Análisis de la calidad de vida en pacientes con insuficiencia cardíaca mediante el cuestionario genérico SF-36 / Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure

Objetivo. La insuficiencia cardíaca es una de las principales enfermedades crónicas que afectan a la calidad de vida relacionada con la salud. El objetivo del presente estudio ha sido evaluar la calidad de vida en pacientes con clase funcional i - iii de la New York Heart Association mediante el cuestionario SF-36 usando una cohorte de supervivientes del Grupo de Estudio EPICOUR y compararlo con la calidad de vida de la población general española para el mismo sexo y grupo de edad. Material y métodos. Se diseñó un estudio de cohorte, observacional y prospectivo con los supervivientes del Grupo de Estudio EPICOUR a los que se les realizó control clínico-evolutivo y cuestionario SF-36. Resultados. Se estudió la calidad de vida en 50 pacientes (60% hombres). La edad media de los hombres fue de 64,8 años y de las mujeres de 68,3. Al analizar el SF-36 se observó que los resultados fueron más bajos en la esfera física que en la esfera mental. La calidad de vida empeoraba a medida que aumentaba la clase funcional. Al comparar los pacientes con la población general para el mismo sexo y edad, los pacientes con insuficiencia cardíaca mostraron puntuación inferior en todas las escalas (diferencias significativas en función física, dolor corporal, vitalidad y función social para los hombres y función física y rol emocional para las mujeres). Conclusiones. La insuficiencia cardíaca provoca un impacto negativo en la calidad de vida, tanto en la función física como en la función psicosocial, agravándose el deterioro con el incremento de la clase funcional(AU)

Objective: Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class i-iii using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. Material and methods: A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. Results: The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). Conclusions: Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class (AU)

[Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure]. / Análisis de la calidad de vida en pacientes con insuficiencia cardíaca mediante el cuestionario genérico SF-36.

OBJECTIVE: Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class I-III using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. MATERIAL AND METHODS: A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. RESULTS: The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). CONCLUSIONS: Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class.

[Neuropsychological performance in patients with human inmunodeficiency (HIV) and hepatitis C virus (HCV) coinfection]. / Rendimiento neuropsicológico en pacientes coinfectados por virus de la inmunodeficiencia humana (VIH) y de la hepatitis C (VHC).

INTRODUCTION: Few investigations have focused their attention on the study of neuropsychological deterioration associated to human inmunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection. This study has aimed to evaluate neuropsychological performance and neuropsychological impairment rates in HIV and HCV positive patients (HIV+/HCV+) of Spanish nationality of the region of Galicia. METHOD: Three groups of 122 subjects underwent neuropsychological evaluation: 55 HIV+, 29 HIV/HCV+ and 34 seronegative to both HIV/HCV. All subjects gave their written informed consent and underwent the same evaluation process. RESULTS: HIV+ and HIV/HCV+ patients showed significantly lower levels of neuropsychological performance in all neuropsychological domains evaluated in comparison with the control group. Nevertheless, only visual memory showed significantly differences between both groups. The rate of neuropsychological impairment of HIV+/HCV+ patients (62%) was significantly greater than that of HIV+ (38%). CONCLUSIONS: HIV and HIV/HCV infection are related to low levels of neuropsychological performance, HIV/HCV patients showing lower performance in visual memory tasks. HIV/HCV coinfection represents a neuropsychological impairment risk factor in HIV patients, because it influences the probability of having neuropsychological impairment. However, this may not only be related with HCV, but also with being in methadone-maintenance programs.

Rendimiento neuropsicológicoen pacientes coinfectadospor virus de la inmunodeficienciahumana (VIH) y de la hepatitis C (VHC) / No disponible

