Podcasts about neurohospitalist

Neurohospitalist and clinical neurophysiologist Franklyn Rocha Cabrero discusses their article, "Missing prescription: long-term parental leave for fathers in medicine." In this episode, Franklyn delves into the systemic and societal barriers that hinder male physicians from taking full advantage of parental leave, explores the benefits of longer leave on family well being, and highlights actionable strategies for balancing demanding medical careers with family responsibilities in the field of health care. Drawing from personal experiences as a self-employed practitioner, Franklyn offers practical insights for aspiring fathers in medicine who seek to prioritize family without sacrificing career advancement. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme I'm partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably increase the INR Current use of Direct thrombin inhibitor or Factor Xa inhibitor  aPTT/PT/INR are insufficient to assess the degree of anticoagulant effect of Factor Xa inhibitors like apixaban (Eliquis) and rivaroxaban (Xarelto)  Intracranial or intraspinal surgery in the last 3 months Intracranial neoplasms or arteriovenous malformations also increase the risk of bleeding Current intracranial or subarachnoid hemorrhage History of intracranial hemorrhage from thrombolytic therapy also contraindicates tPA/TNK Recent (within 21 days) or active gastrointestinal bleed Hypertension BP >185 systolic or >110 diastolic Administer labetalol before thrombolytics to lower blood pressure Timing of symptoms Onset > 4.5 hours contraindicates tPA Platelet count < 100,000 BGL < 50 Potential alternative explanation for stroke-like symptoms obviating need for thrombolytics References 1. Fugate JE, Rabinstein AA. Absolute and Relative Contraindications to IV rt-PA for Acute Ischemic Stroke. The Neurohospitalist. 2015;5(3):110-121. doi:10.1177/1941874415578532 2. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke a Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Vol 50.; 2019. doi:10.1161/STR.0000000000000211 Summarized by Jorge Chalit, OMSII | Edited by Jorge Chalit

To effectively treat stroke and prevent stroke, you need to know just what is literally happening in a patient's head. CT Scans and MRI scans are tools most of us are familiar with. Generally if you suspect a stroke is possible, you need these two scans done. There's another tool out there, too, that's cheaper, more portable, and involves no radiation. It's called Transcranial Doppler Ultrasound. It's a great complement to the other scans, and it can provide impressive insight to supplement the information from the radiologists. A skilled practitioner is a great complement to the care team. I first talked about this technology in my conversation with Dr. Aaron Stayman a few years back (Is my Brain Pregnant? Ultrasound and Stroke: Transcranial Doppler Ultrasound). It's fascinating stuff. The problem is that it does require a skilled technician or someone specifically trained in the technique. Despite the work of advocates like Dr. Stayman and Dr. Mar Rubin, there just aren't enough of those techs. Dr. Mark Hamilton of Nova Signal has a solution. His robotic machine automates the whole process, makes it faster, more reliable, and cheaper while giving more accurate results in a lot of scenarios. The Nova Signal solution has the potential to make this technology available to patients and medical practitioners around the world. Drs. Rubin and Hamilton join me in this episode to discuss the technology, the research, and the device itself. If you don't see the audio player below, visit http://Strokecast.com/TCD to listen to the conversation.   Click here for a machine-generated transcript Who are Drs. Rubin and Hamilton? Dr. Mark N. Rubin is a vascular neurologist and associate professor of neurology with the University of Tennessee Health Science Center Department of Neurology. He specializes in vascular neurology and is experienced in stroke and cerebrovascular disease, and an experienced sonographer and expert interpreter of carotid duplex ultrasound and transcranial Doppler ultrasonography. He received his medical degree from University of Illinois College of Medicine and completed his Adult Neurology residency and fellowships (Neurohospitalist and Vascular Neurology) at the Mayo Clinic. Robert Hamilton, Ph.D. is the Chief Scientific Officer and Co-Founder of NovaSignal. He is an accomplished entrepreneur, engineer, and clinical researcher with a passion for innovative technologies that allow for increased access to care. Robert, a biomedical engineer by training, is an expert in image/signal processing and machine learning, with extensive experience in cerebral blood flow, traumatic brain injury, stroke, and other neurological disorders. Robert co-founded NovaSignal based on technology he developed during his Ph.D. During his tenure at the company, Robert has supported the entire lifecycle of the NovaSignal autonomous ultrasound platform from idea to commercialization with regulatory clearances in the US, Europe, and Canada. Additionally, Robert has designed and completed several clinical trials supporting the use of the technology in different neurological conditions and has acted as principal investigator on federal grants and contracts totaling more than $25M from the Department of Defense, National Institutes of Health, and the National Science Foundation.  Finally, Robert has achieved greater than 100 citations of his work in peer-reviewed publications and conferences and holds over 50 patent assets related to the core technology developed during his PhD studies. TCD vs Traditional Ultrasound When most of us think of ultrasound in medicine, we think of the sonograms of developing children, where parents and doctors swear they can see a human being in those black and white lines. Personally, they seem more like those Magic Eye pictures from the 90s. Traditional ultrasound can also capture pictures of the heart, the blood vessels in the neck, and the condition of other organs in the body. It can be another way of getting a picture of the structures at play. And then you can frame those pictures or make them your Facebook profile picture. TCD is different. The goal is not to capture a picture of the structures of the brain. The goal instead is to understand blood flow through the brain. The technology helps practitioners understand the rate of flow, where there may be leaks or disruptions, if stuff is flowing with the blood that shouldn't, the direction of flow, and whether things are shunting (or crossing) between the veins and arteries that shouldn't. That shunting is at the core of the recent study Nova Signal was part of and that we talk about in this conversation. There are several reasons shunting can occur, but one of the most common is a PFO, or a hole in the heart. I talked in more detail about just what a PFO is in the last episode here: http://Strokecast.com/Anna TCD is a great technology for helping doctors understand the dynamic flow of blood in each individual patient. And it doesn't involve the dedicated rooms or radiation that might come with CT  or MRI Scans. NovaGuide™ 2 Intelligent Ultrasound The Nova Guide 2 Intelligent Ultrasound is the device we talked about in this conversation. While TCD is a great tool, it does take a while to get the scan just right, and we face a dearth of practitioners who are able to do it. The Nova Signal solution is simpler. It's small and automated. The device can orient itself and complete a scan much quicker than a human can. The research shows it's more accurate, too. It doesn't take up much space in a medical facility and can easily be brought from one patient to another. Plus, an operator can perform a lot more scans per hour or get back to other tasks more quickly. With hospitals perpetually understaffed these days, that speed makes a lot of financial sense. And since, in stroke, time is brain, it can make a lot of medical sense, too. Nova Signal vs Transthoracic Echocardiography The information about the presentation at the International Stroke conference is here: https://eventpilotadmin.com/web/page.php?page=IntHtml&project=ISC22&id=1176 This is the data we talked about a lot in the conversation. The Nova Signal device was significantly better at detecting the vein-artery shunts indicative of PFO and other conditions than the gold-standard  evaluation technique using Transthoracic Echocardiogram. This matters in stroke because when we talk about shunting in tests we're usually talking about very small bubbles. Outside of the test context we're usually talking about clots and other stuff sneaking across from veins to arteries, bypassing the body's filters. When they do that they can go to the brain and cause a stroke. Accurate detection of shunting allows physicians to make more appropriate treatment recommendations and decisions. Hack of the Week Cultivating a sense of gratitude, as unlikely as it may seem, is something that helps a lot of folks deal with the challenges pf post stroke life. Simply being alive means thing can get better. And being alive in the 21 century with the medical resources available is a huge asset to the community. Of course those medical resources are not evenly distributed within the US and around the world, but they exist, and that's a start. Develop a sense of purpose. After stroke, it can be hard to see a way forward, especially if you have severe disabilities. People who succeed in their recovery, or in their goals in general, typically have a pretty strong "Why?" driving them. Achieving their goals gets them closer to something important to them. In the dark times, when you find yourself feeling it's just not worth it, your why -- your sense of purpose can give you a reason to push through. We sometimes ask, "Why should I go on?" almost rhetorically to express or pain. For some folks, though, it can be an exercise to identify the things that matter to you. So ask yourself that question, but assume there is an answer. And write down everything that could be an answer. Cultivate the sense of purpose to get through the darkness. Links Where do we go from here? To learn more about Nova Signal and the research around TCD, visit http://NovaSignal.com Share this link with someone you know by giving them the link http://Strokecast.com/TCD Share a recent win (we all have them) at 321-5Stroke or by email Don't get best…get better.

