Camilo R . Gomez | University of Missouri Columbia (original) (raw)
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Papers by Camilo R . Gomez
New England Journal of Medicine, 2020
![Research paper thumbnail of Recent advances in the management of transient ischemic attacks [version 1; referees: 2 approved]](https://attachments.academia-assets.com/111757125/thumbnails/1.jpg)
](F1000Research, Oct 1, 2017
Journal of stroke and cerebrovascular diseases, 1991
Journal of Neuroimaging, Apr 1, 2000
Journal of the American College of Cardiology, 1991
Neurosurgery, Jun 1, 1994
Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Neurosurgery. Ent... more Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Neurosurgery. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining ...
Stroke, Feb 1, 2019
Introduction: Acute ischemic stroke (AIS) treatment is time sensitive and every 15 minutes saved ... more Introduction: Acute ischemic stroke (AIS) treatment is time sensitive and every 15 minutes saved in treatment results in 1 additional month of disability-free life in patients treated with thrombolysis. Pre-notification by Emergency Medical Services (EMS) has shown to reduce door to CT scan time, door to needle time for thrombolysis and increase the number of patients treated with thrombolysis. Determining which factors contribute to recognition and emergent treatment of stroke in the emergency department (ED) which are not recognized in the field can help improve models of pre-hospital notification. Objective: To determine which factors predict pre-hospital notification by EMS in patients with AIS treated with emergent therapy. Methods: We retrospectively reviewed our institutional database for all patients arriving through the ED by EMS who underwent acute stroke treatment from 2007-2018. All patient's arriving by EMS were dichotomized by the presence or absence of pre-hospital notification. We assessed the impact of demographic, clinical [NIHSS, FAST scores ((Face, Arm, Speech, Time) dichotomized into 0-1 or 2-3)], and diagnostic (vascular territory) factors on the likelihood of pre-hospital notification by EMS. A multivariate logarithmic regression analysis with assessment for confounding factors was applied. Results: A total of 183 patients were identified. The presence of 2 or 3 FAST criteria increased the odds of pre-hospital notification by EMS by 3.07 (p = 0.022, 95% CI 1.17-8.05) when adjusted for age. The vascular territory involved did not independently predict the likelihood of pre-hospital notification. We did not identify any significant confounders in the multivariate analysis. Conclusions: Patients with AIS receiving emergent treatment are over three times more likely to benefit from pre-hospital notification by EMS when presenting with 2 or 3 FAST criteria. Pre-hospital notification of AIS has established itself as a means to expedited clinical and radiographic evaluation and faster and more frequent treatment on hospital arrival. Improving EMS triage of AIS patients presenting with symptoms not well represented in the FAST criteria represents a stroke systems of care performance and quality improvement opportunity.
Journal of Neuroimaging, Oct 1, 1997
... Physician The Stroke Institute University of Pittsburgh Medical Center Pittsburgh, Pennsylvan... more ... Physician The Stroke Institute University of Pittsburgh Medical Center Pittsburgh, Pennsylvania Jason Heil.MD Clinical Instructor Department of Neurology University of Cincinnati; Resident Department of Neurology University Hospital Cincinnati, Ohio Monica M. Henderson, RN ...
Stroke
Introduction: Although there is emphasis on performing carotid artery stent placement (CAS) withi... more Introduction: Although there is emphasis on performing carotid artery stent placement (CAS) within two weeks after index event of transient ischemic attack (TIA) or minor stroke in patients with cervical internal carotid artery (ICA) stenosis, the risk and characteristics of recurrent cerebral ischemic events while waiting for CAS are not well defined. Method: We analyzed patients admitted to our institution over a 45-month period with symptomatic cervical ICA stenosis. All patients were initiated on daily aspirin and clopidogrel 75mg on the day of admission. We identified any new cerebral ischemic events that occurred between index event and CAS and categorized them as TIA, and minor or major ischemic strokes. We calculated the risk of new ipsilateral cerebral ischemic events between index ischemic event and CAS. Results: The mean age of 150 patients analyzed was 67 years (range: 46-94 years; 106 were men); and 94 and 56 patients had ≥ 70% and 50-69% stenosis, respectively. The mea...
