Strokes Averted by Intravenous Thrombolysis: A Secondary Analysis of a Prospective, Multicenter, Controlled Trial of Mobile Stroke Units.

Objective: This study was undertaken to examine averted stroke in optimized stroke systems.

Methods: This secondary analysis of a multicenter trial from 2014 to 2020 compared patients treated by mobile stroke unit (MSU) versus standard management. The analytical cohort consisted of participants with suspected stroke treated with intravenous thrombolysis.

Validation of the Code for the National Institutes of Health Stroke Scale Score.

Background: Administrative data can be useful for stroke research but have historically lacked data on stroke severity. Hospitals increasingly report the National Institutes of Health Stroke Scale (NIHSS) score using an , () diagnosis code, but this code's validity remains unclear.

Methods: We examined the concordance of NIHSS scores versus NIHSS scores recorded in CAESAR (Cornell Acute Stroke Academic Registry).

Risk Stratification Models for Stroke in Patients Hospitalized with COVID-19 Infection.

Objectives: To derive models that identify patients with COVID-19 at high risk for stroke.

Materials And Methods: We used data from the AHA's Get With The Guidelines® COVID-19 Cardiovascular Disease Registry to generate models for predicting stroke risk among adults hospitalized with COVID-19 at 122 centers from March 2020-March 2021. To build our models, we used data on demographics, comorbidities, medications, and vital sign and laboratory values at admission.

Prospective, Multicenter, Controlled Trial of Mobile Stroke Units.

Background: Mobile stroke units (MSUs) are ambulances with staff and a computed tomographic scanner that may enable faster treatment with tissue plasminogen activator (t-PA) than standard management by emergency medical services (EMS). Whether and how much MSUs alter outcomes has not been extensively studied.

Methods: In an observational, prospective, multicenter, alternating-week trial, we assessed outcomes from MSU or EMS management within 4.

HaNDL Syndrome Presenting with Thunderclap Headache.

Introduction: Transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL) is defined as a secondary, nonvascular headache disorder characterized by the findings described in its name. Patients with HaNDL syndrome typically present with gradual onset migrainous headaches of moderate to severe intensity with transient neurological symptoms. .

Missed cerebrovascular events during prolonged sedation for COVID-19 pneumonia.

Cerebrovascular complications among critically ill patients with COVID-19 have yet to be fully characterized. In this retrospective case series from a single academic tertiary care referral center in New York City, we present 12 patients with ischemic or hemorrhagic strokes that were found on imaging after a period of prolonged sedation in the setting of COVID-19 pneumonia. This series demonstrates a pattern of cerebrovascular events clinically masked by deep sedation required for management of COVID-19 related acute respiratory distress syndrome (ARDS).

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza.

Importance: It is uncertain whether coronavirus disease 2019 (COVID-19) is associated with a higher risk of ischemic stroke than would be expected from a viral respiratory infection.

Objective: To compare the rate of ischemic stroke between patients with COVID-19 and patients with influenza, a respiratory viral illness previously associated with stroke.

Design, Setting, And Participants: This retrospective cohort study was conducted at 2 academic hospitals in New York City, New York, and included adult patients with emergency department visits or hospitalizations with COVID-19 from March 4, 2020, through May 2, 2020.

Risk of Ischemic Stroke in Patients with Covid-19 versus Patients with Influenza.

Importance: Case series without control groups suggest that Covid-19 may cause ischemic stroke, but whether Covid-19 is associated with a higher risk of ischemic stroke than would be expected from a viral respiratory infection is uncertain.

Objective: To compare the rate of ischemic stroke between patients with Covid-19 and patients with influenza, a respiratory viral illness previously linked to stroke.

Design: A retrospective cohort study.

Mobile Stroke Units: Bringing Treatment to the Patient.

Purpose Of Review: Mobile stroke units (MSUs) have revolutionized emergency stroke care by delivering pre-hospital thrombolysis faster than conventional ambulance transport and in-hospital treatment. This review discusses the history of MSUs technological development, current operations and research, cost-effectiveness, and future directions.

Recent Findings: Multiple prospective and retrospective studies have shown that MSUs deliver acute ischemic stroke treatment with intravenous recombinant tissue plasminogen activator (IV r-tPA) approximately 30 min faster than conventional care.

Geographic Analysis of Mobile Stroke Unit Treatment in a Dense Urban Area: The New York City METRONOME Registry.

Background Mobile stroke units (MSUs) reduce time to intravenous thrombolysis in acute ischemic stroke. Whether this advantage exists in densely populated urban areas with many proximate hospitals is unclear. Methods and Results We evaluated patients from the METRONOME (Metropolitan New York Mobile Stroke) registry with suspected acute ischemic stroke who were transported by a bi-institutional MSU operating in Manhattan, New York, from October 2016 to September 2017.

Clinical Information Systems Integration in New York City's First Mobile Stroke Unit.

Background: Mobile stroke units (MSUs) reduce time to thrombolytic therapy in acute ischemic stroke. These units are widely used, but the clinical information systems underlying MSU operations are understudied.

Objective: The first MSU on the East Coast of the United States was established at New York Presbyterian Hospital (NYP) in October 2016.

Modeling the Impact of Interhospital Transfer Network Design on Stroke Outcomes in a Large City.

Background And Purpose: We sought to model the effects of interhospital transfer network design on endovascular therapy eligibility and clinical outcomes of stroke because of large-vessel occlusion for the residents of a large city.

Methods: We modeled 3 transfer network designs for New York City. In model A, patients were transferred from spoke hospitals to the closest hub hospitals with endovascular capabilities irrespective of hospital affiliation.

Novel iron oxide microparticles used to render stone fragments paramagnetic: assessment of toxicity in a murine model.

Purpose: We developed novel peptide coated iron oxide supraparamagnetic microparticles that bind to calcium stones, allowing for extraction of these stones with magnetic tools. Urothelial and fibroblast cell lines show minimal to no toxicity when exposed to the particles. Before clinical evaluation, assessment of the in vivo systemic toxicity of the microparticles was required.

Tadalafil for prevention of renal dysfunction secondary to renal ischemia.

Introduction: Growing evidence suggests that phosphodiesterase-5 inhibitors may mitigate ischemia-related renal damage through multiple mechanisms. We evaluated the role of tadalafil in renal function preservation during experimentally induced ischemia/reperfusion injury (IRI) in a solitary kidney porcine model.

Materials And Methods: Ten adult female pigs underwent left laparoscopic nephrectomy followed by a 1 week recovery period.

Importance of cosmesis to patients undergoing renal surgery: a comparison of laparoendoscopic single-site (LESS), laparoscopic and open surgery.

Unlabelled: Study Type - Therapy (case series). Level of Evidence 4. What's known on the subject? and What does the study add? Studies in other surgical populations have found that scarring is a relatively unimportant preoperative patient consideration when compared with surgical cure and safety, but that younger age was a significant factor influencing preference for 'scarless' surgery.

Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective.

Purpose: In pre-clinical studies, acute erythropoietin (EPO) administration has been shown to mitigate the deleterious effects of ischemia/reperfusion injury. We reviewed our clinical experience with intraoperative EPO administration as a potential renoprotective agent during laparoscopic partial nephrectomy (LPN).

Methods: Patients who underwent LPN at our institution between August 2008 and March 2010 received 500 IU/kg EPO 30 min prior to hilar occlusion.

Patient-reported body image and cosmesis outcomes following kidney surgery: comparison of laparoendoscopic single-site, laparoscopic, and open surgery.

Background: Laparoendoscopic single-site surgery (LESS) is reported to result in superior cosmesis versus alternative surgical approaches, based solely on surgeon assessment or anecdotal evidence.

Objective: Evaluate patient-reported body image and cosmesis outcomes following kidney surgery.

Design, Setting, And Participants: We conducted a prospective and retrospective observational cohort study involving patients who underwent kidney surgery (n=114) via LESS (n=35), laparoscopic (n=52), or open (n=27) approaches.

Minimal arterial in-flow protects renal oxygenation and function during porcine partial nephrectomy: confirmation by hyperspectral imaging.

Objectives: To examine the potential for renal protection through incomplete renal artery (RA) occlusion with both assessments of creatinine changes and the use of hyperspectral imaging to monitor tissue oxygenation. Renal ischemia during partial nephrectomy can have adverse consequences on renal function.

Methods: Fourteen pigs with a solitary kidney underwent open partial nephrectomy with warm ischemia.

Novel stone-magnetizing microparticles: in vitro toxicity and biologic functionality analysis.

Background And Purpose: We have developed novel iron-based microparticles (Fe-MP) that bind to calcium oxalate stone fragments, rendering them paramagnetic. Previously, we demonstrated enhanced efficiency of stone extraction in an inanimate model using magnetic instrumentation. Before in vivo stone extraction studies, we sought to further characterize Fe-MP with regard to cellular toxicity and to assess the influence of biologic fluids on binding performance.

Complications during the initial experience with laparoendoscopic single-site pyeloplasty.

Objective: • To review our initial series of laparoendoscopic single-site (LESS) pyeloplasties, focusing on 30-day complication rates as an indicator of learning curve, and to define the expected morbidity.

Patients And Methods: • The study comprised 28 patients who underwent LESS pyeloplasty by a single surgeon from October 2007. • A chart review was undertaken to identify the complications that occurred within the first 30 days after surgery.