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  • 1
    Online Resource
    Online Resource
    Neonatal Viral Infection Decreases Neuronal Progenitors and Impairs Adult Neurogenesis in the Hippocampus
    Elsevier BV ; 2002
    In:  Neurobiology of Disease Vol. 11, No. 2 ( 2002-11), p. 246-256
    Details
    In: Neurobiology of Disease, Elsevier BV, Vol. 11, No. 2 ( 2002-11), p. 246-256
    Type of Medium: Online Resource
    ISSN: 0969-9961
    URL: Article
    DOI: 10.1006/nbdi.2002.0531
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2002
    detail.hit.zdb_id: 1471408-5
    SSG: 12
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  • 2
    Online Resource
    Online Resource
    Viral infection of developing GABAergic neurons in a model of hippocampal disinhibition
    Ovid Technologies (Wolters Kluwer Health) ; 2000
    In:  NeuroReport Vol. 11, No. 11 ( 2000-08), p. 2433-2438
    Details
    In: NeuroReport, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 11 ( 2000-08), p. 2433-2438
    Type of Medium: Online Resource
    ISSN: 0959-4965
    URL: Article
    DOI: 10.1097/00001756-200008030-00019
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2000
    detail.hit.zdb_id: 2031485-1
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  • 3
    Online Resource
    Online Resource
    Transcranial Doppler in Adult Patients with Sickle Cell Disease
    S. Karger AG ; 2006
    In:  Cerebrovascular Diseases Vol. 21, No. 1-2 ( 2006), p. 38-41
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 21, No. 1-2 ( 2006), p. 38-41
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Transcranial Doppler (TCD) is the key test in determining the need for prophylactic blood transfusion to prevent stroke in children with sickle cell disease (SCD). The role of TCD in assessing stroke risk in adults with SCD as well as the pattern of TCD velocities in these patients are still undetermined. 〈 i 〉 Methods: 〈 /i 〉 The authors compared TCD velocities in SCD adults (n = 56) with those of healthy controls (n = 56). 〈 i 〉 Results: 〈 /i 〉 Velocities in SCD adults were lower than those found in children and higher than in controls and negatively correlated to hematocrit in both groups. 〈 i 〉 Conclusion: 〈 /i 〉 The pattern of TCD velocities in adults with SCD is different from that described in children. Age-specific TCD criteria may assist the detection of stroke risk in these patients.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000089592
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2006
    detail.hit.zdb_id: 1482069-9
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  • 4
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    Online Resource
    Abstract 3771: Does Mixing T-pa At Bedside Improve DTN, Without Increasing The Risk Of Complications
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Abstract: Background/issues: Acute Ischemic stroke is a time sensitive disease. The only approved treatment is t-PA. Prior studies have demonstrated faster Door-to-Needle (DTN) times for t-PA treated stroke patients were associated with fewer complications and lower risk adjusted mortality. In conjunction to these findings the American Stroke Association has adopted in 2011 the goal to decrease the door to needle time on all eligible patients. The Georgia Stroke Professional Alliance (GA-SPA) has continued to encourage its members to achieve Target:Stroke designation. In response to this challenge seven separate facilities were able to reach this goal. Of note each facility is unique in its geographical location, size, and setting. Despite these differences each was able to obtain the same result in meeting the Target:Stroke criteria. In an effort to reduce the DTN, some facilities have begun mixing t-PA at bedside, while others utilize central pharmacy. Purpose: Identify the method utilized at each facility to mix t-PA. Determine if mixing at Bedside versus central pharmacy improves DTN times. Determine if mixing at bedside increases the risk of adverse affects such as sICH or increase length of stay. Methods: Of the Seven Target:Stroke facilities six submitted data on all t-pa recipients from January 2010 to December 2010. Each facility identified where t-PA is mixed and by whom. Facilities also provided the number of complications resulting from t-PA. Complications included increased length of stay directly related to t-pa, and sICH with an increase of two or more on the National Institute of Health Stroke Scale. Results: Two hundred seventeen ( 217) t-PA cases were reviewed. Four facilities mix t-PA in Pharmacy representing 115 cases with a total of three reported complications. Two facilities mix t-PA at bedside by a trained RN with a total of three reported complications. There was no statistically significant increase in complications by facilities mixing at bedside. Conclusions: Complications did not increase when t-PA is mixed outside of pharmacy. Facilities can successfully attain Target:Stroke Designation, regardless of where t-pa is mixed. Further studies will be conducted to see if mixing at bedside decreases DTN time.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A3771
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 1467823-8
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  • 5
    Online Resource
    Online Resource
    Psychogenic Movement Disorder Masquerading as CJD
    American Psychiatric Association Publishing ; 2006
    In:  The Journal of Neuropsychiatry and Clinical Neurosciences Vol. 18, No. 4 ( 2006-10), p. 562-563
    Details
    In: The Journal of Neuropsychiatry and Clinical Neurosciences, American Psychiatric Association Publishing, Vol. 18, No. 4 ( 2006-10), p. 562-563
    Type of Medium: Online Resource
    ISSN: 0895-0172 , 1545-7222
    URL: Article
    DOI: 10.1176/jnp.2006.18.4.562
    RVK:
    XA 10000
    Language: English
    Publisher: American Psychiatric Association Publishing
    Publication Date: 2006
    detail.hit.zdb_id: 1474283-4
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  • 6
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    Abstract 24: Implementing Target Stroke Best Practice Time Sensite Guidelines Improves Door To Needle Time (DTN).
