Repositorio Institucional Fleni
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COVID-19 in multiple sclerosis and neuromyelitis optica spectrum disorder patients in Latin America: COVID-19 in MS and NMOSD patients in LATAM
No full textBackground: There is no data regarding COVID-19 in Multiple Sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients in Latin America.
Objective: The objective of this study was to describe the clinical characteristics and outcomes of patients included in RELACOEM, a LATAM registry of MS and NMOSD patients infected with COVID-19.
Methods: RELACOEM is a longitudinal, strictly observational registry of MS and NMOSD patients who suffer COVID-19 and Dengue in LATAM. Inclusion criteria to the registry were either: (1) a biologically confirmed COVID-19 diagnosis based on a positive result of a COVID-19 polymerase chain reaction (PCR) test on a nasopharyngeal swab; or (2) COVID-19-typical symptoms (triad of cough, fever, and asthenia) in an epidemic zone of COVID-19. Descriptive statistics were performed on demographic and clinical variables. The cohort was later stratified for MS and NMOSD and univariate and multivariate logistic regression analysis was performed to identify variables associated with hospitalizations/intensive critical units (ICU) admission.
Results: 145 patients were included in the registry from 15 countries and 51 treating physicians. A total of 129 (89%) were MS patients and 16 (11%) NMOSD. 81.4% patients had confirmed COVID-19 and 18.6% were suspected cases. 23 (15.8%) patients were hospitalized, 9 (6.2%) required ICU and 5 (3.4 %) died due to COVID-19. In MS patients, greater age (OR 1.17, 95% CI 1.05 - 1.25) and disease duration (OR 1.39, 95%CI 1.14-1.69) were associated with hospitalization/ICU. In NMOSD patients, a greater age (54.3 vs. 36 years, p=<0.001), increased EDSS (5.5 vs 2.9, p=0.0012) and disease duration (18.5 vs. 10.3 years, p=0.001) were significantly associated with hospitalization/ICU.
Conclusion: we found that in MS patients, age and disease duration was associated with hospitalization and ICU admission requirement, while age, disease duration and EDSS was associated in NMOSD.Fil: Alonso, Ricardo. Hospital Ramos Mejía. Centro Universitario de Esclerosis Múltiple; Argentina. Hospital Universitario Sanatorio Güemes. Servicio de Neurología; Argentina.Fil: Silva, Berenice. Hospital Universitario Sanatorio Güemes. Servicio de Neurología; Argentina.Fil: Garcea, Orlando. Hospital Universitario Sanatorio Güemes. Servicio de Neurología; Argentina.Fil: Correa Díaz, Edgar Patricio. Hospital Carlos Andrade Maín; Ecuador.Fil: Rodrigues Dos Passos, Giordani. Pontifícia Universidade Católica do Rio Grande do Sul; Brasil.Fil: Ramirez Navarro, Deyanira A. Hospital Docente Padre Billini; República Dominicana.Fil: Garcia Valle, Luis A. Hospital Militar Escuela Managua; Nicaragua.Fil: Rodriguez Salinas, Luis C. Instituto Hondureño De Seguridad Social; Honduras.Fil: Negrotto, Laura. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Luetic, Geraldine. Instituto de Neurociencias de Rosario; Argentina.Fil: Tkachuk, Verónica A. Hospital de Clínicas José de San Martín; Argentina.Fil: Míguez, Jimena S. Hospital Italiano de Buenos Aires; Argentina.Fil: Hamuy Diaz de Bedoya, Fernando. Hospital IMT; Paraguay.Fil: Goiry, Lorna Galleguillos. Clínica Alemana de Santiago; Chile.Fil: Ramírez Sánchez, Nicia E. Hospital Dr. Mario C. Rivas de San Pedro Sula; Honduras.Fil: Burgos, Marcos. Hospital San Bernardo; Argentina.Fil: Steinberg, Judith. Hospital Británico de Buenos Aires; Argentina.Fil: Balbuena Aguirre, María Eugenia. Hospital de Clínicas José de San Martín; Argentina.Fil: Monterrey Álvarez, Priscilla. Hospital San Rafael; Costa Rica.Fil: Ysrraelit, Maria. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina
Distinct Neural Processing of Acute Stress in Major Depression and Borderline Personality Disorder
No full textBackground: Major depressive disorder (MDD) and borderline personality disorder (BPD) are highly prevalent and often comorbid psychiatric conditions, with abnormal processing of negative affect resulting from psychological stress. Characteristics of central processing of autonomic response to stress in each disorder are not clearly settled.
