A5108022086- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Traumatic Brain Injury and Neurovascular Disturbances
- Clinical practice guidelines implementation
- Neurological Disorders and Treatments
- Peripheral Artery Disease Management
- Atrial Fibrillation Management and Outcomes
- Inflammatory Bowel Disease
- Intracerebral and Subarachnoid Hemorrhage Research
- Cancer-related molecular mechanisms research
- COVID-19 and healthcare impacts
- Intracranial Aneurysms: Treatment and Complications
- Helicobacter pylori-related gastroenterology studies
- Climate Change and Health Impacts
- RNA modifications and cancer
- Vascular Malformations Diagnosis and Treatment
- Long-Term Effects of COVID-19
- Viral gastroenteritis research and epidemiology
- Trigeminal Neuralgia and Treatments
- Cardiac electrophysiology and arrhythmias
- Microscopic Colitis
- Neurological Disease Mechanisms and Treatments
- Connective tissue disorders research
Arcadia
2024
German Cancer Research Center
2023
Heidelberg University
2023
Boston University
2021-2022
Boston Medical Center
2021-2022
Hospital de Clínicas de Porto Alegre
2021
Grady Memorial Hospital
2021
Universidade Federal do Rio Grande do Sul
2021
St. John's Hospital
2021
St. John's Hospital
2016-2020
Earlier tissue-type plasminogen activator (tPA) treatment for acute ischemic stroke increases efficacy, prompting national efforts to reduce door-to-needle times. We used lean process improvement methodology develop a streamlined intravenous tPA protocol.In early 2011, multidisciplinary team analyzed the steps required treat patients with using value stream analysis (VSA). directly compared tPA-treated in "pre-VSA" epoch "post-VSA" regard baseline characteristics, protocol metrics, and...
Background and Purpose— Parenchymal hematoma (PH) is a rare but dreadful complication of acute ischemic stroke with unclear underlying mechanisms. We aimed to study the incidence predictors PH after mechanical thrombectomy. Methods— Data from prospective observational multicenter registry was screened identify patients an anterior circulation large vessel occlusion who underwent Clinical, imaging, procedural characteristics were used for analysis, including brain imaging systematically...
Penumbral biomarkers promise to individualize treatment windows in acute ischemic stroke. We used a novel magnetic resonance imaging approach that measures oxygen metabolic index (OMI), parameter closely related positron emission tomography-derived cerebral rate of utilization (CMRO2), derive pair thresholds: (1) an irreversible-injury threshold differentiates core from penumbra and (2) reversible-injury tissue not-at-risk for infarction.Forty patients with stroke underwent at 3 time points...
Purpose To evaluate the diagnostic accuracy and reliability of computed tomographic (CT) angiography to distinguish true cervical internal carotid artery (ICA) occlusion from pseudo-occlusion (defined as an isolated intracranial thrombus that impedes ascending blood flow) in context acute stroke. Materials Methods This was a retrospective study patients who underwent thrombectomy with preprocedural CT helps demonstrate lack attenuation ICA on symptomatic side (24 men 13 women; mean age, 63...
Background and Purpose— We aimed to study the intrarater interrater agreement of clinicians attributing DWI-ASPECTS (Diffusion-Weighted Imaging–Alberta Stroke Program Early Computed Tomography Scores) DWI-FLAIR Imaging–Fluid Attenuated Inversion Recovery) mismatch in patients with acute ischemic stroke referred for mechanical thrombectomy. Methods— Eighteen raters independently scored anonymized magnetic resonance imaging scans 30 participants from a multicentre thrombectomy trial, 2...
Background and Purpose— Stroke mimics (SM) challenge the initial assessment of patients presenting with possible acute ischemic stroke (AIS). When SM is considered likely, intravenous tissue-type plasminogen activator (tPA) may be withheld, risking an opportunity to treat AIS. Although computed tomography routinely used for tPA decision making, magnetic resonance imaging (MRI) diagnose AIS when favored but not certain. We hypothesized that a hyperacute MRI (hMRI) protocol would identify...
Background and purpose An external validation of the selection criteria diffusion‐weighted imaging or computerized tomography perfusion assessment with clinical mismatch in triage wake‐up late‐presenting strokes undergoing Neurointervention Trevo ( DAWN ) Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke DEFUSE 3) trials was conducted a cohort unknown onset stroke UOS patients treated thrombectomy. Methods A selected from prospectively collected thrombectomy database to...
