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2020

Stroke

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Full-Text Articles in Medicine and Health Sciences

A Systematic Reviewarticle On Discharge Destinations For Patients With Stroke, Lin-Fu Lee, Wen-Chih Lin, Willy Chou Dec 2020

A Systematic Reviewarticle On Discharge Destinations For Patients With Stroke, Lin-Fu Lee, Wen-Chih Lin, Willy Chou

Rehabilitation Practice and Science

Introduction: Complex and diverse factors affect the placement of patients with stroke after they are discharged from hospitals. In this study, a systematic reviewarticle of relevant literature was performed to compile related research data and explore the importance of individuals factors and the overall predictive power of multiple variables. Methods: Electronic resources from PubMed and the Cochrane Library were used along with keywords such as "stroke" and "discharge destination" to search for relevant articles published between 2005 and 2018. Only original research articles written in English were selected. Results: A total of 19 articles were selected to compile 10 factors, …


Effects Of An Anterior Ankle-Foot Orthosis On Static Standing Balance Control In Patients With Chronic Stroke Wearing The Orthosis For A Long Time, Min-Yuan Yu, Yu-Hsuan Tseng, Po-Chih Chen, Jen-Wen Hung Dec 2020

Effects Of An Anterior Ankle-Foot Orthosis On Static Standing Balance Control In Patients With Chronic Stroke Wearing The Orthosis For A Long Time, Min-Yuan Yu, Yu-Hsuan Tseng, Po-Chih Chen, Jen-Wen Hung

Rehabilitation Practice and Science

Aims: To investigate the effects of anterior ankle-foot orthosis (A-AFO) on static standing postural control in patients with chronic stroke wearing the A-AFO for a long time. Methods: We recruited patients with chronic stroke wearing an A-AFO for at least 5 months. Static standing balance control was evaluated using the Tetrax Balance System in eight positions: (1) eyes open on a solid surface [NO];(2) eyes closed on a solid surface [NC];(3) eyes open on a foam surface [PO];(4) eyes closed on a foam surface [PC];and head turned at 30° to (5) right [HR], (6) left [HL], (7) up [HB], and …


Kienböck's Disease In A Patient With Hemiparetic Stroke: A Casereport, Pao-Sheng Wu, Yen-Ting Cho Dec 2020

Kienböck's Disease In A Patient With Hemiparetic Stroke: A Casereport, Pao-Sheng Wu, Yen-Ting Cho

Rehabilitation Practice and Science

Kienböck's disease of the wrist is a multifactorial, progressive osteonecrosis of the lunate bone. Patients with this disease often complain of dorsal wrist pain and other wrist dysfunctions. Image studies are usually required for definite diagnosis; however, careful history taking and physical examination are also necessary. Treatment varies according to the stage of the disease; although surgery is needed in most of the cases, rehabilitation after the surgery seems helpful as well. Kienböck's disease is rarely seen in our daily practice, and even though we do recognize the disease, diagnosing it correctly in patients with comorbidities such as stroke is …


Watchman Compared To Warfarin In Reducing Risk Of Stroke In Patients With Non-Valvular Atrial Fibrillation, Peyton Parrish, Matt Isherwood Dec 2020

Watchman Compared To Warfarin In Reducing Risk Of Stroke In Patients With Non-Valvular Atrial Fibrillation, Peyton Parrish, Matt Isherwood

Physician Assistant Capstones, 2020-current

Objective: To determine if the WATCHMAN device is as efficacious as warfarin for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) using a systematic review. Methods: Pubmed and Google Scholar databases were used to evaluate clinical trials using the search terms atrial fibrillation, watchman, warfarin, and stroke prevention. Results: Three studies met inclusion criteria, with 2 being randomized control trials (RCT), and 1 being a prospective cohort study. Reddy et al found that after 3.8 years of follow-up, patients with percutaneous closure of Left atrial appendage (LAA) met criteria for both non-inferiority and superiority, compared with warfarin for preventing …


