ABSTRACT
Background: Poststroke fatigue is a prevalent issue among stroke survivors, significantly impeding functional recovery and diminishing their quality of life. Aim: This prospective cohort study aims to investigate the association between poststroke fatigue and the extent of functional recovery in survivors of ischemic and hemorrhagic strokes. Additionally, it seeks to delineate the temporal progression of poststroke fatigue in these two stroke subtypes. Methods: We assessed a cohort of 79 patients recovering from acute ischemic or hemorrhagic strokes. Poststroke fatigue was quantified using the Fatigue Severity Scale (FSS) and the Numeric Rating Scale (NRSfatigue). Patients' condition was evaluated using the National Institute of Health Stroke Scale (NIHSS), and functional independence levels were determined using the Barthel Index for Activities of Daily Living (BIADL) and the Modified Rankin Scale (MRS). Depressive mood and pain were measured using the Beck Depression Inventory (BDI) and the Numeric Rating Scale for pain (NRSpain), respectively. Results: Our primary findings indicate that the early manifestation of clinically significant fatigue (CSF) is predictive of a poorer trajectory in functional independence levels during recovery. Furthermore, we observed differing patterns of fatigue progression between ischemic and hemorrhagic strokes. Fatigue tends to ameliorate over time in hemorrhagic stroke cases, paralleling functional recovery, while it remains stable over time in ischemic stroke cases. Conclusion: Our results underscore the detrimental impact of early poststroke fatigue on long-term outcomes. Furthermore, they highlight the imperative of managing poststroke fatigue, particularly during the subacute phase of stroke recovery.
ABSTRACT
BACKGROUND: Restless legs syndrome (RLS) and chronic mountain sickness (CMS) share physiological traits. Our objective was to explore a possible association between RLS and CMS. METHODS: We carried a cross-sectional study with male subjects living between 4100 and 4300 m above sea level. Participants underwent a clinical interview, physical examination, electrocardiographic (EKG) recording, and spirometry. We classified subjects into CMS, Limbo, and healthy high-altitude dwellers (hHAD), according to their Quinghai score and hematocrit levels. We applied the "Paradigm of questions for epidemiological studies of RLS," The International Restless Leg Syndrome Study Group Scale, and the Pittsburgh Sleep Quality Index. Logistic regression analysis was used to determine the association between variables. RESULTS: Seventy-eight male subjects were included. Forty subjects were hHAD, 23 were CMS patients, and 15 participants were considered as Limbo. CMS and Limbo subjects had a higher frequency of RLS (p <0.05). Limbo subjects had the highest severity score for RLS. There were no differences in age, body mass index (BMI), or tobacco use between RLS patients and non-sufferers. In the multivariate analysis, CMS was not associated with RLS diagnosis. Oxygen saturation (p = 0.019), poor sleep quality (p <0.01), and Quinghai score of ≥6 (p = 0.026) were independently associated with RLS diagnosis. CONCLUSIONS: Our results did not show a direct association between RLS and CMS; however, RLS was associated with reduced oxygen saturation. Hence, RLS could represent an early clinical manifestation of hypoxia, or, in CMS natural history, an early sign of maladaptation to high altitude.
Subject(s)
Altitude Sickness/complications , Restless Legs Syndrome/etiology , Adolescent , Adult , Aged , Altitude Sickness/blood , Altitude Sickness/epidemiology , Chronic Disease , Cross-Sectional Studies , Electrocardiography , Hematocrit , Humans , Logistic Models , Male , Middle Aged , Oxygen/blood , Peru/epidemiology , Restless Legs Syndrome/blood , Severity of Illness Index , Spirometry , Surveys and Questionnaires , Young AdultABSTRACT
La Esclerosis Múltiple (EM) es la principal enfermedad desmielinizante a nivel mundial. La epidemiología señala una mayor prevalencia de esta entidad en áreas alejadas de la línea ecuatorial. Existen algunos estudios de prevalencia en Latinoamérica, ninguno publicado en el Perú. Objetivo: Determinar la prevalencia de Esclerosis Múltiple en Lima, Perú. Material y métodos: Se utilizó el método captura recaptura para estimar la prevalencia de EM en Lima en 4 centros de pacientes con Esclerosis Múltiple de la ciudad: Hypnos Instituto del Sueño en la Clínica San Felipe, elHospital Nacional Cayetano Heredia, la Clínica El Golf y la Asociación ôEsclerosis Múltiple Perúõ (ESMUP). Resultados: Se calculó la prevalencia de EM en 7,69 x 100 000 habitantes (intervalo de confianza al 95 por ciento 7,09 a 8,30). Conclusiones: La prevalencia estimada de EM, para la ciudad de Lima, se encuentra en rango medio bajo.
