scholarly journals Mild Luminal Stenosis of Parent Artery and Neurologic Deterioration After Acute Lacunar Stroke

Author(s):  
Dixon Yang ◽  
Jose Gutierrez ◽  
Shawna Cutting ◽  
Eytan Raz ◽  
Kursat Gurel ◽  
...  

BACKGROUND Early neurologic deterioration (END) occurs in a quarter of acute lacunar infarcts, but the underlying pathophysiological features are poorly understood. We sought to determine the association between luminal stenosis (<50%) of the parent artery and END. METHODS This observational study included consecutive patients with lacunar stroke from the ischemic stroke registries of New York University Langone Health and Brown University. All included patients were admitted for acute lacunar stroke, which was defined as a subcortical infarct <1.5 cm on computed tomography or <2 cm on diffusion‐weighted imaging without significant stenosis (>50%) in the parent vessel and no cardioembolic source. We defined END as any neurologic deterioration referable to the acute lacunar stroke and not related to a medical or noncerebrovascular neurological complication. We used univariate and logistic regression analyses to determine associations between luminal stenosis (<50%) and the odds of END. Furthermore, we attempted to validate findings using the Columbia University Medical Center stroke registry and perform a meta‐analysis combining the derivation and validation groups because of the expected small samples and event rates. RESULTS The New York University Langone Health and Brown University sample included 205 patients, of whom 41 (20%) had END. In adjusted models, we found no definite association between luminal stenosis (<50%) and END (adjusted odds ratio [OR], 1.74; 95% CI, 0.73–4.14). From Columbia University Medical Center, 361 total patients were included, of whom 59 (16%) had END. In adjusted models, we found an association between luminal stenosis (<50%) and END (adjusted OR, 2.28; 95% CI, 1.15–4.50). Meta‐analysis of both cohorts found luminal stenosis (<50%) associated with END (relative risk, 1.69; 95% CI, 1.17–2.43). CONCLUSIONS In this multicenter study, luminal stenosis (<50%) may be associated with END following an acute lacunar infarct. Larger studies using vessel wall imaging are needed to validate our findings.

2013 ◽  
Vol 1 (1) ◽  
pp. 1-11
Author(s):  
Julie Walsh ◽  
Julie Walsh

Renowned neurologist and author Dr Oliver Sacks is a visiting professor at the University of Warwick as part of the Institute of Advanced Study. Dr Sacks was born in London. He earned his medical degree at the University of Oxford (Queen’s College) and the Middlesex Hospital (now UCL), followed by residencies and fellowships at Mt. Zion Hospital in San Francisco and at University of California Los Angeles (UCLA). As well as authoring best-selling books such as Awakenings and The Man Who Mistook His Wife for a Hat, he is clinical professor of neurology at NYU Langone Medical Center in New York. Warwick is part of a consortium led by New York University which is building an applied science research institute, the Center for Urban Science and Progress (CUSP). Dr Sacks recently completed a five-year residency at Columbia University in New York, where he was professor of neurology and psychiatry. He also held the title of Columbia University Artist, in recognition of his contributions to the arts as well as to medicine. He is a fellow of the Royal College of Physicians and the Association of British Neurologists, the American Academy of Arts and Sciences, and the American Academy of Arts and Letters, and has been a fellow of the New York Institute for the Humanities at NYU for more than 25 years. In 2008, he was appointed CBE.


1991 ◽  
Vol 39 (4) ◽  
pp. 1037-1064 ◽  
Author(s):  
John Frosch

The goal of this contribution is to give an overall survey of the analytic schisms in the New York area from 1934 on. The general background, laying the groundwork for potential schisms, is described. There were several major schisms in the New York area. The first related to Horney's departure from the New York Psychoanalytic Society and Institute. There were multiple splits in this group which eventuated in a psychoanalytic facility at the New York Medical College, as well as the establishment of the William Alanson White Institute. Then there was the establishment of a psychoanalytic training facility at Columbia University, one at the Downstate Medical Center, and another at the New York University School of Medicine. The various factors that played a role in the splits are discussed. Finally, there is a discussion of why psychoanalytic schisms take place.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 686-686
Author(s):  
Erin Emery-Tiburcio ◽  
Rani Snyder

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.


PEDIATRICS ◽  
1949 ◽  
Vol 4 (1) ◽  
pp. 142-144

The National Foundation for Infantile Paralysis has awarded postgraduate fellowships in the fields of scientific research, physical medicine and public health. Three of the new fellows will devote their time to research projects in the field of pediatrics. Dr. John J. Osborn, of Larchmont, N.Y., has already begun his project at New York University—Bellevue Medical Center under Drs. L. Emmett Holt, Jr., Professor of Pediatrics, and Colin MacLeod, Professor of Microbiology; Dr. Paul Harold Hardy, Jr., of Baltimore, Md., and Dr. David I. Schrum, of Houston, Texas, will start their work July 1, respectively, at Johns Hopkins Hospital, under Drs. Francis F. Schwentker, Pediatrician-in-Chief, and Horace L. Hodes, Associate Professor of Pediatrics; and at Louisiana State University School of Medicine under Drs. Myron E. Wegman, Professor of Pediatrics, and G. John Buddingh, Professor of Microbiology.


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