Background: Internal carotid artery (ICA) dissections generally occur when a tear occurs in the intima-media layer, either of traumatic or spontaneous origin. In this scenario, multifocal cerebral thrombosis may be a ...Background: Internal carotid artery (ICA) dissections generally occur when a tear occurs in the intima-media layer, either of traumatic or spontaneous origin. In this scenario, multifocal cerebral thrombosis may be a clear consequence of untreated ICA dissection. The incidence of internal carotid artery dissection in the US is estimated to be 1.72 per 100,000 population per year. Objective: To make a brief review of the literature and to explain, through a clinical case, the scenario of multiple ischemic cerebrovascular events is associated with the dissection of the internal carotid artery, in a young patient with no relevant history. Presentation of the Case: A 46-year-old female patient, with no significant history, who came to the emergency service presenting loss of strength in the right pelvic limb, disordered language, and difficulty walking for 3 hours, in the neurological examination evidence of decreased tendon reflexes and loss of strength of the right side of the body. Imaging studies show compromise of the M2 and M3 segments of the left middle cerebral artery, as well as multiple areas of associated ischemia in this hemisphere. Additional studies identify concomitant left ICA dissection. Based on the findings, it was decided to perform a thrombectomy of the affected area, as well as subsequent placement of a stent in the area of dissection. In the control angioTC study, revascularization of the M2 and M3 segments was observed, and in the follow-up of the patient, complete recovery of the symptoms was observed, with muscle strength, tendon reflexes, and preserved language functions. Conclusions: The ischemic cerebrovascular event is a frequent pathological entity in the emergency service;in the scenario of a young patient as mentioned above, it is important to take into consideration the different causes of this pathology. We are obliged to familiarize ourselves with the different imaging modalities for an adequate diagnostic approach, as well as the treatment methods according to the time of evolution.展开更多
Objective: The objective of the study is to estimate the prevalence of Intimate Partner Violence (IPV) and identify factors linked to it in pregnant Mexican adult and adolescent women. Methods: Data were gathered by t...Objective: The objective of the study is to estimate the prevalence of Intimate Partner Violence (IPV) and identify factors linked to it in pregnant Mexican adult and adolescent women. Methods: Data were gathered by the National Survey of Violence against Women (2006), applied to women between the ages 15-49, users of Mexican public health institutions. Multinomial logistic regression analyses were performed to explore the significant factors associated with IPV against pregnant women. Results: Both adolescent and adult study participating women showed a 24% prevalence of current IPV (during the previous 12 months). The study’s multivariate model for adult women revealed the following as main predictors for IPV: a woman’s agreement with traditional gender roles (OR = 4.35, CI95% = 2.20 - 8.60), and women with a history of childhood sexual abuse (OR = 2.76, CI95% = 1.68 - 4.55). The main predictor of IPV in pregnant adolescents was their partners’ frequency of alcohol consumption: often/usually (OR = 6.49, CI95% = 2.18 - 19.33). Conclusion: To this date, Mexico has not been able to guarantee universal screening methods for IPV as a part of prenatal care protocols. The phenomenon of IPV towards pregnant women neither has been followed-up by further research nor has been identified as a public health problem in spite of the seriousness of its implications for women and their offspring.展开更多
文摘Background: Internal carotid artery (ICA) dissections generally occur when a tear occurs in the intima-media layer, either of traumatic or spontaneous origin. In this scenario, multifocal cerebral thrombosis may be a clear consequence of untreated ICA dissection. The incidence of internal carotid artery dissection in the US is estimated to be 1.72 per 100,000 population per year. Objective: To make a brief review of the literature and to explain, through a clinical case, the scenario of multiple ischemic cerebrovascular events is associated with the dissection of the internal carotid artery, in a young patient with no relevant history. Presentation of the Case: A 46-year-old female patient, with no significant history, who came to the emergency service presenting loss of strength in the right pelvic limb, disordered language, and difficulty walking for 3 hours, in the neurological examination evidence of decreased tendon reflexes and loss of strength of the right side of the body. Imaging studies show compromise of the M2 and M3 segments of the left middle cerebral artery, as well as multiple areas of associated ischemia in this hemisphere. Additional studies identify concomitant left ICA dissection. Based on the findings, it was decided to perform a thrombectomy of the affected area, as well as subsequent placement of a stent in the area of dissection. In the control angioTC study, revascularization of the M2 and M3 segments was observed, and in the follow-up of the patient, complete recovery of the symptoms was observed, with muscle strength, tendon reflexes, and preserved language functions. Conclusions: The ischemic cerebrovascular event is a frequent pathological entity in the emergency service;in the scenario of a young patient as mentioned above, it is important to take into consideration the different causes of this pathology. We are obliged to familiarize ourselves with the different imaging modalities for an adequate diagnostic approach, as well as the treatment methods according to the time of evolution.
文摘Objective: The objective of the study is to estimate the prevalence of Intimate Partner Violence (IPV) and identify factors linked to it in pregnant Mexican adult and adolescent women. Methods: Data were gathered by the National Survey of Violence against Women (2006), applied to women between the ages 15-49, users of Mexican public health institutions. Multinomial logistic regression analyses were performed to explore the significant factors associated with IPV against pregnant women. Results: Both adolescent and adult study participating women showed a 24% prevalence of current IPV (during the previous 12 months). The study’s multivariate model for adult women revealed the following as main predictors for IPV: a woman’s agreement with traditional gender roles (OR = 4.35, CI95% = 2.20 - 8.60), and women with a history of childhood sexual abuse (OR = 2.76, CI95% = 1.68 - 4.55). The main predictor of IPV in pregnant adolescents was their partners’ frequency of alcohol consumption: often/usually (OR = 6.49, CI95% = 2.18 - 19.33). Conclusion: To this date, Mexico has not been able to guarantee universal screening methods for IPV as a part of prenatal care protocols. The phenomenon of IPV towards pregnant women neither has been followed-up by further research nor has been identified as a public health problem in spite of the seriousness of its implications for women and their offspring.