Introducción. Pocas investigaciones han centrado su atenciónen el estudio del deterioro neuropsicológico asociado a la coinfecciónpor los virus de la inmunodeficiencia humana (VIH) y de la hepatitisC (VHC). El objetivo de este estudio es evaluar el rendimientoneuropsicológico y las tasas de deterioro neuropsicológico en pacientesgallegos seropositivos coinfectados por VIH/VHC.Método. Se realizó una evaluación neuropsicológica a tres gruposde 122 sujetos, 59 infectados por VIH, 29 coinfectados porVIH/VHC y 34 seronegativos a ambos virus. Todos los sujetos dieronel consentimiento informado y fueron sometidos al mismo procesode evaluación.Resultados. Los pacientes monoinfectados por VIH y los coinfectadospor VIH/VHC mostraron niveles significativamente más bajosde rendimiento neuropsicológico que el grupo control en todaslas funciones estudiadas, apreciándose diferencias significativas entreel grupo de monoinfectados y coinfectados únicamente en elfactor que evalúa la memoria visual. En cuanto a las tasas de deterioroneuropsicológico, éstas fueron significativamente más elevadasen el grupo de pacientes coinfectados (62%) frente al de monoinfectados(38%).Conclusiones. La infección por VIH y la coinfección por VIH yVHC se asocia a niveles de rendimiento bajos, mostrando los pacientescoinfectados un rendimiento más bajo en tareas de memoria visual.La coinfección por VIH/VHC representa un factor de riesgo dedaño neuropsicológico en sujetos seropositivos al VIH, ya que influyede forma significativa en la probabilidad que tienen éstos de presentardeterioro neuropsicológico, si bien ésta pudiera estar relacionadano sólo con el VHC, sino también con la permanencia en programasde mantenimiento con metadona (AU)

Introduction. Few investigations have focused their attentionon the study of neuropsychological deterioration associated tohuman inmunodeficiency virus (HIV) and hepatitis C virus (HCV)coinfection. This study has aimed to evaluate neuropsychologicalperformance and neuropsychological impairment rates in HIVand HCV positive patients (HIV+/HCV+) of Spanish nationality ofthe region of Galicia.Method. Three groups of 122 subjects underwent neuropsychologicalevaluation: 55 HIV+, 29 HIV/HCV+ and 34 seronegativeto both HIV/HCV. All subjects gave their written informedconsent and underwent the same evaluation process.Results. HIV+ and HIV/HCV+ patients showed significantlylower levels of neuropsychological performance in all neuropsychologicaldomains evaluated in comparison with the controlgroup. Nevertheless, only visual memory showed significantlydifferences between both groups. The rate of neuropsychologicalimpairment of HIV+/HCV+ patients (62%) was significantly greaterthan that of HIV+ (38%).Conclusions. HIV and HIV/HCV infection are related to low levelsof neuropsychological performance, HIV/HCV patients showinglower performance in visual memory tasks. HIV/HCV coinfectionrepresents a neuropsychological impairment risk factor in HIV patients,because it influences the probability of having neuropsychologicalimpairment. However, this may not only be related withHCV, but also with being in methadone-maintenance programs (AU)

Infección por VIH, consumo de drogas y rendimiento neuropsicológico / HIV-1 infection, use of drugs and neuropsychologic efficiency

Introducción: El abuso de sustancias ha sido considerado como un factor explicativo del deterioro neuropsicológico. Sin embargo, persisten dudas sobre la distinción entre efectos directos o indirectos e incluso sobre la interacción entre el efecto del VIH y el consumo de sustancias. El objetivo de esta investigación consistió en estudiar el efecto del consumo de drogas y la seropositividad al VIH-1 sobre el rendimiento neuropsicológico. Método: Tras obtener el consentimiento informado fueron reclutados 113 suetos, integrados en cuatro grupos (34 seropositvos exconsumidores de drogas por vía parenteral; 33 seropositivos en programas de mantenimiento con metadona; 19 seronegativos exconsumidores de drogas por vía parenteral; y 27 seronegativos sin antecedentes de consumo. A todos ellos se les aplicó una batería neuropsicológica integrada diseñada ad hoc, una entrevista semiestructurada sobre aspectos sociodemográficos, toxicológicos, neuropsiquiátricos y clínico-biológicos y una evaluación de la sintomatología ansioso-depresiva. Resultados: los sujetos seropositivos en metadona presentan mayores tasas de prevalencia del deterioro que el resto de los grupos (c2 = 32.22, p ,000). Conclusiones: El consumo de drogas y la seropositividad son factores que se asocian al bajo rendimiento neuropsicológico. Además, la situación respecto al consumo explica diferencias en los niveles de ejecución y tasas de deterioro neuropsicológico, siendo los sujetos en programas de mantenimiento con metadona los que presentan los peores niveles de ejecución, así como las tasas más elevadas de afectación neuropsicológica

