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Frequent Etiology (frequent + etiology)
Selected AbstractsEtiology and Distribution of Headaches in Two Brazilian Primary Care UnitsHEADACHE, Issue 3 2000Marcelo E. Bigal MD Objectives.,To determine (a) which patients seek primary care services with a complaint of headache, (b) the percentages of the various types of headache in this population, and (c) the impact of the care provided to these patients on the basic health care network. Background.,Headache is one of the most frequent symptoms reported in medical practice, resulting in significant medical services costs and loss of patient productivity, as well as reduced quality of life. Methods.,A prospective study was conducted in two towns (Ribeirão Preto and São Carlos) in the State of São Paulo, Brazil. The participants in the study consisted of 6006 patients (52.4% women) with highly varied acute symptoms. The patients ranged in age from 14 to 98 years. Results.,Headache as the main complaint was reported by 561 (9.3%) of the patients considered, with 312 (55.6%) of those patients presenting with primary headache, 221 (39.4%) with headaches secondary to systemic disorders, and 28 (5.0%) with headaches secondary to neurological disorders. Migraine, the most prevalent primary headache, accounted for 45.1% of patients reporting headache as the single symptom. The most frequent etiologies of headaches secondary to systemic disorders were fever, acute hypertension, and sinusitis. The most frequent headaches secondary to neurological disorders were posttraumatic headaches, headaches secondary to cervical disease, and expansive intracranial processes. Of the 26 cases of drug abuse, 20 were secondary to alcohol (hangover). Headaches secondary to systemic disorders were more frequent in the extreme age ranges. Conclusions.,Headache is a very frequent symptom among patients seen at primary health care units and should be considered a public health problem. The dissemination of the diagnostic criteria of the International Headache Society among primary health care physicians is urgently needed in order to avoid the repeated return of patients or their referral to more differentiated emergency units, which overburden an already insufficient health care network. [source] Distribution of etiologies in patients above and below age 45 with first-ever ischemic strokeACTA NEUROLOGICA SCANDINAVICA, Issue 5 2008G. Telman Background,,, There is limited information about distribution of etiologies of ischemic stroke in different age groups. Materials and methods,,, In this study, we applied the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification in 87 patients aged ,45, and in 347 patients aged 46,60 years with first-ever ischemic stroke in order to follow the distribution of stroke etiologies in different age groups. Results,,, Traditional risk factors, except smoking and atrial fibrillation, were more frequent in older patients. The most frequent etiologies in the younger stroke patients (aged ,45) were ,other' than routine causes (26.4%), cardioembolism (22.4%) and ,idiopathic' strokes (20.7%), when no cause was found. In older patients (aged 46,60), small vessel disease (25.1%) and cardioembolism (22.2%) were the most frequent etiologies of stroke. Conclusions,,, In stroke patients below the age of 45, the TOAST classification should be expanded to better classify the wide diversity of stroke etiologies. The relatively low frequency of routine stroke etiologies in patients aged ,45 can be explained by the significantly lower prevalence of traditional risk factors in these patients. In patients 46,60 years old, the TOAST classification is adequate in the characterization of ischemic stroke etiologies. [source] Specific Epileptic Syndromes Are Rare Even in Tertiary Epilepsy Centers: A Patient-oriented Approach to Epilepsy ClassificationEPILEPSIA, Issue 3 2004Christoph Kellinghaus Summary: Purpose: To assess the practicability and reliability of a five-dimensional patient-oriented epilepsy classification and to compare it with the International League Against Epilepsy (ILAE) classification of epilepsy and epileptic syndromes. The dimensions consist of the epileptogenic zone, semiologic seizure type(s), etiology, related medical conditions, and seizure frequency. Methods: The 185 epilepsy patients (94 adults, 91 children, aged 18 years or younger) were randomly selected from the database of a tertiary epilepsy center and the general neurological department of a metropolitan hospital (28 adults). The charts were reviewed independently by two investigators and classified according to both the ILAE and the patient-oriented classification. Interrater reliability was assessed, and a final consensus among all investigators was established. Results: Only four (4%) adults and 19 (21%) children were diagnosed with a specific epilepsy