ABSTRACT
As lesões do Traumatismo Cranioencefálico (TCE) de caráter macro ou micro podem comprometer fisicamente e/ou psicologicamente o indivíduo. Sendo uma doença da sociedade moderna que acomete qualquer idade, é considerada principal causa de morbimortalidade no Brasil ao abranger a população economicamente ativa podendo incapacitar de forma temporária ou permanente, consequentemente gerando impacto na qualidade de vida, sendo difícil mensurar o perfil funcional, nível de recuperação e quanto tempo ficará em determinado perfil. Com o objetivo de determinar e classificar o perfil funcional de indivíduos com TCE na alta hospitalar, foi realizado um estudo analítico, observacional e transversal onde foi aplicado a Glasgow Outcome Scale/Escala de Resultado Ampliada de Glasgow (GOSE/ERGA) através de uma ficha para coleta de dados e entrevistas. A população do estudo foi constituída por 26 voluntários, admitidos para tratamento no Hospital Universitário São Francisco de Bragança Paulista-São Paulo com diagnóstico comprovado de TCE por meio de exames de imagem entre setembro/2019 e março de 2020. Encontramos evidências de 88,46% pertencente ao gênero masculino, e 11,54% gênero feminino, onde foram observados média e desvio padrão de idade 35,73±16,76. Entre os tipos de trauma mais comuns o politrauma se sobressaiu com 80,77% e a GOSE/ERGA teve maior indício com 46,15% de escore 8. A maioria dos colaboradores recebeu alta do HUSF com o perfil funcional de boa recuperação e poderão retornar a vida anterior ao trauma. Através das classificações funcionais pode-se orientar profissionais responsáveis pela reabilitação daqueles que foram acometidos pelo trauma e ficaram com sequelas, bem como orientar os familiares e centros de assistência a comunidade.
The lesions caused by a Traumatic Brain Injury (TBI) of macro or micro character can physically and/or psychologically compromise an individual. Being a disease of modern society that affects any age, it is considered the main cause of morbidity and mortality in Brazil as it covers the economically active population. It can temporarily or permanently disable people, consequently generating an impact on their quality of life, and is difficult to measure their functional profile, level of recovery, and how long they will remain in a given profile. In order to determine and classify the functional profile of individuals with TBI at hospital discharge, an analytical, observational, and cross-sectional study was carried out in which the Glasgow Outcome Scale/Glasgow Extended Outcome Scale (GOSE) was applied through a form for data collection and interviews. The study population consisted of 26 volunteers, admitted for treatment at Hospital Universitario Sao Francisco de Braganca Paulista, Sao Paulo with a confirmed diagnosis of TBI through imaging tests between September 2019 and March 2020. We found evidence of 88.46 % belonging to the males, and 11.54% female, where the mean and standard deviation of age 35.73±16.76 were observed. Among the most common types of traumas, polytrauma stood out with 80.77% and GOSE had the highest scores where 46.15% had a score of 8. Most participants of the study were discharged from the HUSF with the functional profile of good recovery and may return to their lives before the trauma. Through functional classifications, it is possible to guide professionals responsible for the rehabilitation of those who were affected by trauma and were left with sequelae, as well as guide family members and community assistance centers.
ABSTRACT
Objective: To describe the clinical, socio-demographic, and functional profile of children with Attention Deficit Hyperactivity Disorder (ADHD) referred to a tertiary care center in Kerala, India. Methods: A retrospective descriptive study was conducted from records of developmental evaluation clinic over a period of one year. All-consecutive cases the first time diagnosed as ADHD were enrolled. Autism Spectrum Disorder, genetic disorders, and children with sensory impairments were excluded. Clinical profile was based on presenting symptoms, gender, and socio-demographic characteristics; functional status assessed by Conner’s 3 Parent Scale and cognitive status by Intelligence Quotient. Results: ADHD prevalence in a clinically referred sample was 12.7%. Boy to girl ratio was 6:1. The mean age of presentation was 8.2 years (SD 6.09). The most common presenting symptom was hyperactivity and behavioral problems followed by poor scholastic performance and poor memory. The functional status assessment showed major concerns in all six domains - Inattention, Hyperactivity, Learning Problem, Executive Functioning, Aggression, and Peer relation, in the majority of children. Children presenting with ADHD symptoms at a later age (9-12 years) had lower IQ scores than those diagnosed at a younger age. Conclusion: Course of childhood ADHD shows a consistent clinical and functional pattern. Early diagnosis and quantification of difficulties at the outset is suggested, which can help in providing early intervention and is likely to improve long-term outcome in these children.
