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  1. Article ; Online: Cases of Stroke Presenting With an Isolated Third Nerve Palsy.

    Indraswari, Fransisca / Mukharesh, Loulwah / Burger, Kathleen M / Leon Guerrero, Christopher R

    Stroke

    2021  Volume 52, Issue 2, Page(s) e58–e60

    MeSH term(s) Humans ; Male ; Middle Aged ; Oculomotor Nerve Diseases/etiology ; Stroke/complications
    Language English
    Publishing date 2021-01-07
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.120.030568
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Assessing the capacity of methylated DNA markers of cervical squamous cell carcinoma to discriminate oropharyngeal squamous cell carcinoma in human papillomavirus mediated disease.

    Bartemes, Kathleen R / Gochanour, Benjamin R / Routman, David M / Ma, Daniel J / Doering, Karen A / Burger, Kelli N / Foote, Patrick H / Taylor, William R / Mahoney, Douglas W / Berger, Calise K / Cao, Xiaoming / Then, Sara S / Haller, Travis J / Larish, Alyssa M / Moore, Eric J / Garcia, Joaquin J / Graham, Rondell P / Bakkum-Gamez, Jamie N / Kisiel, John B /
    Van Abel, Kathryn M

    Oral oncology

    2023  Volume 146, Page(s) 106568

    Abstract: Objective: Early identification of human papillomavirus associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC) is challenging and novel biomarkers are needed. We hypothesized that a panel of methylated DNA markers (MDMs) found in HPV(+) cervical ...

    Abstract Objective: Early identification of human papillomavirus associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC) is challenging and novel biomarkers are needed. We hypothesized that a panel of methylated DNA markers (MDMs) found in HPV(+) cervical squamous cell carcinoma (CSCC) will have similar discrimination in HPV(+)OPSCC tissues.
    Materials and methods: Formalin-fixed, paraffin-embedded tissues were obtained from patients with primary HPV(+)OPSCC or HPV(+)CSCC; control tissues included normal oropharynx palatine tonsil (NOP) and cervix (NCS). Using a methylation-specific polymerase chain reaction, 21 previously validated cervical MDMs were evaluated on tissue-extracted DNA. Discrimination between case and control cervical and oropharynx tissue was assessed using area under the curve (AUC).
    Results: 34 HPV(+)OPSCC, 36 HPV(+)CSCC, 26 NOP, and 24 NCS patients met inclusion criteria. Within HPV(+)CSCC, 18/21 (86%) of MDMs achieved an AUC ≥ 0.9 and all MDMs exhibited better than chance classifications relative to control cervical tissue (all p < 0.001). In contrast, within HPV(+)OPSCC only 5/21 (24%) MDMs achieved an AUC ≥ 0.90 but 19/21 (90%) exhibited better than chance classifications relative to control tonsil tissue (all p < 0.001). Overall, 13/21 MDMs had statistically significant lower AUCs in the oropharyngeal cohort compared to the cervical cohort, and only 1 MDM exhibited a statistically significant increase in AUC.
    Conclusions: Previously validated MDMs exhibited robust performance in independent HPV(+)CSCC patients. However, most of these MDMs exhibited higher discrimination for HPV(+)CSCC than for HPV(+)OPSCC. This suggests that each SCC subtype requires a unique set of MDMs for optimal discrimination. Future studies are necessary to establish an MDM panel for HPV(+)OPSCC.
    MeSH term(s) Female ; Humans ; Squamous Cell Carcinoma of Head and Neck/genetics ; Carcinoma, Squamous Cell/pathology ; Human Papillomavirus Viruses ; Papillomavirus Infections/complications ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/genetics ; Genetic Markers ; Oropharyngeal Neoplasms ; DNA Methylation ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/genetics ; Papillomaviridae/genetics ; Head and Neck Neoplasms/genetics
    Chemical Substances Genetic Markers
    Language English
    Publishing date 2023-09-16
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1120465-5
    ISSN 1879-0593 ; 0964-1955 ; 1368-8375
    ISSN (online) 1879-0593
    ISSN 0964-1955 ; 1368-8375
    DOI 10.1016/j.oraloncology.2023.106568
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Numerous Fusiform and Saccular Cerebral Aneurysms in Central Nervous System Lupus Presenting with Ischemic Stroke.

