Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia
Introduction: The incidence of stroke continues to rise globally, as it remains an important cause in overall mortality and disability. Given the fact that several patients cannot access thrombolytic therapy due to neurologist unavailability or because of geographic barriers, Teleictus and Telestrok...
- Autores:
-
Alexandra, A.N.M.
B.S.J., Luis
R.C.E., Carlos
J.L.S., Patricia
M.R.B., Alexander
A.P., Alexander
E.M., Álvaro
Alfredo, M.L.
Norman, L.V.
Loida, C.C.
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2023
- Institución:
- Corporación Universidad de la Costa
- Repositorio:
- REDICUC - Repositorio CUC
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.cuc.edu.co:11323/10449
- Acceso en línea:
- https://hdl.handle.net/11323/10449
https://repositorio.cuc.edu.co/
- Palabra clave:
- Modelo de atención
Stroke
Thrombolytic therapy
Telehealth
Healthcare models
Telestroke
Ataque Cerebrovascular Agudo
Terapia Trombolítica
Telemedicina
Modelo de atención
- Rights
- openAccess
- License
- Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
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|
dc.title.eng.fl_str_mv |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
dc.title.translated.none.fl_str_mv |
Comparación del modelo de teletrombólisis versus trombólisis presencial en el manejo del ataque cerebrovascular isquémico en Colombia |
title |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
spellingShingle |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia Modelo de atención Stroke Thrombolytic therapy Telehealth Healthcare models Telestroke Ataque Cerebrovascular Agudo Terapia Trombolítica Telemedicina Modelo de atención |
title_short |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
title_full |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
title_fullStr |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
title_full_unstemmed |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
title_sort |
Comparison between telestroke versus face-to-face thrombolysis models in stroke management in Colombia |
dc.creator.fl_str_mv |
Alexandra, A.N.M. B.S.J., Luis R.C.E., Carlos J.L.S., Patricia M.R.B., Alexander A.P., Alexander E.M., Álvaro Alfredo, M.L. Norman, L.V. Loida, C.C. |
dc.contributor.author.none.fl_str_mv |
Alexandra, A.N.M. B.S.J., Luis R.C.E., Carlos J.L.S., Patricia M.R.B., Alexander A.P., Alexander E.M., Álvaro Alfredo, M.L. Norman, L.V. Loida, C.C. |
dc.subject.ddc.spa.fl_str_mv |
Modelo de atención |
topic |
Modelo de atención Stroke Thrombolytic therapy Telehealth Healthcare models Telestroke Ataque Cerebrovascular Agudo Terapia Trombolítica Telemedicina Modelo de atención |
dc.subject.proposal.eng.fl_str_mv |
Stroke Thrombolytic therapy Telehealth Healthcare models Telestroke |
dc.subject.proposal.spa.fl_str_mv |
Ataque Cerebrovascular Agudo Terapia Trombolítica Telemedicina Modelo de atención |
description |
Introduction: The incidence of stroke continues to rise globally, as it remains an important cause in overall mortality and disability. Given the fact that several patients cannot access thrombolytic therapy due to neurologist unavailability or because of geographic barriers, Teleictus and Telestroke have become reasonable alternatives for providing treatment. Objective: The Teleictus network in Colombia was first implemented in 2018 in Boyacá; Our main goal was to compare the results of two models approaching patient care in stroke: Telestroke versus Face-to-face thrombolysis. Materials and Methods: This was an observational, analytic study using a retrospective cohort. Sociodemographic, clinical, protocol thrombolysis related and clinical evolution variables were considered into the study. Results 65 patients were allocated to the Face-to-face thrombolysis model and 35 were set into the Telestroke model. Median age was 69 and 67 years respectively; both groups had a higher proportion of women than men. Median symptom-onset-to-door time was 136 min in the Face-to-face thrombolysis and 81 min in the Telestroke model p = 0.0083. Median start NIHSS was eleven points for the former and twelve for the latter. At discharge, both groups had a median NIHSS score of 4. Conclusions: Thrombolytic therapy showed safety and efficacy. First and second level institutions are key in the setup of the Telestroke and Teleictus algorithms. More studies are needed to further evaluate this intervention. |
