Browsing by Subject "Stroke"

Now showing 1 - 17 of 17
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    Atención al accidente cerebro vascular infantil: perspectiva de la neurología pediátrica
    (Murcia : Servicio de Publicaciones de la Universidad de Murcia, 2011) Liégio Matão, L.; Borges de Miranda, Denismar; Faria Campos, PH.; Pacheco, LP.; Martins Pereira, P.
    Objetivo: discutir en la perspectiva de la neurología pediátrica la atención del accidente cerebro vascular infantil en la ciudad de Goiania. Método: el enfoque descriptivo y abordaje cualitativo. Entrevista abierta en profundidad con neuropediatras, siendo el material sometido a análisis de contenido. El estudio fue aprobado por el Comité de Ética en Investigación de la Pontificia Universidad Católica de Goiás (número de protocolo 95645-0339/06). Resultados: los sujetos enfocaron, en sus narraciones, muchos más aspectos teóricos sobre la enfermedad en la infancia, los cuales aparecen de modo homogéneo y coincidente con la literatura especializada. El análisis reveló tres categorías, a saber: “Aspectos teóricos de accidente cerebro vascular en la infancia”, “Atención hospitalaria (des)organizadao” y “Ausencia de educación en salud a la comunidad”. Conclusiones: el tratamiento del accidente cerebro vascular en Goiania pediátrica se presentó a la población de modo notoriamente distinto. Se puede inferir que la situación económica determina no sólo el acceso a los servicios que ofrece la última tecnología, sino también sobre la "calidad" de la atención, ya que no hay neuropediatras actuando en la red pública, por lo que el servicio es inferior al necesario. En el ámbito privado son mucho más fáciles, más rápidos y cualificados.
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    Blood-brain barrier disruption following brain injury: Implications for clinical practice
    (Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2024) Bai, Ruojing; Ge, Xintong
    The blood-brain barrier (BBB) plays a critical role in regulating the exchange of substances between peripheral blood and the central nervous system and in maintaining the stability of the neurovascular unit in neurological diseases. To guide clinical treatment and basic research on BBB protection following brain injury, this manuscript reviews how BBB disruption develops and influences neural recovery after stroke and traumatic brain injury (TBI). By summarizing the pathological mechanisms of BBB damage, we underscore the critical role of promoting BBB repair in managing brain injury. We also emphasize the potential for personalized and precise therapeutic strategies and the need for continued research and innovation. From this, broadening insights into the mechanisms of BBB disruption and repair could pave the way for breakthroughs in the treatment of brain injury-related diseases.
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    Cessation of oral anticoagulation is an important risk factor for stroke and mortality in atrial fibrillation patients
    (2017) Rivera Caravaca, José Miguel; Roldán Schilling, Vanessa; Esteve Pastor, María Asunción; Valdés Chávarri, Mariano; Vicente García, Vicente; Lip, Gregory YH; Marín Ortuño, Francisco; Enfermería
    Oral anticoagulation (OAC) is highly effective preventing stroke and mortality in AF, but withdrawal is common in the elderly, when high bleeding risk and when are difficulties achieving an optimal time in therapeutic range (TTR). We analysed the rate of OAC cessation, predisposing factors to cessation and the relation to clinical outcomes in a large ‘real world’ cohort of AF patients over a long follow-up period. Consecutive non-valvular AF outpatients clinically stables for six months were recruited. Rates of cardiovascular events, major bleeding and mortality were recorded and related to OAC cessation. We included 1361 patients (48.7 % male; aged 76, IQR 71–81), followed-up for a median of 6.5 years. During follow-up, 244 patients suffered thrombotic events, 250 suffered from major bleeding and 551 patients died. 10 % of patients stopped OAC. After OAC withdrawal, there were 36 thromboembolic events (22 strokes), 10 major bleedings and 75 deaths. OAC cessation was independently associated with adverse cardiovascular events (HR 1.45; 95 % CI 1.01–2.08), stroke/TIA (HR 1.85; 1.17–2.94) and all-cause mortality (HR 1.30; 1.02–1.67). Independent predictors of OAC cessation were age 80 (HR 2.29; 1.60–3.29), previous coronary artery disease (HR 0.32; 0.15–0.71), major bleeding (HR 5.00; 3.49–7.15), heart failure (HR 2.38; 1.26-4.47), cancer (HR 5.24; 3.25–8.44) and renal impairment developed during follow-up (HR 2.70; 1.26–5.75). In conclusion, in non-valvular AF patients, cessation of OAC was independently associated with the risk of stroke, adverse cardiovascular events and mortality. Bleeding events and some variables associated with higher bleeding risk are responsible for OAC cessation.
