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James e siegler

James E Siegler, Sheryl Martin-Schild
INTRODUCTION: Although intravenous tissue plasminogen activator (IV tPA) is associated with neurologic deterioration (ND) caused by hemorrhage, whether it attenuates deterioration as a result of other etiologies including progressive stroke remains unexplored. The objective of this study was to determine whether IV tPA is associated with a reduced risk of ND caused by progressive stroke. METHODS: A retrospective investigation of consecutively admitted patients with acute ischemic stroke (July 2008-June 2014) within 4...
October 2016: Southern Medical Journal
James E Siegler, Sarah Flanagan Wesley
No abstract text is available yet for this article.
October 4, 2016: Neurology
James E Siegler, Christy Marcaccio, Kelsey Nawalinski, Francis Quattrone, Danielle K Sandsmark, Eileen Maloney-Wilensky, Suzanne Frangos, Joshua M Levine, Sherman C Stein, Scott E Kasner, Monisha A Kumar
BACKGROUND: Elevated red blood cell distribution width (RDW) has been associated with thrombotic disorders including myocardial infarction, venous thromboembolism, and ischemic stroke, independent of other inflammatory and coagulation biomarkers. The purpose of this study was to determine whether elevated RDW is associated with cerebral infarction and poor outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: In this retrospective single-center cohort of aSAH patients (October 2009-September 2014), elevated RDW was defined as a mean RDW >14...
August 16, 2016: Neurocritical Care
Neha Patel, James E Siegler, Nathaniel Stromberg, Neil Ravitz, C William Hanson
BACKGROUND: In hospitals, effective and efficient communication among care providers is critical to the provision of high-quality patient care. Yet, major problems impede communications including the frequent use of interruptive and one-way communication paradigms. This is especially frustrating for frontline providers given the dynamic nature of hospital care teams in an environment that is in constant flux. METHODS: We conducted a pre-post evaluation of a commercially available secured messaging mobile application on 4 hospital units at a single institution for over one year...
2016: Applied Clinical Informatics
James E Anaissie, Dominique J Monlezun, James E Siegler, Elizabeth D Waring, Lauren N Dowell, Alyana A Samai, Alexander J George, Tara Kimbrough, Jimmy Berthaud, Sheryl Martin-Schild
GOAL: To evaluate the safety and efficacy of intravenous (IV) tissue plasminogen activator (tPA) in the treatment of wake-up stroke (WUS) using propensity score (PS) analysis. MATERIALS AND METHODS: Consecutive acute ischemic stroke patients meeting inclusion criteria were retrospectively identified from our stroke registry between July 2008 and May 2014, and classified as stroke onset less than or equal to 4.5 hours treated with tPA (control; n = 369), tPA-treated WUS (n = 46), or nontreated WUS (n = 154)...
July 28, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
James E Siegler, Amber R Wang, Joshua D Vanderwerf
In this report, we present the case of a 43-year-old woman with AIDS, disseminated aspergillosis, and malnutrition who developed osmotic demyelination syndrome. AIDS-related osmotic demyelination has only been documented in a handful of cases to date, and it appears independent of the classic mechanism of rapid correction of hyponatremia. In this manuscript, we review the six prior cases of osmotic demyelination in AIDS patients and compare their circumstances to that of our own patient. It appears that complications of malnutrition, possibly related to depletion of organic osmolytes in the central nervous system, may place AIDS patients at greater risk of osmotic demyelination...
July 12, 2016: Journal of Neurovirology
James E Siegler, Alyana Samai, Eleanor Semmes, Sheryl Martin-Schild
BACKGROUND AND PURPOSE: Early neurologic deterioration (END) occurs in up to one-third of patients with ischemic stroke and is associated with poor outcomes. The purpose of the present study was to determine which stroke etiologies and vascular distributions pose a greater threat of END in stroke patients. METHODS: Using a single-center registry of prospectively maintained clinical data, adult ischemic stroke patients admitted (July 2008 to June 2014) within 48 hours of symptom onset were evaluated according to stroke etiology and vascular distribution using diffusion-weighted MRI...
May 2016: Journal of Stroke
James E Siegler, Joseph W Kable, Anjan Chatterjee
No abstract text is available yet for this article.
May 2016: Journal of Graduate Medical Education
James E Siegler, Neha N Patel, C Jessica Dine
No abstract text is available yet for this article.
March 2015: Journal of Graduate Medical Education
James E Siegler, Dina A Jacobs, Defne Amado, Jamie L Adams, Joseph R Berger
We report a woman who presented with rapidly progressive dementia and hypoglycorrhachia and discuss the approach and differential diagnosis for her condition. Rapidly progressive dementia poses a variety of challenges to the treating clinician, not only due to the speed of disease progression, but also due to the poor prognosis if intervention is delayed. The differential diagnosis of a patient presenting with rapid cognitive and functional decline is broad and includes degenerative, infectious, toxic, and neoplastic etiologies, some of which can be identified clinically through history and physical examination...
October 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Catherine L Johnson, Roger J Phillips, Michael E Purucker, Brian J Anderson, Paul K Byrne, Brett W Denevi, Joshua M Feinberg, Steven A Hauck, James W Head, Haje Korth, Peter B James, Erwan Mazarico, Gregory A Neumann, Lydia C Philpott, Matthew A Siegler, Nikolai A Tsyganenko, Sean C Solomon
Magnetized rocks can record the history of the magnetic field of a planet, a key constraint for understanding its evolution. From orbital vector magnetic field measurements of Mercury taken by the MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) spacecraft at altitudes below 150 kilometers, we have detected remanent magnetization in Mercury's crust. We infer a lower bound on the average age of magnetization of 3.7 to 3.9 billion years. Our findings indicate that a global magnetic field driven by dynamo processes in the fluid outer core operated early in Mercury's history...
