Person: González-Brevis, Pablo
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González-Brevis
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Pablo
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Publication Síndrome de Mounier-Kuhn: reporte de caso y revisión de la literatura(2022) Díaz, Israel; Vicentela, Andrés; Lara, Bastián; González-Brevis, Pablo; Villacrés, FabiánEl síndrome de Mounier-Kuhn o traqueobroncomegalia es una condición rara caracterizada por dilatación de la tráquea y del árbol bronquial, la cual se produce por la reducción y atrofia de las fibras elásticas de la tráquea y los bronquios, por lo que habrá mayor predisposición a infecciones respiratorias recurrentes y a la aparición de bronquiectasias cilíndricas. Presentamos el caso de una mujer de 71 años con antecedente de neumonía a repetición que consultó por disnea asocia da a tos productiva mucopurulenta. La exploración física, los exámenes de laboratorio y la radiografía de tórax no fueron concluyentes. Se realizó broncoscopía, que demostró una alteración de la anatomía traqueobronquial con acentuada dila tación traqueal. En la tomografía computarizada de tórax se observó una gran dilatación traqueal asociada a múltiples di vertículos en la pared posterior y anterior, hallazgos con los que se estableció el diagnóstico definitivo de síndrome de Mounier-Kuhn.Publication Intravenous Thrombolysis in Patients 90 Years or Older with Moderate to Severe Acute Ischemic Stroke Increases Ambulation at Discharge and Is Safe: A Prospective Cohort Study from a Single Center in Santiago, Chile(2024) González-Brevis, Pablo; Lavados, Pablo; Aguirre, André I.; Brunser, Alejandro; Olavarría, Verónica V.Introduction: The WorldHealthOrganizationpredictsthat the globalpopulationaged60yearsandolderwilldouble by 2050, leading to a significant rise in the public health impact of acute ischemic stroke (AIS). Existing stroke guidelines do not specify an upper age limit for the administration of intravenous thrombolysis (IVT), although some suggest a relative exclusion criterion in patients aged ≥80 in the 3–4.5-h window. Many physicians avoid treating these patients with IVT, argumenting high risk and little benefit. Our aim was to investigate the efficacy and safety of IVT treatment in patients with nonminor AIS aged ≥90, admitted to our institution. The primary efficacy endpoint was the ability to walk at discharge (mRS 0–3), and the primary safety endpoints were death and symptomatic intracranial hemorrhagic transformation (sIHT) at discharge. Methods: Patients with AIS aged ≥90 admitted to our center from January 2003 to December 2022 were included. They were selected if had an NIHSS ≥5, were previously ambulatory (prestroke mRS score 3 or less), and arrived within 6 h from symptom onset. Those treated or not with IVT were compared with univariate analysis. Results: The mean age was 93.2 (2.4) years, and 51 (73.9%) were female. The admission mRSandNIHSSwere1(IQR0–2) and 14 (IQR 7–22), respectively. Thrombolyzed patients had a shorter time from symptom onset to door and lower glycemia on admission. IVT was associated with a higher proportion of patients achieving mRS 0–3atdischarge (p = 0.03) and at 90 days (p = 0.04). There were no dif ferences between groups in the risk of death (p = 0.55) or sIHT (p = 0.38). Conclusion: In this small sample, ambulatory patients aged ≥90 with moderate or severe AIS treated with IVT had increased odds of being able to walk independently at discharge than those not treated, without safety concerns.