Cortical Thickness Estimation In Individuals With Cerebral Small Vessel Disease, Focal Atrophy, And Chronic Stroke Lesions, Miracle Ozzoude, Joel Ramirez, Pradeep Reddy Raamana, Melissa F. Holmes, Kirstin Walker, Christopher J.M. Scott, Fuqiang Gao, Maged Goubran, Donna Kwan, Maria C. Tartaglia, Derek Beaton, Gustavo Saposnik, Ayman Hassan, Jane Lawrence-Dewar, Dariush Dowlatshahi, Stephen C. Strother, Sean Symons, Robert Bartha, Richard H. Swartz, Sandra E. Black Dec 2020

Cortical Thickness Estimation In Individuals With Cerebral Small Vessel Disease, Focal Atrophy, And Chronic Stroke Lesions, Miracle Ozzoude, Joel Ramirez, Pradeep Reddy Raamana, Melissa F. Holmes, Kirstin Walker, Christopher J.M. Scott, Fuqiang Gao, Maged Goubran, Donna Kwan, Maria C. Tartaglia, Derek Beaton, Gustavo Saposnik, Ayman Hassan, Jane Lawrence-Dewar, Dariush Dowlatshahi, Stephen C. Strother, Sean Symons, Robert Bartha, Richard H. Swartz, Sandra E. Black

Medical Biophysics Publications

Background: Regional changes to cortical thickness in individuals with neurodegenerative and cerebrovascular diseases (CVD) can be estimated using specialized neuroimaging software. However, the presence of cerebral small vessel disease, focal atrophy, and cortico-subcortical stroke lesions, pose significant challenges that increase the likelihood of misclassification errors and segmentation failures. Purpose: The main goal of this study was to examine a correction procedure developed for enhancing FreeSurfer’s (FS’s) cortical thickness estimation tool, particularly when applied to the most challenging MRI obtained from participants with chronic stroke and CVD, with varying degrees of neurovascular lesions and brain atrophy. Methods: In 155 CVD participants …


Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi Nov 2020

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …


Diagnosing And Managing Post-Stroke Aphasia, Shannon M. Sheppard, Rajani Sebastian Nov 2020

Diagnosing And Managing Post-Stroke Aphasia, Shannon M. Sheppard, Rajani Sebastian

Communication Sciences and Disorders Faculty Articles and Research

Introduction: Aphasia is a debilitating language disorder and even mild forms of aphasia can negatively affect functional outcomes, mood, quality of life, social participation, and the ability to return to work. Language deficits after post-stroke aphasia are heterogeneous.

Areas covered: The first part of this manuscript reviews the traditional syndrome-based classification approach as well as recent advances in aphasia classification that incorporate automatic speech recognition for aphasia classification. The second part of this manuscript reviews the behavioral approaches to aphasia treatment and recent advances such as noninvasive brain stimulation techniques and pharmacotherapy options to augment the effectiveness of …


Stroke Preventive In African American Women Ages 20-40 That Are Using Or Have Used Oral Contraceptives, Ashanti L. N. Coleman Nov 2020

Stroke Preventive In African American Women Ages 20-40 That Are Using Or Have Used Oral Contraceptives, Ashanti L. N. Coleman

Electronic Theses and Dissertations

This Doctor of Nursing Practice project will inform the audience of stroke awareness as it pertains to oral contraceptives. The study’s focus was to enhance the knowledge of African American women ages 20–40 that have used or are currently using an oral contraceptive. It has been identified that this patient population lacked the knowledge regarding stroke and oral contraceptives, and African American women continue to have the highest incidence of stroke. African American women also make up more than half of the consumers utilizing oral contraceptives. An oral contraceptive knowledge questionnaire was utilized from previous research to determine if any …


Gains Across Who Dimensions Of Function After Robot-Based Therapy In Stroke Subjects, Jennifer Wu, Lucy Dodakian, Jill See, Erin Burke Quinlan, Lisa Meng, Jeby Abraham, Ellen C. Wong, Vu Le, Alison Mckenzie, Steven C. Cramer Oct 2020

Gains Across Who Dimensions Of Function After Robot-Based Therapy In Stroke Subjects, Jennifer Wu, Lucy Dodakian, Jill See, Erin Burke Quinlan, Lisa Meng, Jeby Abraham, Ellen C. Wong, Vu Le, Alison Mckenzie, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Background

Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.