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. suppl_1 ( 2013-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Implementing: Target Stroke Best Practice Time Sensitive Guidelines Improves Door to Needle Time (DTN) Background: Target Stroke Honor Roll (TSHR) facilities have demonstrated compliance meeting Get With the Guidelines (GWTG) standards for care of the acute stroke patient. TSHR leaders collaborated and recognized there are similar barriers resulting in not achieving the DTN goal. Objective: To review IV-TPA data of patients from TSHR facilities that did not meet the DTN time of less than 60 minutes and specify which of the three categories had the greatest delay. • Internal Process • Patient dynamics • Hemodynamic instability Methods: A six month retrospective review of IV t-PA administrations from 9 Georgia TSHR facilities was performed. The review included those administrations that did not meet the DTN Goal of 〈 60 minutes. Meaningful intervals in treatment were calculated using uniformly abstracted data, and analyzed as proportions of the total DTN time (expressed as a decimal) with the cause(s) for the delay in t-PA administration in each case being placed in one of the three categories. Results: There were 171 cases of which 48 (28%) did not meet the DTN goal time of 60 minutes or less. The data indicates that the most significant barrier to a DTN of 〈 60 minutes is the delay between resulted labs/ CT and the delivery of TPA. The intervals were the time from CT and labs resulted to TPA delivery (.52), patient arrival to MD arriving at the bedside (.13), the time from labs being drawn to labs being resulted (.32), the time from a CT being performed to the CT being resulted (.29), the time from when a CT was resulted to when TPA was ordered (.22), and the time from when TPA was ordered to when it was delivered (.27). Once the total data set was collated, a single factor ANOVA was performed. The results indicated a significant pattern in the data, and meaningful differences between variables (p-value = 1.43E-18). Category results: Internal Process; 28 (58%), Hemodynamic ; 9 (19%), Patient/family ; 11 (23%) Conclusion: The data indicated the primary delay was related to Internal Process 58% (28/48). This concludes that continued vigilance on Target Stroke time sensitive Guidelines can impact the success rate of DTN 〈 60 minutes.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.44.suppl_1.A24
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1467823-8
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  • 7
    Online Resource
    Online Resource
    Evaluation and Management of Amyotrophic Lateral Sclerosis
    Elsevier BV ; 2015
    In:  Primary Care: Clinics in Office Practice Vol. 42, No. 2 ( 2015-06), p. 177-187
    Details
    In: Primary Care: Clinics in Office Practice, Elsevier BV, Vol. 42, No. 2 ( 2015-06), p. 177-187
    Type of Medium: Online Resource
    ISSN: 0095-4543
    URL: Article
    DOI: 10.1016/j.pop.2015.01.009
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
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  • 8
    Online Resource
    Online Resource
    Guillain-Barré Syndrome
    Elsevier BV ; 2015
    In:  Primary Care: Clinics in Office Practice Vol. 42, No. 2 ( 2015-06), p. 189-193
    Details
    In: Primary Care: Clinics in Office Practice, Elsevier BV, Vol. 42, No. 2 ( 2015-06), p. 189-193
    Type of Medium: Online Resource
    ISSN: 0095-4543
    URL: Article
    DOI: 10.1016/j.pop.2015.01.001
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
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  • 9
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    Online Resource
    Abstract WP236: The Acute Ischemic Stroke Process in the Emergency Department: Improving Door to Needle Times and Advancing Best Practice
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. suppl_1 ( 2013-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Background The Acute Ischemic Stroke (AIS) process of care in the emergency department (ED) continues to evolve with interventions that help expedite administration of tPA and decrease “Door-to-Needle” (DTN) time and the burden associated with AIS. We hypothesized that redesigning the ED stroke process using selected best practice strategies would increase the percentage of patients receiving tPA in under 60 minutes, increase the percentage of patients treated with tPA within 4.5 hours, decrease the mean DTN time, and increase the percentage of stroke code activations (Code S) that occur in under 15 