Postgraduate medicine最新文献

{"title":"Statement of Retraction: The interaction between insulin resistance and Alzheimer's disease: a review article.","authors":"","doi":"10.1080/00325481.2024.2436247","DOIUrl":"10.1080/00325481.2024.2436247","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the outcome measures and clinical relevance of respiratory muscle training with multiple sclerosis patients: a systematic review.","authors":"Veleska Wills, Francesco V Ferraro, Mark A Faghy","doi":"10.1080/00325481.2024.2441105","DOIUrl":"10.1080/00325481.2024.2441105","url":null,"abstract":"<p><p>The following systematic review aimed to gather information on the effectiveness of Respiratory Muscle Training (RMT) with Multiple Sclerosis (MS) patients. The method followed the ENTREQ and PRISMA protocol. MEDLINE, Cochrane, and Science Direct databases were used to source relevant literature. Articles included participants diagnosed with MS in randomized, controlled trial studies with objectively measured outcomes, and RMT methods were standardized. Eleven students were included in the results (<i>n</i> = 396, 50.5 ± 9.8 years, 68% F 31% M) and show that RMT (minimum 8 weeks of training) is effective in improving respiratory muscle strength (MIP in 7 out of 9 studies, MEP in 6 out of 11 studies and FVC in 6 out of 7 studies) and health-related outcomes, including mobility. Although muscle strength increased, increases in FVC had moderate effects on functional ability, which were negligible, and patient-reported fatigue. Findings suggest that muscle strength increases were predominantly in inspiratory muscles, and expiratory results were combined. However, the review shows a lack of research concerning the use of RMT and its prescription for MS patients.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication refills do not guarantee medication intake: translation and validation of the Adherence to Refills and Medications Scale in Traditional Chinese among individuals with type 2 diabetes in Taiwan.","authors":"Yen-Ming Huang, Tzu Wang, Yu-Meng Yang, Yung-Hsuan Chang, Hsun-Yu Chan, Hsiang-Wen Lin","doi":"10.1080/00325481.2024.2444258","DOIUrl":"10.1080/00325481.2024.2444258","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to translate and validate the Adherence to Refills and Medications Scale into Traditional Chinese (ChARMS-T) and to investigate common barriers to medication adherence among patients with type 2 diabetes (T2D) in Taiwan.</p><p><strong>Methods: </strong>The ChARMS-T was developed through translation and application phases. During the translation phase, the scale underwent forward translation, backward translation, and cognitive debriefing. In the application phase, the finalized ChARMS-T was administered to patients with T2D at five Taiwan community pharmacies over eleven months starting in June 2023. Psychometric properties were assessed using criterion validity, construct validity through confirmatory factor analysis, and reliability through McDonald's omega.</p><p><strong>Results: </strong>A total of 343 participants completed surveys. Factor analysis of the 12-item ChARMS-T revealed two dimensions: medication-taking (8 items) and medication refill (4 items). The instrument demonstrated acceptable internal consistency, with McDonald's omega scores of 0.841 for medication-taking and 0.647 for medication refill. The medication refill subscale showed strong agreement with the objective refill measure, proportion of days covered, with a coefficient of 0.84, suggesting that these measures evaluate similar constructs. Evidence of known-groups validity was demonstrated by a significant difference between ChARMS-T scores and glycemic control (<i>p</i> = 0.047). Patients with good glycemic control had a significantly higher adherence rate to both refills and medication-taking compared to those with poor glycemic control. The most frequently reported barriers to medication-taking were carelessness (55.7%), forgetfulness (54.8%), and frequent dosing intervals (43.1%). For medication refills, 9.6% of the participants identified a lack of planning as the main reason for not refilling their diabetes medications on time, followed by forgetfulness (7.6%).</p><p><strong>Conclusions: </strong>The ChARMS-T identified a broader range of non-adherence reasons and demonstrated good psychometric properties. It can be integrated into practice settings for screening and follow-up to enhance medication adherence through effective communication between healthcare professionals and patients, ultimately improving long-term patient health outcomes.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High prevalence of low bone mineral density in young adults with phenylketonuria.","authors":"Kısmet Çıkı, Ayça Burcu Kahraman, Halil Tuna Akar, Yılmaz Yıldız, Ali Dursun, Ayşegül Tokatlı, Turgay Coşkun, Serap Sivri","doi":"10.1080/00325481.2024.2444873","DOIUrl":"10.1080/00325481.2024.2444873","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that phenylalanine (Phe)-restricted diets may have negative effects on bone health in patients with classical phenylketonuria (cPKU). We aimed to evaluate bone mineral density (BMD) in adults with cPKU and determine the risk factors associated with low BMD.