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1.
Medicina UPB ; 40(2): 22-32, 13 oct. 2021. tab, Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1342177

ABSTRACT

Objetivo: mejorar la independencia funcional de los pacientes con enfermedad vascular cerebral (EVC) es uno de los objetivos que se plantean los equipos de rehabilitación física y cognitiva. Uno de los modelos que podría dar respuesta a este objetivo es el entrenamiento cognitivo de la memoria de trabajo (MT). Aunque esta estrategia se viene estudiando desde hace 20 años, aún es necesario realizar un estudio de revisión sistemática que permita conocer con claridad los efectos del entrenamiento cognitivo computarizado de la MT en el funcionamiento de la vida diaria en pacientes con EVC isquémica. Metodología: para ello, se creó una ecuación de búsqueda para aplicar en la base de datos Web of Science (WoS), en el rango temporal desde enero de 2010 a enero de 2019. Posteriormente, se realiza un análisis bibliométrico con el objetivo de identificar los autores y revistas más importantes sobre el tema de investigación. Finalmente, el reporte cronológico identifica la evolución y avances del impacto de los entrenamientos de la memoria de trabajo en la EVC. Resultados: se encontraron tres enfoques relacionados con: efectos de un programa de realidad virtual en las actividades de la vida diaria, efectos del entrenamiento de la MT en la plasticidad cerebral y efectos del entrenamiento cognitivo de la MT en las actividades de la vida diaria. Conclusión: se ha propuesto el desempeño cognitivo como uno de los componentes más importantes del funcionamiento en la vida diaria, particularmente la MT como mediador entre los programas de entrenamiento cognitivo y las habilidades funcionales. Los entrenamientos cognitivos reducen el deterioro cognitivo y el riesgo de demencia. Sin embargo, los beneficios de un entrenamiento cognitivo se limitan a dominios muy similares a los entrenados (transferencia cercana, más que lejana).


Objective: improving functional independence of patients with cerebrovascular disease has become one of the main goals for physical and cognitive rehabilitation teams. A well-known framework that addresses this issue is Working Memory Training. Although this model has been studied for more than twenty years, a systematic review on the effects of Working Memory Training after ischemic stroke and its impact on everyday functioning is still needed. Methodology: thus, a search equation has been proposed on Web of Science database from January 2010 to January 2019. Then, a bibliometric analysis presents the most important authors and journals in the research topic. Finally, a chronological report shows advanced research lines and effects of Working Memory Training in patients with cerebrovascular disease. Results:these findings showed 3 approaches related to the following: effects of virtual reality-based programs on everyday functioning, effects of Working Memory Training on brain plasticity, and effects of Working Memory Training on everyday life. Conclusion: cognitive performance has been proposed to be one of the most important components of functioning in daily life. Working Memory has been shown to strongly mediate between cognitive training and functional abilities. Cognitive training is asso-ciated with less cognitive decline and reduced risk of dementia. However, the benefits from cognitive training may be limited to highly similar domains (close transfer rather than far transfer).


Introdução: melhorar a independência funcional do paciente com doença cerebrovas-cular (DCV) é um dos objetivos traçados pelas equipes de reabilitação física e cognitiva. Um dos modelos que poderia responder a esse objetivo é o treinamento cognitivo da memória de trabalho (MT).Objetivo: embora essa estratégia seja estudada há 20 anos, ainda é necessário realizar um estudo de revisão sistemática que nos permita conhecer claramente os efeitos do treinamento cognitivo computadorizado da MT no funcionamento da vida diária em pacientes com DCV isquêmica.Metodologia: para isso, foi criada uma equação de busca a ser aplicada na base de dados Web of Science (WoS), no período de janeiro de 2010 a janeiro de 2019. Pos-teriormente, é realizada uma análise bibliométrica a fim de identificar os autores mais importantes e periódicos sobre o tema de pesquisa. Por fim, o relatório cronológico identifica a evolução e a evolução do impacto do treino da memória de trabalho no CVS.Resultados: foram encontradas três abordagens relacionadas a: efeitos de um programa de realidade virtual nas atividades da vida diária, efeitos do treinamento da MT na plas-ticidade cerebral e efeitos do treinamento cognitivo da MT nas atividades da vida diária.Conclusão: o desempenho cognitivo tem sido proposto como um dos componentes mais importantes do funcionamento na vida diária, particularmente a MT como media-dor entre programas de treinamento cognitivo e habilidades funcionais. O treinamento cognitivo reduz o declínio cognitivo e o risco de demência. No entanto, os benefícios do treinamento cognitivo são limitados a domínios muito semelhantes aos treinados (transferência próxima, em vez de distante).


Subject(s)
Humans , Cerebrovascular Disorders , Activities of Daily Living , Cognitive Dysfunction , Virtual Reality , Ischemic Stroke , Functional Status , Neuronal Plasticity
2.
Rev. cuba. oftalmol ; 34(1): e957, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289533

ABSTRACT

La enfermedad cerebrovascular isquémica tiene una elevada incidencia y prevalencia en Cuba, y constituye la tercera causa de muerte en el país. Existen diferencias anatómicas y clínicas entre el infarto de la circulación anterior y la posterior. En ocasiones, los elementos distintivos que ayudan al diagnóstico topográfico de la enfermedad cerebrovascular isquémica son las manifestaciones neuroftalmológicas. Con el objetivo de profundizar en el conocimiento actual sobre las alteraciones neuroftalmológicas que se asocian a la enfermedad cerebrovascular isquémica, se realizó una revisión bibliográfica, donde se consultaron un total de 69 fuentes de información digital de los últimos 5 años. La circulación cerebral se divide de manera general en anterior y posterior. Los síntomas y signos principales del ictus que afecta la circulación anterior son la desviación conjugada de la mirada, la afectación de las sácadas, la hemianopsia homónima, la heminegligencia y la apraxia de la apertura ocular; mientras que las alteraciones asociadas a la afectación de la circulación posterior son el nistagmo, las anormalidades en la alineación y los movimientos oculares, así como la hemianopsia homónima con conservación macular. Se concluye que en la enfermedad cerebrovascular isquémica aparecen síntomas y signos como consecuencia de la afectación, tanto de la vía visual aferente, como de la eferente. La hemianopsia homónima es el signo más frecuente reportado(AU)


Ischemic cerebrovascular disease has a high incidence and prevalence in Cuba, and it is the third cause of death in the country. A number of anatomical and clinical differences distinguish anterior from posterior circulation infarction. On certain occasions the distinguishing elements that aid in the topographic diagnosis of ischemic cerebrovascular disease are its neuro-ophthalmological manifestations. With the purpose of gaining insight into the current knowledge about the neuro-ophthalmological alterations associated to ischemic cerebrovascular disease, a bibliographic review was conducted based on the analysis of 69 digital information sources from the last five years. Cerebral circulation is generally divided into anterior and posterior. The main symptoms and signs of the stroke that affects anterior circulation are conjugate gaze deviation, altered saccades, homonymous hemianopsia, heminegligence and eyelid opening apraxia, whereas the alterations associated to posterior circulation involvement are nystagmus, eye movement and alignment abnormalities, and homonymous hemianopsia with macular preservation. It is concluded that ischemic cerebrovascular disease presents symptoms and signs related to both the afferent and the efferent visual pathways. Homonymous hemianopsia is the most common sign reported(AU)


