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BACKGROUND: Regular physical activity is a promising strategy to treat and prevent cognitive decline. The mechanisms that mediate these benefits are not fully clear but physical activity is thought to attenuate the harmful effects of chronic psychological stress and hypercortisolism on cognition. However, the circadian pattern of cortisol secretion is complex and it is not known which aspects are most closely associated with increased cognitive function and better physical performance. This is the first study to simultaneously measure cognitive function, the diurnal cycle of salivary cortisol and physical performance in older adults, without cognitive impairment (n = 30) and with amnestic Mild Cognitive Impairment (aMCI) (n = 30). RESULTS: Regression analysis showed that better cognitive function was associated with better physical performance. A greater variance in cortisol levels across the day from morning to evening was associated with better cognitive function and physical performance. CONCLUSIONS: The results support the idea that a more dynamic cortisol secretion pattern is associated with better cognitive function and physical performance even in the presence of cognitive impairment, but our results could not confirm a mediating role in this relationship.
ABSTRACT
Introducción: Los folletos informativos son una herramienta educativa habitual en la práctica neurológica diaria; mediante este mecanismo se pretende incrementar de primera mano los conocimientos que la población tiene sobre una enfermedad concreta, además de evitar fuentes de información erróneas. Las encuestas son el medio más empleado para conocer la satisfacción de los usuarios con los servicios recibidos. Objetivos: Evaluar la satisfacción percibida y establecer una retroalimentación informativa que valore la comprensión y la utilidad global de un folleto educativo sobre migraña. Material y métodos: Estudio abierto, prospectivo y multicéntrico sobre una población de pacientes diagnosticados de migraña en diversas consultas de neurología de la provincia de Alicante. En la visita basal se les entrega un folleto informativo de migraña confeccionado por el grupo de estudio para la cefalea de la Sociedad Valenciana de Neurología (CEFALIC). En la visita control se les solicita la cumplimentación de una encuesta personal y por escrito sobre la calidad global de la información incluida en el folleto. Resultados: Se incluye a un total de 257 pacientes diagnosticados de migraña (83% migraña episódica; 17% migraña crónica), con una edad media de 37,6 años. Confirmaron la lectura del folleto 207 paciente (80,5%) y no lo habían leído 50 pacientes (19,5%), bien por olvido bien por desinterés. Al 90% de los pacientes la lectura del folleto les pareció interesante y comprensible. El 76% de los encuestados opina que la lectura del folleto incrementa sus conocimientos sobre migraña. El 50% de los pacientes opina que el folleto resultó de utilidad para mejorar el control de su migraña. Conclusiones: La utilización de un folleto educativo sobre migraña resultó comprensible, además incrementó el conocimiento global de la enfermedad y en opinión de los pacientes resultó útil para mejorar el control de su migraña. La evaluación de la información educativa que prestamos a nuestros pacientes con migraña debe ser medida para descubrir las causas de descontento, determinar el nivel de calidad del servicio e investigar las posibilidades de mejora de calidad
Introduction: Brochures are commonly used as educational tools in daily neurological practice. They are provided to increase the general population's knowledge of a specific disease and also to combat sources of erroneous information. Surveys are the most commonly used method of ascertaining user satisfaction with services received. Objectives: This study will assess patient-perceived satisfaction and provide feedback to measure the comprehensibility and overall utility of an educational brochure on migraine. Material and methods: Open prospective multicentre study of a group of patients diagnosed with migraine in neurology clinics in Alicante province. During the initial visit, each patient received a migraine brochure prepared by the Valencian Society of Neurology's study group for headaches (CEFALIC). During a follow-up visit, they were then asked to fill out a personal survey on the overall quality of the information in the brochure. Results: We included a total of 257 patients diagnosed with migraine (83% episodic migraine; 17% chronic migraine); mean age was 37.6 years. Two hundred seven patients confirmed having read the brochure (80.5%); 50 patients (19.5%) either forgot to read it or had no interest in doing so. The brochure seemed interesting and easy to understand according to 90% of the patients. Seventy-six per cent of the respondents stated that reading the brochure increased their overall knowledge of migraine, while 50% of the patients found the brochure useful for improving migraine control. Conclusions: Patients found the migraine educational brochure to be comprehensible, a means of increasing overall knowledge of the disease, and useful for increasing control over migraines. Evaluations of the educational brochures that we provide to our patients with migraine should be studied to discover the causes of dissatisfaction, determine the level of quality of service, and investigate potential areas for improvement
Subject(s)
Adult , Female , Humans , Male , Pamphlets , Consumer Health Information/trends , Information Services/standards , Information Services , Patient Education as Topic/methods , Patient Education as Topic/trends , Migraine Disorders/epidemiology , Migraine Disorders/prevention & control , Feedback, Psychological , 24419 , Prospective Studies , Longitudinal StudiesABSTRACT
We present two women with the right temporal lobe variant (RTLV) of frontotemporal dementia (FTD) and analyse the clinical features that are determined by the anatomical distribution of atrophy. Each of our patients displayed different clinical and radiological profiles which were in line with findings reported by other authors. One of two patients carries a novel mutation in the granulin gene. FTD is heterogeneous with regard to clinical manifestation, genetics, distribution of cortical atrophy and underlying disease. Its clinical manifestations are related to the distribution of the cortical atrophy. The RTLV of FTD is an uncommon entity. There is no consensus about its name despite the fact that its clinical and radiological features are well-defined and distinguish it from other types of FTD including semantic dementia.
