High Altitude Headache. A Prospective Study of its Clinical Characteristics

Altitude headache (AH) is the most common symptom of high altitude exposure. This prospective cross-sectional and analytical study, conducted in the Ecuadorian Andes, aimed to explore AH symptomatology, taking into account subjects' views. Thirty mountain climbers took part in the Questionnaire Elaboration. The symptoms were grouped into three categories: (A) pain dimension (PD) — intensity, location, quality, outset form, evolution, exacerbating and relieving elements; (B) concurrent symptom dimension (CSD); and (C) feeling/mood dimension (FMD). Ninety-eight mountain climbers comprised the sample for Field Research. Three evaluations were carried out: 4700-5000 m, n = 1, and 5700-5800 m, n = 2. Pearson's correlation coefficient was used to assess internal consistency. Scores between 0.7 and 1 were considered as significant to assess the strength of association between the PD and its different items and CSD and FMD. The following clinical features were found: holocranial 65.6%; pulsatile-burst type quality 75.3%; oscillating evolution 36.7%; increasing with exercise 49.5%; relieved by rest 41.8%; concurrent symptoms referred to, anorexia 26.8%, irritability 26.5%, and finally pessimism and anxiety feelings 33.2 and 29.5%, respectively. We believe that elements provided by us must lead to a new official AH diagnosis criterion.

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ASSESSMENT OF CORRELATION BETWEEN LEUKODERMA AND PSYCHIATRIC ILLNESS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.475 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Dr. Mukesh Batra

Keyword(s):

Psychiatric Illness ◽

Study Participant ◽

Simple Random Sampling ◽

Anxiety Symptoms ◽

Control Group ◽

P Value ◽

Common Symptom ◽

Cross Sectional ◽

Duration Of Disease ◽

Illness Anxiety

Background: Leukoderma is an acquired disease of pigmentation which is presented by depigmented areas of different shape and sizes on the skin. In various researches it was reported that these defects in melanocytes occurred due to autoimmune pathway or the complex causation of oxidative stress and genetics. Material & Methods: In the present cross‑sectional prospective study 100 patients who were diagnosed with Leukoderma and controls who were not having depigmentation of skin and without any known clinical disease were enrolled for present study by simple random sampling. Written informed consent was taken from each study participant. Clearance from institutional ethical committee was also taken prior to the study. Results: The prevalence of psychiatric illness among leukoderma group was 22% and among 78% patients we did not found any psychiatric illness. The most common symptom was depression which was present among 22% of patients with Leukoderma and 18% patients with Leukoderma had anxiety symptoms. Among the control group depression was present in 5 % subjects and anxiety symptoms were present in 7% of subjects. The mean WHO-Quality of life scores was low among Leukoderma group in relation to the control group (p value <0.05). On correlation with psychiatric illness, observations were statistically non-significant (p > 0.05) with HAMA-A and HAMA- D. The observations were statistically significant (p < 0.05) with GHQ total and BSA score. Conclusion: Higher prevalence of psychitric morbidity among patients with leukoderma and it was found associated with duration of disease and BSA scores. The most common symptom was depression which was followed by anxiety symptoms. Key words: Leukoderma, psychiatric illness, anxiety, depression.

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Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

Journal of Surgical Sciences ◽

10.3329/jss.v23i1.44238 ◽

2020 ◽

Vol 23 (1) ◽

pp. 10-12

Author(s):

Nelema Jahan ◽

Md. Mamunur Rahman ◽

Mohammad Shahidul Alam ◽

Md Saiful Islam

Keyword(s):

Histopathological Examination ◽

Breast Diseases ◽

Histopathological Study ◽

Common Symptom ◽

Breast Lump ◽

Histopathological Findings ◽

Malignant Breast ◽

Breast Lumps ◽

One Year ◽

A Prospective Study

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

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Patient satisfaction with enhanced recovery after colorectal surgery: a cross-sectional analytical study

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1601805810 ◽

2020 ◽

pp. 1

Author(s):

Azzam Aljabri ◽

Bader Alqarni ◽

Yahya Alayafi ◽

Sulaiman Aldawood ◽

Mohannad Munshi ◽

...