ABSTRACT
OBJETIVO: Traçar o perfil clínico-funcional de idosos de uma instituição de longa permanência para idosos (ILPI). MÉTODOS: Participaram 47 idosos de uma ILPI de Belo Horizonte/MG. Utilizaram-se questionário com informações sociodemográficas, Mini Exame do Estado Mental (MEEM), Escala de Depressão Geriátrica (GDS), Índice de Katz e Time Up and Go (TUG). Realizou-se análise descritiva (programa SPSS 14.0). RESULTADOS: Os idosos apresentaram média de 73,0 anos (±8,99). A maioria era mulher (51,1%), solteira (46,8%), sem filhos (51,1%) e de baixa escolaridade. O tempo de institucionalização variou de um mês a 25 anos. O motivo de institucionalização mais frequente foi para tratamento (29,8%), e 80,9% relataram receber visitas. Os idosos tomam em média 3,45 medicamentos (±1,87).Apenas 12,8% relataram quedas nos últimos seis meses e 80,9% tinham medo de cair. Cerca de 38,3% não utilizam dispositivo de auxílio à marcha, 12,8% utilizavam cadeira de rodas, 42,5% andador e 6,4% bengala. O desempenho no MEEM foi baixo, sendo que 93,3% apresentaram valores abaixo da nota de corte para escolaridade. Na GDS, 59,6% obtiveram valores que sugerem quadro depressivo. O TUG variou de 0,10 a 1,58 minutos. A maioria relatou ser independente para realizar as atividades do Katz (banhar-se: 80,9%; vestir-se: 83,0%; usar banheiro: 80,9%; transferir-se: 87,2%; micção: 59,6%; evacuação: 61,7%; alimentar-se: 93,6%) e nenhum relatou dependência completa. CONCLUSÕES: O perfil da população de idosos institucionalizados está de acordo com a literatura nos aspectos clínico-demográficos. A maioria dos idosos, entretanto, relatou ser independente para as atividades básicas de vida diária, o que representa boa oportunidade para intervenções que visem prevenir ou minimizar possíveis perdas funcionais.
OBJECTIVE: To describe the clinical and functional profile of elderly living in a long-term care institution. METHODS: 47 older adults living in a long-term care institution of Belo Horizonte/MG took part in the study. For a data collection were used a structured socio-demographic questionnaire, Mini Mental State Examination (MMSE), Geriatric Depression Scale(GDS), Katz Index and Timed Up and Go (TUG). A descriptive statistics were employed by using SPSS14.0. RESULTS: The mean age of the elderly was 73.0 years (±8.99). Most of the elderly was female (51.1%), single (46.8%) without children (51.1%) and with low education. The time of institutionalization ranged from one month to 25 years. The most frequent reason for institutionalization was with purpose of treatment (29.8%) and majority reported receiving visits (80.9%). The elderly took an average of 3.45 medications (±1.87). Only 12.8% reported at least one fall in the last six months and 80.9% reported being afraid of falling. About 38.3% do not use assistive walk device; 12.8% use wheelchair; 42.5%, walker; and 6.4%, cane. The MMSE scores were low, 93.3% were below the cutoff score for their schooling. At GDS, 59.6% were suggesting possible depression. TUG range from 0.10 to 1.58 minutes. Most elderly people reported being independent to perform the activities of Katz (bathing: 80.9%; dressing: 83.0%; toileting: 80.9%; transferring 87.2%; urination 59.6%; defecation: 61.7%; feeding 93.6%) and none reported complete dependence. CONCLUSION: The profile of institutionalized elderly is consistent with the literature on clinical and demographic variables. However, most patients reported being independent for basic activities of daily living, which represents a good opportunity for interventions that aim to prevent or minimize possible losses of function.