A5038876749- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Autism Spectrum Disorder Research
- Cerebrovascular and Carotid Artery Diseases
- Intracerebral and Subarachnoid Hemorrhage Research
- Parkinson's Disease Mechanisms and Treatments
- Vascular Malformations Diagnosis and Treatment
- Cardiovascular Health and Risk Factors
- Venous Thromboembolism Diagnosis and Management
- Autoimmune and Inflammatory Disorders
- Sepsis Diagnosis and Treatment
- Neurological disorders and treatments
- HER2/EGFR in Cancer Research
- Organ Donation and Transplantation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Global Public Health Policies and Epidemiology
- Facial Nerve Paralysis Treatment and Research
- Transcranial Magnetic Stimulation Studies
- Patient Safety and Medication Errors
- Atrial Fibrillation Management and Outcomes
- Cerebral Venous Sinus Thrombosis
- Vascular Procedures and Complications
- Inflammatory Biomarkers in Disease Prognosis
- Adrenal and Paraganglionic Tumors
- Pain Management and Treatment
Duke Medical Center
2022-2025
Duke University Hospital
2022-2025
Duke University
2024-2025
Universidad Nacional
2025
Universidad de Costa Rica
2012-2024
ORCID
2024
Charleston Area Medical Center
2024
Baylor College of Medicine
2020-2023
Fundación Universitaria de Ciencias de la Salud
2019-2020
Costa Rican Department of Social Security
2017-2018
A patient presented with fever, generalised rash, confusion, orofacial movements and myoclonus after receiving the first dose of mRNA-1273 vaccine from Moderna. MRI was unremarkable while cerebrospinal fluid showed leucocytosis lymphocyte predominance hyperproteinorrachia. The skin evidenced red, non-scaly, oedematous papules coalescing into plaques scattered non-follicular pustules. Skin biopsy consistent a neutrophilic dermatosis. fulfilled criteria for Sweet syndrome. thorough evaluation...
Age and sex are known risk factors for Parkinson's Disease (PD), but it remains controversial if there differences in the diagnosis latency. The objective of this study was to examine these Latin America. American Research Consortium on Genetics PD (LARGE-PD) includes patients from countries across America who were diagnosed using UK Brain Bank criteria. Ages at onset (AAO; N = 2,792), (AAD; 1,416), calculated latency (N 1,416) extracted LARGE-PD database compared both males females overall,...
We conducted an observational study evaluating the association between uric acid, mean platelet volume (MPV), and high-density lipoprotein (HDL) with complications outcomes of patients sepsis in a critical care setting.We followed diagnosis severe septic shock for maximum 28 days. Main assessed included length stay (LOS), need renal replacement therapy (RRT), assisted mechanical ventilation (AMV), vasopressor support as well in-unit mortality.The overall average age 37 enrolled was 48.1...
Background Reports on sex differences in stroke outcome and risk factors are scarce Latin America. Our objective was to analyze clinical prognostic according among participants the LASE (Latin American Stroke Registry). Methods Results Nineteen centers across Central South America compiled data demographics, vascular factors, description, ancillary tests, functional outcomes at short-term follow-up of patients included from January 2012 2017. For present study, all these variables were...
Background . Activating mutations in the RET gene leads to medullary thyroid carcinoma (MTC). Guidelines encourage performing analysis subjects with hereditary and sporadic disease. Materials Methods Design Observational, case series report study. Patients Subjects diagnosed MTC, a thyroidectomy performed single center Costa Rica between years 2006 2015. Diagnosis Follow-Up Pre- postoperative calcitonin, mutation, neck ultrasound tomography were obtained. Results 21 histological diagnosis of...
