145 results on '"Frontera J"'
Search Results
2. P.392 Cerebellar influence on the thalamo-prefrontal firing patterns during fear extinction
- Author
-
Georgescu, I.A., primary, Sala, R., additional, Frontera, J., additional, Aissa, H. Baba, additional, Lena, C., additional, and Popa, D., additional
- Published
- 2020
- Full Text
- View/download PDF
3. Early platelet activation, inflammation and acute brain injury after a subarachnoid hemorrhage: a pilot study
- Author
-
FRONTERA, J. A., ALEDORT, L., GORDON, E., EGOROVA, N., MOYLE, H., PATEL, A., BEDERSON, J. B., and SEHBA, F.
- Published
- 2012
- Full Text
- View/download PDF
4. Regional Brain Monitoring in the Neurocritical Care Unit
- Author
-
Frontera J., Ziai W., O'Phelan K., Leroux P. D., Kirkpatrick P. J., Diringer M. N., Suarez J. I., Citerio Giuseppe, Frontera, J, Ziai, W, O'Phelan, K, Leroux, P, Kirkpatrick, P, Diringer, M, Suarez, J, and Citerio, G
- Subjects
Brain Diseases ,medicine.medical_specialty ,Neurology ,Critical Care ,business.industry ,Clinical exam ,Neurointensive care ,Context (language use) ,Brain monitoring ,Critical Care and Intensive Care Medicine ,Neurophysiological Monitoring ,Oxygen monitoring ,Cerebral blood flow ,Humans ,Medicine ,Brain tissue oxygenation, Cerebral blood flow, Microdialysis, Neurocritical care, Neuromonitoring ,Neurology (clinical) ,business ,Intensive care medicine ,Brain function - Abstract
Regional multimodality monitoring has evolved over the last several years as a tool to understand the mechanisms of brain injury and brain function at the cellular level. Multimodality monitoring offers an important augmentation to the clinical exam and is especially useful in comatose neurocritical care patients. Cerebral microdialysis, brain tissue oxygen monitoring, and cerebral blood flow monitoring all offer insight into permutations in brain chemistry and function that occur in the context of brain injury. These tools may allow for development of individual therapeutic strategies that are mechanistically driven and goal-directed. We present a summary of the discussions that took place during the Second Neurocritical Care Research Conference regarding regional brain monitoring.
- Published
- 2015
5. Combined transcranial direct current stimulation and breathing-controlled electrical stimulation for management of neuropathic pain after spinal cord injury
- Author
-
Li, S, primary, Stampas, A, additional, Frontera, J, additional, Davis, M, additional, and Li, S, additional
- Published
- 2018
- Full Text
- View/download PDF
6. Manejo del dolor en la fibrodisplasia osificante progresiva
- Author
-
Arén Frontera, J. J., López Garrido, J., Martínez Álvarez, L. J., Cordero López, J. L., and Ortiz Gómez, G. A.
- Subjects
Treatment. Dexamethasone ,Fibrodisplasia osificante progresiva ,Pain crisis ,Pregabalin ,Tratamiento ,Dexametasona ,Crisis dolor ,Pregabalina ,Fibrodysplasia ossificans progressiva - Abstract
La fibrodisplasia osificante progresiva es una enfermedad de escasa prevalencia, 1 caso cada 2 millones de habitantes, hereditaria, severamente incapacitante, caracterizada por un proceso de osificación en músculos esqueléticos, fascias, tendones y ligamentos, sin tratamiento eficaz y que evoluciona por empujes, que se acompañan de dolor intenso, dando lugar a posteriori, después de varios empujes, a la instalación de dolor basal permanente. Analizamos las características más salientes de la enfermedad, su historia habitual, su forma de presentación, su evolución, el dolor acompañante y su tratamiento. Este se realiza para combatir el dolor, ya que no existe tratamiento en el momento actual, para la enfermedad de fondo, y será variable de acuerdo al momento evolutivo de la misma, comenzándose con paracetamol y AINE en etapas iniciales, para dar lugar luego al uso de opioides. En lo que se refiere a las crisis de dolor, secundarias a brotes de osificación heterotópicos, existe consenso actualmente en cuanto a la utilización de corticoides de alta potencia antiinflamatoria. Siendo el dolor un hecho relevante en esta patología, no hemos encontrado ninguna publicación que lo aborde específicamente, por lo cual entendemos oportuna esta comunicación. Presentamos el caso de persona de 27 años, sexo femenino, portadora de fibrodisplasia osificante progresiva, controlada desde hace años en nuestra Unidad por sus crisis dolorosas severas, así como también por dolor basal instalado en los últimos años. Se relata la presentación de la enfermedad, su evolución, su estado actual, los tratamientos que se han realizado, así como el manejo de su última, reciente y más severa crisis de dolor, en base a dexametasona en altas dosis, y al uso de pregabalina como coadyuvante. Se concluye con recomendaciones para tratar los empujes dolorosos, basadas en el uso de corticoides, así como el manejo del dolor basal siempre presente en estos pacientes, fundamentado en el uso de opioides. The fibrodysplasia ossificans progressiva is a disease of low prevalence, 1 case per 2 million inhabitants, hereditary, severely disabling, characterized by a process of ossification in skeletal muscles, fascia, tendons and ligaments, without effective treatment, evolving by thrusts which are accompanied by severe pain, resulting in a posteriori, after several thrusts, to installing permanent baseline pain. We analyze the most salient features of the disease, common history, its presentation, its evolution, the accompanying pain and its treatment. This is done to combat the pain, since there is no treatment at present, for the underlying disease, and will vary according to the time course of the same, beginning itself with paracetamol and NSAIDs in early stages, giving rise then to the use of opioids. In regard to pain crises, buds secondary heterotopic ossification, currently there is consensus regarding the use of high potency anti-inflammatory corticosteroids. With pain as a relevant in this disease, we found no publication that specifically addresses; therefore we consider this presentation timely. We report the case of a person of 27 years, female gender, fibrodysplasia ossificans progressiva carrier controlled for years in our unit, for its severe painful crises and baseline pain also installed in recent years. We report the presentation of the disease, its evolution, its current status, as well as treatments that have been made, well as the handling of her latest, recent and more severe pain thrust, based on high-dose dexamethasone, and the use of pregabalin as an adjuvant. It concludes with recommendations for treating painful crises, based on the use of corticosteroids, and baseline pain management always present in these patients, based on the use of opioids.
- Published
- 2014
7. Degree of Collaterals and Not Time Is the Determining Factor of Core Infarct Volume within 6 Hours of Stroke Onset
- Author
-
Cheng-Ching, E., primary, Frontera, J. A., additional, Man, S., additional, Aoki, J., additional, Tateishi, Y., additional, Hui, F. K., additional, Wisco, D., additional, Ruggieri, P., additional, Hussain, M. S., additional, and Uchino, K., additional
- Published
- 2015
- Full Text
- View/download PDF
8. One-year monitoring of an oligonucleotide fluorescence in situ hybridization probe panel laboratory-developed test for bladder cancer detection
- Author
-
Knuth, Shannon, primary, Tinawi-Aljundi, Rima, additional, King, Lauren, additional, Gildea, Michael, additional, Ng, Carrie, additional, Kahl, Joshua, additional, Dion, Jacqueline, additional, Young, Christopher, additional, Schervish, Edward, additional, Frontera, J. Rene, additional, Hafron, Jason, additional, Kernen, Kenneth, additional, Di Loreto, Robert, additional, and Aurich-Costa, Joan, additional
- Published
- 2015
- Full Text
- View/download PDF
9. Manejo del dolor en la fibrodisplasia osificante progresiva
- Author
-
Arén Frontera, J. J., primary, López Garrido, J., additional, Martínez Álvarez, L. J., additional, Cordero López, J. L., additional, and Ortiz Gómez, G. A., additional
- Published
- 2014
- Full Text
- View/download PDF
10. MP69-20 HIGH PREDICTION RATE OF PROSTATE CANCER WITH MINIMALLY INVASIVE OLIGOFISH TEST
- Author
-
Hafron, Jason, primary, Gildea, Mike, additional, Kahl, Josh, additional, Aljundi, Rima, additional, Day, Jackie, additional, Yumpo, Paola, additional, Morgan, Peggy, additional, Lutz, Michael, additional, Frontera, J. Rene, additional, Ng, Carrie, additional, Dion, Jacqueline, additional, Young, Chris, additional, Knuth, Shannon, additional, Di Loreto, Robert, additional, Kernen, Kenneth, additional, and Aurich-Costa, Joan, additional
- Published
- 2014
- Full Text
- View/download PDF
11. Pediatric idiopathic transverse myelitis presenting as an anterior cord syndrome: A case report
- Author
-
Green, M., primary, Berliner, J., additional, and Frontera, J., additional
- Published
- 2012
- Full Text
- View/download PDF
12. Electrographic seizures and periodic discharges after intracerebral hemorrhage
- Author
-
Claassen, J., primary, Jette, N., additional, Chum, F., additional, Green, R., additional, Schmidt, M., additional, Choi, H., additional, Jirsch, J., additional, Frontera, J. A., additional, Connolly, E. S., additional, Emerson, R. G., additional, Mayer, S. A., additional, and Hirsch, L. J., additional
- Published
- 2007
- Full Text
- View/download PDF
13. One-year monitoring of an oligonucleotide fluorescence in situ hybridization probe panel laboratory-developed test for bladder cancer detection.
