RESUMO
The recognition of caregivers working with elderly people with neuro-evolutionary diseases is a fact. The caregivers interviewed for this study reported that they felt recognized and identified by these elderly people, who were considered to be prosopagnosic. The caregivers were even able to show that this recognition was possible, even during changes in appearance.
Assuntos
Cuidadores , Humanos , Cuidadores/psicologia , Idoso , Masculino , Feminino , Transtornos Neurocognitivos/enfermagem , Transtornos Neurocognitivos/psicologia , Pessoa de Meia-Idade , Idoso de 80 Anos ou maisRESUMO
The first orientation test for proteinuria typing is electrophoresis. However, this technique has several drawbacks, such as delayed turnaround time and subjective readings. Some laboratories therefore use quantitative assays of glomerular markers combined with tubular markers. However, the cost of reagents and the instability of certain markers are significant drawbacks for some peripheral laboratories. The aim of this study is to evaluate the implementation of an algorithm based on parameters that can be used by all laboratories for proteinuria typing within a timeframe compatible with the urgency of the situation. Albuminuria and urinary IgG were determined on 161 urines. ROC curves were produced, using urine electrophoresis read by an expert center as the reference method. The decision thresholds used are: glomerular proteinuria is defined by a Albumin+IgGproteinsratio greater than 75.4% (100% specificity), and tubular or overload proteinuria is defined by by a Albuminproteinsratio less than 37.3% (100% sensitivity). Agreement between the results of the algorithm selected and the reference method used in our study was 88 %, with a kappa value of 0.807 (95% CI [0.729 to 0.885]). The algorithm's performance suggests that it can find its place in the diagnostic strategy for clinically significant proteinuria, despite its limited indications. It is up to each biologist to assess the value of this algorithm in relation to the recruitment, habits and needs of clinicians.
Assuntos
Albuminúria , Algoritmos , Imunoglobulina G , Proteinúria , Humanos , Albuminúria/diagnóstico , Albuminúria/urina , Proteinúria/diagnóstico , Proteinúria/urina , Masculino , Feminino , Imunoglobulina G/urina , Pessoa de Meia-Idade , Adulto , Idoso , Glomérulos Renais , Urinálise/métodos , Urinálise/normas , Adulto Jovem , Sensibilidade e Especificidade , Idoso de 80 Anos ou mais , Adolescente , Biomarcadores/urinaRESUMO
The existence of alpha-1 antitrypsin variants with apparently unremarkable phenotypes and serum concentrations, contrasting with a clinical picture suggestive of a severe deficiency, led us to investigate whether in these cases there was a reduction or even suppression of the capacity of alpha-1 antitrypsin to inhibit elastase. To this end, in two different laboratories, we adapted and validated a method for measuring the functional activity of alpha-1 antitrypsin, based on spectrophotometric kinetic analysis of the inhibition by serum alpha-1 antitrypsin of the hydrolytic activity of porcine pancreatic elastase on a chromogenic substrate. This method has proved to be robust, reproducible and transferable and made possible to define, on the basis of an analysis of a hospital population, a functionality index with a confidence interval comprised between 0.87 and 1.2, allowing to identify subjects likely to have a functional deficiency of alpha-1 antitrypsin, whether this deficiency being of a genetic origin without any quantitative or phenotypic translation, or whether being acquired under the effect of external agents (cigarette smoke or viruses).
RESUMO
Our aim is to explore the possible emergence of traumatic symptoms and the identity-related repercussions of the restrictions on elderly, who entered into nursing homes during the Covid-19 health crisis in France. Twenty-five subjects institutionalised before the health crisis and twenty-six subjects institutionalised during the periods of lockdown into nursing homes completed scales assessing anxiety-depressive symptomatology, traumatic symptoms and identity. Anxiety and depression symptoms were similar between the groups. The institutionalised group showed a significantly higher prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria D and E on the Post traumatic Stress Disorder Checklist version DSM-5 (PCL-5) during lockdown. Entry into an institution during the health crisis would have favored the emergence of traumatic symptoms in the participants. Consideration of the ethical issues raised by this study could make it possible to offer more individualised support to elderly during their transition to a new home.
Assuntos
COVID-19 , Idoso , Humanos , Controle de Doenças Transmissíveis , Casas de Saúde , Instituições de Cuidados Especializados de Enfermagem , Ansiedade/epidemiologiaRESUMO
La qualité des soins apportés aux personnes vivant avec la maladie d'Alzheimer (MA) dépend en partie de la capacité des professionnels à déterminer le degré de conscience de la maladie chez les patients. La présente recherche s'est intéressée aux représentations des soignants concernant la conscience des troubles chez les résidents d'établissements de soins de longue durée présentant un diagnostic de MA. Le pouvoir prédicteur de l'anosognosie sur le fardeau soignant a également été examiné. L'anosognosie des troubles de la construction (r = 0,40, p = 0,0164) et de l'initiation (r = 0,32, p = 0,052) était corrélée au fardeau soignant. Les professionnels se représentaient les résidents comme ayant une conscience altérée de leurs capacités, même en l'absence d'anosognosie. Les scores réels d'anosognosie ne prédisaient pas les estimations soignantes, hormis le score global sous forme de tendance (χ2 = 3,38, p = 0,066). Les soignants surestimaient pourtant les performances cognitives des résidents, telles que mesurées au moyen du protocole Misawareness (prédictions aidants/performances réelles : DC = 12,32, p < 0,0001).