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Book: Hankey's clinical neurology

Gorelick, Philip B. / Testai, Fernando D. / Hankey, Graeme / Wardlaw, Joanna M.

2021

Title variant	Clinical neurology
Author's details	edited by Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw
Keywords	Nervous System Diseases
Language	English
Size	xvi, 935 Seiten, Illustrationen
Edition	Third edition
Publisher	CRC Press
Publishing place	Boca Raton
Publishing country	United States
Document type	Book
HBZ-ID	HT020799976
ISBN	978-0-367-28032-1 ; 978-0-367-61087-6 ; 9780429299476 ; 0-367-28032-9 ; 0-367-61087-6 ; 0429299478
Database	Catalogue ZB MED Medicine, Health

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2021 A 331	available for loan (reading room)	Lesesaal EG

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Article ; Online: WITHDRAWN: Advances in Neurovascular Research: Scientific Highlights from the 15

Geraghty, Joseph R / Testai, Fernando D

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

2024 , Page(s) 107614

Abstract: The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2024.107614. The duplicate article has therefore been withdrawn. The full Elsevier Policy ...

Abstract	The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2024.107614. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
Language	English
Publishing date	2024-02-01
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.2024.107614
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Article ; Online: Remote Ischemic Conditioning for Acute Ischemic Stroke: Does Stroke Etiology Matter?

Ganesh, Aravind / Testai, Fernando D

Stroke

2024 Volume 55, Issue 4, Page(s) 880–882

MeSH term(s)	Humans ; Ischemic Stroke ; Stroke/etiology ; Brain Ischemia/etiology ; Ischemia ; Ischemic Postconditioning
Language	English
Publishing date	2024-03-25
Publishing country	United States
Document type	Editorial
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.124.046615
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Article ; Online: Advances in neurovascular research: Scientific highlights from the 15th world stroke congress.

Geraghty, Joseph R / Testai, Fernando D

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

2024 Volume 33, Issue 5, Page(s) 107617

MeSH term(s)	Humans ; Stroke/therapy ; Stroke/drug therapy ; Fibrinolytic Agents/therapeutic use ; Thrombectomy ; Brain Ischemia/drug therapy ; Treatment Outcome ; Tissue Plasminogen Activator ; Endovascular Procedures
Chemical Substances	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2024-02-01
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.2024.107617
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Article ; Online: Advances in neurovascular research: Scientific highlights from the 2024 international stroke conference.

Geraghty, Joseph R / Testai, Fernando D

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

2024 Volume 33, Issue 5, Page(s) 107671

MeSH term(s)	Humans ; Stroke/therapy ; Stroke/drug therapy ; Fibrinolytic Agents/therapeutic use ; Thrombectomy ; Treatment Outcome ; Endovascular Procedures ; Brain Ischemia/drug therapy ; Tissue Plasminogen Activator
Chemical Substances	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Editorial
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2024.107671
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Article ; Online: Navigating Antiplatelet Treatment Options for Stroke: Evidence-Based and Pragmatic Strategies.

Moustafa, Bayan / Testai, Fernando D

Current neurology and neuroscience reports

2022 Volume 22, Issue 11, Page(s) 789–802

Abstract: Purpose of review: The benefit of using antiplatelet monotherapy in acute ischemic stroke and secondary stroke prevention is well established. In the last few years, several large randomized trials showed that the use of short-term dual antiplatelet ... ...

Abstract	Purpose of review: The benefit of using antiplatelet monotherapy in acute ischemic stroke and secondary stroke prevention is well established. In the last few years, several large randomized trials showed that the use of short-term dual antiplatelet therapy in particular stroke subtypes may reduce the risk of recurrent ischemic events. The aim of this article is to provide a critical analysis of the current evidence and recommendations for the use of antiplatelet agents for stroke prevention. Recent findings: Long-term therapy with aspirin, clopidogrel, or aspirin plus extended-release dipyridamole is recommended for secondary stroke prevention in patients with noncardioembolic ischemic stroke. Short-term dual antiplatelet therapy with aspirin and clopidogrel is superior to antiplatelet monotherapy in secondary stroke prevention when used in patients with mild noncardioembolic stroke or high-risk transient ischemic attack. Dual therapy, however, is associated with an increased risk of major bleeding, particularly when the treatment is extended for greater than 30 days. Similarly, aspirin plus ticagrelor is superior to aspirin monotherapy for the prevention of recurrent ischemic stroke, although this combination is associated with a higher risk of hemorrhagic complications when compared to other dual antiplatelet regimens. Among patients who carry CYP2C19 genetic polymorphisms associated with a slow bioactivation of clopidogrel, short-term treatment with aspirin plus ticagrelor is superior to aspirin plus clopidogrel for the reduction of recurrent stroke; however, the use of ticagrelor is associated with a higher risk of any bleeding. In patients with symptomatic intracranial stenosis, aggressive medical management in addition to dual antiplatelet therapy up to 90 days is recommended. Antiplatelet therapy has an essential role in the management of ischemic stroke. The specific antiplatelet regimen should be individualized based on the stroke characteristics, time from symptom onset, and patient-specific predisposition to develop hemorrhagic complications.
MeSH term(s)	Humans ; Platelet Aggregation Inhibitors/therapeutic use ; Clopidogrel/therapeutic use ; Ticlopidine/adverse effects ; Ticagrelor/therapeutic use ; Ischemic Stroke ; Drug Therapy, Combination ; Stroke/drug therapy ; Stroke/prevention & control ; Aspirin/therapeutic use ; Hemorrhage/chemically induced
Chemical Substances	Platelet Aggregation Inhibitors ; Clopidogrel (A74586SNO7) ; Ticlopidine (OM90ZUW7M1) ; Ticagrelor (GLH0314RVC) ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057363-7
ISSN	1534-6293 ; 1528-4042
ISSN (online)	1534-6293
ISSN	1528-4042
DOI	10.1007/s11910-022-01237-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Neurological Manifestations of Acute Porphyrias.

