4 research outputs found
Review of Interventional Therapies for Refractory Pediatric Migraine.
This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children. Children may experience migraine differently than adults, and present not only with headache but also frequent gastrointestinal symptoms. They are frequently shorter in duration than in adults. Traditional migraine treatment in adults is less effective in children. In this population, adjunct therapies - such as interventional techniques - should be considered when traditional treatment fails, including Botulinum Toxin A (BTA) injections, peripheral nerve and ganglion blocks. BTA injections are FDA approved for migraine prophylaxis in adults, but currently not in children; however, recent evidence shows efficacy and safety in pediatric migraine management. Nerve blocks stop nociceptive afferent fibers through injection of local anesthetics, and it may be associated with the local injection of corticosteroids. Although more common in adults, recent data suggests they are safe and effective in children and adolescents. Blocking the sphenopalatine ganglion can be achieved through nasal approach, and achieves a similar action by blocking the entire ganglion. Interventional techniques may provide a key component in the alleviation of this otherwise debilitating chronic migraine pain. Though most studies have been performed in adults, new studies provide encouraging results for treatment in children
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What do individuals experiencing homelessness want for their care?: A needs assessment survey
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.The homeless population is growing across the United States, particularly in urban areas.
Homelessness has a detrimental impact on health and quality of life, especially among the
unsheltered homeless population. Oftentimes, there is a disconnect between existing community
services and actual needs of individuals experiencing homelessness. The purpose of this study
was to identify prioritized needs in an urban unsheltered homeless population and measure
associations with self-reported health. We conducted a needs assessment from April-June 2018
of 144 unsheltered homeless individuals in metro Phoenix, Arizona. The 16-question survey
investigated perceptions of priority needs, sources of medical care, health literacy, and health
status. Survey results were analyzed using Wilcoxon Rank Sum Test, Chi-squared analysis, and
multivariable logistic regression. Most respondents (91.6%) identified food as a top need. The
majority (64.1%) utilized emergency departments (EDs) as their primary source of care, and
40.1% reported suboptimal health. Suboptimal health was more likely to be reported in those
who expressed transportation (OR 3.03, 95% CI: 1.30-7.07) or medical care (OR 2.47, 95% CI:
0.99-6.14) as a top priority need. Health illiteracy (OR 3.68, 95% CI: 0.76-17.9) was associated
with suboptimal health, as was obtaining care at an ED (OR 2.05, 95% CI: 0.81-5.25). The data
demonstrate that food security was the top priority need of this urban unsheltered population.
Interventions improving accessibility to transportation, high-quality medical care, and health
education should be implemented to improve the health of this population. Such interventions
may also decrease care sought in ED settings. These conclusions are likely generalizable to other
unsheltered homeless populations in large urban cities; however, regional and cultural
differences exist. Our needs assessment may serve as a template for future needs assessments of
other urban unsheltered homeless populations.This item is part of the College of Medicine - Phoenix Scholarly Projects 2021 collection. For more information, contact the Phoenix Biomedical Campus Library at [email protected]
Review of Interventional Therapies for Refractory Pediatric Migraine.
This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children. Children may experience migraine differently than adults, and present not only with headache but also frequent gastrointestinal symptoms. They are frequently shorter in duration than in adults. Traditional migraine treatment in adults is less effective in children. In this population, adjunct therapies - such as interventional techniques - should be considered when traditional treatment fails, including Botulinum Toxin A (BTA) injections, peripheral nerve and ganglion blocks. BTA injections are FDA approved for migraine prophylaxis in adults, but currently not in children; however, recent evidence shows efficacy and safety in pediatric migraine management. Nerve blocks stop nociceptive afferent fibers through injection of local anesthetics, and it may be associated with the local injection of corticosteroids. Although more common in adults, recent data suggests they are safe and effective in children and adolescents. Blocking the sphenopalatine ganglion can be achieved through nasal approach, and achieves a similar action by blocking the entire ganglion. Interventional techniques may provide a key component in the alleviation of this otherwise debilitating chronic migraine pain. Though most studies have been performed in adults, new studies provide encouraging results for treatment in children
Review of Interventional Therapies for Refractory Pediatric Migraine
This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children. Children may experience migraine differently than adults, and present not only with headache but also frequent gastrointestinal symptoms. They are frequently shorter in duration than in adults. Traditional migraine treatment in adults is less effective in children. In this population, adjunct therapies -- such as interventional techniques -- should be considered when traditional treatment fails, including Botulinum Toxin A (BTA) injections, peripheral nerve and ganglion blocks. BTA injections are FDA approved for migraine prophylaxis in adults, but currently not in children; however, recent evidence shows efficacy and safety in pediatric migraine management. Nerve blocks stop nociceptive afferent fibers through injection of local anesthetics, and it may be associated with the local injection of corticosteroids. Although more common in adults, recent data suggests they are safe and effective in children and adolescents. Blocking the sphenopalatine ganglion can be achieved through nasal approach, and achieves a similar action by blocking the entire ganglion. Interventional techniques may provide a key component in the alleviation of this otherwise debilitating chronic migraine pain. Though most studies have been performed in adults, new studies provide encouraging results for treatment in children