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1.
J Theor Biol ; 382: 320-7, 2015 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-26164061

RESUMO

Low-complexity regions are sub-sequences of biased composition in a protein sequence. The influence of these regions over protein evolution, specific functions and highly interactive capacities is well known. Although protein sequence entropy has been largely studied, its relationship with low-complexity regions and the subsequent effects on protein function remains unclear. In this work we propose a theoretical and empirical model integrating the sequence entropy with local complexity parameters. Our results indicate that the protein sequence entropy is related with the protein length, the entropies inside and outside the low-complexity regions as well as their number and average size. We found a small but significant increment in the sequence entropy of hubs proteins. In agreement with our theoretical model, this increment is highly dependent of the balance between the increment of protein length and average size of the low-complexity regions. Finally, our models and proteins analysis provide evidence supporting that modifications in the average size is more relevant in hubs proteins than changes in the number of low-complexity regions.


Assuntos
Entropia , Mapas de Interação de Proteínas , Proteínas/química , Sequência de Aminoácidos , Bases de Dados de Proteínas , Humanos , Modelos Logísticos , Análise de Sequência de Proteína
2.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(9): 567-577, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36253286

RESUMO

Hemodynamic and respiratory complications are the main causes of morbidity and mortality in in critical care units (CCU). Imaging techniques are a key tool in differential diagnosis and treatment. In the last decade, ultrasound has shown great potential for bedside diagnosis of respiratory disease, as well as for the hemodynamic assessment of critically ill patients. Ultrasound has proven to be a useful guide for identifying the type of shock, estimating cardiac output, guiding fluid therapy and vasoactive drugs, providing security in the performance of percutaneous techniques (thoracentesis, pericardiocentesis, evacuation of abscesses/hematomas), detecting dynamically in real time pulmonary atelectasis and its response to alveolar recruitment maneuvers, and predicting weaning failure from mechanical ventilation. Due to its dynamic nature, simple learning curve and absence of ionizing radiation, it has been incorporated as an essential tool in daily clinical practice in CCUs. The objective of this review is to offer a global vision of the role of ultrasound and its applications in the critically ill patient.


Assuntos
Cuidados Críticos , Estado Terminal , Humanos , Cuidados Críticos/métodos , Ultrassonografia/métodos , Unidades de Terapia Intensiva , Respiração Artificial
4.
Front Psychol ; 10: 1916, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474920

RESUMO

Cyberbullying is a common relational problem having negative repercussions on the academic performance of adolescents. Numerous questions remain to be answered with regard to the relationship between cyberbullying and school refusal behavior. This study examines school refusal profiles (measured by School Refusal Assessment Scale-Revised) and assesses whether these profiles vary with respect to the level of victimization, aggression, aggression-victimization, and observation of cyberbullying (measured with the Screening of Harassment among Peers). The sample consisted of 1,102 Spanish high school students, aged 12-18 (M = 14.30, SD = 1.71). Latent class analysis revealed three school refusal behavior profiles: non-school refusal behavior, school refusal behavior by negative reinforcements (oriented to the avoidance of social evaluation and negative affectivity in school situations), and school refusal behavior by positive reinforcements (oriented to obtaining the attention of others with significant or tangible reinforcements). The ANOVA found statistically significant differences for all cyberbullying behaviors. Students with school refusal by negative reinforcements had significantly higher mean scores as compared to the other profiles in victimization, aggression, aggression-victimization, and observation behaviors, while the levels of cyberbullying were similar between students without school refusal and students with school refusal behavior by positive reinforcements. These findings underscore the need to consider priority interventions to prevent cyberbullying in children who refuse school for the purpose of avoiding situations of anxiety and negative emotions.