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    Effect of cognitive multisensory rehabilitation on upper extremity function in stroke patients: A randomized controlled trial
    (Universidad de Murcia, Servicio de Publicaciones, 2024) El-Din Mahmoud, Lama Saad; Mohamed, Omnia Shokry; Yacoub, Osama; Sadik Badawy, Mohammad
    The aim of this study was to examine the impact of upper extremity (UE) rehabilitation based on neurocognitive multisensory therapy in stroke patients, focusing on assessing its effects on the recovery of UE function and suggesting it as a post-stroke therapeutic method. The study was conducted as a randomized, prospective, controlled trial with a pre- and post-experimental design. Thirty stroke patients were equally divided into study and control groups and evaluated before and after treatment. Outcome measures included the Action Research Arm Test (ARAT), Manual Function Test (MFT), Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES), and Fugl Myer Assessment upper extremity (FMA-UE). Both groups received a specific physiotherapy program, while the study group also received Cognitive Multisensory Rehabilitation (CMR). All analyses were performed using SPSS (version 25). There were no significant differences between the groups in age, weight, height, BMI, duration of illness, MMSE, sex, or spasticity grade distribution (p > 0.05). Post-treatment comparison between both groups showed a statistically significant increase in the ARAT, MFT, MESUPES, and FMA-UE scores in the study group compared to the control group (p < 0.05). For stroke patients, CMR intervention is considered a beneficial neuro-rehabilitation strategy for enhancing upper extremity sensorimotor capabilities through physical therapy.
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    Effects of neuropilates on functional outcomes in chronic stroke: a randomized clinical trial
    (MDPI, 2024-04-17) García Bravo, Cristina; Delgado Lobete, Laura; Montes Montes, Rebeca; Rodríguez Pérez, María Pilar; Trugeda Pedrajo, Nuria; Fernández Gómez, Gemma; García Bravo, Sara; Atención Sociosanitaria; Facultades de la UMU::Facultad de Ciencias Sociosanitarias (Lorca)
    Neuropilates is an intervention approach that was developed as a modified version of the Pilates Method to be used for neurological rehabilitation. The main objective of this study was to analyze the effectiveness of regular physiotherapy and occupational therapy rehabilitation in comparison to a combination of traditional rehabilitation with Neuropilates in adults with post-stroke motor disabilities. This was a rater- and analyst-blinded randomized clinical trial with a three-month intervention and a one-month follow up. Participants were randomly allocated to either the experimental group (EG, receiving a combination of conventional therapy and Neuropilates; n = 15) or the control group (CG, receiving solely conventional therapy; n = 15). Once adjusted for baseline FIM scores, the results showed significant differences favoring the EG in daily functioning (FIM), static balance (FRT), right-hand manual dexterity (NHPT) and right-upper limb coordination (BBT). Satisfaction with the received treatment as measured with the CSQ-8 was significantly higher for the EG. In conclusion, the incorporation of Neuropilates, facilitated by a single experienced therapist, can be a valuable complement to conventional physical and occupational therapy. However, Neuropilates-based interventions should be supervised and tailored to each individual by a professional specifically trained in the method.