Integrating an ED clinical pharmacist was a complete practice changer for us at UC Davis! It is a positive trend across the US and in this episode, we talk with Chris Adams, Clinical Senior Pharmacist at UC Davis. Tell us how YOUR department integrates a pharmacist @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their stories, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Host: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guest: Chris Adams, Clinical Senior Pharmacist at UC Davis *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Resources: Farmer BM, Hayes BD, Rao R, Farrell N, Nelson L. The role of clinical pharmacists in the emergency department. J Med Toxicol. 2018;14(1):114-116. Acquisto NM, Hays DP, Fairbanks RJT, et al. The outcomes of emergency pharmacist participation during acute myocardial infarction. J Emerg Med. 2012;42(4):371-378. Jacoby JS, Draper HM, Dumkow LE, Farooq MU, DeYoung GR, Brandt KL. Emergency medicine pharmacist impact on door-to-needle time in patients with acute ischemic stroke. Neurohospitalist. 2018;8(2):60-65. Moussavi K, Nikitenko V. Pharmacist impact on time to antibiotic administration in patients with sepsis in an ED. Am J Emerg Med. 2016;34(11):2117-2121. Patanwala AE, Sanders AB, Thomas MC, et al. A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department. Ann Emerg Med. 2012;59(5):369-373.

Dr. Katherine Fu (@KatherineFuMD) discusses with guests Dr. Karima Benameur (@kimaneurologist), Neurohospitalist and Associate Professor of Neurology at Emory University & Dr. Vanessa Cooper (@VanessaCooperMD), Assistant Professor of Neurology at Yale University and Associate Director of Diversity and Inclusion education for the neurology residency program about "Imposter Syndrome" (aka Imposter Phenomenon). They also discuss a variety of strategies to combat Imposter Syndrome on an individual, community, and institution level.

On today's show we'll focus on functional neurological disorder, or FND -- a wide range of conditions including non-epileptic seizures and functional weakness, dystonia and tremor. These conditions are common and can cause serious disability. But what are these conditions, exactly? What have functional neuroimaging and other tools taught us about their pathophysiology, diagnosis, and treatment? Series 3, Episode 2 Featuring: - Guest: Dr. Sara Finkelstein, neurologist and specialist in functional neurological disorder at Massachusetts General Hospital - Interviewer/Producer: Dr. Adeline Goss, Neurohospitalist at Highland Hospital and the host and executive producer of ANA Investigates

Dr. Katherine Fu discusses the emerging subspecialty of neurology hospitalists or “neurohospitalists".  Show references: https://n.neurology.org/content/85/5/e50

A stroke can happen at anytime, anywhere, to anyone. What are the signs of a possible stroke and are you at risk? Dr. Fahed Saadan, Neurohospitalist at St. Joseph's Health, is here to discuss the warning signs and when to take action.

A stroke can happen at anytime, anywhere, to anyone. What are the signs of a possible stroke and are you at risk? Dr. Fahed Saadan, Neurohospitalist at St. Joseph's Health, is here to discuss the warning signs and when to take action.

Dr. Benameur graduated from the University of Oran in Algeria where she received her MD degree. She subsequently trained at the Albert Einstein College of Medicine, then at the National Institutes of Health where she was awarded the excellence in research award. She moved to Atlanta to complete her residency and fellowship at Emory, and was selected as Chief resident of education. She was appointed to current position on the Emory faculty as Assistant Professor of Neurology in 2014, and has been part of the Neurohospitalist team ever since. Her daily work consists of taking care of hospitalized patients with neurological diseases, and educating residents and medical students. She sees first-hand the effects of poor nutrition and a sedentary lifestyle on brain health, as it presents in a myriad of neurological diseases, the most common of which is stroke. Her passion is teaching not only her patients and their families, but also other physicians and medical students about the importance that proper nutrition, exercise, sleep, and other lifestyle changes can have on brain health. Dr. Benameur talks about the influence our lifestyle choices have on brain health. What is the effect of nutrition, exercise and sleep? What is the effect of chronic inflammation and stress? Is memory loss a normal part of aging? And finally, what actions and choices can we make to maintain optimal brain heath and good memory long-term? Tune in to learn more! Dr. Benameur has a course on Coursera called Biohacking Your Brain's Health. You can find it here: https://www.coursera.org/learn/biohacking-your-brains-health

Riverside Healthcare works with Associates of Integrated Medicine (AIM) hospitalists group to provide in-patient hospital care as part of Riverside's hospitalist program.Dr. Veena Bhamre comes on to share how in addition to the existing AIM in-patient hospitalist program, Riverside also has a team of around-the-clock in-patient pediatric hospitalists from Comer's Children Hospital through its partnership with University of Chicago Medicine and a Neurohospitalist program in place to assist the neurologists and other physicians in delivering the highest quality care to patients at all times.

