¿Es el cociente normalizado internacional un factor pronóstico de mortalidad en hemorragias intracerebrales? / Is the international normalised ratio a prognostic factor of mortality in intracerebral haemorrhage?

Background: Oral anticoagulant therapy (ACO) is considered an independent predictor of mortality in patients with intracerebral haemorrhage (ICH), with the role of the international normalised ratio (INR) being unclear. The aim of this work is to evaluate the relationship between ACO and the INR value and the ICH volume, and to determine the relationship between both variables and mortality. Patients and methods: Patients were retrospectively analysed using the Private Community Cerebrovascular Hospital Register (Registro Cerebrovascular del Hospital Privado de Comunidad), between December 2003 and May 2009. Volumes of the haematomas (dependent variable) were calculated from the first image performed, using the abc/2 method. Independent variables were age, gender, vascular risk factors, site of bleeding, intraventricular dump, clinical severity (Glasgow scale), time to image, antiplatelet drugs, and INR value on admission. An analysis of the relationship between all these variables and mortality was also performed. Results: A total of 327 patients with HIC were identified (35 with ACO). Median volume was higher in the anticoagulated patients (55ml vs 24ml P<.05), with no statistically significant relationship between volume and the other variables. In the multivariate analysis, a statistically significant higher mortality associated to volume was observed, but not with anticoagulation. Conclusions: Oral anticoagulation was associated with a higher initial volume of the haematoma, with no correlation between the INR value and volume. The HIC volume was directly related to mortality, however, like the volume, the INR was not associated with increased mortality

Introducción: El uso de anticoagulantes orales (ACO) es considerado predictor independiente de mortalidad en pacientes con hemorragias intracerebrales (HIC), siendo incierto el rol del cociente normalizado internacional (INR). El objetivo de este trabajo es evaluar la asociación entre la ACO y el valor del INR, y el volumen de los HIC, así como determinar la relación entre ambas variables y la mortalidad.Pacientes y métodos: Se analizaron retrospectivamente todos los pacientes con HIC incluidos en el registro cerebrovascular del Hospital Privado de Comunidad, entre diciembre de 2003 y mayo de 2009 inclusive. Los volúmenes de los hematomas (variable dependiente) se calcularon sobre la primera imagen realizada, utilizando el método abc/2. Las variables independientes fueron edad, sexo, factores de riesgo vascular, localización del sangrado, volcado intraventricular, gravedad clínica (escala de Glasgow), tiempo para la realización de la imagen, antiagregación y valor del RIN al ingreso. También se analizó la relación entre todas las variables mencionadas y la mortalidad.Resultados: Se identificó a 327 pacientes con HIC (35 recibían ACO). Fue mayor la mediana de volumen de los anticoagulados (55ml vs 24ml p<0,05), no encontrándose asociación estadísticamente significativa entre el volumen y las demás variables. En el análisis multivariable se observó mayor mortalidad estadísticamente significativa asociada al volumen, no así a la anticoagulación. Conclusiones: La ACO se asoció a un mayor volumen inicial del hematoma, no encontrándose correlación entre el valor de INR y dicho volumen. El volumen de la HIC se relacionó directamente a la mortalidad; sin embargo, a igualdad de volumen el valor de INR no se asoció a mayor mortalidad

[Is the international normalised ratio a prognostic factor of mortality in intracerebral haemorrhage?]. / ¿Es el cociente normalizado internacional un factor pronóstico de mortalidad en hemorragias intracerebrales?

BACKGROUND: Oral anticoagulant therapy (ACO) is considered an independent predictor of mortality in patients with intracerebral haemorrhage (ICH), with the role of the international normalised ratio (INR) being unclear. The aim of this work is to evaluate the relationship between ACO and the INR value and the ICH volume, and to determine the relationship between both variables and mortality. PATIENTS AND METHODS: Patients were retrospectively analysed using the Private Community Cerebrovascular Hospital Register (Registro Cerebrovascular del Hospital Privado de Comunidad), between December 2003 and May 2009. Volumes of the haematomas (dependent variable) were calculated from the first image performed, using the abc/2 method. Independent variables were age, gender, vascular risk factors, site of bleeding, intraventricular dump, clinical severity (Glasgow scale), time to image, antiplatelet drugs, and INR value on admission. An analysis of the relationship between all these variables and mortality was also performed. RESULTS: A total of 327 patients with HIC were identified (35 with ACO). Median volume was higher in the anticoagulated patients (55ml vs 24ml P<.05), with no statistically significant relationship between volume and the other variables. In the multivariate analysis, a statistically significant higher mortality associated to volume was observed, but not with anticoagulation. CONCLUSIONS: Oral anticoagulation was associated with a higher initial volume of the haematoma, with no correlation between the INR value and volume. The HIC volume was directly related to mortality, however, like the volume, the INR was not associated with increased mortality.

Síndrome de leucoencefalopatía posterior reversible por cisplatino. Presentación de un caso / Posterior reversible leukoencephalopathy syndrome caused by cisplatin

No disponible

No disponible

Hipertensión arterial como factor de riesgo de espasmo hemifacial por compresión vascular / Arterial hypertension as a risk factor for hemifacial spasm due to vascular compression

No disponible

No disponible

[A study of the incidence and a descriptive analysis of adult non-tuberculous primary bacterial meningitis in a population in Argentina]. / Estudio de incidencia y análisis descriptivo de la meningitis bacteriana primaria no tuberculosa del adulto en una población argentina.

INTRODUCTION: Adult non tuberculous primary bacterial meningitis (PBM) represents an important cause of morbidity and mortality in hospitals. The shortage of studies based on the population in Latin America provided the motivation for this work. AIMS: To determine the incidence of PBM in the captive population of our hospital and carry out a descriptive analysis of the cases detected. PATIENTS AND METHODS: We performed an epidemiological study of the captive population (CP) of the hospital (an average of 85,200 patients in 11 years) and a retrospective descriptive examination of patients who had been admitted. The clinical histories of all patients over the age of 18 who had been admitted with PBM between 1 January 1988 and 31 December 1998 were studied. RESULTS AND CONCLUSIONS: A total number of 87 cases of primary bacterial meningitis were registered, of which 70 belonged to the CP. The overall gross rate of PBM incidence in the CP was 8.6/100,000 per year. The annual incidence rate, adjusted to the 1991 National Census on the Argentinean Population, was 5.4/100,000 per year, with a greater frequency between the ages of 70 and 79: 21/100,000 per year. Median age: 73 (lower quartile, 66; upper quartile, 78). Clinical manifestations included high temperatures (90%), consciousness disorders (87%), and a stiff neck (81%). The frequency with which it appeared remained constant over the 11 year period, without showing any seasonal variations. The most frequent etiological agent was pneumococcus (50%). No cases of PBM by Listeria were reported. Overall fatality during the stay in hospital was 23%, without any type of modification over the period we studied.

Diagnóstico invasivo frenteal no invasivo en la enfermedad carotídea:una discusión fuera de foco / There is controversy as to whether invasive or non-invasive diagnosis of carotid artery disease is preferable: Here it is considered from a different approach

No disponible