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BackgroundMigraine diagnosis is based on clinical aspects and is dependent on the experience of the attending physician. This study aimed to describe the patients journey profile until they start their experience in a tertiary headache center.MethodsIn a cross-sectional study, medical charts from migraine patients were reviewed to describe which treatments, procedures and follow-up strategies are performed until the first appointment with a headache specialist. Patients from both sexes, ≥18 years old, which came to their first visit from March to July 2017 were included. Sociodemographic information, headache characteristics, diagnostic methods previously used, clinical history, family history and the treatments previously used were assessed in the first appointment with a specialist. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were also applied. Descriptive analyses were performed to describe the sample profile and statistical tests were used to evaluate factors associated with the type of migraine (chronic or episodic).ResultsThe sample consisted of 465 patients. On average, the pain started 17.1 (SD = 11.4) years before the first appointment with a headache specialist. Most of patients were classified as having chronic migraine (51.7%), with an average frequency of 15.5 (SD = 9.9) days per month. Regarding patients’ journey until a specialist, most patients were submitted to laboratory tests (74.0%), cranial tomography (66.8%) and magnetic resonance imaging (66.8%) as diagnostic methods, and preventive drugs (70.2%) and acupuncture (61.0%) as treatments. After stratification by migraine type as episodic or chronic, patients with chronic migraine were submitted to more magnetic resonance imaging test, acupuncture, psychotherapy, used preventive drugs, and reported to have used topiramate without beneficial effects.ConclusionsBrazilian patients with migraine experiment a long journey until getting to a headache specialist and are submitted to a great number of unnecessary exams, especially those with chronic migraine.

Few studies have investigated the “multiple religious affiliations” phenomenon. This study aims to understand those with “multiple religious affiliations,” describing its prevalence and investigating if there are differences in mental health and quality of life between this group and those with a single religious affiliation and those with no religious affiliation. A total of 1169 adults were included, and 58% had a single religious affiliation, 27.7% had multiple religious affiliations, and 12.3% had no religious affiliation. Participants with a single religious affiliation presented better mental health and quality of life than those with multiple or no religious affiliations. Although most outcomes were similar between multiple and no religious affiliations, happiness and optimism were higher in the multiple religious group, and anxiety was lower in the no religious group. Health care professionals should be aware of the secondary religious affiliations of their patients to identify possible conflicts and to treat them comprehensively.

Objective: Headache and rhinitis are highly prevalent and comorbid. The objective of the present study is to analyze the correlation of headache and rhinitis, in addition to the temporal pattern of these diseases in 17 years, using the Google Trends platform. Methods: Google Trends was searched from January 2004 to June 2021, using the entry: ["rinite" (rhinitis) + "dor de cabeça" (headache)" + "Alzheimer" + "enxaqueca" (migraine)]. Migraine, primary headache, and Alzheimer's, with no clear relation with headache, were used as controls. After the descriptive analysis by dispersion diagrams, Pearson's test and a simple regression model were performed. Subsequently, this study analyzed the seasonality of the volume of research on rhinitis and headache. Results: A strong correlation between rhinitis and headache (0.86) was found in the time interval analyzed. In addition, a seasonality was identified in the volume of searches for the term rhinitis with increased volume in the fall and peaks in the month of May, with a decrease in the spring and early summer. Moreover, an increase of searches on headache was observed, suggesting worse burden of this pathology. Conclusion: Headaches and rhinitis were correlated in 17 years of research on the Google Trends platform. Circannual variation of both conditions was observed. Additional studies with digital research may be useful to better understand the epidemiology and comorbidities of headache.

Little research has been done in Brazil regarding religious mobility, that is, the patterns of religious conversion and disaffiliation, the ways in which one moves from one religion to another or from religion to non-religion. This study aimed to investigate the patterns of religious affiliation and disaffiliation in a sample of the Brazilian population and the association of such patterns with sociodemographic characteristics. The sample consisted of 1.169 participants (mean age = 40.84, sd = 15.34). Our results showed that two-thirds of the religious believers have maintained their affiliation over time. However, more than one-third of participants reported that they have switched religions, have left their religion to become non-religious, or have switched from non-religion to religion. Females tend to switch religions more often than males. But depending on the original affiliation, participants avoided certain religions. Catholics were less likely to become Protestants or Unaffiliated. Protestants were less likely to become Catholics or members of mediumistic religions. Members of Spiritism, Umbanda, or Candomblé were less likely to become Catholics. Most Atheists and Agnostics comprised respondents who had initially been religious. These findings suggest that religious mobility depends, at least in part, on the influence of previous religious involvements.