Basal Ganglia Calcification: A Case Report of Two Siblings With Fahr's Disease.

Fahr's disease is a rare neurodegenerative disorder caused by bilateral and usually symmetrical intracranial calcifications. In most cases, it exhibits an autosomal dominant pattern of inheritance and genetic heterogeneity. Patients may present with movement disorders, cognitive impairment, and psychiatric disorders. Currently, there are no disease-modifying drugs, so the management is based on the treatment of the symptoms. We present two cases involving male siblings, both with psychiatric symptoms as the initial presentation of the disease. Brain computed tomography revealed bilateral calcifications in the basal ganglia for which no underlying cause was found. In both cases, remission of behavioural changes and psychiatric symptoms was achieved with psychotropic drugs.

Building Bridges between People with Stroke, Families, and Health Professionals: Development of a Blended Care Program for Self-Management.

Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals. An exploratory sequential mixed methods approach was used, including qualitative methods during stakeholder consultation (stage 1) and co-production (stage 2) and quantitative assessment during prototyping (stage 3). After ethical approval, recruitment occurred in three health units. Results from a literature search led to the adaptation of the Bridges Stroke Self-Management Program. In stage one, 47 participants were interviewed, with two themes emerging: (i) Personalized support and (ii) Building Bridges through small steps. In stage two, the ComVida program was developed, combining in-person and digital approaches, supported by a workbook and a mobile app. In stage three, 56 participants evaluated prototypes, demonstrating a strong level of quality. Understandability and actionability of the developed tools obtained high scores (91-100%). The app also showed good usability (A-grade) and high levels of recommendation (5 stars).

A systematic review of reviews on the psychometric properties of measures of older persons' ability to build and maintain social relationships.

BACKGROUND: Within the scope of the World Health Organisation's (WHO) world report on ageing and health and how healthy ageing was conceptualised, the WHO has been working with academia towards producing reviews of the psychometric properties of instruments that measure different domains of functional ability. This study aimed to conduct a review of reviews to examine existing and validated instruments measuring the ability of older persons to build and maintain social relationships and to evaluate the psychometric properties of these instruments. METHODS: We searched for studies published in the English, Spanish and Portuguese languages. No restrictions were placed on the year of publication. The following databases were searched: PubMed, Embase, Psyinfo and Cumulated Index to Nursing and Allied Health Literature. Titles and abstracts were screened and selected articles were screened and reviewed independently by two reviewers. RESULTS: A total of 3,879 records were retrieved, of which 39 records were retrieved for full-text analysis. None of the reviews met the inclusion criteria, thus resulting in an empty review. CONCLUSIONS: Considering the current definition of older persons' functional ability to build and maintain social relationships, this review did not identify instruments that can measure both constructs simultaneously. We suggest the development of an instrument that simultaneously assesses the ability of older persons to build and maintain relationships.

Quality of life and functional capacity of elderly women with knee osteoarthritis.

OBJECTIVE: To correlate functional ability and quality of life of elderly women with knee osteoarthritis. METHODS: Cross-sectional study composed of 40 elderly women with knee osteoarthritis. We used the following instruments: identification questionnaire, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and World Health Organization Quality of Life Questionnaire-OLD (WHOQOL-OLD). The significance level was 0.05 (5%), and confidence intervals were 95%. For statistical analysis we used parametric statistical tests, descriptive analysis, test for equality of two proportions, Pearson's correlation, correlation test, and analysis of variance. RESULTS: The mean age (± standard deviation) was 74.1 (± 6.7) years, and 47.5% of patients had osteoarthritis in both knees. Moderate pain was reported by 45% of patients when they walked on a flat plane and 40% when they were seated or lying down; 55% had severe or very severe pain when climbing or descending stairs; 50% reported moderate joint stiffness after sitting, lying, or resting; and 65% reported moderate or little stiffness after waking. In physical function, 60% of patients had moderate or severe difficulty in descending stairs and 67.5%, when climbing stairs; 60% reported severe or very severe difficulty in getting in and out of the car, and 70%, when performing strenuous housework. The correlation with WHOQOL-OLD and WOMAC was negative and not significant except for autonomy, which was significant. Sedentary and elderly women who used walking aid devices had worse WOMAC functional capacity, but this finding was not statistically significant. In WHOQOL-OLD, volunteers scored higher on social participation and engagement in physical activity on autonomy, which was statistically significant compared with the nonvoluntary and sedentary domains, respectively. CONCLUSION: It is possible to have a good quality of life even with functional impairment from knee osteoarthritis.