Subject(s)
Frontotemporal Dementia/pathology , Temporal Lobe/pathology , Aged , Aphasia, Primary Progressive/etiology , Aphasia, Primary Progressive/genetics , Aphasia, Primary Progressive/pathology , Atrophy , Female , Frontotemporal Dementia/genetics , Frontotemporal Dementia/psychology , Humans , Intercellular Signaling Peptides and Proteins/genetics , Magnetic Resonance Imaging , Middle Aged , Mutation/genetics , Neurologic Examination , ProgranulinsABSTRACT
INTRODUCTION: Brochures are commonly used as educational tools in daily neurological practice. They are provided to increase the general population's knowledge of a specific disease and also to combat sources of erroneous information. Surveys are the most commonly used method of ascertaining user satisfaction with services received. OBJECTIVES: This study will assess patient-perceived satisfaction and provide feedback to measure the comprehensibility and overall utility of an educational brochure on migraine. MATERIAL AND METHODS: Open prospective multicentre study of a group of patients diagnosed with migraine in neurology clinics in Alicante province. During the initial visit, each patient received a migraine brochure prepared by the Valencian Society of Neurology's study group for headaches (CEFALIC). During a follow-up visit, they were then asked to fill out a personal survey on the overall quality of the information in the brochure. RESULTS: We included a total of 257 patients diagnosed with migraine (83% episodic migraine; 17% chronic migraine); mean age was 37.6 years. Two hundred seven patients confirmed having read the brochure (80.5%); 50 patients (19.5%) either forgot to read it or had no interest in doing so. The brochure seemed interesting and easy to understand according to 90% of the patients. Seventy-six per cent of the respondents stated that reading the brochure increased their overall knowledge of migraine, while 50% of the patients found the brochure useful for improving migraine control. CONCLUSIONS: Patients found the migraine educational brochure to be comprehensible, a means of increasing overall knowledge of the disease, and useful for increasing control over migraines. Evaluations of the educational brochures that we provide to our patients with migraine should be studied to discover the causes of dissatisfaction, determine the level of quality of service, and investigate potential areas for improvement.
Subject(s)
Migraine Disorders/therapy , Pamphlets , Patient Education as Topic/methods , Patient Satisfaction , Adult , Comprehension , Female , Humans , Male , Middle Aged , Prospective Studies , Spain , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Inappropriate admissions to a hospital service generate unnecessary costs for our health care service. Most admissions to a hospital service come from the emergency department. The presence of a neurologist to attend hospital emergencies would be an important factor allowing admission criteria to be streamlined. AIMS: To determine the number of avoidable admissions (AA) in a neurology service, and to define their characteristics. PATIENTS AND METHODS: We conducted a prospective, descriptive study of the admissions that took place in the Neurology Service of the Hospital General Universitario de Elche (Alicante) over a period of three months. The neurologist determines whether admission is indicated or not. We collected demographic data concerning the patient, the admission diagnosis, neurological diagnosis, the reason for appropriateness and the reason for AA. RESULTS: A total of 250 admissions were attended; 65 were considered to be AA (26%). The most frequent diagnoses in the cases of AA were non-neurological (32.3%), clinical findings (15.4%), neuropathies (10.8%) and epilepsy (10.8%). The reasons leading to AA were non-neurological and transfer to another service (30.8%), follow-up by neurology outpatient department (NOD) (29.2%), NOD study (21.5%), non-neurological and discharge (16.9%) and not specified (1.5%). The mean length of stay in the case of AA was 4.3 days. CONCLUSIONS: The number of AA in our service is higher than that found in other studies. On-duty neurologists, streamlining outpatient diagnostic testing and the design of flexible schedules for outpatient care would reduce the amount of resources that are used, while at the same time increasing the quality of the health service.