publishDate |
2023 |
dc.date.accessioned.none.fl_str_mv |
2023-09-06T14:10:25Z |
dc.date.available.none.fl_str_mv |
2023-09-06T14:10:25Z |
dc.date.issued.none.fl_str_mv |
2023 |
dc.type.spa.fl_str_mv |
Artículo de revista |
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http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.type.content.spa.fl_str_mv |
Text |
dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/ART |
dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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publishedVersion |
dc.identifier.citation.spa.fl_str_mv |
A. N. M. Alexandra et al., “COMPARISON BETWEEN TELESTROKE VERSUS FACE-TO-FACE THROMBOLYSIS MODELS IN STROKE MANAGEMENT IN COLOMBIA.”, Neurol. Perspectives, p. 100111, enero de 2023. doi: 10.1016/j.neurop.2023.100111 |
dc.identifier.issn.spa.fl_str_mv |
2667-0496 |
dc.identifier.uri.none.fl_str_mv |
https://hdl.handle.net/11323/10449 |
dc.identifier.doi.none.fl_str_mv |
10.1016/j.neurop.2023.100111 |
dc.identifier.instname.spa.fl_str_mv |
Corporación Universidad de la Costa |
dc.identifier.reponame.spa.fl_str_mv |
REDICUC - Repositorio CUC |
dc.identifier.repourl.spa.fl_str_mv |
https://repositorio.cuc.edu.co/ |
identifier_str_mv |
A. N. M. Alexandra et al., “COMPARISON BETWEEN TELESTROKE VERSUS FACE-TO-FACE THROMBOLYSIS MODELS IN STROKE MANAGEMENT IN COLOMBIA.”, Neurol. Perspectives, p. 100111, enero de 2023. doi: 10.1016/j.neurop.2023.100111 2667-0496 10.1016/j.neurop.2023.100111 Corporación Universidad de la Costa REDICUC - Repositorio CUC |
url |
https://hdl.handle.net/11323/10449 https://repositorio.cuc.edu.co/ |
dc.language.iso.spa.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartofjournal.spa.fl_str_mv |
Neurology Perspectives |
dc.relation.references.spa.fl_str_mv |
1. Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):439–58 1 de mayo de. 2. Ouriques Martins SC, Sacks C, Hacke W, Brainin M, de Assis Figueiredo F, Marques Pontes-Neto O, et al. Priorities to reduce the burden of stroke in Latin American countries. Lancet Neurol. 2019;18(7):674–83 1 de julio de. 3. Muñoz NJM, Gómez FR, Martínez MLO, Duran MM, Cardona J. Ministro de Salud y Protección Social; 2022. 4. Las 10 principales causas de defunción [Internet] [citado 21 de septiembre de 2021]. Disponible en: https://www.who.int/es/ news-room/fact-sheets/detail/the-top-10-causes-of-death. 5. Berge E, Whiteley W, Audebert H, De Marchis GM, Fonseca AC, Padiglioni C, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J. 2021;6(1):ILXII marzo de. 6. Mansilla E, Mazzon E, Cárcamo D, Jurado F, Lara L, Arévalo M, et al. Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores. Rev Médica Chile. 2019;147(9):1107–13 septiembre de. 7. Levine SR, Gorman M. «Telestroke»: the application of telemedicine for stroke. Stroke. 1999;30(2):464–9 febrero de. 8. Hacke W. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA J Am Med Assoc. 1995;274(13):1017–25 4 de octubre de. 9. Zarama-Valenzuela Á, Bustos-Sánchez JL, Gordillo-Navas GC, Vargas-Rodríguez LJ, Zarama-Valenzuela Á, Bustos-Sánchez JL, et al. Trombólisis en ataque cerebrovascular isquémico. Experiencia en Boyacá Acta Medica Colomb. 2021;46(1):14–9 marzo de. 10. de Hospital San Rafael a Hospital Regional de Duitama. Google Maps [Internet] [citado 13 de septiembre de 2021]. Disponible en: https://www.google.com/maps/dir/Hospital+San+Rafael, +Carrera+11,+Tunja,+Boyac%C3%A1/Hospital+Regional+de+Duitama,+Avenida+de+las+Am%C3%A9ricas,+Duitama,+Boyac%C3% A1/@5.6712987,-73.3361109,11z/data=!3m1!4b1!4m13!4m12! 1m5!1m1!1s0x8e6a7c2e52e749c5:0xf8cd0723565cd990!2m2!1d73.36126!2d5.5404291!1m5!1m1!1s0x8e6a3f7b738ed2f9:0xe02 a5ebe5ac48f3a!2m2!1d-73.0313268!2d5.8117931?hl=es-ES. 11. Audebert HJ, Kukla C, Clarmann von Claranau S, Kühn J, Vatankhah B, Schenkel J, et al. Telemedicine for safe and extended use of thrombolysis in stroke: the telemedic pilot project for integrative stroke care (TEMPiS) in Bavaria. Stroke. 