A Single Institution's Experience of Primary Headache in Children With Celiac Disease
celiac disease; children; migraine; primary headache; questionnaire
October 2019 Update
BACKGROUND: Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution. METHODS: Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria. RESULTS: 247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet. CONCLUSION: This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.
Hom Grant L; Hom Brian L; Kaplan Barbara; Rothner A David
Journal of Child Neurology
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0883073819873751" target="_blank" rel="noreferrer noopener">10.1177/0883073819873751</a>
Office Management of COPD in Primary Care: A 2009 Clinical Update
chronic obstructive pulmonary disease; spirometry; asthma; General & Internal Medicine; risk-factors; randomized; follow-up; controlled-trial; double-blind; obstructive pulmonary-disease; questionnaire; differentiating copd; dyspnea; receptor partial agonist; smoking-cessation; sustained-release bupropion; symptom-based; tobacco smoking
Primary care physicians (PCPs) usually are the first to diagnose and care for patients with chronic obstructive pulmonary disease (COPD). This article discusses key teaching points of recently published guidelines for PCPs and the common challenges of treating COPD patients in a primary care setting, and clarifies common misconceptions. First, PCPs should choose one of the published screening tools to assess for COPD. Spirometry is a useful tool to confirm the diagnosis of COPD to distinguish COPD from asthma, to stage the disease for determining treatment, and it can help with smoking cessation efforts. Chest radiographs do not help to diagnose COPD but are useful to rule out other causes of dyspnea and cough. Differentiating COPD from asthma is important because it affects treatment decisions and prognosis. Second, the goals of COPD treatment are to relieve symptoms, improve exercise tolerance, prevent exacerbations, and improve quality (although not necessarily extend quantity) of life. Chronic obstructive pulmonary disease can be treated at any stage, and the treatments are adjusted in a stepwise approach based on disease severity. Third, as part of the long-term management of COPD, smoking cessation should be discussed at every visit, and inhaler technique should be reviewed at regular intervals. Chronic obstructive pulmonary disease patients should also receive the recommended influenza and pneumococcal vaccinations. Primary care physicians are in a unique position to identify COPD patients early, to implement primary and secondary preventive measures, and to provide care that addresses the full spectrum of COPD and its comorbidities.
Belfer M H
Postgraduate Medicine
2009
2009-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.3810/pgm.2009.07.2034" target="_blank" rel="noreferrer noopener">10.3810/pgm.2009.07.2034</a>
Family History Predicts Stress Fracture In Active Female Adolescents
adolescent health; amenorrhea; athlete triad; bone mineral density; bone strength; bone mineral density; epidemiology; exercise; mass accumulation; Pediatrics; questionnaire; reproducibility; risk-factors; stress fracture; track
Loud K J; Micheli L J; Bristol S; Austin B; Gordon C M
Pediatrics
2007
2007-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1542/peds.2006.2145" target="_blank" rel="noreferrer noopener">10.1542/peds.2006.2145</a>
Prioritizing Age-Friendly Domains for Transforming a Mid-Sized American City.
questionnaire; survey; older people; age-friendliness; age-friendly; age-friendly cities; use of technology
In May 2019, the city of Akron in the state of Ohio was admitted into AARP's network of age friendly cities and communities. Akron has a long history of aging services initiative that date back to the 1970s. To provide direction for future aging initiatives, an assessment of Akron's current state was conducted in early 2020. A survey designed to capture information on the eight Age-friendly domains was designed and mailed to 3000 randomized individuals in Akron's ten political wards. A total of 656 individuals responded and returned the survey. Akron is rated good to excellent by older Akronites; people want to stay in their neighborhood and in their home. Most Akronites like and use their neighborhood parks, find their streets well-lit, and feel safe walking in their neighborhood. Most respondents rated transportation in Akron as good to very good, but they found sidewalks good to poor. There is a high level of access to social and educational activities and a substantial opportunity to include more people. About two-thirds of respondents participate in faith-based activities, volunteer, and participate in city-sponsored events. Loneliness is not or rarely a problem for three quarters of respondents. Around 56.5% of respondents indicated they disagree they are disconnected from the community. There is high level of access to the Internet and public WiFi in Akron and a substantial opportunity to include more people. Overall, Akron has benefitted from its historical efforts and has the opportunity to impact on more older adults as the older population grows.
Sterns AA; Sterns HL; Walter A
International Journal Of Environmental Research And Public Health
2020
2020-12-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.3390/ijerph17239103" target="_blank" rel="noreferrer noopener">10.3390/ijerph17239103</a>
Understanding Minimally Invasive Gynecologic Surgery Fellowship Training in Canada: A National Survey of Recent Graduates.
curriculum; questionnaire; Accreditation; laparoscopy; postgraduate_education; surgical_education
OBJECTIVE: To characterize fellowship training experiences in the 11 Canadian minimally invasive gynaecologic surgery (MIGS) programs and compare the surgical exposure of fellows in these programs to that of the American Association of Gynecologic Laparoscopists (AAGL) accredited fellowship in MIGS (FMIGS). METHODS: In this cross-sectional study, 2017 and 2018 MIGS fellowship graduates across Canada were given an web-based survey via SurveyMonkey software to evaluate 5 key components of postgraduate fellowship curricula: 1) surgical exposure; 2) teaching and evaluation methods; 3) research experience; 4) clinical responsibilities; and 5) pursuit of other academic endeavours. Interest in creating a national standardized curriculum and seeking accreditation for MIGS fellowships were also examined. RESULTS: The survey attained a 91% (20/22) response rate of the target population. All Canadian MIGS programs met the minimum standards for at least 62% (8/13) of the surgical competencies listed by the AAGL, with office hysteroscopy being the procedure with the largest discordance. Half of respondents (10/20) attended a program with an established curriculum, and 75% (15/20) believed there would be a benefit to standardizing training nationwide. Seventy percent (14/20) had published at least one manuscript during their fellowship and 60% (12/20) pursued postgraduate degrees. The majority (55%; 11/20) felt certain that MIGS should become a credentialed fellowship in Canada. CONCLUSION: Canada has made meaningful progress in MIGS training over the past decade with 11 well-established fellowship programs. Although this survey identifies a general interest in standardized training and accreditation for Canadian MIGS programs, more research is needed on how best to accomplish this.
Smith JP; Thiel J; Singh SS; Allaire C; Warrington S; Murji A
Journal Of Obstetrics And Gynaecology Canada : JOGC Journal D'obstetrique Et Gynecologie Du Canada : JOGC
2021
2021-02-10
journalArticle
<a href="http://doi.org/10.1016/j.jogc.2021.01.014" target="_blank" rel="noreferrer noopener">10.1016/j.jogc.2021.01.014</a>