Strokecast regular, neurologist Dr. Nirav Shah joins us again this week to talk about Remote Ischemic Conditioning. Essentially it makes the body more resistant to oxygen deprivation by depriving it of oxygen. It's a fascinating area. In some respects, it does the opposite of hyperbaric oxygen therapy. As we learned in episode 48, the theory is that Hyperbarics, which floods the body with extra oxygen at high pressure can bring back the stroke damaged brain tissue and help with recovery. And while hyperbaric oxygen therapy does help for a lot of conditions, the science doesn't back it up for stroke. Remote Ischemic conditioning does appear to have positive results in the early studies and may be helpful in the future. Does this mean you should go ahead and tie a tourniquet around your limbs to give it a shot? Absolutely not. That would be a terrible idea. At least for now. I like the potential in Remote Ischemic Conditioning. I also like that it is potentially simple, inexpensive, and something I can do at home. Sure, it might be physically uncomfortably, but if it works, I think Io can get past that. For many of us, that discomfort may be minor compared to the other things we deal with on a regular basis. Of course this is all still preliminary. There's research to be done. Another thing that's interesting to think about is how something that's bad can still have positive outcomes. And yet that doesn't make up for the problem itself. It's sort of a Mussolini made the trains run on time kind of thing. Specifically, the issue of smoking. Smoking causes some remote ischemic conditioning. As we talked about that means smokers may have less severe stroke. Good, right? Except smoking causes many of those strokes in the first place! The best way to minimize the effect of stroke is not to have one in the first place. Finally, the other thing about this episode that makes me smile is that it added the phrase "vascular milieu' to my vocabulary. And that's just delightful. To hear more from Nirav, head on over to Strokecast.com/nirav to find all his Strokecast interviews. Bio Dr. Nirav H. Shah is a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging. He is a practicing neurohospitalist and served as the stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. He enjoys mentoring trainees and collaborating on publications and conference presentations. Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit. Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer. Hack of the Week If you struggle with communicating and meeting new people, prepare a preprinted bio and bring it with you. An attendee with aphasia came to our support group recently and brought such a Bio. When it was her turn to introduce herself, she was able to hand me that sheet to read for the group.  This can be a great way to meet other people and can relieve a lot of anxiety. If you want to get fancy, you could even laminate it. This can also be helpful even if you can usually speak well. Sometimes stressful situations (like traffic stops) can make the words tougher to grab. A preprinted bio or introduction can help quite a bit. Links   Nirav's other Appearances http://strokecast.com/nirav Hyperbaric Oxygen Therapy http://strokecast.com/hyperbaric Kristen Talks about Sleep Apnea http://strokecast.com/kristen Nirav  on LinkedIn https://www.linkedin.com/in/nirav-h-shah/ Nirav at Swedish https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893 Nirav on Twitter http://twitter.com/NeuroNirav The Neurohospitalist http://journals.sagepub.com/home/nho Nirav’s Photography www.thoughtpotential.com Sentinel Healthcare https://www.sentinel.healthcare/ Remote Ischemic Conditioning: From Bench to Bedside https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282534/ RECAST (Remote Ischemic Conditioning After Stroke Trial) https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.116.016429 Remote ischemic conditioning for stroke: clinical data, challenges, and future directions https://onlinelibrary.wiley.com/doi/full/10.1002/acn3.691 Immediate remote ischemic postconditioning reduces cerebral damage in ischemic stroke mice by enhancing leptomeningeal collateral circulation https://onlinelibrary.wiley.com/doi/full/10.1002/jcp.27858 Remote limb ischemic postconditioning promotes motor function recovery in a rat model of ischemic stroke via the up‐regulation of endogenous tissue kallikrein https://onlinelibrary.wiley.com/doi/full/10.1111/cns.12813   Where do we go from here? To hear more from Nirav, head on over to Strokecast.com/nirav to find all his Strokecast interviews. Tell a friend, colleague, relative or patient about Strokecast. Don't get best…get better.  

  When I had my stroke at 46, it took a little while for the medical team to settle on the cause. I suppose that's a good thing. We don't want them to rush to a conclusion. Ultimately, they concluded the probable cause was a history of high blood pressure. It didn't make sense to me at the time. In 2015 I developed high blood pressure, AKA hypertension, but I didn't know. That's the thing about high blood pressure -- it doesn't hurt. There was no pain. I only found out because during the last week of December, I began have massive 30 minute pouring nosebleeds every other day. I checked my blood pressure on a home blood pressure machine, and it registered more than 200 over 160. That and the random surprise bleeding got me into the doctor's office. They measured my BP at 162/102. So it had dropped from apparently ER levels by that time. Over the course of the next few months, we worked to get my BP under control through medication and some diet tweaks. By March of 2016, my BP was coming in at 105/75. Be February of 2017, it was down to 100/70. And on June 3, 2017, I had my stroke. I had serious high blood pressure for maybe a year to a year and a half. I had it under control for a year before my stroke. So how could previous high blood pressure cause a stroke? This week, Dr. Nirav Shah, a neurologist at Swedish Medical Center in Seattle and the founder and CEO of Sentinel Healthcare, returns to Strokecast to answer that very question as we talk about just how high blood pressure causes stroke.   Bio Dr. Nirav H. Shah is a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging. He is a practicing neurohospitalist and served as the stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. He enjoys mentoring trainees and collaborating on publications and conference presentations. Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit. Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer. Hack of the Week After I lost the use of my left arm, eating became a challenge for some dishes. Sushi was easy. Steak was difficult because to cut a steak, you need to hold it still with your fork and slice with the steak with the knife in your other hand. So how do you manage this out at a restaurant?  You've got a couple options. One, of course is to just skip cutting it, pick up the slab of meat with the one usable hand and start chowing down. Of course your dining companions may not prefer that choice. The other option is incredibly simple. When you place your order, ask them to have the kitchen cut up the steak for you.  That's it. It's a simple request that will take them just seconds and it solves your problem. Links Lipohyalinosis https://en.wikipedia.org/wiki/Lipohyalinosis C. Miller Fisher on Wikipedia https://en.wikipedia.org/wiki/C._Miller_Fisher C. Miller Fisher On AHA Journals https://www.ahajournals.org/doi/10.1161/STROKEAHA.112.661512 Atherosclerosis on WebMD https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569 Arteriosclerosis / atherosclerosis on Mayo Clinic https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569 Lacunar Stroke on Wikipedia https://en.wikipedia.org/wiki/Lacunar_stroke Lacunar Infarction and Small Vessel Disease: Pathology and Pathophysiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325635/ Effect of reducing blood pressure with medications immediately following ischemic stroke https://medicalxpress.com/news/2013-11-effect-blood-pressure-medications-immediately.html Blood Pressure-Lowering Treatment After Subacute Stroke to Prevent Recurrent Stroke, Major Vascular Events, and Dementia https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.118.023087?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed Higher Blood Pressure May Be Linked to Brain Disease, Alzheimer’s https://www.rush.edu/news/press-releases/higher-blood-pressure-may-be-linked-brain-disease-alzheimers Nirav  on LinkedIn https://www.linkedin.com/in/nirav-h-shah/ Nirav at Swedish https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893 Nirav on Twitter http://twitter.com/NeuroNirav The Neurohospitalist http://journals.sagepub.com/home/nho Nirav’s Photography www.thoughtpotential.com Where do we go from here? Control your blood pressure. If you don't know what it is, find out. Talk with your doctor to develop a plan to drive it to safe levels -- under 120/80 Post a link to this episode on your Facebook, LinkedIn, or Twitter account by using the link http://strokecast.com/bloodpressure  If you'd like to hear more from Nirav, check out his other appearances by going to http://Strokecast.com/Nirav Don't get best…get better   Strokecast is the stroke podcast where a Gen X stroke survivor explores rehab, recovery, the frontiers of neuroscience and one-handed banana peeling by helping stroke survivors, caregivers, medical providers and stroke industry affiliates connect and share their stories.