syndrome of the ILAE classification. All other patients were in unspecific categories. The patient-oriented classification revealed that 64 adults and 56 children had focal epilepsy. In an additional 34 adults and 45 children, the epileptogenic zone could be localized to a certain brain region, and in 14 adults and five children, the epileptogenic zone could be lateralized. Fourteen adults and 21 children had generalized epilepsy. In 16 adults and 14 children, it remained unclear whether the epilepsy was focal or generalized. Generalized simple motor seizures were found in 66 adults and 52 children, representing the most frequent seizure type. Etiology could be determined in 40 adults and 45 children. Hippocampal sclerosis was the most frequent etiology in adults (10%), and cortical dysplasia (9%), in children. Seven adults and 31 children had at least daily seizures. Seventeen adults and 26 children had rare or no seizures at their last documented contact. The most frequent related medical conditions were psychiatric disorders and mental retardation. Interrater agreement was high (kappa values of 0.8 to 0.9) for both the patient-oriented and the ILAE classification. Conclusions: Specific epilepsy syndromes included in the current ILAE classification are rare even in a tertiary epilepsy center. Most patients are included in unspecific categories that provide only incomplete information. In contrast, all of the patients could be classified by the five-dimensional patient-oriented classification, providing all essential information for the management of the patients with a high degree of interrater reliability. [source] Epidemiologic and etiologic features of pigmentation disorders observed during consultation at the Dermatology Center of Abidjan, Ivory CoastINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2005Pauline Yoboue MD Skin color is important to people in many societies. In this descriptive cross-sectional study, the causes of skin disorders in patients presenting for consultation over a period of 5 years were assessed and identified. A total of 4510 dyschromia cases were recorded, representing 9% of the total number of patients attending for consultations at the Dermatology Center of Abidjan over this period. Pigmentation disorders were more often found in female patients (53.56%; sex ratio female:male = 1.44) and were predominant in patients 20,30 years old (50%). All socio-professional categories were represented. However, students and service professionals (hairdressers, dressmakers, traders and switchboard operators) represented 50% of the patients with pigmentation disorders. Hyperchromia was common (48.49%) and was found in exposed areas of the skin. Most of the pigmentation disorders (60.94%) were of post-inflammation origin. Vitiligo was the most frequent etiology of systemic or endocrine dyschromia (92.63%). Among the hereditary pigmentation disorders, pigmented naevus was the most commonly found (41.5%). Dyschromic chemical eruptions appeared most frequently in the form of fixed pigmented erythema (84.55%). This study demonstrates that pigmentation disorders are still a frequent reason for consultation due to their distressing consequences. [source] The clinical and neuroimaging studies in Holmes tremorACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010A. Gajos Gajos A, Bogucki A, Schinwelski M, So,tan W, Rudzi,ska M, Budrewicz S, Koszewicz M, Majos A, Górska-Chrz,stek M, Bie,kiewicz M, Ku,mierek J, S,awek J. The clinical and neuroimaging studies in Holmes tremor. Acta Neurol Scand: 2010: 122: 360,366. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Aim,,, Holmes tremor (HT) is a combination of rest, postural and action tremor. A parallel dysfunction of cerebello-thalamic and nigrostriatal pathways seems necessary to produce this kind of tremor. We present the clinical and neuroimaging study verifying that hypothesis. Material and methods,,, A total of 10 patients: five male, five female, fulfilling consensus criteria were included. Demographic, clinical and neuroimaging data (MRI = 9; CT = 1, SPECT with the use of 123-I-FP CIT: DaTSCAN in six patients to assess the presynaptic dopaminergic nigrostriatal system involvement, indices of asymmetry for ligand uptake for each striatum were calculated) were analyzed. Results,,, Hemorrhage was the most frequent etiology and thalamus , the most commonly involved structure. Contrary to the previous reports, the visual assessment did not reveal remarkable interhemispheric differences of DaTSCAN uptake. Quantitative measurements showed only minimal differences. Conclusions,,, It is open to debate whether nigrostriatal pathway damage is crucial for the phenomenology of HT. Alternative hypothesis is presented that HT represents the heterogeneous spectrum of tremors with similar phenomenology, but different pathophysiology. [source] | ||||||||||