Joaquı́n Serena
A5019880814- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiovascular and Diving-Related Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Intracranial Aneurysms: Treatment and Complications
- S100 Proteins and Annexins
- Neurological Disorders and Treatments
- Cardiovascular Health and Disease Prevention
- Advanced MRI Techniques and Applications
- Advanced Neuroimaging Techniques and Applications
- Neurosurgical Procedures and Complications
- Aortic Disease and Treatment Approaches
- Peripheral Artery Disease Management
- Cerebrovascular and genetic disorders
- Neurological Disease Mechanisms and Treatments
- Protease and Inhibitor Mechanisms
- Atrial Fibrillation Management and Outcomes
- Antiplatelet Therapy and Cardiovascular Diseases
- Neuroscience and Neuropharmacology Research
- Functional Brain Connectivity Studies
- Botulinum Toxin and Related Neurological Disorders
- Vascular Malformations Diagnosis and Treatment
Institut d'Investigació Biomèdica de Girona
2015-2024
Hospital Universitari de Girona Doctor Josep Trueta
2015-2024
Tufts Medical Center
2013-2024
Hospital Universitario Fundación Jiménez Díaz
2024
University of Girona
2010-2023
Health and Education Research Management and Epidemiologic Services (United States)
2021-2023
Hospital la Serena
2021-2023
Hospital Universitari i Politècnic La Fe
2009-2022
Population Health Research Institute
2021
Hamilton Health Sciences
2021
We aimed to assess the safety and efficacy of thrombectomy for treatment stroke in a trial embedded within population-based reperfusion registry.During 2-year period at four centers Catalonia, Spain, we randomly assigned 206 patients who could be treated 8 hours after onset symptoms acute ischemic receive either medical therapy (including intravenous alteplase when eligible) endovascular with Solitaire stent retriever (thrombectomy group) or alone (control group). All had confirmed proximal...
Under current guidelines, intravenous thrombolysis is used to treat acute stroke only if it can be ascertained that the time since onset of symptoms was less than 4.5 hours. We sought determine whether patients with an unknown and features suggesting recent cerebral infarction on magnetic resonance imaging (MRI) would benefit from use alteplase.
Background and Purpose— Different definitions have been proposed to define the ischemic penumbra from perfusion-CT (PCT) data, based on parameters thresholds tested only in small pilot studies. The purpose of this study was perform a systematic evaluation all PCT (cerebral blood flow, volume [CBV], mean transit time [MTT], time-to-peak) large series acute stroke patients, determine which (combination of) most accurately predicts infarct penumbra. Methods— One hundred thirty patients with...
We aimed to create an index stratify cryptogenic stroke (CS) patients with patent foramen ovale (PFO) by their likelihood that the was related PFO.Using data from 12 component studies, we used generalized linear mixed models predict presence of PFO among CS, and derive a simple CS. estimated stratum-specific PFO-attributable fraction stroke/TIA recurrence rates.Variables associated in CS included younger age, cortical on neuroimaging, absence these factors: diabetes, hypertension, smoking,...
Background and Purpose— Studies on the relation between blood pressure (BP) stroke outcome have shown contradictory results. We explored association of systolic (SBP) diastolic (DBP) BP during acute with early neurological deterioration, infarct volume, outcome, mortality at 3 months. Methods— included 304 patients ischemic stroke. SBP DBP admission first day were average values all readings obtained in emergency department a 24-hour period after patient allocation unit. Results— A U-shaped...
Pretreatment with statins has been shown to reduce brain injury in cerebral ischemia. In this controlled randomized study, we investigated the influence of statin pretreatment and its withdrawal on outcome acute ischemic stroke patients.From 215 patients admitted within 24 hours a hemispheric stroke, 89 chronic treatment were randomly assigned either for first 3 days after admission (n = 46) or immediately receive atorvastatin 20 mg/day 43). The primary event was death dependency (modified...
<h3>Importance</h3> It is estimated that only 27% of patients with acute ischemic stroke and large vessel occlusion who undergo successful reperfusion after mechanical thrombectomy are disability free at 90 days. An incomplete microcirculatory might contribute to these suboptimal clinical benefits. <h3>Objective</h3> To investigate whether treatment adjunct intra-arterial alteplase improves outcomes following reperfusion. <h3>Design, Setting, Participants</h3> Phase 2b randomized,...
The microbiota-gut-brain axis has emerged as a novel target in depression, disorder with low treatment efficacy. However, the field is dominated by underpowered studies focusing on major depression not addressing microbiome functionality, compositional nature, or confounding factors. We applied multi-omics approach combining pre-clinical models three human cohorts including patients mild depression. Microbial functions and metabolites converging onto glutamate/GABA metabolism, particularly...