- Author
-
Tinawi-Aljundi, Rima, King, Lauren, Knuth, Shannon T., Gildea, Michael, Ng, Carrie, Kahl, Josh, Dion, Jacqueline, Young, Chris, Schervish, Edward W., Frontera, J. Rene, Hafron, Jason, Kernen, Kenneth M., Di Loreto, Robert, and Aurich-Costa, Joan
- Subjects
OLIGONUCLEOTIDES ,NUCLEOTIDES ,CPG nucleotides ,IN situ hybridization ,BLADDER cancer - Abstract
Background: Previously, we had developed and manufactured an oligonucleotide fluorescence in situ hybridization (OligoFISH) probe panel based on the most clinically sensitive chromosomes found in a reference set of bladder carcinoma cases. The panel was clinically validated for use as a diagnostic and monitoring assay for bladder cancer, reaching 100% correlation with the results of the UroVysion test. After 1 year of using this probe panel, we present here the comparison of cytology, cystoscopy, and pathology findings to the OligoFISH probe panel results to calculate its clinical performance. Materials and methods: In order to calculate clinical performance, we compared the OligoFISH results to the cytology and cystoscopy/pathology findings for 147 initial diagnoses and 399 recurrence monitorings. Finally, we compared clinical performance to published values for the UroVysion test, including both low- and high-grade tumors. Results: Chromosomes 3, 6, 7, and 20 were highly involved in bladder carcinoma aneuploidy. At the initial diagnosis, we obtained 90.5% (95% confidence interval [CI]: 84.5%-94.7%) accuracy, 96.8% sensitivity (95% CI: 91.0%-99.3%), 79.2% specificity (95% CI: 65.9%-87.8%), 89.2% positive predictive value (PPV; 95% CI: 81.5%-94.5%), and 93.3% negative predictive value (NPV; 95% CI: 81.7%-97.3%). When monitoring for recurrence, we obtained 85.2% accuracy (95% CI: 81.3%-88.5%), 82.0% sensitivity (95% CI: 76.0%-87.1%), 88.4% specificity (95% CI: 83.2%-92.5%), 87.7% PPV (95% CI: 82.1%-92.0%), and 83.0% NPV (95% CI: 77.3%-87.8%). When looking at low- and high-grade tumors, the test showed 100% sensitivity for high-grade tumors (95% CI: 92.5%-100%) and 87.5% sensitivity (95% CI: 68.8%-95.5%) for low-grade tumors. All the clinical parameters for the OligoFISH panel were higher than the UroVysion test' s published performance. We found significantly higher clinical sensitivity and NPV at initial diagnosis and significantly higher specificity and PPV for recurrence. Conclusion: The OligoFISH probe panel is a fast, easy, and reproducible test for bladder cancer diagnosis and monitoring, with excellent clinical performance and utility. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
14. Indicaciones del ultrasonido endoscopico en pediatria. Experiencia de 3 años
- Author
-
Frontera, J. and Fogel, R.
- Published
- 2005
15. El propofol administrado en sala de endoscopia a pacientes pediatricos ¿es seguro?
- Author
-
Frontera, J. and Fogel, R.
- Published
- 2005
16. Tratamiento endoscopico del reflujo gastroesofagico en pediatrÃa con endocinch II. Presentación del primer caso informado en Latinoamerica
- Author
-
Frontera, J. and Fogel, R.
- Published
- 2005
17. Acute trismus associated with Foix-Marie-Chavany syndrome
- Author
-
Frontera, J. A., primary and Palestrant, D., additional
- Published
- 2006
- Full Text
- View/download PDF
18. Cerebrovascular reactivity and vasospasm after subarachnoid hemorrhage: A pilot study
- Author
-
Frontera, J. A., primary, Rundek, T., additional, Schmidt, J. M., additional, Claassen, J., additional, Parra, A., additional, Wartenberg, K. E., additional, Temes, R. E., additional, Mayer, S. A., additional, Mohr, J. P., additional, and Marshall, R. S., additional
- Published
- 2006
- Full Text
- View/download PDF
19. P0735 CONGENITAL HYPERTROPHIC OESOPHAGEAL STENOSIS IN AN OLDER INFANT
- Author
-
Fogel, R., primary, Bonilla, Y., additional, and Frontera, J., additional
- Published
- 2004
- Full Text
- View/download PDF
20. P1030 EXPERIENCE IN PEDIATRIC ENDOSCOPIC ULTRASOUND AT THE HOSPITAL DE CLINICAS CARACAS ???PRELIMINARY REPORT
- Author
-
Fogel, R., primary, Frontera, J., additional, and Bonilla, Y., additional
- Published
- 2004
- Full Text
- View/download PDF
21. Right-Side Endocarditis in Injection Drug Users: Review of Proposed Mechanisms of Pathogenesis
- Author
-
Frontera, J. A., primary and Gradon, J. D., additional
- Published
- 2000
- Full Text
- View/download PDF
22. Seizures after Onyx Embolization for the Treatment of Cerebral Arteriovenous Malformation.
- Author
-
DE LOS REYES, K., PATEL, A., DOSHI, A., EGOROVA, N., PANOV, F., BEDERSON, J. B., and FRONTERA, J. A.
- Subjects
THERAPEUTIC embolization ,ARTERIOVENOUS malformation ,VASCULAR diseases ,HEMORRHAGE ,FEBRILE seizures - Abstract
Onyx embolization of cerebral arteriovenous malformations (AVM) has become increasingly common. We explored the risk of seizures after Onyx use. A retrospective review was conducted of 20 patients with supratentorial brain arteriovenous malformation (AVM) who received Onyx embolization between 2006 and 2009. Baseline demographics, clinical history, seizure history, AVM characteristics and treatment were compared between those who developed post-onyx seizure and those who did not. MRIs were reviewed for edema following Onyx treatment. Of 20 patients who underwent Onyx embolization, the initial AVM presentation was hemorrhage in 40% (N=8). The median number of embolizations was two (range 1-4) and the median final obliteration amount was 90% (range 50-100%). A history of seizure was present in 50% (N=10) of patients pre-embolization and 12 (60%) patients received seizure medications (treatment or prophylaxis) prior to embolization. Seizur post-Onyx embolization occurred in 45% (N=9). The median time to seizur post-Onyx was seven days (range 0.3-210). Four patients (20%) with seizures post-Onyx had no seizure history. Two of these patients (10%) had no other identifiable cause for seizure other than recent Onyx embolization. Seizures in these two patients occurred within 24 hours of Onyx administration. Among patients with post-Onyx seizures, there was a trend toward larger AVM size (P=0.091) and lower percent obliteration (P=0.062). Peri-AVM edema was present in 75% of MRIs performed within one month of Onyx treatment and may represent a possible etiology for seizures. New onset seizures post-Onyx embolization are not uncommon. Further study of seizure prevention is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
23. A novel nonpharmacological intervention – breathing-controlled electrical stimulation for neuropathic pain management after spinal cord injury – a preliminary study
- Author
-
Li S, Davis M, and Frontera JE
- Subjects
Neuromodulation ,Neuropathic pain ,spinal cord injury ,electrical stimulation ,BreEStim ,Medicine (General) ,R5-920 - Abstract
Shengai Li,1,2 Matthew Davis,1 Joel E Frontera,1 Sheng Li1,2 1Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, 2TIRR Memorial Hermann Research Center, TIRR Memorial Hermann Hospital, Houston, TX, USA Objective: The objective of this study was to examine the effectiveness of a novel nonpharmacological intervention – breathing-controlled electrical stimulation (BreEStim) – for neuropathic pain management in spinal cord injury (SCI) patients. Subjects and methods: There were two experiments: 1) to compare the effectiveness between BreEStim and conventional electrical stimulation (EStim) in Experiment (Exp) 1 and 2) to examine the dose–response effect of BreEStim in Exp 2. In Exp 1, 13 SCI subjects (6 males and 7 females, history of SCI: 58.2 months, from 7 to 150 months, impairments ranging from C4 AIS B to L1 AIS B) received both BreEStim and EStim in a randomized order with at least 3 days apart. A total of 120 electrical stimuli to the median nerve transcutaneously were triggered by voluntary inhalation during BreEStim or were randomly delivered during EStim. In Exp 2, a subset of 7 subjects received BreEStim120 and 240 stimuli randomly on two different days with 7 days apart (BreEStim120 vs BreEStim240). The primary outcome variable was the visual analog scale (VAS) score. Results: In Exp 1, both BreEStim and EStim showed significant analgesic effects. Reduction in VAS score was significantly greater after BreEStim (2.6±0.3) than after EStim (0.8±0.3) (P
- Published
- 2016
24. Immediate Primary Realignment of Prostatomembranous Urethral Disruptions Using Endourologic Techniques
- Author
-
Gheiler, E. L. and Frontera, J. R.
