Browsing by Author "Leheste, Alo Rainer"
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Item Accuracy of migraine diagnosis and treatment by neurologists in the Baltic states : e-survey with clinical case challenge(2023-12) Jokubaitis, Mantas; Vrublevska, Greta; Zvaune, Linda; Braschinsky, Mark; Leheste, Alo Rainer; Saknītis, Gatis; Žukovs, Danils; Ryliškienė, KristinaBackground: Underdiagnosis of migraine causes a significant health burden, including lower quality of life, excessive medication use, and a delay in effective treatment. The purpose of this study was to evaluate migraine diagnosis accuracy and to review the treatment approaches used by neurologists in the Baltic states. Methods: The research was conducted as an anonymous e-survey with four cases in March and April 2021. Results: 119 practicing adult neurologists have participated. The migraine diagnostic accuracy was 63.2%. The most commonly used diagnostic criteria were moderate/severe pain, unilateral pain, and disruption of daily activities. Diagnostic accuracy did not differ significantly between neurologists who always use ICHD-3 criteria and those who don’t (68.4% vs. 58.5%, p = 0.167). It was higher in neurologists who were working in headache centers (91.7% vs. 60.9%, p = 0.012), and was related to a higher percentage of migraine diagnoses in all consulted headache patients (R 2 = 0.202, adjusted R 2 = 0.195, p < 0.001), prophylaxis with onabotulinumtoxin A [OR = 4.332, 95% Cl (1.588–11.814)], and anti-CGRP monoclonal antibodies [OR = 2.862, 95% Cl (1.186–6.907)]. Conclusions: Migraine diagnostic accuracy is improved through practical patient counseling and modern treatment prescription. Although the neurologists in the Baltic states follow current European guidelines, there is room for improvement in diagnostic accuracy to reduce migraine burden.Item Risk factors for development of personal protective equipment induced headache : e-survey of medical staff in Baltic states(2022-12) Jokubaitis, Mantas; Timofejavaitė, Reda; Braschinsky, Mark; Zvaune, Linda; Leheste, Alo Rainer; Gribuste, Laura; Mattila, Paula; Strautmane, Sintija; Dapkutė, Austėja; Ryliškienė, KristinaBackground: The COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic. Methods: From January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states. Results: In total, 2132 individuals participated. 52.3% experienced a PPE-induced headache. Usual onset time was between 2–3 h, lasting up to 1 h after PPE removal. The most common localization was in temporal and frontal regions. Headache usually occurred 2 to 3 days per week with an average pain score of 5.04 ± 1.80 points. Higher risk was associated with discomfort/pressure OR = 11.55, heat stress OR = 2.228, skin conditions OR = 1.784, long PPE use (duration 10-12 h) OR = 2,18, headache history prior PPE use OR = 1.207. Out of 52.3% respondents with PPE-induced headache, 45.5% developed de novo headache, whereas 54.5% had headache history. Statistically significant differences of PPE-induced headache between respective groups included severity (4.73 vs 5.29), duration (≥ 6 h 6.7% vs 8.2%), accompanying symptoms (nausea (19.3% vs 25.7%), photophobia (19.1% vs 25.7%), phonophobia (15.8% vs 23.5%), osmophobia (5.3% vs 12.0%)) and painkiller use (43.0% vs 61.7%). Conclusions: Over half of the medical personnel reported headache while using PPE. The risk was higher in individuals with headache history, increased duration of PPE use and discomfort while using PPE. Predisposed individuals reported PPE-induced headache which persisted longer, was more intense and debilitating than in the respondents with de novo headache.