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1. Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta‐Analysis

Author: Marilaura Nuñez, Carlos Delfino, Claudia Asenjo‐Lobos, Andrea Schilling, Pablo Lavados, Craig S. Anderson, and Paula Muñoz Venturelli
Subjects: epidemiology, intracranial hemorrhage, ischemic stroke, women, sex, and gender, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background High‐income country studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region. Methods and Results A search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective population‐based observational studies with first‐ever stroke incidence in Latin America. Reports without data broken down by age and sex were excluded. Risk of bias was assessed with The Joanna Briggs Institute's guide. The main outcomes were incidence rate ratio and relative temporal trend ratio of SI, comparing time periods before 2010 with after 2010. Pooled relative temporal trend ratios considering only studies with 2 periods in the same population were calculated by random‐effects meta‐analysis. Meta‐regression analysis was used to evaluate incidence rate determinants. From 9242 records identified, 6 studies were selected including 4483 first‐ever stroke in 4 101 084 individuals. Crude incidence rate ratio in younger subjects (
Published: 2023
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2. Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients: insights from the ENCHANTED trialResearch in context

Author: Chen Chen, Menglu Ouyang, Sheila Ong, Luyun Zhang, Guobin Zhang, Candice Delcourt, Grant Mair, Leibo Liu, Laurent Billot, Qiang Li, Xiaoying Chen, Mark Parsons, Joseph P. Broderick, Andrew M. Demchuk, Philip M. Bath, Geoffrey A. Donnan, Christopher Levi, John Chalmers, Richard I. Lindley, Sheila O. Martins, Octavio M. Pontes-Neto, Paula Muñoz Venturelli, Verónica Olavarría, Pablo Lavados, Thompson G. Robinson, Joanna M. Wardlaw, Gang Li, Xia Wang, Lili Song, and Craig S. Anderson
Subjects: Blood pressure, Acute ischaemic stroke, Clinical trial, Brain imaging, Cerebral infarction, Thrombolysis, Medicine (General), R5-920
Abstract: Summary: Background: Intensive blood pressure lowering may adversely affect evolving cerebral ischaemia. We aimed to determine whether intensive blood pressure lowering altered the size of cerebral infarction in the 2196 patients who participated in the Enhanced Control of Hypertension and Thrombolysis Stroke Study, an international randomised controlled trial of intensive (systolic target 130–140 mm Hg within 1 h; maintained for 72 h) or guideline-recommended (systolic target 150 mm Hg) after thrombolysis treatment for acute ischaemic stroke between March 3, 2012 and April 30, 2018. Methods: All available brain imaging were analysed centrally by expert readers. Log-linear regression was used to determine the effects of intensive blood pressure lowering on the size of cerebral infarction, with adjustment for potential confounders. The primary analysis pertained to follow-up computerised tomography (CT) scans done between 24 and 36 h. Sensitivity analysis were undertaken in patients with only a follow-up magnetic resonance imaging (MRI) and either MRI or CT at 24–36 h, and in patients with any brain imaging done at any time during follow-up. This trial is registered with ClinicalTrials.gov, number NCT01422616. Findings: There were 1477 (67.3%) patients (mean age 67.7 [12.1] y; male 60%, Asian 65%) with available follow-up brain imaging for analysis, including 635 patients with a CT done at 24–36 h. Mean achieved systolic blood pressures over 1–24 h were 141 mm Hg and 149 mm Hg in the intensive group and guideline group, respectively. There was no effect of intensive blood pressure lowering on the median size (ml) of cerebral infarction on follow-up CT at 24–36 h (0.3 [IQR 0.0–16.6] in the intensive group and 0.9 [0.0–12.5] in the guideline group; log Δmean −0.17, 95% CI −0.78 to 0.43). The results were consistent in sensitivity and subgroup analyses. Interpretation: Intensive blood pressure lowering treatment to a systolic target
Published: 2023
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3. Stroke care and collaborative academic research in Latin America

Author: Paula Muñoz-Venturelli, Francisca González, Francisca Urrutia, Enrico Mazzon, Victor Navia, Alejandro Brunser, Pablo Lavados, Verónica Olavarría, Juan Almeida, Rodrigo Guerrero, Alexis Rojo, Juan Pablo Gigoux, José Vallejos, Nathalie Conejan, Tomas Esparza, Arturo Escobar, Alvaro Soto, Octavio Pontes-Neto, Antonio Arauz, Carlos Abanto, Cheryl Carcel, Jessica Hanae Zafra-Tanaka, Hueiming Liu, Lili Song, J Jaime Miranda, and Craig S Anderson
Subjects: cerebrovascular disorders, brain infarction, cerebral hemorrhage, latin america, stroke, Public aspects of medicine, RA1-1270
Abstract: Objective. A narrative overview of regional academic research collaborations to address the increasing burden and gaps in care for patients at risk of, and who suffer from, stroke in Latin America (LA). Materials and methods. A summary of experiences and knowledge of the local situation is presented. No systematic literature review was performed. Results. The rapidly increasing burden of stroke poses immense challenges in LA, where prevention and management strategies are highly uneven and inadequate. Clinical research is increasing through various academic consortia and networks formed to overcome structural, funding and skill barriers. However, strengthening the ability to generate, analyze and interpret randomized evidence is central to further develop effective therapies and healthcare systems in LA. Conclusions. Regional networks foster the conduct of multicenter studies –particularly randomized controlled trials–, even in resource-poor regions. They also contribute to the external validity of international studies and strengthen systems of care, clinical skills, critical thinking, and international knowledge exchange.
Published: 2022
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4. Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments

Author: Sheila Cristina Ouriques Martins, Pablo Lavados, Thaís Leite Secchi, Michael Brainin, Sebastian Ameriso, Fernando Gongora-Rivera, Claudio Sacks, Carlos Cantú-Brito, Tony Fabian Alvarez Guzman, Germán Enrique Pérez-Romero, Mario Muñoz Collazos, Miguel A. Barboza, Antonio Arauz, Carlos Abanto Argomedo, Nelson Novarro-Escudero, Hector Ignacio Amorin Costabile, Roberto Crosa, Claudia Camejo, Ricardo Mernes, Nelson Maldonado, Daissy Liliana Mora Cuervo, Octávio Marques Pontes Neto, Gisele Sampaio Silva, Leonardo Augusto Carbonera, Ana Claudia de Souza, Eduardo David Gomes de Sousa, Alan Flores, Donoban Melgarejo, Irving R. Santos Carquin, Arnold Hoppe, João José Freitas de Carvalho, Francisco Mont'Alverne, Pablo Amaya, Hernan Bayona, Victor Hugo Navia González, Juan Carlos Duran, Victor C. Urrutia, Denizar Vianna Araujo, Valery L. Feigin, and Raul G. Nogueira
Subjects: stroke, Latin America, stroke units, stroke centers, stroke system of care, Neurology. Diseases of the nervous system, RC346-429
Abstract: Introduction: Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke.Method: In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting.Results: In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge.Conclusion: The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.
Published: 2021
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5. Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time

Author: Jie Yang, Xia Wang, Jian ping Yu, Jing Hang, Pablo Lavados, Thompson Robinson, Hisatomi Arima, Richard I. Lindley, Craig S. Anderson, and John Chalmers
Subjects: Medicine, Science
Abstract: Abstract Door-to-needle time (DNT) is a key performance indicator for efficient use of intravenous thrombolysis in acute ischemic stroke (AIS). We aimed to determine whether DNT improved over time in the Enhanced Control of Hypertension and Acute Stroke Study (ENCHANTED) and the clinical predictors of DNT. Temporal trends in DNT were assessed across fourths of time since activation of study centers using generalized linear model. Predictors of long DNT (>60 min) were determined in logistic regression models. Overall mean DNT (min) was 71.8 (95% confidence interval [CI] 70.4–73.2), but decreased significantly over time (fourths): 77.9 (74.9–80.9), 69.3 (66.7–72.0), 69.1 (66.5–71.8) and 71.4 (68.7–74.2) (P for trend, 0.003). The reduction in DNT was particularly marked in China (P for trend, 0.001), but was not significant across the other participating countries (P for trend, 0.065). Independent predictors of long DNT were recruitment from China, short onset-to-door time, lower numbers of patients treated per center, higher diastolic blood pressure, off-hour admission, and absence of proximal clot occlusion. DNT in ENCHANTED declined progressively during the trial, especially in China. However, DNT in China is still longer than the key performance parameter of ≤60 minutes recommended in guidelines. Effective national programs are needed to improve DNT in China.
Published: 2017
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6. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study.

Author: Danni Zheng, Hisatomi Arima, Shoichiro Sato, Antonio Gasparrini, Emma Heeley, Candice Delcourt, Serigne Lo, Yining Huang, Jiguang Wang, Christian Stapf, Thompson Robinson, Pablo Lavados, John Chalmers, Craig S Anderson, and INTERACT2 investigators
Subjects: Medicine, Science
Abstract: BACKGROUND:Rates of acute intracerebral hemorrhage (ICH) increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2) participants on an hourly timescale. METHODS:INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (
Published: 2016
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7. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial

