Neck Pain and Other Location Patterns in Episodic and Chronic Migraine: A Cross-Sectional Study

2020 ◽  
Author(s):  
Marco Antonio Takashi Utiumi ◽  
João Guilherme Bochnia Küster ◽  
Keryn Sporh Godk ◽  
Nikolai José Eustátios Kotsifas ◽  
Pedro André Kowacs ◽  
...  

Abstract Background: The pain location of migraine has limited diagnostic value and has usually been assessed using non-standard verbal descriptors.Methods: This study uses non-verbal descriptors of pain location in episodic and chronic migraineurs seen at 3 centers of different complexities (tertiary-level hospital and outpatient clinics) and from different sectors (public and private). The explicit pain location was recorded by asking patients to indicate in an electronic form 3 points on the anterolateral side and 3 points on the posterolateral side of the head and neck. A multivariate logistic regression model was fitted to assess the association of different pain location patterns with demographic and clinical variables.Results: Ninety-seven episodic migraine and 113 chronic migraine patients were included, with the most commonly affected sites being the frontal (73% and 65%, respectively), temporal (67% and 73%, respectively) and parietal (27% and 34%, respectively) regions. The posterior cervical site was most often involved in the chronic migraine group (21% vs. 33%, p=0.034). No other locations showed a significant difference. The adjusted model showed that diffuse pain (OR=13.74, CI=4.89-49.85) and the presence of medication overuse associated with tactile allodynia (OR=2.65, CI=1.05-6.87) were associated with increased odds of neck pain. Disease duration was marginally relevant (p=0.078).Conclusions: The migraine attacks most commonly involve the fronto-temporal regions, although neck pain can be more often found in chronic migraine. Some features commonly found in this group such as more diffuse pain, tactile allodynia, and medication overuse are associated with this extratrigeminal site of pain.

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Li Luo ◽  
Huan Zeng ◽  
Mao Zeng ◽  
Xueqing Liu ◽  
Xianglong Xu ◽  
...  

Abstract Background After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy. Methods A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies. Results No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9). Conclusions The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.


Cephalalgia ◽  
2014 ◽  
Vol 35 (8) ◽  
pp. 683-691 ◽  
Author(s):  
Marian Gómez-Beldarrain ◽  
Ane Anton-Ladislao ◽  
Urko Aguirre-Larracoechea ◽  
Isabel Oroz ◽  
Juan Carlos García-Moncó

Objective The objective of this article is to test the hypothesis that cognitive reserve (CR) is related to migraine chronification, medication overuse and poor quality of life in migraineurs. Design/methods A cross-sectional study on patients with chronic migraine with medication overuse (CM-MOH), episodic migraine (EM), and controls, matched by sex, age and education, was carried out. CR was assessed by a specific questionnaire, and quality of life was measured by general and specific questionnaires (SF-36 and MSQoL). Migraine Disability Assessment Scale and Beck questionnaires for depression and anxiety were used. Medication dependence was evaluated by the medication-dependence questionnaire in headache (MDQ-H). Results Fifty-five individuals were enrolled: 18 CM-MOH patients (32.73%), 22 EM patients (40%) and 15 controls (27.27%). Fifty (90.91%) of them were females and aged 43.53 (7.54) years. Univariate analysis showed a significant association between the study group and CR, and all items of the SF-36, anxiety and depression questionnaires, MSQoL and MDQ-H. The lower CR and CM-MOH group were related to a worse quality of life, more anxiety and depression and the highest medication dependence scores. Multivariate analysis showed that higher CR scores were related to higher quality of life as measured by the physical and mental composite scores of the SF-36, and to lower anxiety (beta = −1.08, p = 0.001) and depression (beta = −0.56, p = 0.03) levels. Focusing on MSQoL, the increase in CR was predictive of a better quality of life (beta = 1.88, p < 0.0001). By all the models, the explained variance of the sample ranged from 39% (mental composite score) to 58% (MSQoL). Conclusions Low CR appears to be an independent factor associated with the deterioration of quality of life, the presence of anxiety and depression, and drug dependence and medication overuse in CM-MOH.


2014 ◽  
Vol 37 (9) ◽  
pp. 641-646 ◽  
Author(s):  
Gabriela F. Carvalho ◽  
Thais C. Chaves ◽  
Maria C. Gonçalves ◽  
Lidiane L. Florencio ◽  
Carolina A. Braz ◽  
...  

