High Prevalence Of Headache Research Articles

Headache and Associated Psychological Variables in Intensive Care Unit Nurses during the COVID-19 Pandemic: A Prospective Study.

(1) Background: Headaches in health professionals have been studied over the years. This has become even more relevant during the COVID-19 pandemic, due to their link with the use of masks, being female or working in highly complex units. However, their association with different personality traits has not been studied in healthcare workers (HCWs). The aim of this study was to assess the prevalence and evolution of headaches throughout the pandemic in Intensive Care Unit (ICU) nurses and to analyze their association with sociodemographic, occupational and personality variables as well as with other symptoms. (2) Methods: This was an observational, descriptive, longitudinal, prospective study with two periods of data collection (at the end of the containment phase and six months thereafter). A non-probabilistic convenience sampling was performed (n = 131). (3) Results: A high percentage of ICU nurses reported headaches during the first (71%) or second (79.4%) time point; more than half of the sample (58.8%) reported headaches over time (chronic headache). Although a higher prevalence of headaches was observed in women at both assessment points, no significant gender-related relationships were observed for headaches maintained across the two time points. Regarding the symptoms and personality variables, positive relationships were found between headaches and anxiety (p = 0.005), insomnia (p = 0.030) and emotional exhaustion (p = 0.022), and a negative relationship was found between headaches and hardiness (p = 0.031). (4) Conclusions: Our study highlights the importance of assessing occupational, psychological and emotional aspects in order to decrease the prevalence of headaches and thus improve the quality of the work life of nurses in such demanding environments as the ICU.

QOL-53. EXPLORING HEADACHES IN PEDIATRIC NEURO-ONCOLOGY PATIENTS: A SINGLE INSTITUTION RETROSPECTIVE CHART REVIEW

Abstract BACKGROUND Despite the high prevalence of headaches in pediatric patients with brain tumors, very little research has been done to characterize their traits and to assess current management practices. Effective and efficient treatment of these headaches is critical to the optimization of brain tumor survivors’ quality of life. Foundational knowledge of any clinical associations likely would be beneficial to develop rational management strategies. METHODS A retrospective single-institution chart review of pediatric patients seen in the Children’s Hospital Colorado (CHCO) Neuro-oncology clinic from 1/1/22-12/31/22 is underway. Information is being collected via manual chart review including basic demographic information, oncologic diagnosis and tumor location, surgical interventions, and tumor-directed treatments. Headache characteristics, including timing of onset, associated symptoms, severity and frequency, referral to CHCO Neurology Headache Clinic and any headache therapies attempted will be sought. Additional information will include the number of emergency department visits and unplanned MRIs obtained as part of headache management. RESULTS 384 patients (53% male; median age 12 years, range 2-24 years) received care in the CHCO Neuro-oncology clinic in 2022. The majority of these patients were Caucasian/Non-Hispanic (61.7%), followed by Caucasian/Hispanic (13.8%) and African American/Non-Hispanic (4.2%). In this cohort, the preferred language for 93% was English and for 6% was Spanish. The majority (55%) of patients had a low-grade glioma/ glioneuronal tumor as their oncologic diagnosis. Patients with referrals to CHCO Headache clinic made up 13% of this cohort. Data collection and analysis are ongoing. CONCLUSIONS This data set will help to characterize the prevalence and features of headaches in pediatric patients with CNS tumors. This information will serve as the foundation for planned prospective studies that will collect more comprehensive and consistent data related to headaches in the pediatric neuro-oncology population and to formalize processes that will identify appropriate patients for referral to specialized headache providers.