</p><p><strong>Methods: </strong>Eighty adult patients with cPKU were examined, including 41 women and 39 men. The age range was 18.3-39.4 years (median 22.8). The femoral and lumbar BMD were measured by dual energy X-ray absorptiometry. The patients were evaluated in two groups with low (Z-score ≤-2) and normal BMD (Z-score > -2).</p><p><strong>Results: </strong>Low BMD was detected in 20 patients (25%). The low BMD group had significantly more males (75% vs 40%, <i>p</i> < 0.01) and lower mean body mass index (BMI, 22.4 vs 24.5 kg/m², <i>p</i> = 0.02). Paradoxically, mean blood calcium and 25-hydroxy vitamin D levels were higher in the low BMD group, but only marginally (10.0 vs 9.8 mg/dl and 25.1 vs 21.0 µg/L respectively, <i>p</i> < 0.05). The groups did not differ significantly with regards to age, mean Phe levels at diagnosis, median Phe levels above the age of 12 years, other nutritional parameters or vitamin-mineral supplementation. There was no history of clinical fractures.</p><p><strong>Discussion: </strong>Although osteopenia, osteoporosis and low BMD have been reported in PKU, conflicting data also exist. Our study of a large adult cPKU cohort strongly supports previously published limited data that suggest male sex and low BMI confer a higher risk for low BMD in cPKU; and age, Phe levels and dietary adherence do not. In our study, although the patients were young, low BMD was quite common (25%). Bone health should be evaluated even in young adults with cPKU, especially in males and those with low BMI, regardless of treatment compliance and vitamin-mineral status. Prospective studies reporting on clinical outcomes such as bone pain or fractures will be valuable in the coming years.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of gene dosage and age at the disease onset on the severity of familial Mediterranean fever.","authors":"Merve Cansu Polat, Elif Çelikel, Zahide Ekici Tekin, Vildan Güngörer, Cüneyt Karagöl, Melike Mehveş Kaplan, Nimet Öner, Nilüfer Tekgoz, Didem Öztürk, Emine Özçelik, Mehveş Işıklar Ekici, Yasemin Uğur Es, Serdar Sezer, Banu Çelikel Acar","doi":"10.1080/00325481.2024.2444870","DOIUrl":"10.1080/00325481.2024.2444870","url":null,"abstract":"<p><strong>Objective: </strong>To compare the demographic and clinical characteristics of familial Mediterranean fever (FMF) patients according to age at disease onset and evaluate the dose effect of the number of pathogenic or likely pathogenic exon 10 mutations of the MEFV gene on disease severity.</p><p><strong>Methods: </strong>This medical record review study was performed on 485 pediatric FMF patients with uni- or biallelic exon 10 mutations of the MEFV gene (M694V, M694I, M680I, V726A, R761H, T267I). Patients were grouped according to age at disease onset (Group 1:<6 years; Group 2:6-11 years; and Group 3:>11 years). Disease severity was assessed by the international severity scoring system for FMF (ISSF).</p><p><strong>Results: </strong>Of the patients, 294 (60.6%) were classified in Group 1, 152 (31.4%) in Group 2 and 39 (8%) in Group 3. The mean elapsed time to diagnosis was 26.7 ± 27.4 months in Group 1 and was higher than the other groups (<i>p</i> < 0.001). During the attack, fever was higher in Group 1, arthritis in Group 2, and chest pain in Group 3 (<i>p</i> < 0.001). The median ISSF score was similar in patients with uni- or biallelic mutations in Group 1 and 3 (<i>p</i> = 0.086, <i>p</i> = 0.35, respectively) but lower in heterozygous patients in Group 2 (<i>p</i> < 0.001). In Groups 1 and 2, mild disease severity was higher in heterozygotes, while moderate disease severity was higher in homozygotes (<i>p</i> = 0.034, <i>p</i> = 0.001, respectively).</p><p><strong>Conclusion: </strong>The presence of pathogenic or likely pathogenic homozygous or compound heterozygous mutations in exon 10 of the MEFV gene in patients with early-onset disease is associated with a more severe disease course compared to patients with heterozygous mutations. The gene dose effect of the number of mutations on disease severity is more common in children aged 6-11 years.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plain language summary about the use and difficulties of medicines given as an injection in Hospital-at-Home.","authors":"Margaret Peinovich, Jeremy R DeGrado, Michael C Cotugno, Raj Gokani, Elizabeth Wilks, Pradeep Shetty, Juliana Hey-Hadavi","doi":"10.1080/00325481.2024.2436839","DOIUrl":"https://doi.org/10.1080/00325481.2024.2436839","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of metabolic health on fibromyalgia: insights from insulin resistance and related indexes.","authors":"Sibel Tunç Karaman, Berrin Hüner, Okcan Basat","doi":"10.1080/00325481.2024.2439244","DOIUrl":"10.1080/00325481.2024.2439244","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association between fibromyalgia (FM) and insulin resistance (IR) using multiple IR indices in FM patients and to investigate how these indices vary with the severity of FM.