Abstract
Background: Epilepsy is a risk factor for suicidal ideation (SI). SI still poorly investigated in caregivers of people with epilepsy (PWE). Aim: We aimed to analyze the prevalence and predictors of SI in adults PWE and caregivers. Methods: We analyzed 548 consecutive PWE (60% women; median age 41 [18-83]) and 191 caregivers (72% women; median age 47 [18-82]) followed at Outpatients’ epilepsy clinics from a tertiary center. We used “item nine” (item scores ≥1) of the BDI-II to determine the SI presence. The presence of symptoms of anxiety (with BAI) and depression (with BDI-II) was defined with scores ≥14 (for both PWE and caregivers). The presence of anti-seizure drugs (ASDs) adverse effects was defined with the “Liverpool Adverse Events Profile” score≥46. Epidemiological factors and anxiety were investigated as predictors of SI in caregivers and PWE (along with seizure frequency, epilepsy-type, and ASDs’ adverse events). Results: Depression was present in 41% of the PWE and 32% of the caregivers (p=0.04). Anxiety was observed in 37% of PWE and 33% of caregivers (p=0.32). The SI frequency was higher in PWE (19%) compared to the caregivers (11%; p=0.02). Logistic regression analyses were performed for both groups separately. For the PWE (model accounted for 17%-27%), the most significant predictors were anxiety (OR 4.4, p<0.001), presence of ASDs’ adverse effects (OR 2, p=0.021), recurrent seizures (OR 3, p<0.004), and younger age (OR 0.98, p<0.037). For the caregivers (model accounted for 18-37%), only anxiety (OR 43, p<0.001) predicted SI. Conclusion: Identifying SI predictors is equally necessary for PWE and caregivers.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation
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