5.
PLoS One ; 14(10): e0223276, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31589649

RESUMO

The prediction of cell-lines sensitivity to a given set of compounds is a very important factor in the optimization of in-vitro assays. To date, the most common prediction strategies are based upon machine learning or other quantitative structure-activity relationships (QSAR) based approaches. In the present research, we propose and discuss a straightforward strategy not based on any learning modelling but exclusively relying upon the chemical similarity of a query compound to reference compounds with annotated activity against cell lines. We also compare the performance of the proposed method to machine learning predictions on the same problem. A curated database of compounds-cell lines associations derived from ChemBL version 22 was created for algorithm construction and cross-validation. Validation was done using 10-fold cross-validation and testing the models on new data obtained from ChemBL version 25. In terms of accuracy, both methods perform similarly with values around 0.65 across 750 cell lines in 10-fold cross-validation experiments. By combining both methods it is possible to achieve 66% of correct classification rate in more than 26000 newly reported interactions comprising 11000 new compounds. A Web Service implementing the described approaches (both similarity and machine learning based models) is freely available at: http://bioquimio.udla.edu.ec/cellfishing.


Assuntos
Resistência a Medicamentos , Aprendizado de Máquina , Relação Quantitativa Estrutura-Atividade , Animais , Linhagem Celular , Descoberta de Drogas/métodos , Humanos , Bibliotecas de Moléculas Pequenas/química , Bibliotecas de Moléculas Pequenas/farmacologia , Software
6.
Mol Cell Biol ; 11(11): 5592-602, 1991 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1922065

RESUMO

Previous analysis of cdc20 mutants of the yeast Saccharomyces cerevisiae suggests that the CDC20 gene product (Cdc20p) is required for two microtubule-dependent processes, nuclear movements prior to anaphase and chromosome separation. Here we report that cdc20 mutants are defective for a third microtubule-mediated event, nuclear fusion during mating of G1 cells, but appear normal for a fourth microtubule-dependent process, nuclear migration after DNA replication. Therefore, Cdc20p is required for a subset of microtubule-dependent processes and functions at multiple stages in the life cycle. Consistent with this interpretation, we find that cdc20 cells arrested by alpha-factor or at the restrictive temperature accumulate anomalous microtubule structures, as detected by indirect immunofluorescence. The anomalous microtubule staining patterns are due to cdc20 because intragenic revertants that revert the temperature sensitivity have normal microtubule morphologies. cdc20 mutants have a sevenfold increase in the intensity of antitubulin fluorescence in intranuclear spindles compared with spindles from wild-type cells, yet the total amount of tubulin is indistinguishable by Western immunoblot analysis. This result suggests that Cdc20p modulates microtubule structure in wild-type cells either by promoting microtubule disassembly or by altering the surface of the microtubules. Finally, we cloned and sequenced CDC20 and show that it encodes a member of a family of proteins that share homology to the beta subunit of transducin.


Assuntos
Proteínas Fúngicas/genética , Genes Fúngicos , Microtúbulos/fisiologia , Saccharomyces cerevisiae/genética , Transducina/genética , Sequência de Aminoácidos , Sequência de Bases , Cruzamentos Genéticos , Reparo do DNA , DNA Fúngico/genética , Imunofluorescência , Genótipo , Dados de Sequência Molecular , Plasmídeos , Mapeamento por Restrição , Saccharomyces cerevisiae/fisiologia , Homologia de Sequência do Ácido Nucleico , Tubulina (Proteína)/análise , Tubulina (Proteína)/genética
7.
J Clin Pathol ; 59(9): 997-8, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16935978

RESUMO

Apical bronchial carcinoma is the most common cause of Pancoast's syndrome. Of the many other causes reported, infection is a rare one. A literature review is presented and a case of Pancoast's syndrome, secondary to apical lung pneumonia with bronchocutaneous fistulisation caused by Staphylococcus aureus infection, is reported. Clinical and radiological resolution was achieved after treatment with antibiotics.