Prevalence of primary headaches in multiple sclerosis patients

BackgroundMultiple sclerosis (MS) is the most common immune-mediated inflammatory disease of the central nervous system. It is characterized by symptoms such as visual disturbances, paresis with spasticity, paresthesia, numbness, and fatigue. However, several studies have shown a high prevalence of headaches in individuals with MS. Migraine and tension-type headaches are the most frequent types of headaches experienced by those with MS. Additionally, the role of MS disease-modifying agents must be considered. These agents have different modes of action and side effect profiles, and their use may sometimes trigger headaches in patients with MS. ObjectivesThis study aimed to explore the prevalence and clinical characteristics of primary headaches in MS patients. The relationship between headache and clinical features of MS (Course of MS, duration, EDSS, brain imaging and DMD) are also investigated. Subjects and MethodsTwo hundred and eighty-one MS patients diagnosed according to according to the 2017 revisions to the McDonald Criteria were included in the study. Data was collected from the MS unit medical records and from the interview with the patients. Patients with reported headaches are asked to recall their headache characteristics and patterns using an interviewer administered Arabic language-structured validated questionnaire. ResultsThe median age of patients was 33 years old, with a range of 22–55. Tension-type headache (TTH) was more common in males, patients with more severe disability (EDSS ≥ 3), and those with SPMS and PPMS phenotypes. Additionally, patients on rituximab or cyclophosphamide therapy were more likely to have TTH. On the other hand, females, patients with milder disability (EDSS < 3), and those with RRMS phenotype were more likely to have migraine. This was also true for patients with MRI lesions involving the periaqueductal gray, and those receiving INF or fingolimod (P < 0.05). Periaqueductal gray matter lesions were found in the MRI of 48 patients (40 %) who experienced headaches on more than 10 days per month. Sensorimotor lesions in the brain were found in 55 patients (53.4 %) with severe headaches (p-value < 0.001). Interferons were associated with an increased risk of worsening preexisting headaches and the appearance of de novo headaches related to its intake (odds ratio: 2.84, 3.72; relative risk: 1.63, 2.04; p-value = 0.03, < 0.001, respectively). On the other hand, rituximab was associated with a decreased risk of worsening preexisting headaches and the appearance of de novo headaches related to its intake (odds ratio: 0.04, 0.09; relative risk: 0.11, 0.18; p-value = < 0.001, < 0.001, respectively). ConclusionPrimary headaches are a common occurrence in patients with MS. Migraines and tension-type headaches (TTH) are among the most prevalent types. It has been observed that interferon can exacerbate preexisting headaches and even cause new ones. Additionally, the location of MS plaques may play a role in the frequency and severity of headaches.

The burden attributable to primary headache disorders in children and adolescents in Ethiopia: estimates from a national schools-based study.

We previously reported high prevalences of headache disorders among children (6-11 years) and adolescents (12-17 years) in Ethiopia. Here we provide data on headache-attributed burden collected contemporaneously from the same study participants. Part of the global schools-based programme within the Global Campaign against Headache, the study is the first to present such data from sub-Saharan Africa. A cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. The child or adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaires were self-completed under supervision by pupils in class. Headache diagnostic questions were based on ICHD-3 beta but for the inclusion of undifferentiated headache (UdH). Of 2,349 eligible participants, 2,344 completed the questionnaires (1,011 children [43.1%], 1,333 adolescents [56.9%]; 1,157 males [49.4%], 1,187 females [50.6%]; participating proportion 99.8%). Gender- and age-adjusted 1-year prevalence of headache, reported previously, was 72.8% (migraine: 38.6%; tension-type headache [TTH]: 19.9%; UdH: 12.3%; headache on ≥ 15 days/month (H15+): 1.2%). Mean headache frequency was 2.6 days/4 weeks but, with mean duration of 2.7h, mean proportion of time with headache was only 1.0% (migraine: 1.4%; TTH: 0.7%; H15+: 9.1%). Mean intensity was 1.8 on a scale of 1-3. Symptomatic medication was consumed on about one third of headache days across headache types. Lost school time reportedly averaged 0.7 days over the preceding 4 weeks, representing 3.5% of school time, but was 2.4 days/4 weeks (12.0%) in the important small minority with H15+. However, actual absences with headache the day before indicated averages overall of 9.7% of school time lost, and 13.3% among those with migraine. Emotional impact and quality-of-life scores reflected other measures of burden, with clear adverse impact gradients (H15 + > migraine > TTH > UdH). The high prevalence of headache among children and adolescents in Ethiopia, who represent half its population, is associated with substantial burden. Lost school time is probably the most important consequence. Estimates suggest a quite deleterious effect, likely to be reflected in both individual prospects and the prosperity of society.

Associations of Electronic Device Use and Physical Activity with Headaches in Saudi Medical Students.