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Eren Pek ◽  
Fatma Beyazit ◽  
Nilay Sen Korkmaz

Objectives: This study was conducted to evaluate the diagnostic value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in vaginitis patients. Methods: This cross-sectional retrospective study was performed in Afyon Dinar State Hospital between July 2016 to August 2017. A total of 64 bacterial vaginosis (BV) patients, 66 vulvovaginal candidiasis (VVC) patients and 65 age-matched control subjects were enrolled. NLR, PLR, mean platelet volume (MPV), red cell distribution width (RDW) and other conventional inflammatory marker values were recorded for all patients before and after treatment. Results: In the BV group, NLR values were found to be elevated compared to VVC and healthy controls [2.9 (1.2-14.7), 2.1 (1.1-11.7) and 2.1 (0.8-7.0), respectively] (p=0.008). Although not found to be statistically significant, the median NLR levels of BV patients decreased from 2.9 (1.2-14.7) to 2.4 (1.2-7.0) after treatment. PLR levels did not show a statistically significant difference between the three groups (p=0.970). The cut-off value of the NLR for BV was 2.19, with 67.2% sensitivity and 63.8% specificity. Conclusions: The present study demonstrated that NLR levels are elevated in bacterial vaginosis and NLR levels can be used as a reflection of systemic inflammatory response in vaginosis patients. doi: https://doi.org/10.12669/pjms.37.1.2774 How to cite this:Pek E, Beyazit F, Korkmaz NS. Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis. Pak J Med Sci. 2021;37(1):250-255. doi: https://doi.org/10.12669/pjms.37.1.2774 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 15 (11) ◽  
pp. 2846-2848
Author(s):  
Muhammad Salman Rashid ◽  
Qurat Ul Ain Manzoor ◽  
Irsam Haide ◽  
Aroosa Ashraf ◽  
Uzma Jabbar Khan ◽  
...  

Aim: To analyze prevalence of cervical spondylitis among dentists practicing in Lahore. Methods: A cross sectional survey of 6 months was conducted on 110 dentists practicing in dental clinics of Lahore were examined using neck disability index performa. SPSS Version 24 used for entering/analyzing the data. Results: In 110 individuals, 22% dentists including males (n=19%) and females (n=24.2%) were suffering from cervical spondylitis. According to neck disability index 34.5% had no disability, 47.2% had mild, 10.9% had moderate, 5.4% had severe disability and only 1.9% had complete disability. The major number (30%) was among 41-50years, and also statistically significant difference was observed (p-value = 0.02). Similarly maximum number of cervical spondylitis was found among females, 15(24.2%) but statistically insignificant difference was observed with respect to gender (p-value = 0.493). Longer practicing experience had also significant impact on the occurrence of spondylitis (p-value <0.001). Conclusion: Dentists are likely to have neck pain prevalent in them and very few had cervical spondylitis (22%) but the damage could be reduced if postural changes and regular exercises could be adapted. Keywords: Cervical Spondylitis, Neck Disability Index, Postural Changes


Cephalalgia ◽  
2013 ◽  
Vol 34 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Song Guo ◽  
Sarvnaz Shalchian ◽  
Pascale Gérard ◽  
Michael Küper ◽  
Zaza Katsarava ◽  
...  

Background It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication-overuse headache (MOH), one may wonder if they have a more severe form of the disorder and more frequently a PFO. Objective The objective of this study is to determine the prevalence and grade of RLS in patients suffering from CM and MOH. Methods A cross-sectional multicenter study of air-contrast transcranial Doppler was conducted in 159 patients with CM ( n = 57) or MOH ( n = 102) attending a tertiary headache clinic. Results The prevalence of RLS in CM was 37% (11% large shunts) and in MOH patients 31% (13% large shunts). There was no difference between the two groups ( p = 0.49). Conclusion RLS prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches.


Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3512-3521
Author(s):  
Sureeporn Uthaikhup ◽  
Marco Barbero ◽  
Deborah Falla ◽  
Munlika Sremakaew ◽  
Surat Tanrprawate ◽  
...  

