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Artikel ; Online: Multimodal imaging selection for IV alteplase in unknown time of onset stroke: Are we there yet?

Urrutia, Victor C

2020 Band 95, Heft 22, Seite(n) 989–990

Mesh-Begriff(e)	Brain Ischemia/drug therapy ; Fibrinolytic Agents/therapeutic use ; Humans ; Ischemic Stroke ; Magnetic Resonance Imaging ; Multimodal Imaging ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Thrombolytic Therapy ; Time ; Tissue Plasminogen Activator/therapeutic use ; Tomography, X-Ray Computed
Chemische Substanzen	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Sprache	Englisch
Erscheinungsdatum	2020-10-23
Erscheinungsland	United States
Dokumenttyp	Editorial ; Comment
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000011061
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature.

Reyna-Urrutia, Víctor A / González-González, Arely M / Rosales-Ibáñez, Raúl

Polymers

2022 Band 14, Heft 3

Abstract: Cleft palate (CP) is one of the most common birth defects, presenting a multitude of negative impacts on the health of the patient. It also leads to increased mortality at all stages of life, economic costs and psychosocial effects. The embryological ... ...

Abstract	Cleft palate (CP) is one of the most common birth defects, presenting a multitude of negative impacts on the health of the patient. It also leads to increased mortality at all stages of life, economic costs and psychosocial effects. The embryological development of CP has been outlined thanks to the advances made in recent years due to biomolecular successions. The etiology is broad and combines certain environmental and genetic factors. Currently, all surgical interventions work off the principle of restoring the area of the fissure and aesthetics of the patient, making use of bone substitutes. These can involve biological products, such as a demineralized bone matrix, as well as natural-synthetic polymers, and can be supplemented with nutrients or growth factors. For this reason, the following review analyzes different biomaterials in which nutrients or biomolecules have been added to improve the bioactive properties of the tissue construct to regenerate new bone, taking into account the greatest limitations of this approach, which are its use for bone substitutes for large areas exclusively and the lack of vascularity. Bone tissue engineering is a promising field, since it favors the development of porous synthetic substitutes with the ability to promote rapid and extensive vascularization within their structures for the regeneration of the CP area.
Sprache	Englisch
Erscheinungsdatum	2022-01-28
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2527146-5
ISSN	2073-4360 ; 2073-4360
ISSN (online)	2073-4360
ISSN	2073-4360
DOI	10.3390/polym14030547
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Cerebral venous thrombosis: Associations between disease severity and cardiac markers.

Johansen, Michelle C / Gottesman, Rebecca F / Urrutia, Victor C

Neurology. Clinical practice

2020 Band 10, Heft 2, Seite(n) 115–121

Abstract: Background: Plasma cardiac troponin (cTn) elevation occurs in acute ischemic stroke and intracranial hemorrhage and can suggest a poor prognosis. Because acute cerebral venous thrombosis (CVT) might lead to venous stasis, which could result in cardiac ... ...

Abstract	Background: Plasma cardiac troponin (cTn) elevation occurs in acute ischemic stroke and intracranial hemorrhage and can suggest a poor prognosis. Because acute cerebral venous thrombosis (CVT) might lead to venous stasis, which could result in cardiac stress, it is important to evaluate whether cTn elevation occurs in patients with CVT. Methods: Inpatients at Johns Hopkins Hospital from 2005 to 2015 meeting the following criteria were included: CVT ( Results: Of 81 patients with CVST, 53 (66%) met the inclusion criteria. Participants were, on average, aged 42 years, white (71%), and female (66%). The left transverse sinus was most commonly thrombosed (47%), with 66% having >2 veins thrombosed. Twenty-two (41%) had cTn elevation. Odds of cTn elevation increased per each additional vein thrombosed (adjusted OR 2.79, 95% CI [1.08-7.23]). Of those with deep venous involvement, 37.5% had cTn elevation compared with 4.4% without deep clots ( Conclusions: In this single-center cohort study, markers of CVT severity were associated with increased odds of cTn elevation; further investigation is needed to elucidate causality and significance.
Sprache	Englisch
Erscheinungsdatum	2020-03-04
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2645818-4
ISSN	2163-0933 ; 2163-0402
ISSN (online)	2163-0933
ISSN	2163-0402
DOI	10.1212/CPJ.0000000000000670
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Impact of RapidAI mobile application on treatment times in patients with large vessel occlusion.