Journal of Stroke and Cerebrovascular Diseases
Neurology, 2017
Objective: To determine the clinical impact of the AAN Choosing Wisely recommendations on the use... more Objective: To determine the clinical impact of the AAN Choosing Wisely recommendations on the use of ENVU in patients with syncope, at Loyola University Medical Center. Background: Cost - effectiveness in practice depend on careful patient selection. Studies have shown the low yield of extracranial neurovascular ultrasound (ENVU) for syncope. The Choosing Wisely initiative of the AAN released on February 21 st , 2013, described a list of unnecessary tests regularly ordered, and recommended against ENVU in the evaluation of syncope not associated with other neurologic symptoms. However, the impact of the AAN recommendations in the “real world” has not been fully evaluated. Design/Methods: We retrospectively analyzed medical records of patients with diagnosis of syncope (ICD-9 780.2) at our institution between January 1 st , 2011 and December 31 st , 2015. Multiple variables were assessed, and categorized in two distinct groups, before and after the release of the AAN Choosing Wisely ...
Handbook of Transcranial Doppler, 1997
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 25, 2018
Since the introduction of the philosophical tenet "Time is Brain!," multiple lines of r... more Since the introduction of the philosophical tenet "Time is Brain!," multiple lines of research have demonstrated that other factors contribute to the degree of ischemic injury at any one point in time, and it is now clear that the therapeutic window of acute ischemic stroke is more protracted than it was first suspected. To define a more realistic relationship between time and the ischemic process, we used computational modeling to assess how these 2 variables are affected by collateral circulatory competence. Starting from the premise that the expression "Time=Brain" is mathematically false, we reviewed the existing literature on the attributes of cerebral ischemia over time, with particular attention to relevant clinical parameters, and the effect of different variables, particularly collateral circulation, on the time-ischemia relationship. We used this information to construct a theoretical computational model and applied it to categorically different yet abn...
New England Journal of Medicine, 2020
F1000Research, Oct 1, 2017
Journal of stroke and cerebrovascular diseases, 1991
Journal of Neuroimaging, Apr 1, 2000
Journal of the American College of Cardiology, 1991
Neurosurgery, Jun 1, 1994
Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Neurosurgery. Ent... more Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Neurosurgery. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining ...
Stroke, Feb 1, 2019
Introduction: Acute ischemic stroke (AIS) treatment is time sensitive and every 15 minutes saved ... more Introduction: Acute ischemic stroke (AIS) treatment is time sensitive and every 15 minutes saved in treatment results in 1 additional month of disability-free life in patients treated with thrombolysis. Pre-notification by Emergency Medical Services (EMS) has shown to reduce door to CT scan time, door to needle time for thrombolysis and increase the number of patients treated with thrombolysis. Determining which factors contribute to recognition and emergent treatment of stroke in the emergency department (ED) which are not recognized in the field can help improve models of pre-hospital notification. Objective: To determine which factors predict pre-hospital notification by EMS in patients with AIS treated with emergent therapy. Methods: We retrospectively reviewed our institutional database for all patients arriving through the ED by EMS who underwent acute stroke treatment from 2007-2018. All patient's arriving by EMS were dichotomized by the presence or absence of pre-hospital notification. We assessed the impact of demographic, clinical [NIHSS, FAST scores ((Face, Arm, Speech, Time) dichotomized into 0-1 or 2-3)], and diagnostic (vascular territory) factors on the likelihood of pre-hospital notification by EMS. A multivariate logarithmic regression analysis with assessment for confounding factors was applied. Results: A total of 183 patients were identified. The presence of 2 or 3 FAST criteria increased the odds of pre-hospital notification by EMS by 3.07 (p = 0.022, 95% CI 1.17-8.05) when adjusted for age. The vascular territory involved did not independently predict the likelihood of pre-hospital notification. We did not identify any significant confounders in the multivariate analysis. Conclusions: Patients with AIS receiving emergent treatment are over three times more likely to benefit from pre-hospital notification by EMS when presenting with 2 or 3 FAST criteria. Pre-hospital notification of AIS has established itself as a means to expedited clinical and radiographic evaluation and faster and more frequent treatment on hospital arrival. Improving EMS triage of AIS patients presenting with symptoms not well represented in the FAST criteria represents a stroke systems of care performance and quality improvement opportunity.
