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Biomedical subjects

F Formiga

Publications and source records attributed to F Formiga.

At least 19 recordsLinked to original sources
PubMed2006

[Interobserver concordance in functional assessment by Barthel Index].

BACKGROUND: The aim of this study is to analyze interobserver "reproductiveness" between clinical nurses in gerontology and residents in family medicine in their first contact with the Barthel Index (BI). MATERIALS AND METHODS: One hundred patients were assessed. BI at two weeks before admission was scored by a patient or carer interview. Eighteen patients were excluded because interviews were not completed. RESULTS: Mean BI of 82 patient included, assessed by nurses was 87.3 and by residents 88.2. In 40 patients some differences in the mean values of BI were observed. When analyzing the overall BI score the agreement was high (r=0.793) but interobserver agreement was low (kappa<0.4) in some fields such as eating, dressing and transfers and medium in others (kappa from 0.40 to 0.75). CONCLUSIONS: Low reproductiviness interobserver in some patients of the BI when clinical nurses in gerontology and residents in family medicine are compared suggest that they need specific training in functional capacity evaluation in order to improve the BI use.

Activities of Daily Living↗
PubMed2005

[Acute confusional syndrome in elderly patients hospitalized due to medical condition].

INTRODUCTION: Delirium or acute confusional syndrome (ACS) is a frequent problem during hospitalization of elderly patients. We study the appearance of delirium and its characteristics in patients admitted to an internal medicine service. METHODS: Prospective study of 148 patients over 64 years admitted due to medical condition (non-surgical) in the internal medicine service of the University Hospital of Bellvitge. Functionality was quantified with the Barthel index (BI) and comorbidity with the Charlson index (CI). The Confusional Assessment Method was used for the diagnosis of the ACS. RESULTS: Seventy-seven (77) (52%) of the 148 patients were women, with a mean age of 78.5 years. The CI was 2.2. Mean of previous BI was 81.7. Mortality during admission was 8% (12 patients). A total of 42.5% of the patients (63) had ACS (30% prevalent). It was hyperactive in 68%, hypoactive in 16% and mixed in 16%. In 38% of the patients, the ACS had morning predominance and 62% it appeared after the evening. Advanced age was the only significant differences between patients with or without ACS (p < 0.001). There were no significant differences in the ACS percentage between patients who survived or who died (p = 0.36). CONCLUSIONS: Frequency of appearance of the confusional picture is high in patients admitted to acute hospitals, it being more frequent in the elderly. Measures to prevent the confusional picture in elderly patients who are hospitalized should be increased.

Acute Disease↗
PubMed2004

One-year follow-up of heart failure patients after their first admission.

BACKGROUND: Outcomes related to heart failure remain relatively poor. AIM: To examine the clinical course of patients for one year after their first admission because of heart failure, including prognosis, mortality, and rehospitalization. DESIGN: Prospective observational study. METHODS: Of 121 patients hospitalized over 6 months for decompensation of previously unknown heart failure, we excluded those with a possible previous diagnosis of heart failure (n = 5), who suffered from another serious disease with a poor prognosis (n = 6), died during the index hospitalization (n = 5), refused to participate (n = 4) or were lost to follow-up (n = 6). Mortality and readmissions were identified by prospective follow-up of all patients. RESULTS: Of the 98 patients evaluated, half (49) were women. Mean +/- SD age was 75.2 +/- 12 years. The 1-year case-fatality rate after the first admission was 24%; 19% of the deaths were heart failure-related, with progressive pump failure the predominant cause (14% of the total). Age was the only factor associated with increased mortality (p < 0.007). Of the 74 survivors, 32% experienced at least one hospital readmission during follow-up. DISCUSSION: The prognosis of unselected new cases of heart failure after their first hospitalization remains relatively poor, despite recent advances in pharmacological therapy and medical care.

Acute Disease↗
PubMed2004

End-of-life preferences in elderly patients admitted for heart failure.

