Prevalencija vertiga u bolesnika s migrenom i u osoba bez glavobolje

The aim of this study was to assess the prevalence of vertigo and dizziness in patients with migraine as compared to the control group without a headache. A total of 327 patients with migraine and the control group of 324 subjects were evaluated for vertiginous signs and dizziness, time of onset of the symptoms, frequency of the symptoms and temporal association of the symptoms with the migraine attack. More than half of the migraine patients had in their lifetime experienced a sense of vertigo or dizziness: 169 patients (51.7%), and 102 subjects (31.5%) in the control group. Vertigo symptoms were associated with a migraine attack always in 38 (22.5%), sometimes in 38 (22.5%) and were not associated in 93 (55.0%) patients. Patients having migraine with aura significantly more often have migraine attacks associated with symptoms of vertigo or dizziness. Our study, together with other similar studies, suggests that migraine should be considered in the differential diagnosis of vertigo.Cilj ovog istraživanja bio je procijeniti prevalenciju vertiga u bolesnika s migrenom i u kontrolnoj skupini osoba bez glavobolja. Ukupno je 327 bolesnika s migrenom i 324 osobe u kontrolnoj skupini ispitano da li imaju simptome vrtoglavice, o vremenu nastanka simptoma, učestalosti simptoma i vremenskoj povezanosti simptoma s napadom migrene. Više od polovine bolesnika s migrenom je imalo osjećaj vrtoglavice: 169 bolesnika (51.7%), a u kontrolnoj skupini 102 osobe (31.5%). Simptomi vrtoglavice bili su povezani s napadom migrene uvijek u 38 bolesnika (22.5%), ponekad u 38 bolesnika (22.5%), a nisu bili povezani u 93 bolesnika (55.0%). Bolesnici koji imaju migrenu s aurom značajno češće imaju napade migrene povezane sa simptomima vrtoglavice. Ovo istraživanje, kao i ostala slična istraživanja, pokazuje da treba uzeti u obzir migrenu u diferencijalnoj dijagnozi vertiga

Infekcije respiratornim sincicijskim virusom u zimskoj sezoni 2005/2006

Cilj ovog rada bio je određivanje epidemioloških karakteristika infekcija respiratornim sincicijskim virusom (RSV) u djece na području zagrebačke županije u zimskoj sezoni 2005/2006. godine.Metode: U istraživanju je sudjelovalo 588 bolesnika s akutnom respiratornom infekcijom (ARI). Bolesnici su bili s područja zagrebačke županije i hospitalizirani u zagrebačkim bolnicama od kolovoza 2005. do kolovoza 2006. godine. Od svakog bolesnika uzet je klinički materijal-nazofaringealni sekret, te je detekcija virusa rađena pomoću komercijalnih monoklonskih protutijela u izravnom imunofluorescentnom testu, a izolacija virusa u staničnoj kulturi. Rezultati: Infekcija RSV-om dokazana je u 121/588 tj. 20,57% bolesnika s ARI RSV je dokazan kao uzročnik infekcija gornjeg respiratornog trakta u 39/286 tj. 13,63% bolesnika. Dokazan je kao najčešći uzročnik bronhiolitisa u 38/70 tj. 54,28% bolesnika, pneumonije u 19/71 tj. 26,76%, bronhitisa u 20/71 tj.28,16%, te krupa u 1/7 tj. 14,28% bolesnika. Vrhunac epidemijskog tijeka RSV-infekcije je bio u ožujku 2006. godine.Zaključak: Kako je RSV čest uzročnik infekcija donjeg respiratornog trakta u dojenačkoj dobi, poglavito u zimskim mjesecima, nužno je - provođenjem adekvatne virološke dijagnostike- ustanoviti bolest zbog individualnog liječenja i profilakse, te početak epidemije i njen tijek u populaciji zbog poduzimanja mjera sprječavanja širenja infekcije u dječjim kolektivima

