Publications by authors named "Freitag E"

Article Synopsis
  • Medical cannabis use has become more accepted in the U.S., but access is still limited for underserved populations, prompting a study at Montefiore’s Medical Cannabis Program to analyze patient experiences.
  • Between 2017 and 2019, 562 patients were certified for medical cannabis; only 45% made purchases, with barriers such as affordability and accessibility impacting usage.
  • The study found that patients who purchased medical cannabis were more likely to be white and have better insurance, highlighting the need for improved access to promote equitable use and reduce unregulated use among different demographics.
View Article and Find Full Text PDF

Introduction: In patients with acute intracerebral haemorrhage (ICH) and elevated systolic blood pressure (BP), guidelines suggest that systolic BP reduction to <140 mmHg should be rapidly initiated. Compared with conventional care, Mobile Stroke Units (MSUs) allow for earlier ICH diagnosis through prehospital imaging and earlier BP lowering.

Patients And Methods: ICH patients were prospectively evaluated as a cohort of the controlled B_PROUD-study in which MSU availability alone determined MSU dispatch in addition to conventional ambulance.

View Article and Find Full Text PDF

This commentary is a call to action for researchers to create and use genome-wide association studies (GWASs) with previously missed age groups (e.g., infancy, elderly), which will improve our ability to ask important developmental questions using genetic data to trace pathways across the lifespan.

View Article and Find Full Text PDF

Introduction: Intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are well-established, evidence-based, time-critical therapies that reduce morbidity and mortality in acute ischemic stroke (AIS) patients. The exclusion of intracerebral hemorrhage (ICH) is mandatory and has been performed by cerebral imaging to date. Mobile stroke units (MSUs) have been shown to improve functional outcomes by bringing cerebral imaging and IVT directly to the patient, but they have limited coverage.

View Article and Find Full Text PDF

Thrombotic thrombocytopenic purpura (TTP) is a potentially life-threatening thrombotic microangiopathy (TMA) that needs prompt identification and treatment. Disseminated malignancy-related TMA can potentially be misdiagnosed as TTP, and patients may be inappropriately subjected to therapeutic plasma exchange (TPE) with serious implications. Likewise, the presence of a concurrent cancer diagnosis in a patient with microangiopathic hemolytic anemia and thrombocytopenia may lead to suspicion of disseminated malignancy as the cause, delaying the TPE with serious outcomes.

View Article and Find Full Text PDF
Article Synopsis
  • The study found that using mobile stroke units (MSUs) improved quality of life and reduced disability for ischemic stroke patients, but came with higher costs.
  • The economic evaluation revealed that dispatching MSUs resulted in an incremental cost of €40,984 per quality-adjusted life year (QALY) gained, with varying scenarios showing costs ranging from €24,470.76 to €61,690.88 per QALY.
  • Overall, MSU dispatch was deemed cost-effective according to accepted thresholds, meaning the benefits in patient quality of life justified the extra expenses involved.
View Article and Find Full Text PDF

Objective: To determine the effect of additional mobile stroke unit (MSU) dispatch on functional outcomes among the full spectrum of stroke patients, regardless of subtype or potential contraindications to reperfusion therapies.

Methods: We used data from the nonrandomized Berlin-based B_PROUD study (02/2017 to 05/2019), in which MSUs were dispatched based solely on availability, and the linked B-SPATIAL stroke registry. All patients with final stroke or transient ischemic attack (TIA) diagnoses were eligible.

View Article and Find Full Text PDF
Article Synopsis
  • The study highlights a selection bias in stroke research due to informed consent restrictions, particularly affecting patients with communication issues.
  • An "opt-out" approach was used in the Berlin-SPecific Acute Treatment in Ischemic or hAemorrhagic Stroke with Long Term Follow-up (B-SPATIAL) registry, allowing data collection without prior consent while informing patients about the study.
  • Results indicated high follow-up rates, with 83.4% of participants providing functional outcome data, demonstrating the effectiveness of the opt-out strategy in capturing important information.
View Article and Find Full Text PDF

Importance: Effects of thrombolysis in acute ischemic stroke are time-dependent. Ambulances that can administer thrombolysis (mobile stroke units [MSUs]) before arriving at the hospital have been shown to reduce time to treatment.

Objective: To determine whether dispatch of MSUs is associated with better clinical outcomes for patients with acute ischemic stroke.

View Article and Find Full Text PDF
Article Synopsis
  • The Mobile Stroke Unit (MSU) has shown benefits in thrombolysis rates and treatment times, but there’s no definitive evidence proving better functional outcomes compared to regular ambulances.
  • The B_PROUD trial is revising its protocol to compare outcomes between patients receiving MSU care and those treated by regular ambulances, focusing on specific criteria for stroke patients in Berlin.
  • Blinded assessments will evaluate disability levels three months post-stroke, with the study aiming to provide clearer insights for improving acute stroke care responses.
View Article and Find Full Text PDF

Introduction: This study assessed the activity of compounds from Piper tuberculatum against Plasmodium falciparum and Leishmania guyanensis.