  Tracking Blood Pressure After my stroke (and before my stroke, too) I'm supposed to monitor my blood pressure regularly. That means I have to: Put the cuff on my arm Relax while it reads the data Record the data on my log Print off my log when I go see the doctor every few months Seems simple, right? Well here's where it gets complicated. Because my left arm was affected by the stroke, I can't get reliable blood pressure there. Tone, spasticity, occasional edema, lack of use, and variable circulation mean the results are less accurate. That means, I have to put the cuff on my right arm to get a reading. Have you ever tried to scratch your right elbow with your right hand? Yeah. You can see the challenge. As I've gotten a little more left arm use back, I can kind of get the cuff in place by also using my teeth. That involves frustration, effort, and all sorts of movement. You know what that does? Yup. It raises my blood pressure. When The GF is around, she can place the cuff which helps. Of course that's best in the summer. In the winter, I'm wearing fleece or sweaters. And I don't want to take them off. So now I'm less likely to take a reading. When I do take a reading during the day and log it, great. That data may be helpful in another 6 months. But what if there was a better way? Sentinel Healthcare Long time listeners will be happy to welcome neurologist and Sentinel Healthcare CEO Dr. Nirav Shah back to the show. Nirav and Sentinel have that better way. In Sentinel's solution, a patient uses a highly accurate wrist cuff blood pressure reader to take a reading, which transmits via Bluetooth to their iPhone and into a secure platform that gets that data to the care team. It solves the problems above while creating a bigger data-set to provide better care for the patient. This week, I talk with Nirav about telemedicine in general and about what he and Sentinel are doing to pair telemedicine with blood pressure management to help patients receive better care while making it easy to comply with doctors' post-hospital instructions Bio Dr. Nirav H. Shah is a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging. He is a practicing neurohospitalist and served as the stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. He enjoys mentoring trainees and collaborating on publications and conference presentations. Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit. Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer. Links Sentinel Healthcare http://www.sentinel.healthcare/ Sentinel Healthcare launches platform to fill gaps between IoT devices and doctors' offices https://www.geekwire.com/2018/sentinel-healthcare-launches-platform-fill-gaps-iot-devices-doctors-offices/     Hypertension costly to patients, society https://www.reuters.com/article/us-health-hypertension/hypertension-costly-to-patients-society-idUSKBN1J72MB Apple unveils Watch Series 4 with FDA-approved ECG https://www.healthcareitnews.com/news/apple-unveils-watch-series-4-fda-approved-ecg Nirav’s previous appearances http://strokecast.com/nirav Nirav on Stem Cells and Stroke Recovery http://strokecast.com/stemcells Nirav  on LinkedIn https://www.linkedin.com/in/nirav-h-shah/ Nirav at Swedish https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893 Nirav on Twitter http://twitter.com/NeuroNirav The Neurohospitalist http://journals.sagepub.com/home/nho Nirav’s Photography www.thoughtpotential.com Hack of the Week -- Bring Joy to your Rehab Team As a survivor, do you like the work your inpatient team did? Did they help you walk or eat or speak again? If you haven't talked with them since leaving the hospital, the Holiday season is a great time to send a note or card. Once patients leave their care, most inpatient OT, PT, Speech Therapists, and others never hear more. If you want to brighten their day send an email or physical note, or visit the rehab unit them how you're doing. They love to hear from their alumni and to celebrate the progress you've made. A card or note is a simple, low cost gift for the Holiday (or really any) season. Where do we go from here? Check out Sentinel Healthcare's website to learn more about the product and solution  Send a message to your rehab team and let them know how you're doing Subscribe to Strokecast for free in your favorite podcast app so you never miss an episode Don't get best…get better   Strokecast is the stroke podcast where a Gen X stroke survivor explores rehab, recovery, the frontiers of neuroscience and one-handed banana peeling by helping stroke survivors, caregivers, medical providers and stroke industry affiliates connect and share their stories.

This week, Dr. Nirav Shah and I talk about antidepressants -- SSRIs specifically -- in Stroke Recovery. The FLAME study demonstrated the benefits to motor recovery. SSRI stands for Selective Serotonin Re-uptake Inhibitor. Basically, the way data gets sent from one nerve cell to another is through the use of chemicals, like serotonin. The body produce serotonin and the collects it when done, taking it out of the system. An SSRI slows down the collection process -- it inhibits the re-uptake. That leaves more serotonin floating around the brain. Having more serotonin floating around the brain can help reduce, manage, or eliminate depression and other conditions. That's why SSRIs are some of the most common anti-depressants on the market. The FLAME study looked at how Fluoxetine (AKA Prozac) behaves in folks who recently had a stroke. Fluoxetine is an old school antidepressant and SSRI. The study appeared to show that the extra serotonin in the brain may help promote neuroplasticity and recovery of motor skills after stroke, and that's why we're talking about it today. My Experience When I was inpatient, the doctor put me on an SSRI due to the FLAME study. She tried Prozac (AKA Fluoxetine) first. Unfortunately, it gave me an anxiety attack. On the other hand, I now know what an anxiety attack feels like. Not pleasant. A Xanax took care of that. We tried again the next day, this time with another SSRI called Lexapro (AKA Escitalopram). Someone explained to me that the molecule that makes up Lexapro is the mirror image of the Prozac molecule. I'd had Lexapro in the past, with no ill effects so it was worth a shot. Success! No anxiety attack this time. And that's how an SSRI earned a spot in my daily collection of medication. But did it help my recovery? Maybe. There's no way to tell for sure. The data indicates that it should and there is no reason to think it didn't help. As a side effect, I did not go into the deep depression so common among other stroke survivors. This is a new use for SSRIs, Fluoxetine, and Escitalopram. It's borderline off-label. Not all doctors are familiar with the idea that SSRIs promote the neuroplasticity that supports recovery of motor functions. And that's how I ended up explaining the research to my primary care physician as he reviewed my meds with me post-hospital. The FLAME study covered 6 months. I'm still taking the Lexapro today. When I talked to my rehab doctor about whether I should continue we concluded that since I don't have any negative results from it, we may as well keep it up. If there's a chance it can help, and it's not hurting, then that sounds good to me. Dr. Nirav H. Shah Dr. Nirav H. Shah is a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in t: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging. He is a practicing neurohospitalist and served as the stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. He enjoys mentoring trainees and collaborating on publications and conference presentations. Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit. Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer. So let's fan the FLAME of stroke recovery with Nirav. Hack of the Week Many stroke survivors use a day of the week pill organizer to keep track of meds. And, sometimes, the day of the week. The organizer can also make it easy to keep track of whether or not we've taken pills for the day. After taking your pills, leave the door for that day open exposing the now empty chamber. That gives you and your caregiver an easy to see visual queue the deed is done.   Links FLAME study Presentation http://www.my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_427770.pdf Efficacy of Fluoxetine - a Trial in Stroke (EFFECTS) https://clinicaltrials.gov/ct2/show/NCT02683213 Predicting recovery in acute poststroke aphasia https://www.ncbi.nlm.nih.gov/pubmed/29451321 Nirav’s previous appearance http://strokecast.com/nirav Nirav on Stem Cells and Stroke Recovery http://strokecast.com/stemcells Nirav  on LinkedIn https://www.linkedin.com/in/nirav-h-shah/ Nirav at Swedish https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893 Nirav on Twitter http://twitter.com/NeuroNirav The Neurohospitalist http://journals.sagepub.com/home/nho Nirav’s Photography www.thoughtpotential.com Sentinel Healthcare http://www.sentinel.healthcare/ Where do we go from here? Check out the links to the FLAME study and the other SSRI stroke studies above. Subscribe to Strokecast for free in your favorite podcast app. Use your pill box door as a reminder/calendar. Don't get best…get better.