- Published
- 1997
- Full Text
- View/download PDF
25. La enseñanza profesional obligatoria en el extranjero
- Author
-
Frontera, J. M.
- Subjects
Ciencias de la Educación ,educación ,enseñanza - Abstract
Que las masas obreras están realmente necesitadas de las modernas enseñanzas, es cosa ya fuera de duda. Ahora, ¿cómo suministrar al obrero y al empleado de mañana y al futuro modesto agricultor la preparación para el concienzudo ejercicio de su profesión, que no pueden adquirir actualmente ni en el taller, ni en la fábrica, ni en el mostrador, ni en el almacén, ni en el campo? Nos hallamos, insisto, ante uno de los problemas que más seriamente han preocupado a los pueblos cultos, frente a una de las cuestiones más debatidas en el extranjero y que reclaman la atención de nuestro país y una pronta solución, si tratamos de hacer algo, y algo eficaz, aprovechando las circunstancias presentes., Departamento de Ciencias de la Educación
- Published
- 1916
26. Hyperglycemia and hyperinsulinemia in circulatory disorder after subarachnoid hemorrhage.
- Author
-
Tsuda K, Frontera J, Mayer S, and Tsuda, Kazushi
- Published
- 2006
- Full Text
- View/download PDF
27. The Curing Coma Campaign International Survey on Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER)
- Author
-
Helbok, Raimund, Rass, Verena, Beghi, Ettore, Bodien, Yelena G., Citerio, Giuseppe, Giacino, Joseph T., Kondziella, Daniel, Mayer, Stephan A., Menon, David, Sharshar, Tarek, Stevens, Robert D., Ulmer, Hanno, Venkatasubba Rao, Chethan P., Vespa, Paul, McNett, Molly, Frontera, Jennifer, Helbok, R, Rass, V, Beghi, E, Bodien, Y, Citerio, G, Giacino, J, Kondziella, D, Mayer, S, Menon, D, Sharshar, T, Stevens, R, Ulmer, H, Venkatasubba Rao, C, Vespa, P, Mcnett, M, and Frontera, J
- Subjects
Disorders of consciousness ,Critical care ,Cross-Sectional Studies ,Surveys and Questionnaires ,Aftercare ,Humans ,Glasgow Coma Scale ,Neurology (clinical) ,Coma ,Critical Care and Intensive Care Medicine ,Disorders of consciousne ,Survey ,Patient Discharge - Abstract
Background Although coma is commonly encountered in critical care, worldwide variability exists in diagnosis and management practices. We aimed to assess variability in coma definitions, etiologies, treatment strategies, and attitudes toward prognosis. Methods As part of the Neurocritical Care Society Curing Coma Campaign, between September 2020 and January 2021, we conducted an anonymous, international, cross-sectional global survey of health care professionals caring for patients with coma and disorders of consciousness in the acute, subacute, or chronic setting. Survey responses were solicited by sequential emails distributed by international neuroscience societies and social media. Fleiss κ values were calculated to assess agreement among respondents. Results The survey was completed by 258 health care professionals from 41 countries. Respondents predominantly were physicians (n = 213, 83%), were from the United States (n = 141, 55%), and represented academic centers (n = 231, 90%). Among eight predefined items, respondents identified the following cardinal features, in various combinations, that must be present to define coma: absence of wakefulness (81%, κ = 0.764); Glasgow Coma Score (GCS) ≤ 8 (64%, κ = 0.588); failure to respond purposefully to visual, verbal, or tactile stimuli (60%, κ = 0.552); and inability to follow commands (58%, κ = 0.529). Reported etiologies of coma encountered included medically induced coma (24%), traumatic brain injury (24%), intracerebral hemorrhage (21%), and cardiac arrest/hypoxic-ischemic encephalopathy (11%). The most common clinical assessment tools used for coma included the GCS (94%) and neurological examination (78%). Sixty-six percent of respondents routinely performed sedation interruption, in the absence of contraindications, for clinical coma assessments in the intensive care unit. Advanced neurological assessment techniques in comatose patients included quantitative electroencephalography (EEG)/connectivity analysis (16%), functional magnetic resonance imaging (7%), single-photon emission computerized tomography (6%), positron emission tomography (4%), invasive EEG (4%), and cerebral microdialysis (4%). The most commonly used neurostimulants included amantadine (51%), modafinil (37%), and methylphenidate (28%). The leading determinants for prognostication included etiology of coma, neurological examination findings, and neuroimaging. Fewer than 20% of respondents reported routine follow-up of coma survivors after hospital discharge; however, 86% indicated interest in future research initiatives that include postdischarge outcomes at six (85%) and 12 months (65%). Conclusions There is wide heterogeneity among health care professionals regarding the clinical definition of coma and limited routine use of advanced coma assessment techniques in acute care settings. Coma management practices vary across sites, and mechanisms for coordinated and sustained follow-up after acute treatment are inconsistent. There is an urgent need for the development of evidence-based guidelines and a collaborative, coordinated approach to advance both the science and the practice of coma management globally.
- Published
- 2022
28. Organ donation in adults: a critical care perspective
- Author
-
Jennifer A. Frontera, Sam D. Shemie, Franco Valenza, Beatriz Domínguez-Gil, Giuseppe Citerio, Marcelo Cypel, G. J. Dobb, Alex Manara, David M. Greer, Martin Smith, Eelco F. M. Wijdicks, Citerio, G, Cypel, M, Dobb, G, Dominguez Gil, B, Frontera, J, Greer, D, Manara, A, Shemie, S, Smith, M, Valenza, F, and Wijdicks, E
- Subjects
Adult ,Brain Death ,medicine.medical_specialty ,Tissue and Organ Procurement ,Care perspective ,Pain medicine ,Economic shortage ,Critical Care and Intensive Care Medicine ,Organ donation ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,Anesthesiology ,medicine ,Humans ,030212 general & internal medicine ,Intensive care medicine ,Donation after circulatory death ,Withholding Treatment ,business.industry ,030208 emergency & critical care medicine ,Heart Arrest ,Donation after brain death ,Transplantation ,Intensive Care Units ,surgical procedures, operative ,business - Abstract
Purpose: The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. Methods: We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Results: Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Conclusions: Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.
- Published
- 2016
29. Negative disease-related stigma 3-months after hemorrhagic stroke is related to functional outcome and female sex.
- Author
-
Pullano A, Melmed KR, Lord A, Olivera A, Frontera J, Brush B, Ishida K, Torres J, Zhang C, Dickstein L, Kahn E, Zhou T, and Lewis A
- Subjects
- Humans, Female, Male, Sex Factors, Middle Aged, Aged, Time Factors, Risk Factors, Subarachnoid Hemorrhage psychology, Subarachnoid Hemorrhage physiopathology, Subarachnoid Hemorrhage diagnosis, Health Knowledge, Attitudes, Practice, Recovery of Function, Social Stigma, Functional Status, Hemorrhagic Stroke diagnosis, Hemorrhagic Stroke psychology, Hemorrhagic Stroke physiopathology, Quality of Life, Disability Evaluation
- Abstract
Objectives: The objective of this study was to determine factors associated with negative disease-related stigma after hemorrhagic stroke., Materials and Methods: Patients with non-traumatic hemorrhage (ICH or SAH) admitted between January 2015 and February 2021 were assessed by telephone 3-months after discharge using the Quality of Life in Neurological Disorders (Neuro-QoL) Negative Disease-Related Stigma Short Form inventory. We evaluated the relationship between disease-related stigma (T-score >50) and pre-stroke demographics, admission data, and poor functional outcome (3-month mRS score 3-5 and Barthel Index <100)., Results: We included 89 patients (56 ICH and 33 SAH). The median age was 63 (IQR 50-69), 43 % were female, and 67 % graduated college. Admission median GCS score was 15 (IQR 13-15) and APACHE II score was 12 (IQR 9-17). 31 % had disease-related stigma. On univariate analysis, disease-related stigma was associated with female sex, non-completion of college, GCS score, APACHE II score, and 3-month mRS score (all p < 0.05). On multivariate analysis, disease-related stigma was associated with female sex (OR = 3.72, 95 % CI = 1.23-11.25, p = 0.02) and 3-month Barthel Index <100 (OR = 3.46, 95 % CI = 1.13-10.64, p = 0.03) on one model, and female sex (OR = 3.75, 95 % CI = 1.21-11.58, p = 0.02) and 3-month mRS score 3-5 (OR = 4.23, 95 % CI = 1.21-14.75, p = 0.02) on a second model., Conclusion: Functional outcome and female sex are associated with disease-related stigma 3-months after hemorrhagic stroke. Because stigma may negatively affect recovery, there is a need to understand the relationship between these factors to mitigate stroke-related stigma., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)
- Published
- 2024
- Full Text
- View/download PDF
30. An Exploratory Analysis of Preclinical and Clinical Factors Associated With Sleep Disturbance Assessed via the Neuro-QoL After Hemorrhagic Stroke.
