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Author: search.filters.author.LAVADOS GERMAIN, PABLO MANUEL

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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
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    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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    Sex Differences in Stroke Incidence, Prevalence, Mortality and Disability-Adjusted Life Years: Results from the Global Burden of Disease Study 2013
    (S. Karger AG, 2015)
    Suzanne Barker-Collo
    ;
    Derrick A. Bennett
    ;
    Rita V. Krishnamurthi
    ;
    Priya Parmar
    ;
    Valery L. Feigin
    <jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Stroke incidence, prevalence, mortality, disability-adjusted life years (DALYs) and healthy years lost due to disability were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UIs) were computed. &lt;b&gt;&lt;i&gt;Findings:&lt;/i&gt;&lt;/b&gt; In 2013, global ischemic stroke (IS) and hemorrhagic stroke (HS) incidence (per 100,000) in men (IS 132.77 (95% UI 125.34-142.77); HS 64.89 (95% UI 59.82-68.85)) exceeded those of women (IS 98.85 (95% UI 92.11-106.62); HS 45.48 (95% UI 42.43-48.53)). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 (95% UI 137.87-157.66); 1990 female IS incidence 113.31 (95% UI 103.52-123.40)), but the only significant change in IS incidence was among women. Changes in global HS incidence were not statistically significant for males (1990 = 65.31 (95% UI 61.63-69.0), 2013 = 64.89 (95% UI 59.82-68.85)), but was significant for females (1990 = 64.892 (95% UI 59.82-68.85), 2013 = 45.48 (95% UI 42.427-48.53)). The number of DALYs related to IS rose from 1990 (male = 16.62 (95% UI 13.27-19.62), female = 17.53 (95% UI 14.08-20.33)) to 2013 (male = 25.22 (95% UI 20.57-29.13), female = 22.21 (95% UI 17.71-25.50)). The number of DALYs associated with HS also rose steadily and was higher than DALYs for IS at each time point (male 1990 = 29.91 (95% UI 25.66-34.54), male 2013 = 37.27 (95% UI 32.29-45.12); female 1990 = 26.05 (95% UI 21.70-30.90), female 2013 = 28.18 (95% UI 23.68-33.80)). &lt;b&gt;&lt;i&gt;Interpretation:&lt;/i&gt;&lt;/b&gt; Globally, men continue to have a higher incidence of IS than women while significant sex differences in the incidence of HS were not observed. The total health loss due to stroke as measured by DALYs was similar for men and women for both stroke subtypes in 2013, with HS higher than IS. Both IS and HS DALYs show an increasing trend for both men and women since 1990, which is statistically significant only for IS among men. Ongoing monitoring of sex differences in the burden of stroke will be needed to determine if disease rates among men and women continue to diverge. Sex disparities related to stroke will have important clinical and policy implications that can guide funding and resource allocation for national, regional and global health programs.</jats:p>
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    Effect of magnesium treatment and glucose levels on delayed cerebral ischemia in patients with subarachnoid hemorrhage: a substudy of the Magnesium in Aneurysmal Subarachnoid Haemorrhage trial (MASH-II)
    (SAGE Publications, 2015-10)
    Jolien F. Leijenaar
    ;
    Sanne M. Dorhout Mees
    ;
    Ale Algra
    ;
    Walter M. Van Den Bergh
    ;
    Gabriel J. E. Rinkel
    <jats:sec><jats:title>Background</jats:title><jats:p> Magnesium treatment did not improve outcome in patients with aneurysmal subarachnoid haemorrhage in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. We hypothesized that high glucose levels may have offset a potential beneficial effect to prevent delayed cerebral ischemia. We investigated if magnesium treatment led to less delayed cerebral ischemia and if glucose levels interacted with magnesium treatment in the Magnesium in Aneurysmal Suba-rachnoid Haemorrhage II trial. </jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p> To investigate the effect of magnesium treatment on occurrence of delayed cerebral ischemia and the interaction between glucose levels and magnesium treatment in subarachnoid hemorrhage patients. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> The Magnesium in Aneurysmal Subarachnoid Haemorrhage was a phase III randomized placebo-controlled trial assessing the effect of magnesium sulphate on clinical outcome in aneurysmal subarachnoid hemorrhage patients. For the current study, we included only the patients admitted to the University Medical Centre-Utrecht. We calculated hazard ratios for occurrence of delayed cerebral ischemia in patients treated with magnesium vs. placebo for the entire study population, and separately in the subgroups of patients with high and low mean fasting and mean daily glucose levels until onset of delayed cerebral ischemia. We used the cross-product of magnesium and glucose in the regression analysis to evaluate whether an interaction between magnesium and glucose existed. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> We included 616 patients: 307 received magnesium and 309 placebo; 156 patients had delayed cerebral ischemia. Hazard ratio for magnesium on occurrence of delayed cerebral ischemia was 1.0 (95% confidence interval: 0.7-1.4). Results were similar in patients with low or high fasting or daily glucose levels. We found no interactions between magnesium treatment and high fasting ( P = 0.54) and daily glucose ( P = 0.60). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Magnesium treatment did not reduce the risk of delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage, nor was there an interaction with glucose levels. It is therefore unlikely that glucose levels explain the failure of magnesium to prevent delayed cerebral ischemia and poor outcome after aneurysmal subarachnoid hemorrhage. </jats:p></jats:sec>
      1Scopus© Citations 19
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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