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Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

2017 , Craig S. Anderson , Hisatomi Arima , LAVADOS GERMAIN, PABLO MANUEL , Laurent Billot , Maree L. Hackett , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , MUÑOZ VENTURELLI, PAULA ANDREA , BRUNSER RABOVICH, ALEJANDRO MICHEL , Bin Peng , Liying Cui , Lily Song , Kris Rogers , Sandy Middleton , Joyce Y. Lim , Denise Forshaw , C. Elizabeth Lightbody , Mark Woodward , Octavio Pontes-Neto , H. Asita De Silva , Ruey-Tay Lin , Tsong-Hai Lee , Jeyaraj D. Pandian , Gillian E. Mead , Thompson Robinson , Caroline Watkins

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The Role of TCD in the Evaluation of Acute Stroke

2016 , BRUNSER, ALEJANDRO , Eloy Mansilla , Arnold Hoppe , Verónica Olavarría , Emi Sujima , Pablo M. Lavados

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Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

2021 , Raul G. Nogueira , Muhammad M. Qureshi , Mohamad Abdalkader , Sheila Ouriques Martins , Hiroshi Yamagami , Zhongming Qiu , Ossama Yassin Mansour , Anvitha Sathya , Anna Czlonkowska , Georgios Tsivgoulis , Diana Aguiar de Sousa , Jelle Demeestere , Robert Mikulik , Peter Vanacker , James E. Siegler , Janika Kõrv , Jose Biller , Conrad W. Liang , Navdeep S. Sangha , Alicia M. Zha , Alexandra L. Czap , Christine Anne Holmstedt , Tanya N. Turan , George Ntaios , Konark Malhotra , Ashis Tayal , Aaron Loochtan , Annamarei Ranta , Eva A. Mistry , Anne W. Alexandrov , David Y. Huang , Shadi Yaghi , Eytan Raz , Sunil A. Sheth , Mahmoud H. Mohammaden , Michael Frankel , Eric Guemekane Bila Lamou , Hany M. Aref , Ahmed Elbassiouny , Farouk Hassan , Tarek Menecie , Wessam Mustafa , Hossam M. Shokri , Tamer Roushdy , Fred S. Sarfo , Tolulope Oyetunde Alabi , Babawale Arabambi , Ernest O. Nwazor , Taofiki Ajao Sunmonu , Kolawole Wahab , Joseph Yaria , Haytham Hussein Mohammed , Philip B. Adebayo , Anis D. Riahi , Samia Ben Sassi , Lenon Gwaunza , Gift Wilson Ngwende , David Sahakyan , Aminur Rahman , Zhibing Ai , Fanghui Bai , Zhenhui Duan , Yonggang Hao , Wenguo Huang , Guangwen Li , Wei Li , Ganzhe Liu , Jun Luo , Xianjin Shang , Yi Sui , Ling Tian , Hongbin Wen , Bo Wu , Yuying Yan , Zhengzhou Yuan , Hao Zhang , Jun Zhang , Wenlong Zhao , Wenjie Zi , Thomas W. Leung , Chandril Chugh , Vikram Huded , Bindu Menon , Jeyaraj Durai Pandian , PN Sylaja , Fritz Sumantri Usman , Mehdi Farhoudi , Elyar Sadeghi Hokmabadi , Anat Horev , Anna Reznik , Rotem Sivan Hoffmann , Nobuyuki Ohara , Nobuyuki Sakai , Daisuke Watanabe , Ryoo Yamamoto , Ryosuke Doijiri , Naoki Tokuda , Takehiro Yamada , Tadashi Terasaki , Yukako Yazawa , Takeshi Uwatoko , Tomohisa Dembo , Hisao Shimizu , Yuri Sugiura , Fumio Miyashita , Hiroki Fukuda , Kosuke Miyake , Junsuke Shimbo , Yusuke Sugimura , Yoshiki Yagita , Yohei Takenobu , Yuji Matsumaru , Satoshi Yamada , Ryuhei Kono , Takuya Kanamaru , Hidekazu Yamazaki , Manabu Sakaguchi , Kenichi Todo , Nobuaki Yamamoto , Kazutaka Sonoda , Tomoko Yoshida , Hiroyuki Hashimoto , Ichiro Nakahara , Aida Kondybayeva , Kamila Faizullina , Saltanat Kamenova , Murat Zhanuzakov , Jang-Hyun Baek , Yangha Hwang , Jin Soo Lee , Si Baek Lee , Jusun Moon , Hyungjong Park , Jung Hwa Seo , Kwon-Duk Seo , Sung Il Sohn , Chang Jun Young , Rechdi Ahdab , Wan Asyraf Wan Zaidi , Zariah Abdul Aziz , Hamidon bin Basri , Law Wan Chung , Aznita Binti Ibrahim , Khairul Azmi Ibrahim , Irene Looi , Wee Yong Tan , Nafisah Wan Yahya , Stanislav Groppa , Pavel Leahu , Amal M. Al Hashmi , Yahia Zakaria Imam , Naveed Akhtar , Maria Carissa Pineda-Franks , Christian Oliver Co , Dmitriy Kandyba , Adel Alhazzani , Hosam Al-Jehani , Carol Huilian Tham , Marlie Jane Mamauag , Narayanaswamy Venketasubramanian , Chih-Hao Chen , Sung-Chun Tang , Anchalee Churojana , Esref Akil , özlem aykaç , Atilla Ozcan Ozdemir , Semih Giray , Syed Irteza Hussain , Seby John , Huynh Le Vu , Anh Duc Tran , Huy Hoang Nguyen , Thong Nhu Pham , Thang Huy Nguyen , Trung Quoc Nguyen , Thomas Gattringer , Christian Enzinger , Monika Killer-Oberpfalzer , Flavio Bellante , Sofie De Blauwe , Geert Vanhooren , Sylvie De Raedt , Anne Dusart , Robin Lemmens , Noemie Ligot , Matthieu Pierre Rutgers , Laetitia Yperzeele , Filip Alexiev , Teodora Sakelarova , Marina Roje Bedeković , Hrvoje Budincevic , Igor Cindric , Zlatko Hucika , David Ozretic , Majda Seferovic Saric , František Pfeifer , Igor Karpowic , David Cernik , Martin Sramek , Miroslav Skoda , Helena Hlavacova , Lukas Klecka , Martin Koutny , Daniel Vaclavik , Ondrej Skoda , Jan Fiksa , Katerina Hanelova , Miroslava Nevsimalova , Robert Rezek , Petr Prochazka , Gabriela Krejstova , Jiri Neumann , Marta Vachova , Henryk Brzezanski , David Hlinovsky , Dusan Tenora , Rene Jura , Lubomír Jurák , Jan Novak , Ales Novak , Zdenek Topinka , Petr Fibrich , Helena Sobolova , Ondrej Volny , Hanne Krarup Christensen , Nicolas Drenck , Helle Klingenberg Iversen , Claus Z. Simonsen , Thomas Clement Truelsen , Troels Wienecke , Riina Vibo , Katrin Gross-Paju , Toomas Toomsoo , Katrin Antsov , Francois Caparros , Charlotte Cordonnier , Maria Dan , Jean-Marc Faucheux , Laura Mechtouff , Omer Eker , Emilie Lesaine , Basile Ondze , Roxane Peres , Fernando Pico , Michel Piotin , Raoul Pop , Francois Rouanet , Tatuli Gubeladze , Mirza Khinikadze , Nino Lobjanidze , Alexander Tsiskaridze , Simon Nagel , Peter Arthur Ringleb , Michael Rosenkranz , Holger Schmidt , Annahita Sedghi , Timo Siepmann , Kristina Szabo , Götz Thomalla , Lina Palaiodimou , Dimitrios Sagris , Odysseas Kargiotis , Peter Klivenyi , Laszlo Szapary , Gabor Tarkanyi , Alessandro Adami , Fabio Bandini , Paolo Calabresi , Giovanni Frisullo , Leonardo Renieri , Davide Sangalli , Anne Pirson , Maarten Uyttenboogaart , Ido van den Wijngaard , Espen Saxhaug Kristoffersen , Waldemar Brola , Małgorzata Fudala , Ewa Horoch-Lyszczarek , Michal Karlinski , Radoslaw Kazmierski , Pawel Kram , Marcin Rogoziewicz , Rafal Kaczorowski , Piotr Luchowski , Halina Sienkiewicz-Jarosz , Piotr Sobolewski , Waldemar Fryze , Anna Wisniewska , Malgorzata Wiszniewska , Patricia Ferreira , Paulo Ferreira , Luisa Fonseca , João Pedro Marto , Teresa Pinho e Melo , Ana Paiva Nunes , Miguel Rodrigues , Vítor Tedim Cruz , Cristian Falup-Pecurariu , Georgi Krastev , Miroslav Mako , María Alonso de Leciñana , Juan F. Arenillas , Oscar