Propuesta de protocolo de estudio de las enfermedades cerebrovasculares de la infancia
Proposed protocol for the study of cerebrovascular disease in childhood
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"apellidos" => "Rubio Fernández" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300773759?idApp=UINPBA00005H" "url" => "/16954033/0000005200000005/v1_201307051502/S1695403300773759/v1_201307051502/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Propuesta de protocolo de estudio de las enfermedades cerebrovasculares de la infancia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "435" "paginaFinal" => "442" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Cardo Jalón, M. Pineda Marfà, R. Artuch Iriberri, M.A. Vilaseca Buscà, J. Campistol Plana" "autores" => array:5 [ 0 => array:3 [ "nombre" => "E." "apellidos" => "Cardo Jalón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Pineda Marfà" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Artuch Iriberri" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M.A." "apellidos" => "Vilaseca Buscà" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "J." "apellidos" => "Campistol Plana" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servei de Neuropediatria. Unitat Integrada. Hospital Sant Joan de Déu-Clínic." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servei de Bioquímica. Hospital Sant Joan de Déu. Universitat de Barcelona. Barcelona." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servei de Neurologia. Hospital Sant Joan de Déu. Passeig Sant Joan de Déu, 2.08950 Esplugues. Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Proposed protocol for the study of cerebrovascular disease in childhood" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-09-30" "fechaAceptado" => "2000-03-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186324" "palabras" => array:5 [ 0 => "Enfermedad cerebrovascular" 1 => "Protocolo" 2 => "Factores de riesgo" 3 => "Hiperhomocisteinemia" 4 => "Niños" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186323" "palabras" => array:6 [ 0 => "Cerebrovascular disease" 1 => "Stroke" 2 => "Protocol" 3 => "Risk factors" 4 => "Hyperhomocysteinemia" 5 => "Children" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La etiología de la enfermedad cerebrovascular en la población pediátrica permanece sin aclarar hasta en un 40% de los casos. Recientes avances en el conocimiento de la etiopatogenia pueden mejorar este porcentaje. Pretendemos diseñar un protocolo de estudio estructurado con el objetivo de identificar los factores de riesgo de enfermedad cerebrovascular potencialmente modificables.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En nuestra base de datos constaban 141 pacientes con enfermedad cerebrovascular (desde enero de 1984 hasta diciembre de 1995); se invitó a los pacientes con enfermedad cerebrovascular idiopática a completar el protocolo de investigación. También se incluyeron los nuevos casos que aparecieron desde enero de 1996 hasta julio de 1999.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron en total 68 casos. Se realizó un diagnóstico en el 38% de los pacientes, y en el 76% de los casos se identificó algún factor de riesgo. El factor de riesgo vascular no estructural más frecuente fue la hiperhomocisteinemia (36 frente al 5% de los controles), entre ellos un lactante con infarto hemorrágico fatal que se diagnosticó de homocistinuria clásica. Un 31% de los pacientes tenían factores pretrombóticos (déficit de proteína S, C, antitrombina III, factor V de Leiden, etc.). El 17,6% padecía un proceso febril inespecífico en el momento del infarto y el 11,7% refería historia de traumatismo craneal menor previo al infarto.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La aplicación de un protocolo para el estudio de la enfermedad cerebrovascular mejoró el porcentaje de casos diagnosticados, así como la identificación de factores de riesgo de enfermedad cerebrovascular potencialmentemodificables. El protocolo de investigación es tan importante como las estrategias de actuación en la fase aguda o la prevención de recurrencia, actualmente en estudio para la población adulta.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The etiology of cerebrovascular disease in the paediatric population, remains unknown in up to 40% of the cases (idiopathic), but recent advances could improve this percentage. We devised a comprehensive study protocol for such investigation aimed at the identification of potentially modifiable risk factors for paediatric stroke.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">From the 141 patients initially registered in our data base for stroke population (from January 1984 until December 1995), we invited all the patients with idiopathic cerebrovascular disease to complete the study protocol. New cases appeared from January 1996 until July 1999 were also included.