    Majidi, Shahram / Leon Guerrero, Christopher R / Gandhy, Shreya / Burger, Kathleen M / Sigounas, Dimitri

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

    2017  Volume 26, Issue 7, Page(s) e126–e128

    Abstract: Central nervous system (CNS) involvement occurs in up to 50% of patients with systemic lupus erythematosus (SLE). Cerebral aneurysm formation is a rare complication of CNS lupus. The majority of these patients present with subarachnoid hemorrhage. We ... ...

    Abstract Central nervous system (CNS) involvement occurs in up to 50% of patients with systemic lupus erythematosus (SLE). Cerebral aneurysm formation is a rare complication of CNS lupus. The majority of these patients present with subarachnoid hemorrhage. We report a patient with an active SLE flare who presented with a recurrent ischemic stroke and was found to have numerous unruptured fusiform and saccular aneurysms in multiple vascular territories. He was treated with high-dose steroid and rituximab along with aspirin and blood pressure control for stroke prevention.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2017.03.040
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  4. Article ; Online: Surface ocean warming near the core of hurricane Sam and its representation in forecast models

    Andrew M. Chiodi / Hristina Hristova / Gregory R. Foltz / Jun A. Zhang / Calvin W. Mordy / Catherine R. Edwards / Chidong Zhang / Christian Meinig / Dongxiao Zhang / Edoardo Mazza / Edward D. Cokelet / Eugene F. Burger / Francis Bringas / Gustavo Goni / Hyun-Sook Kim / Sue Chen / Joaquin Triñanes / Kathleen Bailey / Kevin M. O’Brien /
    Maria Morales-Caez / Noah Lawrence-Slavas / Shuyi S. Chen / Xingchao Chen

    Frontiers in Marine Science, Vol

    2024  Volume 10

    Abstract: ... in the upper 30 m, followed by deeper mixing and entrainment of warmer subsurface water into the mixed layer ...

    Abstract On September 30, 2021, a saildrone uncrewed surface vehicle intercepted Hurricane Sam in the northwestern tropical Atlantic and provided continuous observations near the eyewall. Measured surface ocean temperature unexpectedly increased during the first half of the storm. Saildrone current shear and upper-ocean structure from the nearest Argo profiles show an initial trapping of wind momentum by a strong halocline in the upper 30 m, followed by deeper mixing and entrainment of warmer subsurface water into the mixed layer. The ocean initial conditions provided to operational forecast models failed to capture the observed upper-ocean structure. The forecast models failed to simulate the warming and developed a surface cold bias of ~0.5°C by the time peak winds were observed, resulting in a 12-17% underestimation of surface enthalpy flux near the eyewall. Results imply that enhanced upper-ocean observations and, critically, improved assimilation into the hurricane forecast systems, could directly benefit hurricane intensity forecasts.
    Keywords tropical cyclones ; saildrone intercept ; enthalpy flux ; salinity stratification ; temperature inversions ; ARGO ; Science ; Q ; General. Including nature conservation ; geographical distribution ; QH1-199.5
    Subject code 551
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Inpatient versus Outpatient Management of TIA or Minor Stroke: Clinical Outcome.

    Majidi, Shahram / Leon Guerrero, Christopher R / Burger, Kathleen M / Rothrock, John F

    Journal of vascular and interventional neurology

    2017  Volume 9, Issue 4, Page(s) 49–53

    Abstract: Background: The management of patients with acute transient ischemic attack (TIA) or minor stroke is highly variable. Whether hospitalization of such patients significantly improves short-term clinical outcome is unknown. We assessed the short-term ... ...