  Shortly after I started this show I began asking folks at Swedish about who I should speak with about this project. I got really lucky, and the team there connected me with Dr. Nirav H Shah. He's involved with research, clinical patient care, and development of new technologies.   What's really awesome is how his face lights up when he talks not only about his work, but the work other researchers are doing in this field to improve the quality of life of stroke survivors and to reduce the amount of strokes to begin with.   Bio Dr Nirav H Shah a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in t: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging. He is a practicing neurohospitalist and stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. H enjoys mentoring trainees and collaborating on publications and conference presentations. Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit. Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer.   Notes on Audio Quality My audio is not great this week. I think the batteries were too low in my recorder when we met onsite at Swedish. This mainly affected my side of the conversation. I spent some time tweaking it and pulling it out from the low-volume graveyard to get it to the point where it works, but you'll notice it seems a little thinner this week. Relevant Links Nirav H Shah on LinkledIn https://www.linkedin.com/in/nirav-h-shah/ Nirav H Shah at Swedish https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893 Nirav on Twitter http://twitter.com/NeuroNirav The Neurohospitalist http://journals.sagepub.com/home/nho ARTSS-2 Study https://www.ahajournals.org/doi/abs/10.1161/strokeaha.117.016720 Nirav H Shah Letter on ARTSS-2 https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.018121 ARCADIA Study https://clinicaltrials.gov/ct2/show/NCT03192215 Sentinel Healthcare http://www.sentinel.healthcare/ Nirav's Photography www.thoughtpotential.com   Where do we go from here? What questions do you have about neurology? What would you like Nirav to talk more about in the future? Let us know in the comments below. Do you know anyone else who finds brains interesting? Send them the link http://strokecast.com/nirav so they can listen, too. Subscribe to Strokecast in your favorite podcast app. Don't get best...get better.  

1. Featured Article: Intravenous thrombolysis and platelet count2. What’s Trending: Gene Drives, part IThis podcast begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the February 6, 2018, issue of Neurology. In the first segment, Dr. Kevin Barrett talks with Dr. Henrik Gensicke about his article on the effect of platelet count on bleeding risk and mortality in stroke patients treated with IV thrombolysis. In the second part of the podcast, you’ll hear the first part of Dr. Ted Burns’ interview with Dr. Kevin Esvelt about gene drives.DISCLOSURES: Dr. Barrett serves on the editorial board of Neurology and Neurohospitalist; has received research/grant support from the National Institute of Neurological Disorders and Stroke for serving on the executive committees of the CREST-2 and SHINE clinical trials; and receives publishing royalties from Wiley Blackwell. Dr. Gensicke receives research support from Swiss National Science Foundation (33CM30-124119 and P300PB_161071). Dr. Burns is the deputy section editor of the Neurology® podcast; has served on scientific advisory boards for Argenx, UCB, and CSL Behring; has received travel funding/speaker honoraria from Argenx and Alexion; and has received support for consulting activities from UCB Pharma and CSL Behring. Dr. Esvelt reports no disclosures.

1) Featured Article: Collateral response modulates the time–penumbra relationship in proximal arterial occlusions2) Lesson of the Week: Migraine and neuromodulationThis podcast begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the January 23, 2018, issue of Neurology. In the first segment, Dr. Kevin Barrett talks with Dr. Smriti Agarwal about her paper on collateral circulation in proximal arterial occlusions and extending the scope of thrombolytic therapy. In the second part of the podcast, Dr. Teshamae Monteith focuses her Lesson of the Week interview with Dr. Stewart Tepper on acute and preventative neuromodulation treatment for migraine. DISCLOSURES: Dr. Barrett serves on the editorial board of Neurology and Neurohospitalist; has received research/grant support from the National Institute of Neurological Disorders and Stroke for serving on the executive committees of the CREST-2 and SHINE clinical trials; and receives publishing royalties from Wiley Blackwell.Dr. Agarwal reports no disclosures.Dr. Monteith serves as an editorial advisory board member for Neurology Now and receives research support from the NIH.Dr. Tepper is a member of the board for the American Headache Society and has been a consultant for or participated on a paid advisory board for Acorda Therapeutics, Inc; Alder BioPharmaceuticals, Inc; Allergan plc; Amgen, Inc; Avanir Pharmaceuticals, Inc; BioVision, Inc; Charleston Laboratories, Inc; Dr. Reddy’s Laboratories, Ltd; electroCore, LLC; eNeura, Inc; Eli Lilly and Company; GLG Pharma, LLC; Guidepoint Inc, LLC, Ltd; Kimberly-Clark Corporation; Pernix Therapeutics Holdings, Inc; Pfizer, Inc; Scion NeuroStim, LLC; Teva Pharmaceutical Industries, Ltd; and Zosano Pharma, Corp.

