The Relationship Between Cognitive Impairment And Functionality In Euthymic Bipolar Patients: A Case Controlled Study

ABSTRACT Objective: We sought to compare differences in cognitive function between patients with bipolar disorder type 1 (BPD-1) and healthy controls (HC) and to investigate the relationship between cognitive functions and functional areas of patients with BPD-1. Methods: This study included 93 euthymic patients with BPD-1 and 64 healthy age- and sex-matched individuals. All participants completed a sociodemographic form; took the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Montreal Cognitive Assessment Scale (MoCA) assessments; and underwent a neuropsychometric battery. Results pertaining to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth revision Axis I Disorders (SCID-I), Young Mania Rating Scale score, and Bipolar Disorder Functioning Questionnaire score were obtained for the patients; the HC group was investigated using the SCID nonpatient version. Results: All of the cognitive domain scores were significantly lower in the BPD-1group than in the HC group (p < 0.05). A statistically significant positive correlation was observed between the neurocognitive domains of attention, verbal memory, visual memory, and BPD-1 total functioning (p < 0.05). Discussion: Impairments in verbal memory, visual memory, and attention among euthymic patients with BPD-1 may cause impaired functionality.

Bienestar Espiritual y Funcionalidad del Paciente Crónico Complejo Hospitalizado en una Institución de Bogotá / Spiritual Well-being and Functionality of the Complex Chronic Patient Hospitalized in an Institution of Bogotá

El presente estudio tiene como propósito establecer la relación que existe entre el bienestar espiritual y la funcionalidad de los pacientes crónicos complejos hospitalizados en una institución de tercer nivel de atención. Metodología: El estudio, de carácter descriptivo correlacional, contó con una muestra que reunía los siguientes criterios de inclusión: pacientes hospitalizados en una institución de tercer nivel de atención, considerados como pacientes crónicos complejos, mayores de 18 años y sin alteración cognitiva. Se incluyeron en el estudio 100 pacientes, internados en los servicios de hospitalización general de la institución de salud, los cuales cumplieron con los criterios definidos y se seleccionaron en un muestreo por conveniencia. Para el presente estudio se utilizaron la Escala de bienestar espiritual de Ellison®, en sus componentes existencial y religioso para evaluar el bienestar espiritual y la escala PULSES, que establece la funcionalidad determinando el nivel de dependencia, a través de la puntuación de diferentes aspectos. El análisis se realizó utilizando el coeficiente de Sperman. Resultados: Los resultados evidenciaron que no existe relación estadística significativa entre el bienestar espiritual y la funcionalidad, con un coeficiente de correlación de 0,147 con un valor p de 0,144. Respecto al bienestar religioso no se pudo establecer una correlación con la funcionalidad, y tampoco para el caso del bienestar existencial se estableció una relación con el desempeño adecuado de los pacientes en sus actividades cotidianas. El 79% de los participantes tuvieron un bienestar espiritual alto y ninguno presentó bienestar espiritual bajo. Respecto a la funcionalidad el 9% presentó un grado de dependencia alto, el 41% dependencia mediana y el 29% dependencia baja.

The present study aims to establish the relationship between spiritual well-being and functionality in complex chronic patients hospitalized in a tertiary care institution. Methodology: The descriptive correlational study had a sample that met the following inclusion criteria: patients hospitalized in a tertiary care institution, considered complex chronic patients, older than 18 years and without cognitive impairment. The study included 100 patients, selected in a convenience sampling, admitted to the general hospitalization services of the health institution, who met the defined criteria. Two scales were used for this study: the Ellison Spiritual Well-being Scale in its existential and religious components, to assess spiritual well-being and the PULSES scale, which establishes functionality by determining the level of dependency through the scoring of different aspects. Regarding the analysis, this was carried out using the Sperman coefficient. Results: The results showed that there is not a statistically significant relationship between spiritual well-being and functionality, with a correlation coefficient of 0.147 with a "p" value of 0.144. Regarding religious well-being, a correlation with functionality could not be established and neither between existential well-being with the adequate performance of patients in their daily activities. According to the percentages, 79% of the participants had high spiritual well-being and none had low spiritual well-being. In terms of functionality, 9% presented a high degree of dependency, 41% a medium one and 29% a low dependency.

Avaliação da capacidade funcional em pacientes com artrite reumatoide: implicações para a recomendação de exercícios físicos / Assessment of functional capacity in patients with rheumatoid arthritis: implications for recommending exercise

