Search

Objective\ud Magnetic resonance (MR) diffusion-weighted imaging (DWI) is sensitive to small acute ischemic lesions and might help diagnose transient ischemic attack (TIA). Reclassification of patients with TIA and a DWI lesion as “stroke” is under consideration. We assessed DWI positivity in TIA and implications for reclassification as stroke.\ud \ud Methods\ud We searched multiple sources, without language restriction, from January 1995 to July 2012. We used PRISMA guidelines, and included studies that provided data on patients presenting with suspected TIA who underwent MR DWI and reported the proportion with an acute DWI lesion. We performed univariate random effects meta-analysis to determine DWI positive rates and influencing factors.\ud \ud Results\ud We included 47 papers and 9,078 patients (range = 18–1,693). Diagnosis was by a stroke specialist in 26 of 47 studies (55%); all studies excluded TIA mimics. The pooled proportion of TIA patients with an acute DWI lesion was 34.3% (95% confidence interval [CI] = 30.5–38.4, range = 9–67%; I2 = 89.3%). Larger studies (n > 200) had lower DWI-positive rates (29%; 95% CI = 23.2–34.6) than smaller (n \ud \ud Interpretation\ud The commonest DWI finding in patients with definite TIA is a negative scan. Available data do not explain why ⅔ of patients with definite specialist-confirmed TIA have negative DWI findings. Until these factors are better understood, reclassifying DWI-positive TIAs as strokes is likely to increase variance in estimates of global stroke and TIA burden of disease.

En los últimos años se intentado incorporar la participación de la sociedad en la gestión del riesgo de desastre; Actualmente, se están generando estrategias que incluyen la participación de múltiples actores; en particular de los habitantes de áreas expuestas, junto con actores de los sectores público y privado, así como con profesionales con el interés de apoyar los procesos de gestión de riesgos. In recent years we have sought to incorporate the participation of society in disaster risk management. Nowadays, strategies are being generated that include the participation of multiple actors; in particular of the inhabitants of exposed areas, together with actors from the public and private sectors, as well as with professionals interested in supporting the risk management processes.

El presente trabajo de grado busca impulsar el uso de la energía renovable (ER) mediante una propuesta que tiene como propósito sensibilizar sobre la pertinencia del uso de energía solar para mitigar el Cambio Climático (CC). Esto a través de la elaboración de un Plan de Implementación de Árboles Solares en el Parque Papagayo de Acapulco, articulando tecnología, arquitectura y diseño urbano, rompiendo con el paradigma en la forma tradicional de suministrar energía eléctrica dentro de un espacio público, y visibilizando un servicio eléctrico sustentable alternativo. The present work of degree seeks to promote the use of renewable energy (RE) through a proposal that seeks to raise awareness about the relevance of the use of solar energy to mitigate climate change (CC). This is through the development of a solar tree implementation plan in the Papagayo Park of Acapulco, articulating technology, architecture and urban design, breaking with the paradigm in the traditional way of supplying electric power within a public space, and making visible a alternative sustainable electric service.