Tratamiento endovascular del ictus isquémico agudo en el territorio vascular posterior cerebral

El ictus isquémico sigue constituyendo una de las causas principales de muerte y dependencia. El objetivo del tratamiento es la recanalización precoz de la arteria y las técnicas de revascularización endovascular de oclusiones de la circulación anterior cerebral se han correlacionado con una mejoría significativa en el pronóstico en pacientes seleccionados. El ictus isquémico agudo en el territorio vascular cerebral posterior tiene unas características clínicas propias que dificultan el diagnóstico precoz, determinadas por sus características morfológicas y funcionales y provocando cuadros con una alta morbilidad y mortalidad, no habiendo en la actualidad suficiente evidencia científica en cuanto a la eficacia y seguridad del tratamiento endovascular en este territorio.Tomando como hipótesis que el tratamiento endovascular en el territorio vascular cerebral posterior debería ser eficaz y seguro y debería también mejorar el pronóstico funcional de los pacientes, se han descrito y analizado los 62 pacientes tratados en el Hospital Universitario Donostia (San Sebastián, Guipúzcoa) entre los años 2011 y 2017, el 85% de ellos con oclusiones en la arteria basilar y con unas características clínicas y epidemiológicas similares a otras series publicadas..

Humanities, Stem, Social Sciences

Personal statements and reports from the departments belonging to the Humanities, STEM, and Social Sciences.https://digitalcommons.andrews.edu/pda/1000/thumbnail.jp

TRIBUNAL ARBITRAL DE UNIÓN TEMPORAL ORIENTE REGIÓN 5 VS. NACIÓN FONDO NACIONAL DE PRESTACIONES SOCIALES DEL MAGISTERIO FOMAG

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ATENDIMENTO A PESSOAS COM PARADA CARDIORRESPIRATÓRIA NA ESF

Cardiorespiratory arrest (CPA) is a critical medical emergency that requires rapid and effective intervention to increase the chances of survival. The Family Health Strategy (ESF) plays a fundamental role in promoting health and preventing diseases in communities. However, the ESF approach to managing PCR is still a topic that deserves analysis and evaluation. The objective of this integrative review is to analyze and synthesize the existing literature related to the care of people with cardiorespiratory arrest in the FHS. The aim is to identify the best practices, challenges and impacts of the ESF intervention in this medical emergency scenario. This integrative review involved the selection of scientific studies, research and relevant articles through searches in databases, such as PubMed, Scopus, Lilacs and Google Scholar. Descriptors such as "cardiorespiratory arrest", "pre-hospital care", "Family Health Strategy" and related terms were used. Studies published in the last ten years in Portuguese, Spanish or English were included. The results of the selected studies were analyzed and synthesized to identify the most effective practices for CPA care in the FHS, as well as the challenges faced in implementing these practices and the impacts observed on patients' survival and quality of life. The successful implementation of these practices can have a significant impact on the survival and quality of life of people who experience a CA, reinforcing the crucial role of the ESF in pre-hospital care. However, future research is needed to further improve the guidelines and protocols related to CPA care in the FHS, as well as to evaluate its long-term impact.  A parada cardiorrespiratória (PCR) é uma emergência médica crítica que requer intervenção rápida e eficaz para aumentar as chances de sobrevivência. A Estratégia de Saúde da Família (ESF) desempenha um papel fundamental na promoção da saúde e na prevenção de doenças em comunidades. No entanto, a abordagem da ESF na gestão da PCR ainda é um tópico que merece análise e avaliação. O objetivo desta revisão integrativa é analisar e sintetizar a literatura existente relacionada ao atendimento a pessoas com parada cardiorrespiratória na ESF. Pretende-se identificar as melhores práticas, desafios e impactos da intervenção da ESF nesse cenário de emergência médica. Esta revisão integrativa envolveu a seleção de estudos científicos, pesquisas e artigos relevantes por meio de buscas em bases de dados, como PubMed, Scopus, Lilacs e Google Scholar. Utilizaram-se descritores como "parada cardiorrespiratória", "atendimento pré-hospitalar", "Estratégia de Saúde da Família" e termos relacionados. Foram incluídos estudos publicados nos últimos dez anos em português, espanhol ou inglês. Os resultados dos estudos selecionados foram analisados e sintetizados para identificar as práticas mais eficazes de atendimento a PCR na ESF, bem como os desafios enfrentados na implementação dessas práticas e os impactos observados na sobrevida e na qualidade de vida dos pacientes.  A implementação bem-sucedida dessas práticas pode ter um impacto significativo na sobrevivência e na qualidade de vida das pessoas que vivenciam uma PCR, reforçando o papel crucial da ESF na assistência pré-hospitalar. No entanto, são necessárias pesquisas futuras para aprimorar ainda mais as diretrizes e protocolos relacionados ao atendimento de PCR na ESF, bem como para avaliar seu impacto em longo prazo

Herramienta Kahoot como estrategia para fomentar la participación y el aprendizaje activo del alumno

Depto. de Química en Ciencias FarmacéuticasFac. de FarmaciaFALSEsubmitte

ADAPT technique with ACE68 and ACE64 reperfusion catheters in ischemic stroke treatment: results from the PROMISE study.

