Assuntos
COVID-19 , Acidente Vascular Cerebral , Humanos , Vacinas contra COVID-19 , SARS-CoV-2 , VacinaçãoRESUMO
OBJECTIVE: This study aimed to evaluate the concept of health professionals affiliated with the Brazilian League of Epilepsy on whether or not to inform patients about the risk factors related to the occurrence of sudden unexpected death in epilepsy. METHODS: A descriptive research of inquiry was conducted with direct survey on the Brazilian neurologist's view, regarding medical behavior in the health area to report or not about the risk of sudden unexpected death in epilepsy. Data collection consisted of a structured questionnaire available online. RESULTS: The study population consisted of a sample of 44 Brazilian League of Epilepsy members who answered the questionnaire, of which 25 (56.8%) were men and 19 (43.2%) were women. Among the analyzed questionnaires, 79.5% reported that they were aware of the risk factors for sudden unexpected death in epilepsy and 18.2% admitted not knowing the potential risk factors for sudden unexpected death in epilepsy. Notably, 59.1% of these professionals thought that an early discussion with the patient about sudden unexpected death in epilepsy must be considered. The majority (70%) felt that the neurologist should do this, and 22% believed that the subject should be discussed with psychologists. It was noted that 84.1% of respondents did not discuss or discussed only with some of their patients about the risk factors for sudden unexpected death in epilepsy. CONCLUSIONS: There is a need for encouraging early discussion of sudden unexpected death in epilepsy with epilepsy patients if the patient asks about the risks related to epilepsy and its treatment, when treatment adherence is low, in cases of intractable epilepsy with strong indication for surgical treatment, and when polytherapy is needed.
Assuntos
Epilepsia , Morte Súbita Inesperada na Epilepsia , Brasil/epidemiologia , Morte Súbita/epidemiologia , Morte Súbita/etiologia , Epilepsia/complicações , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Neurologistas , Fatores de RiscoRESUMO
SUMMARY OBJECTIVE: This study aimed to evaluate the concept of health professionals affiliated with the Brazilian League of Epilepsy on whether or not to inform patients about the risk factors related to the occurrence of sudden unexpected death in epilepsy. METHODS: A descriptive research of inquiry was conducted with direct survey on the Brazilian neurologist's view, regarding medical behavior in the health area to report or not about the risk of sudden unexpected death in epilepsy. Data collection consisted of a structured questionnaire available online. RESULTS: The study population consisted of a sample of 44 Brazilian League of Epilepsy members who answered the questionnaire, of which 25 (56.8%) were men and 19 (43.2%) were women. Among the analyzed questionnaires, 79.5% reported that they were aware of the risk factors for sudden unexpected death in epilepsy and 18.2% admitted not knowing the potential risk factors for sudden unexpected death in epilepsy. Notably, 59.1% of these professionals thought that an early discussion with the patient about sudden unexpected death in epilepsy must be considered. The majority (70%) felt that the neurologist should do this, and 22% believed that the subject should be discussed with psychologists. It was noted that 84.1% of respondents did not discuss or discussed only with some of their patients about the risk factors for sudden unexpected death in epilepsy. CONCLUSIONS: There is a need for encouraging early discussion of sudden unexpected death in epilepsy with epilepsy patients if the patient asks about the risks related to epilepsy and its treatment, when treatment adherence is low, in cases of intractable epilepsy with strong indication for surgical treatment, and when polytherapy is needed.
RESUMO
There is increasing evidence that COVID-19 can be associated with ischemic stroke (COVID-stroke). The frequency and pathogenesis of COVID-stroke, however, remains largely unknown. This narrative review aimed at summarizing and discussing current knowledge about frequency and pathogenesis of COVID-stroke in 455 patients collected from the literature. COVID-stroke occurs in all age groups and predominantly in males. The anterior circulation is more frequently affected than the posterior circulation. COVID-stroke is most frequently embolic. The severity of COVID-stroke ranges from NIHSS 3 to 32. Cardiovascular risk factors are highly prevalent in patients with COVID-stroke. COVID-stroke occurs simultaneously with the onset of pulmonary manifestations or up to 40 days later. Clinical manifestations of COVID-19 are most frequently mild or even absent. The majority of patients with COVID-stroke achieve complete or partial recovery, but in one-quarter of patients, the outcome is fatal. In conclusion, the frequency of ischemic stroke has not increased since the outbreak of the SARS-CoV-2 pandemic. COVID-stroke predominantly affects males and the anterior circulation. COVID-stroke is multifactorial but predominantly embolic and more frequently attributable to cardiovascular risk factors than to coagulopathy.