    Abstract Background: The management of patients with acute transient ischemic attack (TIA) or minor stroke is highly variable. Whether hospitalization of such patients significantly improves short-term clinical outcome is unknown. We assessed the short-term clinical outcome associated with inpatient versus outpatient management of patients with TIA or minor stroke.
    Methods: We evaluated a consecutive series of patients with acute TIA or minor ischemic stroke (NIH Stroke Scale score ≤ 3) presenting to a single emergency department (ED). We randomized patients to either hospital-based or outpatient-based management. All patients underwent interview and examination 7-10 days following the index event.
    Results: This study included 100 patients, 41 with TIA and 59 with minor stroke. Nineteen (46%) of the TIA patients and 29 (49%) of the minor stroke patients randomized to hospital management, and the remaining 22 TIA patients and 30 minor stroke patients randomized to outpatient-based management. In the patients with a minor stroke, neurologic worsening occurred in 6 out of 29 (21%) in the inpatient arm compared with 3 out of 30 (10%) in the outpatient arm (
    Conclusion: Routine hospitalization of all patients with TIA or minor ischemic stroke may not positively affect short-term clinical outcome.
    Language English
    Publishing date 2017-07-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2627963-0
    ISSN 1944-141X ; 1941-5893
    ISSN (online) 1944-141X
    ISSN 1941-5893
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Clinical impact of the first pass effect on clinical outcomes in patients with near or complete recanalization during mechanical thrombectomy for large vessel ischemic stroke.

    Memon, Muhammad Zeeshan / Daniel, David / Chaudhry, Mohammad Rauf A / Grewal, Manjot / Saini, Vasu / Lukas, Joshua / Siddu, Mithilesh / Algahtani, Rami / Nisar, Taha / Majidi, Shahram / Leon Guerrero, Christopher R / Burger, Kathleen M / Greenberg, Edward / Khandelwal, Priyank / Malik, Amer M / Starke, Robert M / Koch, Sebastian / Yavagal, Dileep R

    Journal of neuroimaging : official journal of the American Society of Neuroimaging

    2021  Volume 31, Issue 4, Page(s) 743–750

    Abstract: Background and purpose: The first pass effect has been reported as a mechanical thrombectomy (MT) success metric in patients with large vessel occlusive stroke. We aimed to compare the clinical and neuroimagign outcomes of patients who had favorable ... ...

    Abstract Background and purpose: The first pass effect has been reported as a mechanical thrombectomy (MT) success metric in patients with large vessel occlusive stroke. We aimed to compare the clinical and neuroimagign outcomes of patients who had favorable recanalization (mTICI 2c or mTICI 3) achieved in one pass versus those requiring multiple passes.
    Methods: In this "real-world" multicenter study, patients with mTICI 2c or 3 recanalization were identified from three prospectively collected stroke databases from January 2016 to December 2019. Clinical outcomes were a favorable functional outcome at 90 days (modified Rankin Scale score 0-2), and the rate of symptomatic intracranial hemorrhage (ICH) any ICH, and 90-day mortality.
    Results: Favorable recanalization was achieved in 390/664 (59%) of consecutive patients who underwent MT (age 71.2 ± 13.2 years, 188 [48.2%] women). This was achieved after a single thrombectomy pass (n = 290) or multiple thrombectomy passes (n = 100). The rate of favorable clinical outcome was higher (41% vs. 28 %, p = .02) in the first pass group with a continued trend on multivariate analysis that did not reaching statistical significance (OR 1.68 95% confidence interval [CI] 1.0-2.95, p = .07). Similarly, the odds of any ICH were significantly lower (OR 0.56 CI 0.32-0.97, p = .03). A similar trend of favorable clinical outcomes was noticed on subgroup analysis of patients with M1 occlusion (OR 1.81 CI 1.01-3.61, p = .08).
    Conclusion: The first-pass reperfusion was associated with a trend toward favorable clinical outcome and lower rates of ICH. These data suggest that the first-pass effect should be the mechanical thrombectomy procedure goal.
    MeSH term(s) Aged ; Aged, 80 and over ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/surgery ; Female ; Humans ; Ischemic Stroke ; Male ; Middle Aged ; Retrospective Studies ; Stroke/diagnostic imaging ; Stroke/surgery ; Thrombectomy ; Treatment Outcome
    Language English
    Publishing date 2021-04-30
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1071724-9
    ISSN 1552-6569 ; 1051-2284
    ISSN (online) 1552-6569
    ISSN 1051-2284
    DOI 10.1111/jon.12864
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Fixed Dose IV rt-PA and Clinical Outcome in Ischemic Stroke Patients With Body Weight >100 kg: Pooled Data From 3 Randomized Clinical Trials.

