Introducción: La terapia trombolítica intravenosa en la circulación cerebral, dentro de las primeras 3 horas del accidente cerebrovascular isquémico ofrece importantes beneficios netos para prácticamente todos los pacientes con déficit potencialmente incapacitantes. Objetivo: Evaluar el curso de la enfermedad en pacientes con accidente cerebrovascular isquémico con una mejoría clínica del déficit neurológico durante el período de ventana de 3 horas en los grupos de pacientes que recibieron y no recibieron trombólisis intravenosa. Métodos: Se realizó un estudio descriptivo, retrospectivo, donde revisamos los registros demográficos, clínicos, tomográficos, de procedimiento de los pacientes en el 6° Hospital Clínico Municipal, Zaporozhye desde 2010-2017. Se analizaron un total de 78 historias clínicas, 12 eran pacientes con terapia trombolítica intravenosa y 66 con terapia tradicional. Los resultados del tratamiento se evaluaron sobre la base de la escala NIHSS y la escala de Rankin modificada después de 90 días después del tratamiento. Los datos se procesaron utilizando estadístico STATISTICA 7.0. Resultados: En el grupo de pacientes con terapia trombolítica intravenosa, ninguno de los pacientes presentó un empeoramiento clínico. En el segundo grupo, 21 pacientes mostraron un aumento en el déficit neurológico en los primeros 3-5 días después de la hospitalización. La puntuación de NIHSS en el 1er grupo, cuando se decidió sobre terapia trombolítica intravenosa y al alta durante 20 días, fue de 6±3,8 y 0,5±0,2, respectivamente. En el segundo grupo; 6±2,9 y 4±1,11. De acuerdo con la escala de Rankine modificada, después de 3 meses en el primer grupo, el índice fue de 0,5±0,1 (≤ 1 en 8 pacientes); en el segundo grupo 1±0,3. Conclusiones: La trombólisis intravenosa en pacientes con regresión temprana espontánea de déficits neurológicos es aconsejable, y el fracaso no está justificado.

No abstract

No abstract

Introduction: Hypertensive urgency is raised in systolic blood pressure greater than 120mmHg without evidence for target organ damage. Vascular stiffness can be assessed using oscillometric devices and determine cardiovascular risk for increased vascular age. When uncontrolled hypertensive urgency, manifests as a hypertensive emergency, which is high systolic and diastolic blood pressure values with target organ damage. Aim: To estimate the values of central blood pressure (CBP), pulse wave velocity (PWV) in patients with hypertensive urgency in a South Indian population. Methods and materials: We included 20 patients with a clinical diagnosis of hypertensive crisis with no end target organ damage, who entered the emergency outpatient clinics at Kasturba Medical hospital, Mangalore. The PWV, pulse pressure (PP), CBP, brachial pressure (BP) were evaluated using the noninvasive Agedio B900 device (Germany). Statistical data was processed in SPSS software; significant differences were considered at p < 0,05. Results: Average age of patients was 63.35 ± 9.74 years, 30% were females and 70% males. Average brachial systolic BP was 191,42 ± 9,88 mmHg. Average central systolic blood pressure was 178.35 ± 28.61 mm Hg, and the average central diastolic blood pressure was 115.64 ± 8.01. PWV for each patient was higher than the reference range for age with values of 11.74 ± 1.74 m/s. Median of increased vascular age compared to biological age of patients was 11 years. Student's t-test showed statistically significant difference between PWV measured in males and females (M-11.17 ± 1.74, F-10.85 ± 1.3; p = 0.008). Values of PWV showed a positive correlation with age (r = 0.838, p < 0.00001). Central systolic blood pressure shows a weak positive correlation with PWV (r = 0.1294, p = 0.05). Conclusions: The reason for increase in vascular stiffness in coastal population in India could be high salt intake, irregular diet and sleep. Pre-assessment reduces the risk of cardiovascular accidents occurrence and increases the quality of life.

Background: Aortic systolic pressure is regarded more reliable due to elastic properties of the central arterial walls, than the peripheral blood pressure (BP) brachial arteries being more muscular. The arterial distensibilty is an important factor in determining the vascular age and predicting future acute aortic events. The non-invasive central blood pressure can aid in early detection and harmonising treatment in patients with Refractory hypertension (RH). Aim: To assess the Central aortic systolic pressure (CASP) in RH patients. Methods and materials: We identified 111 patients with refractory hypertension (uncontrolled BP despite use of 3 or more anti-hypertensives) at the outpatient clinic of Kasturba Medical College Hospital, Mangalore in the period of July-August 2018. The non-invasive CASP, Average systolic, diastolic and pulse (AvgS, AvgD, AvgP) measured with A-PULSE CASPal® Monitoring Device. Statistical analysis using SPSS software and parameters like Independent t-test, descriptive statistics (mean, standard deviation) were calculated. Results: The average age of the patients was 58 ± 14.95; 39 (35.1%) were females(F) and 72 (64.9%) were males (M). There was a significant difference in the CASP in F 146.6 ± 29.34 and 139.6 ± 21.8 in M; AvgS in F and M was 157.9 ± 28 and 152.4 ± 21.8 respectively. AvgD and AvgP in F and M were 92.9 ± 17.1, 92.5 ± 13.3 and 83.87 ± 13.9, 79.2 ± 13.6 respectively. Conditions age and CASP p = 0.324; age and AvgS p = 0.338; CASP and AvgS p = 0.919 were significant at p < 0.01. Conclusions: In patients with refractory hypertension, chrono-modulation with centrally acting anti-hypertensive drugs and synchronous CASP monitoring non-invasively can predict early target organ damage and helps improve the quality of life.