2005;36(2):287–91 febrero de. 12. Pinilla-Monsalve GD, Vergara-Aguilar JP, Machado-Noguera B, Gutiérrez-Baquero J, Cabezas-Vargas Z, Bejarano-Hernández J. Estudio de la epidemiología neurológica en Colombia a partir de información administrativa (ESENCIA). Resultados preliminares 2015–2017. Salud UIS [Internet]. 2021:53 20 de septiembre de. [citado 5 de junio de 2022]. Disponible en: https://revistas.uis. edu.co/index.php/revistasaluduis/article/view/11958. 13. Kasab SA, Almallouhi E, Harvey JB, Girotra T, Debenham E, Turner N, et al. Long-term functional outcome for patients treated under drip and stay versus drip and ship paradigm: a single network experience. J Stroke. 2019;21(2):224–7 31 de mayo de. 14. Moreno E, Rodríguez J, Bayona-Ortiz H. Trombólisis endovenosa como tratamiento del ACV isquémico agudo en Colombia: una revisión sistemática de la literatura. Acta Neurológica Colomb. 2019;35(3):156–66 18 de septiembre de. 15. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke [Internet]. 2019;50(12) diciembre de. [citado 11 de septiembre de 2021]. Disponible en: https://www.ahajournals.org/doi/10.11 61/STR.0000000000000211. 16. Tejada Meza H, Saldaña Inda I, Serrano Ponz M, Ara JR, Marta Moreno J. Impacto en los tiempos puerta-aguja de un conjunto de medidas para optimizar la atención hospitalaria del código ictus. Neurología. 2020 octubre de. S0213485320302735. 17. López-Cancio E, Ribó M, Cardona P, Serena J, Purroy F, Palomeras E, et al. Telestroke in Catalonia: Increasing Thrombolysis Rate and Avoiding Interhospital Transfers. Cerebrovasc Dis. 2018;46(1–2):66–71. 18. Fonarow GC, Smith EE, Saver JL, Reeves MJ, Hernandez AF, Peterson ED, et al. Improving Door-to-Needle Times in Acute Ischemic Stroke. Stroke. 2011;42(10):2983–9 octubre de. 19. Brunser AM, Hoppe A, Muñoz P, Lavados PM, Illanes S, Díaz V, et al. Thrombolysis in stroke mimics: experience in 10 cases. Rev Médica Chile. 2016;144(10):1266–9 octubre de. 20. Moulin S, Leys D. Stroke mimics and chameleons. Curr Opin Neurol. 2019;32(1):54–9 febrero de. 21. Mohamed A, Fatima N, Shuaib A, Saqqur M. Comparison of faceto-face thrombolysis versus drip-and-ship models in treating patients with acute ischemic stroke: A systematic review and meta-analysis. Int J Stroke. 13 de mayo de 2021. 22. Fiorelli M, Bastianello S, von Kummer R, del Zoppo GJ, Larrue V, Lesaffre E, et al. Hemorrhagic transformation within 36 hours of a cerebral infarct: relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort. Stroke. 1999;30(11):2280–4 noviembre de. 23. Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet. 1998;352(9136):1245–51 octubre de. 24. Waseem H, Salih YA, Burney CP, Abel MA, Riblet N, Kim A, et al. Efficacy and safety of the telestroke drip-and-stay model: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2021;30(4):105638 1 de abril de. 25. Sairanen T, Soinila S, Nikkanen M, Rantanen K, Mustanoja S, Farkkila M, et al. Two years of Finnish telestroke: thrombolysis at spokes equal to that at the hub. Neurology. 2011;76(13): 1145–52 29 de marzo de. |
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© 2023 Sociedad Española de Neurología. |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) |
dc.rights.uri.spa.fl_str_mv |
https://creativecommons.org/licenses/by-nc-nd/4.0/ |
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info:eu-repo/semantics/openAccess |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) © 2023 Sociedad Española de Neurología. https://creativecommons.org/licenses/by-nc-nd/4.0/ http://purl.org/coar/access_right/c_abf2 |
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openAccess |
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7 páginas |
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Colombia |
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Ediciones Doyma, S.L. |
dc.publisher.place.spa.fl_str_mv |
Spain |
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https://www.elsevier.es/en-revista-neurology-perspectives-17-articulo-comparison-between-telestroke-versus-face-to-face-S2667049623000030 |
institution |
