Pertinencia de la atención de la salud mental de conductores para lograr que sean competitivos

Fundamento: Cuidar la salud mental de los conductores de vehículos, es indispensable para que estos sean competitivos y para prevenir accidentes de tránsito, debido a que una de las causas de los accidentes, es la deficiente salud mental de los conductores. Objetivo: Determinar la pertinencia de la atención en salud mental de conductores de vehículos para evitar accidentes y para que sean competitivos. Métodos: La muestra fue de 219 conductores y cobradores de transporte terrestre en Trujillo, La Libertad, Perú; que contestaron el Test de Bienestar General-5, anteriormente aplicado en el Perú por otros investigadores, conformado por 5 preguntas compuestas. La prueba de Hipótesis nula (Ho) y alterna (Ha); se plantearon con una respecto al puntaje decisorio de 54,75 puntos. Resultados: Para las preguntas 2 y 4 se aprobó la hipótesis alterna con la indicación de que es pertinente la atención de salud mental para conductores para que puedan estar relajados; descansen bien e inicien el día sintiéndose sosegados. Para las preguntas 1, 3 y 5 se aceptó la hipótesis nula. Conclusiones: se percibe que los promedios más bajos se corresponden con las preguntas 2 y 4, entonces es pertinente la atención en salud mental para que los conductores de transporte público, puedan recibir asistencia psicológica para sentirse relajados y descansados. Para las demás preguntas se acepta la hipótesis nula.

Foundation: Taking care of the mental health of vehicle drivers is essential for them to be competitive and to prevent traffic accidents because one of the causes of accidents is the poor mental health of drivers. Objective: Determine the relevance of mental health care for vehicle drivers to avoid accidents and to make them competitive. Methods: The sample was 219 drivers and collectors of land transportation in Trujillo, La Libertad, Peru; who answered the General Well-being Test-5, previously applied in Peru by other researchers, made up of 5 composite questions. The null (Ho) and alternate (Ha) hypothesis test; were raised with a respect to the decisive score of 54.75 points. Results: For questions 2 and 4, the alternative hypothesis was approved with the indication that mental health care for drivers is pertinent so that they can be relaxed; also so that they rest well and start the day feeling well rested. For questions 1, 3 and 5, the null hypothesis was accepted. Conclusions: It is perceived that the lowest averages correspond to questions 2 and 4, then mental health care is pertinent for public transport drivers, so that they can receive psychological assistance to feel relaxed and rested. For the other questions, the null hypothesis is accepted.

A retrospective study of correlation between serum levels of omega-3 polyunsaturated fatty acids and post-stroke cognitive impairment / 中华物理医学与康复杂志

Objective:To quantify any correlation between serum levels of omega-3 polyunsaturated fatty acids (ω3-PUFAs) and post-stroke cognitive impairment (PSCI).Methods:The clinical data of 77 patients hospitalized after a first stroke were analyzed. The Minimum Mental State Examination (MMSE) was used to divide them into impaired (PSCI) and unimpaired (non-PSCI) cohorts. The serum levels of ω3-PUFAs, α-linolenic acid (ALA), eieosapentaenoic acid (EPA) and dueosahexenoie acid (DHA) were compared between the two groups and correlated with the individuals′ MMSE scores.Results:The average ALA, EPA, DHA and total ω3-PUFAs levels of PSCI group were in most cases significantly lower than those of the non-PSCI group. Spearman correlation analysis showed that serum DHA level was a weak positive predictor of the MMSE scores (R=0.32, P≤0.05). Logistic regression analysis indicated that low serum DHA level was an independent risk factor for PSCI ( P≤0.01). Conclusions:Cognitively impaired stroke survivors tend to have lower serum ω3-PUFAs levels than those without cognitive impairment. There is a weak positive correlation between serum DHA levels and MMSE scores. Low serum DHA level is an independent risk factor for PSCI. The serum level of ω3-PUFAs is of high value in the auxiliary diagnosis and evaluation of PSCI.

Cognitive profile in mild cognitive impairment with Lewy bodies

INTRODUCTION@#This study aimed to elucidate the cognitive profile of patients with mild cognitive impairment with Lewy bodies (MCI-LB) and to compare it to that of patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD).@*METHODS@#Subjects older than 60 years with probable MCI-LB (n = 60) or MCI-AD (n = 60) were recruited. All patients were tested with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to assess their global cognitive profile.@*RESULTS@#The MCI-AD and MCI-LB patients did not differ in total MMSE and MoCA scores. However, some sub-items in MMSE and MoCA were shown to be screening markers for differentiating MCI-LB from MCI-AD. In the visuoconstructive test, the total score and hands subitem score in the clock-drawing test were significantly lower in MCI-LB than in MCI-AD. As for the executive function, the 'animal fluency test', 'repeat digits backward test' and 'take paper by your right hand' in MMSE all showed lower scores in MCI-LB compared with MCI-AD. As for memory, 'velvet' and 'church' in MoCA and 'ball' and 'national flag' in MMSE had lower scores in MCI-AD than in MCI-LB.@*CONCLUSION@#This study presents the cognitive profile of patients with MCI-LB. In line with the literature on Dementia with Lewy bodies, our results showed lower performance on tests for visuoconstructive and executive function, whereas memory remained relatively spared in the early period.

