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1.
Eur Heart J Suppl ; 22(Suppl H): H104-H107, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32884485

RESUMO

Building on the gains of May Measurement Month 2017 (MMM17), the Philippine Society of Hypertension once again took part in MMM18 to raise awareness of high blood pressure (BP) in the country and to harness opportunistic BP screening in detecting unaware hypertensive individuals and referring them for treatment. We followed the standard MMM18 protocol designed by the International Society of Hypertension, utilizing convenience sampling with volunteer investigators, taking three sitting BP measurements of volunteer adults (≥18 years). Basic data on demographic, lifestyle, and environmental factors were also taken. We analysed 177 176 screened individuals from the Philippines. Of these, 29.1% (51 527) had also participated in MMM17, whereas 68.8% (121 893) were new screenees; and 14.2% (25 232) had their BP taken for the first time ever. After multiple imputation, 39.0% (69 126) were hypertensive. Of these, 50.3% (34 795) were aware they were hypertensive. 49.9% (34 491) were on antihypertensive medication, 58.0% (20 010) of whom had controlled BP <140/90 mmHg. Only 28.9% of all participants with hypertension had controlled BP. Systolic BPs and diastolic BPs were significantly higher in the overweight and obese, in those receiving antihypertensive medications, in patients with diabetes, and significantly lower in pregnant women. MMM18 has again shown that opportunistic BP screening, harnessing volunteers, is a pragmatic public health measure to improve awareness and treatment rates of raised BP.

2.
Eur Heart J Suppl ; 21(Suppl D): D92-D96, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31043890

RESUMO

Cardiovascular diseases remain the Philippines' leading cause of mortality, with hypertension as a prevalent contributory risk factor. We took part in May Measurement Month 2017 (MMM17), a global initiative to raise awareness of high blood pressure (BP) and to serve as a temporary solution to the lack of screening programs worldwide. Following the standard MMM protocol, data for 271 604 screened individuals were submitted from the Philippines. After multiple imputation, 91 994 (34.3%) were hypertensive; 28 662 out of 205 158 participants (14.0%) not receiving treatment had hypertension; and of the 60 370 receiving treatment, 25 144 (41.6%) had uncontrolled BP. Blood pressures were significantly higher in the overweight and obese, current smokers, in participants receiving antihypertensive medication, those with previous myocardial infarction or stroke. The BP measurements were relatively lower when taken on the left arm, and in pregnant women. A slightly higher systolic BP was noted in participants who reported no alcohol intake. Blood pressures recorded during the weekends were highest, and the lowest readings were obtained on Tuesdays. MMM17 was the largest BP screening campaign conducted in the Philippines. Opportunistic BP screening, harnessing volunteers, are a cost-effective public health measure to improve awareness and treatment rates of raised BP. These may help provide additional information that can guide medical practitioners and health officials in drafting preventive and therapeutic measures to improve control rates and long-term outcomes of hypertensive individuals in the population.