Subject(s)
Hospital Departments/statistics & numerical data , Neurology/statistics & numerical data , Patient Admission/statistics & numerical data , Unnecessary Procedures/statistics & numerical data , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Diagnosis-Related Groups , Diagnostic Errors , Female , Hospitals, General/statistics & numerical data , Hospitals, University/statistics & numerical data , Humans , Male , Middle Aged , Nervous System Diseases/diagnosis , Nervous System Diseases/epidemiology , Patient Admission/economics , Prospective Studies , Spain , Unnecessary Procedures/economicsABSTRACT
Introducción. Los ingresos inadecuados a un servicio hospitalariogeneran costes innecesarios a nuestro sistema de salud.La mayoría de ingresos en un servicio hospitalario procede delárea de urgencias. La presencia de un neurólogo que atienda lasurgencias hospitalarias constituiría un factor importante pararacionalizar los criterios de hospitalización. Objetivos. Determinarel número de ingresos evitables (IE) en un servicio de neurologíaasí como definir las características de éstos. Pacientes y métodos.Estudio descriptivo prospectivo de los ingresos realizados enel Servicio de Neurología del Hospital General Universitario deElche (Alicante) durante tres meses. El neurólogo determina laindicación de ingreso. Se recogen los datos de filiación del paciente,el diagnóstico del ingreso, el diagnóstico del neurólogo, el motivode adecuación y el motivo de IE. Resultados. Se atendieron untotal de 250 ingresos; 65 se consideraron IE (26%). Los diagnósticosmás frecuentes de los IE fueron: no neurológico (32,3%), síntomasy signos (15,4%), neuropatías (10,8%) y epilepsia (10,8%).Los motivos de IE fueron: no neurológico y traslado de servicio(30,8%), seguimiento en consultas externas de neurología (CEN)(29,2%), estudio en CEN (21,5%), no neurológico y alta (16,9%) yno consta (1,5%). Los IE tuvieron una estancia media de 4,3 días.Conclusiones. El número de IE en nuestro servicio es más elevadoque en otros estudios. La disponibilidad de guardias de neurología,la agilización de la realización ambulatoria de pruebasdiagnósticas y el diseño de agendas flexibles de asistencia ambulatoriasupondrían una reducción en la utilización de recursos, yaumentaría la calidad del servicio asistencial
Introduction. Inappropriate admissions to a hospital service generate unnecessary costs for our health care service.Most admissions to a hospital service come from the emergency department. The presence of a neurologist to attend hospitalemergencies would be an important factor allowing admission criteria to be streamlined. Aims. To determine the number ofavoidable admissions (AA) in a neurology service, and to define their characteristics. Patients and methods. We conducted aprospective, descriptive study of the admissions that took place in the Neurology Service of the Hospital General Universitariode Elche (Alicante) over a period of three months. The neurologist determines whether admission is indicated or not. Wecollected demographic data concerning the patient, the admission diagnosis, neurological diagnosis, the reason for appropriatenessand the reason for AA. Results. A total of 250 admissions were attended; 65 were considered to be AA (26%). The mostfrequent diagnoses in the cases of AA were non-neurological (32.3%), clinical findings (15.4%), neuropathies (10.8%) andepilepsy (10.8%). The reasons leading to AA were non-neurological and transfer to another service (30.8%), follow-up byneurology outpatient department (NOD) (29.2%), NOD study (21.5%), non-neurological and discharge (16.9%) and notspecified (1.5%). The mean length of stay in the case of AA was 4.3 days. Conclusions. The number of AA in our service ishigher than that found in other studies. On-duty neurologists, streamlining outpatient diagnostic testing and the design offlexible schedules for outpatient care would reduce the amount of resources that are used, while at the same time increasingthe quality of the health service
Subject(s)
Male , Female , Adult , Middle Aged , Aged , Humans , Hospital Departments/statistics & numerical data , Neurology/statistics & numerical data , Patient Admission/statistics & numerical data , Unnecessary Procedures/statistics & numerical data , Epidemiology, Descriptive , Prospective Studies , Spain , Diagnosis, Differential , Diagnosis-Related Groups , Diagnostic Errors , Hospitals, General/statistics & numerical data , Hospitals, University/statistics & numerical data , Nervous System Diseases/diagnosis , Nervous System Diseases/epidemiology , Patient Admission/economics , Unnecessary Procedures/economicsABSTRACT
