A5086708867- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Intracerebral and Subarachnoid Hemorrhage Research
- Traumatic Brain Injury and Neurovascular Disturbances
- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Antiplatelet Therapy and Cardiovascular Diseases
- Protease and Inhibitor Mechanisms
- Health Systems, Economic Evaluations, Quality of Life
- Neurosurgical Procedures and Complications
- Neurological Disorders and Treatments
- Blood Coagulation and Thrombosis Mechanisms
- Cancer-related molecular mechanisms research
- Atrial Fibrillation Management and Outcomes
- Intracranial Aneurysms: Treatment and Complications
- Neurological Disease Mechanisms and Treatments
- Airway Management and Intubation Techniques
- Neuroinflammation and Neurodegeneration Mechanisms
- Cardiac Arrest and Resuscitation
- Epilepsy research and treatment
- S100 Proteins and Annexins
- Clinical practice guidelines implementation
- Ethics in Clinical Research
University of Cincinnati Medical Center
2004-2024
University of Virginia
2024
University of Cincinnati
2010-2022
Sabin Vaccine Institute
2001-2021
Cincinnati Children's Hospital Medical Center
2005-2015
Kings County Hospital Center
2015
State University of New York
2015
Medical University of South Carolina
2010-2014
Wake Forest University
2010-2011
University Medical Center
2009-2011
Background and Purpose —The Greater Cincinnati/Northern Kentucky Stroke Study was designed to be the first large, population-based metropolitan study of temporal trends in stroke incidence rates outcome within a biracial population. Methods —We are identifying all hospitalized autopsied cases transient ischemic attack (TIA) among 1.3 million inhabitants five-county region for period 7/1/93–6/30/94. We have already prospectively monitored out-of-hospital TIAs this same time at 128 screening...
Early termination of prolonged seizures with intravenous administration benzodiazepines improves outcomes. For faster and more reliable administration, paramedics increasingly use an intramuscular route.This double-blind, randomized, noninferiority trial compared the efficacy midazolam that lorazepam for children adults in status epilepticus treated by paramedics. Subjects whose convulsions had persisted than 5 minutes who were still convulsing after arrived given study medication either...
Patient delay in seeking treatment for acute coronary syndrome and stroke symptoms is the major factor limiting delivery of definitive these conditions. Despite decades research public education campaigns aimed at decreasing patient times, most patients still do not seek a timely manner. In this scientific statement, we summarize evidence that (1) demonstrates benefits early treatment, (2) describes extent problem delay, (3) identifies factors related to (4) reveals inadequacies our current...
Context.—Decreasing the time from stroke onset to hospital arrival and improving control of risk factors depend on public knowledge warning signs factors.Objective.—To assess current factors.Design.—A population-based telephone interview survey using random digit dialing conducted in 1995.Setting.—The Greater Cincinnati, Ohio, metropolitan area, population which is similar that United States overall age, sex, percentage blacks, economic status.Participants.—Respondents with race, sex matched...
Background and Purpose— Transient ischemic attacks (TIAs) have been shown to be a strong predictor of subsequent stroke death. We present the incidence short-term prognosis TIA within large population with significant proportion minorities out-of-hospital TIA. Methods— cases were identified between July 1, 1993 June 30, 1994 from Greater Cincinnati/Northern Kentucky 1.3 million inhabitants by previously published surveillance methods, including inpatient events. Incidence rates adjusted 1990...
Background and Purpose — Intracerebral hemorrhage (ICH) has a 30-day mortality rate of 40% to 50% lacks proven treatment. We report preplanned, midpoint analysis the first population-based, case-control study that examines both genetic environmental risk factors ICH. Methods prospectively identified cases hemorrhagic stroke at all 16 hospitals in Greater Cincinnati/Northern Kentucky region. All underwent medical record neuroimaging review. Cases enrolled direct interview sampling arm were...
Background and Purpose— Excess mortality resulting from stroke is an important reason why blacks have higher age-adjusted rates than whites. This observation has 2 possible explanations: Strokes occur more commonly among or after stroke. Our population-based epidemiological study set in the Greater Cincinnati/Northern Kentucky region of 1.31 million people, which representative US white black populations with regard to many demographic socioeconomic characteristics. Methods— Hospitalized...
<h3>Context</h3> Poor public knowledge of stroke warning signs and risk factors limits effective intervention prevention. <h3>Objective</h3> To examine temporal trends in factors. <h3>Design Setting</h3> Population-based random-digit telephone survey conducted July-November 2000 among individuals the greater Cincinnati, Ohio, region. <h3>Participants</h3> A total 2173 respondents (69% response rate) were randomly identified based on their demographic similarities to ischemic population with...
Background and Purpose —The safety the effectiveness of surgical treatment spontaneous intracerebral hemorrhage (ICH) remain controversial. To investigate feasibility urgent evacuation ICH, we conducted a small, randomized study early versus current nonoperative management in patients with supratentorial ICH. Methods —Patients ICH who presented to 1 university 2 community hospitals were or best medical treatment. Principal eligibility criteria volume >10 cm 3 on baseline CT scan focal...