Corporación Universidad de la Costa |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)© 2023 Sociedad Española de Neurología.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Alexandra, A.N.M.B.S.J., LuisR.C.E., CarlosJ.L.S., PatriciaM.R.B., AlexanderA.P., AlexanderE.M., ÁlvaroAlfredo, M.L.Norman, L.V.Loida, C.C.2023-09-06T14:10:25Z2023-09-06T14:10:25Z2023A. N. M. Alexandra et al., “COMPARISON BETWEEN TELESTROKE VERSUS FACE-TO-FACE THROMBOLYSIS MODELS IN STROKE MANAGEMENT IN COLOMBIA.”, Neurol. Perspectives, p. 100111, enero de 2023. doi: 10.1016/j.neurop.2023.1001112667-0496https://hdl.handle.net/11323/1044910.1016/j.neurop.2023.100111Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Introduction: The incidence of stroke continues to rise globally, as it remains an important cause in overall mortality and disability. Given the fact that several patients cannot access thrombolytic therapy due to neurologist unavailability or because of geographic barriers, Teleictus and Telestroke have become reasonable alternatives for providing treatment. Objective: The Teleictus network in Colombia was first implemented in 2018 in Boyacá; Our main goal was to compare the results of two models approaching patient care in stroke: Telestroke versus Face-to-face thrombolysis. Materials and Methods: This was an observational, analytic study using a retrospective cohort. Sociodemographic, clinical, protocol thrombolysis related and clinical evolution variables were considered into the study. Results 65 patients were allocated to the Face-to-face thrombolysis model and 35 were set into the Telestroke model. Median age was 69 and 67 years respectively; both groups had a higher proportion of women than men. Median symptom-onset-to-door time was 136 min in the Face-to-face thrombolysis and 81 min in the Telestroke model p = 0.0083. Median start NIHSS was eleven points for the former and twelve for the latter. At discharge, both groups had a median NIHSS score of 4. Conclusions: Thrombolytic therapy showed safety and efficacy. First and second level institutions are key in the setup of the Telestroke and Teleictus algorithms. More studies are needed to further evaluate this intervention.Introducción: el ataque cerebrovascular (ACV) ha aumentado su incidencia global en los últimos años, asociado constituye causa importante de mortalidad y una de las primeras causas de años perdidos por discapacidad. Por ende, es necesario contar con tratamientos que modifiquen el habitual desarrollo natural de la enfermedad. La trombólisis intravenosa con activador tisular del plasminógeno (tPA) es el principal tratamiento de reperfusión sistémica. Los pacientes no pueden acceder a esta terapia por falta de neurólogos y barreras geográficas, siendo el teleictus o telestroke una opción para que los pacientes no pierdan la ventana terapéutica. Objetivo: la primera red de teleictus en Colombia fue implementada en el año 2018 en Boyacá, nuestro objetivo fue comparar los resultados de dos modelos de atención del ACV: teleictus versus trombólisis presencial. Materiales y Métodos: estudio observacional analítico de cohorte retrospectiva, se tomó como cohorte no expuesta las historias clínicas de población adulta que se le realizó trombólisis presencial y la cohorte expuesta aquellas en las que se realizó mediante teleictus en el periodo comprendido entre junio de 2019 y abril 2021. Se tuvieron en cuenta variables sociodemográficas: edad, sexo; variables clínicas como NIHSS de ingreso, territorio del ACV; variables relacionadas con los protocolos de Trombólisis como tiempos inicio-puerta, puerta-TC, puerta- aguja; variables de evolución: NIHSS de egreso, complicación hemorrágica, presencia de fibrilación auricular, porcentaje de estenosis carotidea, fracción de eyección (%), días de estancia hospitalaria, mortalidad al egreso y a los 3 meses. Resultados: se identificaron 65 pacientes con ACV manejados con el modelo de trombólisis presencial y 35 con teleictus. La mediana de edad de los pacientes fue de 69 y 67 años en los grupos respectivamente; con mayor frecuencia del sexo femenino en ambos grupos. Se observó una mediana de tiempo inicio – puerta de 136 minutos (RIC): 81–180 en el grupo presencial y de 81 minutos (RIC): 44–51 en el grupo de teleictus, p = 0,0083. Los tiempos puertaTC y puerta-aguja mostraron respectivamente medianas de 4,6 y 49,50 respectivamente con una p > 0,05. La mediana del NIHSS de ingreso fue de 11 en el presencial y 12 en teleictus y la mediana del