Ayo-Martin , Antonio Cruz Culebras , Exuperio Diez Tejedor , Joan Montaner , Soledad Pérez-Sánchez , Miguel Angel Tola Arribas , Alejandro Rodriguez Vasquez , Michael Mayza , Gianmarco Bernava , Alex Brehm , Paolo Machi , Urs Fischer , Jan Gralla , Patrik L. Michel , Marios-Nikos Psychogios , Davide Strambo , Soma Banerjee , Kailash Krishnan , Joseph Kwan , Asif Butt , Luciana Catanese , Andrew M. Demchuk , Thalia Field , Jennifer Haynes , Michael D. Hill , Houman Khosravani , Ariane Mackey , Aleksandra Pikula , Gustavo Saposnik , Courtney Anne Scott , Ashkan Shoamanesh , Ashfaq Shuaib , Samuel Yip , Miguel A. Barboza , Jose Domingo Barrientos , Ligia Ibeth Portillo Rivera , Fernando Gongora-Rivera , Nelson Novarro-Escudero , Anmylene Blanco , Michael Abraham , Diana Alsbrook , Dorothea Altschul , Anthony J. Alvarado-Ortiz , Ivo Bach , Aamir Badruddin , Nobl Barazangi , Charmaine Brereton , Alicia Castonguay , Seemant Chaturvedi , Saqib A. Chaudry , Hana Choe , Jae H. Choi , Sushrut Dharmadhikari , Kinjal Desai , Thomas G. Devlin , Vinodh T. Doss , Randall Edgell , Mark Etherton , Mudassir Farooqui , Don Frei , Dheeraj Gandhi , Mikayel Grigoryan , Rishi Gupta , Ameer E. Hassan , Johanna Helenius , Artem Kaliaev , Ritesh Kaushal , Priyank Khandelwal , Ayaz M. Khawaja , Naim N. Khoury , Benny S. Kim , Dawn O. Kleindorfer , Feliks Koyfman , Vivien H. Lee , Lester Y. Leung , Guillermo Linares , Italo Linfante , Helmi L. Lutsep , Lisa Macdougall , Shailesh Male , Amer M. Malik , Hesham Masoud , Molly McDermott , Brijesh P. Mehta , Jiangyong Min , Manoj Mittal , Jane G. Morris , Sumeet S. Multani , Fadi Nahab , Krishna Nalleballe , Claude B. Nguyen , Roberta Novakovic-White , Santiago Ortega-Gutierrez , Rahul H. Rahangdale , Pankajavalli Ramakrishnan , Jose Rafael Romero , Natalia Rost , Aaron Rothstein , Sean Ruland , Ruchir Shah , Malveeka Sharma , Brian Silver , Marc Simmons , Abhishek Singh , Amy K. Starosciak , Sheryl L. Strasser , Viktor Szeder , Mohamed Teleb , Jenny P. Tsai , Barbara Voetsch , Oscar Balaguera , Virginia A. Pujol Lereis , Adriana Luraschi , Marcele Schettini Almeida , Fabricio Buchdid Cardoso , Adriana Conforto , Leonardo De Deus Silva , Luidia Varrone Giacomini , Fabricio Oliveira Lima , Alexandre L. Longo , Pedro S.C. Magalhães , Rodrigo Targa Martins , Francisco Mont'alverne , Daissy Liliana Mora Cuervo , Leticia Costa Rebello , Lenise Valler , Viviane Flumignan Zetola , LAVADOS GERMAIN, PABLO MANUEL , Victor Navia , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , Juan Manuel Almeida Toro , Pablo Felipe Ricardo Amaya , Hernan Bayona , Angel Corredor , Carlos Eduardo Rivera Ordonez , Diana Katherine Mantilla Barbosa , Osvaldo Lara , Mauricio R. Patiño , Luis Fernando Diaz Escobar , Donoband Edson Dejesus Melgarejo Fariña , Analia Cardozo Villamayor , Adolfo Javier Zelaya Zarza , Danny Moises Barrientos Iman , Liliana Rodriguez Kadota , Bruce Campbell , Graeme J. Hankey , Casey Hair , Timothy Kleinig , Alice Ma , Rodrigo Tomazini Martins , Ramesh Sahathevan , Vincent Thijs , Daniel Salazar , Teddy Yuan-Hao Wu , Diogo C. Haussen , David Liebeskind , Dileep R. Yavagal , Tudor G. Jovin , Osama O. Zaidat , Thanh N. Nguyen