S troke continues to be a significant cause of morbidity and mortality in the United States.Approximately 700 000 Americans have new or recurrent stroke each year, remains third leading death States when considered independently from other cardiovascular diseases.Stroke also serious, long-term disability States. 1 Major advances been made during past several decades prevention, treatment, rehabilitation.Despite successes delivering effective therapies, obstacles remain ensuring that...
Background and Purpose— Acute ischemic stroke patients are infrequently treated with recombinant tissue plasminogen activator (rtPA). We present unique population-based data regarding the eligibility of for rtPA treatment. Methods— All strokes presenting to an emergency department (ED) within a biracial population 1.3 million were identified. The patient was considered eligible on basis exclusion criteria from National Institute Neurological Disorders Stroke trial. Results— Of 2308 strokes,...
Background and Purpose— Blacks have an excess burden of stroke compared with whites; however, data comparing ischemic subtypes among the 2 groups are limited typically involve relative frequencies. The objective this study is to compare incidence rates between blacks whites within a large, representative, biracial population. Methods— Greater Cincinnati/Northern Kentucky Stroke Study designed measure trends all strokes well-defined, Hospitalized cases were ascertained by International...
Background and Purpose — Subarachnoid hemorrhage (SAH) caused by ruptured intracranial aneurysm affects approximately 16 000 Americans annually, almost 40% of affected patients die within 30 days despite the best current therapy. Prevention SAH is therefore paramount importance. We present a preliminary analysis risk factors for from our population-based, case-control study. Methods Cases were prospectively collected matched 2:1 age, race, gender to controls using random digit dialing....
Background and Purpose— Stroke is the third leading cause of death disability in United States. Intracerebral hemorrhage subarachnoid represent ≈20% all stroke cases have a mortality rate 40% to 50%. Hypertension an important risk factor for these subtypes stroke. We sought determine whether untreated hypertension carries different from treated hemorrhagic Methods— Cases greater Cincinnati region were identified by screening area hospital emergency rooms, radiology reports, International...
Background and Purpose— Multiple approaches are being studied to enhance the rate of thrombolysis for acute ischemic stroke. Treatment myocardial infarction with a combination reduced-dose fibrinolytic agent glycoprotein (GP) IIb/IIIa receptor antagonist has been shown improve recanalization versus fibrinolysis alone. The c ombined approach l ysis utilizing e ptifibatide nd r ecombinant tissue-type plasminogen activator (rt-PA) (CLEAR) stroke trial assessed safety treating patients within 3...
Delay in seeking medical attention after stroke symptom onset is the most important reason for low rates of thrombolytic use ischemic (IS) United States. This may be related to poor recognition symptoms, or lack awareness time-sensitive treatments. We describe public knowledge t-PA as a treatment IS, well changes over time warning signs (WS) and risk factors (RF).Survey respondents were drawn from our biracial population 1.3 million using random-digit dialing 1995, 2000, 2005 reflect age,...
A blood-based biomarker of acute ischemic stroke would be significant value in clinical practice. This study aimed to (1) replicate a larger cohort our previous using gene expression profiling predict stroke; and (2) refine prediction by including control groups relevant stroke.Patients with (n=70, 199 samples) were compared subjects who healthy (n=38), had vascular risk factors (n=52), myocardial infarction (n=17). Whole blood was drawn ≤3 hours, 5 24 hours after onset from subjects. RNA...
Abstract Objective: The cause of stroke remains unknown or cryptogenic in many patients. We sought to determine whether gene expression signatures blood can distinguish between cardioembolic and large‐vessel causes stroke, these profiles predict etiology the group. Methods: A total 194 samples from 76 acute ischemic patients were analyzed. RNA was isolated run on Affymetrix U133 Plus2.0 microarrays. Genes that determined at 3, 5, 24 hours following onset. Predictors evaluated using...
Aims Epidemiological studies suggest that sex has a role in the pathogenesis of cardioembolic stroke. Since stroke is vascular disease, identifying sexually dimorphic gene expression changes blood leukocytes can inform on sex-specific risk factors, response and outcome biology. We aimed to examine immune following by studying differential peripheral white cells. Methods Results Blood samples from patients with were obtained at ≤3 hours (prior treatment), 5 24 (after treatment) after onset (n...
In a previous study, 0.3 and 0.45 mg/kg of intravenous recombinant tissue plasminogen activator (rt-PA) were safe when combined with eptifibatide 75 mcg/kg bolus 2-hour infusion (0.75 per minute). The Combined Approach to Lysis Utilizing Eptifibatide rt-PA in Acute Ischemic Stroke-Enhanced Regimen (CLEAR-ER) trial sought determine the safety higher-dose regimen establish evidence for phase III trial.CLEAR-ER was multicenter, double-blind, randomized study. stroke patients 0.6 plus (135 at...