Keyword(s):

Patient Satisfaction ◽

Colorectal Surgery ◽

Analytical Study ◽

Enhanced Recovery ◽

Cross Sectional

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A cross-sectional analytical study to evaluate need of prophylactic antimicrobials in patients undergoing normal vaginal delivery with episiotomy before and after implementation of antimicrobial policy

MedPulse International Journal of Gynecology ◽

10.26611/10121235 ◽

2019 ◽

Vol 12 (3) ◽

pp. 81-85

Author(s):

Sujal Vaibhav Mehta ◽

◽

Sanjivani Ashok Deshpande ◽

Keyword(s):

Vaginal Delivery ◽

Analytical Study ◽

Normal Vaginal Delivery ◽

Cross Sectional ◽

Before And After

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Significados de Morte: o Discurso do Sujeito Coletivo da Enfermagem / Meaning of Death: the collective subject speech of the nursing staff

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v6i1.458 ◽

1970 ◽

Vol 6 (1) ◽

pp. 52-58

Author(s):

Fellipe Afonso de Azevedo ◽

Noé D’jalma Araújo ◽

Néliton Célio de Novais ◽

José Vítor da Silva ◽

Renato Augusto Passos

Keyword(s):

Nursing Staff ◽

Hospital Setting ◽

Field Research ◽

Structured Interview ◽

Minas Gerais ◽

Structured Interviews ◽

Cross Sectional ◽

Emergency Units ◽

Methodological Guidelines

RESUMOObjetivo: o presente trabalho teve como objetivo identificar os significados de morte emergentes das equipes de enfermagem que atuam nas unidades de Pronto Socorro e Unidade de Terapia Intensiva (UTI) em uma entidade de médio porte situada no Sul de Minas Gerais. Materiais e métodos: estudo de abordagem qualitativa, do tipo descritivo, de campo e transversal. A amostra estudada foi composta de oito enfermeiros, 22 técnicos e quatro auxiliares de enfermagem, totalizando 34 profissionais, sendo utilizado o instrumento de caracterização pessoal e profissional da equipe de enfermagem e o roteiro de entrevista semiestruturada. A amostragem foi proposital. A coleta de dados foi realizada através de entrevista semiestruturada, gravada e transcrita. As diretrizes metodológicas do Discurso do Sujeito Coletivo foram utilizadas para a seleção das ideias centrais e expressões-chave correspondentes, a partir das quais foram extraídos os discursos dos sujeitos, no cenário da instituição hospitalar. Resultados e Discussão: ao analisar o tema “significados de morte”, obtiveram-se as seguintes ideias centrais: “passagem”, “diversos significados”, “fim da vida” e “fim e começo de outra vida”. Conclusão: As concepções acerca do tema morte para os profissionais participantes deste trabalho reforça a necessidade de estudos sobre o tema durante a formação acadêmica. Certos de que irão vivenciar este tipo de situação no dia-a-dia profissional, é preciso prepará-los psicologicamente para isso.Palavras-chave: Morte, Equipe de enfermagem, Assistência ao paciente.ABSTRACTObjective: This study aimed to identify the meanings of emerging death of the nursing staff working in the Emergency Units and Intensive Care Unit (ICU) in a medium-sized entity located in southern Minas Gerais. Materials and methods: A cross-sectional qualitative field research. The sample was composed of 8 nurses, 22 technicians and 4 nursing assistants, totaling 34 professionals. It was used a tool of personal and professional characterization of the nursing team and a semi-structured interview. Sampling was intentional. Data collection was conducted through semi-structured interviews, that were recorded and transcribed. The methodological guidelines of the Collective Subject Speech were used for the selection of the central ideas and corresponding key expressions, from which the speeches of the subjects were taken, in the hospital setting. Results and discussion: to examine the topic "death meanings" yielded the following core ideas: "pass", "different meanings", "end of life" and "end and beginning of another life." Conclusion: The conceptions about the death theme for the professional participants of this study reinforces the need for studies on the subject during their academic training. It is certain that they will experience this type of situation on their daily professional routine, therefore there is a need to prepare them psychologically for this.Keywords: Death, Nursing staff, Patient care.