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    Efficacy of robotic training gloves in improving hand function and movement in stroke patients
    (Universidad de Murcia. Servicio de Publicaciones, 2025) Abd Elhady, Abd Elhady Samy; Ahmed, Gehan Mousa; Hassan, Amr; Ibrahim, Saied Mohamed; Abdelmageed, Shaima Mohamed; Sin departamento asociado
    Robotic training gloves are designed to assist with hand movements by providing resistance, support, or guidance. The efficacy of robotic training gloves on hand function in stroke patients, particularly when using the mirror mode, is an intriguing topic in rehabilitation therapy. This study aimed to investigate the effect of assistive robotic rehabilitation devices on hand function in stroke patients. A controlled randomized study was conducted with thirty (9 males and 21 female) stroke patients, who were selected from the outpatient clinic of Al-Delingat Central Hospital - Al-Buhaira Governorate. These patients were randomly assigned to two groups: the study group (A), which received the selected physical therapy program and mirror therapy assisted by a robotic rehabilitation glove, and the control group (B), which received only the conventional physical therapy program. When comparing between both groups, the results indicate that the patients in group A that underwent the combined therapy had a statistically significant improvement in grip strength when tested by the Jamar dynamometer (MD= 1.87 [0.39, 3.35], P=0.015) and in motor function when evaluated by the Fugl-Meyer scale than the group who had only conventional physical therapy (Group B) (MD= 16.67 [3.9, 29.4], p=0.012). This controlled randomized study provides evidence that combining robotic rehabilitation with a standard physical therapy program yields superior improvements in grip strength and motor function compared to standard physical therapy alone.
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    Evaluation of retinal injury in a rat model of transient ischemic stroke
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2019) Wang, Saibin; Ye, Qian; Tu, Junwei
    Stroke-associated ocular disorders are visionthreatening. This study was designed to evaluate in vivo retinal injury induced by transient global cerebral ischemia/reperfusion (I/R). A stroke-induced retinal injury model in Wistar rats was established by electrocoagulation of bilateral vertebral arteries, combined with transient ligation of the bilateral common carotid arteries. Rats were randomly divided into groups based on the time post cerebral perfusion (3 h, 24 h, 48 h, 72 h, and 7 days). Retinal injury was evaluated by histological analysis, examination of eye fundus, and TUNEL staining. The expression of protein kinase Calpha (PKCα) and fibrillary acidic protein (GFAP) was determined using qRT-PCR and immunofluorescence analysis. Both retinal neurons and the vasculature underwent significant damage in the cerebral-I/R groups when compared to rats in the sham group. Moreover, when compared to non-stroke rats, TUNEL staining revealed signs of apoptosis in the retina after transient ischemic stroke was induced (P<0.001). In these rats, the expression of PKCα and GFAP in the retinas was enhanced and peaked at 72 h after induction of cerebralI/R (P<0.001). In this study, we found that retinas are very susceptible to transient global cerebral-I/R injury. The expression of PKCα and GFAP may be implicated in the pathogenesis of ischemic stroke-induced retinal injury.
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    Expression of Tie2 (angiopoietin receptor) on the monocyte subpopulations from ischemic stroke patients: Histological and flowcytometric studies
    (Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2023) Alrafiah, Aziza R.
    Introduction. Different subpopulations of monocytes play roles in phagocytosis, inflammation, and angiogenic processes e.g., Tie2-expressing monocytes (TEMs). The brain is flooded with macrophages that are derived from monocytes within 3-7 days after a stroke. This study aimed to determine the expression level of Tie2 (an angiopoietin receptor) on monocytes and their subpopulations in ischemic stroke patients using the histological and immunohistological study of bone marrow biopsies and blood flow cytometry examination. Methods. Ischemic stroke patients within two days were selected. Participants in the control group were healthy volunteers of matched age and gender. Sample collection was performed within 24 to 48 hours after medical consultants confirmed the stroke