Background and Objectives: Primary headaches are highly prevalent among medical students, negatively impacting their health and academic performance. Excessive electronic device use has been implicated as a risk factor, in contrast to physical activity, which may be a protective factor; however, comprehensive data are lacking, especially for Saudi medical trainees. This study aims to investigate the associations between device use, exercise, and headaches among Saudi medical students. Materials and Methods: In this cross-sectional study, 504 medical students at Jazan University completed an online survey collecting sociodemographic factors, headache characteristics/triggers, electronic device habits, exercise frequency, and headache impacts. Descriptive analyses summarized sample characteristics. Logistic regression identified predictors of 12-month headache prevalence. Results: Overall, 83% reported experiencing headaches in the past year. High headache prevalence was observed among females (86.6%) and third-year students (88.3%). Using electronic devices ≥4 h daily was associated with higher adjusted odds of headaches (OR 13.89, 95% CI 1.96-98.54) compared to ≤1 h daily. Low physical activity (exercising 1 day vs. 7 days a week) also increased headache odds (OR 3.89, 95% CI 1.61-9.42). Headaches impairing productivity (OR 4.39, 95% CI 2.28-8.45) and exacerbated by exercise (OR 10.37, 95% CI 2.02-53.35) were further associated with headache susceptibility. Conclusions: Excessive electronic device use and physical inactivity appear to be modifiable risk factors for frequent headaches in Saudi medical students. Multifaceted interventions incorporating education campaigns, skills training, and support services focused on promoting responsible technology habits, and regular exercise may help mitigate headaches in this population. Robust longitudinal studies and trials are warranted to establish causal mechanisms between lifestyle factors and headaches among medical undergraduates.

Sex-Related Differences in Self-Reported Symptoms at Diagnosis in Pheochromocytomas and Paragangliomas.

Biological sex can play a role in the severity of certain diseases. Our objective was to evaluate whether sex-related differences affect the signs and symptoms of pheochromocytomas and paragangliomas (PPGLs) at presentation. We reviewed the records of patients with PPGLs at our center from 1995 to 2022. Our study included 385 patients with PPGLs: 118 (30.6%) head and neck paragangliomas (HNPGLs), 58 (15.1%) thoracoabdominal paragangliomas (TAPGLs) and 209 (54.3%) pheochromocytomas (PHEOs). The cohort consisted of 234 (60.8%) women and 151 (39.2%) men. At diagnosis, more women than men presented with headaches (47.5% vs 32.4%; P = .007); however, more men presented with diabetes (21.1% vs 12.5%; P = .039). When subdivided by tumor location, headaches occurred more often in women with HNPGLs and TAPGLs (31.0% vs 11.4%; P = .0499 and 60.0% vs 21.7%; P = .0167). More men presented with diabetes among patients with PHEOs (28.2% vs 11.2%; P = .0038). In regard to nonsecretory PPGLs, women presented with a higher prevalence of headaches (46.9% vs 3.6%; P = .0002), diaphoresis (16.3% vs 0.0%; P = .0454), and palpitations (22.4% vs 0.0%; P = .0057). In patients with secretory tumors, women presented with more headaches (58.9% vs 42.7%; P = .0282) and men with more diabetes (29.3% vs 12.5%; P = .0035). In our cohort, more women presented with headaches across all tumor types and secretory statuses. More men presented with diabetes among patients with PHEOs and secretory tumors. In nonsecretory PPGLs, women had more adrenergic symptoms. These findings can be explained by differences in adrenergic receptor sensitivity, self-reported symptoms, and possibly other vasoactive peptides and sex-hormone status.

Examining the Impact of Puberty on Primary Headache Disorders in Female Schoolchildren: A Cross-Sectional Study.

Introduction and aim Headaches are one of the most prevalent childhood disorders. Primary and secondary headaches are the two types of headaches affecting kids and teenagers. The three most typical primary headache forms are tension-type headaches (TTH), migraine, and cluster headaches. This study sought to determine the relationship between puberty and types of headaches. Methods This cross-sectional study was conducted from May 18 to July 31, among female schoolchildren aged between eight and 15 years in the Eastern Province of Saudi Arabia. Respondents were recruited through face-to-face interviews. A self-administered questionnaire was utilized, mainly consisting of demographic data and questions related to diagnosing and managing the impact of puberty in girls on the prevalence of primary headache disorder. Results In total, 481 female schoolchildren were interviewed, mostly between 13 and 15 years old (65.9%). Last year prevalence of headaches was 65.5%, with a significant difference among those who lived in Dhahran (p=0.001) and those with a family history of headaches (p<0.001). The most common type of headache was frequent TTH (16.4%) and chronic TTH (16%). Chronic TTH (p<0.001), frequent TTH (p<0.001), and migraine without aura (p=0.005) were significantly more common among the older age groups. Conclusion There was a high prevalence of headaches among female schoolchildren, with frequent TTH and chronicTTH being the most common. Furthermore, increasing age was associated with an increasing risk for chronic TTH, frequent TTH, and migraine headaches without aura. More epidemiological studies are necessary to determine the underlying causes of headaches among schoolchildren.

