A5079405464- Traumatic Brain Injury and Neurovascular Disturbances
- Traumatic Brain Injury Research
- Stroke Rehabilitation and Recovery
- Acute Ischemic Stroke Management
- Cardiac Arrest and Resuscitation
- Psychosomatic Disorders and Their Treatments
- Intensive Care Unit Cognitive Disorders
- Cerebrospinal fluid and hydrocephalus
- Intracerebral and Subarachnoid Hemorrhage Research
- Functional Brain Connectivity Studies
- Respiratory Support and Mechanisms
- Transcranial Magnetic Stimulation Studies
- Health, Environment, Cognitive Aging
- Palliative Care and End-of-Life Issues
- Cerebral Palsy and Movement Disorders
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Venous Thromboembolism Diagnosis and Management
- Anesthesia and Neurotoxicity Research
- Dementia and Cognitive Impairment Research
- Anesthesia and Sedative Agents
- Diabetes Management and Research
- Thermoregulation and physiological responses
- Clinical practice guidelines implementation
- Botulinum Toxin and Related Neurological Disorders
- Neurosurgical Procedures and Complications
Johns Hopkins Hospital
2015-2025
Louis Stokes Cleveland VA Medical Center
2025
Johns Hopkins University
2010-2024
Johns Hopkins Medicine
2010-2024
Presbyterian Hospital
2024
Columbia University
2024
NewYork–Presbyterian Hospital
2024
New York Hospital Queens
2024
Blakelands Hospital
2024
King's College London
2023
Introduction: Abused women often report a wide range of physical and psychological symptoms that present challenges to providers. Specifically, injuries the head or strangulation, may initiate neurological changes contribute central nervous system (CNS) symptoms. These are attributed mental health diagnoses in this population. The purpose analysis is examine prevalence associations between reported probable traumatic brain injury (TBI) CNS sample African descent. Methods: A convenience 901...
BACKGROUND: Red blood cell (RBC) product wastage in hospitals is reported to range from 0.1% 6.7%. Wastage at our institution averaged 4.4% of 63,000 issued RBC products. Data indicated that approximately 87% wasted units were either individual out bank for more than 30 minutes (dispensed but not administered) or packed transport containers had temperature indicators affixed each unit. We hypothesized Lean Sigma methodology could be used reduce by 50%. STUDY DESIGN AND METHODS: An...
Abstract Coma and disorders of consciousness (DoC) are highly prevalent constitute a burden for patients, families, society worldwide. As part the Curing Campaign, Neurocritical Care Society partnered with National Institutes Health to organize symposium bringing together experts from all over world develop research targets DoC. The conference was structured along six domains: (1) defining endotype/phenotypes, (2) biomarkers, (3) proof-of-concept clinical trials, (4) neuroprognostication,...
This proceedings article presents actionable research targets on the basis of presentations and discussions at 2nd Curing Coma National Institutes Health (NIH) symposium held from May 3 to 5, 2021. Here, we summarize background, priorities, panel discussions, deliverables discussed during across six major domains related disorders consciousness. The include (1) Biology Coma, (2) Database, (3) Neuroprognostication, (4) Care Comatose Patients, (5) Early Clinical Trials, (6) Long-term Recovery....
Therapeutic activity after stroke is a component of early recovery strategies. Interactive video games have been shown to be safe as an adjunct rehabilitation therapy in the medical intensive care setting, but patients with neurologic disease were often excluded from those protocols.
Background: The transition period after hospitalization for stroke is a vulnerable time patients as all adapt to new physical, cognitive, or emotional changes and destabilized comorbid conditions. Transitional care programs designed post-stroke carry the promise of improved outcomes reduced hospital readmission rates, however attendance rates these scheduled visits in other early supported discharge are reported low 35%. In addition patient specific consequences, missed clinic impact system...
Introduction: Chronic gait deficits after stroke are prevalent. Current therapy fails to restore normal for many survivors. Transcranial Direct Stimulation (tDCS), a form of non-invasive brain stimulation, is promising adjunct intervention that may enhance motor-learning induced neuroplasticity. tDCS readily deployable into the clinic owing its safety, ease set-up, and feasibility be paired with therapies. Our objective was test whether bihemispheric would improve response stance-phase...