Abstract Objectives The primary aim was to quantify and compare the location and extent of pain in people with either episodic migraine, chronic migraine, or cervicogenic headache. A secondary aim was to examine the associations between pain extent and headache features, quality of life, and psychological distress for each headache type. Design A cross-sectional, single-site, observational study. Setting Headache outpatient clinic. Subjects From a sample of 390 patients, 114 patients with migraine or cervicogenic headache (48 episodic migraine, 30 chronic migraine, 36 cervicogenic headache) were eligible for the study. Methods Pain location and extent were determined using a novel approach for digital pain drawing acquisition and analysis. Headache features included intensity and history duration. Quality of life was measured using the SF-36 and psychological distress using the Hospital Anxiety and Depression Scale. Results Overall, pain was most frequently reported in the frontal and temporal regions in patients with either episodic or chronic migraine, whereas pain was most frequent in the suboccipital region in patients with cervicogenic headache. A larger pain extent was moderately correlated with higher headache intensity (rs = 0.53, P = 0.003) and poorer quality of life (rs ranged from –0.36 to –0.40, P &lt; 0.05) in patients with chronic migraine, whereas pain extent was associated with longer headache duration in those with cervicogenic headache (rs = 0.35, P = 0.04). No correlation was found between pain extent and psychological features for any headache type (P &gt; 0.05). Conclusions Despite some differences, there was a large symptomatic overlap between headache types, highlighting the limitations of using pain location in the differential diagnosis of headache.


2016 ◽  
Vol 96 (10) ◽  
pp. 1576-1587 ◽  
Author(s):  
Karen V. Richards ◽  
Darren J. Beales ◽  
Anne J. Smith ◽  
Peter B. O'Sullivan ◽  
Leon M. Straker

Abstract Background There is conflicting evidence on the association between sagittal neck posture and neck pain. Objective The purposes of this study were: (1) to determine the existence of clusters of neck posture in a cohort of 17-year-olds and (2) to establish whether identified subgroups were associated with biopsychosocial factors and neck pain. Design This was a cross-sectional study. Methods The adolescents (N=1,108) underwent 2-dimensional photographic postural assessment in a sitting position. One distance and 4 angular measurements of the head, neck, and thorax were calculated from photo-reflective markers placed on bony landmarks. Subgroups of sagittal sitting neck posture were determined by cluster analysis. Height and weight were measured, and lifestyle and psychological factors, neck pain, and headache were assessed by questionnaire. The associations among posture subgroups, neck pain, and other factors were evaluated using logistic regression. Results Four distinct clusters of sitting neck posture were identified: upright, intermediate, slumped thorax/forward head, and erect thorax/forward head. Significant associations between cluster and sex, weight, and height were found. Participants classified as having slumped thorax/forward head posture were at higher odds of mild, moderate, or severe depression. Participants classified as having upright posture exercised more frequently. There was no significant difference in the odds of neck pain or headache across the clusters. Limitations The results are specific to 17-year-olds and may not be applicable to adults. Conclusion Meaningful sagittal sitting neck posture clusters were identified in 17-year-olds who demonstrated some differences with biopsychosocial profiling. The finding of no association between cluster membership and neck pain and headaches challenges widely held beliefs about the role of posture in adolescent neck pain.


Author(s):  
Masoud Esmaeili ◽  
Moein Soltanzade ◽  
Motahareh Kaboodsaz Yazdi

Introduction: Panoramic radiography is a valuable tool in the diagnosis of maxillofacial lesions, due to the visibility of all the teeth, alveolar bone and TMJ. This study was performed to evaluate the status of panoramic radiography in accordance with FDA rules in general dentists in Yazd in 2019. Methods: In this descriptive cross-sectional study, 170 general dentists (86 women and 84 men) working in Yazd in 2019 were completed questionnaires, including two parts: the first part consisted of demographic information( age, gender, number of years of graduation, university of Education), and the second part was specific questions in three areas: survey (28 questions), case introduction (6 cases) and diagnostic value (6 questions) about panoramic radiography. The collecting data were entered into SPSS software version 18 and analyzed using t-test and linear regression. Results: The mean score of the survey questions was 103/05±12/86, the mean score of case questions was 5/76±2/22 and the mean score of diagnostic value questions was 8/12±2/56, respectively. There was a significant difference between the mean score of diagnostic value questions in terms of participation in radiology retraining courses (p=0.016). There was a statistically significant relationship between the mean score of diagnostic value questions with the age of dentists (p=0.015) and the mean score of survey questions (p=0.029) and mean score of case questions (p=0.039) with the university of study. Conclusion Panoramic radiography prescriptions in general dentists working in Yazd, in some cases, do not comply with the FDA guidelines for prescribing panoramic radiography, and further training in this field seems necessary.


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