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1.
J Clin Periodontol ; 46(1): 20-30, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30362631

RESUMEN

AIM: To investigate the association between periodontitis (PD) and lacunar infarct (LI) as well as to analyse whether PD could be a predictor of poor functional prognosis in patients with LI. MATERIAL AND METHODS: Full-mouth periodontal examination was done in 120 cases (patients with LI) and 157 healthy controls. Demographic, clinical, medical and neurological information were collected from all of them. In addition, a measure of periodontal inflammation and disease activity, namely the periodontal inflamed surface area (PISA), was also calculated for each patient. Poor functional outcome was considered as a modified Rankin Scale >2 at 3 months. RESULTS: PD was independently associated with the presence of LI (OR = 3.3, p < 0.001). Poor outcome was observed in 31 patients with LI (25.8%), of which 90.3% had PD. A PISA value ≥727 mm2 was an independent predictor of poor prognosis, after adjusting for clinical confounders (OR = 6.5, p = 0.001). CONCLUSIONS: PD and LI were associated. Active moderate to severe PD predicted poor prognosis in patients with LI. Further evidence is warranted to confirm our results and investigate potential mechanisms behind this association.


Asunto(s)
Periodontitis , Accidente Vascular Cerebral Lacunar , Humanos , Inflamación , Factores de Riesgo
2.
Neuroscience ; 550: 30-42, 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38387732

RESUMEN

The constant failure of new neuroprotective therapies for ischemic stroke has partially halted the search for new therapies in recent years, mainly because of the high investment risk required to develop a new treatment for a complex pathology, such as stroke, with a narrow intervention window and associated comorbidities. However, owing to recent progress in understanding the stroke pathophysiology, improvement in patient care in stroke units, development of new imaging techniques, search for new biomarkers for early diagnosis, and increasingly widespread use of mechanical recanalization therapies, new opportunities have opened for the study of neuroprotection. This review summarizes the main protective agents currently in use, some of which are already in the clinical evaluation phase. It also includes an analysis of how recanalization therapies, new imaging techniques, and biomarkers have improved their efficacy.


Asunto(s)
Accidente Cerebrovascular Isquémico , Neuroprotección , Fármacos Neuroprotectores , Humanos , Accidente Cerebrovascular Isquémico/terapia , Fármacos Neuroprotectores/uso terapéutico , Fármacos Neuroprotectores/farmacología , Animales , Neuroprotección/fisiología
3.
Protoplasma ; 261(3): 477-486, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38030853

RESUMEN

Differences in stomatal density (SD) and stomatal index (SI) are associated with the conditions of the environment in which they are distributed. Mimosa species are important elements in different plant communities, yet knowledge of the ecological implications of its stomatal characteristics is scarce. For this reason, SD and SI were determined in seven Mimosa species from different environments in this study. Five individuals per species were selected, and a sample of leaflets was obtained from each. Fifteen mature leaflets per individual were then extracted and observed by optical microscopy. SD, SI, epidermal cell density (ECD), and guard cell length (GCL) values were obtained. Differences between species were analyzed through a balanced analysis of variance test, and the correspondence between the stomatal characteristics and 21 climate variables was determined by canonical correspondence analysis. The species differed in all evaluated characteristics. It should be noted that only M. affinis showed differences between the leaflet surfaces. Both DE and ECD were negatively associated with altitude and solar radiation and positively with temperature and precipitation. SI was explained by temperature and seasonality of precipitation, and GCL by temperature oscillation and seasonality of precipitation. The results suggest that the stomatal characteristics of the leaflets confer resistance in the species to alterations in environmental conditions.