Subject(s)
Humans , Cerebrovascular Circulation , Cerebrovascular Disorders/epidemiology , Hemianopsia/etiology , Review Literature as Topic , Neurologic Manifestations
3.
Chinese Medical Journal ; (24): 1431-1440, 2021.
Article in English | WPRIM | ID: wpr-878193

ABSTRACT

BACKGROUND@#The impacts of previous cardio-cerebrovascular disease (pre-CCVD) on the outcomes of hematopoietic cell transplantation (HCT) are not well described. Patients with pre-CCVD may often be poor candidates for HCT. This study aimed to investigate the impact of pre-CCVD on transplant outcomes.@*METHODS@#A retrospective study was conducted between patients with and without pre-CCVD who consecutively received allogeneic or autologous HCT between November 2013 and January 2020 with a matching of age and disease status. The cardiovascular complications and HCT outcomes of the two groups were evaluated and compared. The primary endpoints were post-transplant cardio-cerebrovascular disease (post-CCVD) and non-relapse mortality (NRM). We used a multivariable Cox proportional hazard model and the Fine-Gray competing risk regressions for analyses to estimate the hazard ratios (HRs).@*RESULTS@#The outcomes of 23 HCT recipients with pre-CCVD were compared with those of 107 patients in the control group. No significant differences were noted in terms of engraftment, overall survival (OS) (67.00% vs. 67.90%, P = 0.983), or relapse (29.78% vs. 28.26%, P = 0.561) between the pre-CCVD group and the control group. The cumulative incidences of 2-year NRM were similar between patients with pre-CCVD and the controls (14.68% vs. 17.08%, P = 0.670). However, pre-CCVD was associated with an increased incidence of post-CCVD (HR: 12.50, 95% confidence interval [CI]: 3.88-40.30, P < 0.001), which was an independent risk factor for increased NRM (HR: 10.29, 95% CI: 3.84-27.62, P < 0.001) and inferior OS (HR: 10.29, 95% CI: 3.84-27.62, P < 0.001).@*CONCLUSIONS@#These findings suggest that the existence of pre-CCVD before transplantation might not result in increased mortality directly but superpose the toxicity of the transplantation procedure, leading to a risk of post-CCVD. Post-CCVD was a powerful predictor for high NRM and inferior OS. Further risk stratification of pre-CCVD is needed to reduce NRM in various transplantation settings.


Subject(s)
Cerebrovascular Disorders/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Proportional Hazards Models , Retrospective Studies , Transplantation Conditioning , Transplantation, Autologous
4.
MedUNAB ; 24(2): 262-267, 20210820.
Article in Spanish | LILACS | ID: biblio-1291953

ABSTRACT

Introducción. La arteria basilar se forma de las arterias vertebrales, cursa sobre el puente y se bifurca originando las arterias cerebrales posteriores. Irriga parte del tronco encefálico, cerebelo, tálamo y los lóbulos occipitales y temporales cerebrales. Su obstrucción es rara (1% de los accidentes isquémicos), puede ocurrir en cualquier parte de su trayecto, con cuadro clínico diverso. En jóvenes se añaden otros factores de riesgo distintos a los cardiovasculares, se incluye el consumo de sustancias psicoactivas. El objetivo de este artículo es presentar el caso de un adulto joven, su evolución posterior a la intervención endovascular y la asociación, pasada por alto, al consumo de cannabinoides. Caso clínico. Individuo de 23 años con 14 horas de parálisis facial periférica derecha, diplopía, disartria, hemiparesia e hiperreflexia izquierda, disfagia, náuseas y emesis. Tomografía Axial Computarizada de cráneo simple sin alteraciones. Posteriormente, al realizarse resonancia magnética nuclear, se evidencia isquemia pontomesencefálica y focos isquémicos agudos lacunares en lóbulos cerebelosos. Se consideró comprometido el territorio de la arteria basilar, por lo que se realizó angiotomografía que evidenció una obstrucción crítica de dicho vaso a nivel del tercio distal. Se realizó trombectomía con stent-retriever con recanalización total de la arteria basilar con flujo en toda su extensión. Al egreso fue clasificado como TOAST idiopático. Conclusiones. Las escalas etiológicas para stroke creadas para adultos mayores sobreestiman la etiología idiopática en pacientes jóvenes, lo cual puede ocasionar que el consumo de cannabis sea pasado por alto como causante pese a la asociación reportada por la literatura.


Introduction. The basilar artery is formed from the vertebral arteries, runs over the pons and bifurcates, originating the posterior cerebral arteries. It irrigates part of the brainstem, cerebellum, thalamus, and the occipital and temporal lobes of the brain. Its obstruction is rare (1% of ischemic accidents), it can occur in any part of its path, with a diverse clinical condition. In young people, other risk factors other than cardiovascular ones are added; psychoactive substance use is included. The objective of this article is to present the case of a young adult, his evolution after endovascular intervention and the association, overlooked, to the consumption of cannabinoids. Clinical case. 23-year-old man with 14 hours of right peripheral facial paralysis, diplopia, dysarthria, left hyperreflexia and hemiparesis, dysphagia, nausea and emesis. Simple skull Computerized Axial Tomography without alterations. Subsequently, when a nuclear magnetic resonance was performed, pontomesencephalic ischemia and acute lacunar ischemic foci in the cerebellar lobes were evidenced. The basilar artery territory was considered compromised, so a CT angiography was performed, which revealed a critical obstruction of said artery at the level of the distal third. A stent-retriever thrombectomy was performed with total recanalization of the basilar artery with flow in its entirety. Upon discharge, he was classified as "idiopathic" according to the TOAST classification. Conclusions. The etiological scales for stroke created for older adults overestimate idiopathic etiology in young patients, which may cause cannabis use to be overlooked as a cause despite the association reported in the literature.


Introdução. A artéria basilar é formada pelas artérias vertebrais, passa pela ponte e se bifurca, originando as artérias cerebrais posteriores. Irriga parte do tronco cerebral, cerebelo, tálamo e os lobos occipital e temporal do cérebro. Sua obstrução é rara (1% dos acidentes isquêmicos), podendo ocorrer em qualquer parte de seu trajeto, com quadro clínico diverso. Nos jovens, são adicionados outros fatores de risco além dos cardiovasculares, incluindo o consumo de substâncias psicoativas. O objetivo deste artigo é apresentar o caso de um adulto jovem, sua evolução após a intervenção endovascular e a associação, despercebida, ao consumo de canabinoides. Caso clínico. Indivíduo de 23 anos com 14 horas de paralisia facial periférica direita, diplopia, disartria, hemiparesia e hiperreflexia esquerda, disfagia, náuseas e vômitos. Tomografia axial computadorizada de crânio simples sem alterações. Posteriormente, quando foi realizada a ressonância magnética nuclear, foram evidenciados isquemia pontomesencefálica e focos agudos de isquemia lacunar nos lobos cerebelares. O território da artéria basilar foi considerado comprometido, por isso foi realizada uma angiotomografia, que revelou uma obstrução crítica do referido vaso no terço distal. Foi realizada trombectomia stent-retriever com recanalização total da artéria basilar com fluxo em sua totalidade. No momento da alta, foi classificado como TOAST idiopática. Conclusões.As escalas etiológicas para AVC criadas para idosos superestimam a etiologia idiopática em pacientes jovens, o que pode fazer com que o uso de cannabis seja negligenciado como causa, apesar da associação relatada na literatura.