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 68 cases were identified. We found an etiology in 38% and in 76% of the cases we found at least one risk factor for stroke. Mild hyperhomocysteinemia was the most frequent risk factor identified (36% of patients versus 5% of controls), one of them an infant with fatal haemorrhagic infarct with classic homocystinuria. 31% of the patients had thrombotic risk factors (protein S, protein C, antithrombine III deficiency, factor V Leiden, etc). 17.6% had unspecific febrile illness at the time of the cerebral infarction and 11.6% had minor head injuries before the stroke.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The use of the protocol improves the identification of potentially modifiable risk factors for stroke in childhood and may serve as a practical guideline for clinicians. 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| año/Mes | Html | Total | |
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| 2023 Marzo | 23 | 28 | 51 |
| 2023 Febrero | 28 | 17 | 45 |
| 2023 Enero | 23 | 25 | 48 |
| 2022 Diciembre | 30 | 27 | 57 |
| 2022 Noviembre | 37 | 33 | 70 |
| 2022 Octubre | 29 | 50 | 79 |
| 2022 Septiembre | 19 | 35 | 54 |
| 2022 Agosto | 39 | 53 | 92 |
| 2022 Julio | 23 | 48 | 71 |
| 2022 Junio | 21 | 45 | 66 |
| 2022 Mayo | 23 | 40 | 63 |
| 2022 Abril | 24 | 31 | 55 |
| 2022 Marzo | 43 | 64 | 107 |
| 2022 Febrero | 39 | 29 | 68 |
| 2022 Enero | 28 | 44 | 72 |
| 2021 Diciembre | 33 | 50 | 83 |
| 2021 Noviembre | 27 | 44 | 71 |
| 2021 Octubre | 39 | 61 | 100 |
| 2021 Septiembre | 32 | 46 | 78 |
| 2021 Agosto | 26 | 34 | 60 |
| 2021 Julio | 42 | 40 | 82 |
| 2021 Junio | 54 | 43 | 97 |
| 2021 Mayo | 34 | 35 | 69 |
| 2021 Abril | 98 | 58 | 156 |
| 2021 Marzo | 67 | 25 | 92 |
| 2021 Febrero | 63 | 32 | 95 |
| 2021 Enero | 45 | 21 | 66 |
| 2020 Diciembre | 57 | 28 | 85 |
| 2020 Noviembre | 28 | 19 | 47 |
| 2020 Octubre | 27 | 19 | 46 |
| 2020 Septiembre | 33 | 11 | 44 |
| 2020 Agosto | 27 | 22 | 49 |
| 2020 Julio | 34 | 17 | 51 |
| 2020 Junio | 24 | 20 | 44 |
| 2020 Mayo | 37 | 20 | 57 |
| 2020 Abril | 104 | 14 | 118 |
| 2020 Marzo | 45 | 15 | 60 |
| 2020 Febrero | 39 | 16 | 55 |
| 2020 Enero | 42 | 30 | 72 |
| 2019 Diciembre | 46 | 21 | 67 |
| 2019 Noviembre | 29 | 15 | 44 |
| 2019 Octubre | 34 | 9 | 43 |
| 2019 Septiembre | 25 | 23 | 48 |
| 2019 Agosto | 23 | 13 | 36 |
| 2019 Julio | 16 | 16 | 32 |
| 2019 Junio | 36 | 38 | 74 |
| 2019 Mayo | 34 | 24 | 58 |
| 2019 Abril | 24 | 42 | 66 |
| 2019 Marzo | 14 | 5 | 19 |
| 2019 Febrero | 13 | 15 | 28 |
| 2019 Enero | 10 | 10 | 20 |
| 2018 Diciembre | 15 | 15 | 30 |
| 2018 Noviembre | 20 | 12 | 32 |
| 2018 Octubre | 54 | 4 | 58 |
| 2018 Septiembre | 16 | 9 | 25 |
| 2018 Agosto | 1 | 0 | 1 |
| 2018 Julio | 2 | 0 | 2 |
| 2018 Mayo | 3 | 0 | 3 |
| 2018 Abril | 21 | 0 | 21 |
| 2018 Marzo | 5 | 0 | 5 |
| 2018 Febrero | 18 | 0 | 18 |
| 2018 Enero | 6 | 0 | 6 |
| 2017 Diciembre | 5 | 0 | 5 |
| 2017 Noviembre | 14 | 0 | 14 |
| 2017 Octubre | 11 | 0 | 11 |
| 2017 Septiembre | 8 | 0 | 8 |
| 2017 Agosto | 4 | 0 | 4 |
| 2017 Julio | 12 | 0 | 12 |
| 2017 Junio | 17 | 12 | 29 |
| 2017 Mayo | 20 | 4 | 24 |
| 2017 Abril | 17 | 9 | 26 |
| 2017 Marzo | 10 | 4 | 14 |
| 2017 Febrero | 10 | 7 | 17 |
| 2017 Enero | 17 | 2 | 19 |
| 2016 Diciembre | 25 | 3 | 28 |
| 2016 Noviembre | 40 | 6 | 46 |
| 2016 Octubre | 27 | 4 | 31 |
| 2016 Septiembre | 27 | 7 | 34 |
| 2016 Agosto | 27 | 3 | 30 |
| 2016 Julio | 15 | 8 | 23 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 2 | 0 | 2 |
| 2016 Febrero | 3 | 0 | 3 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Septiembre | 1 | 0 | 1 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 18 | 0 | 18 |
| 2015 Junio | 12 | 0 | 12 |
| 2015 Mayo | 16 | 0 | 16 |
| 2015 Abril | 10 | 0 | 10 |
| 2015 Marzo | 13 | 0 | 13 |
| 2015 Febrero | 14 | 0 | 14 |
| 2015 Enero | 19 | 0 | 19 |
| 2014 Diciembre | 35 | 2 | 37 |
| 2014 Noviembre | 14 | 0 | 14 |
| 2014 Octubre | 15 | 0 | 15 |
| 2014 Septiembre | 12 | 2 | 14 |
| 2014 Agosto | 14 | 1 | 15 |
| 2014 Julio | 14 | 2 | 16 |
| 2014 Junio | 18 | 0 | 18 |
| 2014 Mayo | 16 | 4 | 20 |
| 2014 Abril | 13 | 1 | 14 |
| 2014 Marzo | 15 | 9 | 24 |
| 2014 Febrero | 12 | 6 | 18 |
| 2014 Enero | 9 | 3 | 12 |
| 2013 Diciembre | 14 | 6 | 20 |
| 2013 Noviembre | 16 | 9 | 25 |
| 2013 Octubre | 16 | 9 | 25 |
| 2013 Septiembre | 18 | 10 | 28 |
| 2013 Agosto | 18 | 6 | 24 |
| 2013 Julio | 5 | 5 | 10 |
| 2013 Junio | 5 | 1 | 6 |
| 2013 Mayo | 4 | 4 | 8 |
| 2013 Abril | 6 | 0 | 6 |
| 2013 Marzo | 6 | 2 | 8 |
| 2013 Febrero | 18 | 1 | 19 |
| 2013 Enero | 27 | 1 | 28 |
| 2012 Diciembre | 10 | 1 | 11 |
| 2012 Noviembre | 24 | 4 | 28 |
| 2012 Octubre | 9 | 1 | 10 |
| 2012 Septiembre | 3 | 1 | 4 |
| 2012 Agosto | 1 | 0 | 1 |
| 2000 Abril | 1888 | 0 | 1888 |
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