Tuesday, June 22, 2010

Neurologist, Lipid Researcher Win College’s Highest Honor

By Dama Kimmon
Published June 2010

A neurologist and a lipid researcher have been selected to receive the UC College of Medicine’s top honors.

Joseph Broderick, MD, professor and chair of UC’s neurology department, and Patrick Tso, PhD, professor and director of the UC Lipid Biology Group, received Daniel Drake Medals—the college’s most prestigious award given to distinguished living faculty and alumni—May 22 during a dinner at the Queen City Club.

"The 2010 Drake Medal winners represent the best of our college in terms of its commitment to research excellence, patient care and education,” says David Stern, MD, vice president for health affairs and College of Medicine dean.

"Drs. Broderick and Tso have both developed strong programs in their respective fields, are internationally known for their work and serve as great examples for our faculty and students.”

Broderick, co-director of the Greater Cincinnati/Northern Kentucky Stroke Team, has been chair of UC’s neurology department since 2000.

A 1982 UC College of Medicine graduate, Broderick was ranked first in his medical school class.

He completed his neurologic training and cerebrovascular fellowship at the Mayo Clinic in Rochester, Minn.

Broderick is an internationally recognized expert on the acute treatment of stroke, and has led studies in the 1980s that resulted in the approval of tissue plasminogen activator (t-PA) for the treatment of ischemic stroke.

He is considered a leader on the epidemiology of stroke, and the causes and management of hemorrhagic stroke.

Broderick has authored more than 610 publications and has received numerous awards, including the 2003 William M. Feinberg Award for Excellence in Clinical Stroke.

Tso obtained his PhD from the University of Western Australia in 1978 and was recruited to UC from Louisiana State University in 1996.

He has made significant contributions to the understanding of intestinal lipid metabolism and diet-induced obesity.

He, along with colleague David Hui, PhD, formed the UC Lipid Research Group, and also played a role in the establishment of the UC Obesity Research Center.

It was nearly 10 years ago when Tso led the successful application for UC’s National (NIH) Institutes of Health-supported Mouse Metabolic Phenotyping Center—a resource for researchers at UC and across the country.

In 2008 he became director of the Physician Scientist Training Program.

He is the recipient of a Research Career Development Award from the NIH and was appointed to the National Institute of Diabetes and Digestive and Kidney Diseases Advisory Council in 2006.

To read full biographies of each College of Medicine Drake Medal award winner, visit healthnews.uc.edu.

Friday, May 28, 2010

Zuccarello Appointed Chair of Neurosurgery Department

CINCINNATI—Mario Zuccarello, MD, has been appointed chair of the University of Cincinnati (UC) College of Medicine’s neurosurgery department and Frank H. Mayfield Professor of Neurosurgery.

Zuccarello’s appointment was approved May 25, 2010, by the UC Board of Trustees and takes effect June 1, 2010. He had been serving as interim chair of the department since July 1, 2009.

"I am delighted that Dr. Zuccarello has accepted this post on the College of Medicine leadership team,” says David Stern, MD, vice president for health affairs at UC and dean of the college. "He has continued the positive momentum in neurosurgery, which in the past decade has experienced unprecedented growth in size and scope.

"Additionally, the UC neurosurgery residency has become one of the most sought-after training programs in the country.”

Zuccarello is a 1976 graduate of the University of Padova in Italy. He served his residency at the University of Padova from 1976-1980, followed by four years as an instructor in neurosurgery there. He served fellowships at the University of Iowa and University of Virginia Medical Center (1984-1985) and UC Health University Hospital in Cincinnati (1985-1988).

From 1988-1990, he was assistant professor of neurosurgery at Galliera Hospital, Genova, Italy.

Zuccarello joined the UC neurosurgery department in 1990 and the Mayfield Clinic in 1993. He serves as director of the neurovascular program for the UC Neuroscience Institute at University Hospital and as a member of the Greater Cincinnati/Northern Kentucky Stroke Team. He is a distinguished physician scientist who has published 163 articles in peer-reviewed journals and given 88 presentations at symposia across the globe.

Zuccarello is dedicated to clinical research in neurovascular disease and the development of new neurosurgical techniques for the treatment of stroke, cerebral hemorrhage, vasospasm, carotid artery disease and moyamoya disease. He is a member of the Academy of Medicine of Cincinnati, the American Heart Association, the Congress of Neurological Surgeons, the Frank H. Mayfield Society, the Italian Association of Neurosurgeons and the International Society for Cerebral Blood Flow and Metabolism.