Methods: The effects of compounds from P. tuberculatum fruits on P.

View Article and Find Full Text PDF

Objective: To investigate the association of Epstein-Barr virus (EBV) nuclear antigen-1 (EBNA-1) and viral capsid antigen (VCA) immunoglobulin (Ig)G antibodies in serum as well as EBV DNA load in saliva with radiological and clinical disease activity in patients with clinically isolated syndrome (CIS) and early relapsing-remitting MS (RRMS).

Methods: EBNA-1 and VCA immunoglobulin (Ig)G antibodies were determined in serum of 100 patients with CIS/early RRMS and 60 healthy controls. EBV DNA load was measured in saliva of 48 patients and 50 controls.

View Article and Find Full Text PDF

Background: In response to DNA double-strand breaks, the histone protein H2AX becomes phosphorylated at its C-terminal serine 139 residue, referred to as γ-H2AX. Formation of γ-H2AX foci is associated with recruitment of p53-binding protein 1 (53BP1), a regulator of the cellular response to DNA double-strand breaks. γ-H2AX expression in peripheral blood mononuclear cells (PBMCs) was recently proposed as a diagnostic and disease activity marker for multiple sclerosis (MS).

View Article and Find Full Text PDF

Background And Purpose: Low 25-hydroxyvitamin D [25(OH)D] levels correlate with higher disease activity in patients with multiple sclerosis (MS). However, it is not clear whether low 25(OH)D levels directly contribute to increased disease activity or merely represent a consequence of reduced endogenous vitamin D synthesis in more disabled MS patients. Furthermore, recent data suggest that bioavailable vitamin D, which also integrates the levels of vitamin D binding proteins and albumin, could be a biologically more relevant parameter than 25(OH)D.

View Article and Find Full Text PDF

Multiple sclerosis (MS) is associated with Epstein-Barr virus (EBV) infection. A characteristic feature of MS is an intrathecal synthesis of immunoglobulin (Ig)G. In 90 patients with clinically isolated syndromes/early relapsing-remitting MS, serum antibodies to Epstein-Barr nuclear antigen-1, but not to EBV viral capsid antigen, rubella, or varicella zoster virus, were higher (p=0.

View Article and Find Full Text PDF

Background And Purpose: Specialized management of patients with stroke is not available in all hospitals. We evaluated whether prehospital management in the Stroke Emergency Mobile (STEMO) improves the triage of patients with stroke.

Methods: STEMO is an ambulance staffed with a specialized stroke team and equipped with a computed tomographic scanner and point-of-care laboratory.

View Article and Find Full Text PDF

Polyomavirus-associated graft nephropathy (PAN) has emerged as a significant risk factor for kidney graft loss. We analyzed intracellular cytokine responses for possible protective versus permissive immunologic effects on BK-virus replication. One hundred five renal transplant patients included in a prospective single-center study were randomized to receive cyclosporine mycophenolate mofetil (MMF) (CM: n = 31), tacrolimus (Tac)/MMF (TM: n = 32) or Tac/MMF with conversion to everolimus (TErl; n = 32).

View Article and Find Full Text PDF

In children, the Intermittent Preventive Treatment (IPTc), currently called Seasonal Malaria Chemoprevention (SMC), was considered effective on malaria control due to the reduction of its incidence in Papua New Guinea and in some areas with seasonal malaria in Africa. However, the IPT has not been indicated because of its association with drug resistance and for hindering natural immunity development. Thus, we evaluated the alternative IPT impact on malaria incidence in three riverside communities on Madeira River, in the municipality of Porto Velho, RO.

View Article and Find Full Text PDF

Purpose: Monitoring of fluid balance (FB) can be achieved by subtracting recorded fluid output from input or by measuring changes in body weight (BW). The latter approach is difficult in the critically ill. Recently, hospital beds have become available with the ability to directly weigh patients in the intensive care unit (ICU) patients directly.

View Article and Find Full Text PDF

Cognitive and behavioral functions depend on the activation of stable neuronal assemblies, i.e. distributed groups of co-active neurons within neuronal networks.

View Article and Find Full Text PDF

Purpose: Measuring body weight and height of critically ill patients in intensive care often challenge nurses. Estimated weight and height is thought to be inaccurate. This quality improvement project was to determine one effective method of how all patients in intensive care unit (ICU) could be measured and weighed accurately and cost effectively.

View Article and Find Full Text PDF