    Majidi, Shahram / Leon Guerrero, Christopher R / Burger, Kathleen M / Sigounas, Dimitri / Olan, Wayne J / Qureshi, Adnan I

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

    2018  Volume 27, Issue 10, Page(s) 2843–2848

    Abstract: Background and purpose: The ASA/AHA guidelines recommend a fixed dose of 90 mg of intravenous (IV) recombinant tissue plasminogen activator (rt-PA) for acute stroke patients weighing more than 100 kg. We aimed to determine if body weight >100 kg (and ... ...

    Abstract Background and purpose: The ASA/AHA guidelines recommend a fixed dose of 90 mg of intravenous (IV) recombinant tissue plasminogen activator (rt-PA) for acute stroke patients weighing more than 100 kg. We aimed to determine if body weight >100 kg (and receiving <0.9 mg/kg dose) independently influence patient clinical outcomes following IV rt-PA treatment.
    Methods: We pooled data from IV rt-PA treatment arms from 3 randomized controlled clinical trials; NINDS IV rt-PA study, Interventional Management of Stroke 3 and ALIAS (part 1 and 2). Baseline characteristic, hospital course and 90-day mRS were compared between patients >100 kg and those ≤100 kg body weight. Multivariate logistic regression model was used to identify the independent effect of >100 kg body weight on favorable 90-day outcome (defined as mRS 0-2), the rate of symptomatic intracranial hemorrhage, and poor 90-day outcome (mRS 4-6).
    Results: Among 873 patients treated with IV rt-PA, a total of 105 (12%) subjects had body weight >100 kg. Compared with patients having ≤100 kg body weight, the rate of favorable outcome at 90 days was not significantly different among patients with >100 kg body weight (OR: 0.99; 95% CI: 0.91-1.01; p=0.91) , after adjusting for potential confounders. The ordinal analysis did not show any significant shift in the distribution of 90-day mRS score in patients with >100 kg body weight (OR, 0.93; 95% CI, 0.64-1.37; P = 0.74) CONCLUSIONS: There was no reduction in the rate of favorable outcome in patients with acute ischemic stroke with body weight >100 kg who received <0.9 mg/kg dose of IV rt-PA. Our results support the current recommendations in the ASA/AHA guidelines.
    MeSH term(s) Aged ; Aged, 80 and over ; Body Weight ; Brain Ischemia/diagnosis ; Brain Ischemia/drug therapy ; Brain Ischemia/physiopathology ; Chi-Square Distribution ; Disability Evaluation ; Female ; Fibrinolytic Agents/administration & dosage ; Fibrinolytic Agents/adverse effects ; Humans ; Infusions, Intravenous ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Randomized Controlled Trials as Topic ; Recombinant Proteins/administration & dosage ; Recovery of Function ; Risk Factors ; Stroke/diagnosis ; Stroke/drug therapy ; Stroke/physiopathology ; Thrombolytic Therapy/adverse effects ; Thrombolytic Therapy/methods ; Time Factors ; Tissue Plasminogen Activator/administration & dosage ; Tissue Plasminogen Activator/adverse effects ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents ; Recombinant Proteins ; Tissue Plasminogen Activator (EC 3.4.21.68)
    Language English
    Publishing date 2018-07-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2018.06.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Correlation of imaging and plasma based biomarkers to predict response to bevacizumab in epithelial ovarian cancer (EOC).

