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1.
Disabil Rehabil ; 43(10): 1342-1358, 2021 05.
Article in English | MEDLINE | ID: covidwho-1455011

ABSTRACT

PURPOSE: Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning. MATERIALS AND METHODS: An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. RESULTS: After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. CONCLUSIONS: In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.


Subject(s)
Activities of Daily Living , Cognitive Dysfunction , Adult , Cognition , Cognitive Dysfunction/diagnosis , Executive Function , Humans , Neuropsychological Tests
2.
J Speech Lang Hear Res ; 64(6): 2038-2046, 2021 06 04.
Article in English | MEDLINE | ID: covidwho-1263515

ABSTRACT

Purpose The use of technology (e.g., telehealth) in clinical settings has rapidly increased, and its use in research settings continues to grow. The aim of this report is to present one potential solution to a clinical issue that of virtual and remote assessment for the purposes of spoken language research in persons with aphasia (PWA). To do so, we report detailed methods for conducting a multitimepoint (test-retest) virtual paradigm, assessing lifestyle, physiological, cognitive, and linguistic factors in persons with and without aphasia. Method Procedures for virtual assessment are detailed in a sample of adults with no brain damage (N = 24) and PWA (N = 25) on a test-retest paradigm (data collection approximately 10 ± 3 days apart). This report provides practical information about pre-assessment (e.g., recruitment, scheduling), assessment (e.g., aphasia-friendly consent presentation, investigator fidelity), and postassessment (e.g., data storage, quality check) procedures for human behavior research using a virtual platform. Results Preliminary study data are provided, indicating high retention rates, high rates of data acquisition, and feasibility. Common technological troubles and solutions are discussed, and solutions are offered. The results suggest that our pre-assessment, assessment, and postassessment procedures contributed to the success of our study. Conclusions We provide a practical methodology for conducting a multitimepoint study, with considerations for PWA, adding to the body of research on telehealth in clinical populations. Future studies should continue to evaluate telemethodology, which may be core for diversifying studies, improving study retention, and enrolling larger sample sizes. Supplemental Material https://doi.org/10.23641/asha.14608101.


Subject(s)
Aphasia , Brain Injuries , Adult , Humans , Linguistics
3.
Drugs ; 80(14): 1383-1396, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-669901

ABSTRACT

Severe Acute Respiratory Syndrome-Coronavirus-2 is responsible for the current pandemic that has led to more than 10 million confirmed cases of Coronavirus Disease-19 (COVID-19) and over 500,000 deaths worldwide (4 July 2020). Virus-mediated injury to multiple organs, mainly the respiratory tract, activation of immune response with the release of pro-inflammatory cytokines, and overactivation of the coagulation cascade and platelet aggregation leading to micro- and macrovascular thrombosis are the main pathological features of COVID-19. Empirical multidrug therapeutic approaches to treat COVID-19 are currently used with extremely uncertain outcomes, and many others are being tested in clinical trials. Acetylsalicylic acid (ASA) has both anti-inflammatory and antithrombotic effects. In addition, a significant ASA-mediated antiviral activity against DNA and RNA viruses, including different human coronaviruses, has been documented. The use of ASA in patients with different types of infections has been associated with reduced thrombo-inflammation and lower rates of clinical complications and in-hospital mortality. However, safety issues related both to the risk of bleeding and to that of developing rare but serious liver and brain damage mostly among children (i.e., Reye's syndrome) should be considered. Hence, whether ASA might be a safe and reasonable therapeutic candidate to be tested in clinical trials involving adults with COVID-19 deserves further attention. In this review we provide a critical appraisal of current evidence on the anti-inflammatory, antithrombotic, and antiviral effects of ASA, from both a pre-clinical and a clinical perspective. In addition, the potential benefits and risks of use of ASA have been put in the context of the adult-restricted COVID-19 population.


Subject(s)
Aspirin/pharmacology , Betacoronavirus , Blood Coagulation , Coronavirus Infections , Inflammation , Pandemics , Pneumonia, Viral , Anti-Inflammatory Agents/pharmacology , Betacoronavirus/drug effects , Betacoronavirus/physiology , Blood Coagulation/drug effects , Blood Coagulation/immunology , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/immunology , Humans , Inflammation/blood , Inflammation/drug therapy , Pneumonia, Viral/drug therapy , Pneumonia, Viral/immunology , Risk Assessment , SARS-CoV-2 , Treatment Outcome
4.
J Clin Neurosci ; 76: 236-237, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-98074

ABSTRACT

The diagnosis of hemophagocytic lymphohistiocytosis (HLH) with cerebral involvement is challenging given the rarity of HLH and its resemblance to the much more common severe sepsis. Timely diagnosis and treatment may be lifesaving. We report two cases demonstrating different and rare forms of severe brain involvement in adult patients with HLH: acute necrotizing encephalopathy, and diffuse hemorrhagic disease due to disseminated intravascular coagulation. Severe HLH with brain involvement in adults is rare. HLH with cerebral involvement should be considered in patients presenting with severe systemic inflammatory response syndrome (SIRS) but negative cultures and unusual or unexpectedly severe clinical and/or radiologic signs of cerebral dysfunction. Similar brain injury may occur in patients with cytokine storm syndrome due to COVID-19. BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) presents with fevers, rash, organomegaly, cytopenia, and increased triglycerides and ferritin (Ramos-Casals et al., 2014) [1]. Neurologic abnormalities are reported in about one-third of patients (Cai et al., 2017), including a few cases of acute necrotizing encephalopathy (ANE) (Xiujuan et al., 2015). Coagulation abnormalities are frequent in HLH patients (Valade et al., 2015). OBJECTIVE: To raise awareness about the importance of early diagnosis and treatment of HLH with neurological involvement to prevent serious complications and demise.


Subject(s)
Blood Coagulation Disorders/etiology , Brain Diseases/etiology , Brain Diseases/pathology , Lymphohistiocytosis, Hemophagocytic/complications , Adult , Betacoronavirus , COVID-19 , Coronavirus Infections , Female , Humans , Leukoencephalitis, Acute Hemorrhagic/etiology , Middle Aged , Pandemics , Pneumonia, Viral , SARS-CoV-2
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