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BASAN index (Body mass index, Age, Sex, Arterial hypertension and Neck circumference) predicts severe apnoea in adults living at high altitude

BMJ Open ◽

10.1136/bmjopen-2020-044228 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044228

Author(s):

Henry Oliveros ◽

Rafael Lobelo ◽

Luis Fernando Giraldo-Cadavid ◽

Alirio Bastidas ◽

Constanza Ballesteros ◽

...

Keyword(s):

Body Mass Index ◽

Arterial Hypertension ◽

High Altitude ◽

Body Mass ◽

Sleep Apnoea ◽

Neck Circumference ◽

Binary Logistic Regression Model ◽

Cross Sectional ◽

Derivation Cohort ◽

Obstructive Sleep

ObjectivesObstructive sleep apnoea (OSA)/hypopnoea syndrome is associated with serious and major multiorgan morbidities, particularly in its most severe forms. However, no severe OSA screening instruments are available for high altitude residents that enable adequate identification and clinical prioritisation of such patients. We aimed at developing a severe OSA prediction tool based on the clinical characteristics and anthropometric measurements of a clinical referral cohort living at 2640 m.a.s.l.DesignCohort-nested cross-sectional study.SettingSleep laboratory for standard polysomnography (PSG) in Colombia.ParticipantsA predictive model was generated from 8718 participants referred to the PSG laboratory. Results were subsequently validated in a second cohort of 1898 participants.Primary outcomeTo identify clinical and anthropometric variables associated with severe OSA (>30 events/hour) and to include them in a binary logistic regression model.ResultsThe significant variables that were retained with the presence of severe OSA included Body mass index (BMI), Age, Sex, Arterial hypertension and Neck circumference (BASAN). The area under the receiver operating characteristic curvefor the BASAN index was 0.69 (95% CI: 0.68 to 0.70) in the derivation cohort and 0.67 (95% CI: 0.65 to 0.69) in the validation cohort, whereby a BASAN index ≥2 had a sensitivity of 95% and a specificity of 17% to detect severe OSA.ConclusionAn objectively based approach to screen for the presence of severe OSA, the BASAN index, exhibits favourable sensitivity characteristics that should enable its operational use as a screening tool in a Hispanic population with a clinical suspicion of OSA and living at high altitude.

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Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000514471 ◽

2021 ◽

pp. 1-11

Author(s):

Diego Urrunaga-Pastor ◽

Diego Chambergo-Michilot ◽

Fernando M. Runzer-Colmenares ◽

Josmel Pacheco-Mendoza ◽

Vicente A. Benites-Zapata

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

High Altitude ◽

Web Of Science ◽

Meta Analysis ◽

Cross Sectional ◽

Language Restriction ◽

Newcastle Ottawa Scale ◽

Meta Analyses ◽

Ottawa Scale

Introduction: Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. Methods: We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Results: Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, I2: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, I2: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, I2: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. Conclusions: The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

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Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/08919887211002640 ◽

2021 ◽

pp. 089198872110026

Author(s):

Sivan Klil-Drori ◽

Natalie Phillips ◽

Alita Fernandez ◽

Shelley Solomon ◽

Adi J. Klil-Drori ◽

...

Keyword(s):

Cognitive Assessment ◽

Cross Sectional Study ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Cognitive Screening ◽

Cross Sectional ◽

A Prospective Study ◽

Sectional Analysis ◽

State Examination ◽

Normal Cognition

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.

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