Introduction: The abuse of substances has been considered as an explanatory factor of the neuropsychologic failure. However, doubts persist on the distinction among direct or indirect efects and even on the interaction between the effect of the HIV and the use of substances. The objective of this investigation consisted on studying the effect of the use of drugs and the seropositivity to the HIV-1 on the neuropsychologic efficiency. Method: After obtaining the informed consentiment 113 patients they were recruited, integrated in four groups (34 seropositives ex-UDPP; 33 seropositives in maintenance programs with methadone; 19 seronegatives; and 27 seronegatives without previous use of drugs. To all they were applied a neuropsychologic battery designed ad hoc, an semistructured interview about sociodemographical, toxicological, neuropsychiatric and clinical-biological aspects and an evaluation of the ansious-depressive symptomatology. Results: The seropositive patients in methadone present bigger rates of prevalence of the damage that the rest of the groups (X2 = 32.22, p .000). Conclusions: The abuse of drugs and the seropositivity are factors that associate to the decrease neuropsychologic efficiency. Also, the situation regarding the abuse explains differences in the execution levels and rates of neuropsychologic damage, being the patients in maintenance programs with methadone those that present the worst execution levels, as well as the highest rates in neuropsychologic affectation

[Influence of the clinical and biological variables CD4 and viral load on the neuropsychologic efficiency of patients with HIV-1 infection]. / Influencia de las variables clínico-biológicas CD4 y carga viral sobre el rendimiento neuropsicológico de pacientes con infección por VIH-1.

INTRODUCTION: Diverse investigations have tried to relate the neuropsychologic efficiency with the levels of CD4 and viral load, however the results don't seem to be conclusive. The objective of the present investigation is to determine the relationship grade among the variable level of CD4 and viral load and the neuropsychologic efficiency of patients HIV-I infected. METHOD: A total of 88 seropositive patients of the Complexo Hospitalario Cristal-Piñor (Ourense), in different phases of the infection (A=30,B=17 and C=41) they were recruited after completing a series of inclusion approaches to participate in the study. A total of 4 four patients was rejected by not completing the proposed approaches. To all they were applied a neuropsychologic battery, an evaluation of the anxious-depressive symptomatology and an interview over sociodemographical, toxicological, neuropsychiatrics and clinical-biological aspects. In the same day of the evaluation the levels of CD4 and viral load were determined in peripheral blood. Previous to establish the correlation levels among the studied variables--levels of CD4, viral load in peripheral blood and neuropsychologic efficiency--it was necessary to carry out a factorial analysis to determine the factors that it evaluated the neuropsychologic battery and to standardize the punctuations, transforming them in typical punctuations. Then, the execution levels and neurocognitive deterioration was determined, contrasting them with a group designed control adhoc. Later on, it practiced correlation analysis and multiple regression. RESULTS AND DISCUSSION: The result of the correlates analyses and of regression it seems to indicate the relationship absence between CD4 and viral load in peripheral blood with each one of the five factors studied neuropsychologic (visual memory, attention/psychomotor speed, ver bal intelligence/abstract thought, verbal memory for digits and words and verbal memory for texts). Our data are coincident with other many investigations that throw similar data. The study of this thematic one requires more investigation with innovative methodological focuses. CONCLUSIONS: The neuropsychological execution, seems to be independent of the levels of CD4 and viral load. The disagreement among the investigators, perhaps, respond to complex methodological questions.

Influencia de las variables clínico-biológicas CD4 y carga viral sobre el rendimiento neuropsicológico de pacientes con infección por VIH-1 / Influence of the clinical and biological variables CD4 and viral load on the neuropsychologic efficiency of patients with HIV-1 infection

Introducción: Diversas investigaciones han intentado relacionar el rendimiento neuropsicológico con los niveles de CD4 y carga viral, sin embargo los resultados no parecen ser concluyentes. El objetivo de la presente investigación es determinar el grado de relación entre las variables nivel de CD4 y carga viral y el rendimiento neuropsicológico de pacientes infectados por VIH-1. Método: Un total de 88 pacientes seropositivos del Complexo Hospitalario Cristal-Piñor (Ourense), en diferentes estadios de la infección (A=30, B=17 y C=41) fueron reclutados tras cumplir una serie de criterios de inclusión para participar en el estudio. Un total de 4 cuatro pacientes fueron rechazados por no cumplir los criterios propuestos. A todos ellos se les aplicó una batería neuropsicológica, una evaluación de la sintomatología ansioso-depresiva y una entrevista sobre aspectos sociodemográficos, toxicológicos, neuropsiquiátricos y clínico-biológicos. En el mismo día de la evaluación se determinaron los niveles de CD4 y Carga Viral en sangre periférica. Previo a establecer los niveles de correlación entre las variables estudiadas -niveles de CD4, Carga Viral en sangre periférica y rendimiento neuropsicológico- fue preciso realizar un análisis factorial para determinar los factores que evaluaba la batería neuropsicológica y estandarizar las puntuaciones, transformándolas en puntuaciones típicas. Luego se determinaron los niveles de ejecución y deterioro neurocognitivo, contrastándolos con un grupo control diseñado ad hoc. Posteriormente, practicó análisis de correlación y regresión múltiple. Resultados y discusión: El resultado de los análisis correlacionales y de regresión parece indicar la ausencia de relación entre las variables CD4 y carga viral en sangre periférica con cada uno de los cinco factores neuropsicológicos estudiados (memoria visual, antención/velocidad psicomotora, inteligencia verbal/pensamiento abstracto, memoria verbal para dígitos y palabras y memoria verbal para textos). Nuestros datos son coincidentes con otras muchas investigaciones que arrojan datos similares. El estudio de esta temática requiere más investigación con enfoques metodológicos innovadores. Conclusiones: La ejecución neuropsicológica, parece ser independiente de los niveles de CD4 y carga viral. La discordancia entre los investigadores, tal vez, responda a complejas cuestiones metodológicas

