Frequency of headache in the medical students of Santa Catarina's Federal University.

Studies in well-defined populations are useful in identifying factors that influence frequency and severity of headache and in understanding its impact on people. The aims of this study were to determine the frequency of headache in the medical students of Santa Catarina's Federal University, examine associated factors, verify the diagnostic impressions of the different types of headache, and describe the self-medication level. This study included 408 medical students who were interviewed by a questionnaire from October 1997 to August 1998. The frequency of headache in this group was 33%, with women and students in the five last semesters of the medical course experiencing increased headache frequency. The diagnostic impressions of the different types of headache were migraine without aura (31.3%), migraine with aura (8.2%), episodic tension-type headache (32.1%), chronic tension-type headache (7.5%), and tension-type headache combined with migraine without aura (3%). Self-medication was reported by 51.8% of the medical students with headache; 34.4% used prescribed medications. The most common self-help techniques used by students during a headache were to lie down or isolate themselves from their surroundings.

[Acute myocardial infarction diagnosis. The value of serum myoglobin levels, compared with creatine kinase MB fraction]. / Diagnóstico do infarto agudo do miocárdio. Valor da dosagem de mioglobina sérica comparada com a creatinofosfoquinase e sua fração MB.

PURPOSE: To compare the diagnostic performance of two traditional plasma markers of myocardial infarction (MI), creatine kinase (CK) and its MB fraction (CK-MB), with plasma myoglobin (Mgb) levels, for the diagnosis of MI. METHODS: From September of 94 to February of 95, in an observational, prospective, and non-controlled fashion, 64 patients admitted to a cardiology emergency room (ER), with non-traumatic chest pain were studied. Patients presenting with more than 6 h after the onset of symptoms, muscular trauma, cardiopulmonary resuscitation and renal insufficiency were not included. Definitive MI diagnosis was established if the patient had at least two of the three classic MI findings: ischemic chest discomfort longer than 20 min, electrocardiogram with necrosis (Q waves) and elevated CK and CK-MB levels. RESULTS: There were 18 patients with MI. The sensitivity for CK, CK-MB and Mgb were respectively 33%, 22% and 61%. The specificity was 85%, for CK, 95% for CK-MB and 97% for Mgb. The difference between Mgb and CK sensitivities was 28%, with a 95% confidence interval (CI) from -4% to 59%, the difference between Mgb and CK-MB sensitivities was 39%, (CI 9% to 69%). The difference between Mgb and CK specificities was 13%, (CI 12% to 14%) and the difference between Mgb and CK-MB specificities was 2%, (CI-5% to 9%). CONCLUSION: In the studied population, Mgb was more sensitive than CK-MB for the diagnosis of MI with similar specificity and Mgb was more specific than CK for this diagnosis.