ABSTRACT
Introducción. El ictus es una de las principales causas de invalidez y mortalidad en nuestra sociedad, con importantes repercusiones socioeconómicas y sanitarias. La asistencia precoz puede mejorar el pronóstico de los pacientes. Actualmente, existen tratamientos en fase aguda, que consiguen reperfundir el tejido isquémico en riesgo y revertir la sintomatología, pero son pocos los pacientes que se benefician, por el retraso en su atención, debido a la falta de reconocimiento de los síntomas y la escasa percepción de gravedad. Objetivo. Analizar el conocimiento de la población de nuestra área de salud sobre el ictus. Sujetos y métodos. La muestra analizada ha sido la población del sector III de la provincia de Zaragoza, con selección aleatoria. La herramienta utilizada ha sido una encuesta telefónica estructurada (total de 583). Resultados. Un 63,5% de los encuestados desconoce los síntomas del ictus, y un 48%, los factores de riesgo vascular. Sólo un 9% reconoce al menos dos síntomas y dos factores de riesgo. En cuanto a la actitud, un 56% actuaría correctamente frente a un 44% que no. El análisis multivariante mostró que los factores más relacionados con el conocimiento fueron el nivel cultural y la edad joven. Vivir en un pueblo y sexo femenino se relacionaron con la mejor actitud. Conclusiones. El conocimiento del ictus es escaso, con una baja percepción de urgencia. Los factores que implican un mejor conocimiento son la edad joven y el nivel cultural alto (AU)
Introduction. Acute cerebrovascular disease is a major cause of disability and mortality, with important socio-economic and health impacts. Early stroke care can reduce mortality and improve prognosis. Right now, we can apply treatments in the acute phase, with capacity to reverse the symptoms, but few patients who benefit not reach the hospital soon. One reason for this delay is the lack of recognition of symptoms and poor perception of gravity. Aim. To find out the knowledge of the public about the stroke. Subjects and methods. The sample analyzed was the population of Sector III of Zaragoza, with random selection. The tool used was a telephone survey structured. We analyzed 583 surveys. Results. 63.5% of respondents did not know any symptoms of stroke. 48% do not know any vascular risk factor. Only 9% recognized at least two symptoms and two risk factors. Regarding the attitude, 56% act properly against 44% who do not. Multivariate analysis showed that the factors more related to knowledge are the cultural level and young age. Living in town, and female, they are associated with the best attitude. Conclusions. Knowledge about stroke is poor, with a low sense of urgency. The factors most associated with the best knowledge are young age and cultural level (AU)
Subject(s)
Humans , Cerebrovascular Disorders , Stroke , Health Knowledge, Attitudes, Practice , Delayed Diagnosis/statistics & numerical data , Emergency Treatment , Health Care Surveys/statistics & numerical dataABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Neuralgia/diagnosis , Carcinoma, Hepatocellular/diagnosis , Neuroimaging , Occipital Lobe/physiopathology , Tomography, X-Ray ComputedABSTRACT
Introducción. La cefalea como síntoma es una patología frecuente y uno de los principales motivos de consulta por parte de atención primaria. Objetivo. Analizar las características de los pacientes derivados desde atención primaria a la consulta de neurología general con cefalea o neuralgia como motivo de consulta, y la concordancia diagnóstica. Pacientes y métodos. Estudio descriptivo transversal de todos los pacientes remitidos desde atención primaria; se recogieron variables demográficas/clínicas y se compararon las hipótesis diagnósticas de atención primaria y neurología, determinando su concordancia. Resultados. Se remitieron desde atención primaria 2.514 pacientes (588 de ellos con carácter preferente); en 378 casos el motivo de la consulta fue cefalea o neuralgia (42,46 años de media; el 77,8%, mujeres). En 139 pacientes se estableció tan sólo un diagnóstico semiológico y en el resto predominaron la migraña episódica (49,79%), la cefalea tensional crónica (18,41%) y la neuralgia del trigémino (12,13%). Desde neurología, los diagnósticos más frecuentes fueron, respectivamente, 33,86%, 24,05% y 18,67%. Se obtuvo un coeficiente kappa de 0,543 (p < 0,05), compatible con una concordancia moderada al considerar sólo los pacientes remitidos desde atención primaria con un diagnóstico concreto. Conclusiones. Las cefaleas constituyen un motivo de consulta desde atención primaria muy frecuente (15%). La concordancia diagnóstica es moderada en nuestro sector sanitario, por lo que es necesario diseñar programas de formación que ayuden a perfilar los criterios de derivación al especialista y mejorar la atención a nuestros pacientes (AU)