Subject(s)
Cerebrovascular Disorders , Basilar Artery , Cannabis , Reperfusion , Intracranial Embolism and Thrombosis , Young Adult
5.
Rev. Fundac. Juan Jose Carraro ; 24(44): 54-63, 2021.
Article in Spanish | LILACS | ID: biblio-1223712

ABSTRACT

La periodontitis es una enfermedad inflamatoria, crónica que afecta a los tejidos de soporte de los dientes y puede repercutir en la salud general, afectando la calidad de vida del paciente. La enfermedad de Alzheimer es una condición neurodegenerativa y progresiva que va disminuyendo la memoria, el lenguaje y aprendizaje de los pacientes. El objetivo de la investigación es realizar una revisión bibliográfica para comprender la posible vinculación entre la periodontitis y el Alzheimer. Los microorganismos periodontopatógenos producen una respuesta inflamatoria que, por vía sistémica, puede desencadenar un mecanismo inflamatorio dentro del sistema nervioso central. La respuesta del hospedero es liberar gran cantidad de moléculas proinflamatorias que comprometen la barrera hematoencefálica sobreestimulando a las células microgliales, esto conduce a la destrucción de neuronas vitales y al mantenimiento de la inflamación crónica que contribuye a la progresión del Alzheimer. Por otra parte, la periodontitis puede favorecer la formación de placas ateromatosas que afectan la integridad vascular siendo éste un factor a considerar en el desarrollo de la patología cerebrovascular. A pesar que son pocos los estudios clínicos experimentales, ya se puede sugerir la correlación entre ambas enfermedades (AU)


Periodontitis is a chronic inflammatory disease that affects the supporting tissues of teeth, affecting the systemic health and quality of life of the patient. Alzheimer's disease is a neurodegenerative and progressive condition that decreases memory, speech and learning of patients. The objective of this literature review was to report the possible link between periodontitis and Alzheimer's disease. Periodontopathogens produce an inflammatory response that, systemically, can trigger an inflammatory mechanism within the central nervous system. Due to this attack, the host releases a great quantity of proinflammatory molecules that compromise the blood-brain barrier by over- stimulation microglial cells, this produces destruction of vital neurons and maintenance the chronic inflammation in CNS and that contribute to the progression of Alzheimer's disease. On the other hand, periodontitis can favor the formation of atheromatous plaques that affect vascular integrity, being a factor to consider in the development of the cerebrovascular disease. Although there are few experimental clinical studies, the correlation between both diseases can already be suggested (AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Periodontitis/complications , Periodontitis/prevention & control , Alzheimer Disease/etiology , Cerebrovascular Disorders , Chronic Disease , Inflammation Mediators/physiology , Dental Plaque/prevention & control , Maintenance
6.
Rev. cuba. oftalmol ; 33(4): e951, oct.-dic. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1156579

ABSTRACT

La presión intraocular es considerada el único factor causal potencialmente modificable con el propósito de prevenir la ceguera por glaucoma. Esta es una enfermedad multifactorial y, aunque es el factor de riesgo más importante en su desarrollo, la reducción de sus valores no garantiza el cese de la progresión del daño glaucomatoso. El glaucoma primario de ángulo abierto y el glaucoma de presión normal comparten factores de riesgo similares en la patogénesis y se pueden clasificar en categorías mecánicas y vasculares. La evidencia científica actual ha logrado demostrar que existe una importante asociación entre las enfermedades sistémicas con compromiso vascular, como la migraña, la apnea obstructiva del sueño, la hipotensión arterial de diferentes causas, la hipertensión arterial, la enfermedad cerebrovascular, la cardiopatía isquémica y la diabetes mellitus con los hallazgos a nivel ocular en pacientes con neuropatía óptica glaucomatosa. Esta correlación orienta a considerar estas enfermedades en conjunto para que cada profesional dedicado a la salud visual considere siempre imprescindible la evaluación de los aspectos que vinculan estas enfermedades para actuar en consecuencia. Se realiza una búsqueda sobre el glaucoma y las enfermedades sistémicas con compromiso vascular(AU)


Intraocular pressure is considered to be the only potentially modifiable causative factor to prevent glaucoma blindness. However, glaucoma is a multifactorial disease, and true as it is that its main risk factor is intraocular pressure, its reduction does not ensure cessation of the progress of glaucomatous damage. Primary open angle glaucoma and normal pressure glaucoma share similar pathogenetic risk factors, and may be classified as mechanical or vascular. According to current scientific evidence, an important association exists between systemic diseases with vascular involvement, such as migraine, obstructive sleep apnea, arterial hypotension of various causes, arterial hypertension, cerebrovascular disease, ischemic heart disease and diabetes mellitus, and ocular findings in patients with glaucomatous optic neuropathy. In view of this correlation, these diseases should be considered jointly, so that visual health professionals always bear in mind the evaluation of their common characteristics and act in consequence. A search was carried out on glaucoma and systemic diseases with vascular compromise(AU)


Subject(s)
Humans , Glaucoma/diagnosis , Risk Factors , Intraocular Pressure , Review Literature as Topic , Cerebrovascular Disorders/etiology , Hypertension/etiology
7.
Arq. neuropsiquiatr ; 78(10): 642-650, Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131688

ABSTRACT

ABSTRACT Intracranial vessel wall imaging plays an increasing role in diagnosing intracranial vascular diseases. With the growing demand and subsequent increased use of this technique in clinical practice, radiologists and neurologists should be aware of the choices in imaging parameters and how they affect image quality, clinical indications, methods of assessment, and limitations in the interpretation of these images. Due to the improvement of the MRI techniques, the possibility of accurate and direct evaluation of the abnormalities in the arterial vascular wall (vessel wall imaging) has evolved, adding substantial data to diagnosis when compared to the indirect evaluation based on conventional flow analyses. Herein, the authors proposed a comprehensive approach of this technique reinforcing appropriated clinical settings to better use intracranial vessel wall imaging.