Journal of Neuroimaging, Oct 1, 1997
... Physician The Stroke Institute University of Pittsburgh Medical Center Pittsburgh, Pennsylvan... more ... Physician The Stroke Institute University of Pittsburgh Medical Center Pittsburgh, Pennsylvania Jason Heil.MD Clinical Instructor Department of Neurology University of Cincinnati; Resident Department of Neurology University Hospital Cincinnati, Ohio Monica M. Henderson, RN ...
Stroke
Introduction: Although there is emphasis on performing carotid artery stent placement (CAS) withi... more Introduction: Although there is emphasis on performing carotid artery stent placement (CAS) within two weeks after index event of transient ischemic attack (TIA) or minor stroke in patients with cervical internal carotid artery (ICA) stenosis, the risk and characteristics of recurrent cerebral ischemic events while waiting for CAS are not well defined. Method: We analyzed patients admitted to our institution over a 45-month period with symptomatic cervical ICA stenosis. All patients were initiated on daily aspirin and clopidogrel 75mg on the day of admission. We identified any new cerebral ischemic events that occurred between index event and CAS and categorized them as TIA, and minor or major ischemic strokes. We calculated the risk of new ipsilateral cerebral ischemic events between index ischemic event and CAS. Results: The mean age of 150 patients analyzed was 67 years (range: 46-94 years; 106 were men); and 94 and 56 patients had ≥ 70% and 50-69% stenosis, respectively. The mea...
Journal of Stroke and Cerebrovascular Diseases
Neurology, 2017
Objective: To determine the clinical impact of the AAN Choosing Wisely recommendations on the use... more Objective: To determine the clinical impact of the AAN Choosing Wisely recommendations on the use of ENVU in patients with syncope, at Loyola University Medical Center. Background: Cost - effectiveness in practice depend on careful patient selection. Studies have shown the low yield of extracranial neurovascular ultrasound (ENVU) for syncope. The Choosing Wisely initiative of the AAN released on February 21 st , 2013, described a list of unnecessary tests regularly ordered, and recommended against ENVU in the evaluation of syncope not associated with other neurologic symptoms. However, the impact of the AAN recommendations in the “real world” has not been fully evaluated. Design/Methods: We retrospectively analyzed medical records of patients with diagnosis of syncope (ICD-9 780.2) at our institution between January 1 st , 2011 and December 31 st , 2015. Multiple variables were assessed, and categorized in two distinct groups, before and after the release of the AAN Choosing Wisely ...
Handbook of Transcranial Doppler, 1997
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 25, 2018
Since the introduction of the philosophical tenet "Time is Brain!," multiple lines of r... more Since the introduction of the philosophical tenet "Time is Brain!," multiple lines of research have demonstrated that other factors contribute to the degree of ischemic injury at any one point in time, and it is now clear that the therapeutic window of acute ischemic stroke is more protracted than it was first suspected. To define a more realistic relationship between time and the ischemic process, we used computational modeling to assess how these 2 variables are affected by collateral circulatory competence. Starting from the premise that the expression "Time=Brain" is mathematically false, we reviewed the existing literature on the attributes of cerebral ischemia over time, with particular attention to relevant clinical parameters, and the effect of different variables, particularly collateral circulation, on the time-ischemia relationship. We used this information to construct a theoretical computational model and applied it to categorically different yet abn...