Infekcije respiratornim sincicijskim virusom u zimskoj sezoni 2005/2006

Cilj ovog rada bio je određivanje epidemioloških karakteristika infekcija respiratornim sincicijskim virusom (RSV) u djece na području zagrebačke županije u zimskoj sezoni 2005/2006. godine.Metode: U istraživanju je sudjelovalo 588 bolesnika s akutnom respiratornom infekcijom (ARI). Bolesnici su bili s područja zagrebačke županije i hospitalizirani u zagrebačkim bolnicama od kolovoza 2005. do kolovoza 2006. godine. Od svakog bolesnika uzet je klinički materijal-nazofaringealni sekret, te je detekcija virusa rađena pomoću komercijalnih monoklonskih protutijela u izravnom imunofluorescentnom testu, a izolacija virusa u staničnoj kulturi. Rezultati: Infekcija RSV-om dokazana je u 121/588 tj. 20,57% bolesnika s ARI RSV je dokazan kao uzročnik infekcija gornjeg respiratornog trakta u 39/286 tj. 13,63% bolesnika. Dokazan je kao najčešći uzročnik bronhiolitisa u 38/70 tj. 54,28% bolesnika, pneumonije u 19/71 tj. 26,76%, bronhitisa u 20/71 tj.28,16%, te krupa u 1/7 tj. 14,28% bolesnika. Vrhunac epidemijskog tijeka RSV-infekcije je bio u ožujku 2006. godine.Zaključak: Kako je RSV čest uzročnik infekcija donjeg respiratornog trakta u dojenačkoj dobi, poglavito u zimskim mjesecima, nužno je - provođenjem adekvatne virološke dijagnostike- ustanoviti bolest zbog individualnog liječenja i profilakse, te početak epidemije i njen tijek u populaciji zbog poduzimanja mjera sprječavanja širenja infekcije u dječjim kolektivima

Self-Reported Confidence, Attitudes and Skills in Practical Procedures among Medical Students: Questionnaire Study

The aim of our study was to investigate the influence of gender, loss of academic year(s), confidence and attitudes of students on the clinical experience gained by undergraduate education. The survey was conducted during 2004 and 2005 in a sample of 182 students of the 5th and the 6th year at J.J.Strossmayer University School of Medicine in Osijek. The participants were grouped and matched according to their gender, regular studying, the number of time(s) student has performed certain practical medical procedure and the self-confidence arisen by performing one. Furthermore, participants were grouped and compared due to their own assessment of their own practical and theoreticalmedical knowledge, courses which provide them the least and oppositely – the most practical medical knowledge and their attitude toward current medical faculty curriculum on clinical courses as well as the possibilities of improving them. Fisher’s exact test and c 2-test were used to estimate statistical differences between the groups and the parameters in research, while coefficient of contingency was introduced with the aim of defining their correlation. The results showed statistically significant differences between male students who performed more practical medical procedures than female (p<0.001), nonrepeaters performed medical procedures more often than repeaters (p<0.001, C=0.658) while repeaters thought higher of their theoretical knowledge than non-repeaters (p<0.005). Data analysis showed statistically significant correlation between clinical experience and the level of confidence (C=0.944). This study confirmed influence of male gender, regular studying, better opinion about one’s own practical skills and higher confidence in one’s own work on greater number of clinical skills performed during undergraduate education

Migraine and Tension-Type Headache in Medical Students: A Questionnaire Study

The purpose of our study was to perform an epidemiological study of migraine and tension-type headache (TTH) in medical students (MS) at University of Zagreb Medical School and to determine whether there are differences in prevalence, trigger factors, health care utilization and self-medication between sixth year and first year MS. This study included 314 students who answered a questionnaire from October to November 2003. The prevalence of migraine was 8.86% in first year students and 10.90% in sixth year students while the prevalence of TTH was 60.13% and 57.69% respectively. Female students suffered from migraines significantly more often than male students (p=0.017). Female students with migraine linked their headaches to their menstrual cycle significantly more often than female students with TTH (p=0.011). Significantly more first year students have visited a doctor concerning their headaches than sixth year students. Also, there is a significantly higher level of self-medication amongst sixth year students. Our study has shown that a relatively large percent of MS suffers from TTH; a low percent is seeking medical advice for headaches, the majority is self-medicated, and an unacceptably low percentage is taking triptans for migraine