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Pre-stroke adherence to a Mediterranean diet pattern is associated with lower acute ischemic stroke severity: a cross-sectional analysis of a prospective hospital-register study

2020 , Pablo M. Lavados , MAZZON AGURTO, ENRICO , Alexis Rojo , BRUNSER, ALEJANDRO , Verónica V. Olavarría

Abstract Background High adherence to a Mediterranean Diet is associated with reduced incidence and mortality of acute ischemic stroke (AIS) but may also be associated with severity. Our purpose was to investigate the association of adherence to a Mediterranean diet and severity in a prospective hospital register of AIS patients. Methods We included AIS patients admitted from February 2017 to July 2019. All were assessed by a neurologist with a standard stroke protocol, including NIHSS. Adherence to Mediterranean diet was prospectively measured by the 14-point Mediterranean Diet Adherence Screener (MEDAS) and defined as low (0–6 points) or high (7–14 points). Demographic and clinical characteristics were compared by group with univariate analysis. A Generalized Linear Model (GLM) was used to investigate the association of admission NIHSS as a continuous ordinal variable and an ordinal logistic regression (OLR) analysis to determine the independent association of the NIHSS quartiles with adherence to Mediterranean diet. Results Three hundred sixty-eight patients were included, mean age 68.3 (17.7), 158 (42.9%) females. The median NIHSS score was 3 (IQR 1–9) and the median MEDAS score was 6 (IQR 4.5–8). Patients with high MEDAS scores had significantly lower; admission NIHSS scores, sedentary lifestyle, body mass index, total and LDL cholesterol levels, but higher alcohol consumption. After adjustments, high adherence to Mediterranean diet remained independently associated with lower stroke severity both in the GLM (β coefficient = − 0.19, p = 0.01) and in the OLR model (OR for lower NIHSS quartiles 0.6 (95% CI 0.37–0.98, p = 0.04). Conclusions Higher pre-stroke adherence to a Mediterranean diet is independently associated with lower AIS severity.

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Who is in the emergency room matters when we talk about door-to-needle time: a single-center experience

2023 , BRUNSER RABOVICH, ALEJANDRO MICHEL , Juan-Cristobal Nuñez , Eloy Mansilla , Gabriel Cavada , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , MUÑOZ VENTURELLI, PAULA ANDREA , LAVADOS GERMAIN, PABLO MANUEL

Abstract Background The efficacy of intravenous thrombolysis (IVT) is time-dependent. Objective To compare the door-to-needle (DTN) time of stroke neurologists (SNs) versus non-stroke neurologists (NSNs) and emergency room physicians (EPs). Additionally, we aimed to determine elements associated with DTN ≤ 20 minutes. Methods Prospective study of patients with IVT treated at Clínica Alemana between June 2016 and September 2021. Results A total of 301 patients underwent treatment for IVT. The mean DTN time was 43.3 ± 23.6 minutes. One hundred seventy-three (57.4%) patients were evaluated by SNs, 122 (40.5%) by NSNs, and 6 (2.1%) by EPs. The mean DTN times were 40.8 ± 23, 46 ± 24.7, and 58 ± 22.5 minutes, respectively. Door-to-needle time ≤ 20 minutes occurred more frequently when patients were treated by SNs compared to NSNs and EPs: 15%, 4%, and 0%, respectively (odds ratio [OR]: 4.3, 95% confidence interval [95%CI]: 1.66–11.5, p = 0.004). In univariate analysis DTN time ≤ 20 minutes was associated with treatment by a SN (p = 0.002), coronavirus disease 2019 pandemic period (p = 0.21), time to emergency room (ER) (p = 0.21), presence of diabetes (p = 0.142), hypercholesterolemia (p = 0.007), atrial fibrillation (p < 0.09), score on the National Institutes of Health Stroke Scale (NIHSS) (p = 0.001), lower systolic (p = 0.143) and diastolic (p = 0.21) blood pressures, the Alberta Stroke Program Early CT Score (ASPECTS; p = 0.09), vessel occlusion (p = 0.05), use of tenecteplase (p = 0.18), thrombectomy (p = 0.13), and years of experience of the physician (p < 0.001). After multivariate analysis, being treated by a SN (OR: 3.95; 95%CI: 1.44–10.8; p = 0.007), NIHSS (OR: 1.07; 95%CI: 1.02–1.12; p < 0.002) and lower systolic blood pressure (OR: 0.98; 95%CI: 0.96–0.99; p < 0.003) remained significant. Conclusion Treatment by a SN resulted in a higher probability of treating the patient in a DTN time within 20 minutes.