A 53-year-old postmenopausal woman with non-alcoholic steatohepatitis cirrhosis, type II diabetes mellitus, hirsutism, depression and morbid obesity was evaluated for new onset seizures prior to liver transplant. The patient had been admitted repeated bouts of hepatic encephalopathy over the
Background: Most research in genomics of Parkinson's disease (PD) has been done subjects European ancestry, leading to sampling bias and leaving Latin American populations underrepresented. We sought clinically characterize PD patients Costa Rican origin sequence familial atypical parkinsonism-associated genes cases controls. Methods: enrolled 118 with 97 unrelated Collected information included demographics, exposure risk protective factors, motor cognitive assessments. sequenced coding...
We present a case of patient with diabetes pleural empyema originated from pyomyositis process established after central line procedure. This later on extended into the spinal canal deriving an epidural empyema, leading towards neurogenic shock and death. discuss anatomical substrate for this extension as well anatomopathological findings observed in autopsy.
Despite the reduction in glycemic derangement patients with type 1 diabetes mellitus (T1D) through dietary and therapeutic adjustments implemented before, during after continuous exercise, evidence for its effectiveness intermittent forms of such as soccer, is still lacking.We designed a study protocol randomized, crossover, double-blinded, controlled trial, evaluation effect that strategy modifications may have on safety performance persons T1D soccer training sessions cognitive testing....
<title>Abstract</title> Background Oral anticoagulation (OAC) is a risk factor for intracerebral hemorrhage (ICH) which an important source of disability and mortality. OAC-associated ICH (OAC-ICH) patients have worse outcomes as compared to not on OAC, likely because the associated larger stroke volumes, higher propensity intraventricular hemorrhage, rebleeding. Although current guidelines recommend that OAC should be reversed quickly, many health care systems developed process optimizing...
We evaluated the impact of a simulation-based brain death determination workshop among second-year neurology residents, focusing on foundational understanding as well their proficiency conducting examinations.
Introduction: The Costa Rican Longevity and Healthy Aging Study (CRELES), initiated in 2005, captures the health lifestyle of elderly Ricans with survival data up to 2019. We explored association between sociodemographic clinical variables number controlled cardiovascular risk factors (CVRFs). Methodology: From CRELES, 1943 participants were categorized for meeting targets none 5 CVRFs, which included A1c, blood pressure, exercise, BMI, smoking. modeled CVRFs through ordered logistic...
Introduction: The Costa Rican Longevity and Healthy Aging Study prospective cohort examined older adults' health status in Rica. We investigated the influence of goal attainment on controlling cardiovascular risk factors (CVRFs): BMI, A1C, exercise, blood pressure, smoking, along with their correlation all-cause mortality. Methodology: Survival data from initial 2005 visit to 2019 included 1943 participants. Categorization was based meeting targets for five CVRFs. Hazard ratios mortality...
Introduction: The prospective cohort Costa Rican Longevity and Healthy Aging Study (CRELES) offers comprehensive data on the lifestyle of elderly Ricans enrolled in 2005, with survival status up to 2019. We aimed describe characteristics participants based number controlled cardiovascular risk factors (CVRFs). Methodology: recruited 1943 categorized CVRFs meeting targets from 0 5 (A1c, blood pressure, exercise, BMI, smoking). Descriptively, we report proportions means SD for each variable...
We sought to compare thrombolysis outcomes from the Costa Rican Stroke Registry Program (CRSRP) with published individual patient data NINDS and CLOTBUST-ER trials using matching outcome modeling randomized clinical (RCTs).A retrospective observational study subjects on baseline characteristics, CRSRP, control arm of CLOTBUST-ER, interventional trials. Day 7-10/discharge modified Rankin Score (mRS), early mortality was compared between matched subjects. A model derived RCTs developed, were...
Background and objectives Structured systematised checklists have been shown to prevent complications improve patient care. We evaluated the implementation of systematic safety in our neurocritical care unit (NCCU) assessed its effect on outcomes. Design/methods This quality improvement project followed a Plan–Do–Study–Act (PDSA) methodology. A checklist for medication reconciliation, thromboembolic prophylaxis, glycaemic control, daily spontaneous awakening, breathing trial, diet,...