Methods: We obtained whole brain 3T fMRI with concurrent skin conductance, respiration rate, and heart rate variability measures in a cohort of MDD (N=19), BPD (N=19) patients, and healthy (N=20) individuals. Experiments were conducted in resting conditions, during a control mental arithmetic task, during highly stressful mental arithmetic, and in the period immediately following psychological stress.
Results: Widespread activation of central autonomic network (CAN) structures was observed during stress compared to a control task in the group of healthy participants, whereas CAN activation during stress was less intense in both BPD and MDD. Both patient groups displayed increased sympathetic and decreased parasympathetic activation compared to healthy subjects, as previously reported. The relationship between peripheral sympathetic or parasympathetic activity and simultaneous regional brain BOLD activity was similar in BPD patients and healthy subjects, and markedly different from that seen in MDD patients.
Limitations: The sample size, the fact it belonged to a single study site, and low grade affective symptomatology in both patient groups limit the generalizability of the present findings.
Conclusions: The diverging neurobiological signature in the homeostatic response to stress in MDD and BPD possibly represents a heuristically valuable candidate biomarker to help discern MDD and BPD patients.https://doi.org/10.1016/j.jad.2021.02.055Fil: Villarreal, Mirta Fabiana. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina.Fil: Wainsztein, Agustina Edith. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina. Fleni. Servicio de Psiquiatría; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina.Fil: Álvarez Mercè, Rocío. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina.Fil: Goldberg, Ximena. Institut d'Investigació i Innovació Parc Taulí; España.Fil: Castro, Mariana Nair. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina.Fil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina.Fil: Ladrón de Guevara, Soledad. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina.Fil: Bodurka, Jerzy. Laureate Institute for Brain Research; Estados Unidos.Fil: Paulus, Martin. Laureate Institute for Brain Research; Estados Unidos.Fil: Menchón, José Manuel. Bellvitge University Hospital; España.Fil: Soriano-Mas, Carles. Bellvitge University Hospital; España.Fil: Guinjoan, Salvador Martín. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina. Laureate Institute for Brain Research; Estados Unidos
Cerebellitis, clinical case presentation
No full textAims & Objectives: Introduction: Acute cerebellitis is an inflammatory disease, which occurs as a primary infectious disease, postinfectious or postvaccination disorder. Clinical recovery is usually reported in 2 to 3 months in 90% of patients. Brain MRI shows cerebellar edema.
Methods: Observational descriptive work.
Results: Case 1: 9 y.o. male patient; started with oppressive headache 10 days before admission, later adding vomits, unsteady gait and dysarthria. Admission MRI: cerebellar vermis edema without ventricular system dilation. He presented acute sensory depression secondary to intracranial hypertension. MRI showed: increased intensity of both cerebellar hemispheres with important mass effect and dilation of the supratentorial ventricular system. He evolved favorably. Case 2: 10 y.o. female patient; began 10 days before admission with oppressive headache and subsequently added vomiting. At admission manifested signs of intracranial hypertension, CT-MRI with hydrocephalus and injury in the right cerebellar hemisphere. She required external ventricular drainage, empirical antibiotic treatment and corticosteroid pulses. She evolved favorably. Case 3: 6 y.o. male patient, consulted for headache, vomiting, blurred vision and unsteady gait. CT and MRI showed cerebellar edema. He completed empirical antibiotic treatment without germ rescue and received steroid pulse therapy with favorable evolution.
Conclusions: Conclusion: Cerebellitis is an uncommon pathology and difficult to diagnose, with variable evolution, ranging from a benign self-limited process to a fulminant presentation by compression of the posterior fossa and acute hydrocephalus. That is why it constitutes a medical and surgical emergency that requires a high level of suspicion and an MRI performanceFil: Fulco, Vanesa. Fleni. Departamento de Neurología. Servicio de Neuropediatría; Argentina.Fil: Biaggi, Leticia. Fleni. Departamento de Neurología. Servicio de Neuropediatría. Unidad de Terapia intensiva Pediátrica; Argentina.Fil: Bembenuto, L. Fleni. Servicio de Clínica Médica. Unidad Terapia Intensiva; Argentina.Fil: Routaboul, Carlos. Fleni. Departamento de Neurocirugía. Servicio de Neurocirugía Pediátrica; Argentina.Fil: Carullo, Paulina. Fleni. Centro de Rehabilitación Infantil CRI-CETNA. Clínica de trastornos del aprendizaje; Argentina.Fil: Schteinschnaider, Ángeles. Fleni. Departamento de Neurología. Servicio de Neuropediatría; Argentina
Central Autonomic Network Association With Cardiac Autonomic Sleep-Wake Rhythm in Major Depression and Borderline Personality Disorder
No full textBackground
Resting heart rate variability (HRV), a measure of ANS activity, adaptability and health, has been shown to be altered in patients with Major Depressive Disorder (MDD) and Borderline Personality disorder (BPD). The Central Autonomic Network (CAN) comprises brain regions involved in both physiological and behavioral regulation. Evidence linking cortical thickness of CAN components and HRV circadian patterns is scarce. We explored this relationship in patients with BPD, MDD and healthy controls (CS).