Introduction: Transcranial Direct Current Stimulation (tDCS), a form of non-invasive brain stimulation, is promising adjunct intervention that may enhance motor-learning induced neuroplasticity. It safe and easy to administer, but current distribution can vary due anatomy. Furthermore, it not clear how strong the stimulation should be achieve best outcomes. In this analysis, we evaluated whether higher estimated electric field (e-field) related better response gait training combined with...
Background and Purpose: The inflammatory response after ischemic hemorrhagic stroke is associated with worse clinical outcomes through immune mediated production of pro- cytokines. Repair proteins such as brain derived neurotrophic factor (BDNF) are expressed part the adaptive response. We assessed safety moderate intensity exercise in acute phase its association pro-inflammatory cytokines BDNF expression. Methods: This was a prospective, single center, randomized, pilot prescribed for...
Patients with acute brain injuries are at risk for life threatening elevated intracranial pressure (ICP). External Ventricular Drains (EVDs) used to measure and treat ICP, which switch between clamped draining configurations, accurate ICP data only available during periods. While traditional guidelines focus on mean values, evolving evidence indicates other waveform features may hold prognostic value. However, current machine learning models using waveforms exclude EVD due a lack of digital...
Transtentorial herniation (TTH) is a life-threatening neurologic condition that typically results from expansion of supratentorial mass lesions. A change in bedside pupillary examination central to the clinical diagnosis TTH. Materials and To quantify changes precede accompany TTH its treatment, we evaluated 12 episodes three patients with lesions using automated pupillometry (NeurOptics, Inc., Irvine, CA). Herniation was defined clinically by onset fixed dilated pupils association decreased...
Background and Purpose: At present, stroke patients receiving intravenous thrombolysis (IVT) undergo monitoring of their neurological status vital signs every 15 minutes for the first 2 hours, 30 next 6 hour thereafter up to 24 hours post-IVT. The present study sought prospectively evaluate whether post-IVT with low risk complications may safely be cared utilizing a novel low-intensity protocol. Methods: In this pragmatic, prospective, single-center, open-label, single-arm safety study, we...
Background: The purpose of this study was to evaluate the performance an insulin infusion protocol targeting a blood glucose (BG) level 140–180 mg/dL and characterize adherence. Materials Methods: This retrospective observational cohort including patients for whom ordered from January 2012 May 2013. Performance metrics were assessed in all with initial BG ≥200 mg/dL. Protocol adherence random subset 50 without hypoglycemia hypoglycemic patients. Results: In mg/dL, mean time goal 7.1 h. rate...
The aim of this study was to determine the safety and feasibility an enhanced therapy model for hospitalized stroke patients.This a quasi-experimental cohort acute patients from single hospital. In intervention group, all on service were seen by at least two disciplines daily in addition routine care. comparison group consisted admitted same 1 year before who received standard primary endpoint number completed sessions. Exploratory endpoints compared length hospital stay, readmission rates,...
Background: Rapid administration of hypertonic saline 23.4% is crucial in treatment herniation syndromes. Hypertonic must be administered via a central line. In cases where line access difficult to obtain and leads delay therapy, placement intraosseous can lifesaving. Main body: The purpose this case series describe the use critically ill patients assess feasibility. Conclusion: Intraosseous 6 adult with neurological emergencies was feasible should considered obtaining intravenous time consuming.
Background: Stroke is the second leading cause of death and disability worldwide. centers have become a central component modern stroke services in many high-income countries, but their feasibility efficacy low, middle, emerging countries are less clear. Also, despite availability international guidelines, hospitals worldwide do not organized clinical care. We present methodology to help develop review quality data after implementation. Objectives: To describe compare demographics,...
Upper limb paresis, common in many neurological conditions, is a major contributor of long-term disability and decreased quality life. Evidence shows that repetitive, bilateral arm movement improves upper coordination after injury. However, it difficult to integrate interventions into very early rehabilitation critically ill patients because patient arousal medical acuity. This report describes the safety feasibility cycling with or unilateral paresis. Patients were included this pilot...