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Sampaio Rocha-Filho PA. Headache Associated with Coronavirus Disease 2019. Neurol Clin 2024; 42:507-520. [PMID: 38575263 DOI: 10.1016/j.ncl.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Headache affects around half of patients in the acute phase of COVID-19 and generally occurs at the beginning of the symptomatic phase, has an insidious onset, and is bilateral, and of moderate to severe intensity. COVID-19 may also present complications that cause acute and persistent headaches, such as cerebrovascular diseases, rhinosinusitis, meningitis, and intracranial hypertension. In 10% to 20% of patients with COVID-19, headache may persist beyond the acute phase. In general, the headache improves over time. To date, there are no clinical trials that have assessed the treatment of persistent post-COVID-19 headache.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil; Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Recife, Brazil.
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Kowacs PA, Sampaio Rocha-Filho PA, Peres MFP, Edvinsson L. The history and rationale of the development of new drugs for migraine treatment. Arq Neuropsiquiatr 2023; 81:1084-1097. [PMID: 38157876 PMCID: PMC10756794 DOI: 10.1055/s-0043-1777723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
Migraine is one of the most prevalent and disabling diseases in the world. Migraine attack treatments and prophylactic treatments of this disease are essential to lessen its individual, social, and economic impact. This is a narrative review of the main drugs used for treating migraine, as well as the experimental models and the theoretical frameworks that led to their development. Ergot derivatives, triptans, non-steroid anti-inflammatory drugs, tricyclic antidepressants, beta-blockers,: flunarizine,: valproic acid,: topiramate, onabotulinumtoxin A, ditans, monoclonal antibodies against CGRP and its receptor, and gepants are discussed. Possible therapeutic targets for the development of new drugs that are under development are also addressed. Many of the drugs currently in use for treating migraine were developed for the treatment of other diseases, but have proven effective for the treatment of migraine, expanding knowledge about the disease. With a better understanding of the pathophysiology of migraine, new drugs have been and continue to be developed specifically for the treatment of this disease.
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Affiliation(s)
- Pedro André Kowacs
- Instituto de Neurologia de Curitiba, Serviço de Neurologia, Curitiba PR, Brazil.
- Universidade Federal do Paraná, Complexo Hospital de Clínicas, Unidade do Sistema Nervoso, Curitiba PR, Brazil.
| | - Pedro Augusto Sampaio Rocha-Filho
- Universidade Federal de Pernambuco, Centro de Ciências Médicas, Divisão de Neuropsiquiatria, Recife PE, Brazil.
- Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Clínica de Cefaleia, Recife PE, Brazil.
| | | | - Lars Edvinsson
- Lund University, Institute of Clinical Sciences, 22185 Lund, Sweden.
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de Mélo Silva Júnior ML, Valença MM, Sampaio Rocha-Filho PA. Characteristics of residency programs and residents' learning experience in Brazil: a multispecialty, nation-wide study. PSYCHOL HEALTH MED 2023; 28:2329-2340. [PMID: 35773980 DOI: 10.1080/13548506.2022.2093928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
Factors associated with the optimal physician resident learning are yet to be fully understood. We aimed to correlate the characteristics of residency programs with the learning perception of residents. This was a cross-sectional study using an online structured questionnaire published on social networks, enrolling physician residents from almost all specialties in Brazil. The collection tool was settled considering the current national standards of medical residency programs in Brazil and it was internally validated. The response rate was 71.4% (n = 1,419). The median age was 28 years (IQR = 27-30), 51.9% were from clinical areas and 69.9% from the first or second postgraduation year. Adequate quality of faculty supervision was reported by 50.9%; frequent supervision of assistance activities in 22.1%; proper structure for carrying out healthcare in 82.1%, formal appraisals in 81.8%, classroom activities more than three times a week in 12.3%. Learning was rated as satisfactory by 70.8%. We found an 'inverted-U' shape correlation between duty hours and learning - briefer and longer workloads were associated with unsatisfactory learning. The factors independently associated with learning satisfaction were quantity (OR = 10.79, 95%CI = 7.38-15.77) and quality (1.68, 1.19-2.37) of preceptorship, structure for healthcare (2.10, 1.44-3.08), formal evaluations (1.83, 1.26-2.67), and briefer workload (0.18, 0.04-0.90) and age (0.94, 0.89-0.99) (AUROC = 0.838, 95%CI = 0.816-0.860). We conclude that the perception of satisfactory learning was influenced by higher frequency and quality of faculty supervision, adequate structure for healthcare, formal assessments, and reduced duty hours and age. Regulatory institutions should reinforce strategies to guarantee the fulfillment of residency standards and faculties should receive continued formal training to maximize their teaching skills.
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Affiliation(s)
- Mário Luciano de Mélo Silva Júnior
- Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil
- Neurology Unit, Hospital da Restauração, Recife, Brazil
- Medical School, Uninassau, Recife, Brazil
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil
- Headache Clinic, Hospital Universitario Oswaldo Cruz, University of Pernambuco (UPE), Recife, Brazil
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de Oliveira I, Sampaio Rocha-Filho PA. Headache and systemic lupus erythematosus: A narrative review. Headache 2023; 63:461-471. [PMID: 37036168 DOI: 10.1111/head.14501] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE To review the epidemiology, the differential diagnosis, and the clinical and laboratory factors associated with the care management of headaches in patients with systemic lupus erythematosus (SLE). BACKGROUND SLE is a chronic autoimmune disease and in 12%-95% of patients, the nervous system is involved. Headache is a frequently reported, although nonspecific, symptom that may potentially represent serious underlying diagnoses. Primary headaches may also occur in these patients, thereby causing a negative and significant impact on their quality of life. METHODS This is a narrative review. A literature review was conducted on the PubMed platform using the following terms: (1) headache and (2) lupus. All articles considered relevant were included. No limitations were imposed for the publication date. RESULTS Headache is a frequent symptom in patients with SLE. Although its prevalence is similar to the general population, headaches nonetheless tend to have a greater negative impact on these patients. Patients with SLE are more likely to experience headache due to vascular diseases such as cerebral venous sinus thrombosis, stroke, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, and vasculitis. Aseptic meningitis, neuroinfections, intracranial neoplasms, and intracranial hypertension or hypotension may also be a cause of headache in these patients. Although used in disease activity scores, the concept of lupus headache is controversial. CONCLUSIONS Headache is a frequent symptom in patients with SLE. An appropriate approach enables the potentially serious conditions, which are the causes of secondary headaches, to be recognized and treated, together with an appropriate diagnosis and treatment of primary headaches.
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Affiliation(s)
- Igor de Oliveira
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
- Headache Clinic, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, Brazil
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Mota Albuquerque P, Ribeiro Franco CM, Sampaio Rocha-Filho PA. Assessing the impact of sleep restriction on the attention and executive functions of medical students: a prospective cohort study. Acta Neurol Belg 2023:10.1007/s13760-023-02250-w. [PMID: 37004704 PMCID: PMC10066942 DOI: 10.1007/s13760-023-02250-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/22/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVE To compare the performance of medical students regarding attention and executive functions during a period of sleep restriction (insufficient sleep; period of classes) and a period of free sleep (sufficient sleep; vacation period). BACKGROUND Sleep deprivation is associated with poor academic outcomes. Few studies have assessed the cognitive changes associated with sleep deprivation due to insufficient sleep syndrome in students and how they occur in real-life situations. METHODS This was a prospective cohort study. Medical students were assessed at two moments (class and vacation). The interval between assessments was 30 days. The Pittsburgh Sleep Quality Index, the Consensus Sleep Diary, the Montreal Cognitive Assessment, the Psychomotor Vigilance Test (PVT) and the Wisconsin Sorting Cards Test were used. RESULTS Forty-one students were assessed, 49% were female, with a median age of 21 (20; 23) years. There was a lower number of hours slept (5.75 (5.4; 7.0) vs 7.33 (6.0; 8.0) hours; p = 0.037), and a significantly poorer performance in the PVT (mean reaction time, p = 0.005; Minor lapses, p = 0.009) during the period of classes when compared to the vacation period. There was a correlation between the variation in hours of sleep of the two assessments and a variation in minor lapses in the two assessments (Ro: -0.395; p = 0.011; Spearman's correlation). CONCLUSIONS Students had fewer hours of sleep and more reduced attention during the period of classes than during the vacation period. This decrease in sleeping hours was correlated with more impaired attention.
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Affiliation(s)
- Pedro Mota Albuquerque
- Scientific Initiation Fellowships Institutional Program (CNPq), Recife, Brazil
- Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Av. da Engenharia, 531-611, Recife, Pernambuco , 50730-120, Brazil
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Oliveira FAAD, Dourado-Filho MG, Rocha-Filho PAS. Acute headache attributed to ischemic stroke: assessment of its characteristics and associated factors. Arq Neuropsiquiatr 2023; 81:225-232. [PMID: 37059431 PMCID: PMC10104759 DOI: 10.1055/s-0043-1763487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND It is estimated that headache attributed to ischemic stroke occurs in 7.4% to 34% of the cases. Despite its frequency, this headache has been little studied in terms of its risk factors and characteristics. OBJECTIVE To assess the frequency and clinical characteristics of headache attributed to ischemic stroke and the factors associated with its occurrence. METHODS The present was a cross-sectional study which included patients consecutively admitted within 72 hours of the onset of ischemic stroke. A semi-structured questionnaire was used. The patients underwent magnetic resonance imaging. RESULTS A total of 221 patients were included, 68.2% of whom were male, and the mean age was of 68.2 ± 13.8 years. The frequency of headache attributed to ischemic stroke was of 24.9% (95% confidence interval [95%CI]: 19.6-31.1%). The headache had a median duration of 21 hours and most frequently began at the same time as the focal deficit (45.3%), with a gradual onset (83%). It was of moderate intensity, pulsatile (45.3%), bilateral (54.6%), and presented a similar pattern to that of tension-type headache (53.6%). Headache attributed to stroke was significantly associated with previous tension-type headache, and previous migraine with and without aura (logistic regression). CONCLUSION Headache attributed to stroke is common, with a pattern similar to that of tension-type headache, and it is associated with a history of tension-type and migraine headaches.