Objective

This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.

Methods

Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 …


Relationships Between Accelerometry And General Compensatory Movements Of The Upper Limb After Stroke, Jessica Barth, Joeseph W Klaesner, Catherine E Lang Oct 2020

Relationships Between Accelerometry And General Compensatory Movements Of The Upper Limb After Stroke, Jessica Barth, Joeseph W Klaesner, Catherine E Lang

2020-Current year OA Pubs

BACKGROUND: Standardized assessments are used in rehabilitation clinics after stroke to measure restoration versus compensatory movements of the upper limb. Accelerometry is an emerging tool that can bridge the gap between in- and out-of-clinic assessments of the upper limb, but is limited in that it currently does not capture the quality of a person's movement, an important concept to assess compensation versus restoration. The purpose of this analysis was to characterize how accelerometer variables may reflect upper limb compensatory movement patterns after stroke.

METHODS: This study was a secondary analysis of an existing data set from a Phase II, single-blind, …


A Narrative Analysis Of Psychological Adjustments Of Professionals Transitioning To Work Following Cerebral Vascular Accident (Cva), Mabel Munachiso Korie Oct 2020

A Narrative Analysis Of Psychological Adjustments Of Professionals Transitioning To Work Following Cerebral Vascular Accident (Cva), Mabel Munachiso Korie

Theses & Dissertations

This research study was a narrative analysis of the psychological adjustment of professionals transitioning to work after a cerebral vascular accident, commonly known as a stroke. The purpose of this research was to explore the psychological adjustment of professionals who returned to work after a stroke following their subsequent rehabilitation. This has been an important subject because stroke research predominantly addresses older adults, which means that there has not been enough information on the experience of affected working-age professionals. The Roy Adaptation Model and Social Cognitive Theory were the frameworks for the study. The data collected were from audio-recorded and …


Untreated Stroke As Collateral Damage Of Covid-19: "Time Is Brain" Versus "Stay At Home"., David Z. Rose, W. Scott Burgin, Swetha Renati Oct 2020

Untreated Stroke As Collateral Damage Of Covid-19: "Time Is Brain" Versus "Stay At Home"., David Z. Rose, W. Scott Burgin, Swetha Renati

All publications

For decades, neurologists have been advocating that anyone with acute focal deficits report immediately to the closest hospital's emergency room. Major advancements in the hyperacute diagnosis and treatment of stroke have justified our call-to-action slogan of "Time is Brain"-faster therapy leads to superior outcomes. However, this mantra has been recently usurped by the catchphrase "Stay at Home" during the coronavirus disease 2019 (COVID-19) pandemic. Fewer patients are presenting to hospitals with acute stroke; our census is down. Presumably the etiology of this phenomenon is either strict "social distancing" that some people may misperceive to exclude even emergent situations, or fears …


Effect Of Covid-19 Pandemic On Mechanical Thrombectomy For Acute Ischemic Stroke Treatment In United States, Adnan Qureshi, Farhan Siddiq, Brandi R. French, Camilo R. Gomez, Vishal Jani, Ameer E. Hassan, M.Fareed K. Suri Oct 2020

Effect Of Covid-19 Pandemic On Mechanical Thrombectomy For Acute Ischemic Stroke Treatment In United States, Adnan Qureshi, Farhan Siddiq, Brandi R. French, Camilo R. Gomez, Vishal Jani, Ameer E. Hassan, M.Fareed K. Suri

School of Medicine Publications and Presentations

There is accumulating data suggesting that the ischemic stroke may be increased in patients with corona virus disease 2019 (COVID-19) due to hyper coagulopathy. An increase in acute ischemic stroke patients who require mechanical thrombectomy is to be expected particularly in regions with high rates of COVID-19.


