This study provides a series of updated, evidence-based recommendations for the management of acute stroke. We aim to lay a foundation for the development of individual centres’ internal protocols, ...serving as a reference for nursing care.
We review the available evidence on acute stroke care. The most recent national and international guidelines were consulted. Levels of evidence and degrees of recommendation are based on the Oxford Centre for Evidence-Based Medicine classification.
The study describes prehospital acute stroke care, the operation of the code stroke protocol, care provided by the stroke team upon the patient’s arrival at hospital, reperfusion treatments and their limitations, admission to the stroke unit, nursing care in the stroke unit, and discharge from hospital.
These guidelines provide general, evidence-based recommendations to guide professionals who care for patients with acute stroke. However, limited data are available on some aspects, showing the need for continued research on acute stroke management.
Proporcionar un conjunto de recomendaciones actualizadas y basadas en la evidencia disponible para el manejo del ictus agudo. Nuestro objetivo es proporcionar una base para el desarrollo de los protocolos internos de cada centro, sirviendo de referencia para los cuidados de enfermería.
Revisión de evidencias disponibles sobre los cuidados del ictus agudo. Se han consultado las guías nacionales e internacionales más recientes. Los niveles de evidencia y grados de recomendación se han basado en la clasificación del Centro de Medicina Basada en la Evidencia de Oxford.
Se describen la atención y los cuidados del ictus agudo en la fase prehospitalaria, el funcionamiento de código ictus, la atención por el equipo de ictus a la llegada al hospital, los tratamientos de reperfusión y sus limitaciones, el ingreso en la unidad de ictus (UI), los cuidados de enfermería en la UI y el alta hospitalaria.
Estas pautas proporcionan recomendaciones generales basadas en la evidencia actualmente disponible para guiar a los profesionales que atienden a pacientes con ictus agudo. En algunos casos, sin embargo, existen datos limitados demostrando la necesidad de continuar investigando sobre el manejo del ictus agudo.
This study provides a series of updated, evidence-based recommendations for the management of acute stroke. We aim to lay a foundation for the development of individual centres' internal protocols, ...serving as a reference for nursing care.
We review the available evidence on acute stroke care. The most recent national and international guidelines were consulted. Levels of evidence and degrees of recommendation are based on the Oxford Centre for Evidence-Based Medicine classification.
The study describes prehospital acute stroke care, the operation of the code stroke protocol, care provided by the stroke team upon the patient's arrival at hospital, reperfusion treatments and their limitations, admission to the stroke unit, nursing care in the stroke unit, and discharge from hospital.
These guidelines provide general, evidence-based recommendations to guide professionals who care for patients with acute stroke. However, limited data are available on some aspects, showing the need for continued research on acute stroke management.
Proporcionar un conjunto de recomendaciones actualizadas y basadas en la evidencia disponible para el manejo del ictus agudo. Nuestro objetivo es proporcionar una base para el desarrollo de los ...protocolos internos de cada centro, sirviendo de referencia para los cuidados de enfermería.
Revisión de evidencias disponibles sobre los cuidados del ictus agudo. Se han consultado las guías nacionales e internacionales más recientes. Los niveles de evidencia y grados de recomendación se han basado en la clasificación del Centro de Medicina Basada en la Evidencia de Oxford.
Se describen la atención y los cuidados del ictus agudo en la fase prehospitalaria, el funcionamiento de código ictus, la atención por el equipo de ictus a la llegada al hospital, los tratamientos de reperfusión y sus limitaciones, el ingreso en la Unidad de Ictus, los cuidados de enfermería en la Unidad de Ictus y el alta hospitalaria.
Estas pautas proporcionan recomendaciones generales basadas en la evidencia actualmente disponible para guiar a los profesionales que atienden a pacientes con ictus agudo. En algunos casos, sin embargo, existen datos limitados demostrando la necesidad de continuar investigando sobre el manejo del ictus agudo.
This study provides a series of updated, evidence-based recommendations for the management of acute stroke. We aim to lay a foundation for the development of individual centres’ internal protocols, serving as a reference for nursing care.
We review the available evidence on acute stroke care. The most recent national and international guidelines were consulted. Levels of evidence and degrees of recommendation are based on the Oxford Centre for Evidence-Based Medicine classification.
The study describes prehospital acute stroke care, the operation of the code stroke protocol, care provided by the stroke team upon the patient's arrival at hospital, reperfusion treatments and their limitations, admission to the stroke unit, nursing care in the stroke unit, and discharge from hospital.
These guidelines provide general, evidence-based recommendations to guide professionals who care for patients with acute stroke. However, limited data are available on some aspects, showing the need for continued research on acute stroke management.
Abstract
Study Objectives
The majority of studies investigating the association between sleep and Alzheimer’s disease (AD) biomarkers have been performed in healthy participants. Our objective was to ...investigate the association between sleep and several biomarkers that reflect distinct aspects of AD physiopathology.
Methods
The cohort included 104 individuals with mild-moderate AD. The participants were submitted to one-night polysomnography, and cerebrospinal fluid was collected in the following morning to measure the selected biomarkers associated with amyloid deposition, tau pathology, neurodegeneration, axonal damage, synaptic integrity, neuroinflammation, and oxidative damage.