Importance In nonurban areas with limited access to thrombectomy-capable centers, optimal prehospital transport strategies in patients suspected large-vessel occlusion stroke are unknown. Objective To determine whether, areas, direct a center is beneficial compared the closest local center. Design, Setting, and Participants Multicenter, population-based, cluster-randomized trial including 1401 acute attended by emergency medical services where was not capable of performing thrombectomy...
Background and Purpose— Matrix metalloproteinase-9 (MMP-9) activity has been associated with hemorrhagic transformation (HT) in experimental models of cerebral ischemia. Our aim was to investigate the relationship between MMP-9 concentrations blood within 24 hours stroke onset subsequent HT infarction. Methods— We studied 250 patients a hemispheric ischemic 7.8±4.5 hours’ duration. Early CT signs infarction were evaluated on admission. The infarct volume analyzed from performed days 4...
Background and Purpose —Although right-to-left shunt (RLSh) has been reported to be significantly more frequent in young stroke patients with cryptogenic stroke, its relevance a nonselected population of acute ischemic is not well known. The aim this study was determine the importance RLSh magnitude as risk factor for patients. Methods —Two hundred eight hospitalized consecutively transient attack or cerebral infarction 100 healthy control subjects were studied. Transcranial Doppler...
Background and Purpose — The mechanisms underlying neurological deterioration in patients with lacunar infarction are not completely understood. In this study, we sought to investigate the role of proinflammatory molecules early worsening outcome acute stroke. Methods We performed a secondary analysis 113 consecutive included within first 24 hours onset symptoms previous study aimed at investigating clinical biochemical factors (END). END was defined as fall ≥1 points motor items Canadian...
<b><i>Objective:</i></b> To evaluate the usefulness of a mismatch between severity acute clinical manifestations and diffusion-weighted imaging (DWI) lesion in predicting early stroke outcome infarct volume. <b><i>Methods:</i></b> One hundred sixty-six patients with hemispheric ischemic <12 hours’ duration were studied. The NIH Stroke Scale (NIHSS) score volume DWI measured on admission at 72 ± 12 hours. Infarct was T2-weighted or fluid-attenuated inversion recovery images day 30. Early...
Evidence is accumulating regarding the prognostic influence of hyperglycemia in patients with acute ischemic stroke. However, level associated poor outcome unknown. Our objectives were to establish capillary glucose threshold highest predictive accuracy and evaluate its hypothetical value influencing functional by adjusting for other well-known factors stroke.The authors conducted a multicenter, prospective, observational cohort study 476 stroke within less than 24 hours from onset....
Background and Purpose— Plasma levels of cellular fibronectin (c-Fn) ≥3.6 μg/mL matrix metalloproteinase-9 (MMP-9) ≥140 ng/mL have been associated with parenchymal hematoma (PH) after treatment tissue-type plasminogen activator (t-PA) in patients acute ischemic stroke. In this prospective study, we sought to validate the predictive capacity preestablished cutoff values these biomarkers for PH a larger series patients. Methods— We studied 134 treated t-PA within 3 hours from symptom onset...
Few studies have prospectively examined the risk of recurrent stroke associated with patent foramen ovale. We present results Spanish right-to-left shunt (RLSh) multicenter study.Four hundred eighty-six patients cryptogenic stoke were included at 17 participating hospitals. Patients by contrast transcranial Doppler methods baseline. The magnitude RLSh was quantified during Valsalva maneuver. Transthoracic and/or transesophageal echocardiography, computed tomography scan, or magnetic...
<h3>BACKGROUND AND PURPOSE: </h3> The quantification and clinical significance of WD in CSTs following supratentorial stroke are not well understood. We evaluated the anisotropy by using DTI signal-intensity changes on conventional MR imaging CST to determine whether these findings correlated with limb motor deficit patients MCA ischemic stroke. <h3>MATERIALS METHODS: studied 60 within 12 hours onset. At admission, day 3, 30 evolution, underwent multimodal imaging, including sequences....
<h3>BACKGROUND AND PURPOSE:</h3> Early prediction of motor outcome is interest in stroke management. We aimed to determine whether lesion location at DTT predictive after acute and this information improves the accuracy clinical scores. <h3>MATERIALS METHODS:</h3> evaluated 60 consecutive patients within 12 hours middle cerebral artery onset. used evaluate CST involvement cortex premotor cortex, centrum semiovale, corona radiata, PLIC combinations these regions admission, day 3, 30. Severity...
Studies of gene expression in experimental cerebral ischaemia models can contribute to understanding the pathophysiology brain and identifying prognostic markers potential therapeutic targets. The normalization relative qRT-PCR data using a suitable reference is crucial prerequisite for obtaining reliable conclusions. No validated housekeeping genes have been reported quantification mRNA profile activated in-vitro ischaemic conditions, whereas in-vivo model different used. present study aims...