Author: Lu Ma, Xin Hu, Lili Song, Xiaoying Chen, Menglu Ouyang, Laurent Billot, Qiang Li, Alejandra Malavera, Xi Li, Paula Muñoz-Venturelli, Asita de Silva, Nguyen Huy Thang, Kolawole W Wahab, Jeyaraj D Pandian, Mohammad Wasay, Octavio M Pontes-Neto, Carlos Abanto, Antonio Arauz, Haiping Shi, Guanghai Tang, Sheng Zhu, Xiaochun She, Leibo Liu, Yuki Sakamoto, Shoujiang You, Qiao Han, Bernard Crutzen, Emily Cheung, Yunke Li, Xia Wang, Chen Chen, Feifeng Liu, Yang Zhao, Hao Li, Yi Liu, Yan Jiang, Lei Chen, Bo Wu, Ming Liu, Jianguo Xu, Chao You, Craig S Anderson, Thompson Robinson, J. Jaime Miranda, Craig S. Anderson, Adrian Parry-Jones, Nikola Sprigg, Sophie Durrans, Caroline Harris, Ann Bamford, Olivia Smith, Robert Herbert, Christopher Chen, William Whiteley, Rong Hu, Jayanthi Mysore, Yao Zhang, Stephen Jan, Hueiming Liu, Lingli Sun, Honglin Chu, Anila Anjum, Francisca Gonzalez Mc Cawley, Alejandra Del Rio, Bruna Rimoli, Rodrigo Cerantola, Thanushanthan Jeevarajah, Madhushani Kannangara, Andrene Joseph, Chamath Nanayakkara, Chunmiao Zhang, Zhao Yang, Brook Li, Zhuo Meng, Yi Ning, Le Dong, Manuela Armenis, Joyce Lim, Helen Monaghan, Rui Luo, Guojuan Cheng, Yilin Dong, Ziqin Liu, Shuihong Wang, Ying Zhang, Jipeng Cheng, Hui Shi, Wenjing Li, Langming Mou, Ping Yi, Xue Chen, Shalomi Weerawardena, Poornima Ellawala, Enalee Ranasinghe, Chrishmi Rodrigo, Kolawala Wahab, Sunday Adeniyi, Jeyaraj Pandian, Megha Khanna, Paula Muñoz Venturelli, Francisca González, Francisca Urrutia Goldsack, Dilshad Begum, Octavio Pontes-Neto, Millene Camilo, Francisco Dias, Octavio Vincenzi, Carla Moro, Renata Santos, Nara Texeira, Alexandre Longo, Rafaela Liberato, Sheila Martins, Arthur Pille, Bruna Chwal, Isabel Silva, Natacha Titton, Gustavo Weiss, Daissy Mora, Magda Ouriques, Leonardo Carbonera, Rodrigo Bazan, Gabriel Modolo, Fernanda Winckler, Luana Miranda, Juli Souza, Alexis Rojo, Wilhelm Uslar, Lorena Medel, Javiera Lopez, Diego Herrero, Pablo Lavados, Barbara Vargas Latorre, Nathalie Conejan, Tomas Esparza, Patricio Sotomayor, Denisse Wenger, Juan Pablo Gigoux, Aldo Letelier, Lilian Acevedo, Vivianne Moya, Cristian Figueroa, Nicol Vallejos, Rodrigo Guerrero, Mauricio Velasquez, Jose Vallejos, Kimerly Pallauta, Tamara Santibanez, Angelo Queirolo, Andrea Lobos, Yongming Jiang, Weimin Li, Wei Huang, Ke Luo, Gangying Liu, Guang Yang, Hongtao Jiang, Xu Zhang, Hongyan Jing, Bo Pu, Dong Lv, Hui Kang, Qiuping Hu, Xiaoming Jiang, Yanli Chen, Shenghua Yang, Jianjun He, Zongping Li, Gang Cheng, Hailin Huang, Xiaoyi Wang, Jianqiong Lin, Minhui Chen, Chenghao Yang, Hao Ding, Yunliang Deng, Fei Luo, Rongjun Zhang, Xiaofeng Wang, Hongbing Zhang, Xiaoliang Yang, Yang Zhang, Chengyi Yang, Yu He, Feng Liu, Rongjie Wang, Yuhui Zhang, Xiaodong Xin, Bin Feng, Wanru Hao, Chang Song, Yun Guo, Dehua Jiang, Jie Chen, Changtong Tang, Hongliang Zhu, Xin Li, Jin Cui, Haidong Xu, Boyang Li, Fusheng Tang, Yuanbin Li, Min Gao, Bo Yang, Xuejun Xu, Bing Deng, Yi Zheng, Yuanhong Ge, Keyu Chen, Yang Liu, Xinshen Li, Tingting Zhong, Jianfeng Xu, Hai Zhang, Jiyue Wang, Jianxin Zhu, Hanyu Sun, Fuhua Yu, Xueguang Zhang, Mingsen Zhang, Bin Wang, Yiming Ma, Donglin Jiang, Jun Zhou, Cong Liu, Wenhong Nie, Mingguo Li, Tao Tian, Yong Li, Mingfang He, Xiaolong Tu, Zhengjun Wu, Hong Liu, Dongsheng Zhong, Rongcai Jiang, Jian Sun, Ye Tian, Yingsheng Wei, Shuo An, Pingbo Wei, Le Luo, Bin Lin, Gang Liu, Yan Wen, Qiang Cai, Qianxue Chen, Pan Lei, Zhiyang Li, Meifang Zhang, Jiaquan He, Yan Chen, Jun Liu, Xinghai Liu, Junyan Li, Min Chen, Jing Wang, Bingzhi Zhou, Baichun Ye, Jiancheng Zhang, Manyuan Zhang, Xuming Pan, Xiaoxiang Yu, Jian Xu, Qingbao Xiao, Yuefei Wang, Liang Tao, Lin Shi, Niandong Zheng, Guoliang You, Bo Lei, Shu Chen, Honggang Wu, Jin Hu, Jianlan Zhao, Jian Yu, Qiang Yuan, Zhuoying Du, Xielin Tang, Qianke Li, Shenghua Liu, Feilong Yang, Kui Xiao, Chao Luo, Guang Wang, Xudong Che, Zhipeng Teng, Wenwu Wan, Jun Li, Yu Liu, Mingbo Fan, Tao Zhang, Lun Cai, Yuan Ma, Zhifeng Ma, Bin Li, Linlin He, Jinghui Li, Weibing Zhang, Shuxin Zhang, Hongzhen Zhang, Yingguang Dai, Jun Lei, Lei Mao, Yiyang Huang, Zhi Zhou, Ping Chen, Fang Chen, Pan Wei, Tiangui Li, Honglin Chen, Mengfei Zeng, Kejie Mou, Jun Xue, Yong Jiang, Xiaoping Tang, Tao Chen, Yalan Zhang, Yanbing Xu, Yuchen Gu, Yujun Zhao, Bin Yang, Peng Kuai, Xi Wang, Yuwang Yang, Xueling Hu, Huitian Zhang, Yintao Yang, Weifeng Wang, Junyi Zhang, Wei Cheng, Xiaoxue Zhang, Xiaowen Ma, Qin He, Li Zhang, Rong Gao, Huixiang Liu, Jingwei Ye, Ping Xu, Xin Wu, Yuan Yuan, Peng Zou, Zhen Zhang, Jiyong Cheng, Zhangming Zhou, Yijun Zeng, Zhang Liang, Deming Du, Shui Yu, Yongjun Cao, Jiaping Xu, Zhichao Huang, Dongqin Chen, Wenfeng Xiao, Li Zhu, Miao Yuan, Yuhai Wang, Dongliang Shi, Xu Hu, Dingchao Xiang, Like Shi, Hongqin Wang, Liu Yang, Wang Miao, Yiyi Hu, Yuchun Zhao, Xi Hu, Weiduo Zhou, Chao Sun, Dong Tang, Kun Yao, Jin You, Shishi Chen, Jianmin Yao, Huanmei Li, Jinmei Liu, Ailin Bai, Yong Yi, Qingshan Deng, Peng Luo, Han Wang, Jingcheng Jiang, Qingwei Yang, Shunpo He, Jun Wang, Yu Chen, Hua He, Yuyang Deng, Zhikai Cao, Xuxia Yi, Jinbiao Luo, Shuang Luo, Min Gong, Li Liu, Xuejun Gao, Jia Liu, Li'e Wu, Jia Zhang, Hongying Sun, Xinhui Li, Lu Jia, Jianbing Wu, Jie Zhang, Huajun Zhang, Chunfu Du, Shun Li, Xiaobin Yang, Jie He, Lei Liao, Gezhi Zhou, Wentao Dong, Yunxiang Chen, Xiaofeng Lin, Xujian Shui, Peng Zhang, Yuan Zhao, Hongli Yang, Wenbin Zhao, Xiaoyi Zhang, Jincao Chen, Qian Wu, Xuan Dai, Baogui Tang, Yinjuan Wang, Tao Liu, Haixia Zhang, Faliang Duan, Ming Luo, Qingfang Jiao, Guoliang Lei, Dong Wang, Chunwang Song, Haopeng Tan, Feng Ye, Xinghu Qin, Xiaolong Liang, Junling Liu, Lang Yang, Jie Yang, Yapeng Lin, Qian Yang, Xuntai Ma, Yinkuang Qi, Baogen Pan, Caixia Jiang, Zhanying Ye, Ce Dong, Xiongfei Yue, Xiaopeng Yang, Tuoheti Maimaitiyiming, Jun Dong, Yonggang Wu, Feng Gao, Deqiang Zhao, Xinghai Zhang, PengJun Wang, Hongbo Jiang, Jianping Li, Wei Zhang, Jing Chen, Haibo Tong, Yonghong Wang, Kaipeng Qiao, Fuyou Guo, Mingchu Zhang, Yan Hu, Mengzhao Feng, Dengpan Song, Yi Zuo, Shangjun Chen, Chao Qian, Baoming Li, Jingku Ma, Sunfu Zhang, Bin Kong, Xingyu Dong, Sheng Fang, Bin Lu, Yang Li, Yongling Yang, Hong Yu, Huaiyu Sun, Yue Wang, Weimin Wang, Tong Li, Shengli Li, Zhiming Xu, Yongyi Wang, Qiang Dong, Yuping Tang, Heling Chu, Ying Lu, Zhong Wang, Xiaoou Sun, Jianhua Zhao, Shuaifeng Yang, Xiying Qian, Aralikatte Onkarappa Saroja, Ravishankar Naik k, Sandip Chindhi, Nakul Pampaniya, Kurubara Amaresh, Thomas Iype, Dileep R, Reeja Rajan, Praveen Panicker, Rupjyoti Das, Nupur Choudhury, Pankaja Gohain, Jemin Webster, Biyol Pakma, Lalbiak Sangi, Ivy Sebastian, Gaurav Aggrawal, Komal Raj, Deepankshi Rajoura, Sulena Singh, Varun Aggrawal, Amit Narang, Vanesa Cano-Nigenda, Diego López-Mena, Héctor Valdez-Ruvalcaba, Roberto Toledo-Treviño, Reginald Obiako, Sani Abubakar, Oguike Emeka, Balogun Olayemi, Melika Lois, Ibinaiye Philip, Olurishe Comfort O, Njideka Okubadejo, Osigwe Agabi, Oluwadamilola Ojo, Kolawole Wahab, Abiodun Bello, Oyinloye Ibukun, Olufemi Sanayaolu, Abdulraheem Jimoh, Shahid Waheed, Dr.Ayeesha Kamal, Raja Farhat Shoaib, Fizza Orooj, Sadaf Majid, Taskeen Zehra, Abdus Salam Khan, Ravi Shanker, Nadir Ali Syed, Nashwa Ahmad, Ana Valencia, Danny Barrientos, Jorge Ramirez, Pilar Calle, Dilum Palliyeguruge, Sumudu Muthucumarana, Shiroma Ratnayaka, Dilhara Ganihiarachchi, Arundathi Bandaranayake, S.D.B Somaratne, Saumya Narayana, Sithara Gallage, Bimsara Senanayake, Udari Samarasiri, Dunya Luke, Mythily Sivapathasundaram, Vithoosan Sahadevan, Amani Rasmi, Yuran Deshaka, Nilukshi Fernando, Aruna Munasinghe, Kapilanga Rathnapriya, A.S Nissanka, Kanchana Karunathilake, Isuru Gayan, Kaminda Wijenayake, Hasitha Gunasekara, Jagath Vidyarathne, Ajantha Keshavaraj, Kanagasabapathy Janarthanan, Arhivalaky Gerald Jeevathasan, Sivaram Sivamainthan, Mathyamuthan John Priyanth, Abirami John Priyanth, Thambippillai Rajendiran, Sanjeewa Alwis, Nushara Gunasekare, Vasundara Liyanarachchi, Athula Dissanayake, Wimalasiri Mewa Uluwattage, Gimhani Ratnayake, Charika Rajinee, Sakura Jayawardana, Janaka Peiris, Ranjith Wicramasinghe, Chamila Fernando, Jessie Abbas, Nethmini Withanage, Makaranda Bandara, Duy Ton Mai, Van Chi Nguyen, Viet Phuong Dao, Xuan Trung Vuong, Tien Dung Nguyen, Trung Hieu Dinh, Ha Quan Phan, Quoc Viet Bui, Dinh Tho Phung, Quang Tho Pham, Dinh Dai Pham, Duc Thuan Do, Phuc Duc Dang, Minh Duc Dang, Dang Hai Nguyen, Thi Phuong Nga Nguyen, Quoc Huy Nguyen, Quoc Dai Pham, Quoc Vinh Chau, Vinh Thy Van Tai, Tran Vinh Le, Cong Tri Le, Ha Mai Khuong Tran, Huu Khanh Nguyen, Hoang Minh Thao Ngyen, Duc Chien Vo, Thai My Phuong Nguyen, Trung Thanh Tran, Thi Hanh Vi Vo, Hao Nhien Cao, Ba Thang Nguyen, Thi Ngoc Suong Le, Thien Duc La, Chi Duc Pham, and Huy Thai
Subjects: General Medicine
Published: 2023

8. Disparities in stroke incidence over time by sex and age in Latin America and the Caribbean region: a systematic review and meta-analysis

Author: Marilaura Nuñez, Carlos Delfino, Claudia Asenjo-Lobos, Andrea Schilling, Pablo Lavados, Craig S. Anderson, and Paula Muñoz Venturelli
Abstract: BackgroundHigh-income countries studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region (LAC).MethodsA search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective observational studies with age and sex-disaggregated data of first-ever stroke (FES) incidence. Risk of bias was assessed with The Joanna Briggs Institute’s guide. The main outcomes were incidence rate ratio (IRR) and relative temporal trend ratio (RTTR) of SI, comparing time periods ≥2010 with ResultsFrom 9,242 records identified, six studies were selected including 4,483 FES in 4,101,084 individuals. Crude IRR in younger subjects (ConclusionsAn unfavorable change in SI in young people - especially in women - was detected in the last decade in LAC. Further investigation of the explanatory variables is required to ameliorate stroke prevention and inform local decision-makers.Registration of protocolCRD42022332563 (PROSPERO).
Published: 2023

9. Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients:insights from the ENCHANTED trial

Author: Chen Chen, Menglu Ouyang, Sheila Ong, Luyun Zhang, Guobin Zhang, Candice Delcourt, Grant Mair, Leibo Liu, Laurent Billot, Qiang Li, Xiaoying Chen, Mark Parsons, Joseph P. Broderick, Andrew M. Demchuk, Philip M. Bath, Geoffrey A. Donnan, Christopher Levi, John Chalmers, Richard I. Lindley, Sheila O. Martins, Octavio M. Pontes-Neto, Paula Muñoz Venturelli, Verónica Olavarría, Pablo Lavados, Thompson G. Robinson, Joanna M. Wardlaw, Gang Li, Xia Wang, Lili Song, and Craig S. Anderson
Subjects: Clinical trial, Acute ischaemic stroke, Blood pressure, Cerebral infarction, Brain imaging, General Medicine, Thrombolysis
Abstract: Background: Intensive blood pressure lowering may adversely affect evolving cerebral ischaemia. We aimed to determine whether intensive blood pressure lowering altered the size of cerebral infarction in the 2196 patients who participated in the Enhanced Control of Hypertension and Thrombolysis Stroke Study, an international randomised controlled trial of intensive (systolic target 130–140 mm Hg within 1 h; maintained for 72 h) or guideline-recommended (systolic target 150 mm Hg) after thrombolysis treatment for acute ischaemic stroke between March 3, 2012 and April 30, 2018. Methods: All available brain imaging were analysed centrally by expert readers. Log-linear regression was used to determine the effects of intensive blood pressure lowering on the size of cerebral infarction, with adjustment for potential confounders. The primary analysis pertained to follow-up computerised tomography (CT) scans done between 24 and 36 h. Sensitivity analysis were undertaken in patients with only a follow-up magnetic resonance imaging (MRI) and either MRI or CT at 24–36 h, and in patients with any brain imaging done at any time during follow-up. This trial is registered with ClinicalTrials.gov, number NCT01422616. Findings: There were 1477 (67.3%) patients (mean age 67.7 [12.1] y; male 60%, Asian 65%) with available follow-up brain imaging for analysis, including 635 patients with a CT done at 24–36 h. Mean achieved systolic blood pressures over 1–24 h were 141 mm Hg and 149 mm Hg in the intensive group and guideline group, respectively. There was no effect of intensive blood pressure lowering on the median size (ml) of cerebral infarction on follow-up CT at 24–36 h (0.3 [IQR 0.0–16.6] in the intensive group and 0.9 [0.0–12.5] in the guideline group; log Δmean −0.17, 95% CI −0.78 to 0.43). The results were consistent in sensitivity and subgroup analyses. Interpretation: Intensive blood pressure lowering treatment to a systolic target
Published: 2023

10. Simulación multimodal en ACV: paciente estandarizado, simulador de paciente virtual y una aplicación de seguimiento de procesos para el entrenamiento interprofesional