Headache among combat-exposed veterans and service members and its relation to mild traumatic brain injury history and other factors: a LIMBIC-CENC study.

Headache (HA) is a common persistent complaint following mild traumatic brain injury (mTBI), but the association with remote mTBI is not well established, and risk factors are understudied. Determine the relationship of mTBI history and other factors with HA prevalence and impact among combat-exposed current and former service members (SMs). Secondary cross-sectional data analysis from the Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium prospective longitudinal study. We examined the association of lifetime mTBI history, demographic, military, medical and psychosocial factors with (1) HA prevalence ("lately, have you experienced headaches?") using logistic regression and (2) HA burden via the Headache Impact Test-6 (HIT-6) using linear regression. Each lifetime mTBI was categorized by mechanism (blast-related or not) and setting (combat deployed or not). Participants with non-credible symptom reporting were excluded, leaving N = 1,685 of whom 81% had positive mTBI histories. At a median 10 years since last mTBI, mTBI positive participants had higher HA prevalence (69% overall, 78% if 3 or more mTBIs) and greater HA burden (67% substantial/severe impact) than non-TBI controls (46% prevalence, 54% substantial/severe impact). In covariate-adjusted analysis, HA prevalence was higher with greater number of blast-related mTBIs (OR 1.81; 95% CI 1.48, 2.23), non-blast mTBIs while deployed (OR 1.42; 95% CI 1.14, 1.79), or non-blast mTBIs when not deployed (OR 1.23; 95% CI 1.02, 1.49). HA impact was only higher with blast-related mTBIs. Female identity, younger age, PTSD symptoms, and subjective sleep quality showed effects in both prevalence and impact models, with the largest mean HIT-6 elevation for PTSD symptoms. Additionally, combat deployment duration and depression symptoms were factors for HA prevalence, and Black race and Hispanic/Latino ethnicity were factors for HA impact. In sensitivity analyses, time since last mTBI and early HA onset were both non-significant. The prevalence of HA symptoms among formerly combat-deployed veterans and SMs is higher with more lifetime mTBIs regardless of how remote. Blast-related mTBI raises the risk the most and is uniquely associated with elevated HA burden. Other demographic and potentially modifiable risk factors were identified that may inform clinical care.

Early Postoperative Serum Sodium Level and Urine Output Volume Profile after Endoscopic Endonasal Transsphenoidal Surgery in Macroadenoma Pituitary Tumor

Introduction: Surgery is still the initial treatment of choice to for the majority of date with pituitary tumors. One of the most commonly performed minimally invasive neurosurgical procedures is transsphenoidal endoscopic endonasal surgery (ETS) and microscopic transsphenoidal surgery (MTS), used commonly for the resection of pituitary tumors. Neurosurgical operations for pituitary and suprasellar tumors may result in postoperative complications due to the crucial anatomical location of these tumors. The resulting postoperative complications can manifest as anterior or posterior pituitary dysfunction, particularly sodium disturbances, due to the changes in antidiuretic hormone (ADH) secretion, which remains one of the most frequent postoperative reasons for hospital readmission. Method: The aim of this study is to describe and determine the frequency distribution of patient characteristics who underwent endoscopic endonasal transsphenoidal resection of pituitary adenoma at Universitas Sumatera Utara Hospital between 2021 and 2022. Result: The findings of this study showed the frequency distribution of patient characteristics who underwent endoscopic endonasal transsphenoidal resection and postoperative sodium serum level profile as well as postoperative urine output profile. Discussion: The discussion section briefly discusses the findings and their implications. It mentions the high prevalence of headache and visual deficits among the patients, which aligns with previous studies. It also provides an overview of normal water balance and the pathophysiology of water balance disorders after pituitary surgery.