Methods
Forty-two participants (15 BPD, 14 MDD, 13HC) underwent 24hr-HRV recordings following structural MRI. Cortical thickness analysis was performed (FreeSurfer). Sleep-wake HRV measures (i.e, HF and RMSSD) were calculated. Cortical thickness of CAN regions were tested as HRV predictors.
Results
Cortical thickness of right anterior cingulate and lateral orbitofrontal cortex predicted 50% of RMSSD (p=.023) and 58% of HF (p=.008) nocturnal variation respectively in BPD patients where greater cortical thickness was associated with increased HRV. HC exhibited this association between left inferior frontal gyrus (IFG) and middle frontal gyrus areas and sleep-HRV(p<.05). Left triangular segment of IFG explained 86% variability of nocturnal RMSSD in this group (p=.001). MDD group did not show significant correlations.
Conclusions
Greater cortical thickness of CAN regions may be associated with increased sleep-HRV in BPD patients and HC. Nocturnal HRV patterns could serve as a biomarker of preserved neural architecture and functioning. Neural correlates of HRV may provide important insights into mechanisms involved in self-regulation that might be related to emotional well-being or psychopathology.Fil: Wainsztein, Agustina Edith. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina. Fleni. Servicio de Psiquiatría; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina.Fil: Camacho Téllez, Vicente. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina.Fil: Abulafia, Carolina. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina.Fil: Villarreal, Mirta Fabiana. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina.Fil: Soriano-Mas, Carles. Bellvitge Biomedical Research Institute; España.Fil: Nemeroff, Charles. Dell Medical School at The University of Texas at Austin; Estados Unidos.Fil: Guinjoan, Salvador Martín. Fleni. Servicio de Psiquiatría; Argentina. Laureate Institute for Brain Research; Estados Unidos.Fil: Castro, Mariana Nair. Fleni. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina
Extraction-free protocol combining proteinase K and heat inactivation for detection of SARS-CoV-2 by RT-qPCR
No full textReal-time reverse transcription PCR (RT-qPCR) is the gold-standard technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection in nasopharyngeal swabs specimens. The analysis by RT-qPCR usually requires a previous extraction step to obtain the purified viral RNA. Unfortunately, RNA extraction constitutes a bottleneck for early detection in many countries since it is expensive, time-consuming and depends on the availability of commercial kits. Here, we describe an extraction-free protocol for SARS-CoV-2 detection by RT-qPCR from nasopharyngeal swab clinical samples in saline solution. The method includes a treatment with proteinase K followed by heat inactivation (PK+HID method). We demonstrate that PK+HID improves the RT-qPCR performance in comparison to the heat-inactivation procedure. Moreover, we show that this extraction-free protocol can be combined with a variety of multiplexing RT-qPCR kits. The method combined with a multiplexing detection kit targeting N and ORF1ab viral genes showed a sensitivity of 0.99 and a specificity of 0.99 from the analysis of 106 positive and 106 negative clinical samples. In conclusion, PK+HID is a robust, fast and inexpensive procedure for extraction-free RT-qPCR determinations of SARS-CoV-2. The National Administration of Drugs, Foods and Medical Devices of Argentina has recently authorized the use of this method.Fil: Genoud, Valeria. Universidad de Buenos Aire. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina.Fil: Stortz, Martin. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales, Departamento de Fisiología, Biología Molecular y Celular. Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales, Instituto de Química Biológica. Argentina.Fil: Waisman, Ariel. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Berardino, Bruno G. Universidad de Buenos Aire. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales, Instituto de Química Biológica. Argentina.Fil: Verneri, Paula. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales, Instituto de Química Biológica. Argentina.Fil: Dansey, Virginia. Universidad de Buenos Aire. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Unidad de Microanálisis y Métodos Físicos en Química Orgánica. Argentina.Fil: Salvatori, Melina. Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Argentina.Fil: Remes Lenicov, Federico. Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Argentina.Fil: Levi, Valeria. Universidad de Buenos Aire. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales, Instituto de Química Biológica. Argentina
Abstract P80: Control of Vascular Risk Factors and Response to Stroke Symptoms During the Most Restrictive Period of the Covid-19 Quarantine. A Survey of Population Behavior in Argentina
No full textBackground and objectives: In preparation for the influx of Covid-19 patients and as a contagion prevention strategy, healthcare systems reduced or discontinued provision of ‘‘non-urgent’’ care. This policy could potentially influence stroke prevention and management. We conducted a large population survey to assess the impact of mandatory social isolation on emergency consultations, routine health controls and the behavior of the population during the pandemic.