Al-Kawaz, Mais / Primiani, Christopher / Urrutia, Victor / Hui, Ferdinand

Journal of neurointerventional surgery

2021 Band 14, Heft 3, Seite(n) 233–236

Abstract: Background: Current efforts to reduce door to groin puncture time (DGPT) aim to optimize clinical outcomes in stroke patients with large vessel occlusions (LVOs). The RapidAI mobile application (Rapid Mobile App) provides quick access to perfusion and ... ...

Abstract	Background: Current efforts to reduce door to groin puncture time (DGPT) aim to optimize clinical outcomes in stroke patients with large vessel occlusions (LVOs). The RapidAI mobile application (Rapid Mobile App) provides quick access to perfusion and vessel imaging in patients with LVOs. We hypothesize that utilization of RapidAI mobile application can significantly reduce treatment times in stroke care by accelerating the process of mobilizing stroke clinicians and interventionalists. Methods: We analyzed patients presenting with LVOs between June 2019 and October 2020. Thirty-one patients were treated between June 2019 and March 2020 (pre-app group). Thirty-three patients presented between March 2020 and October 2020 (post-app group). Mann-Whitney U test and Kruskal-Wallis tests were used to examine variables that are not normally distributed. In a secondary analysis we analyzed interhospital time metrics between primary stroke centers and our comprehensive stroke center. Results: Baseline demographic and vascular risk factors were similar in both groups. Use of Rapid Mobile App resulted in 33 min reduction in DGPT (P=0.02), 35 min reduction in door to first pass time (P=0.02), and 37 min reduction in door to recanalization time (P=0.02) in univariate analyses when compared with patients treated pre-app. In a multiple linear regression model, utilization of Rapid Mobile App significantly predicted shorter DGPT (P=0.002). In an adjusted model, National Institutes of Health Stroke Scale (NIHSS) 24 hours after procedure and at discharge were significantly lower in the post-app group (P=0.03). Time of transfer between primary and comprehensive stroke center was comparable in both groups (P=0.26). Conclusion: In patients with LVOs, the implementation of the RapidAI mobile application was independently associated with reductions in intrahospital treatment times.
Mesh-Begriff(e)	Brain Ischemia/drug therapy ; Humans ; Mobile Applications ; Stroke/drug therapy ; Stroke/therapy ; Thrombectomy/methods ; Thrombolytic Therapy/methods ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2021-04-01
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2021-017365
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Successful Thrombectomy for Large Vessel Occlusion after Emergent Transoceanic Patient Transport: An International Hub and Spoke Collaboration.

Gadani, Sachin P / Gayle, Francene / Jones, Phillip / Gailloud, Phillipe / Faigle, Roland / Urrutia, Victor C

Cerebrovascular diseases (Basel, Switzerland)

2022 Band 52, Heft 2, Seite(n) 234–238

Abstract: Mechanical thrombectomy (MT) is the standard of care for the treatment of acute ischemic stroke due to large vessel occlusion, but the capacity to deliver this treatment can be limited in less populous areas and island territories. Here, we describe the ... ...