Association of lifestyle factors with the prevalence and nature of headache in adolescents

The article presents the results of a single-stage cross-sectional study, in which 225 students of a professional educational organization were examined. The frequency, localization, duration, intensity, nature of headache, lifestyle factors of adolescents (physical activity, mental load, use of information and communication tools, sleep quality, smoking) were analyzed. A multiple regression analysis was built, as well as an assessment of the relative risk and the odds ratio of developing a headache. Results. A significant prevalence of high frequency, duration, and intensity of headache has been established. The main lifestyle factors provoking the development of headache and influencing its characteristics are tobacco smoking, prolonged use of information and communication tools, and mental stress. Also, a significant relationship was established between the incidence of headache and sleep disturbance. Research limitations. The study has regional (Saratov region) and age restrictions (adolescence). Conclusion. A high prevalence of headache among the surveyed adolescents was established. Priority modifiable factors influencing the development and course of headache have been identified. Rational pedagogical planning of curricula, raising the awareness of adolescents and their parents about the influence of modifiable factors on the occurrence of headaches can be a significant method for preventing the development of headaches.

CORRELATION BETWEEN EXAMS AND MIGRAINE AMONG MEDICAL STUDENTS IN MADINAH, SAUDI ARABIA

Background: The migraine headache is a common and potentially debilitating disorder often treated by family physicians the students lately is suffering inexam time with migraine headache. Objective:To determine migraine prevalence, prediction, triggers and effects during examinations among medical students in Al Rayan college, Madinah,Saudi Arabia, 2022-2023. Methods: A cross-sectional study well be used. The date collection method is done by sending an online questionnaire to students in Al Madinah Will be validated. The simple size was 343 students in Al - Rayan College, Madinah, Saudi Arabia 2022-2023. Data will be analysed by Microsoft Excel and SPSS. Results: Our study included 345 medical students, whose study years ranged from the fifth year, the sixth year, and the internship year, the prevalence of migraine was (28.7%). More than half of the participants were females, 212 (61.2%), and 134 (38.8%) % were male. In bi variate analysis, migraine was associated with gender (female), family history, and chronic diseases, namely irritable bowel syndrome (IBS), asthma and hypertension. The most frequently reported triggers of migraine were sleep disturbance (76.8%) and stress (61.2%). Photophobia and difficulty in concentration were the commonest associated symptoms. Conclusion:Participants in the current study showed a relatively high prevalence of headaches and migraines. Female gender in the sixth academic year and irritable bowel syndrome enrolment were predictors of migraine. Stress and sleep disturbances are the most common triggers.

Dexamethasone and Statins in Patients Undergoing Primary Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Propensity-Matched Study in the TriNetX Research Network

Middle meningeal artery embolization (MMAE) is an effective minimally invasive option for chronic subdural hematoma (cSDH). Dexamethasone and statins have been reported to improve the resolution of cSDH and reduce its recurrence. However, only 1 study has investigated the role of statins in patients treated with MMAE, and there is no such study on dexamethasone. Thus, we used the TriNetX research network to determine whether adding dexamethasone or statin along with primary MMAE is associated with a benefit in outcomes. We queried all primary MMAE cases for cSDH between January 1st, 2012, and July 1st, 2022, in the TriNetX research network. We included patients greater than or equal to 18years old and separated them regarding statin and dexamethasone use around the time of MMAE. Outcomes were evaluated within 6months and 3years after MMAE, and analyses were performed before and after propensity score matching. The study included 372 patients with chronic subdural hematoma who underwent MMAE and were on dexamethasone, 339 not on dexamethasone, 391 on statins, and 278 not on statins. After propensity score matching, the dexamethasone cohorts included 250 patients each and only headache remained more prevalent in the dexamethasone cohort at both 6months (21.2% vs. 10.0%, P= 0.001) and 3years (23.6% vs. 12.4%, P= 0.001). After propensity score matching, the statin cohorts included 150 patients each and no differences in outcomes were found at both 6months and 3months after MMAE. Patients treated with primary MMAE and were on dexamethasone or statins had no differences in mortality and functional/provider dependence compared to those who were not on dexamethasone or statins. Patients on dexamethasone had a higher prevalence of headaches.