Asunto(s)
Fabaceae , Mimosa , Humanos , Hojas de la Planta , Temperatura , Plantas , Estomas de Plantas
4.
Stroke ; 42(10): 2813-8, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21836082

RESUMEN

BACKGROUND AND PURPOSE: Clinical-diffusion mismatch (CDM; National Institutes of Health Stroke Scale score≥8 and diffusion-weighted imaging lesion volume<25 mL) has been suggested as a surrogate of ischemic brain at risk of infarction and might be used to recognize salvageable ischemic tissue. Our aim was to identify early biomarkers associated with the presence of CDM. METHODS: We prospectively evaluated CDM in 226 patients (71.6±11.1 years, 58% men) with hemispheric ischemic stroke within 12 hours from symptom onset (median, 3.6 hours). Diffusion-weighted MRI lesion volume was measured by manual segmentation method. Serum levels of glutamate, aspartate, interleukin-10, tumor necrosis factor-α, interleukin-6, S100ß, neuron-specific enolase, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, active matrix metalloproteinase-9, and cellular fibronectin were determined by immunoassay or high-performance liquid chromatography techniques in blood samples obtained at admission. RESULTS: CDM was found in 61 patients (26.9%). Patients with CDM had higher serum levels of interleukin-10, tumor necrosis factor-α, and glutamate and lower serum levels of neuron-specific enolase, interleukin-6, and active matrix metalloproteinase-9 (all P<0.0001). Binary logistic regression showed that tumor necrosis factor-α≥21 pg/mL (OR, 21), glutamate≥230 µmol/L (OR, 27), neuron-specific enolase≥23 ng/mL (OR, 0.05), interleukin-6≥10 pg/mL (OR, 0.06), and active matrix metalloproteinase-9≥21 ng/mL (OR, 0.28) were independent molecular predictors of CDM after adjustment for covariates. The association of interleukin-10≥23 pg/mL and glutamate≥230 µmol/L levels predicted CDM with a sensitivity of 96% and a specificity of 98%. CONCLUSIONS: High levels of interleukin-10, tumor necrosis factor-α, and glutamate as well as low levels of neuron-specific enolase, interleukin-6, and active matrix metalloproteinase-9 are associated with CDM.


Asunto(s)
Biomarcadores/sangre , Isquemia Encefálica/sangre , Accidente Cerebrovascular/sangre , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/patología , Imagen de Difusión por Resonancia Magnética , Femenino , Ácido Glutámico/sangre , Humanos , Molécula 1 de Adhesión Intercelular/sangre , Interleucina-10/sangre , Interleucina-6/sangre , Masculino , Metaloproteinasa 9 de la Matriz/sangre , Persona de Mediana Edad , Fosfopiruvato Hidratasa/sangre , Estudios Prospectivos , Accidente Cerebrovascular/patología , Factor de Necrosis Tumoral alfa/sangre , Molécula 1 de Adhesión Celular Vascular/sangre
5.
J Neurosci Res ; 89(7): 979-85, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21488087

RESUMEN

Bone marrow-derived stem/progenitor cells (CD34(+) progenitor cells) were demonstrated to play an important role in the regeneration of damaged brain tissue. Our aim was to study the influence of CD34(+) progenitor cells in the outcome of intracerebral hemorrhage (ICH). Thirty-two patients with primary ICH (64.0% male, mean age 67.1 ± 10.8 years) were prospectively included in the study within 12 hr of symptom onset. The main outcome variable was good functional outcome at 3 months (modified Rankin scale ≤ 2). Circulating CD34(+) progenitor cell levels were measured by flow cytometry at admission and at 7 ± 1 days, and serum levels of growth factors (determined by ELISA) were measured at admission and at 24 and 72 hr. Circulating levels of CD34(+) progenitor cells at day 7 were independently associated with good functional outcome at 3 months (OR 1.17, CI95% 1.06-1.39, P = 0.012). On the other hand, CD34(+) progenitor cells at day 7 were negatively correlated with residual cavity volume at 3 months (r = -0.607, P = 0.001). Serum levels of vascular endothelial growth factor (r = 0.386), angiopoietin 1 (r = 0.518), brain-derived neurotrophic factor (r = 0.484), and stromal cell-derived factor-1α (r = 0.837) but not granulocyte-colony stimulating factor (r = -0.038) at 72 hr showed a strong correlation with CD34(+) progenitor cell levels at day 7. These findings suggest that CD34(+) progenitor cells may participate in the functional recovery of ICH patients.