Abstract	Mechanical thrombectomy (MT) is the standard of care for the treatment of acute ischemic stroke due to large vessel occlusion, but the capacity to deliver this treatment can be limited in less populous areas and island territories. Here, we describe the case of a man who developed right MCA syndrome while in Bermuda who was successfully diagnosed, transported over 800 miles to the East Coast of the USA, and treated with MT within 24 h. This case underscores the benefits of having organized systems of care and demonstrates the feasibility of urgent transoceanic patient transportation for stroke requiring MT.
Mesh-Begriff(e)	Male ; Humans ; Ischemic Stroke ; Thrombectomy ; Stroke/therapy ; Treatment Outcome ; Brain Ischemia/therapy ; Retrospective Studies
Sprache	Englisch
Erscheinungsdatum	2022-10-04
Erscheinungsland	Switzerland
Dokumenttyp	Case Reports
ZDB-ID	1069462-6
ISSN	1421-9786 ; 1015-9770
ISSN (online)	1421-9786
ISSN	1015-9770
DOI	10.1159/000526295
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Sustainability of Intravenous Alteplase Administration via Telephone-Based Consult: Data from a US Health System.

Nelson, Sarah E / Aldrich, Eric / Johnson, Brenda / Groman, Susan / Thompson, Richard E / Urrutia, Victor

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

2022 Band 31, Heft 4, Seite(n) 106316

Abstract: Objectives: Telephone-based consults using remote imaging review and standardization of evaluation but without visualizing the patient are an alternative to video-telestroke consults but are less well-studied. We aim to demonstrate the safety and ... ...

Abstract	Objectives: Telephone-based consults using remote imaging review and standardization of evaluation but without visualizing the patient are an alternative to video-telestroke consults but are less well-studied. We aim to demonstrate the safety and efficacy of telephone-based acute consults in which IV tPA was administered over nearly a decade within one health system. Materials and methods: Clinical characteristics and outcomes were compared between a community hospital (spoke; uses telephone-based consults) and the academic comprehensive stroke center (hub; uses oversight of on-site neurology trainees) from 2008-2017. In both institutions acute therapy decisions are made by the same stroke neurologists. Results: 2518 acute ischemic stroke consults were evaluated at hub and 2049 at spoke. Of these, 191 patients received IV tPA at hub and 184 at spoke. Patients at hub were younger (median (IQR): 61 (51-74) vs 69 (56-81) years, p = 0.0021) but admission National Institutes of Health Stroke Scale (NIHSS) was similar. There were no differences between door-to-needle times (69 (56-101) vs 69 (51-92) minutes, p = 0.13), last known well-to-tPA times (157 (113-202) vs 144 (110-175) minutes, p = 0.053), and rates of overall intracranial hemorrhage (ICH) after tPA (n = 23 (13.5%) vs 31 (17.0%), p = 0.35). In multivariable analyses, hospital was not an independent predictor of ICH after tPA. Conclusions: In a large dataset over nearly a decade, assessment for IV tPA administration using telephone assessment along with imaging review and emergency department standardization resulted in similar safety and outcomes as in the presence of on-site stroke/neurology expertise. Future studies are needed to confirm these findings.
Mesh-Begriff(e)	Administration, Intravenous ; Fibrinolytic Agents ; Humans ; Ischemic Stroke ; Remote Consultation/methods ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Telephone ; Thrombolytic Therapy/adverse effects ; Time Factors ; Time-to-Treatment ; Tissue Plasminogen Activator ; Treatment Outcome
Chemische Substanzen	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Sprache	Englisch
Erscheinungsdatum	2022-01-29
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2022.106316
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Bringing High-Dose Neurorestorative Behavioral Training Into the Acute Stroke Unit.

Bahouth, Mona N / Zink, Elizabeth K / Ahmad, Omar / Roy, Promit / Zeiler, Steven R / Urrutia, Victor C / Krakauer, John W

American journal of physical medicine & rehabilitation

2023 Band 102, Heft 2S Suppl 1, Seite(n) S33–S37

Abstract: Abstract: Stroke remains common and is a leading cause of adult disability. While there have been enormous system changes for the diagnosis and delivery of hyperacute stroke treatments at comprehensive stroke centers, few advances have been made in ... ...