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Affiliation(s)
- Felipe Araújo Andrade de Oliveira
- Universidade Federal de Pernambuco, Área Acadêmica de Neuropsiquiatria do Centro de Ciências Médicas, Recife PE, Brazil
- Real Hospital Português de Beneficência de Pernambuco, Divisão de Neurologia, Recife PE, Brazil
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Oliveira FAAD, Dourado Filho MG, Rocha-Filho PAS. Assessing the influence of migraine on stroke ischemic penumbra. Headache Med 2022. [DOI: 10.48208/headachemed.2022.supplement.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Introduction
There is controversy as to whether migraine affects the behavior of ischemic penumbra during the acute phase of an ischemic stroke, thereby accelerating the formation of cerebral infarction.
Objectives
To assess whether migraine modifies the existence and volume of the divergence between the areas of diffusion and perfusion in the stroke (the penumbra).
Methods
This was a prospective cohort study carried out in a hospital in the city of Recife, Pernambuco, Brazil. We included consecutively hospitalized patients with ischemic stroke within 72 hours of symptom onset. A diagnosis of ischemic stroke was made by the presence of a diffusion restriction pattern on the MRI within a compatible clinical context. Patients were assessed by a neurologist who conducted an interview using a semi-structured questionnaire containing questions regarding sociodemographic data, the presence and characteristics of headaches in their lives, the presence and characteristics of headaches related to ischemic stroke and the related clinical condition to ischemic stroke. The headaches presented were classified according to the diagnostic criteria of the third edition of the International Classification of Headache Disorders. The National Institute of Health Stroke Scale and the modified Rankin scale were used. Patients underwent MRI of the brain with diffusion and with perfusion.
Results: A total of 221 patients were included, 59.3% of whom were male, and a mean age of 68.2 ± 13.8 years. Ischemic penumbra analysis was performed in 118 patients. There was no association between migraine and the absence of ischemic penumbra (OR: 1.22; CI95%: 0.52 – 2.87; p=0.649; Chi-Square Test). There was no difference in the volume of ischemic penumbra between those with and without migraine. There was no difference in stroke volume between those with and without migraine (1.0; 0.38 – 7.9 cm3...
(To see the complet abstract, please, check out the PDF.)
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Oliveira FAAD, Dourado Filho MG, Rocha-Filho PAS. Persistent headache attributed to previous ischemic stroke: a prospective cohort study. Headache Med 2022. [DOI: 10.48208/headachemed.2022.supplement.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction
Headache is a frequent sign of stroke, occurring both in the acute phase and persisting for 3 months after the stroke. The most recent International Classification of Headache Disorders has included persistent headache attributed to past stroke. Diagnosis depends on the presence of headache in the acute phase of stroke, although the headache persists for more than 3 months after the cerebrovascular event.
Objectives
To assess the incidence, course and impact of persistent headache attributed to a past ischemic stroke. To identify risk factors for the development of persistent headache attributed to a past stroke.
Methods
This was a prospective, observational cohort study. Inpatients with stroke, admitted within 72 hours of the onset of symptoms, were assessed at the Real Hospital Português de Beneficência de Pernambuco. Diagnosis of ischemic stroke occurred through the presence of an area of restricted diffusion in the magnetic resonance examination within a compatible clinical context. A semi-structured questionnaire was applied to characterize the sociodemographic information, the cerebrovascular disease and the headaches according to the diagnostic criteria of the International Classification of Headache Disorders. The NIHSS Stroke Scale and the HIT-6 scale were also used. Patients were assessed in person by the researchers in the acute phase of stroke and by telephone after 1 year to assess persistent headache attributed to past stroke.
Results
Initially, 221 patients were included, most of them male (59.3%) and whose mean age was 68.2 years ± 13.8. One hundred and nineteen patients (53.9%) answered the questionnaire by telephone 1 year after the stroke. Persistent headache attributed to a past stroke presented a frequency of 10.1% in the sample (95%CI: 5.3 to 17.0%) 1 year after the stroke. Headache presented a median frequency of 2.5 (1 – 4) days...
(To see the complet abstract, please, check out the PDF.)
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Oliveira FAAD, Dourado Filho MG, Rocha-Filho PAS. Assessing the influence of migraine on the prognosis of ischemic stroke: a prospective cohort study. Headache Med 2022. [DOI: 10.48208/headachemed.2022.supplement.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Introduction
There is controversy as to whether migraine implies a poorer prognosis after the stroke.
Objectives
To assess whether migraine implies a poorer prognosis after the stroke.
Methods
This was a prospective cohort study carried out in a hospital in the city of Recife, Pernambuco, Brazil. We included consecutively hospitalized patients with ischemic stroke within 72 hours of symptom onset. A diagnosis of ischemic stroke was made by the presence of a diffusion restriction pattern on the MRI within a compatible clinical context. Patients were assessed by a neurologist who conducted an interview using a semi-structured questionnaire containing questions regarding sociodemographic data, the presence and characteristics of headaches in their lives and the related clinical condition to ischemic stroke. The headaches presented were classified according to the diagnostic criteria of the third edition of the International Classification of Headache Disorders. The National Institute of Health Stroke Scale and the modified Rankin scale were used. Patients underwent MRI of the brain with diffusion and with perfusion. Patients were assessed by telephone 3 months after the stroke to determine the prognosis.
Results
A total of 221 patients were included, 59.3% of whom were male, and a mean age of 68.2 ± 13.8 years. One hundred and seventy-eight patients (178/221; 81%) were assessed 3 months after the ischemic stroke. Migraine was not associated with the stroke prognosis (logistic regression).
Conclusion
Migraine is not associated with the prognosis of ischemic stroke.
Key-Words: Cerebrovascular Disease, Ischemic Stroke, Migraine, Stroke outcome.
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Oliveira ID, Fontes BRD, Mariz HDA, Duarte ALBP, Rocha-Filho PAS. Headache in patients with systemic lupus erythematosus: a pilot study. Headache Med 2022. [DOI: 10.48208/headachemed.2022.supplement.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction
Headache is a symptom frequently reported by patients with Systemic Lupus Erythematosus (SLE), but it remains controversial as to whether the prevalence is higher than in the those without the disease and if there is an association with disease activity.
Objectives
1) to compare the prevalence, monthly frequency and impact of headaches between patients with SLE and a control group without the disease and 2) to compare the prevalence, monthly frequency and impact of headaches between patients with active SLE and those without disease activity
Methods
This is a case-control study. The case group consisted of patients diagnosed with SLE in regular follow-up at the Rheumatology outpatient clinic of the Hospital das Clínicas, UFPE, excluding those with a previous diagnosis of secondary headache or overlapping autoimmune diseases. A control group, matched for sex and age, consisted of hospital staff and friends and relatives of patients who had no previous diagnosis of secondary headache or autoimmune disease. Data on SLE and headache were collected through interviews and questionnaires administered by a neurologist. Headache impact was assessed using the Headache Impact Test (HIT-6) scale, anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) and disease activity was evaluated using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K modified scale, considering clinical and laboratory data from the last 30 days. All participants who reported at least one headache attack in the last year were considered as having headache and specific diagnoses were made based on the 3rd edition of the International Classification of Headache Disorders. SLE patients with SLEDAI-2K ≥ 6 were considered as having disease activity. Statistical analyzes were performed in SPSS 28.0 with significance defined as p < 0.05....
(To see the complet abstract, please, check out the PDF.)
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Santos PSF, Melhado EM, Kaup AO, Costa ATNMD, Roesler CADP, Piovesan ÉJ, Sarmento EM, Theotonio GOM, Campos HCD, Fortini I, Souza JAD, Júnior JAM, Segundo JBA, Carvalho JJFD, Speziali JG, Calia LC, Barea LM, Queiroz LP, Souza MNP, Figueiredo MRCF, Costa MENDM, Peres MFP, Jurno ME, Peixoto PM, Kowacs PA, Rocha-Filho PAS, Filho PFM, Silva-Neto RP, Fragoso YD. Consensus of the Brazilian Headache Society (SBCe) for prophylactic treatment of episodic migraine: part II. Arq Neuropsiquiatr 2022; 80:953-969. [PMID: 36257618 PMCID: PMC10658446 DOI: 10.1055/s-0042-1755320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/09/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. OBJECTIVE The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. METHODS Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. RESULTS From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. CONCLUSIONS Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options.
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Affiliation(s)
- Paulo Sergio Faro Santos
- Instituto de Neurologia de Curitiba, Departamento de Neurologia, Setor de
Cefaleia e Dor Orofacial, Curitiba PR, Brazil.
| | - Eliana Meire Melhado
- Centro Universitário Padre Albino, Faculdade de Medicina, Departamento de
Neurologia, Catanduva SP, Brazil.
| | - Alexandre Ottoni Kaup
- Houston Headache Clinic, Houston TX, USA.
- Universidade Federal de São Paulo, São Paulo SP, Brazil.
- Universidade de Santo Amaro, São Paulo SP, Brazil.
| | | | | | - Élcio Juliato Piovesan
- Universidade Federal do Paraná, Departamento de Clínica Médica, Disciplina de
Neurologia, Curitiba PR, Brazil.
| | | | | | | | - Ida Fortini
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia,
São Paulo SP, Brazil.
| | - Jano Alves de Souza
- Universidade Federal Fluminense, Departamento de Medicina Clínica, Disciplina
de Neurologia, Niterói RJ, Brazil.
| | - Jayme Antunes Maciel Júnior
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento
de Neurologia, Campinas SP, Brazil.
| | | | - João José Freitas de Carvalho
- Unichristus, Curso de Medicina, Disciplina de Neurologia, Fortaleza CE,
Brazil.