Asunto(s)
Antígenos CD34/metabolismo , Hemorragia Cerebral/patología , Células Madre Hematopoyéticas/patología , Recuperación de la Función/fisiología , Anciano , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/fisiopatología , Femenino , Células Madre Hematopoyéticas/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Regeneración Nerviosa/fisiología , Células-Madre Neurales/fisiología , Neurogénesis/fisiología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Resultado del Tratamiento
6.
Clin Sci (Lond) ; 121(1): 11-7, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21265738

RESUMEN

Ischaemic stroke is associated with an excessive release of glutamate in brain. GOT (glutamate-oxaloacetate transaminase) and GPT (glutamate-pyruvate transaminase) are two enzymes that are able to metabolize blood glutamate facilitating the lowering of extracellular levels of brain glutamate. Our aim was to study the association between blood levels of both enzymes and stroke outcome in patients with acute ischaemic stroke. We prospectively studied 365 patients with first ischaemic stroke<12 h. Glutamate, GOT and GPT levels were determined in blood samples obtained at admission. We considered functional outcome at 3 months [good outcome: mRS (modified Rankin Scale)≤2; poor outcome mRS >2], END (early neurological deterioration) in the first 72 h [increment ≥4 points in NIHSS (National Institutes of Health Stroke Scale)] and infarct volume [CT (computed tomography) at 36-72 h] as end points. We have found an inverse correlation between GOT and GPT levels and blood glutamate levels. Patients with poor outcome showed lower levels of GOT (11.9±8.2 compared with 22.7±10.2 m-units/ml, P<0.0001) and GPT (19.5±14.3 compared with 24.7±20.3 m-units/ml; P=0.004). A negative correlation has been found between GOT (Pearson coefficient=-0.477, P<0.0001) and GPT (Pearson coefficient=-0.116; P=0.027) levels and infarct volume. Patients with END showed higher levels of blood glutamate (381.7±97.9 compared with 237.6±114.0 µmol/l, P<0.0001) and lower levels of GOT (10.8±6.7 compared with 18.1±10.8 m-units/ml; P<0.0001). This clinical study shows an association between high blood GOT and GPT levels and good outcome in ischaemic stroke patients, this association being stronger for GOT than GPT levels.


Asunto(s)
Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Isquemia Encefálica/diagnóstico , Accidente Cerebrovascular/diagnóstico , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Isquemia Encefálica/enzimología , Isquemia Encefálica/patología , Métodos Epidemiológicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Accidente Cerebrovascular/enzimología , Accidente Cerebrovascular/patología
7.
Acta Neurol Belg ; 111(3): 228-31, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22141290

RESUMEN

A 40 year-old woman with subacute headache and visual impairment was admitted. Neurological examination revealed meningismus, diminished visual acuity, bilateral sixth cranial nerve palsy, and papillary edema. Dermatologic examination was normal. The brain CT scan showed hydrocephalus and hyperdense edging around fissures and sulci. The CSF study showed an increased protein level, with persistently negative microbiologic and cytological studies. Prior to Gd-DPTA injection, the brain T1-WI MRI revealed leptomeningeal hyperintensity. A dark subpial substance became evident at cerebral biopsy. The histopatological diagnosis was diffuse leptomeningeal melanomatosis. This case report highlights the diagnostic value of the brain MRI findings in primary leptomeningeal melanomatosis, a rare pathologic condition diagnosed in most published cases only after necropsy. Meningeal T1-WI hyperintensity prior to contrast injection is not caused by sarcoidosis or meningeal carcinomatosis, lymphomatosis or gliomatosis.


Asunto(s)
Imagen por Resonancia Magnética , Melanoma/patología , Neoplasias Meníngeas/patología , Meninges/patología , Adulto , Ceguera/etiología , Ceguera/patología , Resultado Fatal , Femenino , Humanos , Hidrocefalia/etiología , Hidrocefalia/patología , Melanoma/complicaciones , Neoplasias Meníngeas/complicaciones , Meningismo/etiología , Meningismo/patología
8.
Sci Rep ; 10(1): 3513, 2020 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-32103074