RESUMO O estudo angiográfico intracraniano não invasivo está sendo amplamente utilizado no diagnóstico de doenças vasculares intracranianas. Com a crescente demanda e o aumento subsequente do uso dessa técnica na prática clínica, radiologistas e neurologistas devem estar cientes das opções nos parâmetros de imagem e como estes afetam a qualidade da imagem, as indicações clínicas, os métodos de avaliação e as limitações na interpretação dessas imagens. Devido ao aprimoramento das técnicas de imagem por RM, a possibilidade de avaliação precisa e direta das anormalidades na parede vascular arterial (vessel wall imaging) evoluiu, agregando dados substanciais ao diagnóstico quando comparados à avaliação indireta baseada em análises de fluxo convencionais. Neste artigo, os autores discorrem sobre a avaliação e interpretação dos achados de imagem desta nova técnica e suas aplicações clínicas.


Subject(s)
Humans , Magnetic Resonance Imaging , Cerebrovascular Disorders , Magnetic Resonance Angiography/methods , Head
8.
Rev. cuba. med. mil ; 49(3): e580, jul.-set. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1144474

ABSTRACT

Introducción: El conocimiento y control del paciente con ictus puede contribuir a mejorar el pronóstico. Objetivo: Caracterizar a los pacientes geriátricos con ictus, que ingresan en la sala de cuidados intermedios de medicina. Métodos: Se realizó un estudio observacional y transversal, en pacientes geriátricos ingresados con ictus, en la sala de cuidados intermedios de medicina del Hospital Militar Central "Dr. Luis Díaz Soto". El universo fueron 680 pacientes con el diagnóstico clínico e imagenológico de ictus. Se estudiaron las variables: edad, sexo, formas clínicas, índices de NIHSS, antecedentes patológicos personales, morbilidad, letalidad y el estado de dependencia. Resultados: Predominó la forma isquémica (94 por ciento), la edad de 65 a 74 años (40 por ciento), el sexo masculino (61,5 por ciento) y el índice de NIHSS menor de 20 puntos (82,7 por ciento). La hipertensión arterial, la enfermedad cerebrovascular previa y la diabetes mellitus, fueron los antecedentes más frecuentes. La letalidad fue del 10,0 por ciento y la complicación más frecuente fue la bronconeumonía (16,9 por ciento). El 40 por ciento presentó un estado de dependencia total. Conclusiones: Se caracterizaron por el predominio de la forma isquémica, del sexo masculino, edad entre 70 y 79 años y la bronconeumonía como complicación. El índice de NIHSS elevado se asoció a una evolución no satisfactoria y aunque la letalidad en general no fue elevada, fue importante la presencia del estado de dependencia total. Esto exige un trabajo de rehabilitación importante para alcanzar una calidad de vida aceptable(AU)


Introduction: The knowledge and control of the stroke patient can contribute to improve the prognosis. Objective: To characterize geriatric patients with stroke, who enter the intermediate care unit of medicine. Methods: an observational and cross-sectional study was carried out, in geriatric patients admitted with stroke, in the medicine intermediate care room of the Hospital Militar Central Dr. Luis Díaz Soto. The universe was 680 patients with the clinical and imaging diagnosis of stroke. Variables studied were: age, sex, clinical forms, NIHSS indexes, personal pathological history, morbidity, lethality, and dependency status. Results: The ischemic form predominated (94 percent), the age from 65 to 74 years (40 percent), the male sex (61.5 percent) and the NIHSS index less than 20 points (82.7 percent). High blood pressure, previous cerebrovascular disease and diabetes mellitus were the most frequent antecedents. The lethality was 10.0 percent and the most frequent complication was bronchopneumonia (16.9 percent). 40 percent presented a state of total dependency. Conclusions: Patients were characterized by the predominance of the ischemic form, of the male sex, age between 70 and 79 years, and bronchopneumonia as a complication. The high NIHSS index was associated with an unsatisfactory evolution and although the overall case fatality was not high, the presence of the state of total dependence was important. This requires significant rehabilitation work to achieve an acceptable quality of life(AU)


Subject(s)
Humans , Male , Female , Aged , Bronchopneumonia , Cerebrovascular Disorders , Cross-Sectional Studies , Stroke , Diabetes Mellitus
9.
Rev. cuba. med. mil ; 49(3): e568, jul.-set. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1144478

ABSTRACT

Introducción: Las enfermedades cerebrovasculares son la tercera causa de muerte y la primera de invalidez en el mundo. Objetivo: Medir las asociaciones entre los ictus cerebrovasculares y sus factores de riesgo. Métodos: Se realizó un estudio descriptivo, la serie estuvo conformada por 904 pacientes con diagnóstico al ingreso de enfermedad cerebrovascular, en el período comprendido entre junio 2017 a junio 2018, en el Hospital Militar Central "Dr. Carlos J. Finlay". Se analizaron las formas clínicas de enfermedad cerebrovascular, a partir de las variables edad, sexo, hábito de fumar, alcoholismo, hipertensión arterial, diabetes mellitus, hipercolesterolemia e hipertrigliceridemia. Se utilizaron como medidas de resumen, las frecuencias absolutas y relativas. Resultados: El 54,7 por ciento de los pacientes eran mayores de 70 años y el 58,7 por ciento del sexo masculino. El hábito de fumar se constató en el 87,7 por ciento de pacientes con ictus aterotrombótico y en el 89,2 por ciento de los que tuvieron hemorragias intraparenquimatosas y el alcohol en el 64,6 por ciento de los pacientes con hemorragias intraparenquimatosas. Más del 80 por ciento de los pacientes con ictus isquémicos y hemorrágicos, eran hipertensos. El ictus cardioembólico se asoció en el 91,9 por ciento, con arritmia cardiaca. Conclusiones: La enfermedad cerebrovascular predominó por encima de los 70 años y del sexo masculino. Los ictus isquémicos son más frecuentes que los hemorrágicos. La hipertensión arterial y la diabetes mellitus fueron los factores de riesgo más frecuentes, tanto en los ictus isquémicos como hemorrágicos(AU)


Introduction: Cerebrovascular disease is the third leading cause of death and the first cause of disability in the world. Objective: To measure the associations between cerebrovascular strokes and their risk factors. Methods: A descriptive study was carried out, the series was made up of 904 patients diagnosed upon admission of cerebrovascular disease, in the period from June 2017 to June 2018 at the Hospital Militar Central Dr. Carlos J. Finlay. The different clinical forms of cardiovascular diseases were analyzed based on the variables age, sex, smoking, alcoholism, high blood pressure, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia. Absolute and relative frequencies were used as summary measures. Results: 54.7 percent of patients were older than 70 years and 58.7 percent were male. Smoking was found in 87.7 percent of atherothrombotic stroke and in 89.2 percent of intraparenchymal hemorrhages and alcohol in 64.6 percent of intraparenchymal hemorrhages. More than 80 percent of the patients with ischemic and haemorrhagic stroke were hypertensive, and cardioembolic stroke was associated in 91.9 percent with cardiac arrhythmia. Conclusions: Cerebrovascular disease was predominant over 70 years old and male. Ischemic strokes are more frequent than hemorrhagic ones. High blood pressure and diabetes mellitus were the most frequent risk factors for both ischemic and hemorrhagic strokes(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arrhythmias, Cardiac , Cardiovascular Diseases , Cerebrovascular Disorders , Stroke/complications , Smoking , Epidemiology, Descriptive , Diabetes Mellitus , Alcoholism
10.
Rev. Assoc. Med. Bras. (1992) ; 66(8): 1087-1092, Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136328

ABSTRACT

SUMMARY OBJECTIVE To identify the use of Potentially Inappropriate Medications with imminent risk of Cardiovascular and Cerebrovascular Adverse Events (PIM-CCVAE), in addition to the factors associated with a group of elderly individuals undergoing therapeutic care in a Brazilian public service. METHODS A cross-sectional retrospective study conducted at a secondary level service located in Carapicuíba, SP, Brasil. Only elderly individuals (≥60 years) who were treated in one of the outpatient departments were included. The use of PIM-CCVAE was defined based on the PIM-CCVAEs list. In this research, we used descriptive statistics and logistic regression to identify and track possible predictors of MPI use. All statistical analyses were performed using Stata software version 15.1 (Stata Corporation). RESULTS The sample included 233 elderly individuals, with a mean age of 74.9 (± 9.4) years. Of these, 74.2% used at least one PIM-CCVAE, with an average daily intake of 1.3 (± 1) PIM/elderly. The presence of comorbidities, diseases of the circulatory system, polypharmacy, and low to moderate scores in morbidity and mortality were important factors associated with an increased odds ratio for the consumption of PIM-CCVAE. It is also emphasized that the presence of neurological symptoms proved to be a protective factor for this outcome. CONCLUSION Given the clinical severity and imminent risk of CCVAE in the researched group, preventive measures should be instituted to minimize health problems related to medication in the public network.


RESUMO OBJETIVO Identificar o uso de Medicamentos Potencialmente Inapropriados (MPI) com risco iminente de EAM cardiovascular e cerebrovascular (EAM-CC), além dos fatores associados a um grupo de idosos em vigência terapêutica de um serviço público brasileiro. MÉTODOS Estudo seccional e retrospectivo realizado em um serviço de nível secundário localizado em Carapicuíba, SP, Brasil. Incluíram-se, apenas, idosos (idade ≥60 anos) que foram tratados em um departamento de atendimento ambulatorial. O uso de MPI com risco iminente de EAM-CC foi definido empregando a lista PIM-CCVAEs. Nesta pesquisa, apropriou-se da estatística descritiva e de regressão logística para identificação e rastreio de possíveis preditores de uso de MPI. Todas as análises estatísticas foram realizadas usando o software Stata version 15.1 (Stata Corporation). RESULTADOS Incluíram-se, na casuística, 233 idosos, com média de idade igual a 74,9 (±9,4) anos. Destes, 74,2% faziam uso de pelo menos um MPI com risco de EAM-CC, atingindo uma média de consumo diário igual a 1,3 (± 1) MPI/idoso. Verificou-se que a presença de comorbidades, doenças do aparelho circulatório, polifarmácia e score baixo a moderado em índices de morbimortalidade foram importantes fatores associados ao aumento da razão de chances para o consumo de MPI com risco de EAM-CC. Ressalta-se ainda que a presença de sintomas neurológicos mostrou-se como fator protetor para este desfecho. CONCLUSÃO Dada a gravidade clínica e o risco iminente de EAM-CC do grupo pesquisado, medidas de prevenção devem ser instituídas com o intuito de minimizar os problemas de saúde relacionados à medicação na rede pública.


Subject(s)
Humans , Aged , Aged, 80 and over , Cardiovascular System , Inappropriate Prescribing , Brazil , Cerebrovascular Disorders , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Polypharmacy
11.
Rev. enferm. Inst. Mex. Seguro Soc ; 28(3): 255-261, Jul-sept 2020. tab, graf
Article in Spanish | LILACS, BDENF | ID: biblio-1343181

ABSTRACT

Introducción: el incremento de la esperanza de vida, la mayor supervivencia de las personas con discapacidad y el crecimiento de las enfermedades crónicas elevan las cifras de personas en situación de dependencia. Esta transformación ha incrementado las necesidades de apoyo que van más allá de los servicios o programas formales y que requieren la incorporación de nuevas herramientas que permitan identificarlas. Desarrollo: se trata de la valoración de una persona en situación de dependencia a causa de una enfermedad vascular cerebral (EVC) con uso de la Escala de Intensidad de Apoyos (SIS). Los resultados muestran la pertinencia de incorporar al enfoque del cuidado de la enfermería un marco de evaluación que facilite la determinación de la frecuencia, tiempo y tipo de apoyo necesarios para el desarrollo de las actividades cotidianas, de tal modo que sea posible planificar de manera individualizada los apoyos requeridos para mejorar, mantener o recuperar la salud. Conclusiones: el modelo de intensidad de apoyos resultó de gran ayuda para evaluar la diferencia entre las capacidades/habilidades de la persona y los requerimientos/demandas que necesita para funcionar en su entorno; asimismo, permitió planificar el entorno y las adecuaciones ambientales, la cantidad de personas necesarias para el cuidado y el grado de capacitación para suministrar el cuidado previsto.


Introduction: The increase in life expectancy, the greater survival rate of people with disabilities and the growth of chronic diseases raise the numbers of people in situations of dependency. This transformation has increased support needs that go beyond formal services or programs and that require the incorporation of new tools to identify them. Development: This is the assessment of a person in a situation of dependency due to a cerebrovascular disease (EVC) using the Support Intensity Scale (SIS).The results show the pertinence of incorporating into the Nursing Care approach, an evaluation framework that facilitates the estimation of the frequency, time and type of support required for the development of daily activities, thus allowing the intensity to be individually planned of the supports required to improve, maintain or regain health. Conclusions: The support intensity model was of great help to evaluate the difference between the capacities / abilities of the person and the requirements / demands that he needs to function in his environment, as well as allowed to plan the environment and the environmental adaptations, the quantity of people required for care and the level of training needed to provide the intended care.


Subject(s)
Humans , Cerebrovascular Disorders , Disabled Persons , Nursing Care , Activities of Daily Living , Chronic Disease , Survival Rate , Life Expectancy , Health Services Needs and Demand , Institutional Practice
12.
Acta méd. colomb ; 45(2): 45-48, Jan.-June 2020. graf
Article in English | LILACS, COLNAL | ID: biblio-1130691

ABSTRACT

Moyamoya disease is a chronic neurovascular disease characterized by progressive bilateral stenosis of the internal carotid arteries with abnormal formation of new abnormal blood vessels whose blockage of blood flow causes a variety of clinical manifestations and complications associated with acute cerebrovascular events (ischemic or hemorrhagic), which may even be fatal. This article seeks to describe this entity, its incidence, prevalence, forms of presentation, therapeutic measures and prognosis through a clinical case report. (Acta Med Colomb 2020; 45. DOI:http://doi.org/10.36104/amc.2020.1424).