- Hospital Geral de Fortaleza, Serviço de Neurologia, Núcleo de Cefaleias,
Fortaleza CE, Brazil.
| | - José Geraldo Speziali
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto,
Departamento de Neurologia, Ribeirão Preto SP, Brazil.
| | - Leandro Cortoni Calia
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo SP,
Brazil.
| | - Liselotte Menke Barea
- Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Disciplina
de Neurologia, Porto Alegre RS, Brazil.
| | - Luiz Paulo Queiroz
- Universidade Federal de Santa Catarina, Hospital Universitário, Serviço de
Neurologia, Florianópolis SC, Brazil.
| | | | | | | | | | - Mauro Eduardo Jurno
- Fundação José Bonifácio Lafayette de Andrada, Faculdade de Medicina de
Barbacena, Barbacena MG, Brazil.
- Fundação Hospitalar do Estado de Minas Gerais, Hospital Regional de Barbacena
Dr. José Américo, Barbacena MG, Brazil.
| | | | - Pedro André Kowacs
- Instituto de Neurologia de Curitiba, Serviço de Neurologia, Curitiba PR,
Brazil.
- Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de
Neurologia, Curitiba PR, Brazil.
| | - Pedro Augusto Sampaio Rocha-Filho
- Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área de
Neuropsquiatria, Recife PE, Brazil.
- Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Ambulatório de
Cefaleias, Recife PR, Brazil.
| | - Pedro Ferreira Moreira Filho
- Universidade Federal Fluminense, Hospital Universitário Antônio Pedro,
Departamento de Medicina Clínica, Niterói RJ, Brazil.
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Melhado EM, Santos PSF, Kaup AO, da Costa ATNM, Roesler CADP, Piovesan ÉJ, Sarmento EM, Theotonio GOM, de Campos HC, Fortini I, de Souza JA, Maciel JA, Segundo JBA, de Carvalho JJF, Speziali JG, Calia LC, Barea LM, Queiroz LP, Souza MNP, Figueiredo MRCF, Costa MENDM, Peres MFP, Jurno ME, Peixoto PM, Kowacs PA, Rocha-Filho PAS, Moreira PF, Silva-Neto RP, Fragoso YD. Consensus of the Brazilian Headache Society (SBCe) for the Prophylactic Treatment of Episodic Migraine: part I. Arq Neuropsiquiatr 2022; 80:845-861. [PMID: 36252594 PMCID: PMC9703891 DOI: 10.1055/s-0042-1756441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers.
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Affiliation(s)
- Eliana Meire Melhado
- Centro Universitário Padre Albino, Faculdade de Medicina, Departamento de Neurologia, Catanduva SP, Brazil
| | - Paulo Sergio Faro Santos
- Instituto de Neurologia de Curitiba, Departamento de Neurologia, Setor de Cefaleia e Dor Orofacial, Curitiba PR, Brazil
| | - Alexandre Ottoni Kaup
- Houston Headache Clinic, Houston TX, United States,Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil,Universidade de Santo Amaro, São Paulo SP, Brazil
| | | | | | - Élcio Juliato Piovesan
- Universidade Federal do Paraná, Departamento de Clínica Médica, Disciplina de Neurologia, Curitiba PR, Brazil
| | | | | | | | - Ida Fortini
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | - Jano Alves de Souza
- Universidade Federal Fluminense, Departamento de Medicina Clínica, Disciplina de Neurologia, Niterói RJ, Brazil
| | - Jayme Antunes Maciel
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil
| | | | - João José Freitas de Carvalho
- Unichristus, Curso de Medicina, Disciplina de Neurologia, Fortaleza CE, Brazil,Hospital Geral de Fortaleza, Serviço de Neurologia, Núcleo de Cefaleias, Fortaleza CE, Brazil
| | - José Geraldo Speziali
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurologia, Ribeirão Preto SP, Brazil
| | - Leandro Cortoni Calia
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo SP, Brazil
| | - Liselotte Menke Barea
- Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Disciplina de Neurologia, Porto Alegre RS, Brazil
| | - Luiz Paulo Queiroz
- Universidade Federal de Santa Catarina, Hospital Universitário, Serviço de Neurologia, Florianópolis SC, Brazil
| | | | | | | | | | - Mauro Eduardo Jurno
- Fundação José Bonifácio Lafayette de Andrada, Faculdade de Medicina de Barbacena, Barbacena MG, Brazil,Fundação Hospitalar do Estado de Minas Gerais, Hospital Regional de Barbacena Dr. José Américo, Barbacena MG, Brazil
| | | | - Pedro André Kowacs
- Instituto de Neurologia de Curitiba, Serviço de Neurologia, Curitiba PR, Brazil,Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Neurologia, Curitiba PR, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área de Neuropsquiatria, Recife PE, Brazil,Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Ambulatório de Cefaleias, Recife PR, Brazil
| | - Pedro Ferreira Moreira
- Universidade Federal Fluminense, Hospital Universitário Antônio Pedro, Departamento de Medicina Clínica, Niterói RJ, Brazil
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Sampaio Rocha-Filho PA, Magalhães JE, Fernandes Silva D, Carvalho Soares M, Marenga Arruda Buarque L, Dandara Pereira Gama M, Oliveira FAA. Neurological manifestations as prognostic factors in COVID-19: a retrospective cohort study. Acta Neurol Belg 2022; 122:725-733. [PMID: 35060095 PMCID: PMC8776373 DOI: 10.1007/s13760-021-01851-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Neurological manifestations are frequent during COVID-19 but have been poorly studied as prognostic markers of COVID-19. OBJECTIVES The aim of this study was to assess whether neurological manifestations are associated with a poor prognosis of COVID-19, and which patient and COVID-19 characteristics were associated with encephalopathy. METHODS This was a retrospective cohort study and included patients admitted with COVID-19 in four hospitals from Recife, Brazil. Data were collected by reviewing medical records. RESULTS 613 were included; 54.6% were male, the median age was 54 (41-68) years, 26.4% required mechanical ventilation, and 24.1% died. The neurological symptoms presented were: myalgia (25.6%), headache (22%), fatigue (22%), drowsiness (16%), anosmia (14%), disorientation (8.8%), ageusia (7.3%), seizures (2.8%), and dizziness (1.5%). Twelve patients (2%) had strokes (ischemic strokes: 9) and 149 (24.3%), encephalopathy. Older age, a prolonged hospitalization, diabetes mellitus, a previous history of stroke and having epileptic seizures during hospitalization were significantly associated with the occurrence of encephalopathy. Older age, smoking and requiring mechanical ventilation were associated with prolonged hospitalization. Older patients, those requiring mechanical ventilation and those with encephalopathy presented a significantly higher risk, while those who had anosmia presented a significantly lower risk of dying. CONCLUSIONS Neurological symptoms are frequent among patients with COVID-19. Encephalopathy was the most frequent neurological complication and was associated with a higher mortality. Those with anosmia had a lower mortality.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Rua General Joaquim Inacio, 830, Sala 1412, Edf The Plaza Business Center, Recife, PE, CEP: 50070-495, Brazil.
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil.
| | - João Eudes Magalhães
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Brazil
| | | | | | | | | | - Felipe Araújo Andrade Oliveira
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Rua General Joaquim Inacio, 830, Sala 1412, Edf The Plaza Business Center, Recife, PE, CEP: 50070-495, Brazil
- Real Hospital Português de Beneficência de Pernambuco, Recife, Brazil
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de Mélo Silva Júnior ML, Valença MM, Rocha-Filho PAS. Individual and residency program factors related to depression, anxiety and burnout in physician residents - a Brazilian survey. BMC Psychiatry 2022; 22:272. [PMID: 35436910 PMCID: PMC9016975 DOI: 10.1186/s12888-022-03916-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/06/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Psychological distress is common among medical trainees. This study aimed to assess the frequency of depression, anxiety and burnout among physician residents and their association with both individual and residency program-related factors. METHODS This was a cross-sectional study applying an online survey in a national-wide sample of medical residents from Brazil. Depression, anxiety, burnout and diurnal somnolence were assessed with validated tools (Patient Health Questionnaire-4, 2 items version of Maslach Burnout Inventory, and Epworth Sleepiness Scale). Socio-demographic and residency program-related factors were measured with internally validated instruments. We performed multivariate binary logistic regression analysis for each of the main outcomes. RESULTS Screening for depression, anxiety and burnout was positive respectively in 46.9%, 56.6% and 37.0% of our sample (n = 1,419). Depression was independently related to female sex, longer duty hours, absence of day off, poor learning perception, poor feeling about the residency program, overall occurrence of psychological abuse, anxiety, diurnal somnolence and burnout (AUROC = .859 [95%CI = .840-.878], p < .001). Anxiety was independently associated with female sex, higher age and duty hours, work-personal life conflicts, few classroom activities, providing assistance without supervision, depression and diurnal somnolence (837 [.816-.857], p < .001). Burnout was related to lower age and leisure time, male sex, longer duty hours, absence of day off, provision of care without supervision, choice of the wrong specialty, poor learning, psychological abuse, depression and diurnal somnolence (.780 [.753-.806], p < .001). CONCLUSION Frequency of psychological distress in residency training is high and related to both individuals and environmental factors, namely high workloads, occurrence of psychological abuse, poor faculty supervision, poor learning experience and work-personal life conflicts.
