scholarly journals Overview of hospital admissions for migraine and other cephalic pain syndromes in Brazil and regions, 2015 to 2019

2021 ◽  
Author(s):  
Nathália Moreira de Almeida França ◽  
Bárbara Araújo Bonfim ◽  
Mateus Ribeiro de Almeida ◽  
Kátia de Miranda Avena

INTRODUCTION: Headache is defined as a pain in the cephalic segment, and is the fourth cause of demand for emergency care. In Brazil, 98% of women and 95% of men will suffer some episode during their lives. It causes physical, social, labor, and economic damage, and is the third leading cause of years lived with disability. Thus, it is relevant to investigate hospital admissions for migraine and other cephalic pain syndromes. OBJECTIVES: To analyze hospital morbidity due to migraine and other cephalic pain syndromes in Brazil between 2015 and 2019. METHODS: Epidemiological, retrospective, descriptive study, carried out through the Hospital Information System (DATASUS). Variables: sex, ethnicity, age, hospital stay, costs and deaths. RESULTS: Registered 49,508 hospitalizations for migraine and other cephalic pain syndromes from 2015-2019; predominantly women (65.7%), between 20-39 years (37.3%), 40-59 years (29.4%), which occurred mainly in the Southeast (33.1%) and South (23.6%) regions. The average cost per hospitalization was R$ 421.50. The mean hospital stay was 3.9 days, ranging from 3.1 days in the South to 4.8 days in the Northeast, with no differences between genders. There were 384 deaths, of which 56.3% were women. CONCLUSION: The morbidity profile due to cephalic pain syndromes is composed of women, aged 20-39 years, living in the Southeast region. It is important to intensify investments in prevention, diagnosis and treatment, seeking to reduce hospitalizations, the impact on the health system and to improve the patient’s quality of life.

Trauma ◽  
2021 ◽  
pp. 146040862094972
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory ◽  
Gavin Gordon ◽  
Fiona Smith ◽  
Andrew Jennings

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.


2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Richard M Elias ◽  
Karen M Fischer ◽  
Mustaqeem A Siddiqui ◽  
Trevor Coons ◽  
Cindy A Meyerhofer ◽  
...  

Previous studies show that patient complaints can identify gaps in quality of care, but it is difficult to identify trends without categorization. We conducted a review of complaints relating to admissions on hospital internal medicine (HIM) services over a 26-month period. Data were collected on person characteristics and key features of the complaint. The complaints were also categorized into a previously published taxonomy. Seventy-six unsolicited complaints were identified, (3.5 per 1000 hospital admissions). Complaints were more likely on resident services. The mean duration between encounter and complaint was 18 days, and it took an average of 12 days to resolve the complaint. Most patients (59%) had a complaint in the Relationship domain. Thirty-nine percent of complaints mentioned a specific clinician. When a clinician was mentioned, complaints regarding communication and humaneness predominated (68%). The results indicate that the efforts to reduce patient complaints in HIM should focus on the Relationships domain.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mina Pakkhesal ◽  
Elham Riyahi ◽  
AliAkbar Naghavi Alhosseini ◽  
Parisa Amdjadi ◽  
Nasser Behnampour

Abstract Background Childhood dental caries can affect the children’s and their parents’ oral health-related quality of life. The aim of the present study was to evaluate the impact of oral and dental health conditions on the oral health-related quality of life in preschool children and their parents. Methods In this descriptive-analytical cross-sectional study, samples were selected from children 3 to 6 years old enrolled in licensed kindergartens using "proportional allocation" sampling. Then, the parents of the children were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS). Results In this study, 350 children aged 3 to 6 years were evaluated with a mean age of 4.73 years. The mean dmft index (decayed, missed, and filled teeth) was 3.94 ± 4.17. The mean score of oral health-related quality of life was 11.88 ± 6.9, which 9.36 ± 5.02 belongs to the impact on children and 2.52 ± 3.20 to parents' impact. Conclusions The mean score of ECOHIS increased with the dmft index increase in children, indicating a significant relationship between the dmft and ECOHIS score. These outcomes can be used as proper resources to develop preventive policies and promote oral health in young children.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.