La enfermedad de Moyamoya es una enfermedad neurovascular crónica caracterizada por una estenosis progresiva bilateral de las arterias carótidas internas, con la formación anormal de nuevos vasos sanguíneos, cuyo bloqueo en flujo sanguíneo ocasiona variadas manifestaciones clínicas y complicaciones asociadas a eventos cerebrovasculares (isquémicos o hemorrágicos) agudos que pueden llegar a ser incluso mortales. El presente artículo pretende realizar una aproximación acerca de esta entidad, su incidencia, prevalencia, formas de presentación y medidas terapéuticas y pronostico mediante el reporte de un caso clínico.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1424).


Subject(s)
Humans , Female , Adult , Moyamoya Disease , Prognosis , Blood Vessels , Carotid Arteries , Cerebrovascular Disorders , Prevalence , Basal Ganglia Cerebrovascular Disease
13.
Arq. neuropsiquiatr ; 78(5): 290-300, May 2020. tab, graf
Article in English | LILACS | ID: biblio-1131705

ABSTRACT

ABSTRACT Background: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. Objective: To review the literature on neurological complications of SARS-CoV-2 infection. Methods: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. Results: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. Conclusion: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.


RESUMO Introdução: À medida que a pandemia da COVID-19 se desenvolve em todo o mundo, diferentes tipos de publicações descreveram suas manifestações neurológicas. Objetivo: Revisar a literatura sobre complicações neurológicas da infecção por SARS-CoV-2. Métodos: A pesquisa bibliográfica foi realizada seguindo diretrizes de revisões sistemáticas, usando palavras-chave específicas baseadas nas complicações neurológicas da COVID-19 descritas até 10 de maio de 2020. Resultados: Foram selecionados 43 artigos, incluindo descrições que variam de sintomas comuns e inespecíficos, como hiposmia e mialgia, a condições mais complexas e com risco de vida, como doenças cerebrovasculares, encefalopatias e síndrome de Guillain-Barré. Conclusão: O reconhecimento das manifestações neurológicas da SARS-CoV-2 deve ser enfatizado apesar dos óbvios desafios enfrentados pelos clínicos que cuidam de pacientes críticos, muitas vezes sedados e apresentando outras complicações sistêmicas concomitantes.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Nervous System Diseases/complications , Brain Diseases/complications , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/physiopathology , Coronavirus Infections , Guillain-Barre Syndrome/complications , Ageusia/complications , Pandemics , Myalgia/complications , Olfaction Disorders/complications , Nervous System Diseases/physiopathology
14.
Cad. Saúde Pública (Online) ; 36(4): e00227718, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1089454

ABSTRACT

O objetivo foi avaliar os fatores sociodemográficos e clínicos relacionados à falta de assistência hospitalar em óbitos por doença cerebrovascular (DCV) e DCV hemorrágica, no Estado de São Paulo, Brasil, nos triênios 1996-1998 e 2013-2015. Foram utilizados dados dos óbitos provenientes do Sistema de Informações sobre Mortalidade. Para analisar a associação entre a falta de atendimento hospitalar e as variáveis consideradas no estudo utilizou-se a regressão de Poisson. Dos 127.319 indivíduos que morreram por DCV nos dois triênios, 19.362 (15,2%) não tiveram assistência hospitalar. A falta de atendimento hospitalar em óbitos por DCV manteve-se praticamente inalterada para as características sociodemográficas e clínicas, exceto a distribuição por sexo. No período mais recente, identificou-se maior risco de óbito por DCV sem assistência hospitalar entre indivíduos de cor da pele amarela (RR = 1,48), já em pessoas de cor preta (RR = 0,85), parda (RR = 0,86), nos casados (RR = 0,70), naqueles que residiam no Município de São Paulo (RR = 0,92), nos que tiveram assistência médica (RR = 0,17) e naqueles acometidos pela DCV hemorrágica (RR = 0,47) o risco de óbito sem assistência hospitalar foi menor. Além disso, a falta de atendimento hospitalar em óbitos por DCV hemorrágica foi menor entre os casados (RR = 0,67), naqueles que residiam no Município de São Paulo (RR = 0,74) e nos que tiveram assistência médica (RR = 0,08). As características sociodemográficas e clínicas estiveram associadas com a falta de assistência hospitalar em óbitos por DCV e DCV hemorrágica, sugerindo que há diferenças no atendimento ao paciente com DCV.


The objective was to assess sociodemographic and clinical factors related to the lack of hospital care in deaths from ischemic and hemorrhagic cerebrovascular disease (CVD) in the state of São Paulo, Brazil, in 1996-1998 and 2013-2015. The study used data on deaths from the Mortality Information System. Poisson regression was used to analyze the association between lack of hospital care and the study variables. Of the 127,319 individuals that died of CVD in the two three-years periods, 19,362 (15.2%) had failed to receive hospital care. Lack of hospital care in deaths from CVD remained practically unchanged in relation to sociodemographic and clinical characteristics, except for distributions by sex. The more recent three-year period showed higher risk of death from CVD without hospital care among Asian-descendant individuals (RR = 1.48), while lower risk of death from CVD without hospital care in the more recent period was associated with black color (RR = 0.85), brown color (RR = 0.86), married individuals (RR = 0.70), those living in the capital city of São Paulo (RR = 0.92), those who received medical care (RR = 0.17), and those with hemorrhagic CVD (RR = 0.47). In addition, lack of hospital care in deaths from hemorrhagic CVD was lower among married individuals (RR = 0.67), those living in the capital city of São Paulo (RR = 0.74), and those who received medical care (RR = 0.08). Sociodemographic and clinical characteristics were associated with the lack of hospital care in deaths from ischemic and hemorrhagic CVD, suggesting that there are differences in care for CVD patients.


El objetivo fue evaluar factores sociodemográficos y clínicos, relacionados con la falta de asistencia hospitalaria en óbitos por enfermedad cerebrovascular (ECV) y ECV hemorrágica, en el Estado de São Paulo, Brasil, durante los trienios 1996-1998 y 2013-2015. Se utilizaron datos de los óbitos procedentes del Sistema de Informaciones sobre Mortalidad. Para analizar la asociación entre la falta de atención hospitalaria y las variables consideradas en el estudio se utilizó la regresión de Poisson. De los 127.319 individuos que murieron por ECV en los dos trienios, 19.362 (15,2%) no tuvieron asistencia hospitalaria. La falta de atención hospitalaria en óbitos por ECV se mantuvo prácticamente inalterada, respecto a las características sociodemográficas y clínicas, excepto en la distribución por sexo. En el período más reciente se identificó un mayor riesgo de óbito por ECV sin asistencia hospitalaria entre individuos de ascendencia asiática (RR = 1,48), mientras que en personas afrodescendientes (RR = 0,85), mestizos (RR = 0,86), casados (RR = 0,70), en aquellos que residían en el municipio de São Paulo (RR = 0,92), en quienes contaron con asistencia médica (RR = 0,17) y en aquellos afectados por la ECV hemorrágica (RR = 0,47), el riesgo de muerte sin asistencia hospitalaria fue menor. Además, la falta de atención hospitalaria en fallecimientos por ECV hemorrágica fue menor entre los casados (RR = 0,67), en aquellos que residían en el municipio de São Paulo (RR = 0,74) y en los que contaron asistencia médica (RR = 0,08). Las características sociodemográficas y clínicas se asociaron con la falta de asistencia hospitalaria en óbitos por ECV y ECV hemorrágica, sugiriendo que existen diferencias en la atención al paciente con una ECV.