RESUMEN

Neuroprotective treatments in ischemic stroke are focused to reduce the pernicious effect of excitotoxicity, oxidative stress and inflammation. However, those cellular and molecular mechanisms may also have beneficial effects, especially during the late stages of the ischemic stroke. The objective of this study was to investigate the relationship between the clinical improvement of ischemic stroke patients and the time-dependent excitotoxicity and inflammation. We included 4295 ischemic stroke patients in a retrospective study. The main outcomes were intra and extra-hospital improvement. High glutamate and IL-6 levels at 24 hours were associated with a worse intra-hospital improvement (OR:0.993, 95%CI: 0.990-0.996 and OR:0.990, 95%CI: 0.985-0.995). High glutamate and IL-6 levels at 24 hours were associated with better extra-hospital improvement (OR:1.13 95%CI, 1.07-1.12 and OR:1.14, 95%CI, 1.09-1.18). Effective reperfusion after recanalization showed the best clinical outcome. However, the long term recovery is less marked in patients with an effective reperfusion. The variations of glutamate and IL6 levels in the first 24 hours clearly showed a relationship between the molecular components of the ischemic cascade and the clinical outcome of patients. Our findings suggest that the rapid reperfusion after recanalization treatment blocks the molecular response to ischemia that is associated with restorative processes.


Asunto(s)
Reperfusión/métodos , Accidente Cerebrovascular/terapia , Terapia Trombolítica , Anciano , Encéfalo/diagnóstico por imagen , Femenino , Ácido Glutámico/metabolismo , Hospitales , Humanos , Interleucina-6/metabolismo , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Estudios Retrospectivos , Accidente Cerebrovascular/patología , Activador de Tejido Plasminógeno/uso terapéutico , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
9.
Mycologia ; 112(1): 121-132, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31750794

RESUMEN

Septoglomus mexicanum is here described as a new species of arbuscular mycorrhizal fungi (AMF; Glomeromycota) based on morphological and phylogenetic analyses. It was isolated from rhizospheric soil of two endemic Mexican legumes: Prosopis laevigata and Mimosa luisana, which grow in semiarid regions of central Mexico. Septoglomus mexicanum is characterized by forming globose spores of (154.5-)202.8(-228.9) µm diam and a spore wall consisting of four layers (SWL1-SWL4): outer wall layer (SWL1) hyaline, evanescent, (1.7-)3.2(-4.3) µm thick; SWL2 laminate and smooth, orange to reddish orange, (3.1-)4.5(-6.1) µm thick; SWL3 laminate, smooth, reddish orange to reddish brown, (4.1-)5.1(-5.7) µm thick; and SWL4 hyaline, semiflexible, (0.93-)1.2(-1.4) µm thick. None of the spore wall layers stain with Melzer's reagent. The subtending hypha has a color from yellowish to golden and presents a septum on spore base. Septoglomus mexicanum can be distinguished from all other Septoglomus species by spore size and color, by spore wall structure (four layers), and by color change of the subtending hypha. Phylogenetic analysis based on the AMF extended DNA barcode covering a 1.5-kb fragment of the small subunit (SSU), internal transcribed spacer region (ITS1-5.8S-ITS2), and the large subunit (LSU) of rRNA genes places S. mexicanum in the genus Septoglomus, separated from other described Septoglomus species, especially S. turnauae, with whom it could be confused morphologically. All available sequences in public databases suggest that this new fungal species has not yet been previously detected. Thus, there are currently 149 Glomeromycota species registered in Mexico, representing 47.4% of the known species worldwide.


Asunto(s)
Clima Desértico , Glomeromycota/clasificación , Micorrizas/clasificación , ADN de Hongos/genética , ADN Espaciador Ribosómico/genética , Fabaceae/microbiología , Glomeromycota/citología , Glomeromycota/genética , Glomeromycota/crecimiento & desarrollo , Hifa/citología , Hifa/crecimiento & desarrollo , México , Micorrizas/citología , Micorrizas/genética , Micorrizas/crecimiento & desarrollo , ARN Ribosómico/genética , Rizosfera , Análisis de Secuencia de ADN , Esporas Fúngicas/clasificación , Esporas Fúngicas/citología , Esporas Fúngicas/genética , Esporas Fúngicas/crecimiento & desarrollo
11.
Front Neurol ; 10: 388, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31057479