A artrite reumatoide (AR) é uma doença autoimune que se caracteriza por poliartrite crônica simétrica, de grandes e pequenas articulações, e rigidez matinal que pode levar a comprometimento musculoesquelético, com impotência funcional. O conceito da funcionalidade diz respeito à capacidade de o indivíduo realizar atividades e tarefas da vida diária e cotidiana, de forma eficaz e independente. O objetivo desta revisão é familiarizar o reumatologista com o conceito de avaliação da capacidade funcional e os testes que podem ser aplicados nessa população, pois são passos importantes para uma prescrição adequada de exercícios físicos, A partir de testes funcionais já utilizados em população idosa, o Laboratório de Aptidão Física e Reumatologia - LAR - Brasília, que acompanha os pacientes da Coorte Brasília de Artrite Reumatoide Inicial, descreve neste artigo um protocolo de testes para avaliação da capacidade funcional para aplicação nos pacientes com diagnóstico de AR, incluindo a descrição dos seguintes testes: 1) Sentar e Alcançar; 2) Agilidade/Equilíbrio Dinâmico; 3) Dinamometria Manual; 4) Sentar e Levantar; 5) Rosca Bíceps e 6) Teste da Caminhada de Seis Minutos.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic symmetric polyarthritis of large and small joints and by morning stiffness that may lead to musculoskeletal impairment, with functional impotence. The concept of functionality relates to the ability of an individual to perform effectively and independently daily activities and tasks of everyday life. The aim of this review is to familiarize the rheumatologist with the concept of functional capacity evaluation and with the tests that can be applied in this population, as these are important steps for a proper exercise prescription. From functional tests already used in the elderly population, the Physical Fitness and Rheumatology Laboratory - LAR - Brasilia, which is accompanying patients from Brasilia Cohort of Early Rheumatoid Arthritis, describes in this article a protocol of tests to assess functional capacity for application in patients with RA, including the description of tests: 1) Sit and Reach; 2) Agility/Dynamic Balance; 3) Manual Dynamometry; 4) Sit Back and Lift; 5) Biceps Curl and 6) Six-minute Walk Test.

Caracterização Funcional de Indivíduos Acometidos por Acidente Vascular Encefálico Assistidos em uma Unidade de Terapia Intensiva / Functional Characterization of Individuals Affected by Stroke Assisted in an Intensive Care Unit

Caracterizar os dados sociodemográficos eclínicos, identificar os fatores de risco e investigar acapacidade funcional de indivíduos acometidos por AcidenteVascular Encefálico (AVE) assistidos em uma Unidade deTerapia Intensiva (UTI). Material e Métodos: Estudotransversal, descritivo e quantitativo, composto por 21indivíduos acometidos por AVE assistidos na UTI do HospitalRegional de Emergência e Trauma Dom Luiz GonzagaFernandes, na cidade de Campina Grande – PB, no períodode março a setembro de 2011. Utilizou-se uma Fichasociodemográfica e clínica e a Classificação Internacionalde Funcionalidade, Incapacidade e Saúde (CIF) paraavaliação. Os dados foram analisados e expressos emfrequência, percentil, média e desvio padrão da média atravésdo software GraphPad Prism 4.0. Resultados: A amostra foicomposta por 52,4% do gênero masculino, com idade médiade 67,6±11,9 anos, sendo 42,8% casados. Quanto aos dadosclínicos, 57,2% era acometida por AVE hemorrágico (AVEh),61,9% apresentou o dimídio direito afetado e 90,4% possuíadoenças cardio-vasculares (DCVs) como fator da risco. Comrelação à funcionalidade, 81% encontravam-se sedados,38% tinham deficiência completa para mobilidade de váriasarticulações e 71% para deitar-se. Conclusão: Conclui-seque os indivíduos acometidos por AVE assistidos em uma UTIsão predominantemente sexagenários do gênero masculino,casados, com AVEh, dimídio direito afetado, portadores deDCVs e de déficits funcionais graves...

To characterize socio-demographic and clinicaldata as well as to identify risk factors and investigatefunctional capacity of individuals affected by stroke assistedin the Intensive Care Unit (ICU). Material and Methods: Thiswas a cross-sectional, descriptive and quantitative study,consisting of 21 individuals affected by stroke and assistedin the ICU of the Regional Hospital of Emergency and TraumaDom Luiz Gonzaga Fernandes, in the city of Campina Grande- PB, from March to September 2011. We used as evaluationtools a socio demographic and clinical form and theInternational Classification of Functioning, Disability and Health(ICF). Data were analyzed and expressed as frequency,percentile, mean and standard deviation using the softwareGraphPad Prism 4.0. Results: The sample was mainlycomposed by men (52.4%) with mean age of 67.6 ± 11.9years, of which 42.8% were married. With regard to clinicaldata, 57.2% of the individuals had hemorrhagic stroke, 61.9%had the right hemibody affected and 90.4% hadcardiovascular diseases as a risk factor. As to functionality,81% of them were sedated, 38% had complete deficiency tomove several joints and 71% to lie down. Conclusion:Individuals affected by stroke assisted in an Intensive CareUnit are mostly men in their sixties, married, with hemorrhagicstroke, right hemibody affected, having cardiovasculardiseases and severe functional deficits...

Serie de pacientes con artritis reumatoidea tratados con el Sistema Integral de Salud Mokichi Okada / Case series of patients with rheumatoid arthritis treated with Mokichi Okada Style System of Health

Introducción: describir la evolución de siete pacientes con artritis reumatoidea (AR) tratados con el Sistema de Salud Mokichi Okada (SISMO) sumado al tratamiento de dicha entidad clínica...

Introduction: to describe the evolution of seven patients with rheumatoid arthritis (RA) treated with the Mokichi Okada Health System (SISMO) in addition to the treatment of this clinical entity...