Author: Soledad Armijo-Rivera, Daniela Ahumada-Millar, Victor Navia-González, Pablo Lavados, and Robert Partarrieu-Stegmeier
Subjects: business.industry, Medicine, General Medicine, business
Published: 2020

11. Stroke in Latin America: Systematic review of incidence, prevalence, and case-fatality in 1997–2021

Author: Carlos Delfino, Marilaura Nuñez, Claudia Asenjo-Lobos, Francisca Gonzalez, Amy Riviotta, Francisca Urrutia, Pablo Lavados, Craig S. Anderson, and Paula Muñoz Venturelli
Subjects: Neurology
Abstract: Background: Stroke is a major global cause of death and disability. Most strokes occur in populations of low-middle-income country (LMIC); therefore, the subsequent disease burden is greater than in populations of high-income countries. Few epidemiological data exist for stroke in Latin America, composed primarily of LMIC. Aims: To determine epidemiological measures of incidence, prevalence, and 1-month case-fatality for stroke in Latin America/Caribbean (LAC) during 1997–2021. Summary of review: A structured search was conducted to identify relevant references from MEDLINE, WOS, and LILACS databases for prospective observational and cross-sectional studies in LAC populations from January 1997 to December 2021. A total of 9242 records were screened and 12 selected for analysis, seven incidence studies and five prevalence studies. Case-fatality was reported in six articles. Sub-group analysis by age, sex, and income countries was performed. A narrative synthesis of the findings was performed. Meta-analysis was performed using random-effect model to obtain pooled estimates with 95% confidence intervals (CIs). Studies quality was assessed according to the risk of bias criteria described in the Joanna Briggs Institute’s guide. The overall crude annual incidence rate of first-ever stroke in LAC was 119.0 (95% CI = 95.9–142.1)/100,000 people (with high heterogeneity between studies ( I2 = 98.1%)). The overall crude prevalence was 3060 (95% CI: 95.9–142.1)/100,000 people (with high heterogeneity between studies ( I2 = 98.8%)). The overall case-fatality at 1 month after the first stroke was 21.1% (95% CI = 18.6–23.7) ( I2 = 49.40%). Conclusion: This review contributes to our understanding regarding the burden caused by stroke in LAC. More studies with comparable designs are needed to generate reliable data and should include both standardized criteria, such as the World Health Organization clinical criteria and updated standard methods of case assurance, data collection, and reporting.
Published: 2023

12. Multimodal Simulation in Stroke: A Standardized and Virtual Patient With Mobile Tracking App for Interprofessional Training

Author: Victor Navia González, Robert Partarrieu Stegmeier, Daniela Ahumada Millar, Soledad Armijo, and Pablo Lavados
Subjects: genetic structures, education
Abstract: Background: Ischemic stroke is a time-dependent disease, with early diagnosis and interdisciplinary and coordinated management between pre-hospital and in-hospital being key to patient management. Interprofessional training has incorporated various teaching technologies, such as simulation with standardized patients, virtual simulators, and telephone applications for tracking clinical processes. There are few publications regarding the impact of multimodal and interprofessional training on initial stroke management. The objective of this work was to evaluate the impact on confidence, perception of knowledge and satisfaction of the participants of a multimodal workshop for interprofessional training in the initial management of stroke.Methods: A workshop was organized with pre-hospital and intra-hospital interprofessional groups, based on standardized patient simulation, virtual simulation and a telephone application for tracking clinical processes. A questionnaire was applied to the 26 participants to investigate the level of satisfaction with the simulation and the telephone application. Quantitative data was analyzed using descriptive statistics.Results: The response rate was 67% (17/26). 100% reported a self-perception of increased confidence in their stroke management abilities, 100% feel that debriefing instances favor their learning and 93.4% believed that an app contributes to the improvement of prehospital management of patients.Conclusions: The use of multimodal simulation tools and technologies for process monitoring fosters the learning process and confidence of trained personnel in the initial management of time-dependent diseases such as stroke.
Published: 2020

13. Incidencia poblacional, características epidemiológicas y desenlace funcional de pacientes con ataque cerebrovascular isquémico y afasia

Author: Verónica Olavarría I, Francisca González Mc, and Pablo Lavados G
Subjects: First episode, medicine.medical_specialty, Pediatrics, business.industry, Incidence (epidemiology), Infarction, General Medicine, medicine.disease, Surgery, 030507 speech-language pathology & audiology, 03 medical and health sciences, 0302 clinical medicine, Aphasia, Case fatality rate, Etiology, Medicine, cardiovascular diseases, medicine.symptom, Risk factor, 0305 other medical science, business, Stroke, 030217 neurology & neurosurgery
Abstract: Background: Sequelae after a stroke are common and may lead to disability. Aphasia - defined as an acquired language disturbance - can cause important limitations in quality of life. Aim: To describe the epidemiological features of patients who had an aphasia after a first episode of ischemic stroke and their functional outcome at six months. Material and methods: Review of a database of a population study on the incidence, 30-day case fatality rate, and prognosis of stroke performed in a northern Chilean city between 2000 and 2002. Results: Aphasia was diagnosed in 28 of 142 patients in whom the disorder was sought (20%). The projected incidence rate in the city where the study was carried out is 7.6 per 100,000 inhabitants. The mean age of these 28 patients was 66 ± 20 years and 53% were women. The main risk factor for stroke was hypertension in 62%. The etiology of stroke was undetermined in 64% of these patients. Partial anterior circulation infarction was the most common stroke location in 61%. Conclusions: Twenty percent of patients with a first episode of ischemic stroke have aphasia.
Published: 2017

14. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author: Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi Mundl, Stuart J Connolly, Robert G Hart, N Abdelhamid, D Abdul Rahman, M Abdul-Saheb, P Abreu, M Abroskina, F Abu Ahmad, S Accassat, M Acciaresi, A Adami, N Ahmad, F Ahmed, M Alberto Hawkes, F Alemseged, A Ali, R Altavilla, L Alwis, P Amarenco, S Amaro, LE Amaya Sanchez, A Amelia Pinto, SF Ameriso, H Amin, T Amino, AK Amjad, E Anagnostou, G Andersen, C Anderson, DC Anderson, M Andrea Falco, F Andres Mackinnon, D Andreu, M Androulakis, M Angel Gamero, G Angel Saredo, R Angeles Diaz, M Angels Font, S Anticoli, A Arauz, AA Arauz Gongora, P Araya, JF Arenillas Lara, S Arias Rivas, M Arnold, S Augustin, W Avelar, E Azevedo, V Babikian, A Bacellar, K Badalyan, HJ Bae, EM Baez Martinez, H Bagelmann, P Bailey, Z Bak, M Baker, A Balazs, D Baldaranov, I Balogun, T Balueva, Z Bankuti, M Bar, A Baranowska, J Bardutzky, S Barker Trejo, J Barlinn, F Baronnet, C Barroso, M Barteys, T Bartolottiova, A Barulin, M Bas, S Bashir, V Basile, R Bathe-Peters, R Bathula, C Batista, H Batur Caglayan, P Baumgartner, R Bazan, O Bazhenova, M Beaudry, J Beer, Y Behnam, C Beilei, A Beinlich, Y Bejot, A Belkin, OR Benavente, A Benjamin, V Berardi, D Bereczki, SD Berkowitz, J Berlingieri, W Berrios, J Berrouschot, M Bhandari, M Bhargavah, H Bicker, T Bicsak, M Bilik, D Bindila, J Birchenall, L Birnbaum, T Black, D Blacker, D Blacquiere, C Blanc-Labarre, C Blank, B Blazejewska-Hyzorek, S Bloch, E Bodiguel, E Bogdanov, L Boos, L Borcsik, N Bornstein, S Bouly, G Braga, I Bragado, MC Bravi, C Brokalaki, W Brola, R Brouns, D Bruce, J Brzoska-Mizgalska, B Buck, M Buksinska-Lisik, J Burke, M Burn, G Bustamante, L Cabrejo, K Cai, S Cajaraville, M Calejo, D Calvet, J Campillo, E Campos Costa, P Camps, H Can Alaydin, E Candeloro, C Canepa, CG Cantu Brito, M Cappellari, C Carcel, P Cardona Portela, F Cardoso, M Carek, M Carletti, J Carlos Portilla, P Caruso, I Casado-Naranjo, P Castellini, D Castro, F Castro Meira, A Cavallini, N Cayuela Caudevilla, S Cenciarelli, C Cereda, P Cerrone, A Chakrabarti, P Chaloulos-Iakovidis, A Chamorro, D Chandrasena, DI Chang, C Che, J Chembala, J Chen, Z Chen, T Chen, H Chen, X Chen, G Chen, L Chen, S Chen, B Cheripelli, M Chin, E Chiquete Anaya, M Chorazy, H Christensen, T Christensen, L Christian, F Chu, CS Chung, W Clark, R Clarke, S Claverie, E Clemente Agostoni, B Clissold, J Coelho, D Cohen, S Colakoglu, D Collas, R Condurso, SJ Connolly, D Consoli, C Constantin, AB Constantino Silva, L Contardo, A Corlobe, M Correia, C Correia, E Cortijo Garcia, B Coull, S Coutts, S Coveney, P Cras, R Crols, S Crozier, A Csanyi, L Csiba, K Csontos, R Csuha, L Cui, L Cunha, S Curtze, M Czerska, A Czlonkowska, M Czurko, M Czuryszkiewicz, M Dagnino, C Dai, A Daineko, G Dalek, D Damgaard, A Danese, K Dani, V Danku, W Dario Toledo, A Dávalos, A De Havenon, J De Keyser, N De Klippel, J De La Torre, A De Pauw, A De Smedt, R De Torres, MM De Vries Basson, J Dearborn, R Deganutto, M Degeorgia, I Deguchi, A Del Giudice, C Delcourt, R Delgado-Mederos, G Della Marca, B Delpont, S Deltour, DL Demets, M Dennis, J Desai, J Devine, I Dhollander, MT Di Mascio, M Diaconu, F Diaz Otero, J Dietzel, E Diez-Tejedor, N Ding, J Ding, M Diomedi, P Dioszeghy, M Distefano, V Domigo, E Dorodnicov, D Dossi, F Doubal, I Druzenko, P Du, J Du, T Duman, Y Duodu, D Dutta, L Dylewicz, J Eckstein, E Ehrensperger, S Ehrlich, G Einer Allende, B Elena Halac, S Elyas, M Endres, JM Engelbrecht, S Engelter, M Epinat, F Eren, M Esbjornsson, B Escribano, I Escudero, B Esisi, B Essa, M Esterbauer, N Evans, D Eveson, S Fabio, L Fang, S Fanta, M Fares, M Fatar, K Faust, A Favate, F Fazekas, M Federica Denaro, A Fedin, P Felipe Amaya, J Feng, K Ferencova, M Fernanda Gilli, MD Fernandez, PN Fernandez Pirrone, J Fernandez Vera, J Ferrari, A Ferreira, G Ferreira Junior, M Fidler, D Field, T Field, C Figueroa, J Fiksa, A Filipov, A Firstenfeld, L Fisch, U Fischer, M Fisselier, U Fiszer, F Fluri, G Fortea, K Fotherby, A Fraczek, E France, G Freitas, S Frey, M Frick, A Friedman, M Friedrich, G Frisullo, W Fryze, B Fuentes Gimeno, H Fujigasaki, K Fukuyama, A Furlan, G Furlanis, J Furnace, M Gabriel, E Gabriel Reich, RJ Gagliardi, F Galati, E Galli Giqueauk, A Gallina, E Gallinella, J Gallo, S Gangadharan, Y Gao, R Garcia Lopez, A Garcia Pastor, SM Garcia Sanchez, M Garnauf, P Garnier, D Gasecki, K Gasic, K Gasiorek, S Gasser, M Gaugg, M Gebreyohanns, K Gebura, J Geng, M Geniz Clavijo, K Georg Haeusler, R Geran, M Geremek, Z Gerocs, D Ghia, D Giannandrea, F Giatsidis, JA Gien Lopez, A Gil Nunez, L Gimenez, E Giralt, A Glabinski, D Gladstone, M Gliem, M Gluszkiewicz, R Goddeau, E Gogoleva, M Gokce, D Goldemund, K Golikov, A Gomes Neto, M Gomez Schneider, M Gomez-Choco, M Gomis, JF Gongora-Rivera, Y Gonysheva, L Gonzalez, ME Gonzalez Toledo, M Gottschal, I Gozdzik, S Grabowski, S Graf, D Green, D Greer, T Gregorio, S Greisenegger, I Greshnova, M Griebe, M Grzesik, J Guan, S Guarda, A Gueguen, C Guidoux, P Guillermo Povedano, B Guillon, V Guiraudg, G Gunathilagan, N Guryanova, V Gusev, G Gustavo Persi, R Gutiérrez, P Guyler, N Gyuker, V Hachinski, A Hajas, H Hallevi, G Hankey, GJ Hankey, L Hanouskova, L Hao, K Haraguchi, Y Haralur Sreekantaiah, S Haratz, D Hargroves, K Harkness, P Harmel, M Harrasser, RG Hart, M Harvey, R Hasan, Y Hasegawa, A Hassan, M Hattori, A Hatzitolios, M Hauk, T Hayashi, H Hayhoe, VS Hedna, M Heine, V Held, S Hellwig, J Henkner, N Henninger, S Hermans, J Hernandez, D Herrero, M Hervieu-Begue, R Herzig, L Hicken, M Hieber, M Hill, M Hirose, MC Hobeanu, B Hobson, M Hochstetter, J Hoe Heo, M Hoffmann, C Holmstedt, P Hon, KS Hong, Y Honma, A Horev, G Horgan, L Horvath, M Horvath, C Hoyer, D Huang, H Huang, B Huber, J Huhtakangas, M Hussain, S Igarashi, AM Iglesias Mohedano, J Ignacio Tembl, M Impellizzeri, Y Inanc, P Ioli, A Irina Aniculaesei, K Ishida, R Itabashi, H Iversen, A Jagolino, K Jakab, S Jander, H Janka, J Jankovych, J Jansen, L Jasek, M Javier Alet, L Javor, X Jin, P Jing, B Joachim, M Joan Macleod, M Johnson, J Jose Martin, C Joyner, K Judit Szabo, A Jun-Oconnell, R Jura, B Kaczorowska, J Kadlcikova, T Kahles, N Kakaletsis, I Kakuk, K Kalinowska, K Kaminska, C Kaneko, I Kanellos, P Kapeller, K Kapica-Topczewska, O Karasz, M Karlinski, JE Karlsson, K Kasa, E Kashaeva, SE Kasner, M Kaste, J Kasza, A Katalin Iljicsov, M Katsurayama, S Kaur, M Kawanishi, S Kaygorodtseva, K Ke, A Kei, J Keilitz, J Kellner, P Kelly, S Kelly, D Kemlink, M Kerekgyarto, I Keskinarkaus, D Khairutdinova, A Khanna, A Khaw, M Kholopov, C Khoumri, S Kirpicheva, H Kirshner, K Kitagawa, S Kittner, R Kivioja, F Klein, D Kleindorfer, T Kleinig, P Klivenyi, S Knecht, Y Kobayashi, A Kobayashi, M Koch, L Koehler, M Koivu, V Kolianov, I Koltsov, T Kondo, I Konkov, S Kopecky, E Korompoki, J Korpela, K Kosarz-Lanczek, A Koutroubi, K Kovacs, T Kovacs, H Kovacs, K Kowalczyk, M Kowalska, D Krajickova, M Kral, C Krarup Hansen, J Kraska, S Krebs, V Krejci, C Kremer, R Kreuzpointer, M Krzyzanowska, D Kucken, A Kulakowska, J Kunzmann, N Kurenkova, A Kuris, I Kurkowska-Jastrzebska, N Kurtenkova, O Kurushina, G Kusnick, M Kustova, T Kuwashiro, J Kwan Cha, A Lago, M Lagutenko, B Lajos, J Lambeck, C Lamy, A Landolfi, S Lanfranconi, W Lang, LB Lara Lezama, B Lara Rodriguez, T Largo, A Lasek-Bal, L Latte, V Lauer, P Lavados, R Le Bouc, R Leal Cantu, H Lechner, K Lecouturier, S Leder, J Lee, BC Lee, A Leger, E Leira, I Leisse, R Leker, G Lembo, L Lenskaya, J Leyden, G Li, M Li, S Li, J Li, G Liamis, H Liang, Z Liang, N Ligot, H Lin, R Lindert, A Lindgren, M Linna, T Litwin, K Liu, X Liu, L Llull, B Lohninger, M Longoni, C Loomis, D Lopes, M Lopez Fernandez, N Lopez Garza, A Lord, S Louw, R Lovasz, T Lowenkopf, Z Lu, SC Lubke-Detring, R Luder, S Lujan, B Luo, L Lupinogina, G Luschin, H Lutsep, A Lvova, J Ly, G.M. Grosse, H Ma, C Ma, M Machado, C Machado, S Macher, J Machetanz, F Macian-Montoro, E Mackey, A Mackey, G Maclean, J Maestre-Moreno, A Magadan, T Magyar, A Mahagney, A Majid, A Majjhoo, K Makaritsis, J Mandzia, M Mangas Guijarro, D Mangion, E Manios, S Mann, L Manning, C Manno, J Manuel Garcia, V Maqueda, M Mar Castellanos, M Mar Freijo, C Marando, S Marcela Lepera, J Marcos Couto, G Maria Bruera, L Maria Greco, A Maria Lorenzo, S Maria Obmann, A Maria Roa, C Marini, I Marinkovic, G Mario Sumay, C Mario Torres, M Marko, S Markova, H Markus, R Marsh, E Marsili, M Marta Esnaola, J Marta Moreno, J Marti-Fabregas, S Martina Angelocola, P Martínez Sánchez, N Martinez-Majander, S Martins, O Marzelik, S Mastrocola, G Matamala, A Matoltsy, B Matosevic, S Matsumoto, A Maud, G Mauri Cabdevila, Z May, Y Mayasi, A Mayr, T Mazzoli, K Mcarthur, L Mccullough, CE Medina Pech, F Medlin, M Mehdiratta, S Mehta, D Mehta, B Mehta, M Melis, E Melnikova, B Mendez, T Mendonca, JJ Mengual Chirifie, N Menon, A Mensch, E Meseguer, S Messe, K Metcalf, N Meyer, F Michas, N Micheletti, R Mikulik, H Milionis, B Miller, T Milling, C Minelli, J Minhas, M Minns, D Mircea, S Mishra, A Mismas, A Mistri, N Mitrovic, H Miyake, B Modrau, A Moey, C Molina, J Molina, A Molis, J Moller, S Molnar, F Moniche, C Monosi, V Monzani, M Moonis, R Morais, L Morales, A Morales, D Morar-Precup, F Moreton, C Moro, E Morozova, M Morton, T Morvan, E Morvan, T Motko, A Mowla, E Mozhejko, G Muddegowda, O Mudhar, T Mueller, C Muhl, KW Muir, H Mundl, S Munoz, C Murphy, S Murphy, A Murtuzova, T Musuka, J Mutzenbach, M Myint, W Mysliwy, M Naccarato, G Naeije, Y Nagakane, I Natarajan, D Navaratnam, A Nave, B Nazliel, K Nedeltchev, J Nel, H Nell, R Nemeth, L Nemeth, O Neto, K Ng, J Ngeh, L Nicolas Chialvo, T Nieminen, M Nikkanen, J Nikl, M Nikoforova, S Nishino, Y Nishiyama, X Njovane, S Nogawa, F Nombela, B Norrving, K Nosek, B Nowak, E Nowakowska-Sledz, G Ntaios, H Numminen, F Nunez, M Obadia, S Oberndorfer, A Obrezan, J Ochiai, W Oczkowski, MJ O'Donnell, A Odyniec, K Oh, M Ohira, Y Okamoto, M Okpala, S Okubo, L Olah, V Olavarria, J Oleszek, N Onat Demirci, V Ondar, G Ongun, K Ooyama, V Orosz, R Ortiz, G Osseby, E Österlund-Tauriala, C Ovesen, S Ozcekic Demirhan, J Ozdoba-Rot, S Ozturk, E Ozyurt, M Pablo Grecco, G Pablo Povedano, M Paciaroni, C Padiglioni, J Pagola, W Palasik, G Panczel, L Panos, G Papadopoulos, E Papadopoulou, A Papagiannis, V Papavasileiou, M Papina, JR Pardo De Donlebun, V Parisi, JM Park, J Pasten, N Patel, O Pavlik, M Pawelczyk, WF Peacock, H Pei, T Peisker, LF Pena Sedna, A Penn, S Pentek, E Pepper, L Pereira, K Perera, Y Perez, S Perez, P Perez Leguizamon, M Pernicka, R Perry, A Persico, Y Pesant, S Peska, D Peters, G Peters, L Pettigrew, T Phan, S Philippi, T Phinney, F Pico, A Pidal, B Piechowski-Jozwiak, A Pieroni, S Pineiro, V Piras, N Pizova, J Polanco, M Polin, A Polyakov, E Polychronopoulou, A Polymeris, D Popov, A Poppe, P Postorino, C Pozzerese, M Pradhan, L Prats, E Prazdnichkova, B Prendl, M Pretorius, P Profice, S Prokopenko, E Pudov, V Pujol Lereis, G Punzo Bravo, F Purroy, J Qiu, X Qu, V Quenardelle, H Quesada Garcia, L Radrizzani, A Radtke, T Raffelsberger, JM Ramirez Moreno, C Ramos-Estebanez, A Rani, P Rapantova, K Rashed, A Rasheed Nihara, J Rasmussen, L Redondo Robles, M Reif, P Reiner, P Rekova, A Renu, M Repetto, P Reyes, S Reyes Morales, JH Rha, J Ribeiro, S Ricci, C Richard, R Rigual, C Rinaldi, C Riveira Rodriguez, B Rizzato, TG Robinson, A Rocco, M Rodrigues, G Rodriguez, A Rodriguez Campello, F Rodriguez Lucci, M Rodriguez Yanez, C Roesler, C Roffe, R Roine, S Roine, A Roldan, F Romana Pezzella, M Romano, JS Roos, C Rosso, C Rostrup Kruuse, Y Roth, R Roukens, L Roveri, D Rozanski, J Rozniecki, C Rozsa, S Rudilosso, G Ruiz Ares, A Ruiz Franco, G Rum, J Ruuskanen, I Rybinnik, K Ryota, J Saarinen, V Saavedra, C Sabben, A Sabet, D Sagris, J Sahlas, N Sakai, P Salamanca, P Salgado, S Salig, T Salletmayr, M Salnikov, O Samoshkina, Y Samson, D Sanak, M Sànchez Cerón, P Santalucia, M Santamaria Cadavid, P Santiago, G Santo, B Sanz Cuesta, J Sargento, A Sarraj, K Sas, A Sas, O Satoshi, S Satsoglou, N Sattar, S Savitz, C Savopoulos, J Saw, M Sawicka, R Sawyer, T Scandura, N Schillinger, J Schindler, F Schlachetzki, I Schneider, R Schuppner, J Schurig, CJ Schwarzbach, M Sebejova, G Seidel, L Sekaran, D Selcuk, J Selvarajah, A Semerano, J Semjen, D Semushina, S Sen, M Seok Park, J Serena, O Serhat Tokgoz, W Serles, F Serrano, M Sevin, L Seynaeve, S Shah, N Shamalov, T Shang, M Sharma, A Sharrief, M Shazam Hussain, I Shchukin, W Shen, E Shepeleva, I Shinsuke, A Shmonin, A Shoamanesh, A Shuaib, A Shulga, G Sibolt, I Sibon, I Sicilia, M Siebert, E Sieczkowska, C Sila, AA Silva, D Silva, P Silva, Y Silva, M Silvestrini, Z Simony, A Simpkins, B Singh, D Sinha, I Sipos, O Skoda, P Skowron, M Skowronska, B Sliwinska, J Slonkova, A Smolkin, A Smyth, P Sobolewski, A Sobota, SI Sohn, M Soldatov, I Solganov, L Soloveva, E Solovyeva, N Sonntag, P Soors, M Sorgun, C Soriano, D Spence, K Spengos, L Sposato, G Staaf, K Stadler, L Stakhovskaya, K Stamatelopoulos, S Steinert, I Stetkarova, M Stiehm, R Stocker, J Stoinski, A Stoll, G Stotts, A Stumpp, P Sucapane, T Suenaga, X Sun, S Sundararajan, J Sung Kim, H Suzuki, N Svaneborg, G Szasz, W Szczuchniak, S Szczyrba, N Szegedi, A Szekely, Z Szewczyk, G Szilagyi, S Szlufik, K Szoboszlai, L Szpisjak, R Sztajzel, L Sztriha, SE Ta Wil, J Taggeselle, K Takamatsu, M Takao, W Taki, S Takizawa, M Talahma, A Tamayo, J Tan, D Tanne, A Tapanainen, T Tapiola, J Tarasiuk, T Tatlisumak, A Tayal, S Tcvetkova, P Teal, J Tejada Garcia, H Tejada Meza, D Tenora, M Terceno, A Terentiou, S Tezcan, D Thaler, A Thomson, E Thouvenot, M Tiainen, I Timberg, S Timsit, A Tinchon, D Tirschwell, C Togay Isikay, K Tokunaga, M Tolino, C Toloza, G Tomelleri, K Tomoyuki, LM Tomppo, Z Tong, L Tong, D Toni, J Torres, C Tossavainen, G Toth, A Tountopoulou, E Touze, M Tovar, K Toyoda, S Trillo, A Trommer, D Tropepi, D Tryambake, H Tu, S Tuetuencue, R Tumova, O Tumpula, G Turc, A Tutaj, J Tynkkynen, S Uchiyama, U Uchwat, L Uhrinyakova, R Ulku Acar, D Uluduz Ugurlu, X Urra, S Urui, M Usero Ruiz, D Vaclavik, K Vahedi, A Valikovics, J Valpas, P Van Acker, W Van Daele, G Vanderschueren, L Vanina Jure, R Varela, Z Varga, J Varvat, N Varvyanskaya, A Vasco Salgado, P Vasko, L Vass, S Vassilopoulou, I Vastagh, P Vazquez, L Vecsei, R Veltkamp, M Venti, M Verdugo, V Verocai, M Veronica Marroquin, C Veronica Simonsini, T Veverka, M Vigl, A Vila, C Vilar, JA Villanueva Osorio, J Virta, E Vitkova, B Voglsperger, J Volna, PA Von Weitzel-Mudersbach, N Vora, I Voznyuk, A Wach-Klink, A Wacongne, D Walters, Y Wang, J Wang, L Wang, X Wang, W Wang, N Wang, D Wang, H Wang, W Warnack, K Wartenberg, R Waters, M Waters, T Webb, J Weber, G Weiss, K Weissenborn, JI Weitz, B Weller, G Wen, G Weng, P Werner, D Werring, P Wester, W Whiteley, R Whiting, T Wijeratne, C Willems, L Wilson, C Wilson, T Winder, J Windt, A Winkler, A Winska-Tereszkiewicz, A Wisniewska, M Wittayer, A Wlodek, A Wojnarowska-Arendt, M Wolf, V Wolff, C Wolter, A Wong, H Wook Nah, H Worthmann, W Wu, S Wu, S Wunderlich, H Wurzinger, DG Wyse, B Xiao, W Xiaopeng, A Ximenez-Carrillo, L Xiong, Y Xiong, W Xiong, Y Xu, J Xu, Z Xu, B Yalo, T Yamada, M Yamasaki, L Yang, Y Yang, X Yang, Q Yang, B Yang, J Yang, I Yasuhiro, M Yee Lam, C Yegappan, S Yip, E Ylikallio, P Ylikotila, A Yongwon Jin, BW Yoon, Y Yoshida, L Yperzeele, H Yuan, H Yuasa, J Zalewska, C Zanferrari, E Zapata, D Zboznovits, I Zelenka, C Zhang, B Zhang, S Zhang, M Zhang, X Zhang, J Zhang, L Zhao, O Zhirnova, L Zhou, J Zielinska-Turek, I Zinchenko, M Ziomek, A Zitzmann, R Zweifler, J Zwiernik, Yperzeele, Laetitia, and NAVIGATE ESUS Investigators
Subjects: Male, International Cooperation, 030204 cardiovascular system & hematology, antiplatelet therapy, law.invention, Neurology (clinical), ischemic stroke, anticoagulation, Cohort Studies, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, law, Stroke, education.field_of_study, Aspirin, Anticoagulant, Settore BIO/14, Middle Aged, 3. Good health, Treatment Outcome, N/A, Cardiology, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Female, medicine.drug, medicine.medical_specialty, medicine.drug_class, MEDLINE, Population, Foramen Ovale, Patent, Subgroup analysis, Article, Statistics, Nonparametric, 03 medical and health sciences, Double-Blind Method, Internal medicine, medicine, Humans, education, Aged, business.industry, medicine.disease, Human medicine, business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors, Factor Xa Inhibitors
Abstract: Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.
Published: 2018