Terapia cognitivo conductual para pacientes con riesgo clínico de psicosis / Cognitive behavior therapy for young patients at clinical risk for psychosis

INTRODUCCIÓN. Los estudios de tratamiento indican que el riesgo de transición a un trastorno psicótico puede al menos retrasarse en la población clínica de alto riesgo de psicosis (CHR), además de mejorar variables relacionadas con la calidad de vida de los pacientes, existiendo evidencia a favor de la terapia cognitivo conductual (TCC). MÉTODOS. Se realizó una síntesis narrativa, basada en la búsqueda de artículos originales, que abordasen la efectividad de la TCC en pacientes CHR, publicados en los últimos cinco años, incluidos en esta síntesis. RESULTADOS. Se incluyeron un total de 10 artículos que evalúan la TCC en CHR, siendo un tratamiento efectivo y ampliamente utilizado, lo que se asocia a una disminución en las consecuencias psicosociales que conlleva el retraso en la presentación del cuadro clínico y/o la disminución de síntomas comórbidos. CONCLUSIÓN. Actualmente, la TCC se ha convertido en el tratamiento de primera elección para CHR, existiendo una gran variedad de estrategias psicoterapéuticas específicas dentro de este grupo de intervención.

INTRODUCTION. Treatment studies indicate that the risk of transition to a psychotic disorder can at least be delayed in the clinical population at high risk for psychosis (CHR), in addition to improving variables related to the quality of life of patients, with evidence in favor of cognitive behavioral therapy (CBT). METHODS. A narrative synthesis was carried out, based on the search for original articles, which addressed the effectiveness of CBT in CHR patients, published in the last five years, included in this synthesis. RESULTS. A total of 10 articles that evaluate CBT in CHR were included, being an effective and widely used treatment, which is associated with a decrease in the psychosocial consequences that the delay in the presentation of the clinical picture and/or the decrease in symptoms entails. comorbid. CONCLUSION. Currently, CBT has become the treatment of first choice for CHR, with a wide variety of specific psychotherapeutic strategies within this intervention group.

Revisión de las pruebas cognitivas breves para pacientes con sospecha de demencia / Review of brief cognitive tests for patients with suspected dementia

RESUMEN NTRODUCCIÓN: Para ser útiles, las pruebas cognitivas breves (PCB) deben ser rápidas, sensibles, fáciles de realizar y no necesitar de un gran entrenamiento para hacerlo. Las pruebas cognitivas breves comúnmente utilizadas incluyen el Mini Examen del Estado Mental (MMSE) y la Evaluación Cognitiva de Montreal (MoCA). OBJETIVO: Brindar una descripción de las PCB disponibles y sus propiedades psicométricas para la detección de la demencia. MÉTODOS: Revisión narrativa RESULTADOS: El MMSE le otorga un gran peso a la orientación, la memoria, la visuo-espacialidad y el lenguaje, y, en consecuencia, puede ser sensible a los déficits cognitivos encontrados en la demencia tipo Alzheimer. MoCA es una prueba breve más compleja que evalúa una gama más amplia de dominios cognitivos, especialmente funciones ejecutivas, proporcionando una mayor sensibilidad para detectar el deterioro cognitivo leve y otros tipos de demencia, no solo la demencia tipo Alzheimer. CONCLUSIONES: Las PCB son parte del arsenal necesario para ayudar a confirmar la sospecha de la demencia. La escolaridad tiene un impacto importante en el desempeño de las PCB y puede sesgar la interpretación de los resultados obtenidos.

ABSTRACT INTRODUCTION: To be useful, Brief Cognitive Tests (BCTs) must be fast, sensitive, easy to perform, and not require extensive training to do so. Commonly used brief cognitive tests include the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). OBJECTIVE: To provide a description of the available BCTs and their psychometric properties for the detection of dementia. METHODS: Narrative review RESULTS: The MMSE places great weight on orientation, memory, visuospatiality, and language, and, consequently, may be sensitive to the cognitive deficits found in Alzheimer's dementia. MoCA is a more complex brief test that assesses a broader range of cognitive domains, especially executive functions, providing greater sensitivity for detecting mild cognitive impairment and other types of dementia, not just Alzheimer's dementia. CONCLUSIONS: BCTs are part of the arsenal needed to help confirm suspected dementia. Schooling has an important impact on the performance of BCTs and can bias the interpretation of the results obtained.