</p><p><strong>Methods: </strong>This cross-sectional study included 70 female patients diagnosed with FM and 70 age-matched female healthy controls. The data collected included demographics, clinical characteristics, and laboratory parameters. FM severity was evaluated using the Fibromyalgia Impact Questionnaire-Revised (FIQR). The metabolic indices calculated were the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), triglyceride - glucose index (TyG), triglyceride to HDL cholesterol ratio (TG/HDL-C), and Metabolic Score for Insulin Resistance (METS-IR).</p><p><strong>Results: </strong>FM patients exhibited significantly higher HOMA-IR values (<i>p</i> = 0.002), and lower QUICKI values (<i>p</i> = 0.000) than controls. METS-IR also showed significant differences between FM patients and controls (<i>p</i> = 0.026). HOMA-IR and METS-IR values increased with FM severity, whereas QUICKI values decreased (<i>p</i> < 0.05). Duration of FM showed a moderately positive correlation with HOMA-IR (<i>r</i> = 0.249, <i>p</i> = 0.027). For TG/HDL-C and METS-IR, the correlations were weaker, but still positive (<i>r</i> = 0.094, <i>p</i> = 0.378, and <i>r</i> = 0.184, <i>p</i> = 0.056, respectively).</p><p><strong>Conclusion: </strong>This study observed a significant association between FM and IR, as evidenced by metabolic indices in FM patients compared to controls. IR levels tended to increase with FM severity and duration. These findings suggest that IR could play a role in FM pathogenesis. Non-invasive and practical methods, such as METS-IR, may provide advantages for metabolic screening in FM patients; however, further studies are needed to establish their clinical utility.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital and delayed mortality in patients with upper gastrointestinal bleeding on antithrombotic treatment: effects of withdrawal and resuming.","authors":"Eduardo Redondo-Cerezo, Raúl Fernandez-García, Manuel López Vico, Eva Julissa Ortega-Suazo, Cristina Tendero-Peinado, Jose María López-Tobaruela, Ana Lancho, Francisco Valverde-López, Juan Gabriel Martínez-Cara, Rita Jiménez-Rosales","doi":"10.1080/00325481.2024.2436840","DOIUrl":"https://doi.org/10.1080/00325481.2024.2436840","url":null,"abstract":"<p><strong>Background: </strong>Antithrombotic drugs pose a dual challenge to acute upper gastrointestinal bleeding, with associated risks of bleeding complications and thromboembolic events upon withdrawal. We aimed to determine the impact of antithrombotic medications on in-hospital and delayed outcomes and whether suspension and resumption influenced delayed mortality.</p><p><strong>Methods: </strong>This study was a prospective registry analysis of patients between 2013-2021. Anticoagulants and antiplatelets were classified as antithrombotic. The examined outcomes included in-hospital mortality and delayed 6-month cardiovascular, bleeding, and mortality events.</p><p><strong>Results: </strong>A total of 1345 patients were included. 21.7% were taking anticoagulants and 19.1% were taking antiplatelets. Patients on antithrombotic therapy have a longer delay in endoscopic performance (11 ± 11 h vs. 9.6 ± 8 h; <i>p</i> = 0.027) and less need for therapy (38.5% vs. 48.1%;<i>p</i> = 0.002), with gastric erosion being more usual (14.2% vs. 9.1%; <i>p</i> = 0.006).In-hospital mortality was higher in patients not taking antithrombotic (12% vs. 8%;<i>p</i> = 0.022) and suspension < 72 h was associated with increased mortality (14.9% vs. 2.3%;<i>p</i> = 0.001).Delayed mortality was higher in patients taking antithrombotic (9.4% vs. 6%; <i>p</i>=0.034) and in those who suspended them for more than 7days (17% vs. 8.7%; <i>p</i>=0.033), with no differences when it lasted<72h.Patients on antithrombotic therapy exhibited more delayed cardiovascular (13.7% vs. 3.4%; <i>p</i><0.0001) and hemorrhagic events (22.9% vs. 12.9%; <i>p</i><0.0001), with no differences observed in patients who withheld antithrombotic medication.Multivariate analysis identified ASA, disseminated malignancy, and NSAIDs as independent risk factors for in-hospital mortality, whereas antithrombotic therapy and hemoglobin levels were protective factors.</p><p><strong>Conclusion: </strong>Patients with upper gastrointestinal bleeding treated with antithrombotic drugs had lower in-hospital mortality despite increased comorbidities and older age. Conversely, delayed 6-month mortality was higher. Shorter antithrombotic suspension durations increased in-hospital mortality, whereas suspension for > 7 days increased delayed mortality.