RESUMEN

Identifying the complexities of the effect of sex on stroke risk, etiology, and lesion progression may lead to advances in the treatment and care of ischemic stroke (IS) and non-traumatic intracerebral hemorrhage patients (ICH). We studied the sex-related discrepancies on the clinical course of patients with IS and ICH, and we also evaluated possible molecular mechanisms involved. The study's main variable was the patient's functional outcome at 3-months. Logistic regression models were used in order to study the influence of sex on different inflammatory, endothelial and atrial dysfunction markers. We recruited 5,021 patients; 4,060 IS (54.8% male, 45.2% female) and 961 ICH (57.1% male, 42.9% female). Women were on average 5.7 years older than men (6.4 years in IS, 5.1 years in ICH), and more likely to have previous poor functional status, to suffer atrial fibrillation and to be on anticoagulants. IS patients showed sex-related differences at 3-months regarding poorer outcome (55.6% women, 43.6% men, p < 0.0001), but this relationship was not found in ICH (56.8% vs. 61.9%, p = 0.127). In IS, women had higher levels of NT-proBNP and 3-months worse outcome in both cardioembolic and non-cardioembolic stroke patients. Stroke patients showed sex-related differences in pre-hospital data, clinical variables and molecular markers, but only IS patients presented independent sex-related differences in 3-months poor outcome and mortality. There was a relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, resulting in a possible indicator of increased dysfunction.

12.
J Periodontol ; 90(5): 465-474, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30417380

RESUMEN

BACKGROUND: Periodontitis has been associated with lacunar infarct (LI), a type of cerebral small vessel disease. The objective of this study was to ascertain whether periodontitis is associated with increased circulating levels of systemic inflammation and endothelial dysfunction biomarkers in patients with LI. METHODS: One hundred twenty patients with LI and 120 healthy controls underwent a full-mouth periodontal examination. The periodontal inflamed surface area (PISA) was calculated for each participant. Demographic, medical, and neurological information were recorded from all of them. In addition, blood samples were collected in order to investigate differences in terms of interleukin (IL)-6, IL-10, pentraxin (PTX) 3, soluble fragment of tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and amyloid-beta (Aß) peptides (i.e., Aß1-40 , and Aß1-42 ) measured in serum. RESULTS: Periodontitis was independently associated with increased levels of IL-6 (R2  = 0.656, P < 0.001), PTX3 (R2  = 0.115, P < 0.001), sTWEAK (R2  = 0.527, P < 0.001), and Aß1-40 (R2  = 0.467, P < 0.001) in patients with LI. Within patients with poor outcome, PISA positively correlated with IL-6 (r = 0.738, P < 0.001), PTX3 (r = 0.468, P = 0.008), sTWEAK (r = 0.771, P < 0.001), and Aß1-40 (r = 0.745, P < 0.001). CONCLUSIONS: Our data suggest a link between periodontitis, systemic inflammatory response, and disruption of the vascular endothelial function in patients with LI. Experimental studies are needed to elucidate possible pathways through which periodontitis could lead to this systemic inflammatory state with impairment of the endothelial function in LI. Further longitudinal studies with large samples are warranted to confirm our findings.


Asunto(s)
Periodontitis , Accidente Vascular Cerebral Lacunar , Biomarcadores , Proteína C-Reactiva , Humanos , Inflamación , Factor de Necrosis Tumoral alfa
13.
J Appl Oral Sci ; 26: e20170318, 2018 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-29768525

RESUMEN

Probiotics have provided benefits to general health, but they are still insufficient to dental health. This study aimed to evaluate milk supplemented with probiotic bacteria and standard milk, measured by levels of Streptococcus mutans (S. mutans) and Lactobacillus spp., in 3-4-year-old children after 9 months of intervention. The study was a triple-blind, placebo-controlled, randomized trial. The sample was composed of 363 preschoolers attending five child development centers in Cali, Colombia. They were randomized to two groups: children in the intervention group drank 200 mL of milk with Lactobacillus rhamnosus 5x106 and Bifidobacteruim longum 3x106, and children in the control group drank 200 mL of standard milk. Interventions occurred on weekdays and information was gathered through scheduled clinical examination. The primary result was the number of colony forming units (CFU) of S. mutans and Lactobacillus spp. in the saliva. Secondary results were dental caries, rated by the International Caries Detection and Assessment System (ICDAS), dental plaque, pH, and salivary buffer capacity. The proportion of S. mutans was lower in the intervention group compared with the control group after 9 months; however, the differences did not reach statistical significance (p=0.173); on the other hand, statistically significant differences between groups were found in the CFU/mL of Lactobacillus spp. (p=0.002). There was not statistically significant difference in the prevalence of dental caries for both groups (p=0.767). Differences between groups were found in the salivary buffering capacity (p=0.000); neither salivary pH nor dental plaque were significantly different. Regular consumption of milk containing probiotics bacteria reduced CFU/mL of Lactobacillus spp. and increased salivary buffering capacity at 9 months of consumption.


