HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB
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HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB
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ahoppe@udd.cl
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24340003800

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Stroke Care and Application of Thrombolysis in Ibero-America Report From the SITS-SIECV Ibero-American Stroke Register

2019 , María Alonso de Leciñana , Michael V. Mazya , Nikolaos Kostulas , Oscar H. Del Brutto , Carlos Abanto , Ayrton R. Massaro , Mario de Bastos , Sheila Martins , Sebastian F. Ameriso , Fernando Gongora-Rivera , Claudio Sacks , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , Patricio Abad , Gloria Meza , Antonio Arauz-Gongora , Nils Wahlgren , Exuperio Díez-Tejedor , William Arias Sifontes , Margarita Cerda , Franz Chávez-Sell , Juan Carlos Duran , Gabriel de Freitas , Jorge Martinez Cerrato , Marco Tulio Medina , Nelson Novarro , Jamary Oliveira-Filho , Octavio Pontes Neto , German Enrique Perez , Luis Salguero , Marina Romano , Claudia Gandolfo , Gustavo Herrera , Lorena Jure , María Elena Masih , Raul Rey , Facundo Enrique Tomas , Magda Carla Martins , Carlos Aguilera , Pablo Araya , Ludwig Codjambasis , Juan Gigoux , Rodrigo Rivas , Mario Muñoz , Juan Camilo Vargas , Tomás Alarcón , Braulio Martínez , Jorge Moncayo , José Luis Ruiz-Sandoval , Jorge Villarreal , Rosalía Vázquez , Juan Nader , Luis Murillo-Bonilla , Carolina León , Arón Benzadón , Ernesto Triana , Aurora Olmedo , Donoband Melgarejo , Margarita Paredes , Rosa Ecos , Frank Solis , Víctor Gómez , Greasse Muñoz , Juliana Aparcana , Luis Miguel Uchuya , Taly Paredes , Antero Peralta , Enrique Salcedo , Luis Huaroto , Luis Vera , Martín Gavidia , Alejandro Calvo , Evelyn Mariños , Luis Sandoval , Marcos Vilca , René Valderrama , Isolina Villanueva , Daniel Diez-Canseco , Juan Barreto , Guillermo Castillo , Juan Carlos Lazo , José Cruz , Aglaé Duplat , Juan Carlos Guedes

Background and Purpose— Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement. Methods— Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September 2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time, National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality, and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis. Results— Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%) ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%), dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected (median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients. Conclusions— Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.

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Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent

2010 , V. V. Olavarria , DELGADO BECERRA, OROZIMBA IRIS , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , BRUNSER, ALEJANDRO , D. Carcamo , DIAZ TAPIA, VIOLETA DEL CARMEN , LAVADOS GERMAIN, PABLO MANUEL

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Telestroke in Chile: 1 year experience at 7 hospitals

2019 , Eloy Mansilla , Enrico Mazzon , Daniel Cárcamo , Felipe Jurado , Lorena Lara , Mirya Arévalo , Diego Rojas , Gloria Stephens , Arnold Hoppe , BRUNSER, ALEJANDRO

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Nasolaryngoscopic Validation of a Set of Clinical Predictors of Aspiration in a Critical Care Setting

2010 , CAVIEDES SOTO, IVAN RICARDO , LAVADOS GERMAIN, PABLO MANUEL , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , López, María A.

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Clinical prediction of aspiration in acute neurological patients

2005-12-01 , CAVIEDES SOTO, IVAN RICARDO , LAVADOS GERMAIN, PABLO MANUEL , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , López O., Angélica

Glottic dysfunction is a frequent condition in patients with acute neurological diseases: the incidence in stroke patients is between 45-51% increasing mortality three times. The principal complication is aspiration, which demands the involvement of pulmonary physicians and neurologists. The purpose of this study is to evaluate wet voice, water swallow test and cervical auscultation as clinical predictors of aspiration using endoscopical observation as a gold standard. During a period of one year we have prospectively evaluated these tests in acute neurological patients hospitalized in an intensive care unit. Wet voice, 3 oz water swallow test and cervical auscultation demonstrated sensibilities of 66.7, 88.9 and 77.8%, with a respective specificity of 85.2, 59.3 and 77.8%. Positive predictive values were 60, 42.1 and 53.8%, with negative predictive values of 88.5, 94.1 and 91.3% respectively. These results support the utility of clinical aspiration screening as a simple and valuable technique that can be done at the bedside.