- Author
-
Ecker S, Lord A, Gurin L, Olivera A, Ishida K, Melmed KR, Torres J, Zhang C, Frontera J, and Lewis A
- Abstract
Background and Purpose: Sleep disturbance after hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) can impact rehabilitation, recovery, and quality of life. We sought to explore preclinical and clinical factors associated with sleep disturbance after hemorrhagic stroke assessed via the Quality of Life in Neurological Disorders (Neuro-QoL) short form sleep disturbance inventory., Methods: We telephonically completed the Neuro-QoL short form sleep disturbance inventory 3-months and 12-months after hemorrhagic stroke for patients >18-years-old hospitalized between January 2015 and February 2021. We examined the relationship between sleep disturbance (T-score >50) and social and neuropsychiatric history, systemic and neurological illness severity, medical complications, and temporality., Results: The inventory was completed for 70 patients at 3-months and 39 patients at 12-months; 18 (26%) had sleep disturbance at 3-months and 11 (28%) had sleep disturbance at 12-months. There was moderate agreement (κ = .414) between sleep disturbance at 3-months and 12-months. Sleep disturbance at 3-months was related to unemployment/retirement prior to admission ( P = .043), lower Glasgow Coma Scale score on admission ( P = .021), higher NIHSS score on admission ( P = .041) and infection while hospitalized ( P = .036). On multivariate analysis, sleep disturbance at 3-months was related to unemployment/retirement prior to admission (OR 3.58 (95% CI 1.03-12.37), P = .044). Sleep disturbance at 12-months was related to premorbid mRS score ( P = .046)., Conclusion: This exploratory analysis did not demonstrate a sustained relationship between any preclinical or clinical factors and sleep disturbance after hemorrhagic stroke. Larger studies that include comparison to patients with ischemic stroke and healthy individuals and utilize additional techniques to evaluate sleep disturbance are needed., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)
- Published
- 2024
- Full Text
- View/download PDF
31. Factors Associated With Anxiety After Hemorrhagic Stroke.
- Author
-
Olivera A, Ecker S, Lord A, Gurin L, Ishida K, Melmed K, Torres J, Zhang C, Frontera J, and Lewis A
- Subjects
- Humans, Cerebral Hemorrhage complications, Cerebral Hemorrhage epidemiology, Quality of Life, Anxiety epidemiology, Anxiety etiology, Risk Factors, Hemorrhagic Stroke complications, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage epidemiology, Stroke complications, Stroke epidemiology
- Abstract
Objective: A significant number of patients develop anxiety after stroke. The objective of this study was to identify risk factors for anxiety after hemorrhagic stroke that may facilitate diagnosis and treatment., Methods: Patients admitted between January 2015 and February 2021 with nontraumatic hemorrhagic stroke (intracerebral [ICH] or subarachnoid [SAH] hemorrhage) were assessed telephonically 3 and 12 months after stroke with the Quality of Life in Neurological Disorders Anxiety Short Form to evaluate the relationships between poststroke anxiety (T score >50) and preclinical social and neuropsychiatric history, systemic and neurological illness severity, and in-hospital complications., Results: Of 71 patients who completed the 3-month assessment, 28 (39%) had anxiety. There was a difference in Glasgow Coma Scale (GCS) scores on admission between patients with anxiety (median=14, interquartile range [IQR]=12-15) and those without anxiety (median=15, IQR=14-15) (p=0.034), and the incidence of anxiety was higher among patients with ICH (50%) than among those with SAH (20%) (p=0.021). Among patients with ICH, anxiety was associated with larger median ICH volume (25 cc [IQR=8-46] versus 8 cc [IQR=3-13], p=0.021) and higher median ICH score (2 [IQR=1-3] versus 1 [IQR=0-1], p=0.037). On multivariable analysis with GCS score, hemorrhage type, and neuropsychiatric history, only hemorrhage type remained significant (odds ratio=3.77, 95% CI=1.19-12.05, p=0.024). Of the 39 patients who completed the 12-month assessment, 12 (31%) had anxiety, and there was a difference in mean National Institutes of Health Stroke Scale scores between patients with (5 [IQR=3-12]) and without (2 [IQR=0-4]) anxiety (p=0.045). There was fair agreement (κ=0.38) between the presence of anxiety at 3 and 12 months., Conclusions: Hemorrhage characteristics and factors assessed with neurological examination on admission are associated with the development of poststroke anxiety., Competing Interests: The authors report no financial relationships with commercial interests.
- Published
- 2024
- Full Text
- View/download PDF
32. Predicting hematoma expansion using machine learning: An exploratory analysis of the ATACH 2 trial.
- Author
-
Kumar A, Witsch J, Frontera J, Qureshi AI, Oermann E, Yaghi S, and Melmed KR
- Subjects
- Humans, Male, Aged, Middle Aged, Female, Antihypertensive Agents therapeutic use, Disease Progression, Machine Learning, Cerebral Hemorrhage diagnostic imaging, Hematoma diagnostic imaging
- Abstract
Introduction: Hematoma expansion (HE) in patients with intracerebral hemorrhage (ICH) is a key predictor of poor prognosis and potentially amenable to treatment. This study aimed to build a classification model to predict HE in patients with ICH using deep learning algorithms without using advanced radiological features., Methods: Data from the ATACH-2 trial (Antihypertensive Treatment of Acute Cerebral Hemorrhage) was utilized. Variables included in the models were chosen as per literature consensus on salient variables associated with HE. HE was defined as increase in either >33% or 6 mL in hematoma volume in the first 24 h. Multiple machine learning algorithms were employed using iterative feature selection and outcome balancing methods. 70% of patients were used for training and 30% for internal validation. We compared the ML models to a logistic regression model and calculated AUC, accuracy, sensitivity and specificity for the internal validation models respective models., Results: Among 1000 patients included in the ATACH-2 trial, 924 had the complete parameters which were included in the analytical cohort. The median [interquartile range (IQR)] initial hematoma volume was 9.93.mm
3 [5.03-18.17] and 25.2% had HE. The best performing model across all feature selection groups and sampling cohorts was using an artificial neural network (ANN) for HE in the testing cohort with AUC 0.702 [95% CI, 0.631-0.774] with 8 hidden layer nodes The traditional logistic regression yielded AUC 0.658 [95% CI, 0.641-0.675]. All other models performed with less accuracy and lower AUC. Initial hematoma volume, time to initial CT head, and initial SBP emerged as most relevant variables across all best performing models., Conclusion: We developed multiple ML algorithms to predict HE with the ANN classifying the best without advanced radiographic features, although the AUC was only modestly better than other models. A larger, more heterogenous dataset is needed to further build and better generalize the models., (Copyright © 2024. Published by Elsevier B.V.)- Published