3.
Cerebrovasc Dis ; 46(1-2): 82-88, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30184553

RESUMO

BACKGROUND AND PURPOSE: MLC601 has been shown in preclinical studies to enhance neurorestorative mechanisms after stroke. The aim of this post hoc analysis was to assess whether combining MLC601 and rehabilitation has an effect on improving functional outcomes after stroke. METHODS: Data from the CHInese Medicine NeuroAiD Efficacy on Stroke (CHIMES) and CHIMES-Extension (CHIMES-E) studies were analyzed. CHIMES-E was a 24-month follow-up study of subjects included in CHIMES, a multi-centre, double-blind placebo-controlled trial which randomized subjects with acute ischemic stroke, to either MLC601 or placebo for 3 months in addition to standard stroke treatment and rehabilitation. Subjects were stratified according to whether they received or did not receive persistent rehabilitation up to month (M)3 (non- randomized allocation) and by treatment group. The modified Rankin Scale (mRS) and Barthel Index were assessed at month (M) 3, M6, M12, M18, and M24. RESULTS: Of 880 subjects in CHIMES-E, data on rehabilitation at M3 were available in 807 (91.7%, mean age 61.8 ± 11.3 years, 36% female). After adjusting for prognostic factors of poor outcome (age, sex, pre-stroke mRS, baseline National Institute of Health Stroke Scale, and stroke onset-to-study-treatment time), subjects who received persistent rehabilitation showed consistently higher treatment effect in favor of MLC601 for all time points on mRS 0-1 dichotomy analysis (ORs 1.85 at M3, 2.18 at M6, 2.42 at M12, 1.94 at M18, 1.87 at M24), mRS ordinal analysis (ORs 1.37 at M3, 1.40 at M6, 1.53 at M12, 1.50 at M18, 1.38 at M24), and BI ≥95 dichotomy analysis (ORs 1.39 at M3, 1.95 at M6, 1.56 at M12, 1.56 at M18, 1.46 at M24) compared to those who did not receive persistent rehabilitation. CONCLUSIONS: More subjects on MLC601 improved to functional independence compared to placebo among subjects receiving persistent rehabilitation up to M3. The larger treatment effect of MLC601 was sustained over 2 years which supports the hypothesis that MLC601 combined with rehabilitation might have beneficial and sustained effects on neuro-repair processes after stroke. There is a need for more data on the effect of combining rehabilitation programs with stroke recovery treatments.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Idoso , Ásia , Terapia Combinada , Avaliação da Deficiência , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Fármacos Neuroprotetores/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
4.
Rev. Col. Méd. Cir. Guatem ; 156(2): 54-60, nov. 2017. graf
Artigo em Espanhol | LILACS | ID: biblio-986501

RESUMO

Antecedentes: Las anomalías del tubo neural son frecuentes en Guatemala. Una mayor frecuencia se observa en el antiplano guatemalteco, con mayor concentración de población indígena y con mayor depauperación económica. Observaciones de especialistas indican que en el primer semestre del año son mucho más frecuentes que en el segundo. Estas observaciones señalan que algo existe en el ambiente, probablemente en el ambiente alimentario, relacionado con el consumo de maíz, base dietética del guatemalteco. En el grano de este cereal, existe, fumomisinas (micotoxinas producidas por hongos) en gran cantidad, que tienen un efecto inhibidor de la captación celular de ácido fólico, micronutriente íntimamente relacionado con el cierre temprano del tubo neural. Objetivo: Demostrar si es cierto que existe mayor frecuencia de anomalías del tubo neural en Guatemala en el primer semestre del año que en el segundo, principalmente en los denominados meses de verano. Sugerir hipótesis futuras que expliquen este comportamiento epidemiológico. Metodología: Estudio descriptivo-analítico retrospectivo en la Unidad de Espina Bífida del Hospital General San Juan de Dios y en las 8 áreas geoeconómicas de Guatemala, analizando una sola variable: La fecha de nacimiento de niños y niñas que presentaron anomalías del tubo neural de diferente tipo. Resultados: Se demuestra que en efecto las anomalías del tubo neural son más frecuentes en el primer semestre del año que en el segundo. Principalmente en los meses de marzo-abril. Y que ocurren con menos frecuencia en el segundo semestre. Estos datos se podrían vincular con el consumo dietético de maíz, grano que también tiene diferencias estacionales en cuanto a su producción, almacenamiento, preparación y consumo (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Disrafismo Espinal/complicações , Fumonisinas/efeitos adversos , Desnutrição/complicações , Grupos Populacionais , Deficiência de Ácido Fólico/diagnóstico , Malformações do Sistema Nervoso/complicações , Defeitos do Tubo Neural/epidemiologia , Epidemiologia Descritiva , Guatemala/epidemiologia
5.
Rev. Col. Méd. Cir. Guatem ; 156(1): 30-34, 2017 jul. Tab
Artigo em Espanhol | LILACS | ID: biblio-981378

RESUMO

Antecedentes: La evaluación de la excelencia académica de las universidades toma en cuenta varios indicadores, uno de los más determinantes es la investigación científica, que a su vez es usualmente medida por el número y el impacto de las publicaciones en revistas indexadas. Las universidades necesitan saber su posición en relación al resto de universidades del mundo para desarrollar planes de mejoramiento. Objetivo: estimar cuánto del crédito por investigación que la Universidad de San Carlos de Guatemala (USAC) merece, pudiera estar siendo detectado y evaluado por las entidades dedicadas a estratificar las universidades según su rendimiento académico. Material y método: estudio exploratorio de datos obtenidos de PUBMED sobre artículos científicos atribuibles a la USAC, publicados antes del 2017. Los datos bibliométricos analizados incluyeron la cantidad de artículos y el número de citas por articulo...(AU)


