The culturally adapted Italian version of the Barthel Index (IcaBI): assessment of structural validity, inter-rater reliability and responsiveness to clinically relevant improvements in patients admitted to inpatient rehabilitation centers.

The Barthel Index (BI) is widely used to determine eligibility criteria for inpatient rehabilitation and to monitor patients' recovery, irrespective of the illnesses that affect them. The culturally adapted Italian version of the Barthel Index (IcaBI) was recently validated. This paper reports the structural validity and inter-rater reliability of the IcaBI and its responsiveness to the results of inpatient rehabilitation. The IcaBI was administered to a cohort of 264 patients hospitalized in two rehabilitation centers in Rome, Italy. Factor analysis using principal component analysis revealed a monofactorial structure for neurological patients and, after removal of item 1 "feeding", also for orthopedic patients. Substantial to optimal inter-rater reliability was found (0.74 > intraclass correlation coefficient < 0.96). The IcaBI was found to be accurate (area under the curve= 0.72) with a minimal clinically important change score of 35 points. This work confirms that IcaBI is a useful tool for measuring disability in health and social care settings along the continuum of care. Further studies are needed to assess its criterion validity, interpretability and responsiveness in other specific disease conditions.

[Changes in the body's oxygen regime in hypothalamic syndromes under the influence of hypoxic mixtures]. / Izmeneniia kislorodnogo rezhima organizma pri gipotalamicheskikh sindromakh pod vliianiem gipoksicheskoi smesi

A study of the oxygen regimen in the organism of patients with hypothalamic syndromes (vegetative, vascular and neuroendrocrino-metabolic) according to the Lauer and Kolchinskaya method demonstrated that an inhalation of hypoxic mixture containing 15% of oxygen leads to changes in the respiration indices. Such changes were related to circulation, oxygen parameters and indicated an increase of hypoxemia under the influence of this mixture and of a significant drop in the consumption of oxygen by the tissues. This may also speak in favour of an inhibition of activities in the compensatory and adaptational mechanisms. The most expressed inhibitive activity of such mechansims was seen in patients with hypotonic vetetative-vascular syndromes which is most likely connected with a drop of the tone in the neurohormonal system in this group of patients.