Stratifying Chronic Stroke Patients Based On The Influence Of Contralesional Motor Cortices: An Inter-Hemispheric Inhibition Study, Yin-Liang Lin, Kelsey A. Potter-Baker, David A. Cunningham, Manshi Li, Vishwanath Sankarasubramanian, John Lee, Stephen Jones, Ken Sakaie, Xiaofeng Wang, Andre G. Machado Oct 2020

Stratifying Chronic Stroke Patients Based On The Influence Of Contralesional Motor Cortices: An Inter-Hemispheric Inhibition Study, Yin-Liang Lin, Kelsey A. Potter-Baker, David A. Cunningham, Manshi Li, Vishwanath Sankarasubramanian, John Lee, Stephen Jones, Ken Sakaie, Xiaofeng Wang, Andre G. Machado

School of Medicine Publications and Presentations

Objective:

A recent “bimodal-balance recovery” model suggests that contralesional influence varies based on the amount of ipsilesional reserve: inhibitory when there is a large reserve, but supportive when there is a low reserve. Here, we investigated the relationships between contralesional influence (inter-hemispheric inhibition, IHI) and ipsilesional reserve (corticospinal damage/impairment), and also defined a criterion separating subgroups based on the relationships.

Methods:

Twenty-four patients underwent assessment of IHI using Transcranial Magnetic Stimulation (ipsilateral silent period method), motor impairment using Upper Extremity Fugl-Meyer (UEFM), and corticospinal damage using Diffusion Tensor Imaging and active motor threshold. Assessments of UEFM and IHI were repeated …


Initial Experience With The Next-Generation Resolute Onyx Zotarolimus-Eluting Stent In Symptomatic Intracranial Atherosclerotic Disease, Ameer E. Hassan, Mahmoud H. Mohammaden, Rani R. Rabah, Wondwossen G. Tekle Sep 2020

Initial Experience With The Next-Generation Resolute Onyx Zotarolimus-Eluting Stent In Symptomatic Intracranial Atherosclerotic Disease, Ameer E. Hassan, Mahmoud H. Mohammaden, Rani R. Rabah, Wondwossen G. Tekle

School of Medicine Publications and Presentations

Background and Purpose: Intracranial atherosclerotic disease (ICAD) is a common cause of stroke worldwide. Although there are different endovascular options for the treatment of symptomatic ICAD (sICAD), it is still controversial. Herein, we aim to study the safety and efficacy of a new generation of drug-eluting balloon-mounted stent (DES); Resolute (R) onyx DES in the treatment of sICAD.

Methods:A prospectively maintained neuroendovascular procedures database in a high-volume comprehensive stroke center was reviewed from October 2019 through January 2020. Patients were included if they had sICAD (≥70% stenosis), failed medical management, and underwent intracranial stenting with R-onyx DES. Technical success …


Neutrophils-To-Lymphocyte Ratio In Acute Ischemic Stroke Patients, Eman S. Matar, Gelan M. M. Ali, Ibrahim E. Alahmar, Wafeek M. Elsheik Sep 2020

Neutrophils-To-Lymphocyte Ratio In Acute Ischemic Stroke Patients, Eman S. Matar, Gelan M. M. Ali, Ibrahim E. Alahmar, Wafeek M. Elsheik

Menoufia Medical Journal

Objective The aim of this study was to evaluate the neutrophils-to-lymphocyte ratio (NLR) among patients with ischemic stroke and to determine the relationship between NLR and poststroke prognosis Background Inflammations play a role in the pathogenesis of cerebral infarction. Cytokines and adhesion molecules regulate the increased migration of leukocytes to the brain. Neutrophils are the first type of leukocytes to infiltrate ischemic brain (30 min of cerebral ischemia), peak earlier (days 1–3), and then decrease rapidly with time. Lymphocyte recruitment into the brain is involved in the later stages of ischemic brain injury. Patients and methods A retrospective study was …


Paroxysmal Nocturnal Hemoglobinuria: Pandora’S Box?, Mihnea Alexandru Găman, Iulia Ursuleac, Daniel Coriu Sep 2020

Paroxysmal Nocturnal Hemoglobinuria: Pandora’S Box?, Mihnea Alexandru Găman, Iulia Ursuleac, Daniel Coriu

