A5071955049- Acute Ischemic Stroke Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracranial Aneurysms: Treatment and Complications
- Inflammation biomarkers and pathways
- Neurological Disease Mechanisms and Treatments
- IL-33, ST2, and ILC Pathways
- Moyamoya disease diagnosis and treatment
- Alcohol Consumption and Health Effects
- Trauma and Emergency Care Studies
- Cardiac Imaging and Diagnostics
- Cerebrovascular and genetic disorders
- Neurological Disorders and Treatments
- Venous Thromboembolism Diagnosis and Management
- Biomarkers in Disease Mechanisms
- Glioma Diagnosis and Treatment
- Vestibular and auditory disorders
- MicroRNA in disease regulation
- Cerebrospinal fluid and hydrocephalus
- S100 Proteins and Annexins
- Clusterin in disease pathology
- Cardiovascular Syncope and Autonomic Disorders
- MRI in cancer diagnosis
- Metabolomics and Mass Spectrometry Studies
Mayo Clinic in Florida
2022-2024
WinnMed
2022-2024
Massachusetts General Hospital
2017-2022
University of Utah
2021-2022
Harvard University
2018-2022
Johns Hopkins University
2019
Johns Hopkins Hospital
2019
Beth Israel Deaconess Hospital
2019
OBJECTIVE There is variability and uncertainty about the optimal approach to management discontinuation of an external ventricular drain (EVD) after subarachnoid hemorrhage (SAH). Evidence from single-center randomized trials suggests that intermittent CSF drainage rapid EVD weans are safe associated with shorter ICU length stay (LOS) fewer complications. However, a recent survey revealed most neurocritical care units across United States employ continuous gradual wean strategy. Therefore,...
As health systems organize to deliver the highest quality stroke care their patients, there is increasing emphasis being placed on prehospital recognition, accurate diagnosis, and efficient triage improve outcomes after stroke. Emergency medical services (EMS) personnel currently rely heavily dispatch accuracy, screening tools, bypass protocols notification for patients with suspected stroke, but novel tools including mobile units telemedicine-enabled ambulances are already changing...
Objective ST2 is a member of the toll-like receptor superfamily that can alter inflammatory signaling helper T-cells. We investigated whether soluble (sST2) could independently predict outcome and hemorrhagic transformation (HT) in setting stroke. Methods measured sST2 patients enrolled Specialized Program Translational Research Acute Stroke (SPOTRIAS) network biomarker study. 646 had plasma samples collected at time hospital admission 210 second sample 48 h after stroke onset. Functional...
To determine whether altered metabolic profiles represent a link between atrial dysfunction and cardioembolic (CE) stroke, thus underlying dysfunctional substrate may contribute to thromboembolism risk in CE stroke.A total of 144 metabolites were measured using liquid chromatography-tandem mass spectrometry plasma samples collected within 9 hours stroke onset 367 acute patients. Stroke subtype was assigned the Causative Classification System, (n = 181) compared non-CE 186). Markers left...
Metabolite profiling (or metabolomics) can identify candidate biomarkers for disease and potentially uncover new pathways intervention. The goal of this study was to potential functional outcome after subarachnoid hemorrhage (SAH).
Background: Treatment of uncontrolled arterial hypertension reduces the risk cerebral small vessel disease (CSVD) progression, although it is unclear whether this reduction occurs due to blood pressure control or class-specific pleiotropic effects, such as improved beat-to-beat variability with calcium channel blockers. The goal study was investigate influence antihypertensive medication class, particularly blocker, on accumulation white matter hyperintensities (WMH), a radiographic marker...
Objective To investigate whether soluble growth stimulation expressed gene 2 (sST2), a prognostic marker in cardiovascular and inflammatory disorders, is associated with neurological injury after aneurysmal subarachnoid hemorrhage (SAH). Methods We studied SAH patients from independent cohorts. Outcome assessments included functional status at 90 days using the modified Rankin Scale (mRS), mortality, delayed cerebral ischemia (DCI). The relationships between sST2 plasma level outcome...
Objective: Increased visit-to-visit blood pressure variability (vvBPV) has negative effects on multiple organ systems. Prior research suggested that dihydropyridine calcium channel blockers (CCB) may reduce vvBPV, which we attempted to verify in a high-quality dataset with robust statistical methodology. Methods: We performed post hoc analysis of the SPRINT trial and included participants who were CCB either 0 or 100% follow-up study visits. The primary outcome was defined as residual...
Brain edema after a large stroke causes significant morbidity and mortality. Here, we seek to identify pharmacodynamic markers of that are modified by intravenous (i.v.) glibenclamide (glyburide; BIIB093) treatment. Using metabolomic profiling 399 plasma samples from patients enrolled in the phase 2 Glyburide Advantage Malignant Edema Stroke (GAMES)-RP trial, 152 analytes measured using liquid chromatography-tandem mass spectrometry. Associations with midline shift (MLS) matrix...