Assuntos
Fístula Brônquica/complicações , Fístula Cutânea/complicações , Síndrome de Pancoast/microbiologia , Pneumonia Bacteriana/complicações , Infecções Estafilocócicas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
8.
Neurologia (Engl Ed) ; 2016 Sep 16.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27645775

RESUMO

OBJECTIVES: We aimed to determine whether the aetiology of ischaemic stroke has changed in recent years and, if so, to ascertain the possible reasons for these changes. PATIENTS AND METHODS: We analysed the epidemiological history and vascular risk factors of all patients diagnosed with ischaemic stroke at Complejo Hospitalario Universitario de Albacete (CHUA) from 2009 to 2014. Ischaemic stroke subtypes were established using the TOAST criteria. Our results were compared to data from the classic Stroke Data Bank (SDB); in addition, both series were compared to those of other hospital databases covering the period between the two. RESULTS: We analysed 1664 patients (58% were men) with a mean age of 74 years. Stroke aetiology in both series (CHUA, SDB) was as follows: atherosclerosis (12%, 9%), small-vessel occlusion (13%, 25%), cardioembolism (32%, 19%), stroke of other determined aetiology (3%, 4%), and stroke of undetermined aetiology (40%, 44%). Sixty-three percent of the patients from the CHUA and 42% of the patients from the SDB were older than 70 years. Cardioembolic strokes were more prevalent in patients older than 70 years in both series. Untreated hypertension was more frequent in the SDB (SDB = 31% vs CHUA = 10%). The analysis of other databases shows that the prevalence of cardioembolic stroke is increasing worldwide. CONCLUSIONS: Our data show that the prevalence of lacunar strokes is decreasing worldwide whereas cardioembolic strokes are increasingly more frequent in both our hospital and other series compared to the SDB. These differences may be explained by population ageing and the improvements in management of hypertension and detection of cardioembolic arrhythmias in stroke units.

9.
Genetics ; 157(4): 1493-502, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11290706

RESUMO

We have measured the activity of the spindle checkpoint in null mutants lacking kinetochore activity in the yeast Saccharomyces cerevisiae. We constructed deletion mutants for nonessential genes by one-step gene replacements. We constructed heterozygous deletions of one copy of essential genes in diploid cells and purified spores containing the deletion allele. In addition, we made gene fusions for three essential genes to target the encoded proteins for proteolysis (degron alleles). We determined that Ndc10p, Ctf13p, and Cep3p are required for checkpoint activity. In contrast, cells lacking Cbf1p, Ctf19p, Mcm21p, Slk19p, Cse4p, Mif2p, Mck1p, and Kar3p are checkpoint proficient. We conclude that the kinetochore plays a critical role in checkpoint signaling in S. cerevisiae. Spindle checkpoint activity maps to a discreet domain within the kinetochore and depends on the CBF3 protein complex.


Assuntos
Proteínas de Ciclo Celular , Proteínas de Ligação a DNA/metabolismo , Proteínas Fúngicas/metabolismo , Proteínas Associadas aos Microtúbulos , Proteínas de Saccharomyces cerevisiae , Transdução de Sinais/fisiologia , Fuso Acromático/fisiologia , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos , Sítios de Ligação , Cromatina/genética , Cromatina/fisiologia , Proteínas Cromossômicas não Histona , Mapeamento Cromossômico , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/fisiologia , Proteínas Fúngicas/genética , Quinase 3 da Glicogênio Sintase , Cinetocoros , Mutagênese , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo , Proteínas Nucleares/fisiologia , Proteínas Tirosina Quinases/genética , Proteínas Tirosina Quinases/metabolismo , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/fisiologia
10.
Nat Commun ; 6: 6857, 2015 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-25919449

RESUMO

While Amazonian forests are extraordinarily diverse, the abundance of trees is skewed strongly towards relatively few 'hyperdominant' species. In addition to their diversity, Amazonian trees are a key component of the global carbon cycle, assimilating and storing more carbon than any other ecosystem on Earth. Here we ask, using a unique data set of 530 forest plots, if the functions of storing and producing woody carbon are concentrated in a small number of tree species, whether the most abundant species also dominate carbon cycling, and whether dominant species are characterized by specific functional traits. We find that dominance of forest function is even more concentrated in a few species than is dominance of tree abundance, with only ≈1% of Amazon tree species responsible for 50% of carbon storage and productivity. Although those species that contribute most to biomass and productivity are often abundant, species maximum size is also influential, while the identity and ranking of dominant species varies by function and by region.