Does gender influence P300 latency and mini mental state examination score in type 2 diabetes mellitus patients?

Background: P300 event-related potentials (ERPs) is an electrophysiologic marker of cognitive ability which closely reflects cognitive functions. Type 2 Diabetes mellitus (T2DM) causes many complications. Diabetes mellitus-induced damage to the central nervous system is a key focus of research. Latest magnetic resonance imaging evidence suggested that the changes in anatomy of brain is more rapidly seen in males than in females. This study was carried out to study the gender variations in P300 latency and Mini Mental State Examination (MMSE). Aim and Objective: To study the influence of gender on MMSE score as well as P300 ERP. Materials and Methods: 30 diagnosed Type 2 Diabetics aged above 40 years, with more than 2 years duration of diabetes were included in this study. MMSE questionnaire was administered to each diabetic and P300 was recorded using RMS EMG EP MARK 2 machine in all the diabetics. Results: The P300 ERP of male diabetics was prolonged significantly with mean ± standard deviation (SD) of (347.01 ± 31.55) whereas female diabetics had a mean ± SD of (318.26 ± 28.22; P = 0.014) and no significant difference was found between the mean MMSE scores of male diabetics (26.06 ± 1.38) and female diabetics (26.13 ± 1.30). Conclusion: The change in P300 ERP is swifter in males when compared with females in the middle to old age. Compared to MMSE, P300 Latency is a sensitive electrophysiological tool for diagnosing early cognitive deterioration in T2DM.

Effects of repetitive transcranial magnetic stimulation combined with oral paroxetine on cognitive status and activities of daily living in older adult patients with severe depression / 中国基层医药

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with oral paroxetine in the treatment of older adult patients with severe depression and its effects on the scores of the Hamilton Rating Scale for Depression (HAMD), the Mini-Mental State Examination (MMSE), and Activities of Daily Living (ADL).Methods:A total of 192 older adult patients with severe depression who received treatment in Shaoxing 7 th People's Hospital from January 2018 to December 2019 were included in this study. They were randomly assigned to receive either oral paroxetine (control group, n = 96) or rTMS + oral paroxetine (observation group, n = 96). All patients received 1 month of treatment. Clinical efficacy was compared between the two groups. HAMD, MMSE, and ADL scores pre- and post-treatment and the incidence of adverse events during the treatment were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [96.88% (93/96) vs. 89.58% (86/96), χ2 = 4.04, P < 0.05]. HAMD scores post-treatment were significantly lower in the observation group than in the control group [(6.43 ± 2.33) points vs. (11.32 ± 2.02) points, t = 15.53, P < 0.05]. MMSE and ADL scores post-treatment in the observation group were (29.13 ± 3.01) points and (71.52 ± 5.32) points, respectively, which were significantly higher than those in the control group [(24.65 ± 2.79) points, (69.65 ± 5.17) points, t = 10.69, 2.47, P < 0.05]. There was no significant difference in the incidence of adverse events between the two groups ( P > 0.05). Conclusion:The combined therapy of rTMS and oral paroxetine is highly effective on severe depression in older adult patients. It can improve cognitive function and the activities of life living.

Quality of Life of Elderly People Living in Different Types of Long-term Care Facilities

Abstract Population aging is a worldwide occurrence that has become urgent in developing countries. Quality of life can be measured to identify functional capacity and determine the degree of impact on quality of life exerted on an individual. This study aimed to measure the quality of life of elderly people who have been living in different long-term care facilities for the elderly. Therefore, this research was developed with a qualitative and descriptive approach. Data were obtained from medical records and interviews, and were analyzed in R language interpreter software on the Ubuntu Linux operating system. Seventy-nine elderly people participated in the study. Eleven lived in Home Marista, and 68 lived in Home Jesus Maria José. A socioeconomic questionnaire was used to collect data on the socioeconomic characteristics of the participants. The Mini-Mental State Exam was used to measure degree of cognition. The Short Form-36 Questionnaire was used to measure quality of life. The present study suggests that the results found can clarify the individual vulnerability of the elderly in the age group studied regardless of the type of residence. Despite the discrepancy found regarding the care provided at the long-term care facilities, the scores, obtained with the quality of life assessment, did not show significant differences.