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Affiliation(s)
- Mário Luciano de Mélo Silva Júnior
- Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil. .,Neurology Unit, Hospital da Restauração, Recife, Brazil. .,Medical School, Uninassau, Recife, Brazil.
| | - Marcelo Moraes Valença
- grid.411227.30000 0001 0670 7996Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- grid.411227.30000 0001 0670 7996Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil ,grid.26141.300000 0000 9011 5442Headache Clinic, Hospital Universitario Oswaldo Cruz, University of Pernambuco (UPE), Recife, Brazil
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Corrêa Rangel T, Falcão Raposo MC, Sampaio Rocha-Filho PA. Internet addiction, headache, and insomnia in university students: a cross-sectional study. Neurol Sci 2022; 43:1035-1041. [PMID: 34106366 DOI: 10.1007/s10072-021-05377-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is controversy about whether there is an association between headache and internet addiction. Therefore, the objective was to assess whether there is an association between the headache, insomnia, and internet addiction. METHODS This was a cross-sectional study with 420 university students. We used a semi-structured questionnaire, Headache Impact Test, Hospital Anxiety Depression Scale, Insomnia Severity Index, and Internet Addiction Test. RESULTS 51.4% were men, the median age was 21 (19, 23), 399 (95.0%) suffered from headaches in the last year, 265 (63.1%) had migraine, 182 (43.3%) had migraine with aura, 119 (28.3%) had episodic tension-type headache, 84 (20%) had internet addiction, and 95 (22.6%) had insomnia. Internet addiction was associated with anxiety (OR = 2.3; 95% CI: 1.3, 4.0; p = 0.003), insomnia (OR = 3.0; 95% CI: 2.0, 4.6; p < 0.001), and migraine with aura (OR = 1.8; 95% CI: 1.1, 2.9; p = 0.066) (logistic regression). The severity of internet dependence is associated with the impact of headache (p = 0.047) and with the severity of insomnia (p < 0.001) (multiple linear regression). CONCLUSIONS Internet addiction was associated with anxiety, migraine with aura, and insomnia. The severity of internet addiction is associated with the severity of the headache and with the severity of insomnia.
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Affiliation(s)
- Tathiana Corrêa Rangel
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Rua General Joaquim Inacio, 830, Sala 1412 - Edf The Plaza Business Center, Recife, CEP: 50070-495, Pernambuco, Brazil.,Department of Physiotherapy, University of Pernambuco (UPE), Petrolina, Brazil
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Rua General Joaquim Inacio, 830, Sala 1412 - Edf The Plaza Business Center, Recife, CEP: 50070-495, Pernambuco, Brazil. .,Division of Neuropsychiatry, Centro de Ciências Médicas, Federal University of Pernambuco (UFPE), Recife, Brazil. .,Headache Clinic, Oswaldo Cruz University Hospital, University of Pernambuco (UPE), Recife, Brazil.
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Bastos Ferreira AP, do Nascimento ADFS, Sampaio Rocha-Filho PA. Cerebral and spinal cord changes observed through magnetic resonance imaging in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis: a systematic review. J Neurovirol 2022; 28:1-16. [PMID: 34981435 DOI: 10.1007/s13365-021-01043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 11/21/2021] [Accepted: 12/09/2021] [Indexed: 11/27/2022]
Abstract
To verify brain and spinal changes using magnetic resonance imaging in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis. This was a systematic review. The descriptors used were tropical spastic paraparesis and magnetic resonance image. The keyword HTLV-1-associated myelopathy was also used. Twenty-three articles were included: 16 detected brain changes and 18 detected spinal changes. White matter lesions were the most frequent finding in the brain. Brain injuries were most frequently identified in the periventricular region, in the subcortical region, in the centrum semiovale, in the brain stem, and corpus callosum. Atrophy was the most frequent finding of the spinal cord, affecting the thoracic and cervical regions, and was associated with a longer evolution of myelopathy. White matter lesions in these regions were also observed. Cortical white matter lesions and thoracic spinal cord atrophy were the most frequently reported changes in patients with HTLV-1-associated myelopathy.
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Affiliation(s)
- Ana Patrícia Bastos Ferreira
- Post-Graduation Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Federal University of Pernambuco (UFPE), Recife, Brazil.,Rua Carlos Pereira Falcão, 1136, Recife, 51021-350, Brazil
| | - Ana Dolores Firmino Santos do Nascimento
- Post-Graduation Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Federal University of Pernambuco (UFPE), Recife, Brazil.,Rua Arlindo Gouveia, 145, Recife, 50720-595, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil. .,Rua General Joaquim Inácio, Pernambuco- CEP, 1412 - Edifício The Plaza Business Center, Recife, Sala, 83052011-270, Brazil.
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Sampaio Rocha-Filho PA, Albuquerque PM, Carvalho LCLS, Dandara Pereira Gama M, Magalhães JE. Headache, anosmia, ageusia and other neurological symptoms in COVID-19: a cross-sectional study. J Headache Pain 2022; 23:2. [PMID: 34979899 PMCID: PMC8721484 DOI: 10.1186/s10194-021-01367-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022] Open
Abstract
Background Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms are related to one another. Objectives To determine whether there is an association between the neurological symptoms in patients with COVID-19, and to characterize the headache. Method This was a cross-sectional study. All hospital inpatients and health workers at the Hospital Universitario Oswaldo Cruz with a PCR-confirmed COVID-19 infection between March and June 2020 were considered for the study and were interviewed by telephone at least 2-months after the acute phase of the disease. These patients were identified by the hospital epidemiological surveillance department. A semi-structured questionnaire was used containing sociodemographic and clinical data and the ID-Migraine. Results A total of 288 patients was interviewed; 53.1% were male; with a median age of 49.9 (41.5–60.5) years; 91.7% presented some neurological symptom; 22.2% reported some neurological symptom as the symptom that troubled them most during COVID-19. Neurological symptoms were: ageusia (69.8%), headache (69.1%), anosmia (67%), myalgia (44.4%), drowsiness (37.2%), agitation (20.8%); mental confusion (14.9%), syncope (4.9%) and epileptic seizures (2.8%). Females, those who presented with fever, sore throat, anosmia/ageusia and myalgia also presented significantly more with headache (logistic regression). The most frequent headache phenotype was a non-migraine phenotype, was of severe intensity and differed from previous headaches. This persisted for more than 30 days in 18% and for more than 90 days in 10% of patients. Thirteen percent of those with anosmia and 11% with ageusia continued with these complaints after more than 90 days of the acute phase of the disease. Aged over 50 years, agitation and epileptic seizures were significantly associated with mental confusion (logistic regression). Conclusion Headache is frequent in COVID-19, is associated with other symptoms such as fever, sore throat, anosmia, ageusia, and myalgia, and may persist beyond the acute phase of the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01367-8.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Av. da Engenharia, 531-611, Recife, PE, 50730-120, Brazil. .,Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Tv. Jackson Pollock - Santo Amaro, Recife, PE, 52171-011, Brazil.
| | - Pedro Mota Albuquerque
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Av. da Engenharia, 531-611, Recife, PE, 50730-120, Brazil
| | | | - Mylana Dandara Pereira Gama
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Tv. Jackson Pollock - Santo Amaro, Recife, PE, 52171-011, Brazil
| | - João Eudes Magalhães
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Tv. Jackson Pollock - Santo Amaro, Recife, PE, 52171-011, Brazil
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Silva-Júnior MLDM, Rocha-Filho PAS. Moonlighting and physician residents' compensation: is it all about money? A cross-sectional Brazilian study. SAO PAULO MED J 2022; 141:e2022187. [PMID: 36287516 PMCID: PMC10065092 DOI: 10.1590/1516-3180.2022.0187.r2.23082022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Moonlighting is a largely discussed, however under-explored, subject among physician residents. OBJECTIVES To analyze the frequency of moonlighting and its related factors. DESIGN AND SETTING This cross-sectional study enrolled medical residents from all geographical regions of Brazil. METHODS A web-based structured closed-ended survey was applied that explored the frequency and type of moonlighting, residency programs characteristics, and psychological distress. The questionnaire was published on social networks. RESULTS The completion rate was 71.4% (n = 1,419) and 37.7% were males aged 28.8 ± 3.2 (mean ± standard deviation) years, and 571 (40.2%) were post-graduate year (PGY) 1. There were residents from 50 medical specialties (the most common training area was clinical, 51.9%). A total of 80.6% practiced moonlighting, with an average weekly workload of 14.1 ± 9.4 h, usually overnight or in weekend shifts. Factors related to it were being PGY-2 or higher (adjusted odds ratio = 3.90 [95% confidence interval = 2.93-5.18], logistic regression), lower weekly residency duty hours (0.98 [0.97-0.99]), and a higher salary (1.23 [1.08-1.40]). In contrast, perception of a "fair/adequate" compensation was influenced by age (1.02 [1.01-1.02]), not being single (1.05 [1.01-1.10]), and residency duty hours (1.51 [1.22-1.88]). Depression, anxiety, diurnal somnolence scores, and work-personal life conflicts were not correlated with moonlighting status. CONCLUSION Moonlighting frequency is high, and it is related to higher PGY, briefer residency duty hours, and the perception that remuneration should be higher. This study provides insights into the motivations for moonlighting and effort-reward imbalance.
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Affiliation(s)
- Mário Luciano de Mélo Silva-Júnior
- MD, PhD. Professor, Medical School, Division of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil; Professor, Neurology Unit, Medical School, Uninassau, Recife (PE), Brazil; Physician, Neurology Unit, Hospital da Restauração, Recife (PE), Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- MD, PhD. Professor, Medical School, Division of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil. Professor, Postgraduate Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Universidade Federal do Pernambuco (UFPE), Recife (PE), Brazil; and Physician, Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade do Pernambuco (UPE), Recife (PE), Brazil
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de Oliveira FAA, de Oliveira Filho JRB, Rocha-Filho PAS. Multiple demyelinating sensory and motor mononeuropathy associated with COVID-19: a case report. J Neurovirol 2021; 27:966-967. [PMID: 34735692 PMCID: PMC8567975 DOI: 10.1007/s13365-021-01024-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022]
Abstract
The involvement of the nervous system may occur in 36.4% of patients with COVID-19. Cases have been described of cerebrovascular diseases, encephalitis, encephalopathies, and changes in smell and taste. Two months after being discharged from hospital with COVID-19, a 63-year-old male patient presented with a predominantly demyelinating multiple sensory and motor mononeuropathy. A diagnostic possibility of multiple sensory and motor demyelinating mononeuropathy (Lewis-Sumner syndrome) was made. Treatment with human immunoglobulin was initiated. COVID-19 may be associated with multiple demyelinating sensory and motor mononeuropathy.
