Difference in Stroke Knowledge between Rural and Urban Communities in a Developing Country after Community-Based Stroke Educational Campaigns: Results from a Cross-Sectional Study.

BACKGROUND: Ischemic stroke is a leading cause of disability and death in Mexico. Poor ability to identify signs and symptoms of ischemic stroke leads to longer hospital arrival times and precludes prompt treatment. The knowledge of stroke risk factors and warning signs in rural population is scarce. Since 2010, Stroke Education Campaigns are performed with a community-based approach. The aim of this study was to assess and compare stroke knowledge in rural and urban communities. METHODS: During World Stroke Campaign, a standardized questionnaire to assess knowledge of stroke risk factors and warning signs was applied in urban and non-urban communities of Nuevo Leon, Mexico. RESULTS: A total of 4,144 surveys were collected. Mean age was 44.2 ± 16.1 and 75.9% were women. People from rural and semi-urban areas mentioned > 3 risk factors (p < 0.001) and warning signs (p < 0.001) compared to the urban area. After logistic regression analysis, having received previous information about stroke remained significant for the knowledge of > 3 stroke risk factors and warning signs (p < 0.001; 95% CI 1.997-2.727; p < 0.001; 95% CI 1.880-3.787) respectively. CONCLUSIONS: Rural and semi-urban regions performed better than the urban population. Receiving stroke information is a determinant factor for stroke knowledge. Stroke Educational Campaigns are a cost-effective method for raising stroke awareness, thus reducing stroke burden.

Empleo de la buprenorfina y la nalbufina en la analgesia postoperatoria en niños / Use of the buprenorphine and nalbuphine in the postoperative analgesia in children

En el presente estudio se utilizó buprenorfina y nalbufina en pacientes críticamente enfermos, distribuidos en dos grupos en forma aleatoria, tomando en cuenta parámetros indirectos de dolor tales como la frecuencia cardiaca (FC), tensión arterial media, frecuencia respiratoria, gasto urinario. La distribución de los pacientes fue: grupo A seis pacientes con buprenorfina (3µg/hg/ds) y grupo B nalbufina a cinco pacientes (100 µg/kg/ds), ocho cirugías torácicas y tres abdominales. En cuanto a la edad y el peso de cada grupo no existieron diferencias estadísticamente significativas. Se realizó la prueba de t de Student encontrando que con la buprenorfina disminuyó la FC a partir de la segunda dosis con P< 0.01, sin modificación en cuanto a los demás parámetros monitorizados. En el grupo B la modificación ocurrió a partir de la 3a dosis con p< 0.05, con resultados similares en el resto de los parámetros en relación al grupo A. Se concluye que ambos medicamentos son efectivos para el manejo de pacientes pediátricos críticamente enfermos sin repercución hemodinámica y la buprenorfina mostró discreta ventaja en relación al tiempo de acción