Show description/summary:1) Medication-overuse headache: An entrenched idea in need of scrutiny 2) What’s Trending: DAWN TrialThis podcast begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the September 19th, 2017 issue of Neurology. In the first segment, Dr. Alex Menze talks with Dr. Elizabeth Loder about her paper on medication overuse headache. In the second part of the podcast, Dr. Kevin Barrett focuses his interview with Dr. Tudor Jovin on the DAWN trial on Trevo thrombectomy for acute ischemic stroke. Disclosures can be found at Neurology.org.DISCLOSURES: Dr. Menze reports no disclosures.Dr. Loder has received travel funding from the American Headache Society and American Migraine Foundation and The British Medical Journal; has served on the editorial boards of The British Medical Journal, Cephalalgia, and Headache; receives publishing royalties from Cambridge University Press; and has received research support from Harvard Medical School.Dr. Barrett serves on the editorial boards of Neurology and Neurohospitalist; receives publishing royalties from Wiley-Blackwell; and has received research support from NINDS.Dr. Jovin has served on the Codman Neurovascular Data Safety Monitoring Board; has received travel funding from Stryker Neurovascular and Fundacio Ictus; and holds stock/stock options in Silk Road Medical, Anaconda, and Blockade Medical.

Show description/summary:1) Diagnosis of DWI-negative acute ischemic stroke: a meta-analysis 2) Topic of the Month: Multiple sclerosis therapeutics and pediatric multiple sclerosis patientsThis podcast begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the July 18, 2017 issue of Neurology. In the first segment, Dr. Kevin Barrett talks with Dr. Brian L. Edlow about his paper on the diagnosis of DWI-negative acute ischemic stroke: a meta-analysis. In the second part of the podcast Dr. Stacey Clardy focuses her interview with Dr. Emmanuelle Waubant on MS therapeutics and pediatric MS patients. Disclosures can be found at Neurology.org.DISCLOSURES:Dr. Barrett has served on the editorial boards of both Neurology® and The Neurohospitalist; receives publishing royalities from the book Stroke; and receives research support from NINDS.Dr. Edlow receives research support from Guger Technologies, NIH, American Academy of Neurology/American Brain Foundation, and the James S. McDonnell Foundation.Dr. Clardy received research support from Western Institute for Biomedical Research (WIBR).Dr. Waubant volunteers on a Novartis advisory board; serves on the editorial board of Annals of Clinical and Translational Neurology; serves as editor of MSARD; receives royalties from the publication of the book Demyelinating disorders of the central nervous system in childhood; and receives research support from Roche, Novartis, NIH, National MS Society, and Race to Erase MS.

1) Emerging temporal trends in tissue plasminogen activator use: Results from the BASIC project2) e-Pearl topic: Transthyretin familial amyloid polyneuropathy3) Topic of the month: How to examine and approach movement disordersThis podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Kevin Barrett interviews Dr. Lynda Lisabeth about her paper on temporal trends in tissue plasminogen activator administration for acute ischemic stroke. Dr. Ilena George is reading our e-Pearl of the week about transthyretin familial amyloid polyneuropathy. In the next part of the podcast Dr. Jeff Ratliff interviews Dr. Ruth Walker on the topic of chorea.DISCLOSURES: Dr. Barrett serves as Associate Editor for Neurohospitalist; serves as an editorial board member for Neurology®; receives royalties from the publication of the book Stroke and editing the book Neurology in Practice; and receives research support from the NIH.Dr. Lisabeth receives research support from the NIH.Dr. George serves on the editorial team for the Neurology® Resident and Fellow Section. Dr. Walker is a consultant for Neurocrine Biosciences, Inc.; assists with Audio-Digest Board Reviews; received funding for travel from Korean Movement Disorders Society and honoraria from Neurocrine Biosciences, Inc.

1) Low-cost, tablet-based option for prehospital neurologic assessment: the iTREAT Study2) What's Trending: Interview with Dafne Horovitz about her paper on cranial bone collapse in microcephalic infants prenatally exposed to Zika virus infection3) Topic of the month: Controversies in Neurology Plenary Session at the AAN meeting about the pro and con effects of cognitive enhancing activities and their effects on preventing dementiaThis podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Kevin Barrett interviews Dr. Andy Southerland about his paper on a low-cost, tablet-based option for prehospital neurologic assessment. Dr. Ted Burns is interviewing Dr. Dafne Horovitz for our “What's Trending” feature of the week about her paper on cranial bone collapse in microcephalic infants prenatally exposed to Zika virus infection. Dr. Alberto Espay interviews Drs. Dave Knopman and Kaycee Sink about their Controversies in Neurology Plenary Session at the AAN meeting about the pro and con effects of cognitive enhancing activities and their effects on preventing dementia.DISCLOSURES: Dr. Barrett serves as Associate Editor for Neurohospitalist; serves as an editorial board member for Neurology®; receives royalties from the publications of the books Stroke and Neurology in Practice [Edited book]; and receives research support from the NIH.Dr. Southerland serves as Podcast Deputy Editor for Neurology®; receives research support from the American Heart Association-American Stroke Association National Clinical Research Program, American Academy of Neurology, American Board of Psychiatry and Neurology, Health Resources Services Administration and the NIH; has a provisional patent application titled: “Method, system and computer readable medium for improving treatment times for rapid evaluation of acute stroke via mobile telemedicine;” and gave legal expert review.Dr. Ted Burns serves as Podcast Editor for Neurology®; and has received research support for consulting activities with UCB, CSL Behring, Walgreens and Alexion Pharmaceuticals, Inc.Dr. Horovitz serves as Associate Editor for Journal of Community Genetics; received speaker honoraria from Biomarin Pharmaceutical, Genzyme-Sanofi, Shire Pharmaceuticals, Inc. and Alexion Pharmaceuticals, Inc.; received funding for travel to medical meeting from Genzyme-Sanofi and Shire Pharmaceuticals, Inc.Dr. Espay serves as Associate Editor for the Journal of Clinical Movement Disorders; serves as an editorial board member of Parkinsonism and Related Disorders and The European Neurological Journal; serves on the scientific advisory board for Solvay Pharmaceuticals, Inc. (now Abbvie), Chelsea Therapeutics International, Ltd., Teva Pharmaceutical Industries Ltd., Impax, Merz Pharmaceuticals, Inc., Pfizer Inc, Solstice Neurosciences, Eli Lilly and Company, ACADIA Pharmaceuticals, Inc. and USWorldMeds; is a consultant for Chelsea Therapeutics International, Ltd., Solvay Pharmaceuticals, Inc. (now Abbvie), ACADIA Pharmaceuticals, Inc., Cynapsus and Lundbeck, Inc; receives royalties for publications of books from Lippincott, Williams & Wilkins and Cambridge University Press; serves on the speakers' bureau of UCB, Teva Pharmaceutical Industries Ltd., American Academy of Neurology and Movement Disorders Society; receives research support from the CleveMed/Great Lake Neurotechnilogies, Michael J. Fox Foundation and the NIH.Dr. Knopman serves on the scientific advisory board for Consultant Bluefield project, Lundbeck Pharmaceuticals Inc., DIAN study DSMB; served as Associate Editor for Neurology® until October 2015; receives research support from the NIH, Mayo Alzheimer's Disease Research Center, Mayo Alzheimer Disease Patient Registry, ARIC Dementia Study and Chronic Kidney Disease and Cognitive functioning; received funding for travel to two lectures Alzheimer Conference, Seoul Korea and Behavioral Neurology Conference, Hyderabad, India.Dr. Sink served on the data safety monitoring board for two NIH funded clinical trials; initiated grants from the Alzheimer's Association and the Donald W. Reynolds Foundation as an investigator; received research support from the NIH.