Uma poética do feminino: considerações sobre uma certa hora perigosa / A poetics of the feminine: reflections on a certain dangerous hour / Una poética de lo femenino: consideraciones sobre cierta hora peligrosa / Une poétique du féminin: réflexions sur une certaine heure dangereuse

Entrelaçando fragmentos de uma experiência clínica com a narrativa de um dia na vida de Ana, personagem de um conto da escritora Clarice Lispector, a autora considera o feminino não como um adjetivo, uma qualidade, mas como um estado mental, algo não definitivo, não adquirido e perdido de forma absoluta; um estado mental fugidio que encarna o constitutivo do ser humano, isto é, o enigma da criação, a vida e a morte, o indizível, o mistério, a falta; o feminino como uma metáfora do sujeito na psicanálise, constituindo-se permanentemente na sustentação e no repúdio ao que espanta, fascina, causa horror e assombro.

Interweaving fragments of a clinical experience with the narrative of a day in the life of Ana, a character in a short story written by Clarice Lispector, the author considers the feminine not an adjective or a quality, but rather a mental state, something that is not definitive, not acquired and altogether lost; it is a fleeting mental state that embodies what constitutes the human being, that is to say, the enigma of creation, life and death, the unsayable, the mysterious, the lack; the feminine as a metaphor for the subject in psychoanalysis, which is permanently constituted in the support and repudiation of what frightens, fascinates, causes horror and dread.

Entrelazando fragmentos de una experiencia clínica con la narrativa de un día en la vida de Ana, personaje de un cuento de la escritora Clarice Lispector, la autora considera lo femenino no como un adjetivo, una cualidad, sino como un estado mental, algo no definitivo, no adquirido y perdido absolutamente; un estado mental fugaz que encarna lo que constituye el ser humano, es decir, el enigma de la creación, la vida y la muerte, lo indecible, el misterio, la carencia; lo femenino como metáfora del sujeto en psicoanálisis, constituyéndose permanentemente en el soporte y el rechazo de lo que asombra, fascina, provoca horror y asombro.

Entrelaçant des fragments d'une expérience clinique avec le récit d'une journée dans la vie d'Ana, le personnage d'une nouvelle de l'écrivaine Clarice Lispector, l'auteure considère que le féminin n'est pas un adjectif, une qualité, mais un état mental, quelque chose de non définitif, pas acquis et absolument perdu ; un état mental fugace qui incarne ce qui constitue l'être humain, c'est-à-dire, l'énigme de la création, la vie et la mort, l'indicible, le mystère, le manque ; le féminin comme métaphore du sujet en psychanalyse, se constituant en permanence dans le support et le rejet de ce qui étonne, fascine, fait horreur et stupéfaction.

Influence of migration on the thought process of individuals at ultra-high risk for psychosis

Objective: To assess the influence of migration on the psychopathological presentation of individuals at ultra-high risk for psychosis (UHR) in São Paulo, Brazil. Methods: This study is part of the Subclinical Symptoms and Prodromal Psychosis (SSAPP) project, a cohort study in São Paulo, Brazil, designed to follow individuals at UHR. After screening with the Prodromal Questionnaire (PQ) and a clinical interview, the Global Assessment of Functioning (GAF) was administered, a neuropsychological assessment was performed, sociodemographic and migration data were obtained. We then analyzed UHR individuals who had migration data to see if migration had any effect on their cognition and psychopathology. Chi-square tests were used for categorical variables, and Student's t test or analysis of variance (ANOVA) were used for nonparametric and parametric distributions, respectively. Results: The sample was composed of 42 at-risk subjects, of whom 5 had a migration history in the past two generations. Those with migration history showed significantly more formal thought disturbances (p = 0.012) and sleeping problems (p = 0.033) compared to those without. Conclusions: Our data reinforce migration as a risk factor for psychosis in developing countries as well, and highlights the importance of studying the specific effect of this factor in UHR psychopathology.

Análisis descriptivo de los trabajos científicos presentados en la Segunda Conferencia Internacional Chilena de Psicosis 2020 / Descriptive analysis of the posters abstracts submitted to the Chilean International Conference in Psychosis 2020

INTRODUCCIÓN: Dentro de los desafíos de la investigación en Psicosis en Chile y el mundo se encuentra el desarrollo de polos académicos de investigación en estados mentales de riesgo (EMARS). En este artículo se realiza un análisis descriptivo de los resúmenes de los trabajos científicos presentados en la II conferencia internacional: Desafíos Clínicos y terapéuticos en Psicosis realizada en Octubre del 2020. MÉTODOS: Se realizó una selección y premiación del mejor trabajo de acuerdo a un sistema de puntuación realizado por un comité científico ad-hoc. Luego se sistematizó la información en una tabla resumen para su posterior análisis descriptivo cualitativo. RESULTADOS: Se seleccionaron 12 trabajos. El 75% de los trabajos seleccionados abordan el tema de la detección precoz e intervención temprana en psicosis, en particular en la temática EMARS. Asimismo, el 40% de los trabajos presentados provienen de regiones de la zona centro-sur de nuestro país. El 83% de los trabajos realizan un diseño experimental con reclutamiento de pacientes o discusión de casos clínicos complejos. CONCLUSIÓN: Los trabajos seleccionados dan cuenta del interés por el mejoramiento en el diagnóstico y terapéutica en este ámbito. Se debe potenciar el trabajo de investigación y asistencial en Chile en el ámbito de los EMARS.