The recent randomized trials demonstrated the benefit of mechanical thrombectomy in stroke therapy. However, treatment using different strategies is an ongoing area of investigation. The PROMISE study analyzed the safety and effectiveness of the Penumbra System with the ACE68 and ACE64 reperfusion catheters in aspiration thrombectomy of stroke, using A Direct Aspiration First Pass Technique (ADAPT). PROMISE was a prospective study which enrolled 204 patients with intracranial anterior circulation large vessel occlusion (LVO) ischemic stroke in 20 centers from February 2016 to May 2017. Initial treatment was with the ACE68/ACE64 catheters within 6 hours of symptom onset. Imaging and safety review was performed by an independent Core Laboratory and a Clinical Events Committee. The primary angiographic outcome was revascularization to mTICI 2b-3 at immediate post-procedure and the primary clinical outcome was 90-day modified Rankin Scale (mRS) score ≤2. Safety assessment included device- and procedure-related serious adverse events (SAEs), symptomatic intracranial hemorrhage (sICH), mortality, and embolization of new territory (ENT). Enrolled patients had a median age of 74 (IQR 65-80) years and a median admission NIHSS of 16 (IQR 11-20). The post-procedure mTICI 2b-3 revascularization rate was 93.1% and the 90-day mRS 0-2 rate was 61%. Device- and procedure-related SAEs at 24 hours occurred in 1.5% and 3.4%, respectively, 90-day mortality was 7.5%, sICH occurred in 2.9% while ENT occurred in 1.5%. For frontline therapy of LVO stroke, the ACE68/ACE64 catheters for aspiration thrombectomy were found to be safe and showed similar efficacy to randomized trials using other revascularization techniques. NCT02678169; Pre-results

Evaluation of two formulations of adjuvanted RTS, S malaria vaccine in children aged 3 to 5 years living in a malaria-endemic region of Mozambique: a Phase I/IIb randomized double-blind bridging trial

BACKGROUND: Previous trials of the RTS, S malaria candidate vaccine have shown that this vaccine is safe, tolerated and immunogenic. The development plan for this vaccine aims at administering it in the first year of life through the Expanded Program on Immunization (EPI). The objective was to evaluate the safety and reactogenicity of RTS, S/AS02D (0.5 ml dose), a pediatric formulation of GlaxoSmithKline Biologicals' current malaria candidate vaccine RTS, S/AS02A (0.25 ml dose). A 0.5 ml dose of AS02D is composed of the same active ingredients in the same quantities as in a 0.25 ml dose of AS02A and has been developed to be easily introduced into routine EPI practices. METHODS: We performed a phase I/IIb randomized double-blind bridging study in a malaria-endemic region of Mozambique, to compare the safety and immunogenicity of both candidate vaccines with the aim of replacing RTS, S/AS02A with RTS, S/AS02D as the candidate pediatric vaccine. 200 Mozambican children aged 3 to 5 years were randomized 1:1 to receive one of the 2 vaccines according to a 0, 1, 2 month schedule. RESULTS: Both vaccines were safe and had similar reactogenicity profiles. All subjects with paired pre and post-vaccination samples showed a vaccine response with respect to anti-circumsporozoite (CS) antibodies irrespective of initial anti-CS serostatus. Geometric mean titers (GMTs) were 191 EU/ml (95% CI 150–242) in recipients of RTS, S/AS02D compared to 180 EU/ml (95% CI 146–221) in recipients of RTS, S/AS02A. For the anti-hepatitis B surface antigen (HBsAg), all subjects were seroprotected at day 90, and the GMTs were 23978 mIU/ml (95% CI 17896–32127) in RTS, S/AS02D recipients and 17410 mIU/ml (95% CI 13322–22752) in RTS, S/AS02A recipients. There was a decrease in anti-CS GMTs between months 3 and 14 in both groups (191 vs 22 EU/mL in RTS, S/AS02D group and 180 vs 29 EU/mL in RTS, S/AS02A group). CONCLUSION: Our data show that the RTS, S/AS02D is safe, well tolerated, and demonstrates non-inferiority (defined as upper limit of the 95% confidence interval of the anti-CS GMT ratio of RTS, S/AS02A to RTS, S/AS02D below 3.0) of the antibody responses to circumsporozoite and HBsAg induced by the RTS, S/AS02D as compared to the RTS, S/AS02A