diagnosis. An iliac crest bone marrow biopsy was obtained and fixed for histological and immunohistological staining with antiCD14 and antiCD68. Flow cytometry was used to determine the total monocyte population, monocyte subpopulations, and TEMs after staining with monoclonal antibodies to CD45, CD14, CD16, and Tie2. Results. Post-stroke patients' bone marrow cells were hypercellular. There was an apparent increase in CD68 and CD14-positive cells. Ischemic stroke patients exhibited low percentages of nonclassical monocytes CD14lowCD16++, with an increase in intermediate monocytes CD14highCD16+. Moreover, ischemic stroke patients had significantly higher levels of TEMs than control group. Conclusions. The results of this study demonstrate dysregulation of angiogenesis in monocyte subsets in ischemic stroke patients, which could be used as an early diagnostic marker of neurovascular damage and may need angiogenic therapy or improved medications to prevent further damage of blood vessels
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    Impact of particulate matter on the incidence of atrial fibrillation and the risk of adverse clinical outcomes: a review
    (Elsevier, 2023-04-04) Mandaglio-Collados, Darío; López-Gálvez, Raquel; Ruiz Alcaraz, Antonio José; López-García, Cecilia; Roldán Schilling, Vanessa; Lip, Gregory Y.H.; Marín Ortuño, Francisco; Rivera Caravaca, José Miguel; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
    Background. Atrial fibrillation (AF) is common and increases the risk of stroke and mortality. Previous studies have suggested that air pollution is an important risk factor for new-onset AF. Herein, we review the evidence regarding: 1) the association between exposure to particulate matter (PM) and new-onset AF, and 2) the risk of worse clinical outcomes in patients with pre-existent AF and their relation to PM exposure. Methods. A selection of studies between 2000 and 2023 linking PM exposure and AF was performed through searches in PubMed, Scopus, Web of Science, and Google Scholar. Results. 17 studies from different geographical areas demonstrated that exposure to PM was associated with an increased risk of new-onset AF, although the results were heterogeneous regarding the temporal pattern (short- or long-term) ultimately related to AF. Most of the studies concluded that the risk of new-onset AF increased between 2 %–18 % per 10 μg/m3 increment in PM2.5 or PM10 concentrations, whereas the incidence (percentage of change of incidence) increased between 0.29 %–2.95 % per 10 μg/m3 increment in PM2.5 or PM10. Evidence about the association between PM and adverse events in patients with pre-existent AF was scarce but 4 studies showed a higher risk of mortality and stroke (between 8 %–64 % in terms of hazard ratio) in patients with pre-existent AF when PM exposure was higher. Conclusions. Exposure to PM (both PM2.5 and PM10) is a risk factor for AF, and a risk factor for mortality and stroke in patients who already suffer from AF. Since the relationship between PM and AF is independent of the region of the world, PM should be considered as a global risk factor for both AF and worse clinical outcomes in AF patients. Specific measures to prevent air pollution exposure need to be adopted.
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    Incidencia y mecanismo etiológico de ictus en cirugía cardiaca
    (Elsevier, 2020-09) Arribas, J. M.; García, E.; Jara, R.; Gutiérrez, F.; Albert, L.; Bixquert, D.; García Puente, J.; Albacete, C.; Cánovas López, Sergio; Morales, A.; Cirugía, Pediatría y Obstetricia y Ginecología
    Objetivo Estudiar a los pacientes que tuvieron un ictus en el postoperatorio de cirugía cardiaca, para ver la evolución y determinar los factores que influyen en su pronóstico y tratamiento. Métodos Establecimos un protocolo para la detección precoz de ictus en los pacientes tras cirugía cardiaca. Recogimos la aparición de ictus y datos clínicos, quirúrgicos y pronósticos; posteriormente realizamos un análisis descriptivo. Resultados Durante los 15 meses del estudio hubo 16 ictus, un 2,5% de los pacientes operados. Edad media 69 ± 8 años, 63% varones. La incidencia de ictus en pacientes octogenarios fue del 5,1%. Cinco (31%) fueron cirugías urgentes. Por enfermedad cardiaca intervenida: un 7% recibió cirugía mitral, 6,5% cirugía combinada, un 3% cirugía valvular aórtica y un 2,24% cirugía coronaria. La mayoría de los ictus (44%) fueron por embolia, seguida por hipoperfusión (25%). El 69% de los ictus ocurrieron en los 2 primeros días de postoperatorio. La media de la puntuación en la escala NIHSS en el ictus fue 9, se activó código ictus en 10 (62%), y se realizó trombectomía en uno de ellos (14%). La evolución fue favorable en la mayoría, con una escala de Rankin a los 3 meses ≤ 2 en 13 (80%). No hubo muertes hospitalarias entre estos pacientes. Conclusión En nuestro medio, los ictus tras cirugía cardiaca son de pequeño tamaño y tienen una buena evolución a largo plazo. La mayoría ocurren en los primeros 2 días de postoperatorio y su mecanismo es principalmente embólico. La incidencia de ictus en los pacientes octogenarios intervenidos fue del doble que en la población general. -------------------------