Methods: We distributed multiple-choice anonymous questionnaires through the institutional email database and through the email database of clients of a beverage distribution company. Most respondents resided in the Metropolitan Area of Buenos Aires. This is the area where the infection rates were higher and restriction measures were stricter. The survey assessed demographic characteristics and actual and potential behaviors of people regarding medical checkups, risk factors control, medication provision and response to onset of symptoms consistent with stroke or TIA.
Results: A total of 10,303 questionnaires were completed. Thirty-seven percent of the respondents were older than 60 years, 74% were women and 16% lived alone. One or more vascular risk factors were present in 39% of respondents. Seventy-six percent of participants did not continue to attend to their regular medical checkups during the mandatory social preventive isolation, 21% had difficulty obtaining medical prescriptions and only 38% considered hospitals were implementing appropriate measures to avoid Covid-19 infections. When asked about response in case of onset of stroke symptoms, 9% would not consult given the context of the pandemic. Six percent reported having had symptoms consistent with stroke or TIA and only 35% of those consulted in an Emergency Room. Most of the respondents (85%) reported they were waiting for the end of the quarantine to resume their usual medical care.
Conclusions: The implementation of a strict quarantine may have some serious adverse effects on the proper prevention and treatment of stroke. Careful communication and better education strategies are needed to keep the population safe during the pandemic while avoiding increases in the risk of occurrence of other devastating diseases as stroke.Fil: Rodriguez Pérez, María Soledad. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Rosales, Julieta S. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Dossi, Daiana Elizabeth. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina
Surgical anatomy of the cervical plexus and its branches
No full textResumen no disponibleFil: Cejas, Claudia Patricia. Fleni. Departamento de Diagnóstico por Imágenes; Argentina
Galectins as Emerging Glyco-Checkpoints and Therapeutic Targets in Glioblastoma
No full textDespite recent advances in diagnosis and treatment, glioblastoma (GBM) represents the most common and aggressive brain tumor in the adult population, urging identification of new rational therapeutic targets. Galectins, a family of glycan-binding proteins, are highly expressed in the tumor microenvironment (TME) and delineate prognosis and clinical outcome in patients with GBM. These endogenous lectins play key roles in different hallmarks of cancer by modulating tumor cell proliferation, oncogenic signaling, migration, vascularization and immunity. Additionally, they have emerged as mediators of resistance to different anticancer treatments, including chemotherapy, radiotherapy, immunotherapy, and antiangiogenic therapy. Particularly in GBM, galectins control tumor cell transformation and proliferation, reprogram tumor cell migration and invasion, promote vascularization, modulate cell death pathways, and shape the tumor-immune landscape by targeting myeloid, natural killer (NK), and CD8+ T cell compartments. Here, we discuss the role of galectins, particularly galectin-1, -3, -8, and -9, as emerging glyco-checkpoints that control different mechanisms associated with GBM progression, and discuss possible therapeutic opportunities based on inhibition of galectin-driven circuits, either alone or in combination with other treatment modalities.Fil: Videla-Richardson, Guillermo Agustín. Fleni. Laboratorio de Investigación Aplicada en Neurociencias; Argentina.Fil: Morris-Hanon, Olivia. Fleni. Laboratorio de Investigación Aplicada en Neurociencias; Argentina.Fil: Torres, Nicolás I. Instituto de Biología y Medicina Experimental; Argentina.Fil: Esquivel, Myrian I. Fleni. Laboratorio de Investigación Aplicada en Neurociencias; Argentina.Fil: Vera, Mariana B. Fleni. Laboratorio de Investigación Aplicada en Neurociencias; Argentina.Fil: Ripari, Luisina B. Laboratorio de Investigación Aplicada en Neurociencias; Argentina.Fil: Croci, Diego O. Instituto de Histología y Embriología de Mendoza; Argentina.Fil: Sevlever, Gustavo Emilio. Fleni. Laboratorio de Investigación Aplicada en Neurociencias; Argentina.Fil: Rabinovich, Gabriel A. Instituto de Biología y Medicina Experimental; Argentina
