RESUMO
BACKGROUND: Patients with obstructive sleep apnea syndrome (OSAS) are at increased risk for cerebrovascular diseases. The underlying mechanisms remain obscure. It may occur through a reduction in cerebral vascular reactivity. Continuous positive airway pressure (CPAP) is effective in reducing the occurrence of apneas. We hypothesized that treatment with CPAP improves cerebral vascular reactivity. METHODS: This is a prospective study with OSAS patients. The apnea test (ApT) was calculated as an increase of mean artery velocity during apnea: [Artery velocity in apnea minus Resting artery velocity]/Resting artery velocity expressed as percentage. After 2 years of CPAP treatment, the test was repeated. RESULTS: Seventy-six patients represented the study pool. After 2 years of treatment with CPAP, we were able to conduct a reassessment in 65 patients. Of the 65 patients who finished the clinical study, 56 were men, and 9 were women, with an average age of 48.1 ± 10.4 years. There was an improvement in the ApT after CPAP treatment (30.8 ± 12.1 vs 39.8 ± 15.1; p:0.000). The values of cerebral blood flow velocities, diastolic blood pressure in apnea, and basal heart rate decreased. CONCLUSIONS: Cerebral vascular reactivity in OSAS patients measured by ApT improved after 2 years of CPAP.
Assuntos
Encéfalo/irrigação sanguínea , Pressão Positiva Contínua nas Vias Aéreas , Hemodinâmica/fisiologia , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/diagnóstico por imagem , Artéria Cerebral Média/fisiopatologia , Polissonografia , Estudos Prospectivos , Apneia Obstrutiva do Sono/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana , Resistência Vascular/fisiologiaRESUMO
BACKGROUND: Cerebral vasoreactivity in obstructive sleep apnea syndrome is altered. Continuous positive airway pressure is effective in the reduction of the occurrence of apneas. We studied whether this treatment also improves cerebral vasoreactivity. METHODS: The breath-holding maneuver was performed and assessed by apnea test with transcranial Doppler in the basilar artery. After 2 years of continuous positive airway pressure treatment, the test was repeated. RESULTS: There is an improvement in the apnea test after continuous positive airway pressure. There are increases in the pulsatility index, diastolic blood pressure, and basal heart rate. The improvement in the apnea test depends on the body mass index of the patient. CONCLUSIONS: Cerebral vasoreactivity as measured by the apnea test improves after 2 years of continuous positive airway pressure. This improvement depends of the body mass index of the patient.
Assuntos
Artéria Basilar/fisiopatologia , Hemodinâmica/fisiologia , Apneia Obstrutiva do Sono/terapia , Adulto , Artéria Basilar/diagnóstico por imagem , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Pressão Positiva Contínua nas Vias Aéreas , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Apneia Obstrutiva do Sono/diagnóstico por imagem , Apneia Obstrutiva do Sono/fisiopatologia , Resultado do Tratamento , UltrassonografiaRESUMO
After a brief introduction about what an lctus Word is, the authors describe the project for an lctus Ward at the Dr. Josep Trueta University Hospital in Girona. Afterwards, the authors analyze its development and its results during its existence. The authors conclude that there has been a significant increase in benefits for patients since they have received new therapeutic treatments in a specialized ward, furthermore, both doctors and nurses have had the opportunity to develop new research projects.
Assuntos
Unidades Hospitalares/organização & administração , Neurologia , Acidente Vascular Cerebral/terapia , Hospitais Universitários , Humanos , EspanhaRESUMO
Presentamos el trabajo ganador del Primer Premio Ausonia Incontinencia, en la convocatoria correspondiente al año 1999. En él se analiza la prevalencia de incontinencia urinaria en enfermos diagnosticados de ictus en fase aguda a los tres meses, a los seis y al año. También se investigan los factores asociados a la incontinencia en la fase aguda del ictus, cómo influye la incontinencia en la evolución del paciente, y cómo afecta el medio donde se lleva a cabo la rehabilitación (domicilio o institución) a la hora de recuperarse el enfermo. Sus resultados confirman que la incontinencia urinaria en fase aguda es un factor predictivo, independientemente del mal pronóstico funcional a medio y largo plazo, y que su potencia pronóstica es superior a la de la gravedad del déficit neurológico al ingreso (AU)
Assuntos
Adulto , Feminino , Masculino , Pessoa de Meia-Idade , Humanos , Incontinência Urinária/etiologia , Acidente Vascular Cerebral/complicações , Prevalência , Evolução Clínica , Prognóstico , Doenças do Sistema Nervoso/etiologia , Estudos Prospectivos , Estudos Longitudinais , Incontinência Urinária/epidemiologia , Acidente Vascular Cerebral/epidemiologiaRESUMO
Tras una breve introducción sobre qué es una Unidad de Ictus, se describe el proyecto de la Unidad de Ictus del Hospital Universitario Dr. Josep Trueta de Gerona. Posteriormente se analizan su desarrollo y los resultados obtenidos en el tiempo. Se concluye un considerable aumento de beneficios para los pacientes, al tratarlos con nuevas pautas terapéuticas en una unidad especializada y la posibilidad de desarrollar nuevas líneas de investigación, tanto para los médicos como para enfermería (AU)