Journal of Mind and Medical Sciences

Introduction. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired non-malignant hematological disorder which affects the pluripotent hematopoietic stem cell. The cause of PNH development is the occurrence of somatic mutations in the phosphatidylinositol glycan-A gene which encodes a protein necessary for the biosynthesis of glycosylphosphatidylinositol anchors. The diagnosis of PNH requires the presence of signs of intravascular hemolysis, thrombosis, and (or) bone marrow failure. Case Report. We report the case of a 42-year-old female, diagnosed with PNH at the age of 27, whose evolution was initially characterized predominantly by hemolytic attacks and whose disease pattern evolved towards thromboembolic episodes …


Targeted Engagement Of The Action Selection Network During Task-Oriented Arm Training After Stroke, Jill Campbell Stewart Pt,Phd, Kaci Handlery, Jessica F. Baird, Erika L. Blanck, Geetanjali Pathak, Stacy L. Fritz Sep 2020

Targeted Engagement Of The Action Selection Network During Task-Oriented Arm Training After Stroke, Jill Campbell Stewart Pt,Phd, Kaci Handlery, Jessica F. Baird, Erika L. Blanck, Geetanjali Pathak, Stacy L. Fritz

Faculty Publications

Action selection (AS), or selection of an action from a set of alternatives, is an important movement preparation process that engages a frontal-parietal network. The addition of AS demands to arm training after stroke could be used to engage this motor planning process and the neural network that supports it. The purpose of this case series is to describe the feasibility and outcomes associated with task-oriented arm training aimed at engaging the AS behavioral process and the related neural network in three individuals with chronic stroke. Three participants with mild to moderate motor deficits completed 13 to 15 sessions of …


Inspire : Vol 3, Issue 9, Department Of Medicine Sep 2020

Inspire : Vol 3, Issue 9, Department Of Medicine

INSPIRE

Content

  • Message From the Chair
  • Medicine at National and International Forums
  • Building Research Programmes:Perspectives from outstanding mentors- AKU, Duke Collaboration
  • First National Webinar on Covid-19 and Skin
  • In Depth- Section- featuring Dr Adil Aziz
  • Featured Faculty: Prof Amna Subhan Butt “…Be the best version of yourself …”
  • Publications


Call To Action: Sars-Cov-2 And Cerebrovascular Disorders (Cascade), Shahram Abootalebi, Benjamin M. Aertker, Mohammad Sobhan Andalibi, Negar Asdaghi, Ozlem Aykac, M. Reza Azarpazhooh, M. Cecilia Bahit, Kristian Barlinn, Hamidon Basri, Reza Bavarsad Shahripour, Anna Bersano, Jose Biller, Afshin Borhani-Haghighi, Robert D. Brown, Bruce Cv Campbell, Salvador Cruz-Flores, Deidre Anne De Silva, Mario Di Napoli, Afshin A. Divani, Randall C. Edgell, Johanna T. Fifi, Abdoreza Ghoreishi, Teruyuki Hirano, Keun Sik Hong, Chung Y. Hsu, Josephine F. Huang, Manabu Inoue, Amanda L. Jagolino, Moira Kapral, Hoo Fan Kee, Zafer Keser, Rakesh Khatri Sep 2020

Call To Action: Sars-Cov-2 And Cerebrovascular Disorders (Cascade), Shahram Abootalebi, Benjamin M. Aertker, Mohammad Sobhan Andalibi, Negar Asdaghi, Ozlem Aykac, M. Reza Azarpazhooh, M. Cecilia Bahit, Kristian Barlinn, Hamidon Basri, Reza Bavarsad Shahripour, Anna Bersano, Jose Biller, Afshin Borhani-Haghighi, Robert D. Brown, Bruce Cv Campbell, Salvador Cruz-Flores, Deidre Anne De Silva, Mario Di Napoli, Afshin A. Divani, Randall C. Edgell, Johanna T. Fifi, Abdoreza Ghoreishi, Teruyuki Hirano, Keun Sik Hong, Chung Y. Hsu, Josephine F. Huang, Manabu Inoue, Amanda L. Jagolino, Moira Kapral, Hoo Fan Kee, Zafer Keser, Rakesh Khatri