- 2024
- Full Text
- View/download PDF
33. External validation of the SI 2 NCAL 2 C score for outcomes following cerebral venous thrombosis.
- Author
-
Klein P, Shu L, Lindgren E, de Winter MA, Siegler JE, Simpkins AN, Omran SS, Heldner MR, de Havenon A, Abdalkader M, Al Kasab S, Stretz C, Wu TY, Wilson D, Asad SD, Almallouhi E, Frontera J, Kuohn L, Rothstein A, Bakradze E, Henninger N, Zubair AS, Sharma R, Kerrigan D, Aziz Y, Mistry EA, van Kammen MS, Tatlisumak T, Krzywicka K, Aguiar de Sousa D, Jood K, Field TS, Yaghi S, Coutinho JM, and Nguyen TN
- Subjects
- Humans, Female, Male, Middle Aged, Retrospective Studies, Risk Factors, Adult, Reproducibility of Results, Time Factors, Prognosis, Aged, Decision Support Techniques, Risk Assessment, Venous Thrombosis mortality, Venous Thrombosis diagnosis, Venous Thrombosis therapy, Predictive Value of Tests, Disability Evaluation, Intracranial Thrombosis mortality, Intracranial Thrombosis diagnosis, Intracranial Thrombosis therapy, Functional Status
- Abstract
Objectives: Prognostication for cerebral venous thrombosis (CVT) remains difficult. We sought to validate the SI
2 NCAL2 C score in an international cohort., Materials and Methods: The SI2 NCAL2 C score was originally developed to predict poor outcome (modified Rankin Scale (mRS) 3-6) at 6 months, and mortality at 30 days and 1 year using data from the International CVT Consortium. The SI2 NCAL2 C score uses 9 variables: the absence of any female-sex-specific risk factors, intracerebral hemorrhage, central nervous system infection, focal neurological deficits, coma, age, lower level of hemoglobin, higher level of glucose, and cancer. The ACTION-CVT study was an international retrospective study that enrolled consecutive patients across 27 centers. The poor outcome score was validated using 90-day mRS due to lack of follow-up at the 6-month time-point in the ACTION-CVT cohort. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and calibration plots. Missing data were imputed using the additive regression and predictive mean matching methods. Bootstrapping was performed with 1000 iterations., Results: Mortality data were available for 950 patients and poor outcome data were available for 587 of 1,025 patients enrolled in ACTION-CVT. Compared to the International CVT Consortium, the ACTION-CVT cohort was older, less often female, and with milder clinical presentation. Mortality was 2.5% by 30 days and 6.0% by one year. At 90-days, 16.7% had a poor outcome. The SI2 NCAL2 C score had an AUC of 0.74 [95% CI 0.69-0.79] for 90-day poor outcome, 0.72 [0.60-0.82] for mortality by 30 days, and 0.82 [0.76-0.88] for mortality by one year., Conclusions: The SI2 NCAL2 C score had acceptable to good performance in an international external validation cohort. The SI2 NCAL2 C score warrants additional validation studies in diverse populations and clinical implementation studies., Competing Interests: Declaration of competing interest Thanh Nguyen reports research support from Medtronic and the Society of Vascular and Interventional Neurology; advisory board with Brainomix, Aruna Bio; Associate Editor of Stroke. Erik Lindgren reports research support from the Swedish state, ALF agreement (ALFGBG 942851), the Swedish Neurological Society, Elsa and Gustav Lindh's Foundation, Wennerström's Foundation, P-O Ahl's Foundation, and the Rune and Ulla Amlöv's Foundation. Katarina Jood reports research support from the Swedish state ALF agreement (ALFGBG-965417). Mirjam R. Heldner reports grants from SITEM Research Support Funds and Swiss National Science Foundation, Swiss Heart Foundation, not directly related to this manuscript. Thalia S Field reports honoraria for advisory board work for HLS Therapeutics, Roche Canada, AstraZeneca, in-kind study medication from Bayer Canada, is on the board of DESTINE Health, and is supported by a Heart and Stroke/Sauder Family Professorship of Stroke Research at the University of British Columbia. Christoph Stretz reports departmental funding (funds managed by Rhode Island Hospital) for his site's participation in the Neuro AFib study from Massachusetts General Hospital/BSC. Nils Henninger was supported by NINDS R21NS131756 during the conduct of this study (unrelated). Turgut Tatlisumak serves or has served on advisory boards for Astra Zeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Inventiva, and Portola Pharma and received research funding from European Union, Sahlgrenska University Hospital, University of Gothenburg, and Wennerström's Foundation. Diana Aguiar de Sousa reports advisory board participation for Astrazenica, Organon, and Johnson & Johnson, speaker fees from Bial, Bayer, and Astrazeneca, and DSMB participation for the SECRET trial (all unrelated)., (Copyright © 2024. Published by Elsevier Inc.)- Published
- 2024
- Full Text
- View/download PDF
34. Prevalence and Associations of Dural Arteriovenous Fistulae in Cerebral Venous Thrombosis: Analysis of ACTION-CVT.
- Author
-
Shoskes A, Shu L, Nguyen TN, Abdalkader M, Giles J, Amar J, Siegler JE, Henninger N, ElNazeir M, Kasab SA, Klein P, Heldner MR, Antonenko K, Psychogios M, Liebeskind DS, Field T, Liberman A, Esenwa C, Simpkins A, Li G, Frontera J, Kuohn L, Rothstein A, Khazaal O, Aziz Y, Mistry E, Khatri P, Omran SS, Zubair AS, Sharma R, Starke RM, Morcos JJ, Romano JG, Yaghi S, and Asdaghi N
- Published
- 2024
- Full Text
- View/download PDF
35. Relationship Between Hemorrhage Type and Development of Emotional and Behavioral Dyscontrol After Hemorrhagic Stroke.
- Author
-
Talmasov D, Kelly S, Ecker S, Olivera A, Lord A, Gurin L, Ishida K, Melmed K, Torres J, Zhang C, Frontera J, and Lewis A
- Abstract
Objective: Emotional and behavioral dyscontrol (EBD), a neuropsychiatric complication of stroke, leads to patient and caregiver distress and challenges to rehabilitation. Studies of neuropsychiatric sequelae in stroke are heavily weighted toward ischemic stroke. This study was designed to compare risk of EBD following intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) and to identify risk factors for EBD following hemorrhagic stroke., Methods: The authors conducted a prospective cohort study of patients hospitalized for nontraumatic hemorrhagic stroke between 2015 and 2021. Patients or legally authorized representatives completed the Quality of Life in Neurological Disorders (Neuro-QOL) EBD short-form inventory 3 months after hospitalization. Univariable and multivariable analyses identified risk factors for EBD after hemorrhagic stroke., Results: The incidence of EBD was 21% (N=15 of 72 patients) at 3 months after hemorrhagic stroke. Patients with ICH were more likely to develop EBD; 93% of patients with EBD (N=14 of 15) had ICH compared with 56% of patients without EBD (N=32 of 57). The median Glasgow Coma Scale (GCS) score at hospital admission was lower among patients who developed EBD (13 vs. 15 among those without EBD). Similarly, admission scores on the National Institutes of Health Stroke Scale (NIHSS) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) were higher among patients with EBD (median NIHSS score: 7 vs. 2; median APACHE II score: 17 vs. 11). Multivariable analyses identified hemorrhage type (ICH) and poor admission GCS score as predictors of EBD 3 months after hemorrhagic stroke., Conclusions: Patients with ICH and a low GCS score at admission are at increased risk of developing EBD 3 months after hemorrhagic stroke and may benefit from early intervention., Competing Interests: The authors report no financial relationships with commercial interests.
- Published
- 2024
- Full Text
- View/download PDF
36. Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection: The STOP-CAD Study.
- Author
-
Yaghi S, Shu L, Mandel D, Leon Guerrero CR, Henninger N, Muppa J, Affan M, Ul Haq Lodhi O, Heldner MR, Antonenko K, Seiffge D, Arnold M, Salehi Omran S, Crandall R, Lester E, Lopez Mena D, Arauz A, Nehme A, Boulanger M, Touze E, Sousa JA, Sargento-Freitas J, Barata V, Castro-Chaves P, Brito MT, Khan M, Mallick D, Rothstein A, Khazaal O, Kaufmann JE, Engelter ST, Traenka C, Aguiar de Sousa D, Soares M, Rosa S, Zhou LW, Gandhi P, Field TS, Mancini S, Metanis I, Leker RR, Pan K, Dantu V, Baumgartner K, Burton T, Von Rennenberg R, Nolte CH, Choi R, MacDonald J, Bavarsad Shahripour R, Guo X, Ghannam M, Almajali M, Samaniego EA, Sanchez S, Rioux B, Zine-Eddine F, Poppe A, Fonseca AC, Baptista MF, Cruz D, Romoli M, De Marco G, Longoni M, Keser Z, Griffin K, Kuohn L, Frontera J, Amar J, Giles J, Zedde M, Pascarella R, Grisendi I, Nzwalo H, Liebeskind DS, Molaie A, Cavalier A, Kam W, Mac Grory B, Al Kasab S, Anadani M, Kicielinski K, Eltatawy A, Chervak L, Chulluncuy-Rivas R, Aziz Y, Bakradze E, Tran TL, Rodrigo-Gisbert M, Requena M, Saleh Velez F, Ortiz Gracia J, Mudassani V, de Havenon A, Vishnu VY, Yaddanapudi S, Adams L, Browngoehl A, Ranasinghe T, Dunston R, Lynch Z, Penckofer M, Siegler J, Mayer S, Willey J, Zubair A, Cheng YK, Sharma R, Marto JP, Mendes Ferreira V, Klein P, Nguyen TN, Asad SD, Sarwat Z, Balabhadra A, Patel S, Secchi T, Martins S, Mantovani G, Kim YD, Krishnaiah B, Elangovan C, Lingam S, Quereshi A, Fridman S, Alvarado A, Khasiyev F, Linares G, Mannino M, Terruso V, Vassilopoulou S, Tentolouris V, Martinez-Marino M, Carrasco Wall V, Indraswari F, El Jamal S, Liu S, Alvi M, Ali F, Sarvath M, Morsi RZ, Kass-Hout T, Shi F, Zhang J, Sokhi D, Said J, Simpkins AN, Gomez R, Sen S, Ghani M, Elnazeir M, Xiao H, Kala N, Khan F, Stretz C, Mohammadzadeh N, Goldstein E, and Furie K
- Subjects
- Humans, Platelet Aggregation Inhibitors therapeutic use, Anticoagulants therapeutic use, Fibrinolytic Agents therapeutic use, Retrospective Studies, Hemorrhage chemically induced, Arteries, Treatment Outcome, Carotid Artery, Internal, Dissection complications, Carotid Artery, Internal, Dissection drug therapy, Stroke epidemiology, Stroke etiology, Stroke prevention & control, Ischemic Stroke drug therapy, Aortic Dissection, Atrial Fibrillation complications
- Abstract