INTRODUCTION: Within the challenges of research in Psychosis in Chile and the world is the development of academic research poles in mental states of risk (EMARS). This article makes a descriptive analysis of the summaries of the scientific papers presented at the II international conference: Clinical and therapeutic challenges in Psychosis held in October 2020. METHODS: The best work was selected and awarded according to a scoring system carried out by an ad-hoc scientific committee. The information was then systematized in a summary table for subsequent qualitative descriptive analysis. RESULTS: 12 papers were selected. 75% of the selected works address the issue of early detection and early intervention in psychosis, particularly the EMARS theme. Likewise, 40% of the papers presented come from regions of the south-central zone of our country. 83% of the works carry out an experimental design with recruitment of patients or discussion of complex clinical cases. CONCLUSION: The selected works show the interest in the improvement in diagnosis and therapy in this area. Research and assistance work in Chile should be promoted in the field of EMARS.

Application effect of timing theory in alcohol abstinence intervention for patients with alcoholic liver disease / 中国实用护理杂志

Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.

Nutritional profile and biochemical alterations in non-institutionalized senior citizens with Alzheimer disease: a case-control study / Perfil nutricional e alterações bioquímicas em idosos com doença de Alzheimer não institucionalizados: um estudo caso-controle

Assess the nutritional and biochemical state of patients with Alzheimer Disease (AD) compared to a control group. This is an observational, case-control and descriptive type study, based on the recruiting of 22 elderly individuals with a clinical diagnosis of AD considered as the case group, and 22 other elderly individuals considered as the control group. Evaluations were made using the results from the following scales Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), anthropometric measurements for obtaining the body mass index (BMI) and biochemical analyses. The analyses were performed on the program SPSS version 20.0, using absolute and relative measures, T test for independent samples for measurement comparisons and the Spearman correlation test. In the cognitive evaluation MMSE, those participants with AD present higher risk of cognitive decline (81.8%), greater risk of malnutrition according to MNA (45.5%) and altered levels of leptin (90.9%). Upon performing the comparison analysis between the group with AD and the control group, there existed noteworthy differences between the means for the variables MNA (4.40; BMI95% 2.75 ­ 6.06), MMSE (10.54; BMI95% 7.09 ­ 13.99) and doses of HDL (High Density Lipoproteins) (14.53; BMI95% 6.18 ­ 22.88). As well as differences in the p-value < 0.09 in the leptin doses (11.54; BMI95% (-24.98 ­ 1.89) and transferrin dose (-72.31; BMI95% -159.48 ­ 14.84). The Spearman correlation demonstrated that the cognitive decline in the group of senior citizens with AD was strongly associated with nutritional conditions MNA (R 0.484) and the leptin dose (R 0.590). Senior citizens with AD present worse nutritional conditions, cognitive decline and biochemical alterations when compared to senior citizens in the control group. As such, the study demonstrated the need for an integrated healthcare assistance concerning senior citizens with AD.

Avaliar o estado nutricional e bioquímico de pacientes com Doença de Alzheimer (DA) comparando com um grupo controle. Materiais e métodos: trata-se de um tipo observacional, caso-controle e descritivo a partir do recrutamento de 22 idosos diagnosticados clinicamente com DA considerados grupo caso e outros 22 idosos considerados controle, foi utilizado a escala Mini Avaliação nutricional (MNA), Mini Exame do Estado Mental (MMSE), medidas antropométricas para obtenção do índice de massa corporal (IMC) e análises bioquímicas. As análises foram realizadas no programa SPSS versão 20.0, utilizou-se de medidas absolutas e relativas, teste T para amostras independentes para comparação de médias e o teste de correlação de Spearman. Na avaliação cognitiva MMSE os participantes com DA apresentaram maior prevalência de declínio cognitivo (81,8%), maior prevalência de risco para desnutrição segundo MNA (45,5%) e níveis alterados de leptina (90,9%). Ao se realizar a análise de comparação o grupo com DA e o controle observou-se diferenças significativas entre as médias das variáveis MNA (4,40; IC95% 2,75 ­ 6,06), MMSE (10,54; IC95% 7,09 ­ 13,99) e dosagens de HDL (14,53; IC95% 6,18 ­ 22,88). E diferenças com o p-valor < 0,09 nas dosagens de leptina (11,54; IC95% (-24,98 ­ 1,89) e dosagem de transferrina (-72,31; IC95% -159,48 ­ 14,84). A correlação de Spearman demonstrou que o declínio cognitivo no grupo de idosos com DA, esteve associado significativamente às condições nutricionais MNA (R 0,484) e dosagem de leptina (R 0,590). Idosos com DA apresentaram piores condições nutricionais, declínio cognitivo e alterações bioquímicas, ao compara-los com idosos controles. Desta forma, o estudo demonstra a necessidade de uma assistência integral a esses idosos.