Abstract	Abstract: Stroke remains common and is a leading cause of adult disability. While there have been enormous system changes for the diagnosis and delivery of hyperacute stroke treatments at comprehensive stroke centers, few advances have been made in those same centers for treatments focused on behavioral recovery and brain repair. Specifically, during the early hospital period, there is a paucity of approaches available for reduction of impairment beyond what is expected from spontaneous biological recovery. Thus, patients in the early stroke recovery period are not receiving the kind of training needed, at the requisite intensity and dose, to exploit a potential critical period of heightened brain plasticity that could maximize true recovery instead of just compensation. Here, we describe an ongoing pilot program to reconfigure the acute stroke unit experience to allow for a new emphasis on brain repair. More specifically, we have introduced a novel room-based video-gaming intervention; restorative neuroanimation, into the acute stroke hospital setting. This new intervention provides the opportunity for an extra hour(s) of high-intensity neurorestorative behavioral treatment that is complementary to conventional rehabilitation. To accomplish this, system redesign was required to insert this new treatment into the patient day, to properly stratify patients behaviorally and physiologically for the treatment, to optimize the digital therapeutic approach itself, and to maintain the impairment reduction after discharge.
Mesh-Begriff(e)	Humans ; Stroke Rehabilitation ; Stroke/therapy ; Brain ; Recovery of Function/physiology
Sprache	Englisch
Erscheinungsdatum	2023-01-04
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	219390-5
ISSN	1537-7385 ; 0002-9491 ; 0894-9115
ISSN (online)	1537-7385
ISSN	0002-9491 ; 0894-9115
DOI	10.1097/PHM.0000000000002146
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Assessing the Efficacy of Mechanical Thrombectomy in Patients with an NIHSS < 6 Presenting with Proximal Middle Cerebral Artery Vessel Occlusion as Compared to Best Medical Management.

Yedavalli, Vivek Srikar / Hamam, Omar / Gudenkauf, Julie / Wang, Richard / Llinas, Rafael / Marsh, Elisabeth Breese / Caplan, Justin / Nael, Kambiz / Urrutia, Victor

Brain sciences

2023 Band 13, Heft 2

Abstract: Background and purpose: Minor acute ischemic stroke (AIS) patients-defined by an NIHSS score < 6-presenting with proximal middle cerebral artery large vessel occlusions (MCA-LVO) is a subgroup for which treatment is still debated. Although these ... ...

Abstract	Background and purpose: Minor acute ischemic stroke (AIS) patients-defined by an NIHSS score < 6-presenting with proximal middle cerebral artery large vessel occlusions (MCA-LVO) is a subgroup for which treatment is still debated. Although these patients present with minor symptoms initially, studies have shown that several patients afflicted with MCA-LVO in this subgroup experience cognitive and functional decline. Although mechanical thrombectomy (MT) is the standard of care for patients with an NIHSS score of 6 or higher, treatment in the minor stroke subgroup is still being explored. The purpose of this preliminary study is to report our center's experience in evaluating the potential benefit of mechanical thrombectomy (MT) in minor stroke patients when compared to medical management (MM). Methods: We performed a retrospective study with two comprehensive stroke centers within our hospital enterprise of consecutive patients presenting with minor AIS secondary to MCA-LVO (defined as M1 or proximal M2 segments of MCA). We subsequently evaluated patients who received MT versus those who received MM. Results: Between January 2017 and July 2021, we identified 46 AIS patients (11 treated with MT and 35 treated with MM) who presented with an NIHSS score < 6 secondary to MCA-LVO (47.8% 22/46 female, mean age 62.3 years, range 49-75 years). MT was associated with a significantly lower mRS at 90 days (median: 1.0 [IQR 0.0-2.0] versus 3.0 [IQR 1.0-4.0], Conclusions: In our center's preliminary experience, for AIS patients presenting with an NIHSS score < 6 secondary to MCA-LVO, MT may be associated with improved clinical outcomes when compared to MM only.
Sprache	Englisch
Erscheinungsdatum	2023-01-27
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci13020214
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Biological activity of a chitosan-carboxymethylcellulose-zinc oxide and calcium carbonate in 3D scaffolds stabilized by physical links for bone tissue engineering.