Asunto(s)
Lactobacillus/aislamiento & purificación , Leche/química , Probióticos/administración & dosificación , Saliva/microbiología , Streptococcus mutans/aislamiento & purificación , Animales , Preescolar , Recuento de Colonia Microbiana , Caries Dental/microbiología , Caries Dental/prevención & control , Placa Dental/microbiología , Placa Dental/prevención & control , Femenino , Humanos , Masculino , Leche/microbiología , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Factores de Tiempo , Resultado del Tratamiento
14.
Stem Cell Res ; 28: 16-20, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29414412

RESUMEN

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common form of hereditary stroke disorder. It is caused by mutations in NOTCH3 that lead to progressive degeneration of the smooth muscle cells in blood vessels. There is currently no treatment for this disorder. We reprogrammed to pluripotency blood mononuclear cells isolated from a patient carrying a NOTCH3 mutation by using a commercially available non-integrating system. The success in the generation of this iPSC line (IDISi001-A) suggests that the NOTCH3 mutation did not limit cell reprogramming and offers an unprecedented opportunity for studying and modeling CADASIL pathology.


Asunto(s)
Células Sanguíneas/metabolismo , CADASIL/patología , Técnicas de Cultivo de Célula/métodos , Separación Celular , Células Madre Pluripotentes Inducidas/citología , Mutación/genética , Receptor Notch3/genética , Anciano , Secuencia de Bases , CADASIL/sangre , Humanos , Masculino , Reproducibilidad de los Resultados
15.
Transl Stroke Res ; 9(4): 347-355, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29116527

RESUMEN

Based on preclinical studies suggesting that recombinant tissue plasminogen activator (rt-PA) may promote ischemic brain injuries, we investigated in patients the possible risk of worse clinical outcome after rt-PA treatment as a result of its inability to resolve cerebral ischemia. Here, we designed a cohort study using a retrospective analysis of patients who received treatment with intravenous (4.5-h window) or intraarterial rt-PA, without or with thrombectomy. Controls were consecutive patients who did not receive recanalization treatment, who met all inclusion criteria. As a marker of reperfusion, we defined the variable of early neurological improvement as the difference between the score of the National Institute of Health Stroke Scale (NIHSS) (at admission and 24 h). The main variable was worsening of the patient's functional situation in the first 3 months. To compare quantitative variables, we used Student's t test or the Mann-Whitney test. To estimate the odds ratios of each independent variable in the patient's worsening in the first 3 months, we used a logistic regression model. We included 1154 patients; 577 received rt-PA, and 577 served as controls. In the group of patients treated with rt-PA, 39.4% who did not present clinical reperfusion data developed worsening within 3 months after stroke compared with 3.5% of patients with reperfusion (P < 0.0001). These differences were not significant in the control group. In summary, administration of rt-PA intravenously or intraarterially without reperfusion within the first 24 h may be associated with a higher risk of functional deterioration in the first 3 months.


Asunto(s)
Fibrinolíticos/efectos adversos , Accidente Cerebrovascular/tratamiento farmacológico , Activador de Tejido Plasminógeno/efectos adversos , Resultado del Tratamiento , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Hemorragia/inducido químicamente , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Reperfusión
16.
J Am Heart Assoc ; 6(12)2017 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-29203579