Wylie, Kyle / Testai, Fernando D

Current neurology and neuroscience reports

2022 Volume 22, Issue 7, Page(s) 355–362

Abstract: Purpose of review: Porphyrias constitute a group of rare metabolic disorders that result in a deficiency of the heme biosynthetic pathway and lead to the accumulation of metabolic intermediaries. Patients with porphyria can experience recurrent ... ...

Abstract	Purpose of review: Porphyrias constitute a group of rare metabolic disorders that result in a deficiency of the heme biosynthetic pathway and lead to the accumulation of metabolic intermediaries. Patients with porphyria can experience recurrent neurovisceral attacks which are characterized by neuropathic abdominal pain and acute gastrointestinal symptoms, including nausea, vomiting, and constipation. Depending on the type of porphyria, patients can present with cutaneous manifestations, such as severe skin photosensitivity, chronic hemolysis, or evidence of neurologic dysfunction, including alterations in consciousness, neurovascular involvement, seizures, transient sensor-motor symptoms, polyneuropathy, and behavioral abnormalities. Recent findings: More recently, cases of posterior reversible encephalopathy syndrome, cerebral vasoconstriction, and acute flaccid paralysis have also been described. While the exact pathogenic mechanisms linking the accumulation of abnormal heme biosynthetic intermediaries to neurologic manifestations have not been completely elucidated, it has been proposed that these manifestations are more common than previously thought and can result in permanent neurologic injury. This article reviews the basic principles of heme synthesis as well as the pathogenic mechanism of disease, presentation, and treatment of acute hepatic porphyrias with emphasis on those with neurologic manifestations.
MeSH term(s)	Heme/metabolism ; Humans ; Neuralgia ; Porphyria, Acute Intermittent/complications ; Porphyrias/complications ; Porphyrias/diagnosis ; Porphyrias/therapy ; Porphyrias, Hepatic/diagnosis ; Posterior Leukoencephalopathy Syndrome
Chemical Substances	Heme (42VZT0U6YR)
Language	English
Publishing date	2022-06-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057363-7
ISSN	1534-6293 ; 1528-4042
ISSN (online)	1534-6293
ISSN	1528-4042
DOI	10.1007/s11910-022-01205-7
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Article ; Online: Neurological Manifestations of Myocarditis.

Trifan, Gabriela / Testai, Fernando D

Current neurology and neuroscience reports

2022 Volume 22, Issue 7, Page(s) 363–374

Abstract: Purpose of review: The present review discusses the neurological complications associated with myocarditis of different etiologies.: Recent findings: Myocarditis can be idiopathic or caused by different conditions, including toxins, infections, or ... ...

Abstract	Purpose of review: The present review discusses the neurological complications associated with myocarditis of different etiologies. Recent findings: Myocarditis can be idiopathic or caused by different conditions, including toxins, infections, or inflammatory diseases. Clinical findings are variable and range from mild self-limited shortness of breath or chest pain to hemodynamic instability which may result in cardiogenic shock and death. Several neurologic manifestations can be seen in association with myocarditis. Tissue remodeling, fibrosis, and myocyte dysfunction can result in heart failure and arrhythmias leading to intracardiac thrombus formation and cardioembolism. In addition, peripheral neuropathies, status epilepticus, or myasthenia gravis have been reported in association with specific types of myocarditis. Multiple studies suggest the increasing risk of neurologic complications in patients with myocarditis. Neurologists should maintain a high suspicion of myocarditis in cases presenting with both cardiovascular and neurological dysfunction without a clear etiology.
MeSH term(s)	Humans ; Myocarditis/complications ; Myocarditis/diagnosis ; Peripheral Nervous System Diseases
Language	English
Publishing date	2022-05-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057363-7
ISSN	1534-6293 ; 1528-4042
ISSN (online)	1534-6293
ISSN	1528-4042
DOI	10.1007/s11910-022-01203-9
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Article ; Online: Efficacy and Safety of Mechanical Thrombectomy in Elderly and Non-Elderly Patients with Large Vessel Occlusion Stroke A Systematic Review and Meta-Analysis.