Epidemiology and Biostatistics Publications

Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based …


Ontario Neurodegenerative Disease Research Initiative (Ondri): Structural Mri Methods And Outcome Measures, Joel Ramirez, Melissa F. Holmes, Christopher J.M. Scott, Miracle Ozzoude, Miracle Ozzoude, Sabrina Adamo, Gregory M. Szilagyi, Maged Goubran, Fuqiang Gao, Stephen R. Arnott, Jane M. Lawrence-Dewar, Jane M. Lawrence-Dewar, Derek Beaton, Stephen C. Strother, Douglas P. Munoz, Mario Masellis, Richard H. Swartz, Robert Bartha, Sean P. Symons, Sandra E. Black, Michael Strong, Peter Kleinstiver, Natalie Rashkovan, Susan Bronskill, Sandra E. Black, Michael Borrie, Elizabeth Finger, Corinne Fischer, Andrew Frank, Morris Freedman, Sanjeev Kumar, Stephen Pasternak Aug 2020

Ontario Neurodegenerative Disease Research Initiative (Ondri): Structural Mri Methods And Outcome Measures, Joel Ramirez, Melissa F. Holmes, Christopher J.M. Scott, Miracle Ozzoude, Miracle Ozzoude, Sabrina Adamo, Gregory M. Szilagyi, Maged Goubran, Fuqiang Gao, Stephen R. Arnott, Jane M. Lawrence-Dewar, Jane M. Lawrence-Dewar, Derek Beaton, Stephen C. Strother, Douglas P. Munoz, Mario Masellis, Richard H. Swartz, Robert Bartha, Sean P. Symons, Sandra E. Black, Michael Strong, Peter Kleinstiver, Natalie Rashkovan, Susan Bronskill, Sandra E. Black, Michael Borrie, Elizabeth Finger, Corinne Fischer, Andrew Frank, Morris Freedman, Sanjeev Kumar, Stephen Pasternak

Medical Biophysics Publications

The Ontario Neurodegenerative Research Initiative (ONDRI) is a 3 years multi-site prospective cohort study that has acquired comprehensive multiple assessment platform data, including 3T structural MRI, from neurodegenerative patients with Alzheimer's disease, mild cognitive impairment, Parkinson's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and cerebrovascular disease. This heterogeneous cross-section of patients with complex neurodegenerative and neurovascular pathologies pose significant challenges for standard neuroimaging tools. To effectively quantify regional measures of normal and pathological brain tissue volumes, the ONDRI neuroimaging platform implemented a semi-automated MRI processing pipeline that was able to address many of the challenges resulting from this heterogeneity. The purpose …


The Professional And Personal Impact Of The Coronavirus Pandemic On Us Neurointerventional Practices: A Nationwide Survey, Kyle M. Fargen, Thabele M. Leslie-Mazwi, Richard P. Klucznik, Stacey Q. Wolfe, Patrick Brown, Sameer A. Ansari, Guilherme Dabus, Alejandro M. Spiotta, Maxim Mokin, Ameer E. Hassan, David Liebeskind, Babu G. Welch, Adnan H. Siddiqui, Joshua A. Hirsch Aug 2020

The Professional And Personal Impact Of The Coronavirus Pandemic On Us Neurointerventional Practices: A Nationwide Survey, Kyle M. Fargen, Thabele M. Leslie-Mazwi, Richard P. Klucznik, Stacey Q. Wolfe, Patrick Brown, Sameer A. Ansari, Guilherme Dabus, Alejandro M. Spiotta, Maxim Mokin, Ameer E. Hassan, David Liebeskind, Babu G. Welch, Adnan H. Siddiqui, Joshua A. Hirsch

School of Medicine Publications and Presentations

Background Little is currently known about the effects of the coronavirus (COVID-19) pandemic on neurointerventional (NI) procedural volumes or its toll on physician wellness.

Methods A 37-question online survey was designed and distributed to physician members of three NI physician organizations.

