RESUMO
Resumen: ANTECEDENTES: El ácido úrico es un factor de riesgo independiente de enfermedades cardiovasculares y cerebrovasculares. OBJETIVO: Analizar el papel del ácido úrico como factor pronóstico en el accidente cerebrovascular isquémico. MATERIAL Y MÉTODO: Estudio de cohortes retrospectivo, efectuado en un hospital privado y académico. Se incluyeron pacientes con diagnóstico confirmado de evento vascular cerebral en el periodo de 2012 a 2016. Se clasificaron dos grupos: pacientes con hiperuricemia y sin hiperuricemia. RESULTADOS: Se analizaron 202 pacientes, 59 (30%) con hiperuricemia y 143 (70%) sin hiperuricemia. En el análisis comparativo la mortalidad fue de 7.3% (n = 10) en pacientes sin hiperuricemia y de 5% (n = 3) en pacientes con hiperuricemia (p = 0.56). Se encontraron diferencias significativas en las concentraciones de glucosa (p = 0.02), creatinina (p = 0.004), colesterol (p = 0.028), ácido úrico (p ≤ 0.0001) y triglicéridos (p = 0.014) entre ambas poblaciones. El análisis con regresión logística con corrección para potenciales de confusión no encontró asociación significativa entre la existencia de hiperuricemia al ingreso y la probabilidad de muerte (OR 2.098, IC95%: 0.47-9.332, p = 0.3304). CONCLUSIÓN: Este estudio demuestra que en los pacientes hospitalizados con diagnóstico de evento cerebrovascular isquémico las concentraciones de ácido úrico o la hiperuricemia no se relacionan con incremento en la mortalidad intrahospitalaria.
Abstract: BACKGROUND: Elevations in serum uric acid levels are considered a risk factor for cardiovascular and cerebrovascular conditions. OBJECTIVE: To analyze the relationship between high uric acid levels and the prognosis of patients with a cerebrovascular accident. MATERIAL AND METHOD: A retrospective cohort study performed at a single academic center. All patients with a confirmed diagnosis of cerebrovascular accident during the period between 2012 and 2016 were included in the analysis. Cohorts were segregated in patients with hyperuricemia and patients with normal serum uric acid levels. RESULTS: Two hundred two patients with cerebrovascular accident were analyzed, 59 patients (30%) were diagnosed with hyperuricemia, 143 (70%) were used as a control group. On a comparative analysis, mortality rates were 7.3% (n = 10) on hyperuricemia group vs 5% (n = 3) in the control group (p = 0.056). Significant differences were found on serum cholesterol levels (p = 0.028), uric acid (p ≤ 0.0001), glucose (p = 0.02), creatinine (p = 0.004) and triglycerides levels (p = 0.01) between cohorts. After controlling for potential confusing factors, there wasn't found an association between the increase in serum uric acid levels and the odds of mortality (OR 2.098, IC95% 0.47-9.332, p = 0.3304). CONCLUSIONS: This study demonstrates that inpatients diagnosed with a cerebrovascular accident mortality rates are not associated with hyperuricemia or increasing levels of serum uric acid.
RESUMO
Embryo implantation represents the most critical step of the reproductive process in many species, to be successful requires a receptive endometrium, functional embryo at a stage of embryonic development and proper dialogue between embryonic and maternal tissues. Hatching is the process in which the blastocyst gets rid of the zona pellucida to be implemented. The failure in this factor can lead to reproductive problems, even under assisted reproduction techniques. Assisted hatching is a technique used in assisted reproduction laboratories to improve performance in the process of fecundation or in vitro fertilization. This technique is based on impairment or section of the zona pellucida using different techniques. In this review, the most common indications and techniques used to perform this procedure and improve success rates in assisted reproduction techniques are synthesized.
