ABSTRACT
BACKGROUND: Early diagnosis is fundamental in patients with Parkinson's disease (PD) to improve their quality of life. AIM: To determine the latency in the diagnosis of Parkinson's disease (PD) after the onset of motor symptoms. PATIENTS AND METHODS: Prospective study carried out during 16 months in a public hospital. Two hundred newly diagnosed patients aged 41 to 90 years (50% women), were included and analyzed. RESULTS: The lapse between the first symptom -more commonly tremor- and the diagnosis made by a neurologist ranged from 1 to 84 months (19.1 ± 13.8). In 39% of patients, it was done in the first year, in 26% during the second year and in 35% of patients, it took more than two years. The referral by a general practitioner had a delay ranging from 1 to 36 months. Sixty nine and 95% of patients were evaluated within the first 6 months after referral if they came from primary care or the same hospital, respectively. Twenty six percent of patients were classified in stages III to V of Hoehn & Yahr's staging and the Parkinson's Disease Rating Scale motor examination ranged from 5 to 81 points, mean 24 (± 12.8). CONCLUSIONS: The diagnosis of PD has a delay in a public hospital that could be influenced by the referral system.
Subject(s)
Delayed Diagnosis , Parkinson Disease/diagnosis , Adult , Aged , Aged, 80 and over , Chile , Cross-Sectional Studies , Female , Hospitals, Public , Humans , Male , Middle Aged , Prospective Studies , Severity of Illness Index , Socioeconomic FactorsABSTRACT
Background: Early diagnosis is fundamental in patients with Parkinson’s disease (PD) to improve their quality of life. Aim: To determine the latency in the diagnosis of Parkinson’s disease (PD) after the onset of motor symptoms. Patients and Methods: Prospective study carried out during 16 months in a public hospital. Two hundred newly diagnosed patients aged 41 to 90 years (50% women), were included and analyzed. Results: The lapse between the first symptom -more commonly tremor- and the diagnosis made by a neurologist ranged from 1 to 84 months (19.1 ± 13.8). In 39% of patients, it was done in the first year, in 26% during the second year and in 35% of patients, it took more than two years. The referral by a general practitioner had a delay ranging from 1 to 36 months. Sixty nine and 95% of patients were evaluated within the first 6 months after referral if they came from primary care or the same hospital, respectively. Twenty six percent of patients were classified in stages III to V of Hoehn & Yahr’s staging and the Parkinson’s Disease Rating Scale motor examination ranged from 5 to 81 points, mean 24 (± 12.8). Conclusions: The diagnosis of PD has a delay in a public hospital that could be influenced by the referral system.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Delayed Diagnosis , Parkinson Disease/diagnosis , Chile , Cross-Sectional Studies , Hospitals, Public , Prospective Studies , Severity of Illness Index , Socioeconomic FactorsABSTRACT
Mutations in the LRRK2 gene are the most common genetic cause of Parkinson's disease, with frequencies displaying a high degree of population-specificity. Although more than 100 coding substitutions have been identified, only seven have been proven to be highly penetrant pathogenic mutations. Studies however are lacking in non-white populations. Recently, Lrrk2 p.Q1111H (rs78365431) was identified in two affected Hispanic brothers and absent in 386 non-Hispanic white healthy controls. We therefore screened this variant in 1460 individuals (1150 PD patients and 310 healthy controls) from 4 Latin American countries (Peru, Chile, Uruguay and Argentina). In our case-control series from Peru and Chile we observed an increased frequency of Lrrk2 p.Q1111H in patients (7.9%) compared to controls (5.4%) although the difference did not reach significance (OR 1.38; p = 0.10). In addition, the frequency of Lrrk2 p.Q1111H varied greatly between populations and further screening in a set of pure Amerindian and pure Spanish controls suggested that this variant likely originated in an Amerindian population. Further studies in other Latin American populations are warranted to assess its role as a risk factor for Parkinson's disease. Screening in Parkinson's disease patients from under-represented populations will increase our understanding of the role of LRRK2 variants in disease risk worldwide.
Subject(s)
Amino Acid Substitution/genetics , Parkinson Disease/ethnology , Parkinson Disease/genetics , Protein Serine-Threonine Kinases/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Glutamine/genetics , Histidine/genetics , Humans , Indians, South American/ethnology , Indians, South American/genetics , Latin America/epidemiology , Latin America/ethnology , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 , Male , Middle Aged , Parkinson Disease/epidemiology , Young AdultABSTRACT
Se evaluó mediante cartilla de evaluación del pie diabético al 73 por ciento de la población en control de los pacientes diabéticos del Hospital de Molina, y así poder prevenir las invalidantes consecuencias de esta enfermedad. Los resultados muestran que el daño o alteración del pie es mayor a mayor edad y tiempo de evolución, más aún en varones, con mayor prevalencia en deformidad ósea, y a mayor tiempo de evolución de la enfermedad hay un notable aumento de la neuropatía diabética. El presente trabajo nos orienta para que el equipo de salud dirija los esfuerzos en mejor forma, destinados a la prevención del daño irreversible del pie diabético
Subject(s)
Humans , Male , Female , Middle Aged , Diabetes Mellitus/complications , Diabetic Foot/diagnosis , Foot Deformities/etiology , Hospitals, State/statistics & numerical data , Age Distribution , Sex Distribution , Clinical Evolution , Diabetic Neuropathies/etiology , Diabetic Foot/prevention & controlSubject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Middle Aged , Wounds and Injuries/epidemiology , Diagnosis of Health Situation , Arm , Arm Injuries/epidemiology , Wounds and Injuries/classification , Wounds and Injuries/etiology , Causality , Craniocerebral Trauma/epidemiology , Hospitals, State/statistics & numerical data , Leg Injuries/epidemiology , Accidents, Traffic/statistics & numerical data , Age Distribution , Fractures, Bone/epidemiology , Hospitalization/statistics & numerical dataABSTRACT
Con el fin de realizar un diagnóstico de situación del programa Diabetes Mellitus del Hospital de Molina, se efectuó un estudio descriptivo del programa, el cual consideró el total de pacientes en control regular (asistentes) 202 pacientes, que equivale al 82 por ciento del total en control. Se analizaron múltiples variables, obteniendo como resultado una predominancia de sexo femenino, con una distribución por edad en general sobre los 40 años, con grados aceptables de control glicémico (en relación a otras comunidades estudiadas);con una alta incidencia de pacientes obesos o sobrepeso y unn manejo terapéutico de predominio mixto (Dietoterapia más hipoglicemiantes orales). Además, se observó mayor prevalencia de hipertensión en relación a la población general y un grado de pesquisa variable (en general deficiente) de complicaciones secundarias de la enfermedad