Results A total of 151 individual survey responses were obtained. Reduced mechanical thrombectomy procedures compared with pre-pandemic were observed with 32% reporting a greater than 50% reduction in thrombectomy volumes. In concert with most (76%) reporting at least a 25% reduction in non-mechanical thrombectomy urgent NI procedures and a nearly unanimous (96%) cessation of non-urgent elective cases, 68% of …


Considerations For Studying Sex As A Biological Variable In Spinal Cord Injury, Andrew N. Stewart, Steven M. Maclean, Arnold J. Stromberg, Jessica P. Whelan, William M. Bailey, John C. Gensel, Melinda E. Wilson Aug 2020

Considerations For Studying Sex As A Biological Variable In Spinal Cord Injury, Andrew N. Stewart, Steven M. Maclean, Arnold J. Stromberg, Jessica P. Whelan, William M. Bailey, John C. Gensel, Melinda E. Wilson

Physiology Faculty Publications

In response to NIH initiatives to investigate sex as a biological variable in preclinical animal studies, researchers have increased their focus on male and female differences in neurotrauma. Inclusion of both sexes when modeling neurotrauma is leading to the identification of novel areas for therapeutic and scientific exploitation. Here, we review the organizational and activational effects of sex hormones on recovery from injury and how these changes impact the long-term health of spinal cord injury (SCI) patients. When determining how sex affects SCI it remains imperative to expand outcomes beyond locomotor recovery and consider other complications plaguing the quality of …


In-Hospital Outcomes Following Left Atrial Appendage Closure, Shubrandu S. Sanjoy Jul 2020

In-Hospital Outcomes Following Left Atrial Appendage Closure, Shubrandu S. Sanjoy

Electronic Thesis and Dissertation Repository

Left atrial appendage closure (LAAC) is a non-pharmacologic approach for stroke prevention in patients with atrial fibrillation. The impact of comorbidity burden on adverse outcomes following LAAC is very important for clinical decision making. Cohort-based observational study was conducted to evaluate the association of comorbidity burden with in-hospital complications. Of 3294 participants (mean age was 75.7±8.2 years), 60% were male and 86% whites. The majority of participants undergoing LAAC presented with a significant number of comorbid conditions. The occurrence of in-hospital major adverse events (MAE) was 4.6%. Women and patients exhibiting higher Charlson Comorbidity Index (adjusted odds ratio [aOR]: 1.14, …


Physical Activity Interventions For Older Adults: Efficacy, Adherence And Sustainability For Stroke Prevention Outcomes, Agnieszka Suminski Jul 2020

Physical Activity Interventions For Older Adults: Efficacy, Adherence And Sustainability For Stroke Prevention Outcomes, Agnieszka Suminski

DePaul Discoveries

Objective: To examine outcomes of older adults who participate in physical activity intervention programs, whether there is a significant difference in group and individual based physical activity interventions, and assess promise of older adult behavior change post-intervention. Methods: Literature review using seventeen previously published data on physical activity intervention programs for older adults. Results: Studies suggest that physical activity program intervention for older adults show improved physical and mental outcomes. Group-based interventions are more successful for program adherence. Discussion: Family and social support play a significant role in participant adherence to program physical adherence interventions, as well as sustained …


Atrial Fibrillation, Ayushma Neupane Jul 2020

Atrial Fibrillation, Ayushma Neupane

Nursing Student Class Projects (Formerly MSN)

Atrial fibrillation is one of the most common cardiac arrhythmias. Patient can be either symptomatic or asymptomatic. Atrial fibrillation poses a high risk for the development of thromboembolitic stroke and heart failure along with other complications. Nursing provider must take a responsibility to educate the patient regarding the knowledge of disease and importance of adherence to medication and anticoagulants to ensure the quality of life. Understanding the pathophysiology of atrial fibrillation is essential to treat a patient and also to estimate the lifetime risk of atrial fibrillation in various subgroups with one or multiple elevated or borderline-elevated risk factors might …


Utstein Recommendation For Emergency Stroke Care, A. Rudd, P. Panagos, Et Al Jul 2020

Utstein Recommendation For Emergency Stroke Care, A. Rudd, P. Panagos, Et Al

2020-Current year OA Pubs

BACKGROUND: Recent advances in treatment for stroke give new possibilities for optimizing outcomes. To deliver these prehospital care needs to become more efficient.