RESUMEN

BACKGROUND: Besides the relevant role of brain-type natriuretic peptide (BNP) as biomarker of cardioembolic strokes, new experimental evidences suggest that this peptide may mediate neuroprotective effects. In this study, we have evaluated for the first time the clinical association between BNP (by means of proBNP) and good outcome in ischemic stroke patients, and analyzed the effect of blood BNP increase in an ischemic animal model. METHODS AND RESULTS: A retrospective study with 2 different cohorts (262 patients in cohort I and 610 in cohort II) from the same prospective stroke registry was performed. proBNP concentration was analyzed within the first 12 hours from stroke onset. The primary predictor variable was functional outcome evaluated by modified Rankin Scale at 3 months. For the experimental study, BNP pretreatment was tested in an ischemic animal model subjected to a transient occlusion of the cerebral artery, and the infarct volume and sensorimotor deficit were evaluated for 14 days. Cardioembolic strokes presented a positive correlation between proBNP concentration and modified Rankin Scale at 3 months; however, noncardioembolic strokes presented a negative correlation. In the logistic regression analysis, noncardioembolic strokes with concentrations of proBNP ≥340 pg/mL were associated with a good outcome. In line with these clinical findings, the experimental study revealed that those BNP pretreated animals presented a reduction on infarct volumes at 24 hours and functional recovery at days 7 and 14 compared with the control groups. CONCLUSIONS: These clinical and experimental evidences support the potential role of BNP as a protective factor against cerebral ischemia.


Asunto(s)
Isquemia Encefálica/sangre , Infarto de la Arteria Cerebral Media/sangre , Péptido Natriurético Encefálico/sangre , Accidente Cerebrovascular/sangre , Animales , Biomarcadores/sangre , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/prevención & control , Distribución de Chi-Cuadrado , Evaluación de la Discapacidad , Modelos Animales de Enfermedad , Infarto de la Arteria Cerebral Media/diagnóstico , Infarto de la Arteria Cerebral Media/fisiopatología , Infarto de la Arteria Cerebral Media/prevención & control , Modelos Logísticos , Masculino , Actividad Motora , Péptido Natriurético Encefálico/administración & dosificación , Péptido Natriurético Encefálico/farmacocinética , Fármacos Neuroprotectores/administración & dosificación , Oportunidad Relativa , Pronóstico , Factores Protectores , Ratas Sprague-Dawley , Recuperación de la Función , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Umbral Sensorial , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/prevención & control , Factores de Tiempo
17.
Neuromuscul Disord ; 16(8): 498-503, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16806931

RESUMEN

Desminopathies represent a subtype of myofibrillar myopathy caused by mutations in the DES gene, which cause myofibril disruption and intracellular inclusions containing desmin and other protein components. Desminopathy mainly involves skeletal and cardiac muscle, separately or together. Both autosomal dominant and autosomal recessive inheritance have been reported. Here, we describe the second family identified to date with an L370P desmin mutation. The disease in this family shows autosomal dominant inheritance with a particular phenotype, where males suffer from sudden death of cardiac origin while females exhibit a more benign myopathy of distal onset and slower progression. Because the only family previously identified with this mutation was limited to one studied patient, the present kindred represents the largest clinical investigation of the phenotype associated with the L370P mutation.


Asunto(s)
Desmina/genética , Predisposición Genética a la Enfermedad/genética , Enfermedades Musculares/genética , Enfermedades Musculares/fisiopatología , Mutación/genética , Adulto , Cardiomiopatías/diagnóstico , Cardiomiopatías/genética , Cardiomiopatías/fisiopatología , Análisis Mutacional de ADN , Muerte Súbita Cardíaca/patología , Femenino , Marcadores Genéticos/genética , Pruebas Genéticas , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/normas , Músculo Esquelético/metabolismo , Músculo Esquelético/patología , Músculo Esquelético/fisiopatología , Enfermedades Musculares/diagnóstico , Miocardio/metabolismo , Miocardio/patología , Linaje , Fenotipo , Caracteres Sexuales , España
18.
Medisan ; 22(4)abr. 2018.
Artículo en Español | CUMED | ID: cum-70244

RESUMEN

La gestión del conocimiento es una de las funciones sustantivas de las instituciones de la educación superior, es la misión social, la razón de ser que tienen las diferentes instituciones, por medio de la cual logran difundir sus conocimientos y contribuir con el desarrollo socio productivo y cultural de la colectividad. El propósito del presente artículo es analizar la necesidad de la endogenización de las funciones sustantivas; la gestión del conocimiento, la academia y la investigación, en relación con la gestión del conocimiento dentro de las universidades. El vínculo universidad-sociedad, es uno de los puntos que demuestran la pertinencia de la gestión del conocimiento, al incidir de manera positiva en el desarrollo socio-económico del país y en el logro del bienestar humano establecido dentro del Plan del Buen Vivir, al poner en práctica la inclusión, socialización y democratización de la educación(AU)