Study of the prevalence of isolated vitamin B12 deficiency related dementia in patients presenting to a tertiary care hospital

Background: Objective of the study was to determine the prevalence of Isolated B12deficient dementia in patients presenting to a tertiary care hospital. The MMSE was much lower in B12 deficiency compared to irreversible causes Thus, shorter duration, severe dementia, focal neurological signs, and a vegetarian diet were significantly associated with the development of B12 deficiency.Methods: Based on exclusion and inclusion criteria 100 patients were included in this study, a detailed history of the patient were taken with respect to duration of dementia and its symptoms, type and treatment. Study in terms of the correlation of the clinical features with investigations and diet. Estimation of the prevalence of dementia with reference to B12 deficiency. Mean MMSE analysis, assessment of the improvement in MMSE after treatment with B12 injections after a6-8 wks period.Results: In this study most of our patients were in the 60-69 age groups across all causes of dementia, 22out of 26, B12 deficient patients were vegetarians. This value was in keeping with the known fact that a vegetarian diet predisposes a person to develop B12 deficiency. The association between B12 deficiency, high MCV and megaloblastic blood picture in peripheral blood smear was significant. The MMSE scores were significantly lower 13.42 in patients with B12 deficiency as compared to those with Alzheimer's 14.3 means and those with multi-infarct state 17.3 means.Conclusions: The duration of the presentation in B12 deficiency was10-12months averagely. There was a significant improvement in MMSE after treatment in pureB12 deficient patients (by 9 points) if they presented within one year of symptoms. Except for myelopathy, there was an improvement in other neurological symptoms and signs. Early diagnosis and proper treatment can make improvements in a patient's memory and quality of life.

The relevance of Mini Mental State Examination (MMSE) use on demential interdiction exams in judicial proceedings / A importância do Miniexame do Estado Mental (MEEM) nos exames de interdição demencial em processos judiciais

ABSTRACT Objective To highlight the important role of Mini Mental State Examination (MMSE) use on judicial interdiction assessments. Methods On this paper, we present a case in which we have used the Mini mental state examination (MMSE) for screening an initial dementia diagnosis, suggested by clinical and mental state examination. Results The relevance of using a screening test for demencial states on judicial interdictions assessments, as MMSE, in order to provide more objective findings to the court, has been demonstrated. Also, we review the current evidence for using MMSE on this setting and the importance of its use on demential interdiction exams in judicial proceedings. Conclusions Judicial evidence is a critical element in decision making. Judicial interdiction assessment is usually performed by expert psychiatrists. As psychiatric diagnosis relies on clinical history and mental state examination, it is composed of subjective elements, varying also according to the examiner's personal technical orientation and impressions. Neuroimaging exams are helpful on a minority of cases, in which specific findings are present. In such cases, clinical screening questionnaires play an important role - providing objective elements of neuropsychic functioning of an individual, thus limiting the subjective realm of the expert forensic report.

RESUMO Objetivo Destacar a importância do uso do Miniexame do Estado Mental (MEEM) nas perícias de interdição judicial por demência. Métodos Neste artigo, apresentamos um caso no qual aplicamos o MEEM para rastreamento de demência inicial, cujo diagnóstico foi sugerido por meio de história clínica e exame do estado mental. Resultados Foi demonstrada a importância de usar um teste de rastreamento para demência, no caso o MEEM, nas perícias de interdição por esse diagnóstico, a fim de fornecer elementos mais objetivos ao juízo. Ainda, fornecemos uma revisão das evidências atuais para a aplicação do MEEM nesse contexto, bem como a importância do uso dele nas perícias de interdição por demência. Conclusões A prova pericial é um elemento crítico para a tomada de decisão judicial. A perícia de interdição judicial por demência é usualmente realizada por especialistas em psiquiatria. Como o diagnóstico psiquiátrico baseia-se na história clínica e no exame do estado mental, é composto de elementos subjetivos, variando de acordo com a técnica e impressão individual do examinador. Exames de neuroimagem são úteis em uma minoria de casos, nos quais achados específicos estão presentes. Assim, questionários clínicos para rastreamento de doenças mostram-se importantes, pois fornecem elementos objetivos do funcionamento neuropsíquico do indivíduo, diminuindo o papel da subjetividade no laudo pericial.