INTRODUCTION: Intrahospital consultation (IC) is a little analyzed activity within daily neurologist hospital care. It entails an extra investment of time and resources. This study aims to describe the number and characteristics of the IC to a neurological department in our setting and to emphasize its importance within daily neurological health care. METHODS: We performed an eighteen-month retrospective study of the requests for consultations received during this period in the Neurology Service of the Hospital General Universitario. The following variables were analyzed: demographic information, number and type of IC, time of response, syndromic diagnosis, complementary tests requested and resolution of patients. RESULTS: 224 IC in 210 patients were seen. The average time of response was 1.57 days, although it was modified because of type of IC (normal: 1.7 days; for preference: 1.5 days; urgent: 0.2 days). The specialities that requested most consultations were cardiology (12.9%) and internal medicine (12.5 %). The most frequent reasons for consultation were: signs and symptoms (27.2%), focal neurological deficit (22.8%) and cognitive impairment (17.9%). CT scan and MRI were the most common complementary tests. A total of 25.4% of patients were referred to neurology outpatient clinic for follow-up. CONCLUSIONS: IC is an infrastudied activity in the literature. We consider it necessary to analyze this kind of care in every hospital in order to improve the organization and the planning of the day-to-day hospital activity
Subject(s)
Hospital Departments , Neurology , Referral and Consultation , Adult , Aged , Female , Hospital Departments/statistics & numerical data , Hospitals , Humans , Male , Middle Aged , Nervous System Diseases/diagnosis , Nervous System Diseases/physiopathology , Retrospective StudiesABSTRACT
Introducción. Las interconsultas (IC) son una actividad poco analizada dentro del quehacer diario del neurólogo que desempeña su actividad en el hospital. Supone una inversión «extra» de tiempo y recursos. Nuestro objetivo es el de describir en nuestro medio el número y las características de las IC atendidas y destacar la importancia de las mismas en la labor asistencial diaria del servicio. Métodos. Realizamos un estudio descriptivo retrospectivo de las IC atendidas en el Hospital General durante un período de 18 meses. Se recogieron las variables demográficas, número de IC, tipo de IC, la demora de respuesta y datos de los pacientes referentes a patologías atendidas, pruebas solicitadas y destino de los mismos. Resultados. Se realizaron 224 IC pertenecientes a 210 pacientes. El tiempo medio de respuesta fue de 1,57 días, aunque éste fue variable en función de la urgencia de la solicitud (normal: 1,7 días; preferente: 1,5 días; urgente: 0,2 días). Las especialidades más consultoras fueron cardiología (12,9%) y medicina interna (12,5%). Los motivos de consulta más frecuentes fueron: síntomas y signos (27,2%), focalidad neurológica (22,8 %) y trastorno cognitivo (17,9 %). La prueba más solicitada fue la tomografía computarizada craneal seguida de la resonancia magnética cerebral. Tras la IC, el 25,4% de los pacientes fueron remitidos a consultas externas para seguimiento. Conclusiones. La actividad de las IC es un tema poco tratado en la literatura. Consideramos necesario analizar en cada ámbito este tipo de actividad de modo que se consiga una mejor planificación del trabajo asistencial hospitalario (AU)
Introduction: Intrahospital consultation (IC) is a little analyzed activity within daily neurologist hospital care. It entails an extra investment of time and resources. This study aims to describe the number and characteristics of the IC to a neurological department in our setting and to emphasize its importance within daily neurological health care. Methods: We performed an eighteen-month retrospective study of the requests for consultations received during this period in the Neurology Service of the Hospital General Universitario. The following variables were analyzed: demographic information, number and type of IC, time of response, syndromic diagnosis, complementary tests requested and resolution of patients. Results: 224 IC in 210 patients were seen. The average time of response was 1.57 days, although it was modified because of type of IC (normal: 1.7 days; for preference: 1.5 days; urgent: 0.2 days). The specialities that requested most consultations were cardiology (12.9%) and internal medicine (12.5 %). The most frequent reasons for consultation were: signs and symptoms (27.2%), focal neurological deficit (22.8%) and cognitive impairment (17.9%). CT scan and MRI were the most common complementary tests. A total of 25.4% of patients were referred to neurology outpatient clinic for follow-up. Conclusions: IC is an infrastudied activity in the literature. We consider it necessary to analyze this kind of care in every hospital in order to improve the organization and the planning of the day-to-day hospital activity (AU)
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hospital Departments , Neurology , Referral and Consultation , Hospitals , Nervous System Diseases/diagnosis , Nervous System Diseases/physiopathology , Retrospective StudiesABSTRACT
No disponible
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Subject(s)
Male , Aged , Humans , Liver Cirrhosis/complications , Demyelinating Diseases/diagnosis , Hepatitis C, Chronic/complications , Cholecystectomy/adverse effects , Corpus Callosum/physiopathology , Vitamin B Deficiency , Vitamin B 12 DeficiencySubject(s)
Carcinoma, Squamous Cell/radiotherapy , Lumbosacral Plexus/physiopathology , Peripheral Nervous System Diseases/etiology , Uterine Cervical Neoplasms/radiotherapy , Electromyography/methods , Female , Humans , Middle Aged , Peripheral Nervous System Diseases/diagnosis , Peripheral Nervous System Diseases/physiopathology , Radiotherapy/adverse effectsABSTRACT
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