ABSTRACT
Introducción: El Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Española de Neurología publicó en el año 2006 el Plan de Atención Sanitaria del Ictus (PASI) con el objetivo de elaborar un sistema organizado de atención al ictus que dé respuesta a las necesidades de cada enfermo y optimice la utilización de los recursos sanitarios. Este plan pretendía garantizar la equidad en la atención sanitaria del paciente con ictus. La Estrategia Nacional en Ictus del Sistema Nacional de Salud aprobada en el año 2008 recogió en gran medida el tipo de modelo organizativo sanitario del PASI. Sin embargo, en el tiempo transcurrido desde su publicación, han aparecido nuevos avances en el tratamiento de la fase aguda del infarto cerebral que obligan a realizar una revisión del mismo. Fuentes: Un comité de 19 neurólogos especialistas en patología neurovascular y representativos de las diferentes comunidades autónomas han revisado el PASI con el objetivo de incorporar los nuevos avances del tratamiento en la fase aguda del infarto cerebral. Esta revisión se ha basado en una revisión de la literatura científica y en la experiencia acumulada con el plan anterior. Desarrollo: El nuevo modelo organizativo propuesto debe hacer hincapié en las características de los diferentes niveles asistenciales con la potenciación de Hospitales de Referencia, establecer nuevos criterios de activación del Código Ictus menos restrictivos que contemplen las nuevas posibilidades terapéuticas, establecer medidas organizativas para la implantación del intervencionismo neurovascular y permitir la utilización del recurso técnico de la telemedicina (AU)
Introduction: The Spanish Stroke Group published the Plan for stroke healthcare delivery in 2006 with the aim that all stroke patients could receive the same degree of specialised healthcare according to the stage of their disease, independently of where they live, their age, gender or ethnicity. This Plan needs to be updated in order to introduce new developments in acute stroke. Methods: A committee of 19 neurologists specialised in neurovascular diseases representing different regions of Spain evaluated previous experience with this Plan and the available scientific evidence according to published literature. Background: The new organised healthcare system must place emphasis on the characteristics of the different care levels with promotion of Reference Stroke Hospitals, set up less restrictive Stroke Code activation criteria that include new therapeutic options, establish new standard measures for endovascular treatment and develop tele-medicine stroke networks (AU)
Subject(s)
Humans , Stroke/epidemiology , Health Equity , Health Plan Implementation , Outcome and Process Assessment, Health Care , Sanitary Code , Universal Access to Health Care Services , Practice Patterns, Physicians'/organization & administrationABSTRACT
INTRODUCTION: The Spanish Stroke Group published the "Plan for stroke healthcare delivery" in 2006 with the aim that all stroke patients could receive the same degree of specialised healthcare according to the stage of their disease, independently of where they live, their age, gender or ethnicity. This Plan needs to be updated in order to introduce new developments in acute stroke. METHODS: A committee of 19 neurologists specialised in neurovascular diseases representing different regions of Spain evaluated previous experience with this Plan and the available scientific evidence according to published literature. BACKGROUND: The new organised healthcare system must place emphasis on the characteristics of the different care levels with promotion of Reference Stroke Hospitals, set up less restrictive Stroke Code activation criteria that include new therapeutic options, establish new standard measures for endovascular treatment and develop tele-medicine stroke networks.
Subject(s)
Delivery of Health Care , Health Planning , Stroke/therapy , Hospital Units/organization & administration , Hospital Units/standards , Hospitals , Humans , Spain , TelemedicineSubject(s)
Literature, Modern , Medicine in Literature , Myasthenia Gravis/history , Female , History, 19th Century , Humans , SpainABSTRACT
Three patients with Guillain-Barré syndrome (GBS) during active brucellosis are reported: in one of them, who had an unfavorable outcome, the clinical features, the neurophysiological studies and the sural nerve biopsy were consistent with the axonal form of GBS. In the remaining two patients, who had a satisfactory course, the neurophysiological studies and the sural nerve biopsy disclosed the demyelinating character of the disease. We agree with other authors that the axonal and demyelinating forms of GBS should be separated, in view of their different clinical and possibly pathogenetic implications, both in GBS in general and in the form associated with brucellosis.