Background: Small, randomized trials of patients with cervical artery dissection showed conflicting results regarding optimal stroke prevention strategies. We aimed to compare outcomes in patients with cervical artery dissection treated with antiplatelets versus anticoagulation., Methods: This is a multicenter observational retrospective international study (16 countries, 63 sites) that included patients with cervical artery dissection without major trauma. The exposure was antithrombotic treatment type (anticoagulation versus antiplatelets), and outcomes were subsequent ischemic stroke and major hemorrhage (intracranial or extracranial hemorrhage). We used adjusted Cox regression with inverse probability of treatment weighting to determine associations between anticoagulation and study outcomes within 30 and 180 days. The main analysis used an as-treated crossover approach and only included outcomes occurring with the above treatments., Results: The study included 3636 patients (402 [11.1%] received exclusively anticoagulation and 2453 [67.5%] received exclusively antiplatelets). By day 180, there were 162 new ischemic strokes (4.4%) and 28 major hemorrhages (0.8%); 87.0% of ischemic strokes occurred by day 30. In adjusted Cox regression with inverse probability of treatment weighting, compared with antiplatelet therapy, anticoagulation was associated with a nonsignificantly lower risk of subsequent ischemic stroke by day 30 (adjusted hazard ratio [HR], 0.71 [95% CI, 0.45-1.12]; P =0.145) and by day 180 (adjusted HR, 0.80 [95% CI, 0.28-2.24]; P =0.670). Anticoagulation therapy was not associated with a higher risk of major hemorrhage by day 30 (adjusted HR, 1.39 [95% CI, 0.35-5.45]; P =0.637) but was by day 180 (adjusted HR, 5.56 [95% CI, 1.53-20.13]; P =0.009). In interaction analyses, patients with occlusive dissection had significantly lower ischemic stroke risk with anticoagulation (adjusted HR, 0.40 [95% CI, 0.18-0.88]; P
interaction =0.009)., Conclusions: Our study does not rule out the benefit of anticoagulation in reducing ischemic stroke risk, particularly in patients with occlusive dissection. If anticoagulation is chosen, it seems reasonable to switch to antiplatelet therapy before 180 days to lower the risk of major bleeding. Large prospective studies are needed to validate our findings., Competing Interests: Disclosures Disclosures provided by Dr Nguyen in compliance with American Heart Association annual Journal Editor Disclosure Questionnaire are available at https://www.ahajournals.org/editor-coi-disclosures. Dr Arnold reports compensation from Boehringer Ingelheim, AstraZeneca, Bayer, Bristol-Myers Squibb, Covidien, Daiichi Sankyo, Novartis, Sanofi, Pfizer, Medtronic, Novo Nordisk, and Amgen for consultant services. Dr Lester reports a provisional patent for Methods and compositions for disrupting tau aggregates. Dr Touze reports compensation from Elsevier for other services and employment by Caen. J.E. Kaufman reports grants from Goldschmidt Jacobson-Stiftung. Dr Traenka reports travel support from Bayer Healthcare. Dr Aguiar de Sousa reports compensation from Daiichi Sankyo, Bayer, AstraZeneca, Johnson & Johnson, and Fundação Bial for other services; compensation from the University of British Columbia for data and safety monitoring services; compensation from Organon & Co for consultant services. Dr Rosa reports grants from Merck Sharp & Dohme Corporation. Dr Field reports compensation from HLS Therapeutics, AstraZeneca Canada, and Roche for consultant services; service as a board member for Destine Health; and compensation from the Canadian Medical Protective Association for expert witness services; and grants from Bayer. Dr Leker reports compensation from Medtronic, Ischemaview, Bayer, Abbott Diabetes Care, Biogen, Janssen Biotech, and Boehringer Ingelheim for other services. Dr Nolte reports compensation from Daiichi Sankyo Europe GmbH, Boehringer Ingelheim, Pfizer, Bristol-Myers Squibb, and Alexion Pharmaceuticals for consultant services; and compensation from AstraZeneca, Abbott Canada, Deutsches Zentrum für Neurodegenerative Erkrankungen, Novartis, Portola Pharmaceuticals, Deutsches Zentrum für Herz-Kreislaufforschung, and Novartis for other services. Dr Poppe reports grants from Foundation Brain Canada, Heart and Stroke Foundation of Canada, and Stryker; and compensation from Roche for other services. Dr Liebeskind reports compensation from Medtronic, Genentech, Cerenovus, Stryker, and Rapid Medical Ltd, for consultant services. B. Mac Grory reports grants from the National Institutes of Health; employment by Duke University Medical Center; compensation from Bayer for other services; grants from the American Heart Association, Duke Bass Connections, and the Duke Office of Physician Scientist Development. Dr Al Kasab reports compensation from Stryker for other services and employment by Medical University of South Carolina. Dr Kicielinski reports compensation from Stryker, Penumbra Inc, Medtronic, and MicroVention Inc, for other services; travel support from MicroVention Inc; and employment by Medical University of South Carolina and Elsevier. Dr de Havenon reports stock options in TitinKM and Certus; grants from the National Institutes of Health; and compensation from Novo Nordisk for consultant services. Dr Siegler reports grants from Philips and employment by the University of Chicago. Dr Willey reports compensation from Edwards Lifesciences Corporation and Abbott Fund for end point review committee services; compensation from Uptodate for other services; and compensation from the Abbott Laboratories for consultant services. Dr Sharma reports a provisional patent for a stroke etiology classifier algorithm and grants from the National Institutes of Health Clinical Center. Dr Martins reports compensation from Pfizer, Medtronic, Servier Affaires Medicales, Daiichi Sankyo, Bayer, Novo Nordisk, Novartis, Penumbra Inc, and Boehringer Ingelheim for other services. Dr Simpkins reports grants from the National Institutes of Health. Dr Stretz reports grants from Massachusetts General Hospital. Dr Furie reports compensation from Janssen Biotech for consultant services. The other authors report no conflicts- Published
- 2024
- Full Text
- View/download PDF
37. Editorial: Distributed networks: new outlooks on cerebellar function, volume II.
- Author
-
Apps R, Frontera J, Mapelli L, and Watson T
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
- Published
- 2024
- Full Text
- View/download PDF
38. The American Society of Transplant Surgeons Consensus Statement on Normothermic Regional Perfusion.
- Author
-
Wall AE, Adams BL, Brubaker A, Chang CWJ, Croome KP, Frontera J, Gordon E, Hoffman J, Kaplan LJ, Kumar D, Levisky J, Miñambres E, Parent B, Watson C, Zemmar A, and Pomfret EA
- Subjects
- Humans, Perfusion, Consensus, Critical Care, Tissue Donors, Surgeons
- Abstract
On June 3, 2023, the American Society of Transplant Surgeons convened a meeting in San Diego, California to (1) develop a consensus statement with supporting data on the ethical tenets of thoracoabdominal normothermic regional perfusion (NRP) and abdominal NRP; (2) provide guidelines for the standards of practice that should govern thoracoabdominal NRP and abdominal NRP; and (3) develop and implement a central database for the collection of NRP donor and recipient data in the United States. National and international leaders in the fields of neuroscience, transplantation, critical care, NRP, Organ Procurement Organizations, transplant centers, and donor families participated. The conference was designed to focus on the controversial issues of neurological flow and function in donation after circulatory death donors during NRP and propose technical standards necessary to ensure that this procedure is performed safely and effectively. This article discusses major topics and conclusions addressed at the meeting., Competing Interests: E.A.P. is the current President of the American Society of Transplant Surgeons. The other authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
39. Continued Infarction Growth and Penumbral Consumption After Reperfusion in Vaccine-Naive Patients With COVID-19: A Case-Control Study.
- Author
-
Dehkharghani S, Vogel A, Jandhyala N, Chung C, Shu L, Frontera J, and Yaghi S
- Subjects
- Male, Humans, Female, Middle Aged, Aged, Aged, 80 and over, Case-Control Studies, Retrospective Studies, Tomography, X-Ray Computed methods, SARS-CoV-2, Infarction, Reperfusion methods, Treatment Outcome, Stroke therapy, Brain Ischemia therapy, Ischemic Stroke diagnostic imaging, COVID-19, Endovascular Procedures methods
- Abstract
BACKGROUND. Neurologic sequelae of SARS-CoV-2 include potentially malignant cerebrovascular events arising from complex hemodynamic, hematologic, and inflammatory processes occurring in concert. OBJECTIVE. This study concerns the hypothesis that despite angiographic reperfusion COVID-19 promotes continued consumption of at-risk tissue volumes after acute ischemic stroke (AIS), yielding critical insights into prognostication and monitoring paradigms in vaccine-naive patients experiencing AIS. METHODS. This retrospective study compared 100 consecutive COVID-19 patients with AIS presenting between March 2020 and April 2021 with a contemporaneous cohort of 282 AIS patients without COVID-19. Reperfusion classes were dichotomized into positive (extended thrombolysis in cerebral ischemia [eTICI] score = 2c-3) and negative (eTICI score < 2c) groups. All patients underwent endovascular therapy after initial CT perfusion imaging (CTP) to document infarction core and total hypoperfusion volumes. RESULTS. Ten COVID-positive (mean age ± SD, 67 ± 12 years; seven men, three women) and 144 COVID-negative patients (mean age, 71 ± 16 years; 76 men, 68 women) undergoing endovascular reperfusion, with antecedent CTP and follow-up imaging, comprised the final dataset. Initial infarction core and total hypoperfusion volumes (mean ± SD) were 1.5 ± 18 mL and 85 ± 100 mL in COVID-negative patients and 30.5 ± 34 mL and 117 ± 80.5 mL in COVID-positive patients, respectively. Final infarction volumes were significantly larger in patients with COVID-19, with median volumes of 77.8 mL versus 18.2 mL among control patients ( p = .01), as were normalized measures of infarction growth relative to baseline infarction volume ( p = .05). In adjusted logistic parametric regression models, COVID positivity emerged as a significant predictor for continued infarct growth (OR, 5.10 [95% CI, 1.00-25.95]; p = .05). CONCLUSION. These findings support the potentially aggressive clinical course of cerebrovascular events in patients with COVID-19, suggesting greater infarction growth and ongoing consumption of at-risk tissues, even after angiographic reperfusion. CLINICAL IMPACT. SARS-CoV-2 infection may promote continued infarction progression despite angiographic reperfusion in vaccine-naive patients with large-vessel occlusion AIS. The findings carry potential implications for prognostication, treatment selection, and surveillance for infarction growth among revascularized patients in future waves of infection by novel viral strains.