2021 ◽  
pp. 25-27
Author(s):  
Umesh kr. Mishra ◽  
Sunita Tiwari ◽  
Sumit Rungta ◽  
Pooja Mishra ◽  
Gulam Akhtar

Background: Night time reux has been shown to be associated with fragmented sleep. However, few studies have assessed the quality of sleep on gastroesophageal reux and the impact of gastroesophageal reux on reported quality of sleep and quality of sleep on gastroesophageal reux. The aims of this study were to evaluate the quality of sleep and other parameters in patients with gastroesophageal reux disease.50 Subjects with typical GERD symptoms ≥3 times a week and All subjects were administered 3 questionnaires: PSQI , ESS, GERD-HRQL . All the subjects underwent nocturnal polysomnography and completed a all 3 questionnaire before NPSG. Results: Overall ,the mean percentage of N1 was 9.10±9.74 ,N2 was 83.97±13.81 , N3 was 3.44±4.16 , N4 was 0.60±2.04 , REM was 2.14±3.79 , PSQI was 12.48±1.23 , ESS was 11.80±0.76 , TST (hr) was 5.19±0.74 , SPT(hr) was 6.58±0.77 , sleep efciency(%) was 52.50±27.16 , Latency (mint) was 22.79±30.85 , REM Latency (mints) was 96.99±151.86 ,and Microarousal index was 36.05±25.93 . To assess the potential impact of sleep quality via nocturnal polysomnography on severity of gastroesophageal reux , we performed correlations between the GERD questionnaire and nocturnal polysomnography reports . We observed that PSQI(r= -0.285, p<0.045) , ESS(r=0.206, p=0.05) , N1(r=0.202 , p>0.160) , N2(r=- 0.045 ,p>0.758) , N3(r=-0.079, p>0.583) , N4(r-0.209 ,p>0.145),REM(r=0.045 ,p>0.756) , TST(r=0.036 ,p>0.803), SPT(r=0.015,p>0.917) , Sleep Efciency (r=-0.113,p>0.435) , Sleep Latency (r=-0.045 ,p>0.756), REM Latency (r=0.165, p >0.253), Microarousal index (r=0.058 , p>0.683). Conclusions: Gastroesophageal reux disease and sleep disorders are extremely prevalent conditions, and it seems intuitive that there must be some overlap between the two. Sleep disorders may in fact be one of the most prevalent of the extraesophageal complications of GERD and often goes unrecognized.


2021 ◽  
Vol 12 (4) ◽  
pp. 462-463
Author(s):  
Kaoutar Sof ◽  
Soraya Aouali ◽  
Sara Bensalem

Sir, Dermatological pathologies may be responsible for the creation of a real handicap, affecting the patient’s self-esteem and their professional and social life. The aim of this study was to assess the impact of diseases on the quality of life of patients hospitalized at the dermatology department. The following was a retrospective study that included patients over eighteen years of age, hospitalized at the dermatology department of Hospital Mohammed VI in Oujda from January 2018 through December 2019. The Arabic version of the validated DLQI was used for all patients [1]. A total of 294 patients were collected, with a mean age of 53.95 years and a male-to-female ratio of 0.85. The most frequent reasons for hospitalization were infectious dermo-hypodermitis (n = 51), autoimmune bullous dermatosis (n = 23), severe drug eruption (n = 20), genodermatosis (n = 17), melanocytic (n = 9) and non-melanocytic skin tumors (n = 17), severe psoriasis (n = 17), cutaneous lymphoma (n = 11), alopecia areata (n = 10), dermatomyositis (n = 8), and Verneuil’s disease (n = 5). The DLQI was impossible to calculate in eleven patients. The mean DLQI in all patients was 10.20, corresponding to a moderate effect on quality of life. The mean DLQI was as follows: Verneuil’s disease at 17.4, severe psoriasis at 16.6, dermatomyositis at 14.42, genodermatosis at 12.37, cutaneous lymphoma at 11.45, severe drug eruption at 11, alopecia areata at 10.5, AIBD at 9.67, skin tumors at 7.76, and infectious dermo-hypodermitis at 7.52. The DLQI was the first index measuring quality of life in dermatology and is still widely used today[2]. The number of publications concerning the impact of dermatological pathologies on quality of life has increased in recent years [3]. Our results showed that the DLQI was higher in patients with Verneuil’s disease, severe psoriasis, and dermatomyositis. These results agree with the data of the literature, many publications have shown that psoriasis seriously impaired the quality of life and was responsible of social anxiety in patients [4]. Verneuil’s disease is also responsible of a significant impairment on quality of life mainly due to the sexual disorders caused by this pathology [5]. Another study on dermatomyositis showed that there is a significant correlation between the severity of skin signs and the quality of life of patients [6]. Dermatological pathologies are distinguished from other pathologies by their displaying character, which is responsible for a significant impact on the patient’s quality of life. The management of dermatology patients requires psychological support in addition to conventional therapy. However, these pathologies are still not recognized as long-term illnesses in Morocco.


2021 ◽  
pp. 1-6
Author(s):  
Shivani Saini ◽  
◽  
Agarwal Shail ◽  
Jain Manish ◽  
Yadav Devendra ◽  
...  