BACKGROUND: Heart failure is increasing in prevalence and incidence, with considerable mortality among the elderly. AIM: To determine preferences concerning cardiopulmonary-resuscitation (CPR) and end-of-life care in elderly patients hospitalized for heart failure. DESIGN: Prospective interview-based survey. METHODS: Patients >64 years old admitted for acute heart failure were interviewed to address their preferences regarding end-of-life care and cardio-pulmonary resuscitation (CPR) when facing the last stages of their disease. RESULTS: We interviewed 80 patients (mean age 79 years; 58% women). Thirty-two (40%) expressed a wish not to have CPR. Only two had previously discussed their CPR preferences with their physicians. When recovery from the illness was considered unlikely, 40 (50%) participants preferred to receive treatment at home, 32 (40%) preferred in-hospital management, and 8 (10%) were unsure. Thirty-three patients (41%) expressed a desire for spiritual support, 38 (48%) said not and the remaining 9 (11%) were indifferent. DISCUSSION: Advance planning of end-of-life procedures and doctor-patient communication regarding these items remains poor and must be improved.

Advance Care Planning↗
PubMed2004

[Geriatric information in the hospital discharge reports of patients over 65 years of age admitted to an Internal Medicine Department].

CONTEXT: The hospital discharge report (HDR) is a document that serves as a link between the hospital clinician and the primary care team. Our objective has been to evaluate the level of geriatric information in the HDR developed in the Internal Medicine Department of an tertiary care university hospital. Besides, the possible changes along the last 5 years were also evaluated. METHODS: HDRs of 1,000 patients over 65 years (500 in 1996 and 500 in 2001) and cared in the Bellvitge University Hospital were evaluated. Data relative to social, functional (qualitative and quantitative), and cognitive (qualitative and quantitative) assessment were collected. RESULTS: In 269 patients (27%) there was some kind of geriatric information in the HDRs. In the 2001 HDRs a significant increase in the percentage of social, qualitative functional and qualitative cognitive information was observed compared to 1996 HDRs. There were no significant differences upon comparing the subgroup of 269 patients with geriatric data in their HDRs with the subgroup of 731 remaining patients. CONCLUSIONS: The level of geriatric information in the HDRs is low. Care of elderly patients admitted to the Internal Medicine Department requires an additional evaluation on the part of all the professionals involved in their assistance, carrying out a global assessment that let a better knowledge of the patient. These evaluations should be part of the HDR.

Aged↗
PubMed2003

Serum insulin-like growth factor levels do not predict functional recovery after hospitalization in nonagenarian patients.

AIM: To analyze the insulin-like growth factor 1 (IGF-1) serum levels in nonagenarian patients and to investigate the predictive capacity of this measure to assess the functional recovery of this population following hospitalization. METHODS: We performed a prospective study in 60 consecutive nonagenarian patients admitted for medical or surgical diseases. We assessed IGF-1 serum levels and nutritional status. The functional status was assessed using the Barthel index. Thirty-four patients were reinvestigated 3 months after discharge from hospital. RESULTS: The mean levels of IGF-1 were lower in nonagenarians than in younger patients. No relationship was found between IGF-1 levels and nutritional status. The decline in Barthel index values 3 months after discharge from hospital did not correlate with serum levels of IGF-1 on admission. CONCLUSION: IGF-1 serum levels in nonagenarian patients do not predict functional recovery after hospitalization.

Aged↗
PubMed2001

Lipid and lipoprotein levels in premenopausal systemic lupus erythematosus patients.

The purpose of this study was to assess the prevalence of dyslipoproteinemia and to analyze the clinical variables that are associated with it in a sample of premenopausal systemic lupus erythematosus (SLE) patients. We studied 53 premenopausal (34.5 y) SLE outpatients and 45 controls. Clinical variables studied included patient age, weight, height, body mass index (BMI), age at disease onset, disease duration, clinical activity of SLE, renal involvement and drug therapy. Total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), and triglycerides were measured using standard enzymatic techniques. Apolipoproteins (apo) A-I and B were determined by radial immunodiffusion. Twenty-nine patients (55%) and 14 controls (30%) had dyslipoproteinemia. An increase in TC, triglycerides, HDL3-C, apo A-I and apo B, and a decrease in HDL2-C and HDL-C/TC index was found in SLE patients in comparison with controls. TC (P = 0.007), apo B (P = 0.02), LDL-C (P = 0.03) and triglycerides (P = 0.0001) were significantly correlated with proteinuria. Patients on prednisone therapy had higher triglycerides levels (P = 0.03) than untreated patients. TC (P = 0.01), LDL-C (P = 0.006) and triglycerides (P = 0.04) were also correlated with the dose of prednisone. Dyslipoproteinemia is a common feature in adult SLE premenopausal patients which is characterized by an increase in TC, triglycerides and apo B, and an abnormal distribution of HDL subclasses. Corticosteroid therapy and proteinuria are the best predictors of dyslipoproteinemia in these patients.

Adult↗