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Open Access Publications from the University of California

Scholarly Works (17 results)

  • Article
  • Peer Reviewed
UC San Francisco Previously Published Works (2013)
Given recent advances in diagnostic modalities and revascularization capabilities, clinicians are not only able to rapidly and accurately identify acute ischemic stroke, but may also be able to aggressively intervene to minimize the extent of infarction. In those cases where revascularization cannot occur and/or the extent of infarction is large, there are multiple strategies to prevent secondary decompensation as the stroke evolves, for instance, if malignant cerebral edema should develop. In this paper, we will review the indications for specialized ICU care for an ischemic stroke patient, the treatment principles, and strategies employed by neurointensivists to minimize secondary neuronal injury, the literature in support of such strategies (and the questions to be addressed by future studies), all with the ultimate goal of increasing the likelihood of favorable neurologic outcomes in our ischemic stroke population.
    Cover page: Advances in the critical care management of ischemic stroke.
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2013)
    Given recent advances in diagnostic modalities and revascularization capabilities, clinicians are not only able to rapidly and accurately identify acute ischemic stroke, but may also be able to aggressively intervene to minimize the extent of infarction. I
      • Article
      • Peer Reviewed
      UCSF Open Access Publishing Fund (2013)
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2016)
        Infrared pupillometry was introduced in 1962 but portable instruments that use this technology have only recently become available in the hospital setting. Questions surrounding the accuracy of these instruments have been addressed by documenting the inter-observer agreement on pupillary measurements and also by comparisons with standard pen-light examinations. The following commentary summarizes the development of these devices and provides a wider perspective on how the pupil and its reflexes might be used in providing care for patients with critical illness.
          Cover page: Portable infrared pupillometry in critical care.
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2014)
          Background: Acquired hemophilia A (AHA) is a rare coagulopathy linked to a variety of etiologies including autoimmune diseases, neoplasms, diabetes, respiratory diseases, and the post-partum state. While bleeding in AHA is often seen in mucocutaneous or in
            • Thesis
            • Peer Reviewed
            UC San Diego Electronic Theses and Dissertations (2018)

            This dissertation traces U.S. higher education’s contemporary ‘diversity problem’ to 1865 and the racialized and gendered notions of the public good, social mobility, citizenship, and self-determination that rose in the aftermath of Emancipation. It brings together theoretical and methodological tools from ethnic studies, cultural studies, critical gender studies, and feminist geography to examine higher education as a site of contest in the black freedom struggle, arguing that the modern landscape of U.S. higher education is fundamentally shaped by white ‘architects’ responding to the pedagogical and geographic innovations of black radical traditions.

            In the opening chapter I study the history of a vocational institute for black Southerners and demonstrate that education had been a crucial element of the ‘rival geographies’ created by the enslaved, but after 1865 became a technology of enclosure, tying socially mobile black workers to underdeveloped rural areas and respectably gendered occupations. The second chapter looks at the history of a 100-year old community college in Chicago. By tracking changes in the demographics of the neighborhood it serves and relating these to changes in the college’s form and function, I demonstrate how modern U.S. notions of the public good are always-already racialized, while arguing for a defense of the community service pedagogy championed by black neighborhood organizers. In chapter 3 I examine the institutionalization of a student-created ‘Third Worldist’ college in California to illuminate how universities can mold students’ thinking about race and racism away from global political and economic structures to personal identities and individual trauma. The final chapter considers the emergence of an ostensibly color-blind, progressive-minded neoliberalism in the rise of ‘leadership development programs’ like Teach For America. I demonstrate that despite the best intentions of participants, such programs further the criminalization of urban spaces while using the language of civil rights to insinuate the privatization of public services. Throughout I demonstrate how higher education has articulated academic and common sense notions of race, space, and belonging in what I call racial-spatial pedagogies, descriptive and prescriptive theories describing racial difference and how that difference fits in the larger body politic.

              Cover page: Which Neither Devils nor Tyrants Could Remove: The Racial-Spatial Pedagogies of Modern U.S. Higher Education
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2014)
              BACKGROUND: Acquired hemophilia A (AHA) is a rare coagulopathy linked to a variety of etiologies including autoimmune diseases, neoplasms, diabetes, respiratory diseases, and the post-partum state. While bleeding in AHA is often seen in mucocutaneous or intramuscular locations, intracranial and intraspinal bleeds are exceedingly rare. CASE PRESENTATION: We report an unusual case of spontaneous multifocal subdural hematomas in a 25 year old Asian woman with lupus who presented with headache and backache, and was found to have an elevated partial thromboplastin time (PTT) level and new diagnosis of AHA. CONCLUSIONS: Subdural hematomas as the initial sign of AHA are all but unknown in the medical literature. We bring this entity to the attention of the neurology community because lumbar puncture and/or conventional angiogram are often indicated in the work-up of idiopathic multifocal subdural hematomas, but may be dangerous in patients with AHA.
                Cover page: Multifocal subdural hematomas as the presenting sign of acquired hemophilia A: a case report.
                • Article
                • Peer Reviewed
                UCSF Open Access Publishing Fund (2014)
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2013)
                  This report describes an unusual case of a woman who developed progressive hemiparesis, seizures and hemiparkinsonism associated with MRI and angiographic evidence of chronic venous hypertension in the contralateral cerebrum and cerebellum. In the absence of inflammatory or veno-occlusive disorders, the patient's clinical and neuroradiological findings point to a developmental disorder, such as a hemispheric venous dysgenesis, as the underlying lesion.
                    Cover page: Hemispheric venous dysgenesis in a woman presenting with seizures, weakness and parkinsonism
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2017)

                    Background and purpose

                    Shorter time-to-thrombolysis in acute ischemic stroke (AIS) is associated with improved functional outcome and reduced morbidity. We evaluate the effect of several interventions to reduce time-to-thrombolysis at an urban, public safety net hospital.

                    Methods

                    All patients treated with tissue plasminogen activator for AIS at our institution between 2008 and 2015 were included in a retrospective analysis of door-to-needle (DTN) time and associated factors. Between 2011 and 2014, we implemented 11 distinct interventions to reduce DTN time. Here, we assess the relative impact of each intervention on DTN time.

                    Results

                    The median DTN time pre- and postintervention decreased from 87 (interquartile range: 68-109) minutes to 49 (interquartile range: 39-63) minutes. The reduction was comprised primarily of a decrease in median time from computed tomography scan order to interpretation. The goal DTN time of 60 minutes or less was achieved in 9% (95% confidence interval: 5%-22%) of cases preintervention, compared with 70% (58%-81%) postintervention. Interventions with the greatest impact on DTN time included the implementation of a stroke group paging system, dedicated emergency department stroke pharmacists, and the development of a stroke code supply box.

                    Conclusions

                    Multidisciplinary, collaborative interventions are associated with a significant and substantial reduction in time-to-thrombolysis. Such targeted interventions are efficient and achievable in resource-limited settings, where they are most needed.
                      Cover page: Collaborative Interventions Reduce Time-to-Thrombolysis for Acute Ischemic Stroke in a Public Safety Net Hospital
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