Qualidade de vida e capacidade funcional de idosas com osteoartrite de joelho / Quality of life and functional capacity of elderly women with knee osteoarthritis

OBJECTIVE: To correlate functional ability and quality of life of elderly women with knee osteoarthritis. METHODS: Cross-sectional study composed of 40 elderly women with knee osteoarthritis. We used the following instruments: identification questionnaire, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and World Health Organization Quality of Life Questionnaire-OLD (WHOQOL-OLD). The significance level was 0.05 (5%), and confidence intervals were 95%. For statistical analysis we used parametric statistical tests, descriptive analysis, test for equality of two proportions, Pearson's correlation, correlation test, and analysis of variance. RESULTS: The mean age (± standard deviation) was 74.1 (±6.7) years, and 47.5% of patients had osteoarthritis in both knees. Moderate pain was reported by 45% of patients when they walked on a flat plane and 40% when they were seated or lying down; 55% had severe or very severe pain when climbing or descending stairs; 50% reported moderate joint stiffness after sitting, lying, or resting; and 65% reported moderate or little stiffness after waking. In physical function, 60% of patients had moderate or severe difficulty in descending stairs and 67.5%, when climbing stairs; 60% reported severe or very severe difficulty in getting in and out of the car, and 70%, when performing strenuous housework. The correlation with WHOQOL-OLD and WOMAC was negative and not significant except for autonomy, which was significant. Sedentary and elderly women who used walking aid devices had worse WOMAC functional capacity, but this finding was not statistically significant. In WHOQOL-OLD, volunteers scored higher on social participation and engagement in physical activity on autonomy, which was statistically significant compared with the nonvoluntary and sedentary domains, respectively. CONCLUSION: It is possible to have a good quality of life even with functional impairment from knee osteoarthritis.

OBJETIVO: Relacionar capacidade funcional e qualidade de vida de idosas com osteoartrite do joelho. MÉTODOS: Estudo transversal, envolvendo 40 idosas com osteoartrite do joelho. Foram aplicados os seguintes formulários: Questionário de Identificação, Questionário para Osteoartrite Western Ontário and McMaster Universities e Questionário de Qualidade de Vida da Organização Mundial da Saúde (WHOQOL-OLD, sigla em inglês). Definiu-se nível de significância de 0,05 (5%) e intervalo de confiança de 95%. Foram utilizados testes estatísticos paramétricos, análise descritiva, teste de igualdade de duas proporções, correlação de Pearson, teste de correlação e teste de ANOVA. RESULTADOS: Com idade média de 74,1 (±6,7) anos, 47,5% dos pacientes tinham osteoartrite nos dois joelhos. Apresentaram dor moderada: 45% ao caminhar em lugar plano; 40% sentando-se, deitando-se e deitado; 55% apresentaram dor intensa ou muito intensa ao subir ou descer escadas; 50% relataram rigidez articular moderada após sentar, deitar e repousar; e 65% relataram pouca ou moderada rigidez após acordar. Na função física, 60% apresentaram dificuldade moderada ou intensa para descer escadas; 67,5% para subir escadas; 60% relataram dificuldade intensa ou muito intensa para entrar e sair do carro; e 70% para fazer tarefas domésticas pesadas. A correlação do WHOQOL-OLD com o Questionário para Osteoartrite Western Ontário and McMaster Universities foi negativa e não significativa - exceto em "autonomia", que foi significativa. Idosas sedentárias e que usam dispositivo de auxílio à marcha apresentaram pior capacidade funcional no Questionário para Osteoartrite Western Ontário and McMaster Universities, sem significância estatística. No WHOQOL-OLD, voluntárias tiveram maior pontuação em "participação social" e praticantes de atividade física, em "autonomia", com diferença estatisticamente significante em relação às não voluntárias e às sedentárias, respectivamente. CONCLUSÃO: É possível ter uma boa qualidade de vida mesmo com o comprometimento funcional gerado pela osteoartrite do joelho.

Sagittal suture of the human cranium and the time of closing / Sutura sagital en el cráneo humano y el tiempo de cierre

The observation of the stage of ossification of the sagittal suture has been adopted as possible approach of age evaluation in anthropology and legal medicine, as area of cranial pathologies: craniosynostosis and scaphocephaly and as diagnosis resource in tomographies. Regarding it, we found many controversies in the specialized literature, thus we decided to accomplish this research with the following objectives: to examine the ossification of the external surface of the sagittal suture, observing eventual differences due to age, sex and ethnic group. Our material consists of 88 dry craniums of variable ages, both sexes belonging to the ethnic groups: white and black. In that material we observed that: with progression of age, the relation between age and stage of ossification of the sagittal suture stops existing. The statistical analysis didn't demonstrate significant differences between sexes and ethnic groups in the stages of ossification of the sagittal suture. The ossification of the sagittal suture starts developing from the posterior third.

La observación de los estados de osificación de la sutura sagital han sido adoptados como posibles criterios de evaluación de la edad en Antropología y Medicina Legal, como un área de patologías craneales: craneosinostosis, escafocefalia y como recursos diagnóstico en tomografias. Encontramos muchas controversias en la literatura especializada, por lo tanto, decidimos realizar esta investigación con el objetivo de examinar la osificación de la superficie externa de la sutura sagital, observando eventuales diferencias debidas a la edad, sexo y grupo étnico. Nuestro material se componía de 88 cráneos secos de individuos de diferentes edades, de ambos sexos, pertenecientes a los grupos étnicos blancos y negros. En el material se observó: progresión de la edad y relación entre la edad y la etapa de osificación de la sutura sagital. El análisis estadístico no demostró diferencias significativas entre sexos y grupos étnicos en las etapas de la osificación de la sutura sagital. La osificación de la sutura sagital comienza a producirse desde el tercio posterior.