Music as an Auditory Stimulus in Stroke Patients

Auditory stimulation increases mean blood flow velocity (MBFV) in the middle cerebral artery (MCA) in healthy individuals. Our aim was to monitor such changes in the affected MCA of patients with acute ischemic stroke (AIS). The study included 66 non-thrombolysed patients with AIS who were divided into groups according to National Institutes of Health Stroke Scale (NIHSS) score. Group I consisted of patients with NIHSS score £ 10 and group II with NIHSS score ³11. Affected MCA was insonated with transcranial Doppler (TCD). MCA MBFVs were monitored during listening to music for 30 minutes. The first response of MBFV increase was measured as time (Tmax) and percentage of amplitude change (Amax). Pearson Chi-Square test was used. In 78.85% of patients there was a significant increase in MBFV compared to baseline values as a reaction to the music. There was no significant difference in Tmax or Amax between the two groups. However, a trend of longer Tmax was observed with every 2 NIHSS score increase. Music is an auditory stimulus in stroke patients and can be measured with TCD as MCA MBFV increase. Although our study showed no significant change of reaction time with the severity of stroke, a trend of prolonged Tmax was observed with NIHSS score increase

Music as an Auditory Stimulus in Stroke Patients

Auditory stimulation increases mean blood flow velocity (MBFV) in the middle cerebral artery (MCA) in healthy individuals. Our aim was to monitor such changes in the affected MCA of patients with acute ischemic stroke (AIS). The study included 66 non-thrombolysed patients with AIS who were divided into groups according to National Institutes of Health Stroke Scale (NIHSS) score. Group I consisted of patients with NIHSS score £ 10 and group II with NIHSS score ³11. Affected MCA was insonated with transcranial Doppler (TCD). MCA MBFVs were monitored during listening to music for 30 minutes. The first response of MBFV increase was measured as time (Tmax) and percentage of amplitude change (Amax). Pearson Chi-Square test was used. In 78.85% of patients there was a significant increase in MBFV compared to baseline values as a reaction to the music. There was no significant difference in Tmax or Amax between the two groups. However, a trend of longer Tmax was observed with every 2 NIHSS score increase. Music is an auditory stimulus in stroke patients and can be measured with TCD as MCA MBFV increase. Although our study showed no significant change of reaction time with the severity of stroke, a trend of prolonged Tmax was observed with NIHSS score increase

Je li anemija zbog nedostatka željeza povezana s menstrualnom migrenom? – post hoc analiza opservacijske studije za procjenu kliničkih značajka bolesnica s menstrualnom migrenom