minutes. The variables implemented in the AIS process were analyzed for correlation of impact on decreasing DTN time. Methods The team mapped current AIS processes and developed an initiative to redesign the process including developing an AIS treatment room, a “stroke clot box” for storing and mixing tPA at bedside, and NIHSS certification of leadership staff. Multiple regression analysis of the correlation of these strategies as well as the presence of an in-house neurologist and EMS pre-notification on DTN time was performed. Results The initiatives increased the percentage of AIS patients treated with tPA within 4.5 hours from 67% to 100%. AIS patients treated under 60 minutes increased from 50% to 65%. The mean DTN time has decreased from 88.4 to 54.1 minutes. Of patients treated with tPA under 60 minutes (n=11) the mean DTN time was 40.6 minutes (lowest DTN time of 24 minutes). Code S activations within 15 minutes increased by 14 % to 47.8%. Multiple Regression analysis revealed that the presence of an in-house neurologist had the highest correlation (β=0.810, p=0.001) with lower DTN times, followed by using a "stroke clot box" (β=0.631, p=0.008) and a dedicated AIS treatment room (β=0.244, p=0.03). EMS pre-notification was done for nearly every tPA treated patient and its impact was therefore negligible (β=0.05, p=0.2). Conclusions These initiatives increased the number of patients treated, decreased mean DTN time, and increased the percentage of tPA eligible AIS patients within 60 minutes. An in-house neurologist, tPA at bedside, and a dedicated treatment room correlate with lower DTN times and therefore advance best practice for acute stroke care.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.44.suppl_1.AWP236
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1467823-8
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  • 10
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    Online Resource
    Abstract T P260: Confirmation: The Target Stroke Best Practice Strategies Work
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. suppl_1 ( 2015-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. suppl_1 ( 2015-02)
    Abstract: Background: A recent national push for optimizing stroke center performance led by the efforts of AHA/ASA to recognize high performers with the Target Stroke Honor Roll recognition have focused on achieving expedited treatment for stroke with door-to-needle (DTN) time of ≤60 minutes.Our organization recognized the need to optimize our performance and set an initial goal of achieving DTN time of ≤60 minutes in greater than 50% of our patients. The Target Stroke Initiative by the AHA/ASA identified 10 key strategies for best practice associated with reducing DTN times. Our organization adopted and implemented all of these strategies over a 30-day period. Methods: The Target Stroke best practice strategies were implemented over a 30-day period, and the Stroke Team worked collaboratively to identify other weaknesses needing to be addressed. DTN times ≤60 minutes from the 12 months prior to process improvement implementation were compared with the first 2 months post implementation. Results: There were 345 ischemic stroke patients treated at our facility during the 12 month period prior to the process implementation, with a total of 14 patients (1.12 per month) treated with tPA. The percentage of patients treated with tPA was 4%, and the percentage of patients treated with DTN ≤60 minutes was 0%. Over the two months following process implementation, 68 ischemic stroke patients were treated at our facility, with 11 patients treated with tPA (5.5 per month). The percentage of stroke patients treated with tPA was 16%, with 70% of patients treated with DTN ≤60 minutes. Conclusion: This study serves as confirmation that collaboration and implementation of the 10 key strategies for best practice as outlined by the Target Stroke Initiative, coupled with changes to identified areas of weakness, can improve and expedite the care of patients with acute ischemic stroke. This can substantially improve DTN times, as well as the overall number and percentage of patients that receive thrombolysis with a hopeful impact on their outcome as well as Target Stroke Honor Roll recognition for the facility. In conclusion, we recommend implementation of these best practice strategies to other facilities.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.46.suppl_1.tp260
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1467823-8
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