Author
Andy Jagoda
Other affiliations: Uniformed Services University of the Health Sciences, Centers for Disease Control and Prevention, American College of Emergency Physicians ...read more
Bio: Andy Jagoda is an academic researcher from Icahn School of Medicine at Mount Sinai. The author has contributed to research in topics: Emergency department & Traumatic brain injury. The author has an hindex of 32, co-authored 102 publications receiving 6090 citations. Previous affiliations of Andy Jagoda include Uniformed Services University of the Health Sciences & Centers for Disease Control and Prevention.
Papers published on a yearly basis
Papers
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TL;DR: Recommendations for the establishment and operation of primary stroke centers are developed as an approach to improve the medical care of patients with stroke and suggest that several elements of a stroke center would improve patient care and outcomes.
Abstract: ObjectiveTo develop recommendations for the establishment and operation of primary
stroke centers as an approach to improve the medical care of patients with
stroke.ParticipantsMembers of the Brain Attack Coalition (BAC), a multidisciplinary group
of representatives from major professional organizations involved with delivering
stroke care. Supplemental input was obtained from other experts involved in
acute stroke care.EvidenceA review of literature published from 1966 to March 2000 was performed
using MEDLINE. More than 600 English-language articles that had evidence from
randomized clinical trials, meta-analyses, care guidelines, or other appropriate
methods supporting specific care recommendations for patients with acute stroke
that could be incorporated into a stroke center model were selected.Consensus ProcessArticles were reviewed initially by 1 author (M.J.A.). Members of the
BAC reviewed each recommendation in the context of current practice parameters,
with special attention to improving the delivery of care to patients with
acute stroke, cost-effectiveness, and logistical issues related to the establishment
of primary stroke centers. Consensus was reached among all BAC participants
before an element was added to the list of recommendations.ConclusionsRandomized clinical trials and observational studies suggest that several
elements of a stroke center would improve patient care and outcomes. Key elements
of primary stroke centers include acute stroke teams, stroke units, written
care protocols, and an integrated emergency response system. Important support
services include availability and interpretation of computed tomography scans
24 hours everyday and rapid laboratory testing. Administrative support, strong
leadership, and continuing education are also important elements for stroke
centers. Adoption of these recommendations may increase the use of appropriate
diagnostic and therapeutic modalities and reduce peristroke complications.
The establishment of primary stroke centers has the potential to improve the
care of patients with stroke.
725 citations
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Cincinnati Children's Hospital Medical Center1, Albert Einstein College of Medicine2, University of California, San Francisco3, University of Montana4, Rush University Medical Center5, Washington University in St. Louis6, Icahn School of Medicine at Mount Sinai7, Virginia Commonwealth University8, Comprehensive Epilepsy Center9, University of Illinois at Chicago10, Barrow Neurological Institute11
TL;DR: Despite the paucity of well-designed randomized controlled trials, practical conclusions and an integrated treatment algorithm for the treatment of convulsive status epilepticus across the age spectrum (infants through adults) can be constructed.
Abstract: CONTEXT: The optimal pharmacologic treatment for early convulsive status epilepticus is unclear. OBJECTIVE: To analyze efficacy, tolerability and safety data for anticonvulsant treatment of children and adults with convulsive status epilepticus and use this analysis to develop an evidence-based treatment algorithm. DATA SOURCES: Structured literature review using MEDLINE, Embase, Current Contents, and Cochrane library supplemented with article reference lists. STUDY SELECTION: Randomized controlled trials of anticonvulsant treatment for seizures lasting longer than 5 minutes. DATA EXTRACTION: Individual studies were rated using predefined criteria and these results were used to form recommendations, conclusions, and an evidence-based treatment algorithm. RESULTS: A total of 38 randomized controlled trials were identified, rated and contributed to the assessment. Only four trials were considered to have class I evidence of efficacy. Two studies were rated as class II and the remaining 32 were judged to hav...