- Published
- 2023
- Full Text
- View/download PDF
40. Corrigendum to "Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study" [Journal of the Neurological Sciences. 2023 Jun 15;449:120646].
- Author
-
Tamborska AA, Wood GK, Westenberg E, Garcia-Azorin D, Webb G, Schiess N, Netravathi M, Baykan B, Dervaj R, Helbok R, Lant S, Özge A, Padovani A, Saylor D, Schmutzhard E, Easton A, Lilleker JB, Jackson T, Beghi E, Ellul MA, Frontera JA, Pollak T, Nicholson TR, Wood N, Thakur KT, Solomon T, Stark RJ, Winkler AS, and Michael BD
- Published
- 2023
- Full Text
- View/download PDF
41. Perioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation.
- Author
-
Shu L, Jiang W, Xiao H, Henninger N, Nguyen TN, Siegler JE, de Havenon A, Goldstein ED, Mandel D, Rana M, Al-Mufti F, Frontera J, Furie K, and Yaghi S
- Subjects
- Adult, Humans, Female, Aged, Male, Risk Assessment methods, Risk Factors, Atrial Fibrillation complications, Atrial Fibrillation epidemiology, Atrial Fibrillation surgery, Ischemic Stroke complications, Stroke epidemiology, Stroke etiology, Stroke diagnosis
- Abstract
Objective: Anticoagulation therapy is commonly interrupted in patients with atrial fibrillation (AF) for elective procedures. However, the risk factors of acute ischemic stroke (AIS) during the periprocedural period remain uncertain. We performed a nationwide analysis to evaluate AIS risk factors in patients with AF undergoing elective surgical procedures., Methods: Using the Nationwide Readmission Database, we included electively admitted adult patients with AF and procedural Diagnosis-Related Group codes from 2016 to 2019. Diagnoses were identified based on International Classification of Disease, 9th revision-Clinical Modification (ICD-10 CM) codes. We constructed a logistic regression model to identify risk factors and developed a new scoring system incorporating CHA
2 DS2 VASc to estimate periprocedural AIS risk., Results: Of the 1,045,293 patients with AF admitted for an elective procedure, the mean age was 71.5 years, 39.2% were women, and 0.70% had a perioperative AIS during the index admission or within 30 days of discharge. Active cancer (adjusted OR [aOR] = 1.58, 95% confidence interval [CI] = 1.42-1.76), renal failure (aOR = 1.14, 95% CI = 1.04-1.24), neurological surgery (aOR = 4.51, 95% CI = 3.84-5.30), cardiovascular surgery (aOR = 2.74, 95% CI = 2.52-2.97), and higher CHA2 DS2 VASc scores (aOR 1.25 per point, 95% CI 1.22-1.29) were significant risk factors for periprocedural AIS. The new scoring system (area under the receiver operating characteristic curve [AUC] = 0.68, 95% CI = 0.67 to 0.79) incorporating surgical type and cancer outperformed CHA2 DS2 VASc (AUC = 0.60, 95% CI = 0.60 to 0.61)., Interpretation: In patients with AF, periprocedural AIS risk increases with the CHA2 DS2 VASc score, active cancer, and cardiovascular or neurological surgeries. Studies are needed to devise better strategies to mitigate perioperative AIS risk in these patients. ANN NEUROL 2023;94:321-329., (© 2023 American Neurological Association.)- Published
- 2023
- Full Text
- View/download PDF
42. Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study.
- Author
-
Tamborska AA, Wood GK, Westenberg E, Garcia-Azorin D, Webb G, Schiess N, Netravathi M, Baykan B, Dervaj R, Helbok R, Lant S, Özge A, Padovani A, Saylor D, Schmutzhard E, Easton A, Lilleker JB, Jackson T, Beghi E, Ellul MA, Frontera JA, Pollak T, Nicholson TR, Wood N, Thakur KT, Solomon T, Stark RJ, Winkler AS, and Michael BD
- Subjects
- Humans, SARS-CoV-2, Observer Variation, Uncertainty, Headache diagnosis, Headache etiology, COVID-19 Testing, COVID-19 complications, COVID-19 diagnosis, Nervous System Diseases etiology, Nervous System Diseases complications, Encephalitis complications, Guillain-Barre Syndrome diagnosis, Guillain-Barre Syndrome complications
- Abstract
Introduction: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARS-CoV-2 in neurological syndromes, which risks under- or over-reporting., Methods: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (κ ≤ 0.4), "moderate" or "good" (κ > 0.6)., Results: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barré syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). Good inter-rater agreement was observed for five diagnoses: cranial neuropathy, headache, myelitis, CVST, and GBS and poor agreement for encephalopathy. In 13% of vignettes, clinicians incorrectly assigned lowest association ranks, regardless of setting and specialty., Conclusion: The case definitions can help with reporting of neurological complications of SARS-CoV-2, also in settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed, and clinicians underestimated the association with SARS-CoV-2. Future work should refine the case definitions and provide training if global reporting of neurological syndromes associated with SARS-CoV-2 is to be robust., Competing Interests: Declaration of Competing Interest KTT is an external consultant at the World Health Organization and the Clinical Immunization Safety Assessment Committee, CDC. BDM is an external consultant at the World Health Organization., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
43. Training Characteristics, Academic Accomplishments, and Motivation of Current Program Directors in Physical Medicine and Rehabilitation.
- Author
-
Martinez CI, Sanchez AN, Frontera J, Lee MY, Escalon MX, and Verduzco-Gutierrez M
- Subjects
- Humans, Male, Female, United States, Motivation, Surveys and Questionnaires, Internship and Residency, Medicine, Physical and Rehabilitation Medicine
- Abstract
Abstract: This study aimed to report the training characteristics, academic accomplishments, and motivation of current US academic physical medicine and rehabilitation program directors.A 22-question survey was developed and disseminated via email in May 2020 to 91 current residency program directors who are members of the Association of Academic Physiatrists Residency Fellowship Program Director Committee. Follow-up emails were sent 2 and 4 wks after initial distribution, and the survey was closed after 6 wks in June 2020. Data collected were deidentified. Descriptive analysis was performed.Response rate was 49.5% (45/91); 64.4% of program directors were men, and 35.6% were women. Of the respondents, 75.4% were White/Caucasian, 6.7% were Hispanic/Latinx, 15.6% were Asian, and 2.2% were Black/African American. Moreover, 56% (9/16) of female program directors vs. 0% (0/29) of male program directors reported experiencing sex discrimination in the workplace.Four percent of program directors were full professors in physical medicine and rehabilitation when first appointed, 17% were associate professors, and 72% were assistant professors. Thirty-four percent of program directors had at least six peer-reviewed publications when first appointed.This survey provides insight to the training characteristics, accomplishments, and motivation of current program directors for physiatrists aspiring to enter these ranks and highlights the underrepresentation of women/minorities among leadership positions in physical medicine and rehabilitation., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
44. Author Response: Trajectories of Neurologic Recovery 12 Months After Hospitalization for COVID-19: A Prospective Longitudinal Study.
