Multiple Sclerosis (MS) is a neurodegenerative disease characterized by damage to the myelin sheath that covers neurons, and which shows differences between men and women in terms of susceptibility and disease progression related in turn to functional ability and quality of life.
To know the differences based on gender, assessing the functional capacity, muscle strength and fine motor skills of the upper extremities of patients with MS.
A quantitativede, scriptive, cross-sectional study was conducted with a sample of 51 MS patients, that were assessed for functional capacity (DASH scale); static and dynamic balance (Berg scale), perceived balance (ABC); strenght (Jamar and dynamometer); and fine motor skills (NHPT).
The sample consisted of 15 men and 36 women, with a mean age of 47 ± 12 años. No differences were observed in functional capacity DASH (p = 0.616). In addition, men showed greater pincer strength (p < 0.001) and greater triceps strength (p < 0.05) in both arms. Regarding fine motor skills, it was better in women in both the dominant and non-dominant hands (p < 0.05).
Despite not observing functional differences by sex, there are differences in the parameters of pincer and triceps strength, which is higher in men; and in manual dexterity of both hands, which is better in women.
Although cerebral angiography is the reference technique for the diagnosis and treatment of cerebrovascular diseases, it is not without complications.
To determine the incidence and risk factors of complications derived from therapeutic cerebral angiography (TCA), as well as to assess the risk factors associated with the appearance of local and intracranial complications.
Retrospective cross-sectional study on TCAs carried out in 2018 on admission to the Stroke Unit of the Hospital Clínic de Barcelona. The study was approved by the centre’s ethics committee. Demographic, clinical, analytical, and procedure-derived variables were collected. All patients older than 18 years undergoing TCA were included. Patients undergoing diagnostic cerebral arteriography and/or with a hospital stay less than 24 h were excluded. The Mann-Whitney U test was used for the comparison of quantitative variables and Pearson’s Chi-squared test for the qualitative variables.
Complications were frequent, occurring in almost half of the sample (44%). A longer duration of arteriography was associated with an increase in local complications (p = .005). Intracranial complications occurred in 33% of the patients who underwent mechanical thrombectomy and were associated with older age (p = .012), stent use (associated or not with aspiration) (p = .003), and complete recanalization (p = .02), as well as having a worse functional status at discharge (p = .006).
Complications derived from ACT are frequent. Their importance and incidence must be known to detect those subjects at higher risk for developing them due to their functional implications and increased hospital stay.
Analyze the relationship between attendance times and health outcomes of people with ischemic stroke treated with intravenous fibrinolysis, comparing those attended from the emergency units of 061 ARAGON with those arriving by other means.
Cross-sectional, retrospective, descriptive and association study based on a consecutive series of patients treated at the Miguel Servet University Hospital in the period 2014−16, analysing the time of care up to fibrinolysis and results of intravenous fibrinolysis, in terms of mortality and functional status at discharge. We also analysed the influence on attendance times of the protocol change that was carried out in 2016 and that included the direct warning to neurologists, instead of the receiving emergency, as before.
A total of 231 patients with stroke were collected and treated with intravenous fibrinolysis. The mean age of the patients was 75.91 (±12.48). Women accounted for 52.8% of those fibrinolysed, the average age of men being lower [74.07 (±13.71) years, compared with 77.55 (±11.07) years for women]. The mean score on the NIHS scale at admission between the two groups presented significant differences (p = 0.006), being greater the affectation among those who arrived with 061 [NIHSS 13.20 ± 6.78 vs 10.7 ± 6.22]. In the comparison of times between patients who arrive or not with 061, the average time to hospital was 91.42 (±59.64) vs 93.20 (±83.73) (p = 0.731), without significant differences. However, there were significant differences in the time door needle (p = 0.046), noting that patients who are brought by 061 Aragon have better in-hospital time until fibrinolysis (better door-needle time) (67.19 (±26.03) vs 77.83 (±38.35).
In the analysis of the door needle time by years, significant differences were observed (p < 0.001), being shorter each year, with a clear shortening in 2016 compared to previous ones, reflecting the impact of the update of protocols in this time period.
The patients brought in by 061 were different (more affected), fibrinolysed in a greater percentage and faster. Direct notice to neurologists significantly shortened attendance times. In terms of mortality and functional status at discharge, there were no differences between the two groups.
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