713 citations
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Northwestern University1, University of California, Davis2, Case Western Reserve University3, University of Alabama at Birmingham4, Veterans Health Administration5, Harvard University6, National Institutes of Health7, United States Department of Veterans Affairs8, University of Pennsylvania9, Centers for Disease Control and Prevention10, Stroke Association11, Icahn School of Medicine at Mount Sinai12, Christiana Care Health System13, Emory University14, Baptist Memorial Hospital-Memphis15, OSF Saint Francis Medical Center16
TL;DR: A number of key areas supported by evidence-based medicine that are important for a comprehensive stroke center and its ability to deliver the wide variety of specialized care needed by patients with serious cerebrovascular disease are likely to improve outcomes.
Abstract: Background and Purpose—To develop recommendations for the establishment of comprehensive stroke centers capable of delivering the full spectrum of care to seriously ill patients with stroke and cerebrovascular disease. Recommendations were developed by members of the Brain Attack Coalition (BAC), which is a multidisciplinary group of members from major professional organizations involved with the care of patients with stroke and cerebrovascular disease. Summary of Review—A comprehensive literature search was conducted from 1966 through December 2004 using Medline and Pub Med. Articles with information about clinical trials, meta-analyses, care guidelines, scientific guidelines, and other relevant clinical and research reports were examined and graded using established evidence-based medicine approaches for therapeutic and diagnostic modalities. Evidence was also obtained from a questionnaire survey sent to leaders in cerebrovascular disease. Members of BAC reviewed literature related to their field and graded the scientific evidence on the various diagnostic and treatment modalities for stroke. Input was obtained from the organizations represented by BAC. BAC met on several occasions to review each specific recommendation and reach a consensus about its importance in light of other medical, logistical, and financial factors. Conclusions—There are a number of key areas supported by evidence-based medicine that are important for a comprehensive stroke center and its ability to deliver the wide variety of specialized care needed by patients with serious cerebrovascular disease. These areas include: (1) health care personnel with specific expertise in a number of disciplines, including neurosurgery and vascular neurology; (2) advanced neuroimaging capabilities such as MRI and various types of cerebral angiography; (3) surgical and endovascular techniques, including clipping and coiling of intracranial aneurysms, carotid endarterectomy, and intra-arterial thrombolytic therapy; and (4) other specific infrastructure and programmatic elements such as an intensive care unit and a stroke registry. Integration of these elements into a coordinated hospital-based program or system is likely to improve outcomes of patients with strokes and complex cerebrovascular disease who require the services of a comprehensive stroke center. (Stroke. 2005;36:1597-1618.)
589 citations
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TL;DR: Abstract [Jagoda AS, Cantrill SV, Wears RL, Valadka A, Gallagher EJ, Gottesfeld SH, Pietrzak MP, Bolden J, Bruns JJ Jr, Zimmerman R. clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting].
450 citations
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Uniformed Services University of the Health Sciences1, Walter Reed Army Institute of Research2, Dartmouth College3, New York University4, University of Virginia5, Icahn School of Medicine at Mount Sinai6, Naval Medical Center San Diego7, Virginia Commonwealth University8, Boston University9, University of California, Los Angeles10, University of Arkansas for Medical Sciences11, Thomas Jefferson University12
TL;DR: The quality of evidence did not support any treatment standards and few guidelines due to a number of recurrent methodological problems, and options were recommended in the treatment of depression, bipolar disorder/mania, psychosis, aggression, general cognitive functions, and deficits in attention, speed of processing, and memory after TBI.
Abstract: There is currently a lack of evidence-based guidelines to guide the pharmacological treatment of neurobehavioral problems that commonly occur after traumatic brain injury (TBI). It was our objective to review the current literature on the pharmacological treatment of neurobehavioral problems after traumatic brain injury in three key areas: aggression, cognitive disorders, and affective disorders/anxiety/ psychosis. Three panels of leading researchers in the field of brain injury were formed to review the current literature on pharmacological treatment for TBI sequelae in the topic areas of affective/anxiety/ psychotic disorders, cognitive disorders, and aggression. A comprehensive Medline literature search was performed by each group to establish the groups of pertinent articles. Additional articles were obtained from bibliography searches of the primary articles. Group members then independently reviewed the articles and established a consensus rating. Despite reviewing a significant number of studies on...
419 citations
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TL;DR: These guidelines supersede the prior 2007 guidelines and 2009 updates and support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit.
Abstract: Background and Purpose—The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audienc...
7,214 citations
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TL;DR: In this paper, the authors provided evidence-based recommendations for the prevention of future stroke among survivors of ischemic stroke or transient ischemi-chemic attack, including the control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke.
Abstract: The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.
4,545 citations
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TL;DR: These guidelines detail prehospital care, urgent and emergency evaluation and treatment with intravenous and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are appropriately instituted within the first 2 weeks.
Abstract: Background and Purpose- The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations in a single document for clinicians caring for adult patients with acute arterial ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 Acute Ischemic Stroke (AIS) Guidelines and are an update of the 2018 AIS Guidelines. Methods- Members of the writing group were appointed by the American Heart Association (AHA) Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise. Members were not allowed to participate in discussions or to vote on topics relevant to their relations with industry. An update of the 2013 AIS Guidelines was originally published in January 2018. This guideline was approved by the AHA Science Advisory and Coordinating Committee and the AHA Executive Committee. In April 2018, a revision to these guidelines, deleting some recommendations, was published online by the AHA. The writing group was asked review the original document and revise if appropriate. In June 2018, the writing group submitted a document with minor changes and with inclusion of important newly published randomized controlled trials with >100 participants and clinical outcomes at least 90 days after AIS. The document was sent to 14 peer reviewers. The writing group evaluated the peer reviewers' comments and revised when appropriate. The current final document was approved by all members of the writing group except when relationships with industry precluded members from voting and by the governing bodies of the AHA. These guidelines use the American College of Cardiology/AHA 2015 Class of Recommendations and Level of Evidence and the new AHA guidelines format. Results- These guidelines detail prehospital care, urgent and emergency evaluation and treatment with intravenous and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are appropriately instituted within the first 2 weeks. The guidelines support the overarching concept of stroke systems of care in both the prehospital and hospital settings. Conclusions- These guidelines provide general recommendations based on the currently available evidence to guide clinicians caring for adult patients with acute arterial ischemic stroke. In many instances, however, only limited data exist demonstrating the urgent need for continued research on treatment of acute ischemic stroke.
3,819 citations
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TL;DR: Theodore G. Feldman, MD, PhD, FACC, FAHA, Chair as mentioned in this paper, Chair, Chair of FAHA 2015, 2016, 2017, 2018, 2019, 2019
Abstract: Mariell Jessup, MD, FACC, FAHA, Chair [*][1]
William T. Abraham, MD, FACC, FAHA[†][2]
Donald E. Casey, MD, MPH, MBA[‡][3]
Arthur M. Feldman, MD, PhD, FACC, FAHA[§][4]
Gary S. Francis, MD, FACC, FAHA[§][4]
Theodore G. Ganiats, MD[∥][5]
Marvin A. Konstam, MD, FACC[¶][6]
Donna M.
3,542 citations
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TL;DR: In this article, the authors present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage, including diagnosis, hemostasis, blood pressure management, inpatient and nursing management, preventing medical comorbidities, surgical treatment, outcome prediction, rehabilitation, prevention of recurrence and future considerations.
Abstract: Purpose— The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage. Methods— A formal literature search of MEDLINE was performed. Data were synthesized with the use of evidence tables. Writing committee members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council’s Levels of Evidence grading algorithm was used to grade each recommendation. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Statements Oversight Committee and Stroke Council Leadership Committee. It is intended that this guideline be fully updated in 3 years’ time. Results— Evidence-based guidelines are presented for the care of patients presenting with intracerebral hemorrhage. The focus was subdivided into diagnosis, hemostasis, blood pressure management, inpatient and nursing management, preventing medical comorbidities, surgical treatment, outcome prediction, rehabilitation, prevention of recurrence, and future considerations. Conclusions— Intracerebral hemorrhage is a serious medical condition for which outcome can be impacted by early, aggressive care. The guidelines offer a framework for goal-directed treatment of the patient with intracerebral hemorrhage.
3,033 citations