Assuntos
Publicações Periódicas como Assunto , Universidades , Bibliometria , Comunicação Acadêmica
6.
Int J Stroke ; 12(3): 285-291, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27784824

RESUMO

Background and Aim A pre-specified country analysis of subjects from the Philippines in the CHInese Medicine NeuroAiD Efficacy on Stroke recovery (CHIMES) Study showed significantly improved functional and neurological outcomes on MLC601 at month (M) 3. We aimed to assess these effects on long-term functional recovery in the Filipino cohort. Methods The CHIMES-E (extension) Study evaluated subjects who completed three months of randomized placebo-controlled treatment in CHIMES up to two years. Blinding of treatment allocation was maintained and all subjects received standard stroke care and rehabilitation. Modified Rankin Score (mRS) and Barthel Index (BI) were assessed in-person at M3 and by telephone at M6, M12, M18, M24. Odds ratios (OR) with corresponding 95% confidence intervals (CI) for functional recovery using ordinal analysis of mRS and for achieving functional independence (mRS 0-1 or BI ≥ 95) at each time point were calculated, adjusting for age, sex, baseline National Institute of Health Stroke Scale (NIHSS), onset-to-treatment time (OTT) and pre-stroke mRS. Results The 378 subjects (MLC601 192, placebo 186) included in CHIMES-E from the Philippines (mean age 60.2 ± 11.1) had more women ( p < 0.001), worse baseline NIHSS ( p < 0.001) and longer onset to treatment time ( p = 0.002) compared to other countries. Baseline characteristics were similar between treatment groups. The treatment effect of MLC601 seen at M3 peaked at M6 with OR for mRS shift of 1.53 (95% CI 1.05-2.22), mRS dichotomy 0-1 of 1.77 (95% CI 1.10-2.83), and BI ≥ 95 of 1.87 (95% CI 1.16-3.02). The beneficial effect persisted up to M24. Conclusion The beneficial effect of MLC601 seen at M3 in the Filipino cohort is durable up to two years after stroke.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Razão de Chances , Filipinas , Recuperação de Função Fisiológica/efeitos dos fármacos , Índice de Gravidade de Doença , Reabilitação do Acidente Vascular Cerebral , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento
7.
Cerebrovasc Dis ; 43(1-2): 36-42, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27846631

RESUMO

BACKGROUND: The Chinese Medicine NeuroAiD Efficacy on Stroke recovery - Extension (CHIMES-E) study is among the few acute stroke trials with long-term outcome data. We aimed to evaluate the recovery pattern and the influence of prognostic factors on treatment effect of MLC601 over 2 years. METHODS: The CHIMES-E study evaluated the 2 years outcome of subjects aged ≥18 years with acute ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) score 6-14, pre-stroke modified Rankin Scale (mRS) score ≤1 included in a multicenter, randomized, double-blind, placebo-controlled trial of MLC601 for 3 months. Standard stroke care and rehabilitation were allowed during follow-up with mRS score being assessed in-person at month (M) 3 and by telephone at M1, M6, M12, M18 and M24. RESULTS: Data from 880 subjects were analyzed. There was no difference in baseline characteristics between treatment groups. The proportion of subjects with mRS score 0-1 increased over time in favor of MLC601 most notably from M3 to M6, thereafter remaining stable up to M24, while the proportion deteriorating to mRS score ≥2 remained low at all time points. Older age (p < 0.01), female sex (p = 0.06), higher baseline NIHSS score (p < 0.01) and longer onset to treatment time (OTT; p < 0.01) were found to be predictors of poorer outcome at M3. Greater treatment effect, with more subjects improving on MLC601 than placebo, was seen among subjects with 2 or more prognostic factors (OR 1.65 at M3, 1.78 at M6, 1.90 at M12, 1.65 at M18, 1.39 at M24), especially in subjects with more severe stroke or longer OTT. CONCLUSIONS: The sustained benefits of MLC601 over 2 years were due to more subjects improving to functional independence at M6 and beyond compared to placebo. Selection of subjects with poorer prognosis, particularly those with more severe NIHSS score and longer OTT delay, as well as a long follow-up period, may improve the power of future trials investigating the treatment effect of neuroprotective or neurorestorative therapies.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Ásia , Avaliação da Deficiência , Método Duplo-Cego , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuroprotetores/efeitos adversos , Razão de Chances , Recuperação de Função Fisiológica , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
8.
Rev. Col. Méd. Cir. Guatem ; 155(1): 7-13, jul. 2016. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-835546