Multiple Sclerosis (ME) is the main demyelinating disease over the world. The epidemiology shows a higher prevalence of this entity in areas away from the equatorial line. There are some prevalence studies published in Latinamerica, but no previous information reported in Peru. Objective: To determine the prevalence of ME in Lima, Peru. Material and Methods: Capture-recapture method was used to estimate the prevalence of ME in Lima, four centres of patients with ME in the city were evaluated: Hypnos Sleep Institute in ôSan Felipeõ Clinic, Hospital Nacional Cayetano Heredia, ôEl Golfõ Clinic and ôEsclerosis Múltiple del Perúõ Society (ESMUP). Results: The calculated prevalence of ME was 7.69 x 100 000 habitants (Confidence Interval at 95 per cent: 7.09 to 8.30). Conclusions: The estimated prevalence of ME, for Lima, is about the medium low range.
Subject(s)
Humans , Male , Female , Multiple Sclerosis , Multiple Sclerosis/epidemiology , PrevalenceABSTRACT
Se presentan dos casos de mordedura de la araña Phoneutria spp. atendidos en el Hospital Nacional Cayetano Heredia (HNCH) en los años 2005 y 2008. En ambos casos la mordedura fue de sintomatología leve y de buena evolución, y se debió a un accidente laboral en personas que trabajan en mercados de venta de fruta al extraerplátanos de cajas procedentes de Tingo María (Selva central). El phoneutrismo es un accidente por arácnidos poco común; sin embargo, sería un problema importante de salud pública sobretodo en las zonas rurales en donde el comercio de plátanos es una de las principales fuente de ingresos de la población. El personal médico no conoce del todo a esta araña, así como la clínica de sus mordeduras, por ello presentamos estos casos que permitirán reconocer estos accidentes para su adecuado manejo y control.
We present two cases of Phoneutria spp. spiderbite seen at the Hospital Nacional Cayetano Heredia (HNCH) in 2005 and 2008 respectively. In both cases, the bite had few symptoms with a good evolution, and occured as work related accidents in fruit market sales people while extracting bananas from Tingo Maria (central peruvian jungle).Phoneutrism is a relatively common accidental bite; nevertheless it can become an important public health problem in the rural zones where banana trade is one of main income sources for the local population. Medical personnel in the area is mostly unaware of this spider or of the clinical picture its bite produces We hope, by presenting these two cases, to allow them to recognize these accidents for its appropriate diagnosis, management and control.
Subject(s)
Female , Adult , Middle Aged , Humans , Spider BitesABSTRACT
Las crisis epilépticas son complicaciones frecuentes en niños que padecen de Insuficiencia Renal Crónica Terminal (IRC-T). Objetivos: Describir la frecuencia y características de las crisis epilépticas en niños con IRC-T. Material y métodos: Estudio retrospectivo, tipo serie de casos. Se incluyeron 24 pacientes menores de 14 años de ambos sexos con IRC-T que presentaron al menos un episodio de crisis epiléptica, atendidos en el Hospital Nacional Cayetano Heredia entre enero de 1998 y marzo de 2006. Resultados: La frecuencia encontrada de crisis epiléptica en esta población fue de 24/18 (75 por ciento) se encontraban en tratamiento dialítico crónico al momento de presentarse la primera crisis epiléptica; las glomerulopatías fueron la etiología más frecuente de la IRC-T; la mayoría de niños (41.6 por ciento) presentaron crisis parciales, y el hallazgo tomográfico más frecuente fue la hemorragia intraparenquimal. Conclusiones: La frecuencia de crisis epilépticas en esta serie de niños con IRC-T es menor que la descrita en la literatura revisada.
Seizures are a frequent complication seen in children with Terminal Chronic Renal Failure. Objective: To describe the characteristics of seizures seen in the children with Terminal Chronic Renal Failure. Material and methods: Retrospective study, type series of cases. There were included 24, 14 year-old minor patients of both sexes by IRC-T who presented at least an episode of epileptic attack, attended in the Hospital Nacional Cayetano Heredia between January, 1998 and march, 200. Results: We found 24/188 (12.7 per cent) prevalence of seizures in the population, 18/24 (75 per cent) of children were on cvhronic dialysis while they present the first episode of seizures, the most frequent type of seizures were partial crisis (41.6 per cent); we found that the more frequent etiology of Terminal Chronic Renal Failure was glomerulopathies and the most frequent finding on the CT scan was the parenchymal hemorrhage. Conclusions: The frecuency of seizures in children with Terminal Chronic Renal Failure were less frequent than the frequency found in the revised literature.