1) Endovascular versus medical management of acute ischemic stroke and 2) Topic of the month: Neurology Today: Recent Publications. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Kevin Barrett interviews Dr. Brad Worrall about his paper on endovascular versus medical management of acute ischemic stroke. Dr. Ted Burns is interviewing Dr. Daniel Kaufer for our “What's Trending” feature of the week about the AAN Behavioral Neurology Section Workgroup paper on improving clinical cognitive testing. In the next part of the podcast Dr. Ted Burns interviews Dr. Steve Ringel about a Neurology Today story on the topic of defective nuclear transport and endogenous retrovirus in ALS. The participants had nothing to disclose except Drs. Barrett, Worrall, Burns, Kaufer and Ringel.Dr. Kevin Barrett serves as an Associate Editor of Neurohospitalist; serves as an editorial board member of Neurology; and receives research support from the NIH.Dr. Worrall serves as Associate Editor for Neurology®; receives royalties as Chapter Author for Merritt's Neurology editions 10, 11, and 12; and receives research support from the NIH.Dr. Ted Burns serves as Podcast Editor for Neurology®; and has received research support for consulting activities with UCB, CSL Behring, Walgreens and Alexion Pharmaceuticals, Inc.Dr. Kaufer is a consultant for Janssen Research and Development; receives research support from TauRx Therapeutics Ltd, Navidea Biopharmaceuticals, Inc., Guardian Angel Thrift Fund, National Football League Players Association and the NIH.Dr. Ringel serves as editor of Neurology Today.

1) Pathogenic effects of antibodies on gut and brain neurons in anti-DPPX encephalitis and 2) Topic of the month: Updates in tele-neurology. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Michelle Fullard interviews Dr. Johannes Piepgras about his paper on pathogenic effects of antibodies on gut and brain neurons in anti-DPPX encephalitis. Dr. Ted Burns is interviewing Morgan Sorenson for our "What's Trending" feature of the week about twitter handles. In the next part of the podcast Dr. Andy Southerland interviews Dr. Kevin Barrett about the topic of teleneurology (non-stroke applications). The participants had nothing to disclose except Drs. Burns, Sorenson, Southerland and Barrett.Dr. Ted Burns serves as Podcast Editor for Neurology®; and has received research support for consulting activities with CSL Behring and Alexion Pharmaceuticals, Inc.Morgan Sorenson is Managing Editor, Neurology® Neuroimmunology & Neuroinflammation.Dr. Southerland serves as Podcast Deputy Editor for Neurology®; serves as Clinical Research Advisor for Totier Technologies, Inc.Dr. Kevin Barrett serves as an Associate Editor of Neurohospitalist; serves as an editorial board member of Neurology; and receives research support from the NIH.

1) Neurology® Neuroimmunology & Neuroinflammation: Aquaporin-4 autoimmunity and 2) Topic of the month: Updates in tele-neurology. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Melanie Ward interviews Dr. Vanda Lennon about her Neurology: Neuroimmunology & Neuroinflammation paper on aquaporin-4 autoimmunity. Dr. Ted Burns is interviewing Kathy Pieper for our "What's Trending" feature of the week about you tube videos. In the next part of the podcast Dr. Andy Southerland interviews Dr. Kevin Barrett about the topic of updates in telestroke. The participants had nothing to disclose except Drs. Lennon, Burns, Pieper, Southerland and Barrett.Dr. Lennon receives research support from the NIH.Dr. Ted Burns serves as Podcast Editor for Neurology®; and has received research support for consulting activities with UCB, CSL Behring, Walgreens and Alexion Pharmaceuticals, Inc.Kathy Pieper is Managing Editor, Neurology®.Dr. Southerland serves as Podcast Deputy Editor for Neurology®; serves as Clinical Research Advisor for Totier Technologies, Inc.Dr. Kevin Barrett serves as an Associate Editor of Neurohospitalist; serves as an editorial board member of Neurology; and receives research support from the NIH.NO CME WILL BE OFFERED THIS WEEK.

1) Screening with MRI for accurate and rapid stroke treatment and 2) Topic of the month: Voices of encephalitis. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Kevin Barrett interviews Dr. Amie Hsia about her paper on screening with MRI for accurate and rapid stroke treatment. Dr. James Addington is reading our e-Pearl of the week about intracranial hypotension. In the next part of the podcast Dr. Lara Marcuse interviews Mia about the topic of Anti-N-methyl-D-aspartate. The participants had nothing to disclose except Dr. Loddenkemper and Addington.Dr. Barrett serves as an Associate Editor for Neurohospitalist; serves as an editorial board member of Neurology; and receives research support from the NIH.Dr. Addington serves on the editorial team for the Neurology® Resident and Fellow Section.

