Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain

Objective Validation of the intracerebral haemorrhage (ICH) score in patients with a diagnosis of spontaneous ICH admitted to the intensive care unit (ICU). Results A total of 336 patients were included. 105 of whom underwent surgery. Median (IQR) age: 62 (50–70) years. APACHE-II: 21(15–26) points, GCS: 7 (4–11) points, ICH score: 2 (2–3) points. 11.1% presented with bilateral mydriasis on admission (mortality rate=100%). Intraventricular haemorrhage was observed in 58.9% of patients. In-hospital mortality was 54.17% while the APACHE-II predicted mortality was 57.22% with a standardised mortality ratio (SMR) of 0.95 (95% CI 0.81 to 1.09) and a Hosmer-Lemenshow test value (H) of 3.62 (no significant statistical difference, n.s.). 30-day mortality was 52.38% compared with the ICH score predicted mortality of 48.79%, SMR: 1.07 (95% CI 0.91 to 1.23), n.s. Mortality was higher than predicted at the lowest scores and lower than predicted in the more severe patients, (H=55.89, p<0.001), Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva calibration belt (p<0.001). The area under a receiver operating characteristic (ROC) curve was 0.74 (95% CI 0.69 to 0.79). Conclusions ICH score shows an acceptable discrimination as a tool to predict mortality rates in patients with spontaneous ICH admitted to the ICU, but its calibration is suboptimal

Evidencia de propiedades fractales en la sucesión de Fibonacci usando wavelets.

En este artículo mostramos la existencia de una estrecha relación entre la geometría fractal, la divina proporción y la sucesión de Fibonacci;  mediante la utilización de Wavelets

Geometría fractal y transformada de Fourier

En este artículo mostramos la existencia de una estrecha relación entre la geometría fractal, las leyes de potencias y la transformada de Fourier. Usando para ello la densidad espectral de potencia de un objeto fractal

Evidencia de propiedades fractales en la sucesión de Fibonacci usando wavelets.

En este artículo mostramos la existencia de una estrecha relación entre la geometría fractal, la divina proporción y la sucesión de Fibonacci;  mediante la utilización de Wavelets

Aproximación al criterio de Holmes-Melnikov

En este artículo se resuelve una integral impropia usando el teorema de los residuos y la transformada de Fourier. Esta integral resulta de la utilización del método de Melnikov en un sistema dinámico no linea

Aproximación al criterio de Holmes-Melnikov

En este artículo se resuelve una integral impropia usando el teorema de los residuos y la transformada de Fourier. Esta integral resulta de la utilización del método de Melnikov en un sistema dinámico no linea

Who does what the cardiologist recommends? Psychosocial markers of unhealthy behavior in coronary disease patients

Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social support, mental health (coping, self-esteem, and perceived stress), and unhealthy behavior. We conducted a cross-sectional study of 419 patients recently diagnosed with coronary heart disease (myocardial infarction or angina) who participated in the National Health Survey in Spain (2018). Unhealthy behaviors were defined according to the European Guidelines on cardiovascular disease prevention. Only 1% of patients reported no unhealthy behaviors, with 11% reporting one, 40% two, 35% three, and 13% four or more unhealthy behaviors. In multiple regression controlling for demographic and traditional risk factors, mental health was the only significant psychosocial factor, doubling the odds of accumulated unhealthy behaviors, OR(high vs. low) = 2.03, 95% CI [1.14, 3.64]. Mental health was especially strongly related to unhealthy behavior among patients with obesity, OR(high vs. low) = 3.50, 95% CI [1.49, 8.45]. The relationship between mental health and unhealthy behaviors suggests that a large proportion of patients may not adhere to lifestyle recommendations not because they purposefully choose to do so, but because they lack coping skills to maintain the recommended healthy behaviors. Low mental well-being may be especially detrimental for behavior change of patients with obesity.Dafina Petrova is supported by a Juan de la Cierva Fellowship (FJCI-2016-28279) from the Spanish Ministry of Economy, Industry, and Competitiveness. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript