Garzamacmillan8033

Tension-type headache (TTH) is the most common primary headache disorder with a prevalence of up to 78% in general population and huge expenses in terms of health service. Despite its high incidence and impact on life's quality the knowledge on the pathophysiology and efficacious treatment of TTH was still limited.

In recent years, a series of studies highlighted the heterogeneous nature of this pathology that seems to be determined by a complex interaction between genetic, environmental, and neuromuscular factors, which result in nociceptive system activation. In this setting, alongside the simple analgesic therapies used during the acute attack, a series of therapeutic options based on newly acquired experiences have taken hold.

Not having a single substrate or a typical site of pathophysiology, TTH must be analyzed in a global and multidisciplinary way. Herein, we perform a narrative review of the most recent advancement stimulating the concept of this disease as the tip of the iceberg of a more complex individual malaise secondary to different alterations. Strategies based solely on symptomatic drugs should therefore be avoided by experienced personnel and treatment should aim at taking charge of the patient considering the processes behind this complex pathology.

Not having a single substrate or a typical site of pathophysiology, TTH must be analyzed in a global and multidisciplinary way. Herein, we perform a narrative review of the most recent advancement stimulating the concept of this disease as the tip of the iceberg of a more complex individual malaise secondary to different alterations. Strategies based solely on symptomatic drugs should therefore be avoided by experienced personnel and treatment should aim at taking charge of the patient considering the processes behind this complex pathology.Introduction Becoming an EMS professional in most of the United States requires successful completion of the National Certification process. While multiple attempts are allowed, some candidates who are unsuccessful on their first cognitive examination attempt do not return despite personal investment. find protocol Objective We describe the demographic and testing characteristics of EMT and paramedic candidates that do not return for a second examination attempt after an initial unsuccessful attempt on the National EMS Certification Cognitive Examination. Methods This was a cross-sectional evaluation of nonmilitary EMT and paramedic graduates, between ages 18 and 85 years, who completed their education program in 2016, attempted the National Certification Examination, and were unsuccessful. Multivariable logistic regression models were used to estimate the odds of retesting for EMT and paramedic graduates for age, sex, initial test length, and elapsed time from course completion to initial examination. Results Of all EMT geducational programs and stakeholders to support EMT and paramedic graduates at risk of not entering the workforce.This study compares the effectiveness of a 12-week moderate exercise training program (METP), performed in the morning versus the evening, on sleep, physical activity, physical fitness, sleepiness, fatigue and health-related quality of life (HRQoL) in overweight and obese patients. Sedentary and inactive overweight/obese adults (n = 36) were included in METP and randomized into two groups morning group (GM) and evening group (GE). Twenty-eight participants successfully completed METP (3 × 90 min exercise session per week for 12 weeks, completion rates >80%). Sleep, physical activity, and bedtime temperature were measured using accelerometry and infrared tympanic temperature during 3 separate weeks of the study (Week1, Week6, and Week12). Participants also took part in baseline and endpoint assessments including physical fitness as well as subjective physical activity, chronotype, sleep quality, sleepiness, fatigue and HRQoL. METP did not impact objective sleep quality differently between the two groups (morning vs evening). Bedtime and mid-sleep were advanced when METP was done in the morning whereas they were delayed when METP was practiced in the early evening (p = .003). Beside this finding, no valuable differences between the two groups were noted in all the remaining measures. METP resulted in improvements of body composition, cardiorespiratory and muscular endurance, as well as a favorable impact on subjective sleep quality, diurnal sleepiness, fatigue and HRQoL in both groups (all p less then .05). Evening METP could be an effective alternative for overweight/obese adults when morning METP is not possible.The main purpose of the present study was to determine the association of physical activity (PA) patterns prior to COVID-19 confinement with severe respiratory distress consistent with COVID-19 symptoms. Participants were recruited by sending a survey through various social network channels via the snowball method. A voluntary sample of 420 individuals consisting of 199 men and 221 women from the Spanish national territory participated in this study. Some factors, such as being overweight and obese were related to the presence of a greater number of symptoms associated with COVID-19. Interestingly, it was observed that not performing moderate or vigorous PA increased the risk of COVID-19 symptoms. Consequently, when the effect of the practise of PA was evaluated in terms of the number of practises per week and in minutes per practise per week, a protective effect was observed, where moderate PA >150 min per week reported an inverse association with hospitalization for respiratory symptoms (RR 95%CI 0.24, 0.05-1.04, P = 0.05). Likewise, overweight (RR 16.3, 95%CI 1.93-137.9, P = 0.01), obesity (RR 19.1, 95%CI 1.63-222.5, P = 0.019) and non-performance of moderate PA (RR 4.12, 95%CI; 0.95-17.76, P = 0.05) reported positive associations with hospitalization for respiratory symptoms. Thus, the practise of moderate PA (>150 min per week) is a protective factor against hospitalization for respiratory symptoms consistent with COVID-19 symptoms.Circadian clocks regulate multiple physiological domains from molecular to behavioral levels and adjust bodily physiology to seasonal changes in day length. Circadian regulation of cellular bioenergy and immunity in the cardiovascular and muscle systems may underpin the individual diurnal differences in performance capacity during exercise. Several studies have shown diurnal differences in cardiopulmonary parameters at maximal and submaximal workloads in morning and evening circadian human phenotypes. However, the effect of seasons on these changes was not elucidated. In this study, we recruited subjects with Morningness-Eveningness Questionnaire scores corresponding to morning and evening types. Subjects underwent morning (700-900) and evening (2000-2200) maximal workload spiroergometry in both winter and summer seasons. We analyzed their performance time, anaerobic threshold, heart rate, and respiratory parameters. Our results suggest that evening types manifest diurnal variations in physical performance, particularly in winter.