Introduction. Headache as a symptom is a very common disease and one of the main reasons for consultation in primary care. Aim. To analyze the characteristics of patients referred from primary care to general neurology whose chief complaint was headache and/or neuralgia and diagnostic agreement. Patients and methods. Cross-sectional study of all patients referred from primary care; demographic/clinical variables were collected and diagnostic hypothesis by primary care and general neurology were compared by determining their agreement. Results. 2,514 were referred from primary care patients (588 of them on a preferential basis); in 378 cases the reason for consultation was headache and/or neuralgia (average 42.46 years; 77.8% female). In 139 patients it was established only a semiological diagnostic and other episodic migraine predominated (49.79%), chronic tension headache (18.41%) and trigeminal neuralgia (12.13%). Since general neurology, the most common diagnoses were, respectively, 33.86%, 24.05% and 18.67%. A compatible kappa coefficient of 0.543 (p < 0.05) with a moderate agreement when considering only those patients referred from primary care to a specific diagnosis was obtained. Conclusions. Headaches are a very common reason for consultation in primary care (15%). The diagnostic agreement is moderate in our health sector so it is necessary to design training programs to help outline the criteria for referral to specialists and improve care for our patients (AU)
Subject(s)
Humans , Male , Female , Headache/diagnosis , Neurology/methods , Primary Health Care/methods , Migraine Disorders/diagnosis , Migraine Disorders/epidemiology , Tension-Type Headache/complications , Tension-Type Headache/diagnosis , Cross-Sectional Studies/methods , Cross-Sectional Studies/trends , Trigeminal Neuralgia/complications , Migraine without Aura/complications , Migraine without Aura/diagnosisABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Giant Axonal Neuropathy/etiology , Guillain-Barre Syndrome/complications , Vertebroplasty , Spinal Fractures/surgery , Risk FactorsSubject(s)
Guillain-Barre Syndrome/etiology , Postoperative Complications/etiology , Vertebroplasty , Accidental Falls , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Female , Guillain-Barre Syndrome/diagnosis , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Isoxazoles/adverse effects , Isoxazoles/therapeutic use , Leflunomide , Middle Aged , Osteoporosis/complications , Postoperative Complications/immunology , Prednisone/adverse effects , Prednisone/therapeutic use , Spinal Fractures/surgery , Thoracic Vertebrae/injuries , Thoracic Vertebrae/surgeryABSTRACT
Introducción. Los pacientes con migraña crónica refieren frecuentemente un menor rendimiento cognitivo, lo que interfiere en su calidad de vida. Objetivo. Analizar si existe alteración en la capacidad ménsica de los pacientes con migraña crónica. Sujetos y métodos. Estudio transversal en pacientes con migraña crónica valorados de forma consecutiva en nuestra unidad, pareados en edad (18-60 años) y sexo con un grupo control constituido por voluntarios cognitivamente sanos. Se administraron los siguientes instrumentos cognitivos: test minimental de Folstein (MMSE), test de alteración de memoria (T@M), evaluación cognitiva de Montreal (MoCA) y memoria de trabajo. Resultados. Se incluyó un total de 30 pacientes con migraña crónica (edad media: 49,33 ± 10,05 años) pareados con un grupo control de 30 voluntarios sanos (edad media: 44,83 ± 10,91 años). El tiempo medio de evolución de los pacientes con migraña crónica fue de 4,47 ± 2,74 años. Al realizar el análisis comparativo entre ambos grupos, se encontraron diferencias significativas con puntuaciones más bajas de forma global en el grupo de pacientes con migraña crónica en el test de MoCA (24,16 frente a 29), T@M (43,76 frente a 48,8) y memoria de trabajo (17,5 frente a 24,26). El rendimiento en el MMSE fue similar en ambos grupos. Conclusiones. Los pacientes con migraña crónica pueden tener un menor rendimiento cognitivo independientemente de elementos distractores, como el farmacológico o la comorbilidad psiquiátrica, dado que la migraña crónica puede entenderse como un elemento más dentro del espectro del dolor crónico (AU)