Symptoms at presentation in conservatively managed patients with non-functioning pituitary adenomas

Hypopituitarism and tumor growth are rare in patients with non-functioning pituitary microadenomas (NFPmA). However, patients often present with non-specific symptoms. The aim of this brief report is to examine presenting symptomatologyin patients with NFPmA compared to patients with non-functioning pituitary macroadenomas (NFPMA). We performed a retrospective review of 400 patients (347 NFPmA and 53 NFPMA) who were conservatively managed; no patients had indications for urgent surgical intervention. Average tumor size was 4.5 ± 1.9 and 15.5 ± 5.5mm for NFPmA and NFPMA, respectively (p < 0.001). At least one pituitary deficiency was present in 7.5% of patients with NFPmA and 25% of patients with NFPMA. Patients with NFPmA were younger (41.6 ± 15.3 vs. 54.4 ± 22.3years, p < 0.001) and more commonly female (64.6 vs. 49.1%, p = 0.028). There was no significant difference reported for similarly high rates of fatigue (78.4% and 73.6%), headache (70% and 67.9%), and blurry vision (46.7% and 39.6%). There were no significant differences in comorbidities. Despite smaller size and lower rate of hypopituitarism, patients with NFPmA presented with a high prevalence of headache, fatigue, and visual symptoms. This was not significantly different from patients with NFPMA who were conservatively managed. We conclude that symptoms of NFPmA cannot fully be attributed to pituitary dysfunction or mass effect.

Knowledge of the medical resident about diagnosis and treatment of patients with headache

Introduction Considering the high prevalence of headache, it is necessary a study about the effectiveness of the care of patients with headache by medical resident in Emergency Care Units (EDU) and medical outpatient clinics. Objective The objective of this study was to analyze the effectiveness of care in EDUs, outpatient clinics and medical wards and the management of patients with headache complaints. Method The study was observational descriptive (cross-sectional cohort) through the application of an online questionnaire answered by the medical residents. Results There were 115 residents who answered the survey. In the group of residents who see patients with headache (n=95) the number of visits was 4.87 per week. The resident's idea is that headaches are symptoms of an underlying disease in 49.5% of them. On the question about feeling able to differentiate primary from secondary headaches, 50% of the residents said yes. On the question, "Is Migraine the same as Headache?" 6.1% answered yes. On the question, "Would you use morphine derivatives to treat headache?" 19.1% of the residents answered that they would. On the question about having knowledge about the harms of using morphine derivatives in headache, 60% answered that they did not have in-depth knowledge or that they have no knowledge. In this sample of residents, 74/115 (65%) suffer from headache. Only 36/115 (31%) of the residents sought care because of the headache. Of the residents, 3/115 (2.6%) have chronic daily headache. In the question about knowing what is "chronic daily headache" and from medication overuse, about 35% do not know or did not delve into the concept. Conclusion We conclude that there is a lack of teaching about types of headaches, criteria for diagnosis and treatment. Urgent modifications should be made in the medical course to enable newly graduated doctors to diagnose and treat patients with headache.

Associations between Fatty Acid Intake and Tension-Type Headache: A Cross-Sectional Study

Patients with tension-type headache (TTH) are characterized by recurrent pain that can become disabling. Identifying the dietary triggers of headaches has led to defining dietary strategies to prevent this disease. In fact, excessive dietary intake of Omega-6 (ω-6) fatty acids, or an ω-6: ω3 ≥ 5 ratio, typical of Western diets, has been associated with a higher prevalence of headaches. The objectives of the present study were to compare dietary fatty acid intake between participants with and without chronic TTH and to investigate the association between dietary fatty acid intake, pain characteristics, and quality of life in patients with chronic TTH. An observational study was conducted, comparing healthy participants (n = 24) and participants diagnosed with chronic TTH for more than six months (n = 24). The variables analyzed were dietary fatty acid intake variables, the Headache Impact Test (HIT-6), and the characteristics of the headache episodes (intensity, frequency, and duration). The TTH group reported a significantly higher intake of saturated fatty acids (SFAs) but similar intakes of monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and ω-6: ω-3 ratio when compared to controls. Furthermore, in the TTH group, the Ω-6 fatty acid intake was associated with more intense headache episodes. In addition, the TTH group reported a significant impact of headaches on their activities of daily living according to the HIT-6. Higher intakes of SFAs and Ω-6 fatty acids were associated with more severe headache episodes in patients with TTH. Therefore, the characteristics of the diet, in particular the dietary fatty acid intake, should be considered when treating these patients.

