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Abstract P84: Covid-19 and Stroke in the Latin American Stroke Registry (LASE)

2021 , Virginia Pujol-Lereis , Alan F Flores , Antonio Arauz , Carlos Abanto , Pablo Amaya , Hernan Bayona , Pablo Bonardo , Luis Diaz-Escobar , Maia Gomez-Schneider , Fernando Góngora-Rivera , LAVADOS GERMAIN, PABLO MANUEL , Carolina León , Adriana Luraschi , Juan Manuel Márquez-Romero , Sheila CO Martins , Victor Hugo Navia , Angelica Ruiz-Franco , Miguel Angel Vences , Maria Zurru , Miguel A Barboza , Sebastian F Ameriso

Background: Ischemic stroke has been reported to occur in approximately 5% of COVID-19 patients, although some reports are contradictory. Proposed mechanisms of this association are hypercoagulable state, vasculitis and cardiomyopathy, together with traditional vascular risk factors. We analyzed the frequency and clinical characteristics of COVID-19 positive stroke cases during the first months of the pandemic in Latin America. Methods: A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March - June 2020). We assessed acute stroke cases associated to COVID-19 infection. Clinical characteristics, stroke etiology and severity, acute care and functional outcomes, were compared between non-COVID-19 and COVID-19 cases. Results: There were a total of 1037 stroke cases; sixty-two of them (6.0%) were diagnosed with COVID-19 infection. This group consisted of 38 men [61.3%], with a median age of 68 years [IQR 59-79 years]. From these cases, 80.6% were ischemic stroke, 16.1% hemorrhagic stroke, and 1.6% transient ischemic attack and cerebral venous thrombosis respectively. The most common etiology reported for ischemic cases was atherosclerotic large vessel occlusion (30.6% vs. 12.7% in non-COVID cases, p<0.001), and undetermined etiology for hemorrhagic stroke (55.6%). Median NIHSS for COVID-stroke patients was higher (7 IQR 2-16 vs. 5 IQR 2-11, p=0.05). Five (8.1%) patients received acute reperfusion therapy, with no differences in door-to-CT, door-to-needle and door-to-groin times, compared to non-COVID cases. Most characteristics did not differ from those of COVID-19 negative patients. Mortality was higher in COVID-stroke cases (20.9% vs. 9.6%, p<0.001). Conclusions: COVID-19 infection frequency in stroke patients in Latin America is similar to that reported in several series worldwide, with a higher frequency of atherosclerotic ischemic strokes and mortality compared to non COVID-19 strokes

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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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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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Determinantes del tiempo puerta-aguja en trombolisis endovenosa en el infarto cerebral, experiencia de un centro

2020 , BRUNSER, ALEJANDRO , MAZZON AGURTO, ENRICO , MUÑOZ VENTURELLI, PAULA ANDREA , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , LAVADOS GERMAIN, PABLO MANUEL , Alexis Rojo , NAVIA GONZALEZ, VICTOR HUGO , Gabriel Cavada , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , Eloy Mansilla

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Developing clinical decision making in stroke through virtual online simulation: automated asynchronous or instructor-led synchronous feedback? A randomized controlled trial

2023 , Valentina Fuentes Lombardo , Javier Palominos Salas , María A. Pettersen Correa , Patricio Caro Guerra , NAVIA GONZALEZ, VICTOR HUGO , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , Soledad Armijo-Rivera , Felipe Machuca-Contreras

Aim: to determine whether asynchronous virtual simulation with automatic feedback enhances learning about clinical decision-making in stroke compared with synchronous simulation with instructor-guided feedback in 4th-year medical students. We hypothesize that instructor-guided feedback drives better learning than automatic feedback. Methodology: a quantitative randomized controlled parallel study was designed using the CONSORT extension to simulation studies. Twenty 4th year undergraduate medical students were divided into two groups. One group performed virtual simulations with instructor-guided feedback, and the other worked autonomously with automatic feedback. We administered a knowledge score test survey before and after applying the intervention bundle and a usefulness perception survey. Two-way repeated measures analysis of variance (ANOVA) was used to compare changes in performance. Results: the results of the two-way ANOVA on the performance level showed no significant changes between groups and between the first and third scenarios (p=0,428). Analysis of the simple main effect showed no significant difference between groups in the post-test (p =0,086) and no significant difference after the third scenario in the Synchronous (p = 0,001) and Asynchronous (p = 0,009) groups. The most remarkable improvement was the International Normalized Ratio that contraindicates thrombolysis (70 % improvement), followed by the first-line drug for hypertension and the platelet value that contraindicates thrombolysis (25 % improvement for both). Conclusion: we did not identify differences in student stroke knowledge gained via virtual simulation with automated v/s instructor-guided feedback. The students learned specific elements linked to the safety of administering thrombolytics in patients with stroke.

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Regional Initiatives to Empower Young Medical Doctors: The Young Stroke Latin American Task Force

2023 , Julieta Rosales , Ángel Basilio Corredor-Quintero , Leonardo Augusto Carbonera , Matías J. Alet , Pablo Amaya , Vanessa Cano-Nigenda , Miguel A. Barboza , NAVIA GONZALEZ, VICTOR HUGO , Claudio Alejandro Jiménez , Rodrigo Guerrero , Ana Cláudia de Souza

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Topic: AS15 COVID and Stroke IMPACTOF COVID-19 PANDEMIC ON STROKE SEVERITYAND MORTALITY IN THE SOUTH-EAST OF SANTIAGO, CHILE

2021 , ALMEIDA TORO, JUAN MANUEL , NAVIA GONZALEZ, VICTOR HUGO , GARCÍA PRADO, DIEGO RICARDO , Silva, A. , Vallejos, J. , Uribe, R. , Martoni, M. , Miranda, M. , Diaz, P.

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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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Trombolisis endovenosa con tenecteplase en ventana extendida tras selección por CT y AngioCT: Caso clínico

2021 , Claudio Montecinos , María José Angel , NAVIA GONZALEZ, VICTOR HUGO

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Effects of an Avocado-based Mediterranean Diet on Serum Lipids for Secondary Prevention after Ischemic Stroke Trial (ADD-SPISE)

2021 , Verónica V. Olavarría , CAMPODONICO GALDAMES, PAOLA ROSSANA , Valeska Vollrath , Paula von Geldern , Carolina Velásquez , Patricia Pavez , Barbara Valente , Pamela Donoso , Alexandra Ginesta , Gabriel Cavada , MAZZON AGURTO, ENRICO , NAVIA GONZALEZ, VICTOR HUGO , Matías Guzmán , Pablo Brinck , Pablo M. Lavados