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

2021 , Sheila Cristina Ouriques Martins , LAVADOS GERMAIN, PABLO MANUEL , 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 , Raul G. Nogueira

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.

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Determination of Brain Death/Death by Neurologic Criteria

2020 , David M. Greer , Sam D. Shemie , Ariane Lewis , Sylvia Torrance , Panayiotis Varelas , Fernando D. Goldenberg , James L. Bernat , Michael Souter , Mehmet Akif Topcuoglu , Anne W. Alexandrov , Marie Baldisseri , Thomas Bleck , Giuseppe Citerio , Rosanne Dawson , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , Stephen Jacobe , Alex Manara , Thomas A. Nakagawa , Thaddeus Mason Pope , William Silvester , David Thomson , Hussain Al Rahma , Rafael Badenes , Andrew J. Baker , Vladimir Cerny , Cherylee Chang , Tiffany R. Chang , Elena Gnedovskaya , Moon-Ku Han , Stephen Honeybul , Edgar Jimenez , Yasuhiro Kuroda , Gang Liu , Uzzwal Kumar Mallick , Victoria Marquevich , Jorge Mejia-Mantilla , Michael Piradov , Sarah Quayyum , Gentle Sunder Shrestha , Ying-ying Su , Shelly D. Timmons , Jeanne Teitelbaum , Walter Videtta , Kapil Zirpe , Gene Sung

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Stroke epidemiology, prevention, and management strategies at a regional level: Latin America and the Caribbean

2007-04-01 , LAVADOS GERMAIN, PABLO MANUEL , Hennis, Anselm JM , Fernandes, Jefferson G. , Medina, Marco T. , Legetic, Branca , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , Sacks, Claudio , Jadue, Liliana , Salinas, Rodrigo

Stroke is a major health problem in Latin American and Caribbean countries. In this paper, we review the epidemiology, aetiology, and management of stroke in the region based on a systematic search of articles published in Spanish, Portuguese, and English. Stroke mortality is higher than in developed countries but rates are declining. Population-based studies show variations in incidence of strokes: lower rates of ischaemic stroke and similar rates of intracranial haemorrhages, compared with other regions. A significant proportion of strokes in these populations can be attributed to a few preventable risk factors. Some countries have published national clinical guidelines, although much needs to be done in the organisation of care and rehabilitation. Even though the burden of stroke is high, there is a paucity of information for implementing evidence-based management. The Global Stroke Initiative, the WHO STEPS Stroke surveillance, and WHO-PREMISE projects provide opportunities for surveillance at institutional and community levels. © 2007 Elsevier Ltd. All rights reserved.

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Sonothrombolysis for acute ischemic stroke

2014 , BRUNSER, ALEJANDRO , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , MUÑOZ VENTURELLI, PAULA ANDREA , Daniel Cárcamo , LAVADOS GERMAIN, PABLO MANUEL , Javier Gaete , Andrés Roldán , Rodrigo Rivas

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Transcranial Doppler in a Hispanic–Mestizo population with neurological diseases: a study of sonographic window and its determinants

2012 , BRUNSER, ALEJANDRO , SILVA FUENTE ALBA, CLAUDIO SERGIO , Cárcamo, Daniel , MUÑOZ VENTURELLI, PAULA , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , Abarca, Juan , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , DIAZ TAPIA, VIOLETA DEL CARMEN

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