Background/aim: Headaches are one of the most common neurological symptoms. They adversely affect daily life, reduces the workforce, and have high health costs. Managing this symptom in primary care will free up secondary and tertiary health services to better treat patients who need follow-up by specialists. In the present study, we aim to show the rate at which this problem can be solved in primary care for patients who applied tertiary care services with a headache for the first time.
Materials And Methods: Our research is a cross-sectional study of 207 patients who applied to the neurology clinics for the first time with headache. Two questionnaires were prepared by the researchers. IBM SPSS v: 21.0 was used for statistical analysis, and the level of significance was p < 0.05.
Results: The opinions of the patients on the evaluability of headache in primary care were compared. Family physicians and neurologists gave similar responses about the disease management, at a rate of 96.6%, this was found to be statistically significant and shows strong agreement. Both groups of physicians thought that 70% of patients, on average, who applied to the neurology clinics with headache for the first time could be managed in primary care. However, only 9.2% of the patients share this opinion with physicians. Primary headache cases constitute most of the cases that are thought to be solved in primary care. It was revealed that the number of patients seeking primary care with this complaint was lower than expected.
Conclusion: Patients with headache applied tertiary care instead of primary care for different reasons. Both neurologists and family physicians stated that most patients evaluated in tertiary care could be managed in primary care.
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http://dx.doi.org/10.3906/sag-2010-237 | DOI Listing |
JAMA Netw Open
January 2025
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.
Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.
JAMA Netw Open
January 2025
Department of Surgery, University of Washington, Seattle.
Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.
Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.
Clin Cancer Res
January 2025
Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Purpose: Mesothelin (MSLN) is highly expressed in high grade serous/ endometrioid ovarian cancers (HGOC). Anetumab ravtansine (AR) is an antibody drug conjugate directed at MSLN antigen with a tubulin polymerization inhibitor. We assessed safety, activity and pharmacokinetics of the combination AR/bevacizumab (Bev) (ARB) versus weekly paclitaxel (wP)/Bev (PB) in patients with platinum resistant/refractory HGOC (prrHGOC).
View Article and Find Full Text PDFJAMA Pediatr
January 2025
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Importance: Spontaneous reports have indicated that montelukast increases the risk of neuropsychiatric adverse events, and the US Food and Drug Administration added a boxed warning about these risks in 2020. However, the potential mechanism is not well understood, and the observational evidence is scarce, particularly in children.
Objective: To assess the potential association between the use of montelukast and the risk of neuropsychiatric adverse events in children and adolescents.
JAMA Neurol
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Importance: Trials have not demonstrated superiority of alteplase or tenecteplase vs standard care in patients with mild stroke and have raised safety concerns. Prourokinase is an alternative fibrinolytic that may have a favorable safety profile, and the benefit-risk profile of prourokinase in mild stroke is unknown.
Objective: To investigate the efficacy and safety of prourokinase in mild ischemic stroke within 4.
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