Subject(s)
Humans , Male , Female , Adult , Aged , Cerebrovascular Disorders/mortality , Health Services Accessibility/statistics & numerical data , Socioeconomic Factors , Brazil/epidemiology , Cause of Death , Cities , Sex Distribution , Age Distribution , Hospitalization , Middle Aged
15.
Pan Afr. med. j ; 35(2)2020.
Article in English | AIM | ID: biblio-1268659

ABSTRACT

Introduction: coronavirus is a virus with potential to target the nervous and respiratory systems. The aim of this work is to establish the prevalence of strokes in COVID19 positive patients in Guinea. Methods: all patients with stroke confirmed by brain imaging and COVID-positive PCR were included in this study. Retrospective patient data were obtained from medical records. Informed consent was obtained. Results: the RT-PCR confirmed the initial diagnosis and the chest CT scan provided a good diagnostic orientation. Brain imaging identified ischemic brain lesions. We report the case of four patients with stroke and a COVID-19 incidental finding in Guinea.Conclusion: this work shows that the onset of ischemic stroke associated with COVID-19 is generally delayed, but can occur both early and late in the course of the disease. More attention is needed because the early symptoms of viral attack are not just pulmonary


Subject(s)
COVID-19 , Cerebrovascular Disorders , Guinea , Stroke
16.
Rev. baiana saúde pública ; 43(4): 26-43, 20191212.
Article in Portuguese | LILACS | ID: biblio-1343553

ABSTRACT

O objetivo deste estudo foi descrever as taxas de mortalidade e de internação por doenças do aparelho circulatório, em municípios localizados na região norte do Espírito Santo. Foram utilizados dados do Sistema de Informação de Mortalidade e do Sistema de Informação de Internação Hospitalar, dos municípios de Conceição da Barra, Jaguaré, Pedro Canário e São Mateus, no período de 2004 a 2014. Verificou-se o aumento progressivo de mortes e internações por grupo de doenças do aparelho circulatório nos municípios estudados. O coeficiente de mortalidade mais elevado foi em Conceição da Barra (2010) por doença isquêmica do coração entre os homens, e em mulheres (2006) por doenças cerebrovasculares. Os mais elevados coeficientes de internação foram observados em São Mateus (2013) entre os homens, e em Pedro Canário (2014) entre as mulheres, ambos relacionados às doenças cerebrovasculares. Todos os municípios apresentam coeficiente de mortalidade e de internação elevados.


This study aimed to describe mortality and hospitalization rates due to diseases of the circulatory system, in municipalities located in the northern region of the state of Espírito Santo. Data from the Mortality Information System and Hospital Inpatient Information System were used in the municipalities of Conceição da Barra, Jaguaré, Pedro Canário and São Mateus in the period 2004-2014. There was a progressive increase in deaths and hospitalizations per group of diseases of the circulatory system in the municipalities studied. The highest mortality rate was in Conceição da Barra (2010) due to ischemic heart disease among men, and in women (2006) due to cerebrovascular diseases. The highest coefficients of hospitalization were observed in São Mateus (2013) among men, and in Pedro Canário (2014) among women, both related to cerebrovascular diseases. All municipalities have high mortality and hospitalization rates.


El objetivo de este estudio fue describir las tasas de mortalidad y hospitalización por enfermedades del sistema circulatorio, en municipios ubicados en la región norte de Espírito Santo (Brasil). Se utilizaron datos del Sistema de Información de Mortalidad y del Sistema de Información de Internación Hospitalaria en los municipios de Conceição da Barra, Jaguaré, Pedro Canario y São Mateus, en el período 2004-2014. Se verificó el aumento progresivo de muertes y hospitalizaciones por grupo de enfermedades del sistema circulatorio en los municipios estudiados. El coeficiente de mortalidad más elevado fue en Conceição da Barra (2010) por enfermedad isquémica del corazón entre los hombres y en mujeres (2006) por enfermedades cerebrovasculares. Los más altos coeficientes de hospitalización fueron observados en São Mateus (2013) entre los hombres y en Pedro Canario (2014) entre las mujeres, ambos relacionados a las enfermedades cerebrovasculares. Todos los municipios presentan coeficiente de mortalidad e internación elevado.


Subject(s)
Cardiovascular Diseases , Cardiovascular System , Cerebrovascular Disorders , Hospitalization
17.
Rev. medica electron ; 41(3): 628-640, mayo.-jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1094072

ABSTRACT

RESUMEN Introducción: la prevalencia del síndrome metabólico, a nivel mundial, es muy elevada y continúa en aumento vertiginosamente en los últimos años. Por lo que se puede considerar una pandemia de la época contemporánea, se estima que el 25 % de la población adulta la padece. Objetivo: determinar la prevalencia del síndrome metabólico e identificar otras formas clínicas de enfermedad vascular ateroesclerótica, en gerontes hospitalizados en Servicios de Geriatría del Hospital Provincial Clínico Quirúrgico Docente "Celia Sánchez Manduley", Manzanillo, Granma; en el período comprendido entre junio 2015 a junio 2016. Materiales y métodos: se realizó estudio observacional, descriptivo, de corte transversal. Se incluyeron los 120 senescentes que ingresaron en los Servicios de Geriatría. Resultados: se estableció el diagnóstico de síndrome metabólico en 105 individuos de 120 sujetos estudiados. El grupo de 70-79 años de edad y el sexo masculino fueron los más afectados por la endocrinopatía. Las otras formas clínicas de enfermedad vascular ateroesclerótica que se identificaron en los senescentes estudiados, fueron: cardiopatía isquémica, enfermedad cerebrovascular y cardiopatía hipertensiva. Conclusiones: existe una alta prevalencia del síndrome metabólico en los adultos mayores estudiados.


ABSTRACT Introduction: the prevalence of the metabolic syndrome is very high around the world and is still vertiginously increasing in the last years. Therefore, it can be considered a pandemic of the current times. It is thought that 25 % of the adult population suffers it. Objective: to determine the prevalence of the metabolic syndrome and to identify other clinical forms of the atherosclerotic vascular disease in elder people who entered the Service of Geriatrics of the Provincial Teaching Clinical Surgical Hospital "Celia Sanchez Manduley", of Manzanillo, Granma, in the period from June 2015 to June 2016. Materials and methods: a cross-sectional, observational, descriptive study was carried out with the inclusion of the 120 elder people who the Service of Geriatrics. Results: 105 individuals of 129 studied were diagnosed with metabolic syndrome. The 79-79 age group and male sex were the most affected by endocrinopathy. Other clinical forms of the arteriosclerotic vascular disease identified in the studied elder people were ischemic heart disease, cerebrovascular disease and hypertensive heart disease. Conclusions: there is a high prevalence of the metabolic syndrome among the studied elder people.


