ABSTRACT
OBJECTIVES: To study the influence of various factors on the health related quality of life (HRQOL) of patients who have suffered a brain infarction (BI), with special attention to psychopathological disorders (PD). PATIENTS AND METHODS: Prospective observational study on 45 patients admitted due to a BI, evaluated at 4, 12 and 26 weeks of the acute event. Social and demographic data, and medical history were collected; the SF-36 scale was used for the assessment of HRQOL, and the Neuropsychiatric Inventory (NPI), MMSE, Canadian Neurological Scale, Modified Rankin Scale and other instruments for assessing psychopathological, cognitive, neurological and functional status. A linear regression analysis was performed to identify potential predictors of the SF-36 scores at 26 weeks, introducing, as independent variables, medical and psychiatric history, demographic characteristics and the functional, neuropsychological and psychopathological assessments at 4 weeks. RESULTS: Valid predictive models for all the SF-36 domains were obtained, in which a history of pre-morbid depression, higher scores in the NPI and Rankin Scale, and lowest in the Canadian Neurological Scale were the main predictors of a worse HRQOL in the long term. Psychopathology related caregiver's distress (assessed with the NPI) was associated with a lower score in the social function index. CONCLUSIONS: PDs and functional status were the main determinants of HRQOL in patients with BI.
Subject(s)
Anxiety/etiology , Cerebral Infarction/psychology , Depression/etiology , Quality of Life , Aged , Anxiety/epidemiology , Brain Ischemia/psychology , Caregivers/psychology , Depression/epidemiology , Female , Humans , Linear Models , Male , Middle Aged , Neuroimaging , Neuropsychological Tests , Predictive Value of Tests , Prospective Studies , Risk Factors , Severity of Illness Index , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Surveys and QuestionnairesSubject(s)
Neurosyphilis/diagnosis , Adult , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Brain/diagnostic imaging , Electroencephalography , Humans , Magnetic Resonance Imaging , Male , Neurosyphilis/diagnostic imaging , Neurosyphilis/drug therapy , Penicillin G/administration & dosage , Penicillin G/therapeutic use , Penicillin G Benzathine/administration & dosage , Penicillin G Benzathine/therapeutic use , Spinal Puncture , Time Factors , Tomography, X-Ray Computed , Valproic Acid/administration & dosage , Valproic Acid/therapeutic useABSTRACT
Pathological rupture of the spleen (PRS) is a rare, but well known complication of some hematological malignancies. In a recent review of the literature, Giagounidis et al. Identified 136 cases of pathologic rupture of the spleen since 1861. This number gives an idea of how seldom it occurs. In this review, 34% of the cases had occurred in acute leukemias, and 13% in acute lymphoblastic leukemias. In most cases, PRS occurs on the course of the disease. PRS as initial manifestation of ALL is a very rare feature: only six cases have been reported in the literature. Before now, in our hospital, we had only seen one case of a patient suffering from chronic myelomonocytic leukemia who presented splenic rupture as the initial manifestation of this disease. We now describe the seventh case, to our knowledge, of acute lymphoblastic leukemia presenting as pathologic splenic rupture.