Thursday, May 20, 2010

Am J Psychiatry Published May 3, 2010

Psychiatric Manifestations of Paraneoplastic Disorders
Matthew S. Kayser, M.D., Ph.D., Christian G. Kohler, M.D., and Josep Dalmau, M.D., Ph.D.
Abstract: Paraneoplastic disorders of the CNS result from immune responses to neuronal proteins expressed by tumors found elsewhere in the body. Limbic encephalitis, one of the most common manifestations of paraneoplastic disorders, is characterized by rapid onset of psychiatric and neurological symptoms that often culminate in severe neurological deterioration. Recent work has described paraneoplastic syndromes with prominent, and sometimes isolated, psychiatric symptoms for which patients are first seen by a psychiatrist. Here the authors review the existing literature on psychiatric and behavioral manifestations of paraneoplastic disorders, the cellular mechanisms underlying these syndromes, and current treatment and outcomes. They also discuss the broad behavioral findings that highlight the need for psychiatrists to be aware of initial presentations of paraneoplastic disorders.

Tuesday, May 18, 2010

Stroke Increasing at Younger Ages, UC Research Shows

CINCINNATI—Stroke is declining in the elderly but increasing at younger ages, new research from the University of Cincinnati (UC) indicates.

The research, based on data from Greater Cincinnati and Northern Kentucky, is being presented Wednesday, Feb. 24, at the American Stroke Association’s International Stroke Conference 2010 in San Antonio.

In 1993-94, the average age of first stroke in the region was 71.3 years. That number dropped to 70.9 in 1999 and 68.4 by 2005.

Meanwhile, the proportion of all strokes under age 45 was up to 7.3 percent in 2005 from 4.5 percent in 1993-94 and 5.5 percent in 1999.

"This is scary and very concerning,” says Brett Kissela, MD, the study’s lead author, an associate professor and vice chair of the neurology department at the UC College of Medicine and member of the UC Neuroscience Institute at University Hospital. "It shows that stroke is not just a disease of the elderly.

"What was shocking was the proportion of patients under age 45,” adds Kissela, noting that younger strokes carry the potential for greater lifetime burden of disability. "The proportion is up, and the incidence rate is up.”

The region included in the study has a population of about 1.3 million people. Kissela says the trend noted is likely occurring throughout the United States because the higher prevalence of risk factors such as obesity and diabetes in younger patients seen in Greater Cincinnati and Northern Kentucky is also seen in younger patients throughout the country.

Researchers also found racial differences in stroke incidence. For African-Americans, the incidence of strokes among those over age 85 dropped significantly by 2005. For whites, the incidence decreased significantly starting at age 65 by 2005.

In both races, the incidence rates for strokes in 20- to 45-year-olds increased, although the increase was only statistically significant among whites, doubling from 12 to 25 per 100,000 people.

Kissela says he became interested in studying the issue after observing an increase in young stroke patients admitted to UC Health University Hospital in Cincinnati. He says it’s hard to know with certainty what’s driving the trend toward strokes in younger people, but he speculates that the increased prevalence of diabetes, hypertension and obesity is a major contributor.

"As physicians, we need to look for these potent risk factors even in young people,” he says. "Stroke is a life-changing, devastating disease. It can affect young people, and we hope these data will serve as a wake-up call.”

Co-authors of the study, all affiliated with the UC College of Medicine, are: Kathleen Alwell; Jane Khoury, PhD; Charles Moomaw, PhD; Daniel Woo, MD; Opeolu Adeoye, MD; Matthew Flaherty, MD; Pooja Khatri, MD; Simona Ferioli, MD; Joseph Broderick, MD; and Dawn Kleindorfer, MD.

Publish Date: 02/24/10
Media Contact: Keith Herrell, (513) 558-4559

Wednesday, April 21, 2010

Tuesday, April 20, 2010

E-Pearl of the Week
Brought to you by the Resident and Fellow Section of Neurology.
Motor movements in brain death
A variety of spontaneous and reflexive movements may be seen in patients with brain death. The most common are myoclonus-like finger jerks. Others often seen are undulating toe flexion and triple flexion response. The most dramatic of these movements is the classic “Lazarus sign,” which includes flexion of the arms at the elbow, adduction of the shoulders, lifting of the arms, dystonic posturing of the hands, and crossing of the hands. Neurologists must be able to identify these movements and recognize that their presence does not preclude the determination of brain death.
Saposnik G, Bueri JA, MauriƱo J, Saizar R, Garretto NS. Spontaneous and reflex movements in brain death. Neurology 2000;54:221-223.
Submitted by Aamir Hussain, M.D.
Disclosure: Dr. Hussain has nothing to disclose.
For more clinical pearls and other articles of interest to neurology trainees, visit www.neurology.org and click on the link to the Resident and Fellow Pages. Click here to visit the E-Pearl of the Week Archive.