15. Optimal achieved blood pressure in acute intracerebral hemorrhage: INTERACT2

Author: Craig Anderson, Raf Brouns, Joseph Kwan, David Werring, John Chalmers, Emma Heeley, Angel Chamorro, Graeme Hankey, Pablo Lavados, Dominique Hervé, Serge Timsit, Qiang Li, Richard Lindley, Francesco Corea, Tiago Gregorio, Daniel Strbian, Filip Scheperjans, Emmanuel Touzé, Sylvie De Raedt, Mark Woodward, Andrea Zini, Thomas W Leung, Xia Wang, Sami Curtze, David Blacker, Ann De Smedt, C.J.M. Klijn, María del Mar Castellanos, Charlotte Cordonnier, Thompson Robinson, Markku Kaste, Danilo Toni, Laurent Billot, Candice Delcourt, Christian Stapf, Tissa Wijeratne, Victoria Haunton, Supporting clinical sciences, UZB Other, Physical Medicine and Rehabilitation, Clinical sciences, Neuroprotection & Neuromodulation, Neurology, Vriendenkring VUB, Department of Earth Sciences [Uppsala], Uppsala University, Laboratoire de Glaciologie, Département des Sciences de la Terre et de l'Environnement, CAN-FOR, National Institute of Advanced Science and Technology, Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Brest, and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche
Subjects: Male, medicine.medical_specialty, Internationality, [SDV]Life Sciences [q-bio], Treatment outcome, 030204 cardiovascular system & hematology, Physical function, law.invention, 03 medical and health sciences, 0302 clinical medicine, Blood Pressure Determination/methods, Randomized controlled trial, law, Internal medicine, medicine, Humans, Single-Blind Method, In patient, cardiovascular diseases, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Intracerebral hemorrhage, Antihypertensive Agents/therapeutic use, business.industry, blood pressure, Middle Aged, Cerebral Hemorrhage/diagnosis, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], medicine.disease, Surgery, Clinical neurology, Treatment Outcome, Blood pressure, Acute Disease, Hypertension/diagnosis, Antihypertensive Agents, Blood Pressure Determination, Cerebral Hemorrhage, Female, Hypertension, Blood Pressure, Neurology (clinical), Medicine (all), Cardiology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract: Item does not contain fulltext OBJECTIVES: To investigate the effects of intensive blood pressure (BP) lowering according to baseline BP levels and optimal achieved BP levels in patients with acute intracerebral hemorrhage (ICH). METHODS: INTERACT2 was an open, blinded endpoint, randomized controlled trial in 2,839 patients with ICH within 6 hours of onset and elevated systolic BP (SBP) (150-220 mm Hg) who were allocated to receive intensive (target SBP /=190 mm Hg (p homogeneity = 0.790). Analyses of achieved BP showed linear increases in the risk of physical dysfunction for achieved SBP above 130 mm Hg for both hyperacute (1-24 hours) and acute (2-7 days) phases while modest increases were also observed for achieved SBP below 130 mm Hg. CONCLUSIONS: Intensive BP lowering appears beneficial across a wide range of baseline SBP levels, and target SBP level of 130-139 mm Hg is likely to provide maximum benefit in acute ICH. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that the effect of intensive BP lowering on physical function is not influenced by baseline BP.
Published: 2014

16. Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes)