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications


2018 ◽  
Vol 4 (2) ◽  
pp. 129
Author(s):  
Nadya Puspita Dewi ◽  
Tetti Solehati ◽  
Nur Oktavia Hidayati

Dysmenorrhea is a pain before or during the menstrual period. The impact of dysmenorrhea are the disruption on physical function, emotional, social and school activities and disruption of quality of life. The study purpose is to detect the quality of life of adolescents with dysmenorrhea.The research method was a quantitative descriptive with total sampling technique to 195 students which selected using dysmenorrhea screening. The data were collected using the pediatric quality of life 4.0 generic module (PedsQL) teens report in Indonesian version which the validity and reliability have been tested. Analysis of data has been done to find out the mean value in each dimension and frequency distribution. The results showed that the mean value of the quality of life of adolescents with dysmenorrhea in general was 62,04 ± 8,15 and 51,8% was in the low. The mean value in physical dimension was 49,36 ± 9,19, emotional dimension was 57,62 ± 13,16, social dimension was 86,38 ± 13,28, and in the school dimension was 62,41 ± 14,77. The quality of life in high categories were in the emotional dimension (60,0%), social dimension (64,1%), and school dimension (60,5%). Meanwhile, the quality of life in low category was in the physical dimension (57,4%). It showed that the quality of life of adolescents with dysmenorrhea in SMK Negeri 2 Sumedang were low. It was recommended to the school and the health office in Sumedang district to provide the reproductive health education, specifically about the prevention and the treatment of dysmenorrhea on adolescents.  


2020 ◽  
Vol 34 (5) ◽  
pp. 567-573
Author(s):  
Roberta Rowntree ◽  
Sean Murray ◽  
Felicity Fanning ◽  
Dolores Keating ◽  
Atilla Szigeti ◽  
...  

Background: One-third of individuals with schizophrenia have treatment-resistant illness. Of these, up to 60% will respond to clozapine treatment. Aims: This study retrospectively examined clozapine prescribing patterns against National Institute for Health and Care Excellence (NICE) guidelines as treatment-resistant illness emerged in a first-episode psychosis cohort. Methods: A total of 339 individuals with a first-episode psychosis were included in the study. Clozapine prescribing patterns were compared against the NICE guidelines and the impact of clozapine use on one index of service utilisation (hospitalisation) was assessed. Results: A total of 32 individuals (9.4%) from the cohort were prescribed clozapine. The mean time to clozapine trial was 2.1 years (SD 1.95; range 0.17–6.25). The mean number of adequate trials of antipsychotic prior to starting clozapine was 2.74 (SD 1.13; range 1–5). Following clozapine initiation, mean hospital admissions per year reduced from 2.3 to 0.3 ( p=0.00). Mean hospital days pre- and post-clozapine also reduced (147 vs. 53; p=0.00). In total, 18 patients discontinued clozapine use during follow-up – 5 temporarily and 13 permanently. Conclusions: Patients are being prescribed clozapine earlier than previously demonstrated, though delays are still evident, and many patients discontinue treatment. More work needs to be undertaken to understand and address factors which lead to its discontinuation.


2018 ◽  
Vol 3 (1) ◽  
pp. 644-651
Author(s):  
A.O. Adekiya ◽  
C.M. Aboyeji ◽  
T.M. Agbede ◽  
O. Dunsin ◽  
O.T.V. Adebiyi

Abstract Micro-nutrients especially zinc can not only increase the yield of sweet potato but can also improve the quality of tubers. Hence, experiments were carried out in 2015 and 2016 cropping seasons to determine the impact of various levels of ZnSO4 fertilizer on soil chemical properties, foliage and storage root yields and proximate qualities of sweet potato (Ipomoea batatas L.). The experiments consisted of 5 levels (0, 5, 10, 15 and 20 kg ha-1) of ZnSO4 fertilizer. These were arranged in a randomized complete block design and replicated three times. ZnSO4 increased (with the exception of P) soil chemical properties compared with the control. N, K, Ca, Mg and Zn were increased up to the 20 kg ha-1 ZnSO4 level in both years. ZnSO4 reduced P concentrations in soil as the level increased. For sweet potato performance, 5 kg ha-1 ZnSO4 fertilizer had the highest values of foliage yield (vine length and vine weight) and storage root yield. Using the mean of the two years and compared with the control, ZnSO4 fertilizer at 5 kg ha-1 increased storage root yield of sweet potato by 17.4%. On fitting the mean storage root yield data of the two years with a cubic equation, the optimum rate of Zn for sweet potato was found to be 3.9 kg ha-1 to achieve the maximum sweet potato yield. In this study, relative to the control, ZnSO4 fertilizer increased moisture and decreased the fibre contents of sweet potato. There were no consistent patterns of variation between the 5, 10, 15 and 20 kg ha-1 ZnSO4 treatments for proximate qualities except that the highest values of fat, protein, carbohydrate and ash was at 5 kg ha-1 ZnSO4.


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