May 22, 2015: Science
Christopher G Favilla, Erin Ingala, Jenny Jara, Emily Fessler, Brett Cucchiara, Steven R Messé, Michael T Mullen, Allyson Prasad, James Siegler, Mathew D Hutchinson, Scott E Kasner
BACKGROUND AND PURPOSE: Occult paroxysmal atrial fibrillation (AF) is found in a substantial minority of patients with cryptogenic stroke. Identifying reliable predictors of paroxysmal AF after cryptogenic stroke would allow clinicians to more effectively use outpatient cardiac monitoring and ultimately reduce secondary stroke burden. METHODS: We analyzed a retrospective cohort of consecutive patients who underwent 28-day mobile cardiac outpatient telemetry after cryptogenic stroke or transient ischemic stroke...
May 2015: Stroke; a Journal of Cerebral Circulation
Tyler A Scullen, Dominique J Monlezun, James E Siegler, Alexander J George, Melissa Schwickrath, Ramy El Khoury, Min Chan Cho, Sheryl Martin-Schild
BACKGROUND: Cryptogenic stroke can be subdivided into 3 distinct categories: stroke of no determined cause (CyNC), stroke due to multiple etiologies (Cy >1), and stroke etiology unclear due to incomplete evaluation. Although these subdivisions may be very different from one another with respect to baseline features and outcomes, they are often reported as a composite group in clinical trials. METHODS: Patients treated at our academic institution between July 2008 and June 2013 for acute ischemic stroke were retrospectively assessed in our prospective registry...
May 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
James E Siegler, Alyana Samai, Karen C Albright, Amelia K Boehme, Sheryl Martin-Schild
There is growing research interest into the etiologies of cryptogenic stroke, in particular as it relates to hypercoagulable states. An elevation in serum levels of the procoagulant factor VIII is recognized as one such culprit of occult cerebral infarctions. It is the objective of the present review to summarize the molecular role of factor VIII in thrombogenesis and its clinical use in the diagnosis and prognosis of acute ischemic stroke. We also discuss the utility of screening for serum factor VIII levels among patients at risk for, or those who have experienced, ischemic stroke...
October 2015: Clinical and Applied Thrombosis/hemostasis
Adam J Friedant, Brittany M Gouse, Amelia K Boehme, James E Siegler, Karen C Albright, Dominique J Monlezun, Alexander J George, Timothy Mark Beasley, Sheryl Martin-Schild
BACKGROUND: Hospital-acquired infections (HAIs) are a major cause of morbidity and mortality in acute ischemic stroke patients. Although prior scoring systems have been developed to predict pneumonia in ischemic stroke patients, these scores were not designed to predict other infections. We sought to develop a simple scoring system for any HAI. METHODS: Patients admitted to our stroke center (July 2008-June 2012) were retrospectively assessed. Patients were excluded if they had an in-hospital stroke, unknown time from symptom onset, or delay from symptom onset to hospital arrival greater than 48 hours...
March 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
James E Siegler, Sheryl Martin-Schild
The National Institutes of Health Stroke Scale was originally designed to stratify patients according to stroke severity for clinical trials, and now it is used to predict disposition and prognosticate functional outcome. Many researchers have also adopted it to trend patient progress over time and detect early neurologic deterioration. However, few investigators have reported its utility in monitoring the daily progress of patients hospitalized for stroke. In the present article, the authors discuss the advantages of daily National Institutes of Health Stroke Scale assessments and our clinical experience with this invaluable tool...
February 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Brittany M Gouse, Amelia K Boehme, Dominique J Monlezun, James E Siegler, Alex J George, Katherine Brag, Karen C Albright, T Mark Beasley, Cindy Leissinger, Ramy El Khoury, Sheryl Martin-Schild
Background. Heightened levels of Factor VIII (FVIII) have been associated with both arterial and venous thrombosis. While elevated FVIII is common during acute ischemic stroke (AIS), whether elevated FVIII confers an increased risk for recurrent thrombotic events (RTEs) following AIS has not been previously explored. Methods. Consecutive AIS patients who presented to our center between July 2008 and September 2013 and had FVIII measured during admission were identified from our stroke registry. Baseline characteristics and the occurrence of RTE (recurrent or progressive ischemic stroke, DVT/PE, and MI) were compared in patients with and without elevated FVIII levels...
2014: Thrombosis
Alexander J George, Amelia K Boehme, Casey R Dunn, T Beasley, James E Siegler, Karen C Albright, Ramy El Khoury, Sheryl Martin-Schild
BACKGROUND: International management of acute ischemic stroke patients treated with intravenous tissue plasminogen activator frequently includes 24-h head imaging. These recommendations stem from the National Institute of Neurological Disorders and Stroke (NINDS) clinical trial protocol regarding the risk of intracerebral hemorrhage post-tissue plasminogen activator administration. Follow-up computed tomography scans on select patients, however, may not effect clinical management, resulting in unnecessary radiation exposure and healthcare costs...
January 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Amelia K Boehme, Andre D Kumar, Michael J Lyerly, Michael A Gillette, James E Siegler, Karen C Albright, T Mark Beasley, Sheryl Martin-Schild
BACKGROUND: In the setting of acute ischemic stroke (AIS), leukocytosis has been shown to be an indicator of inflammatory response. Although leukocytosis on admission has been shown to correlate with initial stroke severity in AIS patients, no work has been done to assess if there are differences in transient or persistent leukocytosis in patients without infection. The objective of this study is to determine the clinical significance of persistent versus transient leukocytosis during the early phase of AIS...
August 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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