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1.
Neurology Perspectives ; 2021.
Article Dans Anglais | ScienceDirect | ID: covidwho-1199001

Résumé

RESUMEN Introducción: La pandemia ocasionada por la aparición del SARS-CoV-2, ha transformado la práctica médica y ha alterado gravemente la formación de los médicos residentes a nivel mundial. Desde la Sociedad Española de Neurología (SEN) se ha querido conocer el grado de repercusión que la COVID-19 ha tenido en el ámbito formativo entre los residentes de neurología. Método: Se realizó un estudio descriptivo transversal mediante el envío de una encuesta por e-mail a todos los residentes de neurología miembros de dicha Sociedad. Se incluyeron preguntas relativas a aspectos demográficos, actividad asistencial y repercusión a nivel formativo y personal durante la pandemia, así como su previsión sobre el futuro laboral “post-COVID”. Resultados: De 422 encuestas, respondió un total de 152 (36%) residentes, 79 mujeres (52%) y 73 hombres (48%). La distribución por año de residencia fue R4: 51 (33,6%), R3: 45 (29,6%), R2: 28 (18,4%) y R1: 28 (18,4%). La actividad de hospitalización se vio alterada en 139 (90,8%) casos. Consideraron que la situación afectaría negativamente a su formación 126 (82,8%) residentes, de los que 99 (64,7%) perdieron rotaciones no recuperables. Manifestaron deseo de alargar el periodo de residencia 101 (66%). Conclusiones: La pandemia ha tenido un gravísimo impacto en todo el sistema sanitario, siendo los médicos en formación uno de los colectivos más afectados. En los residentes de neurología ha provocado notables deficiencias de su actividad formativa y asistencial como consecuencia de la suspensión de rotaciones específicas. Un alto porcentaje manifestó deseo de ampliar el periodo de residencia. ABSTRACT Introduction: The COVID-19 pandemic has transformed medical practice and severely disrupted the training of medical residents worldwide. The Spanish Society of Neurology conducted a study to assess its impact on the training of neurology residents in Spain. Methods: We performed a descriptive, cross-sectional study through a survey distributed by e-mail to all neurology residents belonging to the Society. The survey included questions on demographic variables, care activity, and personal and educational impact of the pandemic, as well as respondents’ expectations for the future of their work in the post-pandemic era. Results: Of 422 surveys sent, we received a total of 152 responses (36%);79 respondents (52%) were women and 73 (48%) were men. By year of residency, 51 respondents (33.6%) were in the fourth year, 45 (29.6%) in the third year, 28 (18.4%) in the second year, and 28 (18.4%) in the first year. A total of 139 respondents (90.8%) reported changes in hospital activity, and 126 (82.8%) considered the situation to have had a negative impact on their training, with 99 (64.7%) having lost non-recoverable rotations. Sixty-six percent of respondents (n = 101) expressed a desire to extend their residency period. Conclusions: The pandemic has had an extremely severe impact on all areas of the health system, with trainee physicians being one of the most affected groups. Among neurology residents, the crisis has caused significant shortcomings in their training and clinical activities, through the suspension of specific rotations. A high percentage of respondents wished to extend the residency period.

2.
Neurol Sci ; 42(12): 5087-5092, 2021 Dec.
Article Dans Anglais | MEDLINE | ID: covidwho-1152023

Résumé

BACKGROUND: Face-to-face procedures have been postponed during COVID-19 pandemic. We aim to evaluate the impact of onabotulinumtoxinA follow-up delay in migraine during COVID-19 pandemic. METHODS: Subjective worsening, intensity of migraine attacks, and frequency of headache and migraine were retrospectively compared between patients with unmodified and interrupted onabotulinumtoxinA follow-up in Headache Units. RESULTS: We included 67 patients with chronic migraine or high-frequency episodic migraine under onabotulinumtoxinA treatment, 65 (97.0%) female, 44.5 ± 12.1 years old. Treatment administration was voluntarily delayed in 14 (20.9%) patients and nine (13.4%) were unable to continue follow-up. Patients with uninterrupted follow-up during lockdown presented 7.6 and 8.1 less monthly days with headache (adjusted p = 0.017) and migraine attacks (adjusted p = 0.009) compared to patients whose follow-up was interrupted, respectively. CONCLUSION: Involuntary delay of onabotulinumtoxinA follow-up in patients with migraine due to COVID-19 pandemic was associated with a higher frequency of headache and migraine attacks. Safe administration of onabotulinumtoxinA during lockdown should be promoted.


Sujets)
Toxines botuliniques de type A , COVID-19 , Migraines , Adulte , Maladie chronique , Contrôle des maladies transmissibles , Femelle , Études de suivi , Humains , Adulte d'âge moyen , Migraines/traitement médicamenteux , Migraines/épidémiologie , Pandémies , Études rétrospectives , SARS-CoV-2 , Résultat thérapeutique
3.
Pain Med ; 22(9): 2079-2091, 2021 09 08.
Article Dans Anglais | MEDLINE | ID: covidwho-1117434

Résumé

OBJECTIVE: Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine. DESIGN: Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020. METHODS: We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress. RESULTS: The response rate of the survey was 239/324 (73.8%). The final analysis included 222 subjects. Among them, 201/222 (90.5%) were women, aged 42.5 ± 12.0 (mean±SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0%), while worsening in 105/222 (47.3%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3%) and was related to symptoms of post-traumatic stress, older age and living with five or more people. CONCLUSIONS: Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown.


Sujets)
COVID-19 , Migraines , Adulte , Contrôle des maladies transmissibles , Femelle , Humains , Mâle , Adulte d'âge moyen , Migraines/épidémiologie , Études rétrospectives , SARS-CoV-2
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