Análisis de la situación actual de la cefalea en Andalucía

Resumen: Introducción y objetivo: La cefalea representa un motivo de consulta frecuente entre los médicos de atención primaria, urgencias y especialistas en Neurología, que no siempre es bien manejada. El Grupo de Cefaleas de la Sociedad Andaluza de Neurología (SANCE) se plantea conocer su manejo entre los distintos niveles asistenciales. Material y métodos: Estudio descriptivo transversal realizado mediante una encuesta retrospectiva en julio de 2019. Los participantes completaron una serie de cuestionarios estructurados recogiéndose distintas variables socio-laborales en cuatro grupos sanitarios distintos (Atención Primaria, Servicios de Urgencias, Neurología General, Unidades de Cefalea). Resultados: Se llevaron a cabo un total de 204 entrevistas repartidas entre los distintos grupos profesionales: 35 médicos de urgencias, 113 de atención primaria, 37 neurólogos generales y 19 neurólogos especialistas en cefaleas. El 85% de los médicos de AP prescribe fármacos preventivos, que mantiene durante al menos seis meses (59%), siendo flunarizina y amitriptilina los más utilizados. La atención primaria representa la vía principal de llegada a las consultas de Neurología General (65%), siendo los cambios en el patrón de la cefalea el principal motivo de derivación (74%). Todos los niveles asistenciales incluidos en el trabajo muestran gran interés en la cefalea y en la posibilidad de asistir a cursos de formación (97% AP, 100% médicos de urgencias, 100% neurólogos generales). Conclusiones: El presente trabajo ha observado escasez de recursos reflejado por prolongadas listas de esperas, así como gran interés en las cefaleas por parte de los participantes. Es necesario buscar otras formas de comunicación bilateral entre los distintos ámbitos asistenciales, como por ejemplo el correo electrónico. Abstract: Introduction and objective: Headache is a frequent reason for consultation between primary care physicians, emergency services physicians, and neurology specialists; however, it is not always well managed. The Andalusian Society of Neurology's Headache Study Group (SANCE) aimed to analyse headache management at different levels of care. Material and methods: We conducted a descriptive cross-sectional study with data gathered through a retrospective survey in July 2019. Participants completed a series of structured questionnaires on different social and work-related variables from 4 different groups of healthcare professionals (primary care [PC], emergency departments, neurology departments, headache units). Results: A total of 204 healthcare professionals completed the survey: 35 emergency department physicians, 113 PC physicians, 37 general neurologists, and 19 neurologists specialising in headache. Eighty-five percent of PC physicians reported prescribing preventive drugs, which were maintained for at least 6 months (59%), with flunarizine and amitriptyline being the most commonly used. Most patients attended at neurology consultations (65%) are referred by PC physicians, with changes in the headache pattern being the main reason for referral (74%). Healthcare professionals across all levels of care showed great interest in headache and in receiving training in headache management (97% of PC physicians, 100% of emergency services physicians, 100% of general neurologists). Conclusions: Migraine sparks great interest among healthcare professionals from different levels of care. Our results also reveal a lack of resources for headache management, which is reflected in the long waiting times. Other means of bilateral communication between different levels of care should be explored (e.g., e-mail)