Reyna-Urrutia, Víctor Alonso / Rosales-Ibáñez, Raúl / González-González, Arely M / Estevez, Miriam / Rodríguez-Martínez, Jesús Jiovanni / González-Reyna, M A

Journal of biomaterials applications

2023 Band 37, Heft 10, Seite(n) 1776–1788

Abstract: Today, regenerative osteogenesis represents a clinical need, due to the incidence of bone defects that involve groups of pathologies ranging from congenital anomalies to traumatic injuries, as well as problems presented surgically. This is why the design ...

Abstract	Today, regenerative osteogenesis represents a clinical need, due to the incidence of bone defects that involve groups of pathologies ranging from congenital anomalies to traumatic injuries, as well as problems presented surgically. This is why the design of a polymeric biomaterial (scaffold) of chitosan, carboxymethylcellulose, zinc oxide, and calcium carbonate with similar characteristics in terms of composition and bone structure offers high potential to help address this health problem. The technique for obtaining the scaffolds of this research was to develop a physical hydrogel to have the biofunctionality of the active groups of the polymer chains used, then make use of the lyophilization process to obtain three-dimensional (3D) porous scaffolds. The physicochemical and biological properties of the scaffolds were evaluated. The scaffolds presented morphology with pore size and interconnectivity that favor the need for cell proliferation and viability. The biocompatibility tests confirm that the designed scaffolds do not present cytotoxicity and the analyzes with alizarin red staining show calcium deposits in the materials with CaCO
Mesh-Begriff(e)	Rats ; Animals ; Tissue Engineering/methods ; Chitosan/chemistry ; Zinc Oxide ; Tissue Scaffolds/chemistry ; Carboxymethylcellulose Sodium ; Calcium Carbonate ; Osteogenesis ; Cell Differentiation ; Cell Proliferation
Chemische Substanzen	Chitosan (9012-76-4) ; Zinc Oxide (SOI2LOH54Z) ; Carboxymethylcellulose Sodium (K679OBS311) ; Calcium Carbonate (H0G9379FGK)
Sprache	Englisch
Erscheinungsdatum	2023-04-06
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639283-0
ISSN	1530-8022 ; 0885-3282
ISSN (online)	1530-8022
ISSN	0885-3282
DOI	10.1177/08853282231168239
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Added Value of Arterial Spin Labeling in Detecting Posterior Reversible Encephalopathy Syndrome as a Stroke Mimic on Baseline Neuroimaging: A Single Center Experience.

Weinstein, Joseph D / Hamam, Omar / Urrutia, Victor C / Lu, Hanzhang / Luna, Licia P / Tekes-Brady, Aylin / Bahouth, Mona / Yedavalli, Vivek

Frontiers in neurology

2022 Band 13, Seite(n) 831218

Abstract: Differentiating stroke from stroke mimics is a diagnostic challenge in every day practice. Posterior Reversible Encephalopathy Syndrome (PRES) is an important stroke mimic with nonspecific symptomatology, making prompt and accurate diagnosis challenging. ...

Abstract	Differentiating stroke from stroke mimics is a diagnostic challenge in every day practice. Posterior Reversible Encephalopathy Syndrome (PRES) is an important stroke mimic with nonspecific symptomatology, making prompt and accurate diagnosis challenging. Baseline neuroimaging plays a pivotal role in detection and differentiation of stroke from many common mimics and is thus critical in guiding appropriate management. In particular, MR perfusion (MRP) imaging modalities provide added value through detection and quantification of multiple physiological parameters. Arterial Spin Labeling (ASL) is a non-contrast, noninvasive MRP technique increasingly used in clinical practice; however, there is limited description of ASL in PRES in the existing literature. In this single center retrospective pilot study, we investigate the added value of ASL in detecting PRES in the largest series to date. We hope this study can serve as the basis for larger scale investigations exploring the utility of ASL in detecting stroke mimics such as PRES for accurate and efficient management of such patients.
Sprache	Englisch
Erscheinungsdatum	2022-03-03
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.831218
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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