The aim of this study was to determine the relative prevalence and clinical characteristics of patients with pure menstrual migraine (PMM) and menstrually related migraine (MRM), and to compare them with the women free of it in an outpatient clinic-based population. Adult menstruating women with ICHD-2 migraine were included. Demographic data were obtained by verbal report. Study women were asked to keep a headache diary for 6 months, in which they recorded information on headache characteristics, medication use and presence of menses. Iron deficiency anemia was considered to be present if the patient had received therapy for iron deficiency anemia or laboratory tests indicated low iron and/or hemoglobin levels (within one year). A total of 289 women were included, 52 (18.0%) with PMM and 116 (40.1%) with MRM, whereas 121 (41.9%) women had not observed any relationship between migraine and their menstrual cycle (non- MM). Duration of migraine attacks was longer in PMM/MRM patients (P<0.0001). No significant difference was observed according to other migraine-associated symptoms. Women with PMM/ MRM took significantly more tryptans (P<0.0001) and iron deficiency anemia was significantly more common in women with PMM/MRM (P=0.008). In conclusion, this study supported earlier findings that PMM/MRM has similar clinical characteristics as non-MM, except for longer duration. In addition, iron deficiency anemia is more common in women with PMM/MRM, which may be an underlying mechanism aggravating migraine attacks.Cilj ove studije bio je utvrditi relativnu učestalost i kliničke značajke bolesnica s isključivo menstrualnom migrenom (IMM) i mentrualno povezanom migrenom (MPM) u odnosu na ostale bolesnice s migrenom. U studiju su bile uključene žene reprodukcijske dobi s migrenom prema kriterijima ICHD-2. Sudionice su zamoljene da vode dnevnik glavobolja tijekom 6 mjeseci u koji su zapisivale karakteristike glavobolja, lijekove koje su uzimale i datume menstruacije. Sideropenična anemija je evidentirana ako su laboratorijski testovi u posljednjih godinu dana ukazivali na niske razine željeza i/ili hemoglobina. U studiju je bilo uključeno 289 žena, 52 (18,0%) s IMM i 116 (40,1%) s MPM, dok 121 (41.9%) žena nije primijetila povezanost između migrene i menstrualnog ciklusa (ne-MM). Trajanje migrenskih napadaja je bilo duže kod bolesnica s IMM/MPM (P<0,0001). Nije zabilježena značajna razlika u odnosu na druge prateće simptome migrenske glavobolje. Žene s IMM/MPM značajno su češće uzimale triptane (P<0,0001). Sideropenična anemija bila je značajno češća kod žena s IMM/MPM (P=0,008). Zaključeno je kako uz duže trajanje glavobolja žene s IMM/MPM imaju i druge slične kliničke značajke kao i ne-MM. Također, sideropenična anemija bila je češća kod žena s IMM/MPM, što može biti potencijalni mehanizam koji pogoršava migrensku glavobolju

Women and Stroke: How Much do Women and Men Differ? A Review – Diagnostics, Clinical Differences, Therapy and Outcome

In this article, the authors have gathered data from epidemiological, observational, case-control and cohort studies to evaluate the differences between men and women in terms of ischemic events, mainly stroke. The authors are highlighting the differences that exist between men and women and play a role in terms of social diversities, and the pathophysiological differences that may be responsible at least in part for ischemic events. Studies show that male stroke patients are more likely to have a history of ischemic heart disease, smoking and alcohol consumption, whereas female stroke patients suffer from ischemic events at an older age, are more likely to have hypertension and atrial fibrillation. Women are more likely to arrive to an emergency room in a comatose state, with paralysis, aphasia, swallowing problems and urinary incontinence, which all indicates a more severe stroke. Also, women suffer from a higher level of disability than men, even though their survival rates are the same. Even though clear guidelines for the treatment of stroke exist, there are still differences in both diagnostic procedures and discharge destination between male and female patients

The characteristics of transcranial color-coded duplex sonography in children with cerebral arteriovenous malformation presenting with headache.

PURPOSE: Cerebral arteriovenous malformations (AVM) are uncommon lesions. They are most often presented in childhood as intracranial hemorrhage. The aim of this report is to present the use of transcranial color-coded duplex sonography (TCCS) in detection of AVMs in children suffering headache. METHODS: This report describes five pediatric patients with headache and cerebral AVM which were initially discovered by TCCS. Diagnosis was confirmed by magnetic resonance imaging and digital subtraction angiography. RESULTS: In all patients, TCCS showed saccular enlargement of the vessels with a multicolored pattern corresponding to the different directions of blood flow. Spectral analysis showed significantly high flow systolic and diastolic velocities and low resistance index. CONCLUSIONS: In this report, we describe TCCS as a valuable non-invasive, harmless, low-cost, widely available method for the detection and follow-up of hemodynamic changes of AVMs in children with headache, before and after treatment