e710 Abstracts / Journal of the Neurological Sciences 333 (2013) e679–e727
Abstract — WCN 2013
No: 2583
Topic: 36 — Other Topic
Sleep disorders in HIV–AIDS patients in Cameroon, sub-Saharan Africa
A.K. Njamnshia, A.A. Njohb, E.N. Mbongc, L.N. Nforb, L. Ngarkab,
J.Y. Fonsahd, E.T. Chokoteb, W.F.T. Munae. aNeurology, Cameroon;
b
General Medicine, University of Yaounde 1, Cameroon; cPublic Health,
Ministry of Public Health, Cameroon; dNeurology, Central Hospital of
Yaounde, Cameroon; eCardiology, General Hospital of Yaounde,
Yaounde, Cameroon
Background: Sleep disorders have been reported to be more common
among people living with HIV–AIDS (PLWHA) than matched controls in
Western countries, but few data exist on the subject in Africa. In
Cameroon, no study has been done on the prevalence and character-
istics of sleep disorders in PLWHA, the object of this study.
Patients and methods: A case–control study including 39 PLWHA
age- and sex-matched with 43 HIV negative controls. We used the
Pittsburg Sleep Quality Index (PSQI) to assess sleep quality, the
Epworth Sleepiness Scale (ESS) for daytime sleepiness and the Berlin
Questionnaire (BQ) for obstructive sleep apnea (OSA).
Results: HIV + participants had poorer sleep quality than the controls:
66.7% versus 11.6%, (AOR 20.60; 95% CI, 2.98–142.19) and took
significantly longer to fall asleep (33.08 ± 27.35 min versus 20.81
± 16.61 min, p = 0.015). Poor sleep quality was significantly more
common in HIV1 cases compared to HIV2 (100.0 versus 0.0% respectively,
p = 0.001). No significant differences were observed with respect to age
at HIV diagnosis, disease duration, CD4 count, disease (WHO) stage,
being on HAART or not, 1st or 2nd line treatment or being on Efavirenz.
Daytime sleepiness and OSA were significantly more common in the
cases compared to the controls: 23.1% versus 2.3% (p b 0.001) and
43.6% versus 14.0%, (p = 0.003) respectively.
Conclusion: Sleep disorders are common in Cameroonian HIV-positive
patients. The use of sleep scales in the clinical assessment of patients
could contribute to better management and improves quality of life.
doi:10.1016/j.jns.2013.07.2449
Abstract — WCN 2013
No: 2966
Topic: 36 — Other Topic
Elderly patients in vegetative state and minimally conscious state
M. Pagani, V. Covelli, D. Sattin, A.M. Giovannetti, S. Schiavolin, P. Meucci,
A. Raggi, M. Cerniauskaite, R. Quintas, M. Leonardi. Neurology, Public
Health and Disability Unit, Department of Clinical Neurosciences — DINEC,
Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
Background: Current epidemiological and clinical information related
to vegetative state (VS) and minimally conscious state (MCS) are mainly
based on adult patients, however there is limited research on ageing
with disorder of consciousness (DOC) and on elderly people with DOC.
Objective: The aim of this presentation is to report clinical and
demographic data on patients with DOC above 65 years.
Patients and methods: The multicentric national projects “Functioning
and disability in VS and MCS” and PRECIOUS “Taking care of people with
acquired severe brain injury” collected information on a large sample of
people with DOC in 107 post-acute rehabilitation and long term Italian
institutions.
Results: Among 600 participants in VS and MCS, 201 (33.4%) were aged
above 65 (mean = 74.0; DS = 6.44; range = 65–93). The majority of
the elderly sample were male (55.7%), in VS (72.2%) due to a non-
traumatic aetiology (84.1%), hosted in long term care facilities (78.6%)
and with a mean disease duration equal to 2.5 (DS = 2.1; range = 0.1–
11). The Disability Rating Scale indicated severe levels of disability
(mean = 22.7; SD = 1.2) and no differences of severity of the disease
were found between age groups. Within 2 years, 111 (55.2%) patients,
mainly non-traumatic (n = 87), died.
Conclusions: These results indicated a high prevalence of elderly
non-traumatic patients in VS with complex disability outcomes and
high needs in terms of rehabilitation. Similar outcomes and findings
are found in the data collected in the Coma Research Centre of
Neurological Institute Carlo Besta IRCCS Foundation that undertakes
an in depth evaluation of patients with DOC.
doi:10.1016/j.jns.2013.07.2450
Abstract — WCN 2013
No: 2967
Topic: 36 — Other Topic
Pathways of care of Italian patients in vegetative state and
minimally conscious state: Results from a national study
V. Covelli, M. Pagani, A.M. Giovannetti, D. Sattin, P. Meucci,
M. Cerniauskaite, R. Quintas, S. Schiavolin, A. Raggi, M. Leonardi.
Department of Clinical Neurosciences — DINEC, Neurological Institute
Carlo Besta IRCCS Foundation, Milan, Italy
Evidence has described heterogeneous pathways of taking care of
patients with disorders of consciousness (DOC) both at the national
and local level, with inter- and intra-regional differences.
The aim is to collect data on the clinical condition and pathways of
taking care of a sample of patients in Vegetative State (VS) and
Minimally Conscious State (MCS) in Italy.
Based on the national projects “Functioning and disability in VS and
MCS” (T0), the follow-up PRECIOUS “Taking care of people with
acquired severe brain injury” (T1) collected information on a sample
of patients with DOC in 107 post-acute rehabilitation and long term
institutions, located in the North, Central and South of Italy.
Out of 600 patients collected in T0, 587 patients were followed up. After
two years, 380 (64.7%) were alive and 109 of them (28.7%) changed place
of care. About them, 22% changed region. Movements to rehabilitation
centres range from 3% (South) to 7% (North). 51.3% of patients hosted in
northern structures moved to a long term care and 41.0% to domicile. In
the Centre, 69.6% went to domicile and 26.1% to long term care. In the
South, instead, 82.8% moved to domicile and 13.8% to a long term care.
As Italian Ministry of Health recommends, equal opportunities of
care should be provided to all patients, wherever they live in the
country. The high levels of people at home in centre and south Italy,
where also home care is inadequately provided, represent a lack in
the health and social systems.
doi:10.1016/j.jns.2013.07.2451
Abstract — WCN 2013
No: 2969
Topic: 36 — Other Topic
Italian study on functioning and disability of people with
disorder of consciousness
D. Sattin, M. Pagani, V. Covelli, A.M. Giovannetti, S. Schiavolin,
P. Meucci, A. Raggi, M. Cerniauskaite, R. Quintas, M. Leonardi.
Department of Clinical Neurosciences, Neurological Institute Carlo Besta
IRCCS Foundation, Milan, Italy
Background: The vegetative state (VS) and minimally conscious
state (MCS) are neurological conditions in which patients appear to
be awake but show no or partial signs of awareness of themselves or
of their environment. Patients require adequate health pathways but
the lack of epidemiological information creates difficulty in the
organisation of medical care and treatments.