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    Ischemic stroke activates the VE-cadherin promoter and increases VE-cadherin expression in adult mice
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2018) Nakano Doi, Akiko; Sakuma, Rika; Matsuyama, Tomoiro; Nakagomi, Takayuki
    Endothelial cells (ECs) are a key component of the blood-brain barrier (BBB). Healthy ECs in the BBB form inter-endothelial junctions, including adherens junctions (AJs). Under pathological conditions, such as after ischemic stroke, the BBB may be functionally compromised. However, gene and protein expression patterns involving endothelial AJs have not been well studied. Because expression levels of endothelial AJs are considered to be related to BBB functionality, we investigated the expression pattern of a representative endothelial AJ marker, VE-cadherin, in healthy and diseased mice. We first examined the expression of VE-cadherin in developing mouse brains. In addition, using a mouse model of cerebral infarction, we investigated the expression pattern of VE-cadherin in pathologic brains. Furthermore, using the Cre-LoxP system, we established a strain of mice expressing yellow fluorescent protein (YFP) under the control of the VE-cadherin promoter and investigated the expression pattern of YFP-expressing ECs in developing and pathologic murine brains. VE-cadherin protein and YFP expression driven by the VE-cadherin promoter both showed that VE-cadherin expression was weak during embryonic stages, followed by a steady increase postnatally, which then decreased during adulthood. However, following ischemic stroke, imunohistochemistry of VE-cadherin demonstrated an upregulation in ECs within ischemic regions, concomitant with YFP upregulation. These findings reveal that ischemic stroke activates the VE-cadherin promoter and increases VE-cadherin protein expression, which suggests that endothelial VE-cadherin is involved in the reconstruction of the BBB following ischemic stroke.
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    Predictores del estado post-ictus en el alta hospitalaria. Importancia en enfermería
    (Servicio de publicaciones. Universidad de Murcia, 2023) Rodríguez Vico, Araceli; Sánchez Hernández, Fernando; López Mesonero, Luis; García Cenador, Begoña; Moreno García, María N.
    A menudo, por parte del paciente y de la familia, se solicita a los profesionales de enfermería que predigan los factores que influyen en el estado post-ictus. Se han realizado numerosos estudios para determinar los factores que influyen en el estado neurológico post-ictus en el momento del alta hospitalaria. Sin embargo, las técnicas de aprendizaje automático no se han utilizado para este propósito. Con el objetivo de obtener reglas de asociación del pronóstico neurológico, se ha llevado a cabo un doble análisis, tanto clínico como con técnicas de aprendizaje automático, de las posibles asociaciones de factores que influyen en el estado neurológico de los pacientes post-ictus. El algoritmo Apriori detectó varias reglas de asociación con alta confianza (≥ 95%), con el siguiente patrón: En pacientes en el rango de edad de 50-80 años, la asociación de un NIHSS entre 11 y 15 puntos (NIHSS intermedio/bajo), junto con la trombectomía, conduce a la recuperación ad integrum al alta. Con la técnica de remuestreo SMOTE, se alcanzó el 100% de confianza para la asociación de NIHSS elevado (>20) y afectación de las arterias carótida y basilar, con pronóstico nefasto (exitus). Estas reglas confirman, por primera vez con aprendizaje automático, la importancia de la asociación de algunos predictores, en el pronóstico post-ictus. El conocimiento por parte de las enfermeras de estas reglas puede mejorar los resultados del ictus. Adicionalmente, el papel de la enfermería en los programas de educación sobre los factores de riesgo, y pronóstico de un ictus se torna imprescindible.
