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REVIEW
Kyle Wylie, Fernando D Testai
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...
July 2022: Current Neurology and Neuroscience Reports
#22
REVIEW
Shuo Qian, Prateek Kumar, Fernando D Testai
PURPOSE OF REVIEW: Hyperbilirubinemia is commonly seen in neonates. Though hyperbilirubinemia is typically asymptomatic, severe elevation of bilirubin levels can lead to acute bilirubin encephalopathy and progress to kernicterus spectrum disorder, a chronic condition characterized by hearing loss, extrapyramidal dysfunction, ophthalmoplegia, and enamel hypoplasia. Epidemiological data show that the implementation of universal pre-discharge bilirubin screening programs has reduced the rates of hyperbilirubinemia-associated complications...
July 2022: Current Neurology and Neuroscience Reports
#23
REVIEW
Gabriela Trifan, Fernando D Testai
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...
May 19, 2022: Current Neurology and Neuroscience Reports
#24
REVIEW
Yonatan Hirsch, Joseph R Geraghty, Cory R Reiter, Eitan A Katz, Conner F Little, Matthew K Tobin, Fernando D Testai
Stroke is a leading cause of death and disability worldwide. Inflammation and microvascular dysfunction have been associated with brain injury and long-term disability after both ischemic and hemorrhagic stroke. Recent studies have suggested a potential role of extracellular vesicles (EVs) as a link underlying these pathogenic processes. EVs are cell-derived particles enveloped by a lipid bilayer, containing proteins, lipids, and nucleic acids. From a functional standpoint, EVs can facilitate intercellular communication, including across the blood-brain barrier (BBB)...
May 6, 2022: Translational Stroke Research
#25
JOURNAL ARTICLE
Joji B Kuramatsu, Stefan T Gerner, Wendy Ziai, Jürgen Bardutzky, Jochen A Sembill, Maximilian I Sprügel, Anne Mrochen, Kathrin Kölbl, Malathi Ram, Radhika Avadhani, Guido J Falcone, Magdy H Selim, Vasileios-Arsenios Lioutas, Matthias Endres, Sarah Zweynert, Peter Vajkoczy, Peter A Ringleb, Jan C Purrucker, Jens Volkmann, Hermann Neugebauer, Frank Erbguth, Peter D Schellinger, Ulrich J Knappe, Gereon R Fink, Christian Dohmen, Jens Minnerup, Heinz Reichmann, Hauke Schneider, Joachim Röther, Gernot Reimann, Michael Schwarz, Hansjörg Bäzner, Joseph Claßen, Dominik Michalski, Otto W Witte, Albrecht Günther, Gerhard F Hamann, Hannes Lücking, Arnd Dörfler, Muhammad Fawad Ishfaq, Jason J Chang, Fernando D Testai, Daniel Woo, Andrei V Alexandrov, Dimitre Staykov, Nitin Goyal, Georgios Tsivgoulis, Kevin N Sheth, Issam A Awad, Stefan Schwab, Daniel F Hanley, Hagen B Huttner
BACKGROUND: In patients with intracerebral hemorrhage (ICH), the presence of intraventricular hemorrhage constitutes a promising therapeutic target. Intraventricular fibrinolysis (IVF) reduces mortality, yet impact on functional disability remains unclear. Thus, we aimed to determine the influence of IVF on functional outcomes. METHODS: This individual participant data meta-analysis pooled 1501 patients from 2 randomized trials and 7 observational studies enrolled during 2004 to 2015...
September 2022: Stroke; a Journal of Cerebral Circulation
#26
JOURNAL ARTICLE
Yisi Ng, Wenjing Qi, Nicolas Kon Kam King, Thomas Christianson, Vijay Krishnamoorthy, Shreyansh Shah, Afshin Divani, Margaret Bettin, Elisheva R Coleman, Matthew L Flaherty, Kyle B Walsh, Fernando D Testai, Jacob L McCauley, Lee A Gilkerson, Carl D Langefeld, Tyler Paul Behymer, Daniel Woo, Michael L James
INTRODUCTION: Current guidelines recommend blood pressure (BP) lowering in patients after acute intracerebral haemorrhage (ICH) without guidance on initial choice of antihypertensive class. This study sought to determine if initial antihypertensive class differentially effects acute BP lowering in a large multiethnic ICH cohort. METHODS: Subjects enrolled in the Ethnic/Racial Variations in ICH study between August 2010 and August 2017 with elevated admission BP and who received labetalol, nicardipine or hydralazine monotherapy as initial antihypertensive were analysed...