RESUMO

Desde hace siglos el acopio de información en el mundo ha sido prioritario. En investigación científica, esto es fundamental. Con el aparecimiento de Internet y las redes sociales, la tarea de reunir en un portal y poner a disposición de los investigadores, universidades, autoridades académicas, centros especializados, etc., los conocimientos generados en cualquier área del planeta, se ha facilitado; aunque mucha información aún se encuentra "encriptada", es decir, los buscadores específicos no la logran encontrar. En este artículo abordamos la producción científica, la inversión en ciencia y tecnología y los buscadores de publicaciones e investigadores.


The search and storage of information havebeen crucial in the world throughout history.These processes are fundamental in scienceresearch. With the widespread use of internetand social media, the task of gathering informationin websites of free access, has made it easyfor researchers, universities, specialized centers,academic authorities, etc., to analyzeknowledge generated in any place of the world.Much information is still unavailable (encrypted)to scientific production browsers. In this paperwe describe the scientific production, investmentin science and technology and browsers ofresearch publications and researchers.


Assuntos
Humanos , Pesquisa Científica e Desenvolvimento Tecnológico , Pesquisa/educação , Universidades
9.
Rev. Col. Méd. Cir. Guatem ; 155(1): 14-18, jul. 2016. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-835547

RESUMO

Antecedentes: Aunque se asume que Guatemala,como país, publica poco en revistasacadémicas internacionalmente catalogadascomo prestigiosas, se desconocen estudios quenos aporten cifras concretas sobre su producciónde publicaciones médicas. Objetivo:Conocer la producción de publicaciones médicasde Guatemala y su aporte a la producciónuniversal, de Latinoamérica y de Centroamérica.Material y Método: Investigación “secundaria”basada en los datos crudos disponibles en laplataforma de acceso libre denominada “TheSCImago Journal & Country Rank”. Resultados:La producción de publicaciones médicas deGuatemala ha sido de aproximadamente 40documentos por año durante los últimos 24años.


Antecedents: Even though it is assumed thatGuatemala, as a country, publishes little in medicaljournals internationally ranked, no studiesare known that show actual numbers on theproduction of medical publications. Objective:To find out Guatemala’s production of medicalpublications and the contribution of that productionto the total production of the world, of LatinAmerica and of Central America. Material yMethod: This is a secondary research that analyzesrow data available on the free accessplatform denominated “The SCImago Journal &Country Rank”. Results: The production of medicalpublications by Guatemala has been about40 documents per year during the last 24 years.


Assuntos
Humanos , Guatemala , Pesquisa Biomédica/educação , Publicações/normas
10.
Cerebrovasc Dis ; 39(5-6): 309-18, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25925713