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Corrêa Rangel T, Falcão Raposo MC, Sampaio Rocha-Filho PA. The prevalence and severity of insomnia in university students and their associations with migraine, tension-type headache, anxiety and depression disorders: a cross-sectional study. Sleep Med 2021; 88:241-246. [PMID: 34798440 DOI: 10.1016/j.sleep.2021.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/05/2021] [Accepted: 10/22/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND There is possibly an association between migraine, tension-type headache, anxiety, depression and insomnia. These conditions are prevalent among university students. Our primary objective was to verify whether students with primary headaches (migraine and tension-type headache) have a higher prevalence of insomnia. Our secondary objective was to assess whether the impact of headaches was associated with greater severity of insomnia. METHODS Cross-sectional study. 440 students out of 3030 were randomly selected. A semi-structured questionnaire containing information about the characteristics of the headaches, including their frequencies in the last 3 months; the Headache Impact Test (HIT-6); the Hospital Anxiety Depression Scale; and the Insomnia Severity Index were used. RESULTS 420 students (95.5%) agreed to participate; 51.4% men; median age of 21 (19, 23); 95 (22.6%) had insomnia; 265 (63.1%), migraine; 152 (36.2%), tension-type headache; 201 (47.9%) suffered from anxiety and 108 (25.7%), from depression. The severe impact of headache (HIT-6>55 points; OR = 3.9; p = 0.003) and anxiety (OR = 3.6; p = 0.003) were associated with insomnia (logistic regression). The severity of insomnia was positively and significantly correlated with the impact (HIT-6 score), with frequency of headache, and with having anxiety (multiple linear regression). CONCLUSIONS The diagnoses of migraine and tension-type headache are not associated with the presence of insomnia. The severity of insomnia is associated with the impact and the frequency of the headaches.
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Affiliation(s)
- Tathiana Corrêa Rangel
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil; Department of Physiotherapy, University of Pernambuco (UPE), Petrolina, Brazil
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil; Division of Neuropsychiatry, Centro de Ciências Médicas, Federal University of Pernambuco (UFPE), Recife, Brazil; Headache Clinic, Oswaldo Cruz University Hospital, University of Pernambuco (UPE), Recife, Brazil.
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Coutinho Neta TCDM, Tenório ADS, Oliveira-Souza AIS, Chagas ACDS, Rocha-Filho PAS, Villela DW, de Oliveira DA. Neck and back muscle chains hypomobility in women with migraine. J Bodyw Mov Ther 2021; 28:470-477. [PMID: 34776180 DOI: 10.1016/j.jbmt.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/19/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the mobility of neck and back flexor and extensor muscle chains in women with migraine, chronic migraine and headache-free. METHODS This is a cross-sectional study. The muscle chain test was performed based on the theoretical assumptions of the Busquet method, in women with migraine (MG, n = 24), chronic migraine (CMG, n = 36) and headache-free (CG, n = 27). The evaluation of neck and back mobility was performed by an examiner expert in the Busquet method with the aid of cervical range of motion (CROM®) device (neck muscles) and the Tiltmeter® application (back muscles). RESULTS Compared to woman headache-free, women with migraine (MD = -12° [CI95% = -19°, -5°] and chronic migraine (MD = -15° [CI95% = -21°, -8°] present reduced mobility in the neck extensor muscle chain. Also, in the back extensor muscle chain, migraine vs headache-free (MD = -9° [CI95% = -15°, -2°]) and chronic migraine vs headache-free (MD = -10° [CI95% = -16°, -4°]) and in the back flexor muscle chain, migraine vs headache-free (MD = -6° [CI95% = -10°, -0.1°]) and chronic migraine vs headache-free (MD = -7 [CI95% = -11°, -2°]), with an effect sizes varying between 1.19 e 2.38. No difference was found between groups for neck flexor muscle chain. CONCLUSION Women with migraine and chronic migraine have hypomobility of the neck and back extensor muscle chains, and of the back flexor chain.
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Affiliation(s)
| | - Angélica da Silva Tenório
- Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, PE, Brazil.
| | | | | | | | - Débora Wanderley Villela
- Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, PE, Brazil.
| | - Daniella Araújo de Oliveira
- Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, PE, Brazil.
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22
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Moraes Alves AL, Silva IK, Paula Lemos PH, Lomachinsky Torres V, Crevanzi Arraes E, Sampaio Rocha-Filho PA. FRAMES protocol versus simple advice for medication-overuse headache: a prospective, randomized, controlled clinical trial. Acta Neurol Belg 2021; 121:1259-1264. [PMID: 34297333 DOI: 10.1007/s13760-021-01758-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
It is central to the management of patients with Medication-overuse headache that they reverse their behavior regarding the frequent use of pain medication. The objective of this study was to compare two counseling techniques for treating patients with Medication-overuse headache (MOH). This was a randomized, blind, controlled clinical trial that compared a structured (FRAMES) and unstructured counseling, for the treatment of MOH. Patients were assessed before the counseling and then again four and eight weeks after it. Semi-structured interview, headache diary, the Headache Impact Test (HIT-6) and the Hospital Anxiety and Depression Scale were used. Primary endpoints were the following: number of patients who stopped medication overuse; days with acute medication use; HIT-6; the number of patients who returned for consultations. Secondary endpoints were as follows: days per month of headache; 50% reduction in monthly days with acute medication use; the number of patients with less than 15 days of headache. Thirty-seven patients were allocated to the "FRAMES Group" and 33 to the "Control Group". There was no difference regarding primary or secondary outcomes between the two groups. There was a significant reduction in the frequency of headache and the number of days using pain medication in the first and second months of follow-up compared to baseline in both groups. There was a significant reduction in the HIT-6 in the first and second months of follow-up compared to baseline in the FRAMES Group, but not in the control group. Patients in both counseling groups significantly decreased the use of pain medications and the frequency of their headaches.
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23
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Oliveira FAA, Rocha-Filho PAS. Paroxysmal hemicrania associated to carotid artery dissection: a case report. HM 2021. [DOI: 10.48208/headachemed.2021.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
There are numerous case reports relating trigeminal autonomic cephalalgias to structural injuries. However there is no description of the association between paroxysmal hemicrania and carotid artery dissection. We describe a previously healthy 63-year-old male presented with the onset of severe, throbbing pain in the right frontal region, lasting between 10 and 30 minutes, with a frequency of approximately two to three attacks per day, which began two days before seeking medical care. Pain was associated with ipsilateral tearing, semiptosis and nasal congestion. A cervical arterial magnetic resonance angiography demonstrated left carotid artery dissection in the C1/C2 segment of the left internal carotid artery. The patient became asymptomatic after indomethacin use. We conclude that the possibility of investigating carotid dissection should be considered in patients with paroxysmal hemicrania.
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24
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Sampaio Rocha-Filho PA, Albanês Oliveira Bernardo A. The usefulness of osmophobia for the diagnosis of migraine in children and adolescents. Headache 2021; 61:1143. [PMID: 34219223 DOI: 10.1111/head.14175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Federal University of Pernambuco, Recife, Brazil.,Headache Clinic, Oswaldo Cruz University Hospital, University of Pernambuco, Recife, Brazil
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25
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Sampaio Rocha-Filho PA. Osmophobia in children with headaches: A need for further studies. Headache 2021; 61:797. [PMID: 33990940 DOI: 10.1111/head.14115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Federal University of Pernambuco, Recife, Brazil.,Headache Clinic, Oswaldo Cruz University Hospital, University of Pernambuco, Recife, Brazil
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26
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Bastos Ferreira AP, Cassilhas APP, Moura P, Sampaio Rocha-Filho PA. Intrinsic and Extrinsic Cell Apoptotic Pathways in Patients with HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis: A Systematic Review. Viral Immunol 2021; 34:380-391. [PMID: 33470891 DOI: 10.1089/vim.2020.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We aimed to verify the influence of intrinsic and extrinsic cell apoptotic pathways on the inhibition of cellular apoptosis in patients with tropical spastic paralysis/myelopathy related to human T cell lymphotropic virus type 1. The databases accessed were PubMed, Scopus, Science Direct, and Web of Science. Neither the time of publishing nor the language of the articles was limited. The descriptors used for this systematic literature review were: Tropical Paraparesis, Proto-Oncogenic Protein C, Bcl-2, Bcl-X Protein, Bax protein, Fas ligand (FasL) protein, Fas receptor, TNF-related apoptosis-inducing ligand and Fas-associated protein with death domain (FADD)-like apoptosis regulating. The search resulted in 546 articles from which 9 articles were selected for analysis; ranging from serum levels of Bcl-2, Fas and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) measured by enzyme-linked immunosorbent assay and the levels of cellular expression of Bcl-2 and Bcl-xL the TCD4+ lymphocytes accessed by western blot. Most studies accessed either gene expression or polymorphism of Fas, FasL, and TRAIL in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), whereas one study used flow cytometry and fluorescence to determine Fas expression. Increased Bcl-xL expression inhibited T lymphocyte apoptosis, whereas Bcl-2, serum levels, and cellular expression did not influence T lymphocyte apoptosis and serum levels of Fas were significantly higher and associated with markers of leukocyte activation in patients with HAM/TSP. In addition, Fas polymorphism (FAS-670AA) was associated with higher proviral load. There is a need for additional research on this issue since the number of patients was small and the studies presented higher heterogeneity.