October 2022: Stroke and Vascular Neurology
#27
JOURNAL ARTICLE
Joseph R Geraghty, Dilip K Pandey, Fernando D Testai
No abstract text is available yet for this article.
March 29, 2022: Neurosurgery
#28
REVIEW
Fernando D Testai, Philip B Gorelick, Hugo J Aparicio, Francesca M Filbey, Raul Gonzalez, Rebecca F Gottesman, Miriam Melis, Mariann R Piano, Tiziana Rubino, Sarah Y Song
Marijuana is perceived as a harmless drug, and its recreational use has gained popularity among young individuals. The concentration of active ingredients in recreational formulations has gradually increased over time, and high-potency illicit cannabinomimetics have become available. Thus, the consumption of cannabis in the general population is rising. Data from preclinical models demonstrate that cannabinoid receptors are expressed in high density in areas involved in cognition and behavior, particularly during periods of active neurodevelopment and maturation...
April 2022: Stroke; a Journal of Cerebral Circulation
#29
REVIEW
Amre Nouh, Sepideh Amin-Hanjani, Karen L Furie, Walter N Kernan, DaiWai M Olson, Fernando D Testai, Mark J Alberts, Mohammed A Hussain, Ethan U Cumbler
This scientific statement describes a path to optimizing care for patients who experience an in-hospital stroke. Although these patients are in a monitored environment, their evaluation and treatment are often delayed compared with patients presenting to the emergency department, contributing to higher rates of morbidity and mortality. Reducing delays and optimizing treatment for patients with in-hospital stroke could improve outcomes. This scientific statement calls for the development of hospital systems of care and targeted quality improvement for in-hospital stroke...
April 2022: Stroke; a Journal of Cerebral Circulation
#30
JOURNAL ARTICLE
Alejandro Vargas, Fernando D Testai
No abstract text is available yet for this article.
January 2023: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
#31
JOURNAL ARTICLE
Joseph R Geraghty, Tyler J Lung, Yonatan Hirsch, Eitan A Katz, Tiffany Cheng, Neil S Saini, Dilip K Pandey, Fernando D Testai
BACKGROUND: Delayed cerebral vasospasm is a feared complication of aneurysmal subarachnoid hemorrhage (SAH). OBJECTIVE: To investigate the relationship of systemic inflammation, measured using the systemic immune-inflammation (SII) index, with delayed angiographic or sonographic vasospasm. We hypothesize that early elevations in SII index serve as an independent predictor of vasospasm. METHODS: We retrospectively reviewed the medical records of 289 SAH patients for angiographic or sonographic evidence of delayed cerebral vasospasm...
November 18, 2021: Neurosurgery
#32
REVIEW
Bayan Moustafa, Fernando D Testai
Proprotein convertase subtilisin/kexin type 9 (PCSK9) interacts with the low-density lipoprotein (LDL) receptor and, by enhancing its degradation, has a pivotal role in the regulation of cholesterol homeostasis. Two fully humanized monoclonal antibodies targeting PCSK9, evolocumab and alirocumab, are available for clinical use. PCSK9 inhibitors reduce LDL-C 30% more than ezetimibe and 60% more than placebo when added to statins. This reduction in LDL-C is accompanied by a decrease in the risk of major cardiovascular and cerebrovascular events...
November 2021: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
#33
JOURNAL ARTICLE
Steven J Kittner, Padmini Sekar, Mary E Comeau, Christopher D Anderson, Gunjan Y Parikh, Tachira Tavarez, Matthew L Flaherty, Fernando D Testai, Michael R Frankel, Michael L James, Gene Sung, Mitchell S V Elkind, Bradford B Worrall, Chelsea S Kidwell, Nicole R Gonzales, Sebastian Koch, Christiana E Hall, Lee Birnbaum, Douglas Mayson, Bruce Coull, Marc D Malkoff, Kevin N Sheth, Jacob L McCauley, Jennifer Osborne, Misty Morgan, Lee A Gilkerson, Tyler P Behymer, Stacie L Demel, Charles J Moomaw, Jonathan Rosand, Carl D Langefeld, Daniel Woo
Importance: Black and Hispanic individuals have an increased risk of intracerebral hemorrhage (ICH) compared with their White counterparts, but no large studies of ICH have been conducted in these disproportionately affected populations. Objective: To examine the prevalence, odds, and population attributable risk (PAR) percentage for established and novel risk factors for ICH, stratified by ICH location and racial/ethnic group. Design, Setting, and Participants: The Ethnic/Racial Variations of Intracerebral Hemorrhage Study was a case-control study of ICH among 3000 Black, Hispanic, and White individuals who experienced spontaneous ICH (1000 cases in each group)...
