From the age of 60, the upward curve begins that increases the probabilities of the occurrence of a stroke (ACV), although, in recent years episodes have been evidenced in patients between 15 and 48 years.
This is what the Doctor José Joaquín PuelloMaster of Medicine in the area of Neurosurgery, who received a tribute on Saturday for his career during the celebration of the National Symposium on the Integral Management of ACVorganized by the Unit of Cateterism and Arrhythmias and pacemakers Cruz Jiminián.
During his speech, Puello stressed that, in the world, approximately between 16 and 20 million of people suffer ACV Every year, a figure that goes on the rise, since by 2030, the estimate is that it rises to 77 million people.
In the case of the Dominican Republic, he said that the prevalence is 183 patients per 100,000 inhabitantswhich leads to stipulate that, a year, there are between 20,000 to 22,000 cases, with high mortality.
“Of every 183 patients, in the first ictus90. We are talking about an epidemic, “he said.
He ACValso known as ictus or Stroke, is the Second cause of mortality in the countrybut, at the same time, the First cause of disability.
It occurs when an interruption of blood flow to the brain occurs, being able to be of two types:
- Ischemicwhich occurs in 85 % of the occasions, when a clot stops the circulation of blood and nutrients. It also is called cerebral infarction.
- Hemorrhagiccommonly known as stroke, occurs in 15 % of cases and occurs after a breakdown of blood vessels.
The director of the Sanitary City Luis Eduardo Aybar showed concern about the comorbidities that raise risk factors. Among them he cited: hypertension, diabetes, sedentary lifestyle, smoking and fat -rich diet.
“We are facing a true pandemic. Strokes are reaching number one of the Public Health Disorders more important, “he added.
The doctor indicated that he has observed an increase in cognitive disorders after the infections by Coronavirus in 2020where 38 % of patients who were admitted to COVID continue to present sequelae today, as well as a Increase in kidney disease which keeps hemodialysis units.
1.9 million dead neurons every minute
The abilquis emergenciologist Escoto explained the “ABC of the ACV“, declaring that for every minute that a patient lasts without receiving treatment loses 1.9 million neurons.
“For every hour, the brain ages 3.6 years,” he added.
Escoto cited as serious the fact that among the 30 to 40 % of patients do not recognize the symptoms of a stroke (dizziness, double vision, balancing, crooked face), causing 90 % of the patients received in the Jiminián Cruz Unit to arrive outside the action window.
Similarly, he compared local data with other countries, highlighting that in Europe between 20 to 35 % of patients receives acute treatment for strokeswhen in the Dominican Republic the figure barely reaches between 2 and 5 %.
“50 % of ACV is prevented when the blood pressure remains controlled“He warned.
High treatment cost
Dr. Minenelly Rodríguez, in her talk entitled “Reality of the ictus In the Dominican Republic “commented that the Attention of a first Episode of ACV in a patient can rise to 700,000 pesosincluding intensive care unit (ICU), treatments and subsequent rehabilitation, constituting a load to the health system of up to 54,000 million pesos each year.
The First signals of alarm will be a patient who speaks scrong, who twists his mouth or who dies half of the body.
Rodríguez made a Patient care call that they do not stay in their homes, since the custom of the Dominican is to self -medicate or have a tea recommended by a relative or neighbor, and when talking about ictus Every second counts.
Among the limitations for optimal attention stated:
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Shortage in the units specialized in stroke.
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Little timely access to thrombolysis or thrombectomy, the treatments used to dissolve or remove blood clots in the brain, exceeding the 4.5 -hour window after the event occurred.
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Patients who live in rural areas and distant provinces who do not arrive on time because most centers for stroke are in Santo Domingo and Santiago.
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The need to make improvements to the coverage of medical insurance for care in the acute and post -stump phase.
Primary Care
On his side, the Minister of Public Health, Victor AtallahHe commented that since last year the approach to prevention and primary care has been taken to capture patients before the ACV.
For this, the “More Health and Hope” days are held by different provinces of the country offering medical consultations and images; Improvements have been made to the Hearts strategy for patients with hypertension and diabetes and clinical protocols for the management of these have been strengthened Chronic Noncommissible Diseases.
“He ictus It does not give time, we have to start working, “he said when referring to the action window that is only from 4.5 hours after the patient begins to present symptoms that he is suffering ACV.
To prevent a stroke, it is vital to know the alert signs and act quickly.
Control your blood pressure, sugar and cholesterol, carries healthy eating, exercise regularly and sleeps well; Avoid tobacco and excess alcohol, and keep stress under control.
Before any symptom, look for immediate attention: in stroke, time is brain.