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Affiliation(s)
- Ana Patrícia Bastos Ferreira
- Post-graduation Program in Neuropsychiatry and Behavioral Sciences (POSNEURO), Federal University of Pernambuco (UFPE), Recife, Brazil
| | | | | | - Pedro Augusto Sampaio Rocha-Filho
- Post-graduation Program in Neuropsychiatry and Behavioral Sciences (POSNEURO), Federal University of Pernambuco (UFPE), Recife, Brazil.,Division of Neuropsychiatry, Centro de Ciências Médicas, Federal University of Pernambuco (UFPE), Recife, Brazil
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27
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DE Oliveira FAA, DE Melo TFB, Rocha-Filho PAS. Transient lesion in the splenium of the corpus callosum associated with COVID-19. Arq Neuropsiquiatr 2020; 78:738. [PMID: 33263613 DOI: 10.1590/0004-282x20200183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/14/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Felipe Araújo Andrade DE Oliveira
- Real Hospital Português de Beneficência de Pernambuco, Recife PE, Brazil.,Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área Acadêmica de Neuropsiquiatria, Recife PE, Brazil
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28
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Voss L, Nóbrega M, Bandeira L, Griz L, Rocha-Filho PAS, Bandeira F. Impaired physical function and evaluation of quality of life in normocalcemic and hypercalcemic primary hyperparathyroidism. Bone 2020; 141:115583. [PMID: 32795678 DOI: 10.1016/j.bone.2020.115583] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/30/2020] [Accepted: 08/07/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Severe primary hyperparathyroidism may be associated with muscle weakness and fatigue, but little is known about this effect in milder forms of the disease. This study aimed to evaluate physical function and quality of life in patients with normocalcemic (NPHPT) and hypercalcemic (HPHPT) primary hyperparathyroidism. METHODS This was a case-control study on 40 postmenopausal women. Thirteen patients with NPHPT, 7 patients with HPHPT, and their controls were studied. Mean serum PTH in the control group was 49.10 ± 12.38 pg/mL. All of the participants answered the Medical Outcomes Short-Form Health Survey (SF36) and were submitted to 2 strength tests (Hand Grip strength and Chair stand test) and 2 performance tests for physical function (Short physical performance battery and Gait speed). Body composition analysis was performed by dual-energy X-ray absorptiometry (DXA) and multifrequency bioimpedance (BIA). RESULTS Patients with NPHPT had lower grip strength (p = 0.005), a higher mean time of the chair stand test (p = 0.012), a lower mean gait speed (p < 0.001) and a lower score for the Short Physical Performance Battery (SPPB) (p = 0.010) than the control group. Patients with HPHPT had lower handgrip strength (p = 0.027), a higher mean time of the chair stand test (p = 0.017), and a lower score for the SPPB (p = 0.049) than the control group. Patients with NPHPT showed a higher gait speed when compared to HPHPT (p = 0.048). There was no difference between BIA and DXA body composition indices between the PHPT groups and their controls. The evaluation of the SF-36 showed significantly less quality of life in the general health domain among the NPHPT group and in the mental health domain among the HPHPT than in the controls. CONCLUSION Patients with NPHPT and HPHPT have decreased physical performance and strength.
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Affiliation(s)
- Lara Voss
- Division of Endocrinology & Diabetes, Agamenon Magalhaes Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil
| | - Maira Nóbrega
- Division of Endocrinology & Diabetes, Agamenon Magalhaes Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil
| | | | - Luiz Griz
- Division of Endocrinology & Diabetes, Agamenon Magalhaes Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil
| | | | - Francisco Bandeira
- Division of Endocrinology & Diabetes, Agamenon Magalhaes Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil; FBandeira Endocrine Institute, Recife, Pernambuco, Brazil.
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29
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Rocha-Filho PAS, Magalhães JE. Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia. Cephalalgia 2020; 40:1443-1451. [PMID: 33146035 PMCID: PMC7645592 DOI: 10.1177/0333102420966770] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/05/2020] [Accepted: 09/27/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess the frequency and characteristics of headache in patients with COVID-19 and whether there is an association between headache and anosmia and ageusia. METHODS This was a cross-sectional study. Consecutive patients admitted to hospital with COVID-19, confirmed by reverse transcription polymerase chain reaction (RT-PCR) technique, were assessed by neurologists. RESULTS Seventy-three patients were included in the study, 63% were male; the median age was 58 years (IQR: 47-66). Forty-seven patients (64.4%) reported headaches, which had most frequently begun on the first day of symptoms, were bilateral (94%), presenting severe intensity (53%) and a migraine phenotype (51%). Twelve patients (16.4%) presented with headache triggered by coughing. Eleven (15%) patients reported a continuous headache. Twenty-eight patients (38.4%) presented with anosmia and 29 (39.7%) with ageusia. Patients who reported hyposmia/anosmia and/or hypogeusia/ageusia experienced headache more frequently than those without these symptoms (OR: 5.39; 95% CI:1.66-17.45; logistic regression). Patients with anosmia and ageusia presented headache associated with phonophobia more often compared to those with headache without these complaints (Chi-square test; p < 0.05). Headache associated with COVID-19 presented a migraine phenotype more frequently in those experiencing previous migraine (p < 0.05). CONCLUSION Headaches associated with COVID-19 are frequent, are generally severe, diffuse, present a migraine phenotype and are associated with anosmia and ageusia.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil; Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - João Eudes Magalhães
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil; Faculdade de Ciências Médicas, Universidade de Pernambuco (UPE), Recife, Brazil
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30
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de Mélo Silva Júnior ML, Melo TS, de Sousa Menezes NC, Valença MM, Sampaio Rocha-Filho PA. Headache in Medical Residents: A Cross-Sectional Web-Based Survey. Headache 2020; 60:2320-2329. [PMID: 33118613 DOI: 10.1111/head.14000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although a common complaint and related to factors frequently present in medical residency such as psychological distress, depression, and anxiety, headache is an issue poorly explored among medical residents. METHODS This was a cross-sectional study enrolling medical residents from all geographic regions of Brazil. We applied an online structured survey with demographic and residency program-related questions, as well as validated tools to assess burnout, diurnal somnolence, anxiety, depression, and migraine. RESULTS The link to the survey received 1989 clicks, of which 1421 individuals completed the questionnaire (71.4% of all clicks). The prevalence of at least 1 headache attack in the last 3 months was 1236/1419 (87.1%); migraine occurred in 400/1419 (28.2%). Frequent headache attacks (headaches occurring daily or often) were associated with female sex (OR = 1.80 [95%CI = 1.36-2.37]), substantial weight gain (1.93 [1.38-2.70]), migraine (5.49 [4.16-7.24]), anxiety (1.45 [1.06-1.98]), depression (1.98 [1.47-2.67]), emotional exhaustion domain of burnout (1.49 [1.09-2.04]), and diurnal somnolence symptoms (1.32 [1.00-1.76]). Headaches with functional impact were associated with female sex (1.39 [1.10-1.74]), clinical training areas (1.32 [1.06-1.65]), anxiety (1.74 [1.38-2.21]), an unsatisfactory work-life balance (1.57 [1.17-2.09]), the emotional exhaustion component of burnout (1.49 [1.14-1.94]), and an unsatisfactory subjective learning curve (1.30 [1.02-1.67]). Migraine was associated with female sex (3.10 [2.34-4.13]), anxiety (2.53 [1.94-3.31]), more than 60 hours duty-hours in residency (1.66 [1.29-2.15]), psychological abuse from patients (1.42 [1.06-1.90]) and a clinical training area (1.34 [1.04-1.73]). CONCLUSION Headaches among medical residents are frequent and are related not only to depression, anxiety, burnout, and diurnal somnolence, but also to aspects closely related to residency training such as the occurrence of mistreatment, longer duty-hours, a poor work-life balance, and an unsatisfactory learning curve.
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Affiliation(s)
- Mário Luciano de Mélo Silva Júnior
- Post-graduation Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Federal University of Pernambuco (UFPE), Recife, Brazil.,Neurology Unit, Hospital da Restauração, Recife, Brazil.,Medical School, Uninassau, Recife, Brazil
| | - Thayanara Silva Melo
- Post-graduation Program in Dentistry, Federal University of Pernambuco (UFPE), Recife, Brazil
| | | | - Marcelo Moraes Valença
- Post-graduation Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Federal University of Pernambuco (UFPE), Recife, Brazil.,Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Post-graduation Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Federal University of Pernambuco (UFPE), Recife, Brazil.,Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil.,Headache Clinic, Hospital Universitario Oswaldo Cruz, University of Pernambuco (UPE), Recife, Brazil
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31
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de Oliveira FAA, Palmeira DCC, Rocha-Filho PAS. Headache and pleocytosis in CSF associated with COVID-19: case report. Neurol Sci 2020; 41:3021-3022. [PMID: 32875474 PMCID: PMC7462730 DOI: 10.1007/s10072-020-04694-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/28/2020] [Indexed: 11/05/2022]
Abstract
In December 2019, a new coronavirus infection was identified in China. Although the clinical presentation of COVID-19 is predominantly respiratory, more than 35%% of patients have neurological symptoms. We report an elderly female with asthenia, dry cough, anosmia, ageusia, fever, nausea, and a severe and persistent headache. She had confirmed COVID-19 using the nasal swab RT-PCR technique. Her cranial tomography was normal. The CSF analysis demonstrated a cell count of 21 cells/mm3 (80% lymphocytes and 20% monocytes), 34 mg/dl protein, and 79 mg/dl glucose. She improved after 4 days. Our report draws attention to the meningeal involvement of SARS-Cov-2.