Analysis of Scores of SCL-90 of Patients with Traumatic Subdural Effusion / 法医学杂志

Objective To investigate the factors affecting changes of Symptom Check List-90 （SCL-90） of patients with traumatic subdural effusion. Methods One hundred and forty-two cases of patients with traumatic subdural effusion from the Center of Forensic Identification, Wannan Medical College collected from 2007-2018 were tested with SCL-90. The differences between SCL-90 results and the national norm and the influences of gender, age, education level, the number of effusion sites and location on SCL-90 results were analyzed. Results The differences between the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia and psychosis factors and total mean scores in SCL-90 of traumatic subdural effusion and that of the national norm had statistical significance （P<0.05）. The differences in depression and hostility factor scores between males and females had statistical significance （P<0.05）. The differences in compulsion, anxiety and terror factor scores and total mean scores among different age groups had statistical significance （P<0.05）. The differences in hostility, paranoia and psychosis factors among patients with different degrees of education had statistical significance （P<0.05）. The differences in depression, anxiety, hostility and terror factor scores and total mean scores among single-site group, double-site group and multi-site group had statistical significance （P<0.05）. The differences in somatization, depression and anxiety factor scores and total mean scores between the right cerebral hemisphere group and the left cerebral hemisphere group and bilateral hemisphere group had statistical significance （P<0.05）. Conclusion Traumatic subdural effusion can cause certain psychological changes, which are related to the primary trauma of arachnoid tear as well as the number and location of effusion sites. Attention should be paid to the influence of the above factors during the assessment of psychological symptoms.

Association between serum non-high-density lipoprotein cholesterol and cognitive dysfunction after acute ischemic stroke: a cross-sectional study

This study aimed to explore the association between serum non-high-density lipoprotein cholesterol (non-HDL-C) and cognitive dysfunction risk in patients with acute ischemic stroke (AIS). This cross-sectional study enrolled 583 AIS patients. Biochemical markers and lipid profile were collected after admission. AIS patients were classified into high group (non-HDL-C ≥3.4 mM) and normal group (non-HDL-C <3.4 mM). Mini-Mental State Examination scale (MMSE), Montreal Cognitive Assessment scale (MoCA), Activities of Daily Living (ADL) scale, Neuropsychiatric Inventory (NPI), and Hamilton Depression scale 21 version (HAMD-21) were applied on the third day after admission. Compared with the control group, patients of the high group had higher body mass index and higher frequency of intracranial artery stenosis, and exhibited higher levels of non-HDL-C, total cholesterol, triglycerides, low-density lipoprotein cholesterol, homocysteine, fasting blood glucose, and glycosylated hemoglobin (HbA1c), and lower levels of high-density lipoprotein cholesterol (all P<0.05). Compared with the control group, patients of the high group had significantly lower MMSE and MoCA scores (MMSE: 26.01±4.17 vs 23.12±4.73, P<0.001; MoCA: 22.28±5.28 vs 20.25±5.87, P<0.001) and higher scores on the NPI and HAMD-21 (both P<0.001). MMSE (r=-0.306, P<0.001) and MoCA scores (r=-0.251, P<0.001) were negatively associated with non-HDL-C level. Multivariate regression analysis revealed that non-HDL-C level (OR=1.361, 95%CI: 1.059-1.729, P=0.016) was independently associated with the presence of cognitive dysfunction after adjusting for confounding factors. High serum non-HDL-C level might significantly increase the risk of cognitive dysfunction after AIS.

Correlation among Three Cognitive Tools in Memory Assessment / 中国康复理论与实践

Objective:To explore the correlation and characteristics of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Rivermead Behavioural Memory Test-III (RBMT-III) in evaluating memory ability of patients with brain injuries. Methods:From March, 2016 to February, 2018, 62 patients with brain injuries were evaluated with the Chinese version of MMSE, MoCA and RBMT-III. The correlation among them was analyzed. Results:There was positive correlation among the total scores of MMSE, MoCA and RBMT-III (r = 0.682 to 0.786, P < 0.001), as well as the retrospective memory (r = 0.525 to 0.610, P < 0.001) and long-term memory (r = 0.553 to 0.692, P < 0.001). There was positive correlation between RBMT-III and MMSE in short-term memory (r = 0.337, P = 0.007). The prospective memory of RBMT-III positively correlated with retrospective memory of MMSE and MoCA (r = 0.639, r = 0.585, P < 0.001), and the short-term memory of RBMT-III with long-term memory of MMSE and MoCA (r = 0.454, r = 0.534, P < 0.001). Conclusion:MMSE, MoCA and RBMT-III are consistent in evaluating retrospective memory and long-term memory for patients with brain injuries. RBMT-III and MMSE are consistent in evaluating short-term memory for patients with brain injuries. The memory scores of MMSE and MoCA are helpful to judge the event-based prospective memory in patients with brain injuries, while the scores of long-term memory are helpful to judge short-term memory.

