and increasing numbers of outbreaks and recalls are due to contaminated produce. High prevalence and 91 different serovars were detected in this leafy green growing region. Seventeen serovars that cause most of the human salmonellosis in the United States were detected, with 16 of those serovars detected in multiple locations and multiple years of the 5-year survey. Understanding the widespread prevalence and diversity of Salmonella in the region will assist in promoting food safety practices and intervention methods for growers and regulators.

Perceived Mother–Father Dyad Parenting Typologies Across Four Regions in the United States

2021 ◽  
pp. 0192513X2110551
Author(s):  
Melanie Stearns ◽  
Erica Szkody ◽  
Cliff McKinney
Keyword(s):  
United States ◽  
Emerging Adults ◽  
Parenting Style ◽  
Parenting Styles ◽  
Online Survey ◽  
The United States ◽  
The West ◽  
Mothers And Fathers ◽  
Paternal Parenting ◽  
Very High

Although much research has investigated parenting styles, few studies have examined parenting across regions of the United States. The current study used a nationwide sample to examine perceived maternal and paternal parenting in four regions of the United States: Northeast, South, Midwest, and West. Participants included 1080 emerging adults who answered questionnaires regarding their perceptions of maternal and paternal parenting styles using an online survey. In all regions, the largest profile indicated a parenting style of High Authoritative/Authoritarian and Moderate Permissive mothers and fathers. Similarly, all regions indicated profiles that were High or Very High Authoritarian mothers and fathers. All regions except the West had a profile with High Authoritative mothers and High or Very High Authoritarian fathers. The Northeast, South, and West also had unique profiles found only in those regions. Thus, results indicate similarities as well as distinct differences in parenting style across regions of the United States.

scholarly journals Positivity Rates of in Vitro Inhalant/ Respiratory and Food Allergy Tests in the Northern Midwestern United States

2018 ◽  
Vol 97 (9) ◽  
pp. 296-322 ◽  
Author(s):  
Michael S. Benninger ◽  
Thomas Daly ◽  
Kevin Graffmiller
Keyword(s):  
United States ◽  
Cleveland Clinic ◽  
The United States ◽  
Test Results ◽  
Dust Mites ◽  
Upper Midwest ◽  
Allergy Test ◽  
Wide Variability ◽  
Very High

Rates of allergy-test positivity vary by country and by regions within countries. Several studies have looked at allergy test results to determine the most common allergens. Many of these studies have been based on surveys or on studies of small numbers of tests. Positivity rates for allergy tests are poorly defined in the northern midwestern region of the United States. We conducted a study to identify the rates of positive allergy tests for both inhalant/respiratory allergens and food allergens in the upper Midwest. We extracted from our laboratory database the results of all test samples sent for one of eight allergen panels that had been analyzed between Sept. 1, 2014, and Sept. 1, 2015. All testing was performed at The Cleveland Clinic with the Phadia ImmunoCAP system. The percentage of positive tests, the distribution of the most frequently positive tests, and the class of in vitro responses were identified. A total of 148,628 test results for 63 different allergens were identified. Of the 125,190 tests for inhalant/respiratory allergens, the most frequently positive were dog dander (24% of tests), cat dander (23%), dust mites (23% for both Dermatophagoides pteronyssinus and Dermatophagoides farinae), and June grass (21%). Of the 23,438 food tests, the most frequently positive test results were for milk (18%), peanut (17%), wheat (16%), and egg white (15%). Most of the results fell into classes 1 through 3, although there was still a notable number of very high responses (class 5 and 6). These findings suggest that there is wide variability in the positivity of in vitro allergy tests and that the likelihood of a positive result in screening panels can be estimated. Evaluating such rates will help identify the most and least common allergens and will help to cost-effectively refine allergy screening panels.

scholarly journals Helicopter Pilots Encountering Fog: An Analysis of 109 Accidents from 1992 to 2016

Atmosphere ◽  
2020 ◽  
Vol 11 (9) ◽  
pp. 994
Author(s):  
Alex de Voogt ◽  
Hilary Kalagher ◽  
Andrew Diamond
Keyword(s):  
United States ◽  
Decision Making ◽  
The United States ◽  
Meteorological Conditions ◽  
Transportation Safety ◽  
Online Database ◽  
Fatal Accident ◽  
Instrument Meteorological Conditions ◽  
High Prevalence ◽  
Helicopter Pilots

Helicopters have the ability to make maneuvers or precautionary off-airport landings to avoid flights into instrument meteorological conditions (IMC) such as fog. Flight accidents in which fog was encountered as well as inadvertent and intentional flights into fog were examined to understand their occurrence. A 25-year period in the United States using the National Transportation Safety Board online database was used to collect 109 accident reports of which 73 (67%) were fatal. Pilots flying intentionally into IMC were more likely to be a part of a fatal accident than those who did so inadvertently. Those pilots who were reported as being under pressure when encountering fog conditions were also more likely to be in an accident. The findings confirm a high prevalence and an added danger to intentional flights into IMC. In addition, decision-making under pressure when encountering IMC conditions is now linked to a higher proportion of fatalities, emphasizing that helicopter pilots should be made aware of these specific decision-making circumstances in their operations.

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