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    Refining stroke and bleeding prediction in atrial fibrillation by adding consecutive biomarkers to clinical risk scores
    (2019) Rivera Caravaca, José Miguel; Marín Ortuño, Francisco; Vílchez Aguilera, Juan Antonio; Gálvez, Josefa; Esteve-Pastor, María Asunción; Vicente García, Vicente; Lip, Gregory YH; Roldán Schilling, Vanessa; Enfermería
    Background and Purpose: Current European guidelines for the management of atrial fibrillation suggest using biomarkers to refine the risk stratification process. However, it is unclear whether ≥2 biomarkers incrementally improve risk prediction beyond 1 biomarker alone. We investigated whether the predictive performance of CHA2DS2-VASc and HASBLED scores could be enhanced by incrementally adding consecutive different biomarkers in real-world atrial fibrillation patients taking vitamin K antagonists therapy. Methods: We included 940 atrial fibrillation patients stable on vitamin K antagonists (international normalized ratio, 2.0–3.0) for at least the previous 6 months. At inclusion, VWF (von Willebrand factor), high-sensitivity troponin T, NTproBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity IL (interleukin)-6, fibrin monomers, and BTP (β-trace protein) concentrations were quantified. During follow-up, all adverse events were recorded, and biomarkers were added to CHA2DS2-VASc and HAS-BLED scores depending on the C index. Results: During 6.5 (4.3–7.9) years, there were 98 ischemic strokes (1.60% per year) and 172 major bleeds (1.60% per year). After the addition of biomarkers, the predictive performance of CHA2DS2-VASc was not significantly increased, although the model with 3 biomarkers (ie, NT-proBNP+BTP+VWF) showed a low gain in sensitivity (integrated discrimination improvement, 2.70%; P<0.001). The predictive performance of HAS-BLED was enhanced in all biomarker-based models, with the best prediction shown by the model with 3 biomarkers (ie, VWF+NT-proBNP+high-sensitivity IL-6; C index, 0.600 [95% CI, 0.561–0.625] versus 0.639 [95% CI, 0.607–0.669]; P=0.025). This model also confirmed an increased sensitivity (integrated discrimination improvement, 5.20%; P<0.001) and positive reclassification (net reclassification improvement, 19.20%; P=0.020). Conclusions: By adding consecutive biomarkers, the predictive ability of CHA2DS2-VASc for ischemic stroke was not increased, whereas the predictive ability of HAS-BLED for major bleeding was only slightly enhanced. The net benefit and clinical usefulness of the biomarker-based models were marginal in comparison to the original scores based on clinical factors.
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    Regulation and function of sphingosine kinase 2 in diseases
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2018) Song, Dan Dan; Zhou, Jun Hao; Sheng, Rui
    Sphingosine kinase functions to phosphorylate sphingosine to sphingosine 1-phosphate (S1P) to keep balance in the metabolites of sphingolipids. There are two isoforms of sphingosine kinase, sphingosine kinase 1 (SphK1) and sphingosine kinase 2 (SphK2). Although SphK1 and SphK2 share high sequence similarity, SphK2 has distinct distribution, regulation and function. SphK2 is involved in the pathological processes of varieties of diseases including cancer, neurodegenerative disorders, stroke, cardiovascular diseases and inflammation. SphK2 may promote the proliferation of cancer cells and the progression of inflammation. The SphK2/S1P pathway is also involved in the pathogenesis of neurodegenerative disorders and stroke. S1P produced by SphK2 in the nucleus binds to HDACs, which then inhibits histone acetylation and regulates memory. The SphK2 pathway mediates platelet aggregation, thrombosis, cardioprotection and helps to ameliorate hepatic steatosis. This review focuses on the recent advances in research on SphK2 regulation and its potential roles in diseases, highlighting SphK2 may be a novel therapeutic strategy for diseases.
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    Traducción, adaptación y validación del instrumento de evaluación de la Preparación para la Transición al Hogar
    (Universidad de Murcia: servicio de publicaciones, 2025) Saucedo-Pahua, Gerardo; Jiménez González, María de Jesús; Tirso Duran Badillo; Anel Gómez García; Herlinda Aguilar Zavala; María de Jesús Ruiz-Recéndiz; Sin departamento asociado