    Buechel, Megan E / Enserro, Danielle / Burger, Robert A / Brady, Mark F / Wade, Katrina / Secord, Angeles Alvarez / Nixon, Andrew B / Mirniaharikandehei, Seyedehnafiseh / Liu, Hong / Zheng, Bin / O'Malley, David M / Gray, Heidi / Tewari, Krishnansu S / Mannel, Robert S / Birrer, Michael J / Moore, Kathleen N

    Gynecologic oncology

    2021  Volume 161, Issue 2, Page(s) 382–388

    Abstract: Purpose: Increasing measures of adiposity have been correlated with poor oncologic outcomes and a lack of response to anti-angiogenic therapies. Limited data exists on the impact of subcutaneous fat density (SFD) and visceral fat density (VFD) on ... ...

    Abstract Purpose: Increasing measures of adiposity have been correlated with poor oncologic outcomes and a lack of response to anti-angiogenic therapies. Limited data exists on the impact of subcutaneous fat density (SFD) and visceral fat density (VFD) on oncologic outcomes. This ancillary analysis of GOG-218, evaluates whether imaging markers of adiposity were predictive biomarkers for bevacizumab (bev) use in epithelial ovarian cancer (EOC).
    Patients and methods: There were 1249 patients (67%) from GOG-218 with imaging measurements. SFD and VFD were calculated utilizing Hounsfield units (HU). Proportional hazards models were used to assess the association between SFD and VFD with overall survival (OS).
    Results: Increased SFD and VFD showed an increased HR for death (HR per 1-SD increase 1.12, 95% CI:1.05-1.19 p = 0.0009 and 1.13, 95% CI: 1.05-1.20 p = 0.0006 respectively). In the predictive analysis for response to bev, high VFD showed an increased hazard for death in the placebo group (HR per 1-SD increase 1.22, 95% CI: 1.09-1.37; p = 0.025). However, in the bev group there was no effect seen (HR per 1-SD increase: 1.01, 95% CI: 0.90-1.14) Median OS was 45 vs 47 months in the VFD low groups and 36 vs 42 months in the VFD high groups on placebo versus bev, respectively.
    Conclusion: High VFD and SFD have a negative prognostic impact on patients with EOC. High VFD appears to be a predictive marker of bev response and patients with high VFD may be more likely to benefit from initial treatment with bev.
    MeSH term(s) Adiposity ; Adult ; Aged ; Antineoplastic Agents, Immunological/therapeutic use ; Bevacizumab/therapeutic use ; Biomarkers, Tumor/blood ; Carcinoma, Ovarian Epithelial/blood ; Carcinoma, Ovarian Epithelial/diagnostic imaging ; Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/mortality ; Double-Blind Method ; Female ; Humans ; Intra-Abdominal Fat/diagnostic imaging ; Middle Aged ; Ovarian Neoplasms/blood ; Ovarian Neoplasms/diagnostic imaging ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/mortality ; Subcutaneous Fat/diagnostic imaging ; Survival Analysis ; Tomography, X-Ray Computed ; Treatment Outcome
    Chemical Substances Antineoplastic Agents, Immunological ; Biomarkers, Tumor ; Bevacizumab (2S9ZZM9Q9V)
    Language English
    Publishing date 2021-03-10
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2021.02.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Fully Automatic Treatment Planning for External-Beam Radiation Therapy of Locally Advanced Cervical Cancer: A Tool for Low-Resource Clinics.

    Kisling, Kelly / Zhang, Lifei / Simonds, Hannah / Fakie, Nazia / Yang, Jinzhong / McCarroll, Rachel / Balter, Peter / Burger, Hester / Bogler, Oliver / Howell, Rebecca / Schmeler, Kathleen / Mejia, Mike / Beadle, Beth M / Jhingran, Anuja / Court, Laurence

    Journal of global oncology

    2019  Volume 5, Page(s) 1–9

    Abstract: Purpose: The purpose of this study was to validate a fully automatic treatment planning system for conventional radiotherapy of cervical cancer. This system was developed to mitigate staff shortages in low-resource clinics.: Methods: In collaboration ...