Prevalence of Risk Factors for Dementia in Elderly Population in a Tribal Area of Central India – A Community-Based Cross-Sectional Study

Background: Approximately 50 million people worldwide are suffering from dementia, it is the 7th leading cause of death among the elderly. In India, more than 4 million people have some form of dementia 3. According to the World Health Organization, India’s population of those aged over 65, which was 40 million in 1997, is set to increase to 108 million by 2025 and 240 million by 2050.Aim and Objective: The aim of the study was to study the prevalence of risk factors of dementia among the elderly population residing in a tribal area of Central India.Materials and Methods: A door to door cross-sectional study was conducted in the rural/tribal area with a pre-designed case record form that investigated the prevalence of risk factors along with measurement of anthropometry and mini-mental state examination was used to categorize subjects according to their mental status.Results: This study reports high prevalence of risk factors such as hypertension (31.8%), tobacco chewing (25.43%), high waist-hip ratio (24.57%), smoking habit (15.03%), head injury (11%), overweight (9.54%), alcohol intake (9.25%), 71–80 age (9.25%), diabetics (9%), stroke (4.62%), family history of dementia (2.6%), obesity (2.31%), coronary artery disease (CAD) (1.73%), and depression (1.45%).Conclusions: This study highlights a significant burden of undiagnosed cases of hypertension, diabetes, depression, and CAD all of which are important risk factors for dementia in the community, most of them are poorly controlled. There is a need to identify the large pool of undiagnosed cases of the mentioned morbidities by screening and offer early treatment to avoid complications.

Effect of extended nursing based on traditional Chinese medicine characteristics to mental status and quality of life in empty nest elderly patients with hypertension / 中国实用护理杂志

Objective@#To explore the effect of continuing nursing intervention with traditional Chinese medicine (TCM) characteristics on mental state and quality of life of empty nest elderly patients with hypertension, and to provide evidence-based theoretical basis for the development of continuing nursing care for empty nest elderly patients with hypertension.@*Methods@#Totally 100 cases of empty nest elderly patients with hypertension were randomly divided into study group and control group by random number method, 50 cases in each group; two groups of patients were given regular nursing according to doctor's instructions to adjust blood pressure drugs and hypertension; control group patients were given routine continuing nursing intervention after discharge; study group patients were given traditional Chinese medicine characteristics on the basis of the control group. Sustained nursing intervention; Self-rating Anxiety Scale (SAS) was used to measure the degree of anxiety at admission, discharge and 6 months after discharge. The rate of blood pressure control reaching the standard at admission, discharge and 6 months after discharge and the clinical effect at discharge and 6 months after discharge were compared between the two groups. SF-36 was used to assess the quality of life of the 2 groups at admission, at the time of discharge and 6 months after discharge.@*Results@#There was no significant difference in SAS scores between the two groups at admission and discharge (P>0.05). The SAS score in the study group at 6 months after discharge was (44.65 ± 4.32) points and (46.91 ± 4.56) points in the control group, and there was significant difference (t=2.544, P=0.006). There was no significant difference in the control rates of systolic and diastolic blood pressure between the two groups at admission and discharge (P>0.05). The control rates of systolic blood pressure and diastolic blood pressure in the study group were better than those in the control group at 6 months after discharge (t=4.762,4.336, P = 0.029, 0.037); there was no significant difference in the clinical efficacy between the two groups at discharge (P>0.05), and the clinical efficacy of the study group at 6 months after discharge was better than that of the control group (u=1.997, P=0.046). There was no significant difference in the scores of SF-36 at discharge (P>0.05); the scores of SF-36 at discharge for 6 months in the study group were significantly better than those in the control group (t=4.875-8.975, P=0.000); no cardiovascular and cerebrovascular events occurred in the study group for 6 months, 4 cases of unstable angina pectoris and 4 cases of cerebral infarction occurred in the control group. In 2 cases, the incidence of cardiovascular and cerebrovascular events was 12.00% (6/50). The difference between the two groups was statistically significant (χ2=4.433, P=0.035).@*Conclusion@#Continuous nursing intervention with TCM characteristics can significantly improve the anxiety level of empty nest elderly patients with hypertension, is conducive to the control of blood pressure, improve the clinical efficacy, reduce the incidence of cardiovascular and cerebrovascular events, improve the quality of life of patients, and has the advantages of simplicity, safety and reliability, low cost, and so on. It is worth popularizing and applying.