Time-dependent change in the level of biomarkers after stroke is not well understood. We sought to compare fatty acid-binding protein 4 (FABP4), Galectin-3, and soluble ST2 ascertain for a prediction outcome at admission 48 h later.Plasma FABP4, were measured biospecimens from acute patients time (n = 383) later 244). Functional was assessed 90 days using modified Rankin Scale dichotomized into good (modified 0-2) poor 3-6).On admission, elevated levels each biomarker predicted (FABP4: OR...
Progression of white matter hyperintensities (WMHs), a radiographic marker cerebral small vessel disease, occurs with uncontrolled conventional cerebrovascular risk factors. Less certain, however, is the influence dyslipidemia and impact 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors (statins) on WMH progression. The goal this study was to evaluate statins progression over 4-year interval. We performed post hoc analysis SPRINT-MIND database those serial volumetric data....
Introduction: Leukemic involvement in high grade B cell lymphoma (L-HGBL) is rare and has been sparsely described the literature. We report our experience a large single institution multicenter academic setting. Materials Methods: Medical records of patients with HGBL who received care at Mayo Clinic between 2003 2020 were reviewed. L-HGBL was confirmed by peripheral blood smear flow cytometry corroboration from tissue bone marrow biopsy findings. Results: Twenty met inclusion criteria. All...
Introduction: Collateral cerebrovasculature is important for the survival of penumbral tissue in patients with large vessel occlusive (LVO) stroke, and adequate collateralization associated favorable outcomes. The presence cerebral microbleeds (CMB) have been implicated wall remodeling impaired vasoreactivity. We investigated whether deep and/or lobar CMB predicts poor collateral recruitment LVO stroke who underwent thrombectomy (MT). Methods: performed a retrospective, single-center study...
We sought to design a Virtual Reality (VR) program integrating commercially available eye and hand tracking autonomously accurately assess components of the National Institutes Health Stroke Scale (NIHSS).
Introduction: White matter hyperintensity (WMH), a radiographic marker of cerebral small vessel disease, is typically treated by modification conventional cerebrovascular risk factors. However, the influence dyslipidemia and impact 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors (statins) on WMH less certain. The goal this study was to evaluate statins progression over four-year interval. Methods: We performed post-hoc analysis SPRINT-MIND database for participants who had...
Introduction: Soluble ST2 (sST2) is a member of the interleukin-1 receptor family that predicts mortality and outcome in cardiovascular disease. We aimed to determine whether baseline sST2 functional after stroke examined its potential role hemorrhagic transformation (HT). Methods: measured plasma matrix metalloproteinase-9 (MMP-9) 646 patients who presented with acute ischemic were enrolled Specialized Program Translational Research Acute Stroke (SPOTRIAS) network biomarker study. total...
Stapleton, Christopher J MD; Irvine, Hannah; Wolcott, Zoe; Patel, Aman B Rosand, Jonathan; Kimberly, W Taylor
Introduction: Accurate determination of stroke etiology is important in order to implement appropriate secondary prevention. Approximately 25% are embolic strokes undetermined source, a subset which eventually attributed cardioembolism after prolonged outpatient electrocardiogram monitoring. We applied metabolite profiling determine whether metabolomic profile could identify cardioembolic signature that inform source. Hypothesis: hypothesized specific reflected by circulating metabolites be...
Introduction: Hemorrhagic transformation (HT) is an uncommon but adverse complication after a stroke that can cause secondary injury. We sought to determine whether glyburide reduce HT in ischemia/reperfusion model of stroke. Materials and Methods: used transient filament occlusion the middle cerebral artery (tMCAo), with three hours ischemia. Glyburide (n=10) was administered as intravenous bolus followed by subcutaneous continuous infusion using osmotic pump deliver dose 39.5 ug/day....
Introduction/Hypothesis: The sterile inflammatory response involves activation of the immune system in absence infection following trauma, ischemia, or toxins. Matrix metalloproteinase-9 (MMP-9) is a neuro-inflammatory zinc metalloproteinase implicated secondary injury after acute ischemic stroke. In order to determine whether MMP-9 was associated with response, we examined association between circulating and extracellular ATP [a marker damage-associated molecular pattern (DAMP)] neutrophil...
Introduction: Soluble ST2 (sST2) is a member of the interleukin-1 receptor family known to predict outcome and mortality in cardiovascular disease ischemic stroke. We sought determine whether plasma sST2 concentration associated with functional after intraparenchymal hemorrhage. Methods: Concentration was measured on samples from prospectively collected cohort 75 patients who presented spontaneous Blood were drawn between 24 72 hours symptom onset. using commercially-available ELISA...
Introduction: Soluble ST2 (sST2) is a member of the Toll-like receptor superfamily implicated in pro-inflammatory signaling. We investigated whether sST2 predicts delayed cerebral ischemia (DCI) and 90-day clinical outcome patients with aneurysmal subarachnoid hemorrhage (SAH). Methods: was measured plasma samples from 182 who presented to single institution SAH. Blood were collected between days 1 5 after onset SAH, prior DCI. Functional assessed at 3 months using modified Rankin Scale...