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Minimizing Stroke Misdiagnosis

Minimizing Stroke Misdiagnosis—Each year, some 800,0000 stroke patients arrive in the emergency rooms of American hospitals. Up to nine percent of these patients are initially misdiagnosed. One problem is that some stroke patients have non-specific symptoms including headache, yet most emergency room headache cases are benign. The National Institutes of Health has awarded Ava L. Liberman, M.D., a five-year, $1 million grant to quantify the rate of stroke misdiagnosis among patients reporting to emergency rooms with headaches. Dr. Liberman will use information from the emergency department of John Hopkins and the Montefiore Medical Center to identify both patient- and physician-related factors that contribute to stroke misdiagnosis to develop new clinical tools to improve stroke and headache diagnostic accuracy. Dr. Liberman is an assistant professor in the Saul R. Korey Department of Neurology at Einstein and an attending physician at Montefiore Health System and the Stern Stroke Center. (1K23NS107643-01)

Thursday, July 26, 2018
Focusing on HIV-Related Neurological Problems

Focusing on HIV-Related Neurological Problems—Thanks to antiretroviral drugs, many fewer HIV-infected people experience frank dementia anymore. Nevertheless, more than half of HIV-positive patients treated with antiretrovirals suffer from milder, lifelong HIV-associated neurocognitive disorders, or HAND. Joan W. Berman, Ph.D., professor of pathology and of microbiology & immunology, recently received two NIH grants totaling $7.4 million to study the sequence of events that lead to HAND, examine how certain drugs of abuse increase the risk for HAND, and develop strategies for preventing the disorder. Dr. Berman also holds the Irving D. Karpas M.D. Chair for Excellence in Medical Research.

HAND occurs after HIV-infected white blood cells manage to cross the blood brain barrier, resulting in inflammation, damage to neurons, and persistent reservoirs of virus in the brain. Dr. Berman and Susan Morgello, M.D., of Mount Sinai Icahn School of Medicine, were awarded a five-year, $3.6 million grant from the National Institute of Mental Health to study a particular population of white cells known to be responsible for HAND. The researchers will follow the migration of these cells in HIV-positive patients and study the proteins that regulate the transit of white cells across the blood brain barrier. The research may lead to therapies that block HIV-infected white cells from entering the brain. (1R01MH112391-01A1)

Drugs of abuse and even certain antiretroviral therapies appear to increase the risk for developing HAND. Dr. Berman and Harris Goldstein, M.D., have been awarded a five-year, $3.8 million grant from the National Institute on Drug Abuse (NIDA) to study the interactions among methamphetamines and other drugs of abuse, antiretroviral therapeutics and HIV infection. The researchers hypothesize that methamphetamines and some antiretrovirals weaken the integrity of the blood brain barrier, making it easier for HIV-infected white blood cells to enter the brain. Their research will also use a mouse model of HIV. Dr. Goldstein is professor of pediatrics and of microbiology & immunology and director of the Einstein-Rockefeller-CUNY Center for AIDS Research. He also holds the Charles Michael Chair in Autoimmune Diseases at Einstein. (1R01DA044584-01)

Tuesday, September 05, 2017
Helping HAND from Buprenorphine

Helping HAND from Buprenorphine—Thanks to antiretroviral drugs, the neurological symptoms experienced by HIV-infected people have shifted from dementia to milder, lifelong, HIV-associated neurocognitive disorders (HAND). The National Institute on Drug Abuse has awarded Joan W. Berman, Ph.D., a five-year, $3.6 million grant to study whether buprenorphine--an opiate addiction medication that works by binding to the brain’s opioid receptors--can prevent HAND by binding to the opioid receptors of monocytes in the blood. Using a mouse model of HIV-induced HAND, Dr. Berman’s group, and Matias Jaureguiberry-Bravo, a Ph.D. student in her lab, with her collaborator Dr. David Volsky (Mount Sinai Icahn School of Medicine), will study whether buprenorphine can prevent HIV-infected monocytes from crossing the blood-brain barrier, a key event in causing HAND. This strategy may help both opioid abusers (who are at increased risk for HIV infection) and non-drug using HIV-infected people. Dr. Berman is professor of pathology and of microbiology & immunology. (1R01DA041931-01A1)

Wednesday, May 24, 2017
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