- Author
-
Frontera J
- Subjects
- Humans, Prospective Studies, Longitudinal Studies, Hospitalization, Activities of Daily Living, COVID-19
- Published
- 2023
- Full Text
- View/download PDF
45. Trends in Venous Thromboembolism Readmission Rates after Ischemic Stroke and Intracerebral Hemorrhage.
- Author
-
Shu L, Havenon A, Liberman AL, Henninger N, Goldstein E, Reznik ME, Mahta A, Al-Mufti F, Frontera J, Furie K, and Yaghi S
- Abstract
Background and Purpose: Venous thromboembolism (VTE) is a life-threatening complication of stroke. We evaluated nationwide rates and risk factors for hospital readmissions with VTE after an intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS) hospitalization., Methods: Using the Healthcare Cost and Utilization Project (HCUP) Nationwide Readmission Database, we included patients with a principal discharge diagnosis of ICH or AIS from 2016 to 2019. Patients who had VTE diagnosis or history of VTE during the index admission were excluded. We performed Cox regression models to determine factors associated with VTE readmission, compared rates between AIS and ICH and developed post-stroke VTE risk score. We estimated VTE readmission rates per day over a 90-day time window post-discharge using linear splines., Results: Of the total 1,459,865 patients with stroke, readmission with VTE as the principal diagnosis within 90 days occurred in 0.26% (3,407/1,330,584) AIS and 0.65% (843/129,281) ICH patients. The rate of VTE readmission decreased within first 4-6 weeks (P<0.001). In AIS, cancer, obesity, higher National Institutes of Health Stroke Scale (NIHSS) score, longer hospital stay, home or rehabilitation disposition, and absence of atrial fibrillation were associated with VTE readmission. In ICH, longer hospital stay and rehabilitation disposition were associated with VTE readmission. The VTE rate was higher in ICH compared to AIS (adjusted hazard ratio 2.86, 95% confidence interval 1.93-4.25, P<0.001)., Conclusions: After stroke, VTE readmission risk is highest within the first 4-6 weeks and nearly three-fold higher after ICH vs. AIS. VTE risk is linked to decreased mobility and hypercoagulability. Studies are needed to test short-term VTE prophylaxis beyond hospitalization in high-risk patients.
- Published
- 2023
- Full Text
- View/download PDF
46. Markers of infection and inflammation are associated with post-thrombectomy mortality in acute stroke.
- Author
-
Irvine H, Krieger P, Melmed KR, Torres J, Croll L, Zhao A, Lord A, Ishida K, Frontera J, and Lewis A
- Subjects
- Humans, Retrospective Studies, Treatment Outcome, Thrombectomy, Biomarkers, Inflammation, Anti-Bacterial Agents, Ischemic Stroke, COVID-19, Stroke complications, Brain Ischemia complications
- Abstract
Objective: We explored the relationship between markers of infection and inflammation and mortality in patients with acute ischemic stroke who underwent thrombectomy., Methods: We performed retrospective chart review of stroke patients who underwent thrombectomy at two tertiary academic centers between December 2018 and November 2020. Associations between discharge mortality, WBC count, neutrophil percentage, fever, culture data, and antibiotic treatment were analyzed using the Wilcoxon rank sum test, Student's t-test, and Fisher's exact test. Independent predictors of mortality were identified with multivariable analysis. Analyses were repeated excluding COVID-positive patients., Results: Of 248 patients who underwent thrombectomy, 41 (17 %) died prior to discharge. Mortality was associated with admission WBC count (11 [8-14] vs. 9 [7-12], p = 0.0093), admission neutrophil percentage (78 % ± 11 vs. 71 % ± 14, p = 0.0003), peak WBC count (17 [13-22] vs. 12 [9-15], p < 0.0001), fever (71 % vs. 27 %, p < 0.0001), positive culture (44 % vs. 15 %, p < 0.0001), and days treated with antibiotics (3 [1-7] vs. 1 [0-4], p < 0.0001). After controlling for age, admission NIHSS and post-thrombectomy ASPECTS score, mortality was associated with admission WBC count (OR 13, CI 1.32-142, p = 0.027), neutrophil percentage (OR 1.03, CI 1.0-1.07, p = 0.045), peak WBC count (OR 301, CI 24-5008, p < 0.0001), fever (OR 24.2, CI 1.77-332, p < 0.0001), and positive cultures (OR 4.24, CI 1.87-9.62, p = 0.0006). After excluding COVID-positive patients (n = 14), peak WBC count, fever and positive culture remained independent predictors of mortality., Conclusion: Markers of infection and inflammation are associated with discharge mortality after thrombectomy. Further study is warranted to investigate the causal relationship of these markers with clinical outcome., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
47. Correction to: Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness.
- Author
-
Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, and Suarez JI
- Published
- 2022
- Full Text
- View/download PDF
48. GluN3A excitatory glycine receptors control adult cortical and amygdalar circuits.
- Author
-
Bossi S, Dhanasobhon D, Ellis-Davies GCR, Frontera J, de Brito Van Velze M, Lourenço J, Murillo A, Luján R, Casado M, Perez-Otaño I, Bacci A, Popa D, Paoletti P, and Rebola N
- Subjects
- Animals, Cerebral Cortex metabolism, Glycine metabolism, Interneurons metabolism, Mice, Neurons metabolism, Amygdala metabolism, Neocortex metabolism, Receptors, Glycine genetics, Receptors, Glycine metabolism, Receptors, N-Methyl-D-Aspartate genetics, Receptors, N-Methyl-D-Aspartate metabolism
- Abstract
GluN3A is an atypical glycine-binding subunit of NMDA receptors (NMDARs) whose actions in the brain are mostly unknown. Here, we show that the expression of GluN3A subunits controls the excitability of mouse adult cortical and amygdalar circuits via an unusual signaling mechanism involving the formation of excitatory glycine GluN1/GluN3A receptors (eGlyRs) and their tonic activation by extracellular glycine. eGlyRs are mostly extrasynaptic and reside in specific neuronal populations, including the principal cells of the basolateral amygdala (BLA) and SST-positive interneurons (SST-INs) of the neocortex. In the BLA, tonic eGlyR currents are sensitive to fear-conditioning protocols, are subject to neuromodulation by the dopaminergic system, and control the stability of fear memories. In the neocortex, eGlyRs control the in vivo spiking of SST-INs and the behavior-dependent modulation of cortical activity. GluN3A-containing eGlyRs thus represent a novel and widespread signaling modality in the adult brain, with attributes that strikingly depart from those of conventional NMDARs., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
49. Psychological Outcome after Hemorrhagic Stroke is Related to Functional Status.
- Author
-
Ecker S, Lord A, Gurin L, Olivera A, Ishida K, Melmed K, Torres J, Zhang C, Frontera J, and Lewis A
- Subjects
- Fatigue diagnosis, Fatigue etiology, Functional Status, Humans, Quality of Life, Treatment Outcome, Hemorrhagic Stroke diagnosis, Hemorrhagic Stroke therapy, Stroke diagnosis, Stroke therapy
- Abstract
Background: To identify opportunities to improve morbidity after hemorrhagic stroke, it is imperative to understand factors that are related to psychological outcome., Design/methods: We prospectively identified patients with non-traumatic hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) between January 2015 and February 2021 who were alive 3-months after discharge and telephonically assessed 1) psychological outcome using the Quality of Life in Neurological Disorders anxiety, depression, emotional and behavioral dyscontrol, fatigue and sleep disturbance inventories and 2) functional outcome using the modified Rankin Scale (mRS) and Barthel Index. We also identified discharge destination for all patients. We then evaluated the relationship between abnormal psychological outcomes (T-score >50) and discharge destination other than home, poor 3-month mRS score defined as 3-5 and poor 3-month Barthel Index defined as <100., Results: 73 patients were included; 41 (56%) had an abnormal psychological outcome on at least one inventory. There were 41 (56%) patients discharged to a destination other than home, 44 (63%) with poor mRS score and 28 (39%) with poor Barthel Index. Anxiety, depression, emotional and behavioral dyscontrol and sleep disturbance were all associated with a destination other than home, poor mRS score, and poor Barthel Index (all p<0.05). Fatigue was related to poor mRS score and poor Barthel Index (p=0.005 and p=0.006, respectively)., Conclusion: Multiple psychological outcomes 3-months after hemorrhagic stroke are related to functional status. Interventions to improve psychological outcome and reduce morbidity in patients with poor functional status should be explored by the interdisciplinary team., Competing Interests: Conflicts of Interest None, (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
50. Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness.
- Author
-
Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, and I Suarez J
- Subjects
- Consciousness Disorders diagnosis, Consciousness Disorders therapy, Humans, National Institutes of Health (U.S.), United States, Coma therapy, Consciousness
- Abstract
This proceedings article presents actionable research targets on the basis of the presentations and discussions at the 2nd Curing Coma National Institutes of Health (NIH) symposium held from May 3 to May 5, 2021. Here, we summarize the background, research priorities, panel discussions, and deliverables discussed during the symposium across six major domains related to disorders of consciousness. The six domains include (1) Biology of Coma, (2) Coma Database, (3) Neuroprognostication, (4) Care of Comatose Patients, (5) Early Clinical Trials, and (6) Long-term Recovery. Following the 1st Curing Coma NIH virtual symposium held on September 9 to September 10, 2020, six workgroups, each consisting of field experts in respective domains, were formed and tasked with identifying gaps and developing key priorities and deliverables to advance the mission of the Curing Coma Campaign. The highly interactive and inspiring presentations and panel discussions during the 3-day virtual NIH symposium identified several action items for the Curing Coma Campaign mission, which we summarize in this article., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.