Background: Idiopathic intracranial hypertension (IIH) encompasses patients with elevated intracranial pressure (ICP). Generally, it is difficult to make a differential diagnosis between IIH and co-existing migraine headaches. Thus, this article intends to estimate the prevalence of migraine in patients with IIH and explain the occurrence of new-onset migraine after the diagnosis of IIH. Methods: The case group included 108 patients with IIH referred to the neurology wards of three university hospitals. A random sample of controls (n = 103) were recruited from patients hospitalized in the surgery and orthopedics ward. A checklist for migraine diagnosis was filled out. Cerebrospinal fluid (CSF) pressure and presence or absence of papilloedema (PE) in the patients and any necessary data were also recorded from the inpatient medical documents. All statistical analyses were done by SPSS software. Results: There were 70 (64.80%) and 22 (21.40%) migraineurs in the case and control groups, respectively, and the difference was found to be significant (P < 0.001). In 26 (37.14%) migraine cases in the IIH group, the disorder was diagnosed after developing IIH. Also, there was a past medical history of having migraine in 44 (62.85%) migraineurs. In the fully adjusted regression models, the odds of being affected by migraine in patients with IIH was 6.17 times greater than the controls [odds ratio (OR) = 7.15, 95% confidence interval (CI) = 3.56-14.36, P < 0.010]. The patients’ mean CSF opening pressure was 32.10 ± 1.03 cmH2O and 93 (81.60%) subjects were found to have PE. Conclusion: It was demonstrated that subjects with IIH might have about a 6-time higher likelihood of developing migraine headache than the general population. These considerations can help prevent misdiagnosis of migraine headache as the recurrence of IIH or uncontrolled IIH and subsequent inappropriate management.
As a result of solicited muscles, strong friction, and tensile force on cutaneous tissue, the difference in closure procedure and management strategies and complications of surgical incision healing is a real challenge in lumbar spine surgery. We performed a retrospective study to compare different types of wound closure in lumbar spine surgery. 4383 patients were included in this study. Wound dehiscence was more common in the intracutaneous suture group than in the far-near-near-far suture group. Delayed wound healing occurred more in the far-near near-far suture group than intracutaneous suture group. Also, the far-near near-far interrupted point suture group showed a higher ratio of delayed wound healing compared with crossover suture. The superficial wound infection rate was roughly the same in all types of sutures with an average value of 0.79% with 0.81% SD. This is a preliminary study to compare different types of operative wounds showing the pros and cons related to each option.
New findings in regenerative medicine have always been combined with numerous animal studies. Therefore, choosing the right translational animal model plays an important role in transferring as much basic knowledge as possible to clinical application in this field. Since microsurgery has many capabilities to perform precise interventions on small animal models and facilitates other regenerative medicine procedures, based on scientific articles, we believe that the key to the flourishing of regenerative medicine in the clinic is the use of microsurgery.
Background: Environmental factors such as the lighting of the scene, time of the day, and physical surrounding of the patient and healthcare providers in the prehospital setting can affect difficult intravenous access (DIVA). The study aimed to evaluate the association of environment, patient, and emergency medical services (EMS) technicians on the DIVA in the prehospital setting. Methods: Six-hundred adult patients (aged ≥18 years) who necessitated prehospital peripheral IV access and were transferred to the Sina and Shariati hospitals by EMS technicians from June 2018 to October 2018 were included. There were seven research nurses for interviewing the EMS technicians. Patients were examined using the prepared checklists. Results: Overall, there were 125 (20.83%) DIVA cases. There was a significant relationship between DIVA and the higher respiratory rate of the patients, lower the blood pressure of the patient, prior cannulation of the targeted limb, time since the last meal of EMS technician, and untidiness of the environment (Odds Ratio=1.75, 1.3, 9.4, 3.84 and 7.01, respectively). Conclusion: The results showed fasting of EMS technicians affects DIVA and the study suggests it can be resolved by proper scheduling of the working hours of EMS technicians. Also, some risk factors of DIVA can help the paramedics to predict the DIVA and take the necessary measures.
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