High Brachial Bifurcation: Clinical Implications for Arteriovenous Access

High Brachial Bifurcation is not an uncommon arterial variation occurring in up to 10% of patients undergoing AVFs. It is associated with higher rate of failure or intervention, statistically significant in this study. Patients with this variation need careful consideration in planning arteriovenous access.

Factors associated with academic performance of physical therapy students / Factores asociados con el rendimiento académico de los estudiantes de terapia física

Understanding the pre-matriculation factors that influence academic success facilitates the recruitment and retention of students who are more likely to graduate on time. OBJECTIVE: To determine the factors associated with the academic performance of students enrolled in the physical therapy diploma programme. METHODS: Records of 250 students enrolled over a twenty-year period at the School of Physical Therapy were reviewed. Data were collected and organized using a data collection sheet. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Relationships between the independent variables: age, gender, marital status, work history and entry qualifications, and the dependent variables: academic performance (percentage of subjects passed at the first sitting of examinations and success in the Final Qualifying Examination), withdrawal and delayed graduation were examined using correlation coefficient, t-test, ANOVA and chi-square as appropriate. RESULTS: Results revealed that students gaining the minimum entry qualifications at one sitting of GCE O' Level/CXC examinations (p < 0.01) and who had GCE A' Level passes (p < 0.05) were less likely to withdraw from the programme. Students without prior work experience performed better during the course of study (p < 0.05) but the older and married students were more likely to withdraw (p < 0.01). Older students performed better on the Final Qualifying Practical and Theory Examinations taken at the end of the academic programme (p < 0.05) but had a lower percentage of subjects passed at the first sitting of course examinations (p < 0.05). CONCLUSION: Students with better academic preparation demonstrated better academic performance. These findings were consistent with prior studies in the field.

La comprensión de los factores de pre-matrícula que influyen en el éxito académico, facilita la captación y retención de los estudiantes que tienen mayor probabilidad de graduarse a tiempo. OBJETIVO: Determinar los factores asociados con el rendimiento académico de los estudiantes matriculados en el programa de diploma de terapia física. MÉTODOS: Se revisaron las historias de 250 estudiantes de la Escuela de Terapia Física, correspondientes a un período de 20 años. Los datos fueron recogidos y organizados mediante hojas de recogida de datos. Los datos fueron entonces analizados utilizando el llamado Paquete Estadístico para las Ciencias Sociales (SPSS). Utilizando el coeficiente de correlación, la prueba t, análisis de la varianza (ANOVA), y chi-cuadrado según fuera apropiado, se examinaron las relaciones entre las variables independientes de edad, género, estado civil, historia de trabajo y requisitos de ingreso, así como las variables dependientes: rendimiento académico (por ciento de asignaturas aprobadas en la primera convocatoria de exámenes y éxito en el examen de calificación final), abandono del curso, y graduación diferida. RESULTADOS: Los resultados revelaron que los estudiantes con las calificaciones mínimas de ingreso en los exámenes de CXC y de nivel GCE O (p < 0.01), y nivel GCE A aprobado (p < 0.05) presentaban una probabilidad menor de abandonar el programa. Los estudiantes con experiencia de trabajo anterior tuvieron un mejor desempeño durante el programa de estudios (p < 0.05), en tanto que los estudiantes casados o de mayor edad mostraron una mayor tendencia a abandonar los estudios (p < 0.01). Los estudiantes mayores tuvieron mejores resultados en el examen práctico de calificación final y los exámenes teóricos al final del programa académico (p < 0.05), pero tuvieron un por ciento menor de aprobados en la primera convocatoria de exámenes (p < 0.05). CONCLUSIÓN: Los estudiantes con mejor preparación académica demostraron mejor rendimiento académico. Estos resultados concuerdan con estudios anteriores en este campo.

New migraine preventive options: an update with pathophysiological considerations

BACKGROUND: The pharmacological treatment of migraine may be acute or preventive. Frequent, severe and long-lasting migraine attacks require prophylaxis. Multiple threads of research over the last 15 years have led to the concept that migraine is generated from a hyperexcitable brain. A variety of causes for hyperexcitability of the brain in migraine have been suggested. These causes include low cerebral magnesium levels, mitochondrial abnormalities, dysfunctions related to increased nitric oxide or the existence of a P/Q type calcium channelopathy. The better knowledge about migraine pathophisiology led us to discuss new treatment options. OBJECTIVES: The aim of the present study is to present an evidence-based review of some new drugs or some agents that even though available for a long time, are not frequently used. METHODS/RESULTS: We present a review of anticonvulsants with various mechanisms of action such as lamotrigine, gabapentin, topiramate, tiagabine, levetiracetam and zonisamide. We also review natural products, like riboflavin and magnesium, botulinum toxin A, a specific CGRP antagonist and the anti-asthma medication montelukast, with pathophysiological discussion. CONCLUSIONS: We aimed to present an update of newer or less frequently used preventive migraine therapies, drugs that might reduce the burden and the costs of a disease that should be considered as a public health problem all around the world

Hemicrania continua: a report of ten new cases

Hemicrania continua (HC) is an uncommon primary headache first described as a syndrome in 1984. Being quite unusual, its clinical characterization still demands better description. The aim of this study is to present the main clinical characteristics of 10 patients with the diagnosis of HC seen in a tertiary center, critically discussing their main features. All subjects had strictly unilateral headache without side shift and absolute response to indomethacin. Seven patients (70 percent) presented autonomic features during pain exacerbations. Four (40 percent) had migrainous symptoms during the exacerbations and one presented partial relief with dihydroergotamine. One patient had pain excruciatingly severe during the exacerbations. Although the cardinal features of HC - continuous, unilateral, indomethacin responsive, remain strongly reliable, a refinement on the clinical characterization is needful and desired