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LONGITUDINAL STUDY OF YOUNG PATIENTS WITH EMBOLIC STROKE OF UNDETERMINED SOURCE

2020 , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , Perera, K , Hankey, G. , Arnold, M. , Dyal, L. , Arauz, A. , Marti Fabregas, J. , Meseguer, E. , Birnbaum, L. , Hart, R.

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Low blood pressure and adverse outcomes in acute stroke: HeadPoST study explanations

2020 , Menglu Ouyang , MUÑOZ VENTURELLI, PAULA ANDREA , Laurent Billot , Xia Wang , Lili Song , Hisatomi Arima , LAVADOS GERMAIN, PABLO MANUEL , Maree L. Hackett , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , BRUNSER, ALEJANDRO , Sandy Middleton , Octavio M. Pontes-Neto , Tsong-Hai Lee , Caroline L. Watkins , Thompson Robinson , Craig S. Anderson

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Stroke symptoms, risk factors awareness and personal decision making in Chile. A national survey

2022 , NAVIA GONZALEZ, VICTOR HUGO , MAZZON AGURTO, ENRICO , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , ALMEIDA TORO, JUAN MANUEL , BRUNSER, ALEJANDRO , LAVADOS GERMAIN, PABLO MANUEL , HOFFMEISTER ARCE, LORENA , MUÑOZ VENTURELLI, PAULA ANDREA

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Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial

2020 , Menglu Ouyang , Laurent Billot , Lili Song , Xia Wang , Christine Roffe , Hisatomi Arima , LAVADOS GERMAIN, PABLO MANUEL , Maree L Hackett , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , MUÑOZ VENTURELLI, PAULA ANDREA , Sandy Middleton , Octavio M Pontes-Neto , Tsong-Hai Lee , Caroline L Watkins , Thompson G Robinson , Craig S Anderson

Background An indwelling urinary catheter (IUC) is often inserted to manage bladder dysfunction, but its impact on prognosis is uncertain. We aimed to determine the association of IUC use on clinical outcomes after acute stroke in the international, multi-center, cluster crossover, Head Positioning in Acute Stroke Trial (HeadPoST). Methods Data were analyzed on HeadPoST participants (n = 11,093) randomly allocated to the lying-flat or sitting-up head position. Binomial, logistic regression, hierarchical mixed models were used to determine associations of early insertion of IUC within seven days post-randomization and outcomes of death or disability (defined as “poor outcome,” scores 3–6 on the modified Rankin scale) and any urinary tract infection at 90 days with adjustment of baseline and post-randomization management covariates. Results Overall, 1167 (12%) patients had an IUC, but the frequency and duration of use varied widely across patients in different regions. IUC use was more frequent in older patients, and those with vascular comorbidity, greater initial neurological impairment (on the National Institutes of Health Stroke Scale), and intracerebral hemorrhage as the underlying stroke type. IUC use was independently associated with poor outcome (adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.13–1.74), but not with urinary tract infection after adjustment for antibiotic treatment and stroke severity at hospital separation (aOR: 1.13, 95% CI: 0.59–2.18). The number exposed to IUC for poor outcome was 13. Conclusions IUC use is associated with a poor outcome after acute stroke. Further studies are required to inform appropriate use of IUC.

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Microbleeds and the Effect of Anticoagulation in Patients With Embolic Stroke of Undetermined Source

2021 , Ashkan Shoamanesh , Robert G. Hart , Stuart J. Connolly , Scott E. Kasner , Eric E. Smith , Joan Martí-Fàbregas , Yan Yun Liu , Shinichiro Uchiyama , Robert Mikulik , Roland Veltkamp , Martin J. O’Donnell , George Ntaios , Keith W. Muir , Thalia S. Field , Gustavo C. Santo , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , Hardi Mundl , Helmi Lutsep , Scott D. Berkowitz , Mukul Sharma