    Introduction: Stroke is a leading cause of disability, affecting both survivors and their caregivers. Using a validated instrument to assess caregiver readiness for transitioning to home care will enable an optimal response to caregiving needs. Objective: The objective is to translate, adapt and validate the psychometric properties of the Preparedness Assessment for the Transition Home Instrument for its use in Mexico.Methodology:This is a methodological study with seven stages: Translation, semantic adaptation, validation by judges, style correction, pilot test, psychometric properties and factor analysis.Results: Item Validity Index: 0.37; Criterion Validity: 24% error; Content Validity Index: 10. Kendall's W: coherence (141.848/p=0.000), clarity (143.312/p=0.000), relevance (159.631/p=0.000), sufficiency (59.885/p=0.000). The final version's criterion validity, as determined by the Kaiser-Meyer-Olkin analysis, is 0.832. Bartlett's Sphericity Test yielded a chi-squared value of 2158.306, with 300 degrees of freedom and a p-value of less than 0.000. Exploratory Factor Analysis identified seven factors explaining 63.38% of the total variance. Confirmatory Factor Analysis showed an adequate model fit (X² = 779.423, df = 269, p < 0.000; CFI = 0.741; TLI = 0.687; NFI = 0.660; AIC = 941.423; PNFI = 0.547; RMSEA = 0.087, CI [0.080, 0.094]). The final internal consistency is 0.86 by Cronbach's alpha.Conclusions:The Mexican version of the instrument retains the original 25 items, which are distributed across seven domains. It is valid and reliable for the intended population
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    Triaje por enfermería en el ictus agudo
    (Universidad de Murcia, Servicio de publicaciones, 2021) Rodríguez-Vico, Araceli; Sánchez-Hernández, Fernando
    En las ultimas décadas, el papel de la enfermería en el triaje y cribado de pacientes en los servicios de urgencias y emergencias, tanto en el entorno prehospitalario como sobre todo en los hospitales, es esencial e indiscutible. Con el objetivo de analizar el triaje realizado por enfermería para detectar los pacientes con ictus agudo, y llegado el caso mejorarlo, se ha realizado un estudio retrospectivo de las presentaciones cardinales del ictus, la escala del Instituto Nacional de la Salud de Estados Unidos, y la escala modificada de Rankin, aplicadas en el set del triaje por enfermería en el Hospital Universitario de Salamanca, durante el período comprendido entre los años 2016 y 2019, ambos inclusive. El total de historias clínicas analizadas ha sido de 1572. El análisis está centrado en la fiabilidad, evaluado por enfermería, de la presentación cardinal del ictus agudo, y de las dos escalas, frente a los algoritmos tradicionales rápidos de detección del ictus, en particular el método FAST, y la escala de Cincinnati. Nuestro estudio demuestra que son varias las presentaciones clínicas que escapan a las escalas rápidas, por lo que es esencial ampliar los métodos de triaje del ictus agudo realizados por enfermería, con el fin de evitar retardos en la detección y el tratamiento definitivo (enfermedad tiempo-dependiente). Así pues, la identificación ampliada de las presentaciónes cardinales, junto con el uso de escalas más detalladas aplicadas por enfermería entrenada, se muestran como herramientas muy útiles de detección del ictus agudo.
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    Validación de la escala POMA de Marcha y Equilibrio en población española afectada de ictus y desarrollo de una app para profesionales sanitarios
    (Universidad de Murcia, 2019-02-21) Carrasco Pérez, Ana María; Gómez Conesa, Antonia; Velandrino Nicolás, Antonio Pablo; Escuela Internacional de Doctorado
    Introducción: el ictus supone una de las principales causas de muerte e incapacidad en el adulto. La prevalencia del ictus está aumentando debido al envejecimiento de la población. Es necesario mejorar los métodos de evaluación actuales para el correcto abordaje terapéutico de los pacientes. El uso de teléfonos móviles ha aumentado en gran medida en los últimos años. Las aplicaciones móviles ofrecen una solución viable, rentable y altamente accesible. Objetivos: realizar una adaptación inicial al español de la escala POMA en población afectada por ictus. Realizar una versión inicial de una app que permita la administración de dicha escala. Método: 153 participantes, mujeres y hombres, con una edad media de 70.9 años (DT=13) que sufrieron un ictus hace más de 6 meses. Se analizó la fiabilidad, la validez convergente, el cambio más pequeño detectable (CPD) y la baremación centílica. Realización de una app mediante la plataforma MIT App Inventor 2. Resultados: la escala POMA ha obtenido resultados altos en todas las propiedades psicométricas analizadas. De igual forma, ha demostrado una buena correlación con la escala FAC (r=0.820). El paciente debe experimentar un cambio en su puntuación de ±1.095 para que podamos afirmar que se ha producido un cambio real. La app Escala de Tinetti se ha publicado en Google Play. Discusión: proponemos futuros estudios que aumenten el tamaño muestral para poder obtener conclusiones definitivas. Futuras versiones de la app Escala de Tinetti podrán mejorar la función y el diseño de la misma. Conclusiones: la escala POMA es una herramienta fiable y válida en población española que ha sufrido un ictus de más de 6 meses de evolución. La app Escala de Tinetti resulta una herramienta útil para los profesionales en su clínica diaria.