    Abstract Purpose: The purpose of this study was to validate a fully automatic treatment planning system for conventional radiotherapy of cervical cancer. This system was developed to mitigate staff shortages in low-resource clinics.
    Methods: In collaboration with hospitals in South Africa and the United States, we have developed the Radiation Planning Assistant (RPA), which includes algorithms for automating every step of planning: delineating the body contour, detecting the marked isocenter, designing the treatment-beam apertures, and optimizing the beam weights to minimize dose heterogeneity. First, we validated the RPA retrospectively on 150 planning computed tomography (CT) scans. We then tested it remotely on 14 planning CT scans at two South African hospitals. Finally, automatically planned treatment beams were clinically deployed at our institution.
    Results: The automatically and manually delineated body contours agreed well (median mean surface distance, 0.6 mm; range, 0.4 to 1.9 mm). The automatically and manually detected marked isocenters agreed well (mean difference, 1.1 mm; range, 0.1 to 2.9 mm). In validating the automatically designed beam apertures, two physicians, one from our institution and one from a South African partner institution, rated 91% and 88% of plans acceptable for treatment, respectively. The use of automatically optimized beam weights reduced the maximum dose significantly (median, -1.9%; P < .001). Of the 14 plans from South Africa, 100% were rated clinically acceptable. Automatically planned treatment beams have been used for 24 patients with cervical cancer by physicians at our institution, with edits as needed, and its use is ongoing.
    Conclusion: We found that fully automatic treatment planning is effective for cervical cancer radiotherapy and may provide a reliable option for low-resource clinics. Prospective studies are ongoing in the United States and are planned with partner clinics.
    MeSH term(s) Algorithms ; Automation ; Female ; Humans ; Organs at Risk/diagnostic imaging ; Organs at Risk/radiation effects ; Prospective Studies ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Retrospective Studies ; Tomography, X-Ray Computed/methods ; Uterine Cervical Neoplasms/diagnostic imaging ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/radiotherapy
    Language English
    Publishing date 2019-01-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 2378-9506
    ISSN (online) 2378-9506
    DOI 10.1200/JGO.18.00107
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  10. Article: Thrombolytic treatment of acute cerebral infarction.

    Burger, Kathleen M / Horowitz, Deborah R

    CNS spectrums

    2005  Volume 10, Issue 7, Page(s) 539–549

    Abstract: Stroke is a common cause of death and disability throughout the world. Acute neurologic deficits due to ischemic injury deserve rapid recognition and diagnosis in order to provide effective therapy. Intravenous tissue plasminogen activator (t-PA) ... ...

    Abstract Stroke is a common cause of death and disability throughout the world. Acute neurologic deficits due to ischemic injury deserve rapid recognition and diagnosis in order to provide effective therapy. Intravenous tissue plasminogen activator (t-PA) provided to carefully selected patients that can be treated within 3 hours of stroke onset results in improved outcome in these patients. Intra-arterial administration of t-PA within a 6-hour window is performed at several academic centers in patients with middle cerebral and other intracranial artery occlusions based on results of one randomized clinical trial and numerous case reports. Although acute therapy of ischemic stroke has received much attention since the approval of intravenous t-PA, only a small percentage of individuals suffering a stroke actually receive t-PA. This article will review the optimal management of the acute stroke patient and discuss thrombolytic clinical trials that have been completed as well as those that are in progress.
    MeSH term(s) Acute Disease ; Brain/blood supply ; Brain/diagnostic imaging ; Cerebral Infarction/diagnostic imaging ; Cerebral Infarction/drug therapy ; Fibrinolytic Agents/administration & dosage ; Fibrinolytic Agents/therapeutic use ; Humans ; Injections, Intravenous ; Tissue Plasminogen Activator/administration & dosage ; Tissue Plasminogen Activator/therapeutic use ; Tomography, X-Ray Computed
    Chemical Substances Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
    Language English
    Publishing date 2005-07-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2008418-3
    ISSN 2165-6509 ; 1092-8529
    ISSN (online) 2165-6509
    ISSN 1092-8529
    DOI 10.1017/s1092852900010191
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