AIM: To develop a framework to support improved delivery of prehospital care. The recommendations are aimed at clinicians involved in prehospital and emergency health systems who will often not be stroke specialists but need clear guidance as to how to develop and deliver safe and effective care for acute stroke patients.

METHODS: Building on the successful implementation program from the Global Resuscitation Alliance and the Resuscitation Academy, the Utstein methodology was used to define a generic chain …


Oral Anticoagulants For Nonvalvular Atrial Fibrillation In Frail Elderly Patients: Insights From The Aristophanes Study, G. Y. H. Lip, A. V. Keshishian, A. L. Kang, A. D. Dhamane, X. Luo, X. Li, N. Balachander, L. Rosenblatt, J. Mardekian, X. Pan, M. Di Fusco, A. B. Garcia Reeves, Huseyin Yuce, S. Deitelzweig Jun 2020

Oral Anticoagulants For Nonvalvular Atrial Fibrillation In Frail Elderly Patients: Insights From The Aristophanes Study, G. Y. H. Lip, A. V. Keshishian, A. L. Kang, A. D. Dhamane, X. Luo, X. Li, N. Balachander, L. Rosenblatt, J. Mardekian, X. Pan, M. Di Fusco, A. B. Garcia Reeves, Huseyin Yuce, S. Deitelzweig

Publications and Research

Background

Patient frailty amongst patients with nonvalvular atrial fibrillation (NVAF) is associated with adverse health outcomes and increased risk of mortality. Additional evidence is needed to evaluate effective and safe NVAF treatment in this patient population.

Objectives

This subgroup analysis of the ARISTOPHANES study compared the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) amongst frail NVAF patients prescribed nonvitamin K antagonist oral anticoagulants (NOACs) or warfarin.

Methods

This comparative retrospective observational study of frail, older NVAF patients who initiated apixaban, dabigatran, rivaroxaban or warfarin from 01JAN2013‐30SEP2015 was conducted using Medicare and 3 US commercial claims databases. To compare …


Role Of Neuronal Nitric Oxide Synthase On Cardiovascular Functions In Physiological And Pathophysiological States, Ahmmed Ally, Isabella Powell, Minora M. Ally, Kevin Chaitoff, Surya M. Nauli Jun 2020

Role Of Neuronal Nitric Oxide Synthase On Cardiovascular Functions In Physiological And Pathophysiological States, Ahmmed Ally, Isabella Powell, Minora M. Ally, Kevin Chaitoff, Surya M. Nauli

Pharmacy Faculty Articles and Research

This review describes and summarizes the role of neuronal nitric oxide synthase (nNOS) on the central nervous system, particularly on brain regions such as the ventrolateral medulla (VLM) and the periaqueductal gray matter (PAG), and on blood vessels and the heart that are involved in the regulation and control of the cardiovascular system (CVS). Furthermore, we shall also review the functional aspects of nNOS during several physiological, pathophysiological, and clinical conditions such as exercise, pain, cerebral vascular accidents or stroke and hypertension. For example, during stroke, a cascade of molecular, neurochemical, and cellular changes occur that affect the nervous system …


A Predictive Analytics Model For Differentiating Between Transient Ischemic Attacks (Tia) And Its Mimics, Alia C. Stanciu, Mihai Banciu, Alireza Sadighi, Kyle A. Marshall, Neil Holland, Vida Abedi, Ramin Zand Jun 2020

A Predictive Analytics Model For Differentiating Between Transient Ischemic Attacks (Tia) And Its Mimics, Alia C. Stanciu, Mihai Banciu, Alireza Sadighi, Kyle A. Marshall, Neil Holland, Vida Abedi, Ramin Zand

Faculty Journal Articles

Transient ischemic attack (TIA) is a brief episode of neurological dysfunction resulting from cerebral ischemia not associated with permanent cerebral infarction. TIA is associated with high diagnostic errors because of the subjective nature of findings and the lack of clinical and imaging biomarkers. The goal of this study was to design and evaluate a novel multinomial classification model, based on a combination of feature selection mechanisms coupled with logistic regression, to predict the likelihood of TIA, TIA mimics, and minor stroke.