Knowledge management is one of the substantive roles of the higher education institutions, it is the social mission, the reason for the existence of the different institutions through which the spread of knowledge and contribution to the social, productive and cultural development of the community are achieved. The purpose of the present work is to analyze the need of endogenization of substantive roles such as knowledge management, the academy and the research in relation to the relevance of knowledge management in universities. The university-society link is one of the points that shows the knowledge management relevance that positively influences on the country's social and economic development and reaches the welfare of the human being established in the Good Living Plan, as it implements inclusion, socialization as well as democratization of education(AU)


Asunto(s)
Humanos , Masculino , Femenino , Gestión del Conocimiento para la Investigación en Salud , Gestión del Conocimiento , Academias e Institutos , Universidades
19.
Medisan ; 22(3)mar. 2018.
Artículo en Español | CUMED | ID: cum-70228

RESUMEN

La integración de las funciones sustantivas de las universidades deviene un reto actualmente y la gestión del conocimiento constituye la misión social, la razón de ser de los diferentes centros de altos estudios, por medio de la cual logran difundir sus saberes y experiencias, así como contribuir al desarrollo socioproductivo y cultural de la colectividad. En el presente artículo se proponen acciones necesarias para endogenizar las funciones sustantivas universitarias desde ese tipo de gestión, a partir de la aplicación de métodos empíricos que permitieron conocer los criterios de educandos y docentes en relación con el problema objeto de esta investigación y revelaron a través de los resultados obtenidos,la fragmentación de los procesos sustantivos universitarios que ha estado limitando la producción del conocimiento científico en las instituciones de educación superior(AU)


The integration of the substantive functions of the universities becomes a challenge at present and the knowledge management constitutes the social mission, the reason of the different high studies institutions, by means of which they are able to diffuse their knowledge and experiences, as well as to contribute to the social, productive and cultural development of the collectivity. In this work, necessary tasks for endogenize the university substantive functions from that type of management are proposed, with the use of empiric methods that allowed to know the students and teaching staff criteria related to the object of this investigation, and they revealed through the results obtained, the fragmentation of the university substantive processes which have been limiting the production of the scientific knowledge in the higher education institutions(AU)


Asunto(s)
Humanos , Masculino , Femenino , Gestión del Conocimiento , Tecnología de la Información , Universidades , Estrategias de Salud
20.
Medisan ; 22(4)abr. 2018.
Artículo en Español | LILACS | ID: biblio-894717

RESUMEN

La gestión del conocimiento es una de las funciones sustantivas de las instituciones de la educación superior, es la misión social, la razón de ser que tienen las diferentes instituciones, por medio de la cual logran difundir sus conocimientos y contribuir con el desarrollo socio productivo y cultural de la colectividad. El propósito del presente artículo es analizar la necesidad de la endogenización de las funciones sustantivas; la gestión del conocimiento, la academia y la investigación, en relación con la gestión del conocimiento dentro de las universidades. El vínculo universidad-sociedad, es uno de los puntos que demuestran la pertinencia de la gestión del conocimiento, al incidir de manera positiva en el desarrollo socio-económico del país y en el logro del bienestar humano establecido dentro del Plan del Buen Vivir, al poner en práctica la inclusión, socialización y democratización de la educación


Knowledge management is one of the substantive roles of the higher education institutions, it is the social mission, the reason for the existence of the different institutions through which the spread of knowledge and contribution to the social, productive and cultural development of the community are achieved. The purpose of the present work is to analyze the need of endogenization of substantive roles such as knowledge management, the academy and the research in relation to the relevance of knowledge management in universities. The university-society link is one of the points that shows the knowledge management relevance that positively influences on the country's social and economic development and reaches the welfare of the human being established in the Good Living Plan, as it implements inclusion, socialization as well as democratization of education


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Competencia Profesional , Universidades , Capacitación Profesional , Gestión del Conocimiento , Estudiantes , Educación , Investigación Científica y Desarrollo Tecnológico , Dominios Científicos
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