The Worldwide Alzheimer's Disease Neuroimaging Initiative: ADNI-3 updates and global perspectives
No full textThe Worldwide Alzheimer's Disease Neuroimaging Initiative (WW-ADNI) is a collaborative effort to investigate imaging and biofluid markers that can inform Alzheimer's disease treatment trials. It is a public-private partnership that spans North America, Argentina, Australia, Canada, China, Japan, Korea, Mexico, and Taiwan. In 2004, ADNI researchers began a naturalistic, longitudinal study that continues today around the globe. Through several successive phases (ADNI-1, ADNI-GO, ADNI-2, and ADNI-3), the study has fueled amyloid and tau phenotyping and refined neuroimaging methodologies. WW-ADNI researchers have successfully standardized analyses and openly share data without embargo, providing a rich data set for other investigators. On August 26, 2020, the Alzheimer's Association convened WW-ADNI researchers who shared updates from ADNI-3 and their vision for ADNI-4.Fil: Weber, Christopher J. Alzheimer's Association; Estados Unidos.Fil: Carrillo, María C. Alzheimer's Association; Estados Unidos.Fil: Jagust, William. University of California Berkeley; Estados Unidos.Fil: Jack Jr., Clifford R. Mayo Clinic; Estados Unidos.Fil: Shaw, Leslie M. University of Pennsylvania; Estados Unidos.Fil: Trojanowski, John Q. University of Pennsylvania; Estados Unidos.Fil: Saykin, Andrew J. Indiana University; Estados Unidos.Fil: Beckett, Laurel A. University of California; Estados Unidos.Fil: Sur, Cyrille. Merck Research Laboratories; Estados Unidos.Fil: Rao, Naren P. National Institute of Mental Health and Neurosciences; India.Fil: Chrem Méndez, Patricio Alexis. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría. Centro de Memoria y Envejecimiento; Argentina.Fil: Black, Sandra E. University of Toronto; CanadáFil: Li, Kuncheng. Capital Medical University; ChinaFil: Iwatsubo, Takeshi. University of Tokyo; JapónFil: Chang, Chiung-Chih. Chang Gung University College of Medicine; China.Fil: Sosa, Ana Luisa. National Institute of Neurology and Neurosurgery of Mexico; México.Fil: Rowe, Christopher C. University of Melbourne; Australia.Fil: Perrin, Richard J. Washington University School of Medicine; Estados Unidos.Fil: Morris, John C. Washington University School of Medicine; Estados Unidos.Fil: Healan, Amanda M. B. Independent Science Writer and Editor; Estados Unidos
Uso y resultados de la fibrinolisis intravenosa en una unidad cerebrovascular
Full text linkLa fibrinólisis intravenosa con activador del plasminógeno tisular recombinante (rTPA) y la utilización de unidades cerradas, demostraron disminuir sustancialmente la morbimortalidad en pacientes con accidente cerebrovascular isquémico (ACVi). Sin embargo, los datos publicados en Argentina son escasos. Describimos la experiencia en la utilización de fibrinólisis en pacientes con ACVi agudo antes y después de la implementación de una unidad cerebrovascular (UCV) en un Centro Integral de Neurología Vascular de la Ciudad de Buenos Aires durante 17 años. Se realizó un análisis retrospectivo de pacientes consecutivos tratados con rTPA entre enero 2003 y diciembre 2019. Se evaluaron tiempos de tratamiento, de internación, complicaciones post tratamiento y discapacidad a 3 meses. Para su análisis se evaluaron los períodos pre y post apertura de la UCV, período 1 (P1 de 2003-2011) y P2 (2012 -2019). Se realizó fibrinolisis intravenosa en 182 pacientes. La apertura de UCV resultó en aumento del porcentaje de fibrinólisis sobre el total de los ACVi ingresados (4% en P1 vs. 10% en P2, p < 0.001), acortamiento del tiempo puerta-aguja (75 minutos en P1 vs. 53 minutos en P2, p < 0.00001) y mayor proporción de pacientes tratados dentro de los 60 minutos del ingreso hospitalario (36% en P1 vs. 76% en P2, p < 0.00001). Además, hubo reducción de la me diana de internación de 9 días en P1 a 5 días en P2 (p < 0.00001). En conclusión, la UCV parece optimizar la utilización de fibrinólisis en el ACVi agudo, aumentando el porcentaje de pacientes tratados, reduciendo el tiempo puerta-aguja y disminuyendo el de internación.Fil: Rosales, Julieta S. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Rodríguez Lucci, Federico. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina