Publications by authors named "Gustavo Rey"

Almost two years into the pandemic, the scientific and healthcare communities continue to learn a great deal regarding COVID-19, the disease produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Broad variability during acute COVID-19 infection is seen, ranging from asymptomatic presentation to death. The vast majority of individuals who develop COVID-19 return to their pre-COVID-19 baseline within several weeks.

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Objective: Postsurgical seizure outcome following laser interstitial thermal therapy (LiTT) for the management of drug-resistant mesial temporal lobe epilepsy (MTLE) has been limited to 2 years. Furthermore, its impact on presurgical mood and anxiety disorders has not been investigated. The objectives of this study were (1) to identify seizure outcome changes over a period ranging from 18 to 81 months; (2) to investigate the seizure-free rate in the last follow-up year; (3) to identify the variables associated with seizure freedom; and (4) to identify the impact of LiTT on presurgical mood and anxiety disorders.

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Article Synopsis
  • The study reviews cognitive outcomes in patients with mesiotemporal epilepsy (mTLE) after undergoing laser interstitial thermal therapy (LiTT), focusing on changes in neuropsychological performance.
  • It analyzed 26 patients, comparing their mental abilities before and after surgery across various cognitive areas, revealing improvements in learning, memory, processing speed, and executive functioning, particularly in both dominant and nondominant hemisphere patients.
  • The findings suggest that LiTT results in a lower rate of language or verbal memory decline compared to traditional surgeries, highlighting the need for future research to examine a broader range of cognitive outcomes post-surgery.
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Background: Laser interstitial thermal therapy (LITT) presents an important new minimally invasive tool in the management of drug-resistant mesial temporal epilepsy (MTE). However, because of its relative novelty, not much is known about long-term seizure freedom rates. The objective of this study was to evaluate the postsurgical seizure outcome following LITT after a minimum follow-up period of 2 years.

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Objective: To identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE).

Methods: Clinical and radiographic data were reviewed from a prospectively maintained database of all patients undergoing LiTT for the treatment of mTLE at the University of Miami Hospital. Standard preoperative and postoperative evaluations, including contrast-enhanced magnetic resonance imaging (MRI) and neuropsychological testing, were performed in all patients.

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This study evaluated language organization in children with intractable epilepsy caused by temporal lobe focal cortical dysplasia (FCD) alone or dual pathology (temporal lobe FCD and hippocampal sclerosis, HS). We analyzed clinical, neurological, fMRI, neuropsychological, and histopathologic data in 46 pediatric patients with temporal lobe lesions who underwent excisional epilepsy surgery. The frequency of atypical language representation was similar in both groups, but children with dual pathology were more likely to be left-handed.

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Composition of the bacterial microbiome in the vagina and vestibule from 30 women with vulvar vestibulitis syndrome (VVS) and 15 healthy controls were compared by pyrosequencing 16S rRNA gene amplicons. Vaginal concentrations of interleukin (IL)-1β were determined by ELISA. Questionnaires elicited clinical and symptom data.

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Purpose: Variable predictors of postsurgical seizure outcome have been reported in children with tuberous sclerosis complex (TSC). We analyzed a large surgical series of pediatric TSC patients in order to identify prognostic factors crucial for selection of subjects for epilepsy surgery.

Methods: Thirty-three children with TSC who underwent excisional epilepsy surgery at Miami Children's Hospital were retrospectively reviewed.

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Objective: To determine the most important factors influencing neuropsychological performance in children with intractable epilepsy due to focal cortical dysplasia and the nature of the interaction among significant variables.

Methods: Surgical patients with histologically verified focal cortical dysplasia were retrospectively evaluated to determine the impact of histopathology, extent of lobar involvement, hemispheric laterality, age at onset, and duration of epilepsy on cognitive functioning. A composite neuropsychological variable was obtained by transforming data from 5 major cognitive domains using principal components analysis.

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Objective: This study examined the prevalence of metabolic syndrome among a group of psychiatric outpatients enrolled in a homeless program that is located in a predominantly Hispanic geographic area of South Florida.

Method: Data for this retrospective, cross-sectional analysis were obtained from a record review of 122 adult patients who received full medical and psychiatric assessments based on DSM-IV criteria during participation in our homeless program from January 2009 to May 2009. The primary outcome measure was the presence of metabolic syndrome.