Introduction: Diverse investigations have tried to relate the neuropsychologic efficiency with the levels of CD4 and viral load, however; the results don’t seem to be conclusive. The objective of the present; investigation is to determine the relationship grade among the variable level of CD4 and viral load and the neuropsychologic efficiency of patients HIV-1 infected. Method: A total of 88 seropositive patients of the Complexo Hospitalario Cristal-Piñor (Ourense), in different phases of the infection (A=30, B=17 and C=41) they were recruited after completing a series of inclusion; approaches to participate in the study. A total of 4 four patients was; rejected by not completing the proposed approaches. To all they were; applied a neuropsychologic battery, an evaluation of the anxious-depressive; symptomatology and an interview over sociodemographical, toxicological, neuropsychiatrics and clinical-biological aspects. In the same; day of the evaluation the levels of CD4 and viral load were determined in; peripheral blood. Previous to establish the correlation levels among the studied variables - levels of CD4, viral load in peripheral blood and neuropsychologic efficiency - it was necessary to carry out a factorial analysis to determine the factors that it evaluated the neuropsychologic battery and to standardize the punctuations, transforming them in typical punctuations. Then, the execution levels and neurocognitive deterioration was determined, contrasting them with a group designed control ad hoc. Later on, it practiced correlation analysis and multiple regression. Results and discussion: The result of the correlates analyses and of regression it seems to indicate the relationship absence between CD4 and viral load in peripheral blood with each one of the five factors studied neuropsicologic (visual memory, attention/psycomotor speed, verbal intelligence/abstract thought, verbal memory for digits and words and verbal memory for texts). Our data are coincident with other many investigations that throw similar data. The study of this thematic one requires more investigation with innovative methodological focuses. Conclusions: The neuropsychological execution, seems to be independent of the levels of CD4 and viral load. The disagreement among the investigators, perhaps, respond to complex methodological questions

[HIV-1 infection, use of drugs and neuropsychologic efficiency]. / Infección por VIH, consumo de drogas y rendimiento neuropsicológico.

INTRODUCTION: The abuse of substances has been considered as an explanatory factor of the neuropsychologic failure. However, doubts persist on the distinction among direct or indirect effects and even on the interaction between the effect of the HIV and the use of substances. The objective of this investigation consisted on studying the effect of the use of drugs and the seropositivity to the HIV-1 on the neuropsychologic efficiency. METHOD: After obtaining the informed consent 113 patients they were recruited, integrated in four groups (34 seropositives ex-UDPP; 33 seropositives in maintenance programs with methadone; 19 seronegatives; and 27 seronegatives without previous use of drugs. To all they were applied a neuropsychologic battery designed ad hoc, an semistructured interview about sociodemographical, toxicological, neuropsychiatric and clinical-biological aspects and an evaluation of the anxious-depressive symptomatology. RESULTS: The seropositive patients in methadone present bigger rates of prevalence of the damage that the rest of the groups (X2 = 32.22, p < .000) and lower rates of execution in all the studied factors. Also, it is observed that the seropositive patients as group present lower execution levels and higher rates of damage. Also, all the groups had lower levels of execution that the people seronegative non consumers (F = 15.661, p > .000). CONCLUSIONS: The abuse of drugs and the seropositivity are factors that associate to the decrease neuropsychologic efficiency. Also, the situation regarding the abuse explains differences in the execution levels and rates of neuropsychologic damage, being the patients in maintenance programs with methadone those that present the worst execution levels, as well as the highest rates in neuropsychologic affectation.