RESUMO

BACKGROUND: The CHInese Medicine NeuroAiD Efficacy on Stroke recovery (CHIMES) study was an international randomized double-blind placebo-controlled trial of MLC601 (NeuroAiD) in subjects with cerebral infarction of intermediate severity within 72 h. CHIMES-E (Extension) aimed at evaluating the effects of the initial 3-month treatment with MLC601 on long-term outcome for up to 2 years. METHODS: All subjects randomized in CHIMES were eligible for CHIMES-E. Inclusion criteria for CHIMES were age ≥18, baseline National Institute of Health Stroke Scale of 6-14, and pre-stroke modified Rankin Scale (mRS) ≤1. Initial CHIMES treatment allocation blinding was maintained, although no further study treatment was provided in CHIMES-E. Subjects received standard care and rehabilitation as prescribed by the treating physician. mRS, Barthel Index (BI), and occurrence of medical events were ascertained at months 6, 12, 18, and 24. The primary outcome was mRS at 24 months. Secondary outcomes were mRS and BI at other time points. RESULTS: CHIMES-E included 880 subjects (mean age 61.8 ± 11.3; 36% women). Adjusted OR for mRS ordinal analysis was 1.08 (95% CI 0.85-1.37, p = 0.543) and mRS dichotomy ≤1 was 1.29 (95% CI 0.96-1.74, p = 0.093) at 24 months. However, the treatment effect was significantly in favor of MLC601 for mRS dichotomy ≤1 at 6 months (OR 1.49, 95% CI 1.11-2.01, p = 0.008), 12 months (OR 1.41, 95% CI 1.05-1.90, p = 0.023), and 18 months (OR 1.36, 95% CI 1.01-1.83, p = 0.045), and for BI dichotomy ≥95 at 6 months (OR 1.55, 95% CI 1.14-2.10, p = 0.005) but not at other time points. Subgroup analyses showed no treatment heterogeneity. Rates of death and occurrence of vascular and other medical events were similar between groups. CONCLUSIONS: While the benefits of a 3-month treatment with MLC601 did not reach statistical significance for the primary endpoint at 2 years, the odds of functional independence defined as mRS ≤1 was significantly increased at 6 months and persisted up to 18 months after a stroke.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Recuperação de Função Fisiológica/efeitos dos fármacos , Acidente Vascular Cerebral/tratamento farmacológico , Adulto , Idoso , Coloboma/tratamento farmacológico , Método Duplo-Cego , Feminino , Perda Auditiva Condutiva/tratamento farmacológico , Cardiopatias Congênitas/tratamento farmacológico , Humanos , Ictiose/tratamento farmacológico , Deficiência Intelectual/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Síndromes Neurocutâneas/tratamento farmacológico , Acidente Vascular Cerebral/complicações , Tempo , Resultado do Tratamento
11.
J Stroke Cerebrovasc Dis ; 24(4): 823-7, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25680658

RESUMO

BACKGROUND: Stroke trials often analyze patients with heterogeneous prognoses using a single definition of outcome, which may not be applicable to all subgroups. We aimed to evaluate the treatment effects of MCL601 among patients stratified by prognosis in the Chinese Medicine Neuroaid Efficacy on Stroke Recovery (CHIMES) study. METHODS: Analyses were performed using data from the CHIMES study, an international, randomized, placebo-controlled, double-blind trial comparing MLC601 with placebo in patients with ischemic stroke of intermediate severity in the preceding 72 hours. All subjects with baseline data and the modified Rankin Scale (mRS) score at 3 months were included. RESULTS: Data from 1006 subjects were analyzed. The predictive variables for mRS score greater than 1 at month 3 were age older than 60 years (P < .001), baseline National Institutes of Health Stroke Scale score 10-14 (P < .001), stroke onset to initiation of study treatment of more than 48 hours (P < .001), and female sex (P = .026). A higher number of predictors was associated with poorer mRS score at month 3 for both placebo (P < .001) and treatment (P < .001) groups. The odds ratio (OR) for achieving a good outcome increased with the number of predictors and reached statistical significance in favor of MLC601 among patients with 2 to 4 predictors combined (unadjusted OR = 1.44, 95% confidence interval, 1.02-2.03; adjusted OR = 1.60, 95% confidence interval, 1.10-2.34). CONCLUSIONS: Age, sex, baseline National Institutes of Health Stroke Scale score, and time to first dose are predictors of functional outcome in the CHIMES study. Stratification by prognosis showed that patients with 2 or more predictors of poorer outcome have better treatment effect with MLC601 than patients with single or no prognostic factor. These results have implications on designing future stroke trials.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Recuperação de Função Fisiológica/efeitos dos fármacos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do Tratamento
12.
Int J Stroke ; 9 Suppl A100: 102-5, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25041870