Purpose We aimed to assess the agreement between study investigators and core laboratory (core lab) of a thrombectomy trial for imaging scores. Methods The Alberta Stroke Program Early CT Score (ASPECTS), European Collaborative Acute Study (ECASS) hemorrhagic transformation (HT) classification, Thrombolysis In Cerebral Infarction (TICI) scores as recorded by were compared with lab in order interrater agreement, using Cohen’s unweighted weighted kappa statistics. Results There frequent...
The Endovascular Acute Stroke Intervention (EASI) trial was conceived as a pragmatic care trial, designed to integrate methods with clinical practice. Reporting the EASI experience met objections and criticisms during peer review concerning both scientific ethical issues. Our goal is discuss these in order promote approach of trials outcome-based medical care. comments 11 reviewers from 5 journals were collected analyzed. protocol also compared protocols seven thrombectomy using...
This study aims to describe the morphological alterations in small and large intestines as well expression of some enterocyte enzymes carriers a rat model iodoacetamide-induced colitis. Biopsies from were taken at 1, 2, 4, 8, 16 days postinduction studied by light microscopy. The expressions lactase, sucrase, aminopeptidase, Glut-5 jejunum immunohistochemistry. Gene lactase sucrase determined RT-PCR using specific oligonucleotides. Microscopic examination revealed manifestations concordant...
The way clinical care and research are currently conceived is entangled in multiple problems. While the problems universal, nowhere were they more painfully experienced than acute of patients with severe stroke. we celebrating that now possess evidence can benefit from endovascular interventions, should not miss opportunity to review difficult path led this point reflect on how it could be improved. A narrative past current status treatment stroke may serve expose potential solutions. For...
Purpose The DAWN trial (Diffusion weighted imaging or CT perfusion Assessment with clinical mismatch in the triage of Wake-up and late presenting strokes undergoing Neurointervention Trevo) has demonstrated benefits thrombectomy patients unknown onset strokes, using automated software (RAPID) for measurement infarct volume. Because RAPID is not available all centers, we aimed to assess accuracy repeatability visual volume estimation by clinicians consequences decisions based on criteria....
Endovascular particle embolization is a common procedure with relatively safe profile. We report here four cases in which cranial nerves, skin and mucosal ischemic complications occurred the use of hydrogel microspheres (250–500 µm size). Given compressibility higher penetration potential microsphere particles compared polyvinyl alcohol similar size, we suggest oversizing for head neck embolizations.
Summary In this study, Cucurbita foetidissima (Buffalo gourd) was investigated as a source of edible oil for human consumption. The seeds are rich in (28%) well protein (29%). General chemical tests such the iodine number, saponification acid value and others were favourably compared to values other oils. analysis crude by means gas liquid chromatography showed that it is linoleic (63%) has high unsaturated saturated fatty ratio. percentage extremely low linolenic indicate could be valuable...
Endovascular coil embolization of cerebral aneurysms is an effective treatment for the prevention aneurysm rebleeding after subarachnoid hemorrhage. It also often used in unruptured aneurysms, but it associated with remnants and recurrences up to 20%-33% patients. We hypothesized that better occlusion rates can be achieved coils larger caliber.The Does Embolization Larger lead Treatment Aneurysms (DELTA) trial investigator-initiated, multicenter, prospective, randomized, controlled clinical...
Background and purpose Endovascular coil embolization of cerebral aneurysms is associated with suboptimal angiographic results in up to 20-30% patients. Coil packing density has been used as an index the success initial procedure. The trial sought study effects using 15-caliber coils, compared 10-caliber on density. Methods Does Embolization Larger coils lead better Treatment Aneurysms (DELTA) investigator-initiated multicenter prospective, randomized, controlled clinical trial. Patients are...
Objectives: To assess whether performing a pre-intervention gadolinium-enhanced extracranial magnetic resonance angiogram (MRA) in addition to intracranial vascular imaging is associated with improved thrombectomy time metrics. Methods: Consecutive patients treated by MT at large comprehensive stroke center between January 2012 and December 2017 who were screened using MRI included. Patients characteristics procedural data collected. Univariate multivariate analysis performed compare speed,...