Prevalence of Helmet Induced Headache among Bikers

Aim: To find prevalence of helmet induced headache among bikers. Methods: A cross sectional study using convenient sampling was conducted on male bike riders of Lahore. After approval from ethical committee participants were selected on the basis of inclusion and exclusion criteria. Informed consent was taken. 102 participants filled out self-made questionnaire. Data was analyzed by using SPSS version 21 in form of frequencies, mean, standard deviation and pie chart. Results: The mean age of participants was 22.77±1.72 years. A total of 52 participants (51%) were reported having headache. Prevalence of helmet induced headache came out to be 6(11.5%) among bikers. A total of 83% used helmet occasionally and 18.17% reported to use it always. The duration of headache for half of the participants (50%) was 20-30 min after wearing helmet, 38.5% had headache duration lasting for 1-5 days in a month. Majority had stabbing (25%) type of pain, among them only (9.6%) visited hospital due to headache. Conclusion: There was high prevalence of headache (stabbing and aching) in bikers but mostly didn’t report complaint of headache specifically while wearing helmet or after removing it. Keywords: Headache, helmet, prevalence, primary prevention

Association of Acute Headache of COVID-19 and Anxiety/Depression Symptoms in Adults Undergoing Post-COVID-19 Rehabilitation

As a common non-respiratory symptom of COVID-19, headache should not be overlooked, and its characteristics should be recorded with scrutiny. Identifying risk factors associated with post-COVID headache will ensure immediate action and counseling for this population of patients. Therefore, the study aimed to investigate the relationship between headache and psychological state (stress level, depression, and anxiety symptoms) in adults undergoing post-COVID-19 rehabilitation. In addition, we used mediation analysis to evaluate the mediation effect of psychological variables in the relationship between headache and quality of life. This cross-sectional study included 147 patients undergoing post-COVID-19 rehabilitation at the Public Hospital in Poland (64 males, 83 females, with mean age of 56.97 years). Psychological parameters were evaluated using the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-10), and the brief World Health Organization Quality of Life Scale (WHOQOL-BRIEF). Additionally, all participants completed a questionnaire related to COVID-19 symptoms and their severity, the place of COVID-19 treatment, and the need for oxygen therapy during hospitalization. Of all participants, 65% experienced headache during COVID-19. Of the participants with headache, there were significantly more females in this group (69% vs. 31%), and they were significantly younger (mean age 55.47 vs. 59.78 years). Participants with headache had a 27% higher HADS-D score, a 21% higher HADS-A score, and a 13% higher PSS-10 score. Moreover, gender and headache were found to be important predictor variables for total HADS and HADS-D, accounting for 11% and 7%, respectively. Mediation analysis has shown that the tested psychological variables mediated 39–68% of the total effect of headache influence on WHOQOL domains. In conclusion, our study demonstrated several relationships between headache that occurred during COVID-19 and symptoms of depression, anxiety, and perceived stress level during post-COVID rehabilitation also in the context of quality of life. Our results show that patients who experienced headaches during COVID-19 are at high risk of developing anxiety-depressive symptoms later. Female gender is associated with a higher prevalence of headache during COVID-19.

Brain 18-FDG-PET patterns in early breast cancer subtypes: Relationship with headache.

e12560 Background: Brain metabolic response on 18F-fuorodeoxiglucose(FDG)-PET in breast cancer (BC) patients is not routinely investigated, although several bidirectional relationships have been described between BC (and BC therapies) and brain functions. For example, common forms of headaches, as migraine (Mi) and tension-type headache (TTH), seem to be oddly distributed among BC subtypes and possibly influence the outcome. Methods: We recruited patients with early BC referring to IRCCS Humanitas Research Hospital who received neoadjuvant chemotherapy. Demographic data, BC characteristics and headache diagnosis were recorded, through detailed interview and instrumental investigation. Ki67 was considered high if above 20%. All patients underwent dedicated 18F-FDG PET scan for the evaluation of brain metabolism. Semiquantitative image analysis was performed using Cortex ID software (GE), comparing patient’s scan with a control group by the means of Z-score. The difference between patients’ subgroups were assessed using One-way ANOVA model. Results: Twenty-three patients were recruited. The median age was 52.5±10.8 years; 65.2% were postmenopausal, 30% premenopausal, and one patient perimenopausal. Ten patients were diagnosed as triple-negative BC, 6 as HER2-positive and 7 as Luminal B/HER2+. Nearly 70% (16/23) of patients had high Ki67 values. All patients had ECOG PS 0. Ten patients were diagnosed with TTH, 9 with migraine of whom two with aura, and four patients had no headache. Eleven patients had active headache at the moment of the study. At the whole brain level, we found a significant increase of brain metabolism in the left hemisphere of BC patients with high Ki-67 (p=0.007). Moreover, the same result was found in parietal cortex and in general associative areas bilaterally. Instead, HER-2 positive BC patient showed a reduced metabolism in right temporal cortex compared to HER-2 negative (p=0.04). Grading and other tumor characteristics did not influence FDG-PET uptake. BC patients with TTH had a reduced activity in right medial frontal lobe compared with migraine patients (p=0.01). Those with an active headache had increased activity in posterior cingulate and reduced activity in visual networks (p=0.03). Conclusions: Although exploratory, this study suggests that BC subtypes could present different metabolic pattern of cerebral activity, particularly in dominant hemisphere and associative areas. The high prevalence of headache in our sample does not affect the above pattern, but it is associated with an altered activation in other networks, mainly cingulate and visual cortex, which are well-known areas involved in primary headache.

