RESUMO
BACKGROUND AND PURPOSE: Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain. METHODS: This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed. RESULTS: A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality. CONCLUSION: A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality.
Assuntos
COVID-19 , AVC Isquêmico/terapia , Pandemias , Reperfusão , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviços Médicos de Emergência/estatística & dados numéricos , Procedimentos Endovasculares/estatística & dados numéricos , Feminino , Humanos , AVC Isquêmico/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Sistema de Registros , Estudos Retrospectivos , Espanha/epidemiologia , Terapia Trombolítica/estatística & dados numéricos , Resultado do TratamentoRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Mielite Transversa/complicações , Mielite Transversa/diagnóstico , Varicela/complicações , Punção Espinal/métodos , Biomarcadores Tumorais , Diagnóstico DiferencialRESUMO
No disponible
Assuntos
Humanos , Feminino , Cefaleia/complicações , Cefaleia , Transtornos da Cefaleia/complicações , Diagnóstico Diferencial , Crânio , Espectroscopia de Ressonância Magnética/métodos , Anestesia EpiduralRESUMO
BACKGROUND: Hemineglect is frequent after right hemisphere stroke and prevents functional independence, but effective rehabilitation interventions are lacking. Our objective was to determine if a visual-acoustic alarm in the hemineglect arm activated by a certain discrepancy in movement of both hands can enhance neglect arm use in five tasks of daily living. METHODS: In this pre-post intervention study 9 stroke patients with residual hemineglect of the arm were trained for 7 days in five bimanual tasks of daily living: carrying a tray, button fastening, cutting food with knife and fork, washing the face with both hands and arm sway while walking. This was done through motion sensors mounted in bracelets on both wrists that compared movement between them. When the neglect-hand movement was less than a limit established by two fuzzy logic based classifiers, a visual-acoustic alarm in the neglect-hand bracelet was activated to encourage its use in the task. RESULTS: Both motion and function of the neglect hand improved during the seven days of training when visual-acoustic alarms were active but a worsening to baseline values occurred on day 8 and day 30 when alarms where switched off. Improvement was limited to vision-dependent tasks. CONCLUSIONS: Neglect-hand improvement with this approach is limited to bimanual activities in which an object is manipulated under vision control, but no short or long term learning happens.