Assuntos
COVID-19 , AVC Isquêmico , Acidente Vascular Cerebral , COVID-19/complicações , Humanos , Masculino , Pandemias , SARS-CoV-2 , Acidente Vascular Cerebral/complicaçõesRESUMO
Objetivo: Avaliar a autopercepção e as condições de saúde em idosos assistidos em um Programa Acompanhante do Idoso (PAI) do Município de São Paulo. Método: Estudo observacional de abordagem quantitativa, com uso de dados secundários. Foram sujeitos desta pesquisa 41 idosos cujos dados da Avaliação Multidimensional da Pessoa Idosa na Atenção Básica (AMPI/AB) constavam em banco de dados do referido PAI. As informações correspondem aos seguintes parâmetros de saúde da pessoa idosa: idade, autopercepção de saúde, arranjo familiar, condições crônicas de saúde, medicamentos, internações, quedas, visão, audição, limitação física, cognição, humor, atividades básicas de vida diária, atividades instrumentais de vida diária, incontinência, perda de peso não intencional e condições bucais. Resultados: Predominância do sexo feminino, raça branca e média de idade de 81,53 anos. A maioria dos sujeitos referiu autopercepção regular, ruim ou muito ruim de saúde; morar acompanhados; possuir três ou mais condições crônicas de saúde, utilizar cinco ou mais fármacos ao dia, ausência de internação ou quedas nos últimos doze meses, possuir dificuldades visuais e auditivas, não possuir limitações físicas, piora na memória no último ano, alterações de humor, independência nas atividades básicas de vida diária e dependência nas atividades instrumentais de vida diária e, ainda, ausência de incontinência, de perda de peso não intencional e de alterações bucais. Quanto às classificações da AMPI/AB, a maioria dos idosos ficou na categoria "Pré-frágil" (51,3%), seguida de "Frágil" (39%) e "Saudável" (9,7%). Foram observadas associações da categoria "Frágil" com problemas auditivos e episódios de esquecimentos. Houve correlação entre aumento de idade e piora no resultado da AMPI/AB. Conclusão: Predomínio de autopercepção negativa da saúde, alta ocorrência de doenças crônicas - principalmente a hipertensão - e dependência dos sujeitos para realizar atividades instrumentais de vida diária. Idosos frágeis relataram mais dificuldades auditivas e episódios de esquecimentos. Há uma tendência de maiores acometimentos na saúde conforme o aumento da idade.
Objective: Evaluate self-perception and health conditions in elderly population assisted in an Elderly Companion Program (PAI, according to its acronym in Portuguese) in the city of São Paulo. Method: Observational study of quantitative approach with the use of secondary data. The sample of 41 elderly people came from the PAI database of a Primary Care Unit, in São Paulo, through the application of the Multidimensional Assessment of the Elderly Person in Primary Care (AMPI / AB, according to its acronym in Portuguese). The information corresponds to the following health parameters of the elderly: age, health self-perception, family arrangement, chronic health conditions, medications, hospitalizations, falls, vision, hearing, physical limitation, cognition, mood, basic activities of daily living, instrumental activities of daily living, incontinence, unintended weight loss and oral conditions. Results: Predominance of females, white race, and average age of 81.53 years. Most of the subjects referred to regular, poor or very poor self-perception, living accompanied, having three or more chronic health conditions, using five or more medications per day, absence of hospitalization or falls in the last twelve months, visual and hearing difficulties, absence of physical limitations, worsening of memory in the last year, independence on basic activities of daily living and dependence on instrumental activities of daily living and, still, absence of incontinence, unintended weight loss and oral alterations. As for AMPI / AB classifications, most of the elderly were in the "Pre-fragile" group (51.3%), followed by "Fragile" (39%) and "Healthy" (9.7%). Associations of the "Fragile" group were observed with hearing problems and episodes of forgetfullness. There was a correlation between age increasing and worsening in the result of AMPI/AB. Conclusion: Predominance of negative self-perception of health, high occurrence of chronic diseases - especially hypertension - and dependence on subjects to perform instrumental activities of daily living. Fragile elderly people reported more hearing difficulties and forgetfulness episodes. There's a trend of greater health impairment as the age increases.
Objetivo: Valorar la autopercepción y las condiciones de salud de ancianos asistidos en un Programa Acompañante de Ancianos (PAI, por sus siglas en portugués) de la municipalidad de São Paulo. Método: Estudio observacional de abordaje cuantitativo, utilizando datos secundarios. Fueron sujetos de esta investigación 41 ancianos cuyos datos de la Evaluación Multidimensional de la Persona Anciana en la Atención Básica (AMPI/AB, por sus siglas en portugués) constaban en el banco de datos del PAI mencionado. Las informaciones corresponden a los siguientes parámetros de salud de la persona anciana: edad, autopercepción de salud, circunstancias familiares, condiciones crónicas de salud, medicamentos, internaciones, caídas, visión, audición, limitaciones físicas, cognición, humor, actividades básicas de la vida cotidiana, actividades instrumentales de la vida cotidiana, incontinencia, pérdida de peso no intencional y condiciones bucales. Resultados: Predominancia del sexo femenino, raza blanca y promedio de edad de 81,53 años. La mayoría de los sujetos relató autopercepción regular, mala o muy mala de salud; vivir acompañados; poseer tres o más condiciones crónicas de salud; utilizar cinco o más fármacos por día; ausencia de internación o caídas en los últimos doce meses; poseer dificultades visuales y auditivas; no poseer limitaciones físicas; empeoramiento de la memoria en el último año; alteraciones de humor; independencia en las actividades básicas de vida cotidiana y dependencia en las actividades instrumentales de vida cotidiana; y, además, ausencia de incontinencia, de pérdida de peso no intencional y de alteraciones bucales. En relación con las clasificaciones de la AMPI/AB, la mayoría de los ancianos se encuadra en la categoría "Pre frágil" (51,3%), luego de "Frágil" (39%) y "Saludable" (9,7%). Se observaron asociaciones de la categoría "Frágil" con problemas auditivos y episódios de olvidos. Hubo correlación entre el aumento de edad y empeoramiento del resultado de la AMPI/AB. Conclusión: Predominio de autopercepción negativa de la salud, alto registro de enfermedades crónicas - principalmente la hipertensión - y dependencia de los sujetos para realizar actividades instrumentales de vida cotidiana. Ancianos frágiles relataron más dificultades auditivas y episodios de olvidos. Existe una tendencia de mayores problemas de salud de acuerdo con el aumento de la edad.