11.
Microsc Res Tech ; 36(3): 151-8, 1997 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-9080404

RESUMO

The effects of different fixatives, dehydration procedures, and embedding media on the structural and ultrastructural preservation of young chick embryos (Hamburger and Hamilton stages 18-24) have been studied by means of light and electron microscopy techniques. Under the light microscope, the results obtained with the use of Bouin, glutaraldehyde, or glutaraldehyde-paraformaldehyde mixtures, followed by partial dehydration of the samples and the embedding with two different polar resins (Historesin and Unicryl), were compared with the results obtained using conventional paraffin-embedding methods. Cell and tissue shrinkage was determined by comparing blood cells from those embryos embedded in either of resins with those embedded in paraffin. Samples were also compared with blood smears, either methanol-fixed or unfixed, obtained from embryos at the same Hamburger and Hamilton stages. The results obtained when Unicryl and Araldite were used for electron microscopy have also been compared. When ultrastructural images from glutaraldehyde-tannic acid/osmium tetroxide fixed, Unicryl embedded samples were compared with those from araldite embedded samples, the same good results were observed with either of the resins. Araldite embedding requires a complete dehydration of the samples, while Unicryl allows the embedding of partially dehydrated embryos with optimal ultrastructural results. We suggest that these polar resins can be considered as complementary tools for embedding delicate embryonic tissues, allowing partial dehydration of the specimens with an excellent cell and tissue preservation.


Assuntos
Inclusão do Tecido/métodos , Fixação de Tecidos/métodos , Animais , Aorta/anatomia & histologia , Células Sanguíneas/citologia , Embrião de Galinha/ultraestrutura , Microscopia , Microscopia Eletrônica , Músculos/ultraestrutura , Inclusão em Parafina , Resinas Sintéticas
12.
Eur J Gastroenterol Hepatol ; 10(12): 1051-3, 1998 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9895053

RESUMO

Solitary benign non-parasitic hepatic cysts (SBNHC) are rare congenital cystic abnormalities. Complications of SBNHC include infection, perforation, spontaneous haemorrhage, torsion and neoplastic degeneration. Squamous cell carcinoma is an exceedingly rare entity, which usually arises from metaplastic and subsequent neoplastic transformation of pre-existing cyst of the liver. We report a new case of squamous cell carcinoma of the liver in a non-parasitic solitary hepatic cyst infected by aerobic mixed flora at the time of diagnosis.


Assuntos
Infecções Bacterianas/complicações , Carcinoma de Células Escamosas/complicações , Cistos/complicações , Hepatopatias/complicações , Neoplasias Hepáticas/complicações , Idoso , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Cistos/diagnóstico por imagem , Cistos/patologia , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Radiografia
13.
J Bone Joint Surg Br ; 81(3): 522-30, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10872378

RESUMO

We have studied the formation of collagen fibrils in 'activated fibroblasts' of tendo Achillis of rabbits. The tendon was in the process of regeneration after experimental partial tenotomy. Samples were taken from the peri-incisional region and analysed by transmission electron microscopy. Ultrastructural examination showed the presence of a 'fine dense granular substance' inside the rough endoplasmic reticulum and procollagen filaments. These come together to form collagen fibrils in the dilated vacuoles of the rough endoplasmic reticulum. The possible intra- and extracellular origin of collagen fibrils is suggested. Within the cell biosynthesis of collagen fibrils take place with the formation of collagen substance which gives rise to procollagen filaments. These make contact in parallel apposition to produce striated 'spindle-shaped bodies' which elongate by the longitudinal attachment of more procollagen filaments and form intracellular nascent collagen fibrils.