RESUMO

BACKGROUND: The CHIMES Study compared MLC601 with placebo in patients with ischemic stroke of intermediate severity in the preceding 72 h. Sites from the Philippines randomized 504 of 1099 (46%) patients in the study. We aimed to define the patient characteristics and treatment responses in this subgroup to better plan future trials. METHODS: The CHIMES dataset was used to compare the baseline characteristics, time from stroke onset to study treatment initiation, and treatment responses to MLC601 between patients recruited from Philippines and the rest of the cohort. Treatment effect was analyzed using end-points at month 3 as described in the primary publication, that is, modified Rankin Score, National Institutes of Health Stroke Scale, and Barthel Index. RESULTS: The Philippine cohort was younger, had more women, worse baseline National Institutes of Health Stroke Scale, and longer time delay from stroke onset to study treatment compared with the rest of the cohort. Age (P = 0·003), baseline National Institutes of Health Stroke Scale (P < 0·001), and stroke onset to study treatment initiation (P = 0·016) were predictors of modified Rankin Score at three-months. Primary analysis of modified Rankin Score shift was in favor of MLC601 (adjusted odds ratio 1·41, 95% confidence interval 1·01-1·96). Secondary analyses were likewise in favor of MLC601 for modified Rankin Score dichotomy 0-1, improvement in National Institutes of Health Stroke Scale (total and motor scores), and Barthel Index. CONCLUSIONS: The treatment effects in the Philippine cohort were in favor of MLC601. This may be due to inclusion of more patients with predictors of poorer outcome.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Adulto , Fatores Etários , Idoso , Isquemia Encefálica/complicações , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas , Índice de Gravidade de Doença , Acidente Vascular Cerebral/etiologia , Resultado do Tratamento
14.
Rev. Col. Méd. Cir. Guatem ; 151: 44-47, jul. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-835570

RESUMO

¿Cómo repercuten las altas tasas de pobreza yaltos índices de desempleo en lo que respecta ala Salud en Guatemala? ¿Será que las accionesgubernamentales, los programas de salud, el presupuesto otorgado al Ministerio de Salud, logransu objetivo de asistir y mejorar los problemas de salud de los niños en Guatemala? ¿Cuál es la poblaciónmás afectada en el área de salud? Cuestiones comoestas interesan determinar las principales causas de hospitalización de los niños en Guatemala con tal de evaluar un sistema de salud que en los últimos años ha sido deficiente, criticado a nivel mundial y queha puesto y calificado a Guatemala como un país subdesarrollado.


What effect do high rates of poverty and highunemployment in relation to health in Guatemala? Will it be that government actions, health programs,the budget allocated to the Ministry of Health, achieve their objective to assist and improve the health problems of children in Guatemala? What is the population most affected in the area of health? How are you interested Issues principals determine cause of hospitalization of children in Guatemala provided to evaluate a health care system in recentyears has been inadequate, criticized worldwide and has qualified and Guatemala as an underdeveloped country.


Assuntos
Humanos , Guatemala , Hospitalização/estatística & dados numéricos , Saúde da Criança/legislação & jurisprudência
15.
Stroke ; 44(8): 2093-100, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23780952

RESUMO

BACKGROUND AND PURPOSE: Previous clinical studies suggested benefit for poststroke recovery when MLC601 was administered between 2 weeks and 6 months of stroke onset. The Chinese Medicine Neuroaid Efficacy on Stroke recovery (CHIMES) study tested the hypothesis that MLC601 is superior to placebo in acute, moderately severe ischemic stroke within a 72-hour time window. METHODS: This multicenter, double-blind, placebo-controlled trial randomized 1100 patients with a National Institutes of Health Stroke Scale score 6 to 14, within 72 hours of onset, to trial medications for 3 months. The primary outcome was a shift in the modified Rankin Scale. Secondary outcomes were modified Rankin Scale dichotomy, National Institutes of Health Stroke Scale improvement, difference in National Institutes of Health Stroke Scale total and motor scores, Barthel index, and mini-mental state examination. Planned subgroup analyses were performed according to age, sex, time to first dose, baseline National Institutes of Health Stroke Scale, presence of cortical signs, and antiplatelet use. RESULTS: The modified Rankin Scale shift analysis-adjusted odds ratio was 1.09 (95% confidence interval, 0.86-1.32). Statistical difference was not detected between the treatment groups for any of the secondary outcomes. Subgroup analyses showed no statistical heterogeneity for the primary outcome; however, a trend toward benefit in the subgroup receiving treatment beyond 48 hours from stroke onset was noted. Serious and nonserious adverse events rates were similar between the 2 groups. CONCLUSIONS: MLC601 is statistically no better than placebo in improving outcomes at 3 months when used among patients with acute ischemic stroke of intermediate severity. Longer treatment duration and follow-up of participants with treatment initiated after 48 hours may be considered in future studies. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00554723.