Author: J. Donald Easton, Maria Aunes, Gregory W. Albers, Pierre Amarenco, Sara Bokelund-Singh, Hans Denison, Scott R. Evans, Peter Held, Marianne Jahreskog, Jenny Jonasson, Kazuo Minematsu, Carlos A. Molina, Yongjun Wang, K.S. Lawrence Wong, S. Claiborne Johnston, Sebastiá F. Ameriso, Geoffrey Donnan, Robin Lemmens, Ayrton Massaro, Ekaterina Titianova, Michael D. Hill, Pablo Lavados, David Skoloudik, Joachim Röther, Szegedi Norbert, Giancarlo Agnelli, Natan Bornstein, Norio Tanahashi, Angel Arauz Góngora, Edwin Pretell, Maria Cristina Z. San Jose, Anna Czlonkowska, Ovidiu Bajenaru, Ludmila Stakhovskaya, Miroslav Brozman, Jong-Sung Kim, Nils Wahlgren, Patrik Michel, Tsong Hai Lee, Nijasri Charnnarong Suwanwela, Kursad Kutluk, Sergii Moskovko, Scott Kasner, Daniel Laskowitz, Wayne Clark, Huy Thang Nguyen, Sebastian Ameriso, Sandra Lepera, Marina Romano, David Paulon, Pablo Ioli, Cristina Zurru, Guadalupe Bruera, Lorena Jure, Francisco Klein, Guillermo Povedano, Christopher Levi, Thanh Phan, Romesh Markus, Craig Anderson, Arman Sabet, Stephen Davis, Andrew Lee, Timothy Kleinig, Andrew Wong, Martin Krause, Jim Jannes, Tissa Wijeratne, Dimitri Hemelsoet, André Peeters, Philippe Tack, Peter Vanacker, Patrice Laloux, William Van Landegem, Geert Vanhooren, Philippe Desfontaines, Marc Van Orshoven, Fabio Oliveira, Mauricio Friedrich, Rosane Brondani, Rubens Gagliardi, Soraia Fabio, Marianna Dracoulakis, Rodrigo Bazan, Luiz Marrone, Octavio Pontes Neto, Gisele Silva, Pedro Kowacs, Paraskeva Stamenova, Marin Daskalov, Ivan Staikov, Dimo Baldaranov, Dimitar Maslarov, Hristo Lilovski, Plamen Petkov, Neli Petrova, Radoslav Mavrov, Veska Markova, Valeria Petrova, Tanya Beleva, Borislav Kralev, Nikolay Sotirov, Veska Lekova, Dimcho Hristov, Vera Ermenkova, Lyudmil Mateev, Rumeliya Mitkova, Liybomir Haralanov, Rosen Ikonomov, Margarita Mihailova, Ivan Georgiev, Ashfaq Shuaib, Vladimir Hachinski, Jean-Martin Boulanger, Sharan Mann, Ayman Hassan, Ariane Mackey, Bijoy Menon, Jeffrey Minuk, Muzaffar Siddiqui, Marsha Eustace, Lucia Vieira, Daniel Selchen, Michel Beaudry, Grant Stotts, Angel Castro, Kristo Gasic, Rodrigo Rivas, Pablo Sanchez, Andres Roldan, Ingrid Grossmann, Christian Figueroa, Jimei Li, Xiaolin Xu, Huisheng Chen, Xiaohong Li, Yi Yang, Chunsheng Zhang, Baojun Wang, Guanglai Li, Dong Wang, Hong Lin, Yamei Tang, Anding Xu, Yanjiang Wang, Wenke Hong, Zhi Song, Xu Zhang, Xiaoping Jin, Yun Xu, Fuling Yan, Weihong Zheng, Xiaoping Wang, Qiang Dong, Zhongxin Zhao, Baorong Zhang, Wangtao Zhong, Guoqiang Wen, Jun Xu, Guozhong Li, Xueshuang Dong, Xiangyang Tian, Zhaohui Zhang, En Xu, Kaixiang Liu, Jun Chen, Ondrej Skoda, Edvard Ehler, Daniel Vaclavik, Daniel Sanak, Sylva Klimosova, Eva Vitkova, Jan Fiksa, Robert Mikulik, Jiri Neumann, Richard Plny, Didier Leys, Igor Sibon, Jean-Louis Mas, Sonia Alamowitch, Fernando Pico, Hassan Hosseini, Marie-Hélène Mahagne, Emmanuel Touze, Wilfried Vadot, Stéphane Vannier, Norbert Nighoghossian, Yves Samson, Pierre Garnier, Emmanuel Ellie, Benoît Guillon, Serge Timsit, Maurice Giroud, Frédéric Philippeau, Aude Bagan-Triquenot, Valérie Wolff, Nicolas Raposo, Michel Obadia, Severine Debiais, Jérôme Grimaud, Stéphane Illouz, Didier Smadja, Cédric Urbanczyk, Jörg Berrouschot, Christian Weimar, Georg Gahn, Hassan Soda, Sven Klimpe, Darius Nabavi, Jörg Glahn, Martin Köhrmann, Lars Krause, Christoph Terborg, Peter Urban, Thorsten Steiner, Andreas Ferbert, Rainer Dziewas, Günter Seidel, Götz Thomalla, Richard Li, Wing Chi Fong, Raymond Cheung, Norbert Szegedi, Krisztián Pozsegovits, Attila Valikovics, Gyula Pánczél, Csilla Rózsa, László Németh, Péter Diószeghy, Csaba Óváry, Attila Csányi, Levente Kerényi, Valéria Nagy, Sámuel Komoly, Dániel Bereczki, Sándor Molnár, István Kondákor, David Tanne, Guy Raphaeli, Gregory Telman, Ronen Leker, Yair Lampl, Francesco Corea, Stefano Ricci, Donata Guidetti, Giovanni Malferrari, Simona Marcheselli, Giuseppe Micieli, Andrea Zini, Vincenzo Di Lazzaro, Carlo Gandolfo, Andrea Salmaggi, Rossana Tassi, Maurizia Rasura, Giovanni Orlandi, Giancarlo Comi, Michelangelo Mancuso, Marialuisa Delodovici, Paolo Bovi, Domenico Consoli, Kimiaki Utsugisawa, Tsuneo Fujita, Hideyuki Kurihara, Chikashi Maruki, Takeshi Hayashi, Tsuneaki Ogiichi, Morio Kumagai, Katsunobu Takenaka, Kazunori Toyoda, Kazuhiro Takamatsu, Ryo Ogami, Shigenari Kin, Takeshi Aoki, Katsumi Takizawa, Shigehiro Omori, Takehiko Umezawa, Yasuyuki Toba, Yutaka Nonoyama, Hidemitsu Nakagawa, Takashi Naka, Masanori Morimoto, Shuichi Matsumoto, Tsutomu Hitotsumatsu, Tatsuya Shingaki, Satoshi Okuda, Mamoru Ota, Nobuyuki Sakai, Takeshi Yamada, Jun Niwa, Hitoshi Fujita, Akihito Moriki, Kimihiro Yoshino, Yoshihisa Fukushima, Takahisa Mori, Atsushi Sato, Yoshikazu Kusano, Michiya Kubo, Masashi Yamazaki, Takao Ooasa, Takafumi Nishizaki, Naoki Kitagawa, Masahiro Yasaka, Yasuhiro Manabe, Akira Yoshioka, Masayuki Ishihara, Takato Kagawa, Toshikazu Ichihashi, Hideki Matsuoka, Yasuhiro Ito, Masahiro Yamasaki, Hitonori Takaba, Hisatoshi Saito, Masahiro Sato, Kazumasa Fukuda, Sumio Endo, Minoru Kidooka, Toshitaka Umemura, Yuriko Kikkawa, Shuta Toru, Kentaro Yamada, Hideki Sakai, Jun Asari, Masayuki Ezura, Hisashi Nitta, Keiko Nagano, Jun Ochiai, Keiichi Sakai, Yasutaka Kobayashi, Yasuhiro Yoshii, Hirotomo Miake, Tomohiro Takita, Hidekazu Taniguchi, Kazuhiko Kuroki, Takamitsu Mizota, Kenichi Yamamoto, Hiroshi Nakane, Takeshi Iwanaga, Kei Chiba, Tetsuyuki Yoshimoto, Tsuyoshi Torii, Takeo Kitagawa, Hiroshi Takashima, Naoki Shirasaki, Makoto Dehara, Naomichi Wada, Kensuke Hamada, Noriyuki Kato, Yoshinori Go, Ichiro Izumi, Hirotomo Ninomiya, Junichiro Kumai, Yoshikazu Nakajima, Yasuhiko Kaku, Yukihiro Isayama, Masahiro Kawanishi, Shinya Noda, Kazuhide Yamamoto, Takanori Hazama, Hiroshi Takahashi, Yohei Tanaka, Takashi Hata, Kiyoshi Kazekawa, Eisuke Furui, Hideki Hondo, Nobuyuki Sato, Katsusuke Kusunoki, Kazunori Nanri, Satoshi Abe, Noboru Sasaoka, Takayuki Kuroyanagi, Hisahiko Suzuki, Kouzou Fukuyama, Kimihiro Nakahara, Fernando Gongora, Carlos Cantú Brito, Jorge Villarreal Careaga, Rosalia Vazquez Alfaro, Geronimo Aguayo Leytte, Percy Berrospi, Carlos Chavez, Liliana Rodriguez, Nilton Custodio, Cesar Castañeda, Julio Perez, Maria Cristina San Jose, Alejandro Baroque, Epifania Collantes, Abdias Aquino, Alejandro Díaz, Artemio Roxas, Johnny Lokin, Joel Advincula, Emerito Calderon, Jose Navarro, John Hiyadan, Arturo Surdilla, Danuta Ryglewicz, Grzegorz Krychowiak, Waldemar Fryze, Piotr Sobolewski, Ryszard Nowak, Urszula Fiszer, Beata Papierowska, Justyna Zielińska-Turek, Anetta Lasek-Bal, Ewa Kołodziejska, Anna Kamińska, Bożena Adamkiewicz, Andrzej Tutaj, Dorota Szkopek, Krzysztof Musiatowicz, Zbigniew Bąk, Sławomir Brzozowski, Waldemar Brola, Antoni Ferens, Marek Zalisz, Konrad Rejdak, Monika Rudzińska, Cristina Panea, Mihaela Simu, Rodica Balasa, Iulian Cuciureanu, Bogdan Popescu, Monica Sabau, Corina Roman-Filip, Leonid Pimenov, Alla Gekht, Anna Milto, Ivan Shchukin, Vladimir Parfenov, Liudmila Stakhovskaya, Mikhail Arkhipov, Nadezhda Sokolova, Enver Bogdanov, Radiy Esin, Dina Khasanova, Konstantin Golikov, Elena Melnikova, Leonid Zaslavskiy, Igor Voznyuk, Alexander Nazarov, Leila Akhmadeeva, Aida Iakupova, Nikolay Shamalov, Galina Belskaya, Svetlana Chuprina, Olga Denisova, Ekaterina Drozdova, Yuliya Karakulova, Ilya Sholomov, Nikolay Spirin, Elena Vostrikova, Elena Mordvintseva, Vera Grigoryeva, Dmitry Zateyshchikov, Vladimir Gorbachev, Zhanna Chefranova, Mikhail Dudarev, Rostislav Nilk, Alexey Rozhdestvenskiy, Ladislav Gurcik, Miloslav Dvorak, Georgi Krastev, Egon Kurca, Juraj Vyletelka, Jong Sung Kim, Hee-Joon Bae, Yong-Won Kim, Joon-Tae Kim, Jae-Kwan Cha, Hyo Suk Nam, Dae-Il Chang, Yong-Seok Lee, Kyungmi Oh, Sung-Wook Yu, Sung-Il Sohn, Jun Lee, Han Jin Cho, Eung-Gyu Kim, Joung-Ho Rha, Seo Hyun Kim, Carlos Molina Cateriano, Joaquín Serena Leal, José Vivancos Mora, Manuel Rodríguez Yañez, Jaume Roquer González, Francisco Purroy García, Meritxell Gomis Cortina, Jaime Masjuan Vallejo, Juan Arenillas Lara, Tomás Segura Martín, José Antonio Egido Herrero, Jose Ignacio Tembl Ferrairó, Jaime Gállego Culleré, Francisco Moniche Álvarez, Anna Steinberg, Margarita Callander, Ann Charlotte Laska, Lena Bokemark, Thomas Mooe, Tor-Björn Käll, Lennart Welin, Lars Sjöblom, Joakim Hambraeus, Jörg Teichert, Hans Wannberg, Johan Sanner, Bo Ramströmer, Bo Ziedén, Stefan Olsson Hau, Claes Gustafsson, Timo Kahles, Philippe Lyrer, Marcel Arnold, Martin Liesch, Friedrich Medlin, Carlo Cereda, Georg Kägi, Andreas Luft, Emmanuel Carrera, Tsong-Hai Lee, Helen L. Po, Chang-Ming Chern, Li-Ming Lien, Lung Chan, Chung-Hsiang Liu, Shey-Lin Wu, Jiann-Der Lee, Chih-Hung Chen, Huey-Juan Lin, Ruey-Tay Lin, Wei-Hsi Chen, Yu Sun, Tasanee Tantirittisak, Sombat Muengtaweepongsa, Yongchai Nilanont, Somsak Tiamkao, Chesda Udommongkol, Kanokwan Watcharasaksilp, Witoon Jantararotai, Hadiye Sirin, Birsen Ince, Talip Asil, Murat Arsava, Tulay Kurt Incesu, Hulya Tireli, Hayriye Kucukoglu, Fikri Ak, Ali Unal, Serefnur Ozturk, Nevzat Uzuner, Galyna Chmyr, Volodymyr Lebedynets, Vadym Nikonov, Lyudmyla Shulga, Volodymyr Smolanka, Marta Khavunka, Valentyna Yavorska, Nataliya Tomakh, Olexandr Kozyolkin, Galyna Litovaltseva, Maarten Lansberg, Richard Bernstein, David Brown, Jonathan Dissin, Carmelo Graffagnino, Jonathan Harris, William Hicks, Irene Katzan, Jeffrey Kramer, Joshua Willey, Scott Silliman, Sidney Starkman, David Thaler, Margaret Tremwel, Mauricio Concha, Kumar Rajamani, Bhuvaneswari Dandapani, Brian Silver, Nathan Deal, Ira Chang, Ameer Hassan, Steven Rudolph, Kenneth Fischer, Howard Kirshner, William Logan, Sidney Mallenbaum, Hebah Hefzy, Julius Latorre, Steven Levine, Anthony Ciabarra, Rima Dafer, Benjamin Anyanwu, Laurel Cherian, Spozhmy Panezai, Anna Khanna, Jodi Dodds, Michel Torbey, James Gebel, Henry Woo, David Chiu, Xiao Androulakis, William Burgin, Maria Pineda, Engin Yilmaz, Irfan Altafullah, Christine Boutwell, Salvador Cruz-Flores, Biggya Sapkota, Pierre Fayad, Michael Jacoby, Shahid Rafiq, Efrain Salgado, Eugene Lafranchise, Warren Felton, Ramesh Madhavan, Osama Zaidat, Connie Pieper, Ralph Riviello, Aaron Burnett, Michelle Fischer, Nina Gentile, Christopher Calder, Dennis Dietrich, Jonathan Cross, Larry Blankenship, Liliana Montoya, Wendell Grogan, Mark Young, Farrukh Khan, Duane Campbell, Nizar Daboul, Andrey Espinoza, Paul Cullis, Gilberto Concepcion, John Wulff, Haider Afzal, Naseem Jaffrani, William Reiter, Tamjeed Arshad, Timothy Lukovits, James Welker, Fen Lei Chang, Aamir Badruddin, Viken Babikian, Ravi Menon, James Sander, Mellanie Springer, Ashish Nanda, Luis Mas, Raj Rajan, Bruce Silverman, David Huang, David Carpenter, Joni Clark, Marilou Ching, Sunitha Santhakumar, Jeffrey Gould, Vibhav Bansal, Gabriel Vidal, Timothy Mikesell, John Brick, William French, Qaisar Shah, Christine Holmstedt, Nadir Ishag-Osman, John Kostis, Abbas Shehadeh, Pramodkumak Sethi, Asher Imam, Carl Mccomas, Duc Tran, Mehari Gebreyohanns, Brian Wiseman, Maheen Malik, Aron Schwarcz, Dorothea Altschul, John Castaldo, Amer Alshekhlee, Stephen Gancher, Nagesh Krish, Mai Nguyen-Huynh, Margaret Tremwell, Jitendra Sharma, Lance Lee, William Neil, Fazeel Siddiqui, Ali Malek, Charles Romero, Thang Nguyen Huy, Hoa Hoang, Thang Nguyen, Anh Nguyen, Hung Nguyen, Laboratoire de Recherche Vasculaire Translationnelle ( LVTS ), Université Paris 13 ( UP13 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), AstraZeneca, National Cerebral and Cardiovascular Center ( NCCC - OSAKA ), Osaka University [Osaka], Department of Neurology ( Dep Neuro - BEIJING ), Tiantan Hospital, University of Melbourne, Faculty of Mathematics and Statistics, Ton Duc Thang University, Ho Chi Minh City, Heidelberg University, Centre hospitalier de Namur, IBM Thomas J. Watson Research Center, IBM, Bulgarian Academy of Sciences, Department of Clinical Neurological Sciences [London, Canada], University of Western Ontario ( UWO ), Servicio de Neurologia ( SANTIAGO - Neurologie ), Universidad de Santiago de Chile [Santiago] ( USACH ) -Universidad del Desarrollo, Institut de Chimie de Clermont-Ferrand - Clermont Auvergne ( ICCF ), Sigma CLERMONT ( Sigma CLERMONT ) -Université Clermont Auvergne ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), Universidad de Talca, Shanghai Second Polytechnic University, Northwest Normal University [Lanzhou], Zhongda Hospital, Southeast University [Jiangsu], Cryogenics Laboratory ( CRYOGENICS LABORATORY ), Huazhong University of Science and Technology [Wuhan] ( HUST ) -Wuhan University [China], Centre for Synthetic and Systems Biology, University of Edinburgh-School of Biological Sciences, Duke university [Durham], Fiber Glass, Glass Business and Discovery Center, PPG Industries, National University of Defense Technology [Changsha], School of Oceanography [Seattle], University of Washington [Seattle], Key Laboratory of New Processing Technology for Nonferrous Metals and Materials, Guilin University of Technologie, Laboratoire de Génie Electrique et Ferroélectricité ( LGEF ), Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université de Lyon-Institut National des Sciences Appliquées ( INSA ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Université de Bordeaux ( UB ), Service de Pédiatrie, Centre Hospitalier Universitaire de Nice ( CHU Nice ) -Hôpital l'Archet, Université Pierre et Marie Curie - Paris 6 ( UPMC ), Centre Hospitalier de Versailles ( CHV ), Service de neurologie, Hôpital Sainte-Anne, Functional Exploration of Nervous, CHU Grenoble, Service de Neurologie [Rennes], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière ( NEMESIS-CRICM ), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière ( CRICM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Français de Mécanique Avancée ( IFMA ), Neurologie - Côte Basque ( NEUROLOGIE ), Hopital, Laboratoire d'Intégration des Systèmes et des Technologies ( LIST ), Université Paris-Saclay-Direction de Recherche Technologique (CEA) ( DRT (CEA) ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) ( GGB ), Institut Brestois Santé Agro Matière ( IBSAM ), Université de Brest ( UBO ) -Université de Brest ( UBO ) -EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CIC Brest, Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de la Cavale Blanche, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), CHU Strasbourg, Imagerie cérébrale et handicaps neurologiques, Institut des sciences du cerveau de Toulouse. ( ISCT ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès ( UT2J ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès ( UT2J ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Department of Neurology, Asklepios Klinik Altona, Department of Neurology and Stroke Center, Universität Duisburg-Essen [Essen], Department of Neurology, University of Mainz, Vivantes Klinikum Neukölln, University of Erlangen, University Hospital Münster, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] ( UKE ), PROTOMED, Neurology Department, Ichilov Medical Center, Internal and Cardiovascular Medicine - Stroke Unit ( PERUGIA - ICM-SU ), Università degli Studi di Perugia ( UNIPG ), University Hospital San Raffaele Milan, Scientific Institute and University Ospedale San Raffaele, Dipartimento di Scienze Fisiche, della Terra e dell'Ambiente., Università degli Studi di Siena ( UNISI ), Department of Education, Yamagata University, Nippon Medical School, Catalan Institute of Ornithology (ICO), Museu de Ciències Naturals (Zoologia), Wroclaw University of Science and Technology, Department of neurology, Jagiellonian University [Krakow] ( UJ ), LInguistique et DIdactique des Langues Étrangères et Maternelles ( LIDILEM ), Université Stendhal - Grenoble 3-Université Grenoble Alpes ( UGA ), Metacohorts Consortium, GenXpro GmBH, Lausanne University Hospital, Lausanne university hospital, Northeastern University [Boston], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Cerebral and Cardiovascular Center (NCCC - OSAKA), Department of Neurology (Dep Neuro - BEIJING), Bulgarian Academy of Sciences (BAS), University of Western Ontario (UWO), Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Institut de Chimie de Clermont-Ferrand (ICCF), SIGMA Clermont (SIGMA Clermont)-Institut de Chimie du CNRS (INC)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Shanghai Polytechnic University (SSPU), Cryogenics Laboratory (CRYOGENICS LABORATORY), Huazhong University of Science and Technology [Wuhan] (HUST)-Wuhan University [China], Centre for Synthetic and Systems Biology (Ssynthsys), University of Edinburgh, Duke University [Durham], National University of Defense Technology [China], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Bordeaux (UB), Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Université Pierre et Marie Curie - Paris 6 (UPMC), Centre Hospitalier de Versailles André Mignot (CHV), Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière (NEMESIS-CRICM), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Français de Mécanique Avancée (IFMA), Neurologie - Côte Basque (NEUROLOGIE), Centre hospitalier universitaire de Nantes (CHU Nantes), Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Internal and Cardiovascular Medicine - Stroke Unit (PERUGIA - ICM-SU), Università degli Studi di Perugia (UNIPG), Università degli Studi di Siena = University of Siena (UNISI), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Neurologie - Côte Basque, Centre Hospitalier de la Côte Basque (CHCB), EFS-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Universität Duisburg-Essen = University of Duisburg-Essen [Essen], Università degli Studi di Perugia = University of Perugia (UNIPG), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Jagiellonian University [Krakow] (UJ), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM), Weimar, Christian (Beitragende*r), and Calvez, Ghislaine
Subjects: Male, Risk, Ticagrelor, Adenosine, [SDV]Life Sciences [q-bio], Population, Medizin, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Platelet aggregation inhibitors, Physiology (medical), [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, medicine, Humans, Myocardial infarction, education, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Aspirin, Ischemic attack, Transient, Female, Ischemic Attack, Transient, Purinergic P2Y Receptor Antagonists, Treatment Outcome, Cardiology and Cardiovascular Medicine, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [ SDV ] Life Sciences [q-bio], Ischemic Attack, business.industry, medicine.disease, Clopidogrel, [SDV] Life Sciences [q-bio], Anesthesia, Platelet aggregation inhibitor, business, 030217 neurology & neurosurgery, TIMI, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract: Background: Patients with minor acute ischemic stroke or transient ischemic attack are at high risk for subsequent stroke, and more potent antiplatelet therapy in the acute setting is needed. However, the potential benefit of more intense antiplatelet therapy must be assessed in relation to the risk for major bleeding. The SOCRATES trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes) was the first trial with ticagrelor in patients with acute ischemic stroke or transient ischemic attack in which the efficacy and safety of ticagrelor were compared with those of aspirin. The main safety objective was assessment of PLATO (Platelet Inhibition and Patient Outcomes)–defined major bleeds on treatment, with special focus on intracranial hemorrhage (ICrH). Methods: An independent adjudication committee blinded to study treatment classified bleeds according to the PLATO, TIMI (Thrombolysis in Myocardial Infarction), and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) definitions. The definitions of ICrH and major bleeding excluded cerebral microbleeds and asymptomatic hemorrhagic transformations of cerebral infarctions so that the definitions better discriminated important events in the acute stroke population. Results: A total of 13 130 of 13 199 randomized patients received at least 1 dose of study drug and were included in the safety analysis set. PLATO major bleeds occurred in 31 patients (0.5%) on ticagrelor and 38 patients (0.6%) on aspirin (hazard ratio, 0.83; 95% confidence interval, 0.52–1.34). The most common locations of major bleeds were intracranial and gastrointestinal. ICrH was reported in 12 patients (0.2%) on ticagrelor and 18 patients (0.3%) on aspirin. Thirteen of all 30 ICrHs (4 on ticagrelor and 9 on aspirin) were hemorrhagic strokes, and 4 (2 in each group) were symptomatic hemorrhagic transformations of brain infarctions. The ICrHs were spontaneous in 6 and 13, traumatic in 3 and 3, and procedural in 3 and 2 patients on ticagrelor and aspirin, respectively. In total, 9 fatal bleeds occurred on ticagrelor and 4 on aspirin. The composite of ICrH or fatal bleeding included 15 patients on ticagrelor and 18 on aspirin. Independently of bleeding classification, PLATO, TIMI, or GUSTO, the relative difference between treatments for major/severe bleeds was similar. Nonmajor bleeds were more common on ticagrelor. Conclusions: Antiplatelet therapy with ticagrelor in patients with acute ischemic stroke or transient ischemic attack showed a bleeding profile similar to that of aspirin for major bleeds. There were few ICrHs. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01994720.
Published: 2017