Assuntos
Tendão do Calcâneo/patologia , Colágeno/ultraestrutura , Fibroblastos/patologia , Microfibrilas/patologia , Traumatismos dos Tendões/patologia , Cicatrização/fisiologia , Tendão do Calcâneo/lesões , Animais , Masculino , Microscopia Eletrônica , Pró-Colágeno/ultraestrutura , Coelhos , Regeneração/fisiologia
14.
Accid Anal Prev ; 36(6): 1045-54, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15350881

RESUMO

This paper aims to study the phenomenon known as 'highway hypnosis' or 'driving without attention mode', which has been defined as a state showing sleepiness signs and attention slip resulting from driving a motor vehicle for a long period in a highly predictable environment with low event occurrence, this being the case with motorways and very familiar roads [Highway hypnosis: a theoretical analysis. In: Gale, A.G., Brown, I.D., Haslegrave, C.M., Moorhead, I., Taylor, S. (Eds.), Vision in Vehicles-III. Elsevier, North-Holland, pp. 467-472]. According to Wertheim's hypothesis on 'highway hypnosis', long-term driving on motorways and conventional roads, e.g. main roads, secondary roads--implies differences in the predictability of the movement pattern of the visual stimulation, in the eye musculature activity and in the type of feedback used in visual information processing (mostly extra-retinal on motorways and retinal and extra-retinal on conventional roads). All this ultimately leads to alertness differences between both road types. Our research is intended to provide empirical evidence from the hypothesis, based on the data recorded during the actual driving experience of a group of subjects on a motorway and a conventional road. We studied whether or not significant alertness differences were found-measured by EEG data relative to time periods of on-target eye-tracking performance--between motorway and conventional road driving. Our results partially support the hypothesis, as drowsiness proved to be higher on motorways than on conventional roads during the final driving period but not during the starting stage, when the opposite trend was noticed. This result could be explained by the fact that during the first driving periods the effects of the stimulus movement predictability had not yet become apparent, since they tend to show after a long drive.


Assuntos
Atenção/fisiologia , Condução de Veículo/psicologia , Adulto , Análise de Variância , Eletroencefalografia , Movimentos Oculares , Feminino , Humanos , Hipnose , Masculino , Pessoa de Meia-Idade , Desempenho Psicomotor , Espanha
15.
Eur J Obstet Gynecol Reprod Biol ; 102(1): 48-52, 2002 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-12039089

RESUMO

OBJECTIVE: After tubal ligation, normal bone mass in the presence of gonadal deficit has been reported. These incongruent results motivated us to examine the topic. STUDY DESIGN: Bone mass was assessed by densitometry and ultrasonography 60 days after surgery on 100-day-old female Wistar rats. Fifteen Wistar rats with uterine horn ligation (TL) were compared with 15 unoperated, 15 with a sham uterine horn ligation (Sham-TL), and 15 ovariectomized (OVX), using ANOVA and a correlation test to determine the relations between results. RESULTS: Femoral and vertebral bone mass were significantly lower in the OVX y TL groups than in unoperated and controls groups (P<0.0001). CONCLUSIONS: Our study revealed significantly lower axial and peripheral bone mass in rats with uterine horn ligation.


Assuntos
Densidade Óssea , Útero/cirurgia , Animais , Feminino , Fêmur/anatomia & histologia , Fêmur/diagnóstico por imagem , Ligadura , Modelos Lineares , Tamanho do Órgão , Ovariectomia , Ratos , Ratos Wistar , Ultrassonografia
16.
Rev Neurol ; 30(4): 316-21, 2000.
Artigo em Espanhol | MEDLINE | ID: mdl-10789138