THE IMPORTANCE OF THE SYMPTOMS FOR DIAGNOSING AND TREATING OF HYPERTENSION IN CHILDREN, ADOLESCENTS AND YOUNG-AGED, ASSESSED WITH APPLANATION TONOMETRY

Objective: The aim is to know if the presence of symptoms in children, adolescents, and young-aged are important for early diagnosis and therapy of hypertension. Design and method: For this cross-sectional study was entered 180 children, adolescents, and young-aged, female 96 -male 84 (F-M), divided into 3 groups of age: from 5 years to 12, from 13 to 18, and from 19 to 22 years. Principally, patients consulted for the presence of symptoms. During the anamnesis, several symptoms were registered, such as headache, palpitations, thoracic pain, breathlessness, sweating, asthenia, and mental confusion. Was entered the anthropomorphic measures, systolic and diastolic blood pressure (S-DBP), heart rate, central hemodynamics parameters (CHP), and difference of augmentation index (Diff AIx) between observed values and normal levels, evaluated with applanation tonometry (Sphygmocor-PVX AtCor-Medical Australia) according to standards methods. Results: In F-M, S-DBP increased from 1 group (104.3/66.9–109.1/67.7 mmHg) to 2 group (117.5/71.5–120.4/72.0 mmHg). Into the 3 group (117.9/73.0–126.6/77.8 mmHg) a slight increase was observed (normal values according to JHypertens 2019). Similar changes occur in CHP, but central aortic pressure and pulse pressure were higher than normal, both sexes. The Diff-AIx (surrogate value of arterial stiffness), was measured only in the 3 group and results were higher than normal, both sexes. High prevalence of headache was observed among female 69%-76% and male 53%-47% in the 2-3 groups, respectively, and high percentage of palpitations too, among female 66%-64% and male 47%-41% in the 2-3 groups, respectively. Also, was observed thoracic pain, dyspnoea, sweating, and asthenia whose prevalence increases with age. Few cases of mental confusion were more prevalent in females (7%-7%) in the 2-3 group. Patients in therapy with Angiotensin Receptors Blocker were registered female 31%-38% and male 40%-47% into the 2-3 group, respectively. All the patients treated improved the symptoms since the first month. Conclusions: In the diagnosis of Hypertension in children, adolescents, and young-aged it is very important the evaluation of symptoms and assesses them by applanation tonometry to know the optimal time of therapy to more early age with the objective of preventing future complications.

The online learning experience and reported headaches associated with screen exposure time among Saudi health sciences students during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has become a global health issue and has significantly impacted university education. As a result, learning methods have been shifted to be delivered through online learning. Online learning has increased reliance on computer screens, which can cause visual discomfort and may cause or exacerbate headaches due to prolonged screen exposure. However, time spent using electronic devices has not yet been examined in relation to the online learning experience.PurposeThis study assessed the online learning experiences and reported headaches associated with screen exposure time among health sciences university students.MethodsA cross-sectional study was conducted among a convenience sample of 353 students at Saudi University. Online learning experiences, screen time exposure, and reported headache questionnaires were used to collect the data.ResultsStudents were moderately satisfied with the online learning experience. Nevertheless, they faced many challenges with online learning that affected their communication efficacy, and they preferred that blended learning be continued. In addition, this study found a high prevalence of headache (65.72%) and a high screen exposure time among the studied students (52.69%). Increased screen time exposure is linked with increased headache and migraine reporting among students (p < 0.05).ConclusionHeadache is a common health issue among health professional students, and it can harm their academic performance and quality of life, especially related to online learning. Greater awareness of headaches, stress reduction and prevention programs, and ergonomic practices to deal with headaches are essential. Blended learning approaches can improve student learning and performance in health science courses.