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Affiliation(s)
| | - Danylo César Correia Palmeira
- Real Hospital Português de Beneficência de Pernambuco, Recife, Brazil.,Universidade Federal de Pernambuco, Recife, Brazil
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32
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Sampaio Rocha-Filho PA, Voss L. Persistent Headache and Persistent Anosmia Associated With COVID-19. Headache 2020; 60:1797-1799. [PMID: 32790179 PMCID: PMC7436496 DOI: 10.1111/head.13941] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Department of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil
| | - Lara Voss
- Emergency Department, Hospital Getulio Vargas, Recife, Brazil
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33
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Brito-Marques PR, Cabral-Filho JE, Briano IO, Milet GMM, Silva CE, Rocha-Filho PAS, Cunha-Correia CD. Comparison between the Mini-Mental State Examination and Montreal Cognitive Assessment as a Cognitive Screening Tool in Patients with Human Immunodeficiency Virus-Associated Neurocognitive Disorders. Rev Soc Bras Med Trop 2019; 52:e20190473. [PMID: 31800926 DOI: 10.1590/0037-8682-0473-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 10/31/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The number of human immunodeficiency virus-associated neurocognitive disorders has increased, reaching more than 50% of the cases. However, there are currently no substantial data on the screening methods for this disease. This study aimed to evaluate and compare the Mini-Mental State Examination to the Montreal Cognitive Assessment in human immunodeficiency virus-infected patients. METHODS This was an observational study comprising 82 human immunodeficiency virus-positive individuals with and without cognitive complaints. RESULTS Positive correlation (p<0.001) between the Mini-Mental State Examination and the Montreal Cognitive Assessment test scores was observed, but the mean scores revealed that the Mini-Mental State Examination showed worse performance for trails (p<0.001), cube copying (p<0.001), and clock drawing (p<0.001) than the Montreal Cognitive Assessment. CONCLUSIONS The Mini-Mental State Examination and the Montreal Cognitive Assessment tests should be used concomitantly for the assessment of human immunodeficiency virus-associated neurocognitive disorders, but visuoexecutive and visuospatial dysfunctions are better evaluated using the Montreal Cognitive Assessment test than the Mini-Mental State Examination.
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Affiliation(s)
- Paulo Roberto Brito-Marques
- Universidade de Pernambuco, Faculdade de Ciências Médicas, Unidade de Neurologia do Comportamento, Recife, PE, Brasil.,Hospital Universitário Oswaldo Cruz, Recife, PE, Brasil
| | | | - Isabelle Oliveira Briano
- Universidade de Pernambuco, Faculdade de Ciências Médicas, Unidade de Neurologia do Comportamento, Recife, PE, Brasil
| | | | | | | | - Carolina da Cunha-Correia
- Universidade de Pernambuco, Faculdade de Ciências Médicas, Unidade de Neurologia do Comportamento, Recife, PE, Brasil.,Hospital Universitário Oswaldo Cruz, Recife, PE, Brasil
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Kowacs F, Roesler CADP, Piovesan ÉJ, Sarmento EM, Campos HCD, Maciel JA, Calia LC, Barea LM, Ciciarelli MC, Valença MM, Costa MENDM, Peres MFP, Kowacs PA, Rocha-Filho PAS, Silva-Néto RPD, Villa TR, Jurno ME. Consensus of the Brazilian Headache Society on the treatment of chronic migraine. Arq Neuropsiquiatr 2019; 77:509-520. [PMID: 31365643 DOI: 10.1590/0004-282x20190078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/29/2019] [Indexed: 12/27/2022]
Abstract
Chronic migraine poses a significant personal, social and economic burden and is characterized by headache present on 15 or more days per month for at least three months, with at least eight days of migrainous headache per month. It is frequently associated with analgesic or acute migraine medication overuse and this should not be overlooked. The present consensus was elaborated upon by a group of members of the Brazilian Headache Society in order to describe current evidence and to provide recommendations related to chronic migraine pharmacological and nonpharmacological treatment. Withdrawal strategies in medication overuse headache are also described, as well as treatment risks during pregnancy and breastfeeding. Oral topiramate and onabotulinum toxin A injections are the only treatments granted Class A recommendation, while valproate, gabapentin, and tizanidine received Class B recommendation, along with acupuncture, biofeedback, and mindfulness. The anti-CGRP or anti-CGRPr monoclonal antibodies, still unavailable in Brazil, are promising new drugs already approved elsewhere for migraine prophylactic treatment, the efficacy of which in chronic migraine is still to be definitively proven.
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Affiliation(s)
- Fernando Kowacs
- Departamento Científico de Cefaleia da Academia Brasileira de Neurologia, São Paulo SP, Brasil.,Universidade Federal de Ciências da Saúde de Porto Alegre, Irmandade Santa Casa de Misericórdia, Serviço de Neurologia, Porto Alegre RS, Brasil.,Hospital Moinhos de Vento, Serviço de Neurologia e Neurocirurgia, Porto Alegre RS, Brasil
| | - Célia Aparecida de Paula Roesler
- Departamento Científico de Cefaleia da Academia Brasileira de Neurologia, São Paulo SP, Brasil.,Clínica de Cefaleia e Neurologia Dr. Edgard Raffaelli, São Paulo SP, Brasil
| | - Élcio Juliato Piovesan
- Universidade Federal do Paraná, Hospital das Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Curitiba PR, Brasil
| | - Elder Machado Sarmento
- Centro Universitário de Volta Redonda, Volta Redonda RJ, Brasil.,Fundação Educacional Dom André Arcoverde, Centro de Ensino Superior de Valença, Valença RJ, Brasil
| | | | | | | | - Liselotte Menke Barea
- Universidade Federal de Ciências da Saúde de Porto Alegre, Irmandade Santa Casa de Misericórdia, Serviço de Neurologia, Porto Alegre RS, Brasil
| | | | | | | | - Mário Fernando Prieto Peres
- Hospital Israelita Albert Einstein, São Paulo SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas Instituto de Psiquiatria, São Paulo SP, Brasil
| | - Pedro André Kowacs
- Universidade Federal do Paraná, Hospital das Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Curitiba PR, Brasil.,Instituto de Neurologia de Curitiba, Curitiba PR, Brasil
| | - Pedro Augusto Sampaio Rocha-Filho
- Universidade Federal de Pernambuco, Recife PE, Brasil.,Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Ambulatório de Cefaleias, Recife PE, Brasil
| | - Raimundo Pereira da Silva-Néto
- Departamento Científico de Cefaleia da Academia Brasileira de Neurologia, São Paulo SP, Brasil.,Universidade Federal do Piauí, Teresina PI, Brasil
| | - Thais Rodrigues Villa
- Universidade Federal de São Paulo, Setor de Cefaleias, São Paulo SP, Brasil.,Headache Center Brasil, São Paulo SP, Brasil
| | - Mauro Eduardo Jurno
- Faculdade de Medicina de Barbacena, Barbacena MG, Brasil.,Fundação Hospital do Estado de Minas Gerais, Hospital Regional de Barbacena Dr. José Américo, São Paulo SP, Brasil
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Magalhães JE, Barros IMLD, Pedrosa RP, Sampaio Rocha-Filho PA. Migraine and Markers of Carotid Atherosclerosis in Middle-Aged Women: A Cross-Sectional Study. Headache 2018; 59:77-85. [PMID: 30516278 DOI: 10.1111/head.13460] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study evaluated the association between migraine and the markers of carotid artery disease. BACKGROUND Migraine increases the risk of cardiovascular events, but its relationship with vascular dysfunction is unclear. METHODS In this cross-sectional study, middle-aged women with no known cardiovascular diseases underwent clinical, neurological, and laboratory evaluations; pulse wave velocity (PWV) assessment; and carotid artery ultrasonography. We divided the participants based on the presence of migraine and, further, based on the type of migraine. Associations between migraine and carotid thickening (intima-media thickness >0.9 mm), carotid plaques, or arterial stiffening (PWV >10 m/s) were evaluated using a multiple regression analysis. RESULTS The study comprised 112/277 (40%) women with migraine, of whom 46/277 (17%) reported having an aura. Compared to the non-migraineurs, the migraine with aura group had an increased risk of diffuse carotid thickening (3/46 [6.8%] vs 2/165 [1.3%], adjusted OR = 7.12, 95% CI 1.05-48.49). Migraine without aura was associated with a low risk of carotid plaques (3/66 [4.7%] vs 26/165 [16.7%], adjusted OR = 0.28, 95% CI 0.08-0.99) and arterial stiffening (21/66 [34.4%] vs 82/165 [51.2%], adjusted OR = 0.39, 95% CI 0.19-0.79). There were no correlations between migraine characteristics and arterial stiffness or carotid thickness measurements. CONCLUSION Migraine with aura is associated with an increased risk of carotid thickening, and migraine without aura is associated with a low risk of carotid plaques and arterial stiffening.
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Affiliation(s)
- João Eudes Magalhães
- Division of Neurology, Hospital Universitário Oswaldo Cruz of the Universidade de Pernambuco, Recife, Brazil.,Postgraduate program in Neuropsychiatry and Behavioral Sciences of the Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Rodrigo Pinto Pedrosa
- Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco of the Universidade de Pernambuco, Recife, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Division of Neurology, Hospital Universitário Oswaldo Cruz of the Universidade de Pernambuco, Recife, Brazil.,Department of Neuropsychiatry of the Universidade Federal de Pernambuco, Recife, Brazil.,Postgraduate program in Neuropsychiatry and Behavioral Sciences of the Universidade Federal de Pernambuco, Recife, Brazil
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Magalhães JE, Sampaio Rocha-Filho PA. Migraine and cerebrovascular diseases: Epidemiology, pathophysiological, and clinical considerations. Headache 2018; 58:1277-1286. [DOI: 10.1111/head.13378] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2018] [Indexed: 01/24/2023]
Affiliation(s)
- João Eudes Magalhães
- Postgraduate program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco (UFPE); Pernambuco Brazil
- Stroke Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE); Recife Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Department of Neuropsychiatry; Universidade Federal de Pernambuco (UFPE); Recife Brazil
- Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE); Recife Brazil
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Rocha-Filho PAS, Goncalves LR. Depression and anxiety disorders among patients with human T-cell lymphotropic virus type-1: a cross-sectional study with a comparison group. Rev Soc Bras Med Trop 2018; 51:357-360. [DOI: 10.1590/0037-8682-0365-2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 12/07/2017] [Indexed: 11/21/2022] Open
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Rangel TC, Rocha-Filho PAS. Cefaleia e abuso de internet: uma revisão narrativa. HM 2018. [DOI: 10.48208/headachemed.2018.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Contextualização: Entre os jovens, o prejuízo advindo da cefaleia implica em incapacidade, fracasso e absenteísmo escolar, além de maior vulnerabilidade às comorbidades. Neste contexto, o uso intensivo de telefone celular e do computador foram associados com hábitos insalubres. Pesquisas reforçam a validade preditiva da influência da dependência de internet nas condições físicas, no comportamento emocional e na qualidade de vida dos jovens. Poucos estudos associam o abuso de internet com a prevalência de cefaleia. Material e Métodos: O estudo foi uma revisão narrativa. Resultados: O uso excessivo do computador e de instrumentostecnológicos é considerado um impacto negativo na saúde física, podendo estar associado a sintomas somáticos, como cefaleias, depressão, dor musculoesquelética, fadiga e distúrbios de sono. Conclusões: Há necessidade de mais estudos para avaliar as características da cefaleia atribuída ao abuso de internet assim como o seu tratamento.