Results
There was a positive correlation between neurofilament light (NF-L) and the time spent in stage 1 of non-rapid eyes movement (NREM) (N1) sleep and a negative correlation between this marker and the time spent in stage 3 of NREM (N3) sleep. Accordingly, we observed that deep sleep was associated with lower levels of NF-L, whereas light sleep increased the probability of having higher levels of this marker. Furthermore, chitinase-3-like-1 (YKL-40) was negatively correlated with sleep efficiency, the time spent in stage 2 of NREM (N2) sleep, and the time spent in N3 sleep. Conversely, there was a positive correlation between N3 sleep and the oxidative protein damage markers N-ε-(carboxyethyl)lysine and N-ε-(malondialdehyde)lysine.
Conclusions
There were significant correlations between sleep parameters and AD biomarkers related to axonal damage and neuroinflammation, such as NF-L and YKL-40. A lack of deep sleep was associated with higher levels of NF-L. This highlights a potential role for NF-L as a biomarker of sleep disruption in patients with mild-moderate AD in addition to its role in predicting neurodegeneration and cognitive decline.
The nature and structure of genetic diversity in the Spanish apple germplasm preserved at the national level was widely unknown, since studies performed to date on this topic have been exclusively ...carried out at the regional scale. Here, 1453 accessions from Spanish collections of Malus × domestica were evaluated with a common set of 13 SSR (Simple Sequence Repeats) markers in order to estimate genetic diversity, to identify the underlying genetic structure and to unravel the relationships among them and among a wide set of international cultivars for reference. In total, 737 unique genotypes were identified, 581 diploids and 156 triploids. Using a model‐based Bayesian clustering procedure, two reconstructed populations were obtained for diploid genotypes; one retaining only Spanish cultivars (42% of genotypes), and a second containing all foreign cultivars the latter exhibiting evidence supporting the existence of a secondary sub‐structure. Similarly, analysis performed on the 156 triploid genotypes also revealed two reconstructed populations; one exclusively associated with local Spanish genotypes (44%). The Jaccard coefficient allowed clustering by UPGMA (Unweighted Pair Group Method) diploid and triploid genotypes, and remarkable differences in allelic composition among the different partitioning levels were found. AMOVA analyses showed moderate but significant differentiation among the main groups (0.08 ≤ FST ≤ 0.12). Our results highlight an important fraction of the Spanish apple germplasm that constitutes a differentiated genepool with respect to the international and commercial apple cultivars. Moreover, the extent of the Spanish genetic diversity was spatially distributed along the northern Iberian Peninsula, suggesting an extensive migration of genotypes along the country. This study is the first valuable action for genetic conservation of apple at the national scale, and constitutes a decisive step towards the definition of a Spanish core collection that will be useful for further studies in dissecting the genetic control of important horticultural traits through genome‐wide association analysis in apple.
In this study, 1453 apple accessions were characterized with 13 SSR markers in order to evaluate the genetic diversity and to unravel the structure in the Spanish germplasm. 737 unique genotypes were identified (581 diploids and 156 triploids). Two reconstructed populations were obtained for diploid genotypes: one retaining only Spanish cultivars, and a second containing all foreign cultivars. For triploids, also two reconstructed populations were revealed, one exclusively comprising local Spanish genotypes. The results indicate that an important fraction of the Spanish apple germplasm constitutes a differentiated genepool with respect to the international and commercial apple cultivars.
Objective: The objective of this study is to assess the response of postmortem human subjects (PMHS) to a large-volume side air bag in a fully instrumented and well-controlled side impact test ...condition.
Methods: Three adult male PMHS were subjected to right-side pure lateral impacts. Each stationary seated subject was struck at 4.3 ± 0.1 m/s by a rigid wall installed on a 1700-kg rail-mounted sled. Each subject was held stationary by a system of tethers until immediately prior to being impacted by the moving wall. A large side air bag was mounted to the wall and deployed so that it was fully inflated at the time it contacted the subject's right side. The load wall consisted of an adjustable matrix of 15 individual plates, each supported by a 5-axis load cell that recorded the interaction between the subject and impacting wall. Two-dimensional (external) torso deformation was provided by a chest band that encircled the torso at the level of the sixth rib laterally. Triaxial acceleration was measured at the head, spine, and sacrum via 3 orthogonal accelerometers mounted to the same bone-mounted hardware that held the marker clusters used for kinematic analysis.
Results: Peak pelvic load normal to the wall averaged 6.8 kN, which was over 5 times that recorded for the shoulder (1.3 kN) and the thorax (1.2 kN). Lateral chest deflection ranged from 9 to 21 mm. Two of the 3 subjects sustained 2 and 9 fractures, respectively.
Conclusions: Two of the 3 PMHS sustained rib fractures despite low levels of thorax deflection. We attribute this finding to individual variability in subject injury tolerance. Other response parameters exhibited lower levels of variability and characterize PMHS response to a potentially beneficial side impact countermeasure.
Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.
PDF