NIHSS de egreso fue de 4 en ambos grupos. Hubo hematoma parenquimatoso tipo 2 (PH2) a las 24 horas después de la aplicación de tPA en 6.1% de los pacientes en trombólisis presencial y 5,7% del teleictus, sin encontrarse diferencias significativas en los 2 grupos. No existieron diferencias significativas con respecto a la estancia hospitalaria, vivo al egreso y a los 90 días y en los fallecidos totales en los grupos comparados. El análisis de asociación ajustada mostró que el modelo de atención por telestroke tiene un OR de 3,49 (IC 95%: 1,45 – 8,42) para obtener un tiempo inicio puerta menor o igual a 81 minutos, comparado con el modelo presencial. Conclusiones: La terapia trombolítica es segura y eficaz demostrado por las medianas del NIHSS al egreso, la incidencia de PH2 y la mortalidad al egreso y a los 3 meses. Nuestros datos soportan que los pacientes que se encuentran distantes de un centro primario de atención del ACV pueden acceder a la terapia trombolítica acortando una brecha geográfica. Se reconoce la importancia de los hospitales de primer y segundo nivel de complejidad en el algoritmo telestroke o teleictus. Es necesario que esta experiencia se pueda replicar en diferentes instituciones del país ya que se necesitan más estudios prospectivos.7 páginasapplication/pdfengEdiciones Doyma, S.L.Spainhttps://www.elsevier.es/en-revista-neurology-perspectives-17-articulo-comparison-between-telestroke-versus-face-to-face-S2667049623000030Modelo de atenciónStrokeThrombolytic therapyTelehealthHealthcare modelsTelestrokeAtaque Cerebrovascular AgudoTerapia TrombolíticaTelemedicinaModelo de atenciónComparison between telestroke versus face-to-face thrombolysis models in stroke management in ColombiaComparación del modelo de teletrombólisis versus trombólisis presencial en el manejo del ataque cerebrovascular isquémico en ColombiaArtículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85ColombiaNeurology Perspectives1. Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):439–58 1 de mayo de.2. Ouriques Martins SC, Sacks C, Hacke W, Brainin M, de Assis Figueiredo F, Marques Pontes-Neto O, et al. Priorities to reduce the burden of stroke in Latin American countries. Lancet Neurol. 2019;18(7):674–83 1 de julio de.3. Muñoz NJM, Gómez FR, Martínez MLO, Duran MM, Cardona J. Ministro de Salud y Protección Social; 2022.4. Las 10 principales causas de defunción [Internet] [citado 21 de septiembre de 2021]. Disponible en: https://www.who.int/es/ news-room/fact-sheets/detail/the-top-10-causes-of-death.5. Berge E, Whiteley W, Audebert H, De Marchis GM, Fonseca AC, Padiglioni C, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J. 2021;6(1):ILXII marzo de.6. Mansilla E, Mazzon E, Cárcamo D, Jurado F, Lara L, Arévalo M, et al. Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores. Rev Médica Chile. 2019;147(9):1107–13 septiembre de.7. Levine SR, Gorman M. «Telestroke»: the application of telemedicine for stroke. Stroke. 1999;30(2):464–9 febrero de.8. Hacke W. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA J Am Med Assoc. 1995;274(13):1017–25 4 de octubre de.9. Zarama-Valenzuela Á, Bustos-Sánchez JL, Gordillo-Navas GC, Vargas-Rodríguez LJ, Zarama-Valenzuela Á, Bustos-Sánchez JL, et al. Trombólisis en ataque cerebrovascular isquémico. Experiencia en Boyacá Acta Medica Colomb. 2021;46(1):14–9 marzo de.10. de Hospital San Rafael a Hospital Regional de Duitama. Google Maps [Internet] [citado 13 de septiembre de 2021]. Disponible en: https://www.google.com/maps/dir/Hospital+San+Rafael, +Carrera+11,+Tunja,+Boyac%C3%A1/Hospital+Regional+de+Duitama,+Avenida+de+las+Am%C3%A9ricas,+Duitama,+Boyac%C3% A1/@5.6712987,-73.3361109,11z/data=!3m1!4b1!4m13!4m12! 1m5!1m1!1s0x8e6a7c2e52e749c5:0xf8cd0723565cd990!2m2!1d73.36126!2d5.5404291!1m5!1m1!1s0x8e6a3f7b738ed2f9:0xe02 a5ebe5ac48f3a!2m2!1d-73.0313268!2d5.8117931?hl=es-ES.11. Audebert HJ, Kukla C, Clarmann von Claranau S, Kühn J, Vatankhah B, Schenkel J, et al. Telemedicine for safe and extended use of thrombolysis in stroke: the telemedic pilot project for integrative stroke care (TEMPiS) in Bavaria. Stroke. 