Assuntos
Aracnoidite/diagnóstico por imagem , Cefaleia/diagnóstico por imagem , Meningismo/diagnóstico por imagem , Cervicalgia/diagnóstico por imagem , Hemorragia Subaracnóidea/diagnóstico por imagem , Adulto , Aracnoidite/complicações , Medula Cervical/diagnóstico por imagem , Cefaleia/etiologia , Humanos , Masculino , Meningismo/complicações , Cervicalgia/etiologia , Hemorragia Subaracnóidea/complicaçõesRESUMO
The Fatigue Impact Scale for Daily Use (D-FIS) was used in a cross-sectional study including 142 consecutive Parkinson's disease (PD) patients. Usual clinical measures for PD, the Montgomery-Asberg Depression Rating Scale and the Parkinson's Disease Questionnaire-8 items were applied. In addition to the D-FIS, patients with fatigue (67.6%, PWF) completed the Multidimensional Fatigue Inventory (MFI), a visual analogue scale for fatigue (VAS-F) and a Global Perception of Fatigue scale (GPF). Relevant psychometric D-FIS results were: floor effect = 4.2%; ceiling effect = 1.1%; skewness = 0.44; item homogeneity = 0.63; Cronbach's alpha = 0.93; item-total correlation = 0.68 (item 1)-0.82 (item 8); standard error of measurement = 2.15; convergent validity with other fatigue measures = 0.54 [GPF]-0.62 [VAS-F] (p<0.001). In a multiple linear regression model, fatigue, depression, and disability independently influenced HRQoL, as measured by the PDQ-8. Patients on amantadine had lower prevalence of fatigue. In PD, D-FIS is a consistent and valid measure for fatigue, a frequent symptom previously found to impair patients' HRQoL. Fatigue was also linked to depression and disability in this study.
Assuntos
Fadiga/fisiopatologia , Doença de Parkinson/fisiopatologia , Psicometria/instrumentação , Qualidade de Vida/psicologia , Perfil de Impacto da Doença , Idoso , Comorbidade , Estudos Transversais , Fadiga/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/psicologia , Espanha , Inquéritos e Questionários , Fatores de TempoRESUMO
This multicenter study sought to analyze the validity and reliability of the Unified Parkinson's Disease Rating Scale (UPDRS)-section 2 (Activities of Daily Living, ADL) as applied by patients and caregivers. Sixty pairs of PD patients-caregivers were enrolled for study purposes. Neurologists used a set of scales to determine disease severity and patients' functional state. Patients and caregivers used adapted versions of the UPDRS-section 2 in tandem with other measures. Wilcoxon and Mann-Whitney tests, weighted kappa, intraclass and Spearman's correlation coefficients, as well as multivariate linear regression models were applied. On the whole, PD patient self-assessment and caregiver evaluation of patients' disability showed close concordance with neurologists' ratings. Correlation between caregiver ratings and clinical evaluation tended to be slightly lower than that for patient-based self-assessment. Depression showed a positive correlation with disability and had a nonsystematic influence on UPDRS-section 2 (ADL) scores. As expected, there was a significant correlation between perceived disability and health-related quality of life measures. Caregiver burden did not reduce the level of agreement with neurologists as to the overall rating of any given patient's disability. In PD, UPDRS-section 2-based assessment of disability by patients themselves and caregivers is a valid and reliable outcome.
Assuntos
Cuidadores , Doença de Parkinson/diagnóstico , Médicos , Idoso , Avaliação da Deficiência , Feminino , Humanos , Masculino , Destreza Motora , Exame Neurológico , Variações Dependentes do Observador , Doença de Parkinson/psicologia , Doença de Parkinson/reabilitação , Psicometria , Reprodutibilidade dos Testes , Autoavaliação (Psicologia) , Índice de Gravidade de DoençaRESUMO
Patient- and caregiver-based scores were compared and agreement levels ascertained to determine the reliability of proxy evaluation of Parkinson's Disease (PD) patients' health-related quality of life (HRQoL) using the EuroQoL and PD questionnaire (PDQ)-8. Of 72 patient-caregiver pairs, 64 (88.88%) returned the questionnaires. The degree of agreement varied for individual dimensions. Proxy evaluation of PD patients' HRQoL showed limitations mainly with assessments using the EuroQoL and especially in patients with severe disease and depression.
Assuntos
Nível de Saúde , Doença de Parkinson/psicologia , Qualidade de Vida , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
Un accidente vasculoencefálico isquémico en un paciente anciano se asocia comúnmente a una etiopatologenia trombótica o embólica no teniéndose en cuenta otras teiologías de baja incidencia, pudiendo esto ocasionar la pérdida de oportunidades terapéuticas. Comunicamos el caso de una paciente en la cual un Síndrome del uno y medio de Fisher y una parálisis facial periférica derechos, producto de una lesión inquémica protuberancial, fueron los síntomas graves de presentación de una arterítis temporal en la cual síntomas generales previos atribuibles a la misma, pasaron desapercibidos. Apoyaron la etiologia una biopsia bilateral de arterias temporales positiva y la comprabación de lesiones isquémicas múltiples incluyendo protuberancia en la RMN de cráneo. Conclusiones. Las diversas presentaciones clínicas de la arteritis temporal plantean considerarla entre las opciones etiológicos en todo paciente con signos neurológicos múltiples afectando la circulación vertebrobasiliar, acompañados de signos y síntomas generales y VSG elevada. Evitar la neuropatía óptica isquémica anterior y otras complicaciones exige un diagnóstico y tratamiento precoz.