1) Age of first exposure to football and the effect of later-life cognitive impairment on former NFL players and 2) Topic of the month: Stroke in systemic disease. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Howard Goodkin interviews Dr. Robert Stern about his paper on the age of first exposure to football and the effect of later-life cognitive impairment on former NFL players. Dr. James Addington is reading our e-Pearl of the week about REM behavior disorder. In the next part of the podcast Dr. Michelle Johansen interviews Dr. Kevin Barrett about the topic of stroke in the setting of Endocrine disorders. The participants had nothing to disclose except Drs. Goodkin, Stern, Addington, Johansen and Barrett.Dr. Goodkin serves on the scientific advisory board for Tuberous Sclerosis Alliance and CURE Infantile Spasms; serves as an editorial board member of Neurology, Surgical Neurology International and Epilepsia; receive a royalty from UpToDate for co-authorship of an entry entitled The "choking game" and other strangulation activities in children and adolescents; will be receiving royalties for editing Epilepsy as part of the Neurology in Practice series and receives research support from the NIH.Dr. Stern serves as an Associate Editor of Journal of Neuropsychiatry and Clinical Neurosciences; serves as an editorial board member of Archives of Clinical Neuropsychology; serves as a Review Editor of Frontiers in Neurotrauma and Frontiers in Sports Neurology; serves as Series Editor of Alzheimer's Research and Therapy; serves on the Mackey-White Traumatic Brain Injury Committee of the National Football League Players Association; serves on the medical advisory board of Sports Legacy Institute, the National Graves' Disease Foundation and Amarantus Biosciences (paid advisor); serves on the Medical and Scientific Advisory Committee of the MA/NH Chapter of the Alzheimer's Association; is a consultant for Janssen Research & Development and Athena Diagnostics; receives publishing royalties from Psychological Assessment Resources, Inc. for the Visual Analog Mood Scales, the Boston Qualitative Scoring System for the Rey-Osterreith Complex Figure, and the Neuropsychological Assessment Battery; receives research support from Eisai Inc., Eli Lilly and Company, Amarantus Biosciences, Aethlon Medical, Avid Radiopharmaceuticals, the Department of Defense and the NIH; received honorariums from, Braintree Neurorehabilitation Conference, National Academy of Neuropsychology, Harvard Medical School, The German Center for Research and Innovation and Ludwig-Maximilians-Universitat Munchen, Medical University of South Carolina, Spaulding Rehabilitation Hospital and 8th Annual National Summit on Sports Concussion.Dr. Addington serves on the editorial team for the Neurology® Resident and Fellow Section. Dr. Johansen serves as a scientific advisory member of Stroke and as a contributor to Blogging Stroke.Dr. Kevin Barrett serves as an Associate Editor of Neurohospitalist; serves as an editorial board member of Neurology; and receives research support from the NIH.

1) PARK 10 locus being a major locus for sporadic, neuropathologically-confirmed Parkinson disease and 2) Topic of the month: Stroke in systemic disease. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Michelle Fullard interviews Dr. Jeffrey Vance about his paper on the PARK 10 locus being a major locus for sporadic, neuropathologically-confirmed Parkinson disease. Dr. James Addington is reading our e-Pearl of the week about a mnemonic for the clinical manifestations of CADASIL. In the next part of the podcast Dr. Michelle Johansen interviews Dr. Kevin Barrett about the topic of stroke in the setting of Renal disease. The participants had nothing to disclose except Drs. Vance, Addington, Johansen and Barrett.Dr. Vance serves as an editorial board member of American Journal of Neurodegenerative Diseases; speaker honoraria from Movement Disorders Society, Society of Neuroscience, Hussman Foundation, travel reimbursement for NIH for meeting on Parkinson Disease and NIH for study section; has patents for method of detecting Charcot-Marie-Tooth disease type 2A, TRPC6 involved in glomerulonephritis and methods for identifying an individual at increased risk of developing coronary artery disease; receives research support from NIH; receives royalties for invention from Duke University.Dr. Addington serves on the editorial team for the Neurology® Resident and Fellow Section. Dr. Johansen serves as a scientific advisory member of Stroke and as a contributor to Blogging Stroke.Dr. Kevin Barrett serves as an Associate Editor of Neurohospitalist; serves as an editorial board member of Neurology; and receives research support from the NIH.

1) Current practices in feeding tube placement for US acute ischemic stroke inpatients and 2) Topic of the month: Management of sports concussion. This podcast for the Neurology Journal begins and closes with Dr. Ted Burns, Section Editor Podcasts, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Kevin Barrett interviews Drs. Ben George and Adam Kelly about their paper on current practices in feeding tube placement for US acute ischemic stroke inpatients. Dr. James Addington is reading our e-Pearl of the week about childhood stroke: think metabolic. In the next part of the podcast Dr. Stephen Donahue interviews Dr. Michael Jaffee about the definition of concussion and how the grading has evolved over recent years. The participants had nothing to disclose except Drs. Barrett, George, Kelly, Addington and Jaffee.Dr. Barrett serves as an editorial board member of Neurology; serves as an Associate Editor of Neurohospitalist and receives research support from the NIH.Dr. George receives research support from the American Heart Association/American Stroke Association and the Parkinson's disease Foundation.Dr. Kelly serves as an editorial board member of Continuum; serves as Guest Editor for Cerebrovascular Disease issue, April 2014 and received research support from the Donald W. Reynolds Foundation.Dr. Addington serves on the editorial team for the Neurology® Resident and Fellow Section. Dr. Jaffee serves on the scientific advisory boards for WETA (Public Television) Brainline, U. S. Army Peer Review Alzheimer Research Program and the NIH translational research outcome consortium review.

A discussion with Dr. Sandeep Khot and Dr.Elizabeth Cahill from Harborview Medical Center, Seattle regarding postcardaic arrest management through the use of prognostic tools and markers, including the physical examination, evaluation of myoclonus, electroencephalogram monitoring, somatosensory-evoked potentials, biochemical markers of neuronal injury, and neuroimaging.   Click here to read the full article.  

A discussion with Dr. James Greene from Emory University regarding the enhanced educational value of in-house attending support during a night float rotation for junior neurology residents.

A discussion with Dr. Raman Khanna from UC San Francisco regarding his paper CPOE and discussion regarding the politics surrounding its widespread adoption, literature and studies showed both improved outcomes but also some unexpected negative consequences, and how CPOE will affect the practicing neurologist now and in the future.

A discussion with Dr. Raman Khanna from UC San Francisco regarding his paper CPOE and discussion regarding the politics surrounding its widespread adoption, literature and studies showed both improved outcomes but also some unexpected negative consequences, and how CPOE will affect the practicing neurologist now and in the future.

1) The complexities of acute stroke decision-making and 2) Topic of the month: Living Legends Interviews. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Brett Kissela interviews Dr. Michel Shamy about his paper on the complexities of acute stroke decision-making. Dr. Roy Strowd is reading our e-Pearl of the week about Adie's tonic pupil. In the next part of the podcast Dr. Brett Kissela interviews Dr. Lou Caplan about his medical education and contributions to the field of neurology, interactions with C. Miller Fisher and advice to our younger listeners now beginning their careers. The participants had nothing to disclose except Drs. Kissela, Shamy, Strowd and Caplan.Dr. Kissela serves on scientific advisory board for Allergan, Inc.; has received funding for travel and speaker honoraria from Allergan, Inc.; has received research support from the NIH, will receive compensation from Reata Pharmaceuticals, Inc. for serving on the Event Adjudication Committee for the BEACON study, which they are sponsoring and provides medico-legal reviews.Dr. Shamy serves as an editorial board member of The Neurohospitalist; receives research support from Alberta Innovates Health Solutions Clinical Fellowship, H. Richard Tyler Award for Research in History of Neurology from the American Academy of Neurology.Dr. Strowd serves on the editorial team for the Neurology® Resident and Fellow Section. Dr. Caplan serves as an editorial board member of Archives of Neurology; serves as co-editor of Reviews in Neurological Diseases and receive payment for Aruba monitoring.

A discussion about falls in the hospital touching on frequency, consequences, risk stratification, and prevention.