Subject(s)
Humans , Aged , Aging , Cerebrovascular Disorders/diagnosis , Risk Factors , Myocardial Ischemia/diagnosis , Metabolic Syndrome/diagnosis , Metabolic Syndrome/etiology , Metabolic Syndrome/prevention & control , Metabolic Syndrome/therapy , Metabolic Syndrome/epidemiology , Diabetes Mellitus, Type 2/diagnosis , Geriatrics , Epidemiology, Descriptive , Cross-Sectional Studies , Hospital Care , Obesity, Abdominal/diagnosis , Early Medical Intervention , Observational Study , Hypertension/diagnosis
18.
Rev. cuba. inform. méd ; 11(1)ene.-jun. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093305

ABSTRACT

La anestesia general proporciona al paciente estados de inconciencia, amnesia y analgesia, sin embargo, se reportan casos de despertar intraoperatorio. Debido a la incidencia de este fenómeno y sus efectos psicosomáticos, el Centro de Estudios de Neurociencias, Procesamiento de Imágenes y Señales en la Universidad de Oriente, y el Hospital General Juan Bruno Zayas Alfonso ambos en Santiago de Cuba, Cuba, implementan una metodología que permita detectar automáticamente estados de sedación anestésica aplicando Inteligencia Artificial. Para esto se emplearon las señales registradas por el canal electroencefalográfico F4, nueve parámetros espectrales, las Máquinas de Soporte Vectorial y los Sistemas Neuro-Difusos. En el reconocimiento automático de los estados de Sedación Profunda, Moderada y Ligera se logró una Exactitud de 96.12 por ciento, 90.06 por ciento y 90.24 por ciento respectivamente con las Máquinas de Soporte Vectorial, por lo que se propone el uso del canal electroencefalográfico F4 en la detección de estados anestésicos(AU)


General anesthesia provide the patient states of unconsciousness, amnesia and analgesia, however, cases of intraoperative awareness are reported. Due to the incidence of this phenomenon and the psychosomatic effects it causes, the Neuroscience Studies Center, Images and Signals Processing at the University of Oriente, and the General Hospital Juan Bruno Zayas Alfonso both in Santiago de Cuba, Cuba, implement a methodology that allows the automatic detection of anesthetic sedation states applying Artificial Intelligence. For this, the signals recorded by the electroencephalographic channel F4, nine spectral parameters, the Support Vector Machines and the Neuro-Fuzzy Systems were used. In the automatic recognition of the Sedation States: Profound, Moderate and Mild an Accuracy of 96.12 percent, 90.06 percent and 90.24 percent respectively was achieved with the Support Vector Machines, so the use of the electroencephalographic channel F4 is proposed in the detection of anesthetic states(AU)


Subject(s)
Cerebrovascular Disorders/diagnostic imaging , Electroencephalography/methods , Deep Sedation , Intraoperative Awareness
19.
Rev. bras. anestesiol ; 69(3): 311-314, May-June 2019. graf
Article in English | LILACS | ID: biblio-1013425

ABSTRACT

Abstract Reversible cerebral vasoconstriction syndrome is a cerebrovascular disorder leading to multifocal arterial constriction and dilation. Reversible cerebral vasoconstriction syndrome is possibly caused by transient deregulation of cerebral vascular tone. We report a rare case of a patient with chief complain of postpartum headache, was later diagnosed as a case of reversible cerebral vasoconstriction syndrome. A young full term primigravida with good uterine contraction admitted to labour room. Later she complained of leaking per vagina and on examination meconium stained liquor was noted. Caesarean delivery under spinal anesthesia was done and intra-operative period was uneventful. Both mother and baby were normal and shifted to postoperative ward and nursery respectively. In postoperative ward, mother complained of severe headache after 1 h and later developed seizure. Midazolam was given intravenously and was intubated and transferred to critical care unit for further investigation and management. Non contrast computerised tomography scan of brain showed right occipital intracerebral as well as subarachnoid bleed. CT angiography showed right vertebral artery narrowing without any other vascular malformation. Patient was managed in critical care unit for 2 days and then extubated and shifted to high dependency ward after a day observation and discharged 3 days later after a full uneventful recovery.


Resumo A síndrome de vasoconstrição cerebral reversível é uma doença cerebrovascular que leva à constrição e dilatação arterial multifocal. A síndrome de vasoconstrição cerebral reversível é possivelmente causada pela desregulação transitória do tônus vascular cerebral. Relatamos um caso raro de uma paciente com queixa principal de cefaleia pós-parto, posteriormente diagnosticada como um caso de síndrome de vasoconstrição cerebral reversível. A jovem primigesta a termo apresentando boa contração uterina foi internada em sala de parto. Mais tarde, a parturiente queixou-se de perda de líquido pela vagina e, ao exame, líquido amniótico manchado foi observado. O parto cesariano sob raquianestesia foi realizado, e não houve intercorrência no período intraoperatório. Tanto a mãe quanto o bebê estavam normais e foram transferidos para a sala de recuperação pós-operatória e berçário, respectivamente. Na sala de recuperação, a mãe queixou-se de forte dor de cabeça após uma hora e depois desenvolveu convulsão. Midazolam foi administrado por via intravenosa, e a paciente foi intubada e transferida para uma unidade de terapia intensiva para posterior investigação e tratamento. A tomografia computadorizada sem contraste do cérebro mostrou hemorragia intracerebral occipital direita e subaracnoide. A angiotomografia mostrou estreitamento da artéria vertebral direita, sem qualquer outra malformação vascular. A paciente foi tratada em unidade de terapia intensiva por dois dias e, em seguida, foi extubada e transferida para a ala de alta dependência onde permaneceu um dia em observação, recebendo alta hospitalar três dias depois, após uma recuperação completa e sem intercorrências.


Subject(s)
Humans , Female , Pregnancy , Adult , Vasoconstriction , Cerebrovascular Disorders/diagnostic imaging , Postpartum Period , Headache/etiology , Syndrome , Computed Tomography Angiography/methods , Headache/diagnostic imaging , Anesthesia, Obstetrical/methods , Anesthesia, Spinal/methods
20.
Arq. neuropsiquiatr ; 77(3): 208-214, Mar. 2019. graf
Article in English | LILACS | ID: biblio-1001340

ABSTRACT

ABSTRACT The present article provides the historical background of the Sociedade Brasileira de Doenças Cerebrovasculares (Brazilian Society for Cerebrovascular Diseases), including details on its function, structure, challenges and main achievements.


RESUMO O presente texto apresenta um relato histórico da Sociedade Brasileira de Doenças Cerebrovasculares, incluindo detalhes da sua fundação, estruturação, dificuldades e principais realizações.


Subject(s)
Humans , History, 20th Century , History, 21st Century , Societies, Medical/history , Cerebrovascular Disorders/prevention & control , Societies, Medical/organization & administration , Societies, Medical/trends , Brazil , Guidelines as Topic
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