RESUMO

INTRODUCTION AND OBJECTIVE: To study the postsurgical clinical course of spondylitic myelopathy. PATIENTS AND METHODS: We assessed 39 patients admitted to the Departments of Neurology and Neurosurgery of the Hospital Clinico Quirúrgico Hermanos Ameijeiras, Cuba, with a confirmed diagnosis of spondylitic myelopathy who had decompressing laminectomies during the period between January 1996 and December 1997. RESULTS: Of the predicted variables, there was predominance of an age under 60 years (51.3%); male sex (71.8%); a history of cervical trauma and habitual dangerous physical activity in 38.5% and 41% respectively. The duration of preoperative symptoms was less than one year in 46.2%. The vertebral level most often involved was C5-C6 (97.4%). In 51.3% three levels were affected: 100% of the patients had stenosis in the zone of maximum compression; 28.2% had congenital stenosis of the canal and 66.7% had partial block shown on myelography or magnetic resonance studies of the cervical spine. There was clinical improvement in 78.4% after one month, in 91.9% after 3 months and in 94.6% after 6 months; only 2 patients had not improved on completion of the study. Motor and sensory function of the legs improved more than motor function of the arms and sphincter. CONCLUSIONS: The variables which influenced the degree of improvement were: age, duration of the symptoms, number of vertebral levels affected, presence of blockage and functional state. After application of the multiple regression model, it was seen that the duration of preoperative symptoms is an important predictor of the postoperative clinical course.


Assuntos
Vértebras Cervicais , Laminectomia/efeitos adversos , Traumatismos da Medula Espinal , Espondilite/diagnóstico , Adulto , Idoso , Vértebras Cervicais/patologia , Vértebras Cervicais/cirurgia , Descompressão Cirúrgica/efeitos adversos , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Índice de Gravidade de Doença , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/cirurgia
17.
Neurología (Barc., Ed. impr.) ; 33(6): 369-377, jul.-ago. 2018. tab, graf
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-175939

RESUMO

OBJETIVOS: Comprobar si han existido variaciones en la etiología del ictus isquémico en los últimos años e investigar las posibles causas que lo justifiquen. PACIENTES Y MÉTODOS: Análisis de los antecedentes epidemiológicos y factores de riesgo vascular de los pacientes diagnosticados de ictus isquémico en el Complejo Hospitalario Universitario de Albacete (CHUA) entre 2009 y 2014. La clasificación etiológica del ictus isquémico se realizó según los criterios TOAST. Se compararon los resultados con los de la clásica Stroke Data Bank (SDB) y se contrastaron ambas series con otros registros hospitalarios publicados en el periodo que las separa. RESULTADOS: Se analiza a 1.664 pacientes, 58% varones, mediana de edad 74 años. Según la clasificación etiológica los resultados obtenidos son (CHUA/SDB): aterotrombóticos (12%/9%), lacunares (13%/25%), cardioembólicos (32%/19%), causa infrecuente (3%/4%) e indeterminados (40%/44%). El 63% de los pacientes del CHUA era mayor de 70 años, en la SDB solo el 42% superaba esa edad. En ambos registros el subtipo cardioembólico era más prevalente en mayores de 70 años. La HTA no tratada era más frecuente en la SDB (SDB = 31% vs. CHUA = 10%). El análisis de otras bases de datos muestra una tendencia progresiva a escala mundial al aumento en la prevalencia del ictus cardioembólico. CONCLUSIONES: Nuestro estudio muestra tanto en nuestro centro como a escala mundial una disminución del porcentaje de ictus lacunares y un aumento del de cardioembólicos respecto a la SDB. Estas diferencias pudieran justificarse por el envejecimiento de los pacientes, el mejor control de la HTA actualmente y mayor capacidad para detectar arritmias cardioembólicas en las Unidades de Ictus