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Bernardo AAO, Medeiros FLD, Rocha-Filho PAS. Osmophobia and primary headaches in children and adolescents. HM 2018. [DOI: 10.48208/headachemed.2018.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Headache is one of the most frequent complaints in children and adolescents and there are difficulties to specify the diagnostic in the pediatric population, mainly due to the fact of biological and psychic immaturity. There is an important relationship between odors and primary headaches. Osmophobia can occur during headaches and odors can trigger headache attacks. The prevalence of osmophobia in pediatric patients with migraine varies from 25% to 35%, being a symptom of low sensitivity, but high specificity in the differential diagnosis between migraine and tension-type headache. Odor intolerance, when present, does not appear to be difficult to report and characterized by adults or children.
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Bernardo AAO, Medeiros FLD, Rocha-Filho PAS. Osmofobia e cefaleias primárias em crianças e adolescentes. HM 2018. [DOI: 10.5935/2178-7468.20180003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sampaio Rocha-Filho PA, Torres RCS, Ramos Montarroyos U. HIV and Headache: A Cross-Sectional Study. Headache 2017; 57:1545-1550. [PMID: 28905376 DOI: 10.1111/head.13183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/18/2017] [Accepted: 05/02/2017] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The head and neck are the second most common locations for pain among HIV-positive individuals. Most studies were conducted among HIV patients at an advanced stage of the disease. METHODS This was a cross-sectional study. Patients with HIV and CD4+ T lymphocyte counts >500 were included. Semi-structured interview, the Headache Impact Test (HIT-6), and the Hospital Anxiety and Depression Scale were used. RESULTS Of the 119 cases included, 63% were men. The mean age was 35.5 ± 10.4 years. Among the patients, 103 (87%) had headaches, 53 (45%) had migraines, 50 (42%) had tension-type headaches, and 53 (45%) had substantial and severe impact of headaches. Eleven patients had headaches that started after they had been diagnosed with HIV. These patients had more migraines (72% vs 43%; P < 0.05), greater intensity (8 ± 2 vs 6 ± 2; P < 0.01), and impact (HIT-6: 60 ± 11 vs 51 ± 12; P = 0.02) of headaches compared to others HIV patients. There were no correlations between CD4 counts and the intensity, frequency, or impact of headaches. CONCLUSIONS HIV-positive patients had a high frequency of headaches, which had a great impact on patients' lives. The pattern most often found was migraine. There was no correlation between CD4 counts and the severity of headaches.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Department of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil
| | - Rinailda Cascia Santos Torres
- Universidade de Pernambuco (UPE), Recife, Brazil.,Scientific Initiation Fellowships Institutional Program (FACEPE), Brazil
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Raulino Goncalves L, Fernandes Barbosa LN, Machado Ribeiro Magalhaes P, Sampaio Rocha-Filho PA. Characterization of cognitive performance and evaluation of quality of life among patients with HTLV-1. Clin Neurol Neurosurg 2017; 160:142-146. [DOI: 10.1016/j.clineuro.2017.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 04/06/2017] [Accepted: 07/11/2017] [Indexed: 11/17/2022]
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- 1 Department of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,2 Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil
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Melo ESD, Pedrosa RP, Rocha-Filho PAS. Dialysis Headache. HM 2016. [DOI: 10.48208/headachemed.2016.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Short Communication
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Bezerra MER, Rocha-Filho PAS. Headache Attributed to Craniocervical Dystonia - A Little Known Headache. Headache 2016; 57:336-343. [DOI: 10.1111/head.12996] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/14/2016] [Indexed: 01/03/2023]
Affiliation(s)
| | - Pedro Augusto Sampaio Rocha-Filho
- Department of Neuropsychiatry; Universidade Federal de Pernambuco (UFPE), Recife, Brazil and Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE); Recife Brazil
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Sousa Melo E, Carrilho Aguiar F, Sampaio Rocha-Filho PA. Dialysis Headache: A Narrative Review. Headache 2016; 57:161-164. [PMID: 27349210 DOI: 10.1111/head.12875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 05/20/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Patients with chronic kidney disease who need dialysis often have poor quality of life. Dialysis headache is a frequent complication of hemodialysis and is often a challenge for nephrologists, neurologists, and headache specialists. METHOD This was a narrative review. RESULTS The prevalence of dialysis headache varies between 27% and 73%. Among the characteristics of this headache are the pulsatile pattern, frontal location, moderate to severe intensity, and onset a few hours after the beginning of dialysis. The headache may be accompanied by nausea and vomiting. The physiopathology of hemodialysis headache is still not completely understood. Some factors that seem to be associated with it are variations in urea, sodium, magnesium, blood pressure, and weight levels. The hematoencephalic barrier has an important role. Variations in electrolyte and urea levels occur in the systemic circulation during hemodialysis, but the cerebral concentrations of these substances are stable over the first few hours of the procedure. The flow of free water through the hematoencephalic barrier may lead to cerebral edema. Other potential pathophysiological factors include nitric oxide, calcitonin gene-related peptide, and substance P. There are recommendations for maintenance of volume and control over electrolytes and blood pressure and avoidance of caffeine for prevention of hemodialysis headache. However, there are no controlled studies of prophylactic or abortive hemodialysis headache treatment. CONCLUSION Despite its prevalence, hemodialysis headache has been poorly studied, thus making it difficult to understand the pathophysiological mechanisms involved in its genesis. Current clinical management practices are therefore necessarily empiric with minimal to no evidence base.
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Affiliation(s)
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Department of Neuropsychiatry, Universidade Federal de Pernambuco, Recife, Brazil.,Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Recife, Pernambuco, Brazil
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Rocha-Filho PAS, Marques KS, Torres RCS, Leal KNR. Migraine, Osmophobia, and Anxiety. Pain Med 2015; 17:776-80. [PMID: 26814297 DOI: 10.1093/pm/pnv071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/30/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To evaluate the association between osmophobia and the characteristics of patients and their headaches, among migraine patients. METHODS This was a cross-sectional study. Patients who consecutively sought medical attendance in a primary care unit were asked about their headaches over the last 12 months. Those who had migraine were included. A semi-structured interview, the Headache Impact Test and the Hospital Anxiety and Depression Scale were used. RESULTS 147 patients had migraine; 78 had osmophobia; 60 had significant anxiety symptoms; and 78 had significant depression symptoms. The mean age of these patients was 43.2 years (± 13.7); 91.2% were women. The mean length of time with complaints of headache was 13.8 years (± 12). Among the migraine patients, those with anxiety, more years of headache history, and phonophobia presented significantly more osmophobia (multivariate logistic regression). CONCLUSION Osmophobia in migraine patients is associated with significant anxiety symptoms, length of headache history, and phonophobia.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- *Universidade de Pernambuco, Recife, PE, Brazil Department of Neuropsychiatry, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | | | | | - Kamila Nazare Ribas Leal
- *Universidade de Pernambuco, Recife, PE, Brazil Scientific Initiation Fellowships Institutional Program (CNPq)
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Torres RDCS, Marques KS, Leal KDNR, Rocha-Filho PAS. Main reasons for medical consultations in family healthcare units in the city of Recife, Brazil: a cross-sectional study. SAO PAULO MED J 2015; 133:367-70. [PMID: 26517148 PMCID: PMC10876359 DOI: 10.1590/1516-3180.2014.9490902] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 08/19/2014] [Accepted: 02/09/2015] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Only a few studies have focused on the main reasons for consultations at primary healthcare units within the Family Health Program. The aim here was to describe the reasons that led patients to seek assistance at four primary healthcare units in the city of Recife, Brazil. DESIGN AND SETTING Cross-sectional study at primary healthcare units in the city of Recife. METHODS Among adult patients who were consecutively attended at four primary healthcare units in the city of Recife, their two main reasons for going there were recorded by medical students. The students did not interfere in the consultation dynamics. The data were gathered between September 2010 and March 2011 and between November 2012 and August 2013. The reasons for the consultations were grouped into broader categories in accordance with the International Classification of Primary Care (ICPC-2). RESULTS 478 patients were included. Their mean age was 45.9 years (± 16 years) and 71% were female. Pain was the main reason for seeking medical attention (34%), followed by evaluation of tests, prescription renewal and medical certificates (17.6%). The most frequent types of pain were musculoskeletal pain (15.7%), headache (10.4%) and abdominal pain (8%). The main reasons for consultation according to ICPC-2 were in the general and nonspecific, musculoskeletal, nervous system-related and digestive tract categories. CONCLUSION Pain was the most frequent reason for seeking medical attendance at these primary healthcare units.
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Rocha-Filho PAS, Marques KS, Torres RCS, Leal KNR. Osmophobia and Headaches in Primary Care: Prevalence, Associated Factors, and Importance in Diagnosing Migraine. Headache 2015; 55:840-5. [DOI: 10.1111/head.12577] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 01/03/2023]
Affiliation(s)
| | | | - Rinailda Cascia Santos Torres
- Universidade de Pernambuco; Recife Brazil
- Scientific Initiation Fellowships Institutional Program (CNPq); Recife Brazil
| | - Kamila Nazare Ribas Leal
- Universidade de Pernambuco; Recife Brazil
- Scientific Initiation Fellowships Institutional Program (CNPq); Recife Brazil
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Department of Neuropsychiatry; Universidade Federal de Pernambuco; Recife PE Brazil
- Headache Clinic; Hospital Universitário Osvaldo Cruz; Universidade de Pernambuco; Recife PE Brazil
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