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of companion support during labor on postnatal depression and birth satisfaction: a prospective cohort study.","authors":"Busra Demir Cendek, Burak Bayraktar, Elif Karaman, Mine Adam, Kubra Avsar Yaylacı, Caganay Soysal, Huseyin Levent Keskin","doi":"10.1080/00325481.2024.2435248","DOIUrl":"10.1080/00325481.2024.2435248","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the impact of having a companion during vaginal birth on postpartum depression and birth satisfaction.</p><p><strong>Methods: </strong>This prospective cohort study included 220 postpartum women aged 18-45 who delivered vaginally at Ankara Etlik City Hospital between August 2023 and February 2024. During labor, each woman had the option to be accompanied by a companion person (such as a mother, partner or spouse, sibling, or friend) of her choice; those who opted not to have a relative present received the standard support provided by the hospital's routine birth protocol. Participants were divided into three groups based on the type of support received during childbirth: spousal support, support from others (non-spousal support), and no support. Data were collected within six weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and the Birth Satisfaction Scale-Revised (BSS-R).</p><p><strong>Results: </strong>Women supported by their spouses during childbirth had significantly higher BSS-QC (Quality of care provision), BSS-SL (Stress experienced during labor), and BSS-R total scores compared to those without support. BSS-SL scores were particularly higher for those with spousal support versus support from others or no support. Non-spousal support also resulted in higher BSS-QC scores than no support at all. BSS-WA (Women's personal attributes) scores and EPDS scores were similar between the groups. Additionally, no significant differences in BSS-QC, BSS-SL, BSS-WA, and BSS-R total scores were observed between women with high (≥13) and low (<13) EPDS scores, but a negative correlation between EPDS and BSS-R total scores was noted (<i>r</i>=-0.203, <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>Women receiving spousal support during childbirth reported significantly higher birth satisfaction, particularly in care quality (BSS-QC) and stress management (BSS-SL). The presence of a companion, whether spousal or non-spousal, positively influenced birth satisfaction, though it did not significantly affect postpartum EPDS scores.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin ecchymosis in migraine patients: a retrospective and exploratory study.","authors":"Raimundo Pereira Silva-Néto, Adriana de Almeida Soares, Wallyson Pablo de Oliveira Souza, Yasmine Maria Leódido Fortes, Luciano da Silva Lopes, Ana Gabriela Krymchantowski, Carla Jevoux, Abouch Krymchantowski","doi":"10.1080/00325481.2024.2433939","DOIUrl":"10.1080/00325481.2024.2433939","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a recurrent headache disorder characterized by moderate to severe, throbbing pain, typically unilateral. It can be classified as migraine with or without aura, depending on the presence or absence of visual or sensory disturbances known as auras, respectively.</p><p><strong>Aim: </strong>The objective of this study was to determine the prevalence of ecchymosis in patients with migraine and its accuracy parameters in the differential diagnosis between migraine and tension-type headache (TTH).</p><p><strong>Method: </strong>Patients with migraine or tension-type headache, diagnosed according to the International Classification of Headache Disorders (ICHD-3) criteria, were assessed regarding the prevalence of skin ecchymosis, both during headache attacks and in the pain-free period.</p><p><strong>Results: </strong>Four hundred patients were investigated. The subjects were equally divided in two groups presenting the diagnosis of migraine and TTH. Ages were, respectively, 37.3 ± 9.0 years for migraineurs and 40.0 ± 10.0 years for sufferers of TTH. Ecchymosis was present in 76% of patients with migraine and in 11% of patients with TTH (<i>p</i> < 0.0001). In both patients with migraine and TTH, ecchymosis predominated in women, respectively in 92.1% and 63.6% (<i>p</i> < 0.0001). Among the 152 patients with migraine who reported ecchymosis, they were present in most of headache attacks (69.7%), occurred within the first 24 hours after the headache onset (68.4%) and were unilateral in location (65.1%), mainly on the arms (34.9%) and thigh (24.3%). The ecchymosis were larger than 2 cm in diameter (60.5%), lasting longer than four days (89.5%). During the presence of ecchymosis, the headache was unilateral (91.5%), pulsatile (80.3%), severe to very severe (67.8%) and worsening with physical activity (75%).</p><p><strong>Conclusions: </strong>Intermittent skin ecchymosis may be a differentiating factor between migraine and tension-type headache and a specific marker of migraine to be considered as a criterion for its diagnosis.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}