Fungal planet description sheets: 625-715

Novel species of fungi described in this study include those from various countries as follows: Australia:Apiognomonia lasiopetali on Lasiopetalum sp Blastacervulus eucalyptorum on Eucalyptus adesmophloia,Bullanockia australis (incl. Bullanockia gen. nov.) on Kingia australis, Caliciopsis eucalypti on Eucalyptus marginata, Celerioriella petrophiles on Petrophile teretifolia, Coleophoma xanthosiae on Xanthosia rotundifolia, Coniothyrium hakeae on Hakea sp Diatrypella banksiae on Banksia formosa, Disculoides corymbiae on Corymbia calophylla, Elsinoë eelemani on Melaleuca alternifolia, Elsinoë eucalyptigena onEucalyptus kingsmillii, Elsinoë preissianae on Eucalyptus preissiana, Eucasphaeria rustici on Eucalyptus creta, Hyweljonesia queenslandica (incl. Hyweljonesia gen. nov.) on the cocoon of an unidentified microlepidoptera, Mycodiella eucalypti (incl. Mycodiella gen. nov.) on Eucalyptus diversicolor,Myrtapenidiella sporadicae on Eucalyptus sporadica, Neocrinula xanthorrhoeae (incl. Neocrinula gen. nov.) on Xanthorrhoea sp, Ophiocordyceps nooreniae on dead ant, Phaeosphaeriopsis agavacearum on Agavesp, Phlogicylindrium mokarei on Eucalyptus sp, Phyllosticta acaciigena on Acacia suaveolens,Pleurophoma acaciae on Acacia glaucoptera, Pyrenochaeta hakeae on Hakea sp, Readeriella lehmannii onEucalyptus lehmannii, Saccharata banksiae on Banksia grandis, Saccharata daviesiae on Daviesia pachyphylla, Saccharata eucalyptorum on Eucalyptus bigalerita, Saccharata hakeae on Hakea baxteri,Saccharata hakeicola on Hakea victoria, Saccharata lambertiae on Lambertia ericifolia, Saccharata petrophiles on Petrophile sp, Saccharata petrophilicola on Petrophile fastigiata, Sphaerellopsis hakeae onHakea sp, and Teichospora kingiae on Kingia australis. Brazil: Adautomilanezia caesalpiniae (incl. Adautomilanezia gen. nov.) on Caesalpina echinata, Arthrophiala arthrospora (incl. Arthrophiala gen. nov.) on Sagittaria montevidensis, Diaporthe caatingaensis (endophyte from Tacinga inamoena), Geastrum ishikawae on sandy soil, Geastrum pusillipilosum on soil, Gymnopus pygmaeus on dead leaves and sticks,Inonotus hymenonitens on decayed angiosperm trunk, Pyricularia urashimae on Urochloa brizantha, andSynnemellisia aurantia on Passiflora edulis. Chile: Tubulicrinis australis on Lophosoria quadripinnata.France: Cercophora squamulosa from submerged wood, and Scedosporium cereisporum from fluids of a wastewater treatment plant. Hawaii: Beltraniella acaciae, Dactylaria acaciae, Rhexodenticula acaciae,Rubikia evansii and Torula acaciae (all on Acacia koa). India: Lepidoderma echinosporum on dead semi-woody stems, and Rhodocybe rubrobrunnea from soil. Iran: Talaromyces kabodanensis from hypersaline soil.La Réunion: Neocordana musarum from leaves of Musa sp. Malaysia: Anungitea eucalyptigena onEucalyptus grandis × pellita, Camptomeriphila leucaenae (incl. Camptomeriphila gen. nov.) on Leucaena leucocephala, Castanediella communis on Eucalyptus pellita, Eucalyptostroma eucalypti (incl.Eucalyptostroma gen. nov.) on Eucalyptus pellita, Melanconiella syzygii on Syzygium sp, Mycophilomyces periconiae (incl. Mycophilomyces gen. nov.) as hyperparasite on Periconia on leaves of Albizia falcataria,Synnemadiella eucalypti (incl. Synnemadiella gen. nov.) on Eucalyptus pellita, and Teichospora nephelii onNephelium lappaceum. Mexico: Aspergillus bicephalus from soil. New Zealand: Aplosporella sophorae onSophora microphylla, Libertasomyces platani on Platanus sp, Neothyronectria sophorae (incl.Neothyronectria gen. nov.) on Sophora microphylla, Parastagonospora phoenicicola on Phoenix canariensis, Phaeoacremonium pseudopanacis on Pseudopanax crassifolius, Phlyctema phoenicis onPhoenix canariensis, and Pseudoascochyta novae-zelandiae on Cordyline australis. Panama: Chalara panamensis from needle litter of Pinus cf. caribaea. South Africa: Exophiala eucalypti on leaves ofEucalyptus sp, Fantasmomyces hyalinus (incl. Fantasmomyces gen. nov.) on Acacia exuvialis,Paracladophialophora carceris (incl. Paracladophialophora gen. nov.) on Aloe sp, and Umthunziomyces hagahagensis (incl. Umthunziomyces gen. nov.) on Mimusops caffra. Spain: Clavaria griseobrunnea on bare ground in Pteridium aquilinum field, Cyathus ibericus on small fallen branches of Pinus halepensis, Gyroporus pseudolacteus in humus of Pinus pinaster, and Pseudoascochyta pratensis (incl. Pseudoascochyta gen. nov.) from soil. Thailand: Neoascochyta adenii on Adenium obesum, and Ochroconis capsici on Capsicum annuum. UK: Fusicolla melogrammae from dead stromata of Melogramma campylosporum on bark ofCarpinus betulus. Uruguay: Myrmecridium pulvericola from house dust. USA: Neoscolecobasidium agapanthi (incl. Neoscolecobasidium gen. nov.) on Agapanthus sp, Polyscytalum purgamentum on leaf litter,Pseudopithomyces diversisporus from human toenail, Saksenaea trapezispora from knee wound of a soldier, and Sirococcus quercus from Quercus sp. Morphological and culture characteristics along with DNA barcodes are provided. © 2017 Naturalis Biodiversity Center & Westerdijk Fungal Biodiversity Institute