Ali, Aisha / Testai, Fernando D / Trifan, Gabriela

Cerebrovascular diseases (Basel, Switzerland)

2023

Abstract: INTRODUCTION Mechanical thrombectomy (MT) is recommended for large vessel occlusion (LVO) stroke. However, most of the studies that investigated the superiority of MT over best medical management (BMM) alone included preponderantly non-elderly patients. ... ...

Abstract	INTRODUCTION Mechanical thrombectomy (MT) is recommended for large vessel occlusion (LVO) stroke. However, most of the studies that investigated the superiority of MT over best medical management (BMM) alone included preponderantly non-elderly patients. Thus, there is uncertainty in relation to the efficacy of MT in the elderly. We aim to compare the effect of BMM to BMM plus (MT) among elderly and non-elderly patients with (LVO). METHODS We performed a systematic search of medical databases from inception to April 2023 to identify randomized studies that reported the functional outcome at 90 days by age for patients with LVO treated with MT vs. BMM. Patients were divided into elderly (>70 or >80 years, depending on the cut-off used in each study) and non-elderly. Outcomes were defined as excellent (modified Rankin Scale [mRS]≤1), good (mRS≤3), poor (mRS≥5), or death. Effect sizes were calculated by using random effects meta-analyses. Results were represented by odds ratio (OR) and their 95% confidence intervals (95% CI). RESULTS A total of 2,195 patients were included in the analysis (≥70 years, 7 trials, n= 696; ≥80 years, 2 trials, n=139). Non-elderly patients treated with MT had higher odds of excellent outcome (OR 3.05; 95% CI 2.23-4.18) and good outcome (OR 2.70; 95% CI 1.94-3.74), and lower odds of poor outcome (OR 0.54; 95% CI 0.40-0.72) and death (OR 0.63; 95% CI 0.41-0.96). Similarly, elderly patients treated with MT had higher odds of excellent (OR 2.39; 95% CI 1.05-5.45) and good outcomes (OR 2.18; 95% CI 1.43-3.33) and lower odds of poor outcome (OR 0.48; 95% CI 0.33-0.70) and mortality (OR 0.50; 0.26-0.95). When outcomes were analyzed by age subgroups, MT was associated with higher odds of good outcome in patients ≥70 years (OR 1.95, 95% CI 1.26-3.03) and ≥80 years (OR 4.43, 95% CI 1.02-19.23). DISCUSSION/CONCLUSION MT increases the likelihood of achieving a good outcome in elderly and non-elderly patients without increasing the risk of severe disability or death. MT, when otherwise clinically indicated, should be considered over BMM alone in both age groups.
Language	English
Publishing date	2023-10-09
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	1069462-6
ISSN	1421-9786 ; 1015-9770
ISSN (online)	1421-9786
ISSN	1015-9770
DOI	10.1159/000533204
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Zs.MO 226: Show issues

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Article ; Online: COVID-2019 fundamentals.

Lamberghini, Flavia / Testai, Fernando D

Journal of the American Dental Association (1939)

2021 Volume 152, Issue 5, Page(s) 354–363

Abstract: Background: A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified at the end of 2019. The disease caused by SARS-CoV-2 was named COVID-19. The main purpose of this review was to provide an overview of SARS- ...

Abstract	Background: A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified at the end of 2019. The disease caused by SARS-CoV-2 was named COVID-19. The main purpose of this review was to provide an overview of SARS-CoV-2. Methods: The authors searched the MEDLINE database for clinical studies related to virus characteristics, pathogenesis, diagnosis, transmission mechanisms, and treatment options. Results: As of January 27, 2021, the number of infected people and deaths associated with COVID-19 worldwide were approximately 100 million and 2 million, respectively. The manifestations of COVID-19 are variable, and the severity is affected by age and preexisting medical conditions. Children and adolescents are usually asymptomatic or have mild symptoms. Older adults, in comparison, may experience severe illness and have disproportionally elevated mortality. Among those who survive, some may experience enduring deficits. The viral load is particularly elevated in saliva and oropharynx, which constitute potential sources of infection. The diagnosis of the disease may be confounded by factors related to the replicating cycle of the virus, viral load, and sensitivity of the diagnostic method used. As of January 2021, COVID-19 has no cure but can be prevented. Its treatment is based on supportive care along with antiviral medications and monoclonal antibodies. In severe cases with multiorgan involvement, mechanical ventilation, dialysis, and hemodynamic support may be necessary. Conclusions: COVID-19 is a transmittable disease with a variable course. A substantial number of patients, particularly children, remain asymptomatic. Important advances have been made in the development of new treatments. However, the mortality in vulnerable populations remains elevated. Practical implications: The elevated viral load in the oral cavity and pharynx suggests that oral health care professionals could get infected through occupational exposure. Providers should understand the variables that influence the yield of diagnostic studies because false-negative results can occur.
MeSH term(s)	Adolescent ; Aged ; COVID-19 ; Child ; Humans ; SARS-CoV-2 ; Saliva
Language	English
Publishing date	2021-02-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	220622-5
ISSN	1943-4723 ; 0002-8177 ; 1048-6364
ISSN (online)	1943-4723
ISSN	0002-8177 ; 1048-6364
DOI	10.1016/j.adaj.2021.01.014
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