Introduction. Patients with chronic migraine often report lower cognitive performance, which affects their quality of life. Aims. To analyse whether the mnemonic capacity of patients with chronic migraine is altered or not. Subjects and methods. A cross-sectional study was conducted in patients with chronic migraine evaluated consecutively in our unit, and paired by age (18-60 years) and gender with a control group consisting of cognitively healthy volunteers. The following cognitive instruments were administered: Folstein Minimental State Examination (MMSE), Memory Alteration Test (M@T), Montreal Cognitive Assessment (MoCA) and working memory. Results. A total of 30 patients with chronic migraine were included (mean age: 49.33 ± 10.05 years) paired with a control group of 30 healthy volunteers (mean age: 44.83 ± 10.91 years). The mean elapsed time since onset of the patients with chronic migraine was 4.47 ± 2.74 years. On performing a comparative analysis between the two groups, significant differences were found with overall lower scores in the group of patients with chronic migraine in the MoCA (24.16 versus 29), M@T (43.76 versus 48.8) and working memory tests (17.5 versus 24.26). Performance in the MMSE was similar in both groups. Conclusions. Patients with chronic migraine can have lower cognitive performance regardless of distracting elements, such as pharmacological factors or psychiatric comorbidity, since chronic migraine can be understood as yet another element within the spectrum of chronic pain (AU)
Subject(s)
Humans , Memory Disorders/epidemiology , Cognition Disorders/epidemiology , Migraine Disorders/complications , Cross-Sectional Studies , Drug Overdose/complications , Headache Disorders, Secondary/epidemiology , Analgesics/therapeutic useSubject(s)
Migraine Disorders/physiopathology , Wind , Emergency Service, Hospital/statistics & numerical data , Headache/epidemiology , Hospitals, University/statistics & numerical data , Humans , Meteorological Concepts , Migraine Disorders/epidemiology , Migraine Disorders/etiology , Spain/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Climate Change , Migraine Disorders/epidemiology , Risk Factors , Age and Sex DistributionABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Herpesvirus 7, Human/pathogenicity , Roseolovirus Infections/complications , Cranial Nerves , Facial Neuralgia/etiologyABSTRACT
BACKGROUND: It has been proposed that desaturation of oxygen during an apnea event is the trigger for cluster headache. Obstructive sleep apnea has been associated with a higher than normal cardiovascular morbidity and mortality. Some obstructive sleep apnea syndrome patients lack the sleep-related, nocturnal decrease, or "dip" in blood pressure, which is seen in normal individuals. OBJECTIVE: The aim of this study is to assess whether this non-dipper pattern is present in cluster headache patients. DESIGN AND METHODS: A total of 30 normotensive cluster headache patients underwent an ambulatory blood pressure monitoring. "Non dippers" were defined as patients with a nighttime mean blood pressure fall <10%. RESULTS: Fifteen cluster headache patients (50%) were non-dippers, a frequency higher than expected. The pattern of nocturnal non-dipping is associated with a higher body mass index. Non-dipper patients displayed higher mean nighttime systolic and diastolic blood pressure. No significant difference was observed in the mean 24-hour and daytime blood pressure. CONCLUSIONS: The high incidence (50%) of non-dipper pattern in both processes, cluster headache and obstructive sleep apnea syndrome, provides support for the hypothesis of a relationship between theses 2 disorders.
Subject(s)
Circadian Rhythm , Cluster Headache/complications , Cluster Headache/physiopathology , Hypertension/complications , Hypertension/physiopathology , Adult , Blood Pressure Monitoring, Ambulatory , Circadian Rhythm/physiology , Cluster Headache/epidemiology , Humans , Hypertension/epidemiology , Male , Middle Aged , Sleep Apnea Syndromes/diagnosis , Sleep Apnea Syndromes/epidemiology , Sleep Apnea Syndromes/physiopathologyABSTRACT
No disponible
No disponible