August 2, 2021: JAMA Network Open
#34
JOURNAL ARTICLE
Vladimir Ivanovic, Stephan Seiler, Wassim Tarraf, Emily Crivello, Oliver Martinez, Richard B Lipton, Carmen R Isasi, Tatiana Gomez Copello, Gregory A Talavera, Linda C Gallo, Melissa Lamar, Fernando Testai, Neil Schneiderman, Marc D Gellman, Martha Daviglus, Hector M Gonzalez, Charles DeCarli, Michael L Lipton
BACKGROUND AND PURPOSE: There is limited literature on the prevalence of incidental brain MRI findings in the Hispanic/Latino population, despite their increased prevalence of vascular disease and undertreatment of chronic conditions. The purpose of our study was to determine the prevalence of clinically relevant incidental findings on brain MRI examinations obtained as a part of the Study of Latinos-Investigation of NeuroCognitive Aging MRI (SOL-INCA-MRI) study. METHODS: Brain MRI examinations were obtained on 1389 participants in the SOL-INCA-MRI study, a cross-sectional ancillary study of the Hispanic Community Health Study, Study of Latinos, which is a longitudinal, community-based study...
July 19, 2021: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
#35
JOURNAL ARTICLE
Flavia Lamberghini, Fernando D Testai
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...
May 2021: Journal of the American Dental Association
#36
COMPARATIVE STUDY
Gabriela Trifan, Philip B Gorelick, Fernando D Testai
BACKGROUND: Dual antiplatelet treatment (DAPT) with aspirin plus clopidogrel for a limited time is recommended after minor noncardioembolic stroke. METHODS: We performed a meta-analysis of all major studies that compared the efficacy and safety of DAPT versus monotherapy for the secondary prevention of recurrent stroke or transient ischemic attack. The primary outcomes were stroke and the composite of stroke, transient ischemic attack, acute coronary syndrome, and death from any cause...
June 22, 2021: Circulation
#37
REVIEW
Bayan Moustafa, Fernando D Testai
PURPOSE OF REVIEW: In the last few years, the attitude toward marijuana in many parts of the world has shifted from illicit to legalized for medical use and to decriminalized. In parallel, there has been a gradual increase in the consumption of this product in the general population, particularly among adolescents and young adults. Marijuana is generally perceived as a harmless drug. However, data obtained in observational studies and preclinical models have established associations between cannabis use and cardiovascular events...
April 7, 2021: Current Neurology and Neuroscience Reports
#38
JOURNAL ARTICLE
Fang Bai, Jingsong Chen, Dilip Pandey, Ramon Durazo-Arvizu, Gregory A Talavera, Matthew A Allison, Krista M Perreira, Neil Schneiderman, Melanie W Sutherland, Jianwen Cai, Martha L Daviglus, Fernando D Testai
BACKGROUND AND PURPOSE: We investigated the prevalence, awareness, and control of vascular risk factors (VRFs) and the use of antithrombotic and statin agents in HCHS (Hispanic Community Health Study)/SOL (Study of Latinos) participants with self-reported history of stroke or transient ischemic attack. METHODS: Sociodemographic characteristics, medications, and prevalence of different VRFs were recorded. VRF diagnoses and goals were based on the recommendations of professional organizations...
March 4, 2021: Stroke; a Journal of Cerebral Circulation
#39
JOURNAL ARTICLE
Severe acute respiratory syndrome coronavirus 2 infection in asymptomatic pediatric dental patients.
Flavia Lamberghini, Gabriela Trifan, Fernando D Testai
BACKGROUND: Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are typically asymptomatic but contagious. The authors investigated the positivity rate of asymptomatic SARS-CoV-2 infection in pediatric dental patients. METHODS: The authors reviewed consecutive charts of children younger than 18 years scheduled for elective dental procedures from April 1, 2020, through August 1, 2020. All patients were screened for signs and symptoms of SARS-CoV-2 infection...
January 19, 2021: Journal of the American Dental Association
#40
REVIEW
Tiffany Cheng, Joaquin B Gonzalez, Fernando D Testai
Approximately one-third of strokes are cryptogenic in origin. These patients have a higher prevalence of patent foramen ovale (PFO) compared to individuals with stroke of known origin. It has been proposed that some cryptogenic strokes (CSs) can be caused by paradoxical embolism across a PFO. PFOs can be treated medically with antithrombotic agents and percutaneously with occluder devices. Large randomized clinical trials have found transcatheter PFO closure to be superior to medical treatment for the prevention of recurrent stroke in young patients with CS...
2021: Handbook of Clinical Neurology
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