17. HEAD POSITIONING IN HIGH RISK PATIENTS: POST-HOC SUBGROUP ANALYSIS OF HeadPoST, AN INTERNATIONAL CLUSTER CROSSOVER TRIAL

Author: Pablo Lavados
Published: 2017

18. CHANGES IN THE AGE OF STROKE ONSET IN THE LAST 18 YEARS IN AN ACADEMIC MEDICAL CENTER IN CHILE: RESULTS OF THE RECCA REGISTRY

Author: Pablo Lavados
Published: 2017

19. INCREASING FREQUENCY OF INTRAVENOUS THROMBOLYSIS UTILIZATION IN ACUTE ISCHEMIC STROKE OVER 18 YEARS OF EXPERIENCE IN AN ACADEMIC MEDICAL CENTER IN CHILE: THE RECCA REGISTRY

Author: Pablo Lavados
Published: 2017

20. [Incidence of aphasia in patients experiencing an ischemic stroke]

Author: Francisca, González Mc, Pablo, Lavados G, and Verónica, Olavarría I
Subjects: Adult, Aged, 80 and over, Male, Adolescent, Incidence, Infant, Newborn, Infant, Middle Aged, Prognosis, Severity of Illness Index, Brain Ischemia, Stroke, Young Adult, Age Distribution, Cross-Sectional Studies, Child, Preschool, Aphasia, Humans, Female, Chile, Child, Aged, Retrospective Studies
Abstract: Sequelae after a stroke are common and may lead to disability. Aphasia - defined as an acquired language disturbance - can cause important limitations in quality of life.To describe the epidemiological features of patients who had an aphasia after a first episode of ischemic stroke and their functional outcome at six months.Review of a database of a population study on the incidence, 30-day case fatality rate, and prognosis of stroke performed in a northern Chilean city between 2000 and 2002.Aphasia was diagnosed in 28 of 142 patients in whom the disorder was sought (20%). The projected incidence rate in the city where the study was carried out is 7.06 per 100,000 inhabitants. The mean age of these 28 patients was 66 ± 20 years and 53% were women. The main risk factor for stroke was hypertension in 62%. The etiology of stroke was undetermined in 64% of these patients. Partial anterior circulation infarction was the most common stroke location in 61%.Twenty percent of patients with a first episode of ischemic stroke have aphasia.
Published: 2016

21. SP311INFLUENCE OF RENAL IMPAIRMENT ON OUTCOME FOR THROMBOLYSIS-TREATED ACUTE ISCHEMIC STROKE: THE ENCHANTED TRIAL

Author: Mark Woodward, Xia Wang, Thompson G. Robinson, Verónica V. Olavarría, Pablo Lavados, Shoichiro Sato, Jong Kim, Richard I. Lindley, Vivek Sharma, Jorge Rodriguez, Sue Carr, Stefano Ricci, Octavio M. Pontes-Neto, Tsong-Hai Lee, Craig S. Anderson, and John Chalmers
Subjects: Transplantation, medicine.medical_specialty, Nephrology, business.industry, medicine.medical_treatment, Internal medicine, Ischemic stroke, medicine, Cardiology, Thrombolysis, business, Acute ischemic stroke
Published: 2017

22. Magnesium in Aneurysmal Subarachnoid Hemorrhage (MASH II) Phase III Clinical Trial MASH-II Study Group

Author: Pablo Lavados, Johanna G. Van der Bom, Intensive Care Medicine, Amsterdam Neuroscience, and Neurosurgery
Subjects: Subarachnoid hemorrhage, Ischemia, chemistry.chemical_element, Aneurysm, Ruptured, Neuroprotection, law.invention, Magnesium Sulfate, Aneurysm, Randomized controlled trial, law, medicine, Humans, cardiovascular diseases, Magnesium, business.industry, Intracranial Aneurysm, Subarachnoid Hemorrhage, medicine.disease, nervous system diseases, Clinical trial, Neurology, chemistry, Multicenter study, Anesthesia, business, Anti-Arrhythmia Agents
Abstract: Rationale Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Magnesium is a neuroprotective agent that acts as an NMDA-receptor antagonist and a calcium channel blocker. In a phase II randomized clinical trial of 283 patients, magnesium treatment reduced the risk of DCI by 34% and of poor outcome by 23%. Aims To determine whether magnesium improves clinical outcome in patients with aneurysmal SAH. Design The MASH-II study is a phase III randomized, clinical international multicenter trial. Magnesium sulfate 64 mmol/ day (equals 16 g/day) or placebo is started intravenously within 4 days after the SAH and is continued until 20 days after the hemorrhage. The primary outcome measure is poor outcome, defined as death or dependence (Rankin score > 3) after 3 months. We aim to include 1200 patients in 5 years. Study outcomes Primary outcome will be poor clinical outcome as measured by the modified Rankin scale at 3 months. Sponsor MASH-II is sponsored by the Netherlands Heart Foundation (grant number: 2005BO16). It is registered with IRCTN number: 68742385, EudraCT: 2006-003523-36. Introduction Subarachnoid hemorrhage (SAH) from a ruptured aneurysm is a subset of stroke. The young age (median 55 years) and poor outcome (50% of patients die; 30% of those who survive the initial weeks after the hemorrhage remain dependent) explain why in the population the loss of productive life years from SAH is as large as that from brain infarcts, the most common type of stroke ( 1 ). Summary The MASH-II study is a phase III randomized, clinical international multicenter trial to study the effect of magnesium sulfate after aneurysmal SAH. Magnesium is a neuroprotective agent that acts as a blocker of both the NMDA-glutamate receptor and voltage dependent calcium channels. Patients who are admitted within 4 days after aneurysmal SAH are asked to participate. Study medication (magnesium sulfate 64 mmol/ day or placebo) is given via continuous infusion until 20 days after the hemorrhage. Outcome is determined with the modified Rankin scale 3 months after the hemorrhage. Analysis will be according to the intention-to-treat principle. So far, in May 2007 over 425 patients have been included in five Dutch and one Chilean hospital. Based on the results of the phase II study sample size calculations indicate that 1200 patients are needed to give a statistically significant result (with α = 5% and a power of 80%). We aim to include these patients before 2010. New centers are still very welcome to join the study.
Published: 2008

23. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage

Author: Craig Anderson, Raf Brouns, Joseph Kwan, David Werring, John Chalmers, Emma Heeley, Graeme Hankey, Pablo Lavados, Hauke Schneider, Dominique Hervé, Serge Timsit, Richard Lindley, Elsa Azevedo, Francesco Corea, Tiago Gregorio, Daniel Strbian, Filip Scheperjans, Emmanuel Touzé, Seye Abimbola, Sylvie De Raedt, Mark Woodward, Andrea Zini, Bruce Neal, Jacques De Keyser, Sami Curtze, C.J.M. Klijn, María del Mar Castellanos, Charlotte Cordonnier, Thompson Robinson, Danilo Toni, Laurent Billot, Candice Delcourt, Christian Stapf, Tissa Wijeratne, Victoria Haunton, Neurology, Clinical sciences, Neuroprotection & Neuromodulation, The Georges Institute for International Health, The University of Sydney, Neurology Department (RPA Hospital - Neurology), Royal Prince Alfred Hospital, Department of Neurology, Xuanwu Hospital of Capital-University of Medical Sciences / Beijing, Centre for Epidemiological Studies and Clinical Trials, Shanghai Jiao Tong University School of Medicine-Ruijin Hospital, Deparment of Neurology (LARIBOISIERE - Neurologie), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Neurology Department (RPH Hospital - Neurology), Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Department of Neurology (JH Hospital - Neurology), University of Newcastle [Australia] (UoN), Department of Neurology (BOATOU - Neurology), Boatou Central Hospital, Department of Neurology (TANGSHAN - Neurology), Yutian County Hospital, National Health and Medical Research Council Clinical Trials Centre, Melbourne Brain Centre (Melbourne Brain Centre), and University of Melbourne
Subjects: MESH: Cerebral Hemorrhage, Male, Time Factors, [SDV]Life Sciences [q-bio], Blood Pressure, 030204 cardiovascular system & hematology, MESH: Hypertension, law.invention, Disability Evaluation, 0302 clinical medicine, Randomized controlled trial, law, Modified Rankin Scale, Single-Blind Method, Stroke, MESH: Aged, MESH: Middle Aged, MESH: Disability Evaluation, MESH: Blood Pressure, General Medicine, Middle Aged, 3. Good health, Anesthesia, Acute Disease, Hypertension, MESH: Acute Disease, Female, medicine.medical_specialty, 610 Medicine & health, 03 medical and health sciences, Hypertension/complications, medicine, Humans, In patient, Adverse effect, Antihypertensive Agents, Aged, Cerebral Hemorrhage, Intracerebral hemorrhage, MESH: Antihypertensive Agents, MESH: Humans, business.industry, MESH: Time Factors, Odds ratio, MESH: Single-Blind Method, medicine.disease, Cerebral Hemorrhage/complications, MESH: Male, Confidence interval, Surgery, Blood pressure, Blood pressure lowering, Antihypertensive Agents/administration & dosage, business, MESH: Female, 030217 neurology & neurosurgery
Abstract: International audience; BACKGROUND: Whether rapid lowering of elevated blood pressure would improve the outcome in patients with intracerebral hemorrhage is not known. METHODS: We randomly assigned 2839 patients who had had a spontaneous intracerebral hemorrhage within the previous 6 hours and who had elevated systolic blood pressure to receive intensive treatment to lower their blood pressure (with a target systolic level of
Published: 2013

24. Statistical analysis plan for the second INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2): a large-scale investigation to solve longstanding controversy over the most appropriate management of elevated blood pressure in the hyperacute phase of intracerebral hemorrhage