OBJECTIVES: We aimed to determine whether the aetiology of ischaemic stroke has changed in recent years and, if so, to ascertain the possible reasons for these changes. PATIENTS AND METHODS: We analysed the epidemiological history and vascular risk factors of all patients diagnosed with ischaemic stroke at Complejo Hospitalario Universitario de Albacete (CHUA) from 2009 to 2014. Ischaemic stroke subtypes were established using the TOAST criteria. Our results were compared to data from the classic Stroke Data Bank (SDB); in addition, both series were compared to those of other hospital databases covering the period between the two. RESULTS: We analysed 1664 patients (58% were men) with a mean age of 74 years. Stroke aetiology in both series (CHUA, SDB) was as follows: atherosclerosis (12%, 9%), small-vessel occlusion (13%, 25%), cardioembolism (32%, 19%), stroke of other determined aetiology (3%, 4%), and stroke of undetermined aetiology (40%, 44%). Sixty-three percent of the patients from the CHUA and 42% of the patients from the SDB were older than 70 years. Cardioembolic strokes were more prevalent in patients older than 70 years in both series. Untreated hypertension was more frequent in the SDB (SDB = 31% vs CHUA = 10%). The analysis of other databases shows that the prevalence of cardioembolic stroke is increasing worldwide. CONCLUSIONS: Our data show that the prevalence of lacunar strokes is decreasing worldwide whereas cardioembolic strokes are increasingly more frequent in both our hospital and other series compared to the SDB. These differences may be explained by population ageing and the improvements in management of hypertension and detection of cardioembolic arrhythmias in stroke units


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Acidente Vascular Cerebral/etiologia , Bases de Dados como Assunto/estatística & dados numéricos , Prontuários Médicos/estatística & dados numéricos , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/epidemiologia , Fatores de Risco , Arritmias Cardíacas/epidemiologia , Fibrilação Atrial/epidemiologia , Estudos Prospectivos
18.
Rev. esp. anestesiol. reanim ; 69(9): 567-577, Nov. 2022. ilus
Artigo em Espanhol, Português, Francês | IBECS (Espanha) | ID: ibc-211679

RESUMO

Las complicaciones cardiorrespiratorias son las principales causas de morbimortalidad en las unidades de cuidados críticos (UCC). Las técnicas de imagen son una pieza fundamental tanto en el diagnóstico diferencial como en el tratamiento. En la última década la ecografía ha demostrado gran potencial para el diagnóstico a pie de cama de patología respiratoria, así como para la valoración hemodinámica de los pacientes críticos. La ecografía ha demostrado ser una guía útil para la identificación del tipo de shock, la estimación del gasto cardiaco, guiar la fluidoterapia y los fármacos vasoactivos, aportar seguridad en la realización de las técnicas percutáneas (toracocentesis, pericardiocentesis, evacuación de abscesos/hematomas), objetivar de forma dinámica y en tiempo real la atelectasia pulmonar y su respuesta a las maniobras de reclutamiento alveolar, y predecir el fracaso en el destete de la ventilación mecánica. Por su carácter dinámico, sencilla curva de aprendizaje y ausencia de radiación ionizante, se ha incorporado como una herramienta imprescindible en la práctica clínica diaria en las UCC. El objetivo de la presente revisión es ofrecer una visión global del papel de la ecografía y sus aplicaciones en el paciente crítico.(AU)


Hemodynamic and respiratory complications are the main causes of morbidity and mortality in in critical care units (CCU). Imaging techniques are a key tool in differential diagnosis and treatment. In the last decade, ultrasound has shown great potential for bedside diagnosis of respiratory disease, as well as for the hemodynamic assessment of critically ill patients. Ultrasound has proven to be a useful guide for identifying the type of shock, estimating cardiac output, guiding fluid therapy and vasoactive drugs, providing security in the performance of percutaneous techniques (thoracentesis, pericardiocentesis, evacuation of abscesses/hematomas), detecting dynamically in real time pulmonary atelectasis and its response to alveolar recruitment maneuvers, and predicting weaning failure from mechanical ventilation. Due to its dynamic nature, simple learning curve and absence of ionizing radiation, it has been incorporated as an essential tool in daily clinical practice in CCUs. The objective of this review is to offer a global vision of the role of ultrasound and its applications in the critically ill patient.(AU)


Assuntos
Humanos , Ultrassonografia , Diagnóstico , Monitorização Fisiológica , Unidades de Terapia Intensiva , Doenças Respiratórias/complicações , Cuidados Críticos , Reanimação Cardiopulmonar , Anestesiologia , Espanha
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