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Near infrared spectroscopy (NIRS) is an optical technique with high temporal resolution and reasonably good spatial resolution, which allows non invasive measurement of the blood oxygenation of tissue. The current work is focused in assessing and correlating brain activation, connectivity and cortical lateralization of the frontal cortex in response to language-based stimuli, using NIRS. Experimental studies were performed on 15 normal right-handed adults, wherein the participants were presented with a verbal fluency task.

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Purpose: Prenatal and perinatal adverse events are reported to have a pathogenetic role in focal cortical dysplasia (FCD). However, no data are available regarding the prevalence and significance of this association. A cohort of children with significant prenatal and perinatal brain injury and histologically proven mild malformations of cortical development (mMCD) or FCD was analyzed.

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Objective: To describe the absence of the arcuate fasciculi in 2 cases of congenital bilateral perisylvian syndrome (CBPS).

Design: Case series.

Setting: Pediatric referral hospital-based study.

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This study investigated differences in propositional language organization in children with developmental and acquired brain lesions. We evaluated 30 right-handed subjects with intractable epilepsy due to either focal cortical dysplasia or hippocampal sclerosis with neuropsychological testing and functional MRI prior to epilepsy surgery. Atypical activations were seen in both prenatal and early postnatal lesions, but the contribution of specific histopathological substrate was minimal.

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Objective: This study assessed the effectiveness of a postbooking jail diversion program for a homeless population with mental illness in South Florida, as measured by rate of arrests after admission to the program. The program (termed relationship-based care) is structured to ensure access to psychiatric and primary health care, delivered within a theoretical framework developed for working with this population.

Methods: Data were reviewed from the Criminal Justice Information System in Miami-Dade County for 229 adults who were arrested and found to be appropriate for jail diversion.

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In the early development of social cognition and language, infants tend to participate in face-to-face interactions engaging in joint attention exchanges. Joint attention is vital to social competence at all ages, lacking which is a primary feature to distinguish autistic from non-autistic population. In this study, diffuse optical imaging is used for the first time to investigate the joint attention experience in normal adults.

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Objective: Focal cortical dysplasia (FCD) is the most frequent pathological finding in pediatric epilepsy surgery patients. Several histopathological types of FCD are distinguished. The aim of the study was to define distinctive features of FCD subtypes.

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Introduction: In Colombia the impact of infections of Trypanosoma cruzi are known to produce chronic cardiopathy and expressed by bradycardia. In Colombia the extent and impact of these infections has not been examined.

Objective: The current study aimed to determine the prevalence of T.

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Near-infrared spectroscopy (NIRS) monitors changes in the regional cerebral oxygenation (rSO) and has been used to study cerebral physiologic functions in normal states and during epileptic seizures. Yet, the limitations and pitfalls of the technique are not fully understood. The authors evaluated NIRS changes over the frontal lobes during language tasks known to be associated with the integrity of the dominant frontal lobe in 17 normal adults (handedness: 14 right, 3 left).

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This study integrates a spectral analysis of key frequency bands (Alpha, Beta, Delta, and Theta) with an eigensystem-based study in order to validate brain functional mappings associated with the characterization effects of an Auditory/Comprehension paradigm. This numerical characterization supported by topographic functional maps brings added insight in the involvement of the Wernicke and Broca's brain areas to language comprehension. A thorough examination of EEG recordings through the eigensystem reveals that eigenvectors associated with the largest eigenvalues produce an interesting activity pattern located in the frontal area of the brain directly attributable to those characteristic behaviors found in the Alpha, Beta, Delta, and Theta frequency bands.

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Huntington's disease (HD) is an autosomal dominant neurodegenerative disease caused by a triplet (CAG) expansion mutation. The length of the triplet repeat is the most important factor in determining age of onset of HD, although substantial variability remains after controlling for repeat length. The Venezuelan HD kindreds encompass 18,149 individuals spanning 10 generations, 15,409 of whom are living.

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Mild cognitive impairment (MCI) is increasingly being conceptualized in the literature as a cognitive disturbance representing a transitional phase between normal aging and dementia. The operational definitions of MCI provide an opportunity for neuropsychologists to detect subtle deficit and monitor cognitive status sequentially in order to determine rate and degree of progression. More importantly, clinical and neuropsychological studies are needed that can better characterize which MCI patients are at greatest risk for conversion to dementia.

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