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Author: search.filters.author.LAVADOS GERMAIN, PABLO MANUELStart date: 2020

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    Implementation of stroke prevention: a review of challenges and opportunities in the Americas
    (Elsevier BV, 2026-06)
    Martins, Sheila O.
    ;
    Ordunez, Pedro
    ;
    Borelli, Wyllians Vendramini
    ;
    Ovbiagele, Bruce
    ;
    Urrutia, Victor C.
      3Scopus© Citations 1
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    Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review
    (Elsevier BV, 2026-06)
    Silva, Gisele Sampaio
    ;
    Diestro, Jose Danilo
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    Tarzi, Christopher
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    Kishibe, Teruko
    ;
    Bernabé-Ortiz, Antonio
      3Scopus© Citations 1
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    Collateral status predicts functional outcome in early-treated large-core anterior circulation stroke
    (Frontiers Media SA, 2026-04-14)
    Andrés Gallardo
    ;
    LAVADOS GERMAIN, PABLO MANUEL  
    ;
    Pablo Albiña-Palmarola
    ;
    Gabriel Cavada
    ;
    Andrés Roldán
    <jats:sec> <jats:title>Background and purpose</jats:title> <jats:p>Endovascular therapy (EVT) is increasingly offered to patients with large-core acute ischemic stroke (AIS), yet outcomes remain highly heterogeneous. Collateral circulation may be a key determinant of infarct evolution and recovery, but its role in early-window large-core stroke is not fully defined.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We retrospectively analyzed consecutive adults from a prospective stroke registry who presented within 6 h with anterior-circulation large-vessel occlusion, NIHSS ≥6, and a large ischemic core (MRI core &amp;gt;50 mL or CT perfusion core &amp;gt;70 mL, up to 150 mL). All patients received reperfusion therapy (intravenous thrombolysis, EVT, or both). Collateral status on baseline single-phase CTA was graded using the Tan scale (0–3); no patients had grade 3. The primary outcome was 90-day modified Rankin Scale (mRS); secondary outcome was NIHSS at discharge.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p> Fifty-four patients met inclusion criteria (Tan 0: <jats:italic>n</jats:italic> = 24; Tan 1: <jats:italic>n</jats:italic> = 14; Tan 2: <jats:italic>n</jats:italic> = 16). Baseline NIHSS, ASPECTS, and core volume were similar across groups. Patients without collaterals (Tan 0) had worse 90-day outcomes (median mRS 4 [IQR 3–6]) compared with those with Tan 1 (2 [IQR 1–3]) or Tan 2 (1 [IQR 1–2]) collaterals (both p &amp;lt; 0.001), whereas Tan 1 and Tan 2 did not differ significantly ( <jats:italic>p</jats:italic> = 0.27). NIHSS at discharge showed a similar gradient. In proportional-odds logistic regression, each one-grade increase in collateral status was associated with lower odds of worse 90-day mRS (adjusted per-grade OR 0.32; 95% CI 0.15–0.68; <jats:italic>p</jats:italic> = 0.003). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In early-treated large-core AIS, even simple CTA-based collateral assessment strongly predicts recovery. Patients with absent collaterals follow a distinctly poorer trajectory, while those with any collateral filling behave more favorably. Incorporating collateral status into routine evaluation may improve prognostic accuracy and support treatment decisions in this challenging subgroup.</jats:p> </jats:sec>
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    Surgical outcomes from haematoma evacuation for intracerebral haemorrhage in the INTERACT3 study
    (Elsevier BV, 2025-09)
    Xin Hu
    ;
    Menglu Ouyang
    ;
    Jianguo Xu
    ;
    Yi Liu
    ;
    Xi Li
      1Scopus© Citations 4
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    Patterns and Clinical Implications of Hemorrhagic Transformation After Thrombolysis in Acute Ischemic Stroke
    (Ovid Technologies (Wolters Kluwer Health), 2024-12-10)
    Yanan Wang
    ;
    Toshiki Maeda
    ;
    Shoujiang You
    ;
    Chen Chen
    ;
    Leibo Liu
      2
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    Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
    (Ubiquity Press, Ltd., 2025-05-27)
    Andres Rosende
    ;
    Cesar Romero
    ;
    Donald J. DiPette
    ;
    Jeffrey Brettler
    ;
    Patrick Van der Stuyft
    <jats:p>Background: HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway. Methods: First, the coordinating group defined the project’s scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway. Results: Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation. Conclusion: HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.</jats:p>
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    Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals
    (Elsevier BV, 2025-09)
    Miguel A. Vences
    ;
    Miguel A. Barboza
    ;
    Leonardo Augusto Carbonera
    ;
    Virgilio E. Failoc-Rojas
    ;
    Julieta Rosales
      4
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    Scopus© Citations 22  3