2005;36(2):287–91 febrero de.12. Pinilla-Monsalve GD, Vergara-Aguilar JP, Machado-Noguera B, Gutiérrez-Baquero J, Cabezas-Vargas Z, Bejarano-Hernández J. Estudio de la epidemiología neurológica en Colombia a partir de información administrativa (ESENCIA). Resultados preliminares 2015–2017. Salud UIS [Internet]. 2021:53 20 de septiembre de. [citado 5 de junio de 2022]. Disponible en: https://revistas.uis. edu.co/index.php/revistasaluduis/article/view/11958.13. Kasab SA, Almallouhi E, Harvey JB, Girotra T, Debenham E, Turner N, et al. Long-term functional outcome for patients treated under drip and stay versus drip and ship paradigm: a single network experience. J Stroke. 2019;21(2):224–7 31 de mayo de.14. Moreno E, Rodríguez J, Bayona-Ortiz H. Trombólisis endovenosa como tratamiento del ACV isquémico agudo en Colombia: una revisión sistemática de la literatura. Acta Neurológica Colomb. 2019;35(3):156–66 18 de septiembre de.15. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke [Internet]. 2019;50(12) diciembre de. [citado 11 de septiembre de 2021]. Disponible en: https://www.ahajournals.org/doi/10.11 61/STR.0000000000000211.16. Tejada Meza H, Saldaña Inda I, Serrano Ponz M, Ara JR, Marta Moreno J. Impacto en los tiempos puerta-aguja de un conjunto de medidas para optimizar la atención hospitalaria del código ictus. Neurología. 2020 octubre de. S0213485320302735.17. López-Cancio E, Ribó M, Cardona P, Serena J, Purroy F, Palomeras E, et al. Telestroke in Catalonia: Increasing Thrombolysis Rate and Avoiding Interhospital Transfers. Cerebrovasc Dis. 2018;46(1–2):66–71.18. Fonarow GC, Smith EE, Saver JL, Reeves MJ, Hernandez AF, Peterson ED, et al. Improving Door-to-Needle Times in Acute Ischemic Stroke. Stroke. 2011;42(10):2983–9 octubre de.19. Brunser AM, Hoppe A, Muñoz P, Lavados PM, Illanes S, Díaz V, et al. Thrombolysis in stroke mimics: experience in 10 cases. Rev Médica Chile. 2016;144(10):1266–9 octubre de.20. Moulin S, Leys D. Stroke mimics and chameleons. Curr Opin Neurol. 2019;32(1):54–9 febrero de.21. Mohamed A, Fatima N, Shuaib A, Saqqur M. Comparison of faceto-face thrombolysis versus drip-and-ship models in treating patients with acute ischemic stroke: A systematic review and meta-analysis. Int J Stroke. 13 de mayo de 2021.22. Fiorelli M, Bastianello S, von Kummer R, del Zoppo GJ, Larrue V, Lesaffre E, et al. Hemorrhagic transformation within 36 hours of a cerebral infarct: relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort. Stroke. 1999;30(11):2280–4 noviembre de.23. Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet. 1998;352(9136):1245–51 octubre de.24. Waseem H, Salih YA, Burney CP, Abel MA, Riblet N, Kim A, et al. Efficacy and safety of the telestroke drip-and-stay model: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2021;30(4):105638 1 de abril de.25. Sairanen T, Soinila S, Nikkanen M, Rantanen K, Mustanoja S, Farkkila M, et al. Two years of Finnish telestroke: thrombolysis at spokes equal to that at the hub. 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ada en las Obras Colectivas.

b.	Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda.

c.	Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.
Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas. Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).

4. Restricciones.
La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:

a.	Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).

b.	Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.

c.	Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.

d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:

i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.

ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, los consagrados por la SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.

e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, ACINPRO), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.

5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

7. Término.

a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.

b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.

8. Varios.

a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.

b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.

c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.

d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.
 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