Author: Craig, Anderson, Emma, Heeley, Stephane, Heritier, Hisatomi, Arima, Mark, Woodward, Richard, Lindley, Bruce, Neal, Yining, Huang, Ji-Guang, Wang, Mark, Parsons, Christian, Stapf, Tom, Robinson, Pablo, Lavados, Candice, Delcourt, Stephen, Davis, and John, Chalmers
Subjects: Male, Treatment Outcome, Hypertension, Statistics as Topic, Humans, Female, Cerebral Hemorrhage
Abstract: The Statistical analysis plan (SAP) for the second INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2).
Published: 2013

25. Métodos y mediciones

Author: Fernando Javier González Soto, Claudia Ana Giulano Burrows, Alejandro Tudela Román, Claudia Patricia Romero González, Víctor Manuel Revello Castillo, Carolina Aguilera Muñoz, Enrique Tapia Arriagada, Randy Fuentes Valenzuela, Lorena Hoffmeister Arce, Rodrigo Cabello Ibacache, María Isabel Silva, Sandra Lanza S., Carolina Sepúlveda V., César Espejo C., Macarena Olate B., María De Fátima Costa dos Santos, Roberto Do Nascimento Rodrigues, Iúri Da Costa Leite, Isabel Pereyra G., Joyce Andrade Mendes, Joaquim Gonçalves Valente, Jurema Corrêa Mota, Ricardo José Muza Caroca, Juan Siva Guzmán, Jorge Alberto Rodríguez Tobar, Matías Pruzzo Gaete Universidad de Chile, Macarena Valdés Correa, Enrica Ramírez Pitaluga, Rafael Ramírez Fernández, Daniela Dalbosco Rendic, Pablo Lavados Germain, Miguel Araujo Alonso, Carolina Vidal Gamboa, Mónica Patricia Valladares Salazar, Soledad Burgos de la Vega, María Teresa Escobar Meza, Elizabeth Salinas Rebolledo, Isabel Margarita Abarca Baeza, Julio Rojas Astorga, Daniel Rodríguez Donoso, Alejandro Mariño Beltrán, Lily Jiménez Yáñez, Alberto Rojas Astorga, Ingrid Vargas Méndez, Lissette Gramusset Hepp, Claudia Greppi Quezada, Mauricio González Billault, Marcelo Villalón Calderón, Rodrigo José Mariño Traub, Jorge Fajardo Olmos, María Ramírez Rojas, Miguel Ángel Espinosa Castro, Maglie González Sánchez, Giorgio Solimano Cantuarias, Alex Alarcón Hein, Natalia Sepúlveda Kattan, Sergio Alfonso Jiménez Rivas, Patricia Morgado Alcayaga, Rolf Raimann, Fabiola Rosso Chamorro, Gina Rego Montero Torres, Karen Barbosa Pereira Couto, Marcela Barberán Manríquez, Claudia Albornoz Garrido, José Francisco López Johanon, Gabriel Cavada Chacón, Beatriz Jiménez Retamal, Brenda Gasparini, Alex Brito Olivares, Manuel Olivares Grohnert, Álvaro Castillo Carniglia, Eva Hertrampf Díaz, Paola Olave Müller, Alejandra Díaz Ballesteros, Paola Castro Brezzo, Carolina Amaro Romero, Andrea Muñoz Martínez, Jennifer Mendoza Alonzo, Martha Ramírez Valdivia, Ana Moraga Paumerino, Irma Vargas Palavicino, Yuri Carvajal Bañados, Tuillang Yuing Alfaro, Liliana Basso Musso, Laura Carvajal Riquelme, Kristian Buhring Bonacich, and Patricio Oliva Mella
Subjects: General Medicine
Published: 2011

26. Pablo Lavados: improving stroke care in Chile

Author: Pablo Lavados and James Butcher
Subjects: Stroke, medicine.medical_specialty, Pediatrics, Neurology, business.industry, Family medicine, Medicine, Humans, Neurology (clinical), Stroke care, Chile, History, 20th Century, business
Published: 2007

27. Predicción clínica de aspiración en pacientes con patología neurológica aguda

Author: Angélica López O, Pablo Lavados G., Arnold Hoppe W, and Iván Caviedes S
Subjects: ataque cerebrovascular, Pediatrics, medicine.medical_specialty, disfagia, Stroke patient, business.industry, Incidence (epidemiology), Gold standard, neumonia por aspiración, General Medicine, Predictive value, Intensive care unit, alteraciones de la deglución, Surgery, law.invention, law, medicine, In patient, vía aérea superior, Cervical auscultation, disfunción glótica, Complication, business
Abstract: La disfunción glótica es una entidad prevalente en enfermos con patología neurológica aguda: compromete aproximadamente entre el 45 al 51% de los pacientes que padecen un ataque cerebrovascular, incrementando su mortalidad en una relación de 3/1. Su complicación principal es el síndrome aspirativo, que involucra diversas especialidades, entre ellas enfermedades respiratorias y neurología. El propósito de este estudio ha sido evaluar la fonación húmeda, el test del vaso de agua y la auscultación cervical como indicadores clínicos de aspiración frente a la certificación nasolaringoscópica, considerada patrón estándar de evaluación al lado de la cama del enfermo. Evaluamos prospectivamente durante un año a pacientes neurológicos agudos hospitalizados en una unidad de tratamiento intensivo. La fonación húmeda, el test del vaso de agua y la auscultación cervical demostraron sensibilidades de 66,7, 88,9 y 77,8%, con una especificidad respectiva de 85,2, 59,3 y 77,8%. Los valores predictivos positivo fueron de 60, 42,1 y 53,8%, con valores predictivos negativo de 88,5, 94,1 y 91,3% respectivamente. Nuestros resultados permiten afirmar que el monitoreo clínico de aspiración es un instrumento sencillo y valioso, que puede ser realizado al lado de la cama del enfermo
Published: 2005

28. Patología de la deglución y enfermedades respiratorias

Author: Delfina Büchi B., Raul Yazigi G., Iván Caviedes S, and Pablo Lavados G.
Subjects: business.industry, aspiration pneumonia, Medicine, General Medicine, Swallowing, business, Humanities, upper airway
Abstract: La patologia de la deglucion es una patologia prevalente y relacionada con las enfermedades respiratorias, estimandose en series internacionales que la padece el 7 al 10% de los individuos mayores de 50 anos, y entre el 30-40% de los ancianos que viven en casas de reposo1,2. A nuestro saber, en nuestro medio no se dispone de catastros estadisticos de esta patologia. El diagnostico acucioso del paciente con alteraciones de la deglucion, incluyendo la disfagia, requiere de la comprension de la anatomia y la fisiopatologia de la deglucion, de las patologias que puedan comprometerla, de las tecnicas de laboratorio disponibles para su diagnostico y del tratamiento de cada una de ellas. Como se podra apreciar en esta revision, se trata de un problema que compromete transversalmente a varias sub especialidades, entre ellas neurologia, otorrinolaringologia, enfermedades respiratorias y gastroenterologia, entre otras, por lo que su aproximacion multidisciplinaria parece la mas razonable3
Published: 2002

29. [Cerebrovascular disorders in Chile between 1952 and 1984: the evolution in mortality]

Author: Baeza C, Pablo Lavados, and Alvarez G
Subjects: Adult, Male, Cerebrovascular Disorders, Sex Factors, Adolescent, Age Factors, Humans, Female, Chile, Middle Aged, Child, Aged
Published: 1988

30. [Validation of a screening instrument for studying the prevalence of cerebrovascular diseases in the Chilean population]

Author: Pablo Lavados, Sacks C, Alvarez G, Araya F, Feuerhacke W, Monsalve J, Kleinsteuber K, Prina L, Fernández V, and Hernández J
Subjects: Male, Cerebrovascular Disorders, Cross-Sectional Studies, Evaluation Studies as Topic, Surveys and Questionnaires, Humans, Mass Screening, Female, Chile, Middle Aged, Sensitivity and Specificity, Aged
Abstract: We assessed a screening instrument, adapted from a model suggested by WHO, aimed to perform population studies on the prevalence of cerebrovascular disease in Chile. Sixty-two subjects, 31 with cerebrovascular diseases and 31 without, were asked about symptoms and requested to do simple movements by trained interviewers. The results of the instrument were compared with a neurological examination performed by two specialists. Global sensitivity and specificity of the instrument, using WHO evaluation criteria, were 100 and 38.7% respectively. When three or more symptoms and one positive sign were considered as cutoff points, global specificity increased to 61% and sensitivity decreased to 93%. It is concluded that the present instrument is highly sensitive but lacks specificity.

31. [Neurological diagnostics in primary health care in Santiago, Chile]

Author: Pablo Lavados, Gómez V, Sawada M, Chomali M, and Alvarez M
Subjects: Adult, Aged, 80 and over, Male, Adolescent, Primary Health Care, Infant, Middle Aged, Nervous System, Child, Preschool, Humans, Female, Chile, Nervous System Diseases, Child, Aged, Retrospective Studies
Abstract: Neurological diseases are a growing concern for public health planners. The purpose of this study was to determine the burden of neurological diagnosis in a primary health care setting in the East Metropolitan Health Service in Santiago, Chile.A random blocked sample of diagnosis in a one year period was obtained balanced by each of the fourteen clinics in the area. This corresponded to 3% of all visits. A total of 72 diagnosis corresponding to diseases of the nervous system were selected according to ICD 9 definitions.Of a total of 13,388 visits, 705 (5.3%) corresponded to disease or disorders attributable to the nervous system or that frequently mean consultation with neurologists. Of these, 63.5% were women. The highest rates were found between the second and fourth decades. The most frequent diagnosis were attention deficit disorder in children, headache in adults and spinal pain in the elderly.The demand for care for syndromes that affect the nervous system in the primary health care setting in a sample of visits is concentrated in chronic disease that require a multidisciplinary approach. The finding are similar to other studies. The data help in defining were to concentrate efforts in health planning and education for the care of neurological disorder in the primary care setting.

32. Guidelines for clinical trials in dementia

Author: Bruno, G., Pablo Lavados, Grassini, P., Bonamini, M., Baldinetti, F., and Agnoli, A.

33. Variability of magnetic resonance angiography and computed tomography angiography in grading middle cerebral artery stenosis using the unweighted kappa statistic

Author: Pablo Lavados, Oppenheimer S, and Enger C
Subjects: Cerebrovascular Disorders, Confidence Intervals, Humans, Arterial Occlusive Diseases, Tomography, X-Ray Computed, Severity of Illness Index, Magnetic Resonance Angiography, Sampling Studies, Statistics, Nonparametric, Cerebral Angiography

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33 results on '"Pablo Lavados"'

1. Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta‐Analysis

2. Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients: insights from the ENCHANTED trialResearch in context

3. Stroke care and collaborative academic research in Latin America

4. Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments

5. Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time

6. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study.

7. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial

8. Disparities in stroke incidence over time by sex and age in Latin America and the Caribbean region: a systematic review and meta-analysis

9. Effects of intensive blood pressure lowering on cerebral ischaemia in thrombolysed patients:insights from the ENCHANTED trial

10. Simulación multimodal en ACV: paciente estandarizado, simulador de paciente virtual y una aplicación de seguimiento de procesos para el entrenamiento interprofesional

11. Stroke in Latin America: Systematic review of incidence, prevalence, and case-fatality in 1997–2021

12. Multimodal Simulation in Stroke: A Standardized and Virtual Patient With Mobile Tracking App for Interprofessional Training

13. Incidencia poblacional, características epidemiológicas y desenlace funcional de pacientes con ataque cerebrovascular isquémico y afasia

14. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

15. Optimal achieved blood pressure in acute intracerebral hemorrhage: INTERACT2

16. Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes)

17. HEAD POSITIONING IN HIGH RISK PATIENTS: POST-HOC SUBGROUP ANALYSIS OF HeadPoST, AN INTERNATIONAL CLUSTER CROSSOVER TRIAL

18. CHANGES IN THE AGE OF STROKE ONSET IN THE LAST 18 YEARS IN AN ACADEMIC MEDICAL CENTER IN CHILE: RESULTS OF THE RECCA REGISTRY

19. INCREASING FREQUENCY OF INTRAVENOUS THROMBOLYSIS UTILIZATION IN ACUTE ISCHEMIC STROKE OVER 18 YEARS OF EXPERIENCE IN AN ACADEMIC MEDICAL CENTER IN CHILE: THE RECCA REGISTRY

20. [Incidence of aphasia in patients experiencing an ischemic stroke]

21. SP311INFLUENCE OF RENAL IMPAIRMENT ON OUTCOME FOR THROMBOLYSIS-TREATED ACUTE ISCHEMIC STROKE: THE ENCHANTED TRIAL

22. Magnesium in Aneurysmal Subarachnoid Hemorrhage (MASH II) Phase III Clinical Trial MASH-II Study Group

23. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage

25. Métodos y mediciones

26. Pablo Lavados: improving stroke care in Chile

27. Predicción clínica de aspiración en pacientes con patología neurológica aguda

28. Patología de la deglución y enfermedades respiratorias

29. [Cerebrovascular disorders in Chile between 1952 and 1984: the evolution in mortality]

30. [Validation of a screening instrument for studying the prevalence of cerebrovascular diseases in the Chilean population]

31. [Neurological diagnostics in primary health care in Santiago, Chile]

32. Guidelines for clinical trials in dementia

33. Variability of magnetic resonance angiography and computed tomography angiography in grading middle cerebral artery stenosis using the unweighted kappa statistic

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