Assuntos
Medicamentos de Ervas Chinesas/farmacologia , Medicina Tradicional Chinesa/métodos , Acidente Vascular Cerebral/tratamento farmacológico , Doença Aguda , Idoso , Método Duplo-Cego , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
16.
J AAPOS ; 15(4): 392-4, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21907125

RESUMO

Recurrent sixth nerve palsies are usually idiopathic, although they have been postulated to be caused by a postinflammatory insult or abnormal cerebral circulation. We report the case a 9-month-old boy who had 2 episodes of a left abduction deficit that resolved spontaneously. A 3-dimensional high-resolution T2-weighted sequence magnetic resonance imaging scan of the head revealed a hypoplastic left 6th nerve and a small left Dorello's canal.


Assuntos
Doenças do Nervo Abducente/etiologia , Doenças do Nervo Abducente/patologia , Nervo Abducente/patologia , Fossa Craniana Posterior/anormalidades , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Músculos Oculomotores/patologia , Recidiva
17.
Rev. Col. Méd. Cir. Guatem ; 6(1): 39-45, ene.-jun. 2011. tab
Artigo em Espanhol | LILACS | ID: biblio-835514

RESUMO

Las estadísticas de mortalidad deben utilizarse como fuente de información en salud de una población, porque reflejan los casos en que no pudo actuarse oportunamente y en donde no podía hacerse mayor acción. El diagnóstico correcto por el profesional de salud en la certificación como causa básica de la muerte materna permite producir y analizar datos relacionados con condiciones de vida y problemas de salud que desencadenaron la muerte, en determinado lugar...


Assuntos
Humanos , Certificação/estatística & dados numéricos , Mortalidade Materna
18.
Pediatr. edicion int ; 1(1): 17-9, ene.-mar. 1998. ilus
Artigo em Espanhol | LILACS | ID: lil-205933

RESUMO

Objetivo. Determinar el número de oportunidades perdidas en los niños atendidos en el Departamento de Pediatría del Hospital General San Juan de Dios. Diseño.Estudio prospectivo, operacional y participativo del 1o. de octubre de 1994 al 31 de enero de 1996.Población.Se entrevistaron 769 madres o responsables de niños menores de 5 años de edad, que estuvieron hospitalizados, correspondiendo al 95/100 del universo que demandó servicios médicos pediátricos del período en estudio.Metodología.La entrevista fue semiestructurada, contemplando preguntas de áreas prioritarias de la salud del niño,como son:a)crecimiento y desarrollo;b)nutrición; c)programa ampliado de inmunización; d)control de enfermedades diarréicas y e)control de infecciones respiratorias agudas. Los resultados de las entrevistas realizadas demostraron que el número de oportunidades perdidas, OP en los niños atendidos fue mayor al 50/100.Resultados. Prácticamente no existió monitoreo del crecimiento y desarrollo infantil en el departamento y el PAI no se cumple en este hospital, así como tampoco se refiere a lugares adecuados a las madres de familia para que se cumplan estos componentes básicos de la atención integral del niño. Esto pese a que en talleres realizados con el personal de salud sobre"componentes básicos de la atención integral de salud del niño"se evidencia de que el conocimiento que pediátras, residentes, enfermeras, tiene es adecuado. Conclusiones.Este trabajo de investigación operacional, sirvió de base para fomentar en el Departamento de Atención Integral de Salud del Niño congruente con los lineamientos que el Programa Materno Infantil del Ministerio de Salud Pública tiene para el período 1996-2000.


Assuntos
Humanos , Feminino , Pré-Escolar , Desenvolvimento Infantil , Assistência Integral à Saúde , Diarreia , Educação Alimentar e Nutricional , Guatemala , Hospitais , Imunização , Infecções Respiratórias
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