Neurosciences



Specializing Institutions

Neurology specifically deals with the diagnoses and treatment of diseases involving central, peripheral and autonomic nervous systems. During a neurological examination, neurologists test a patient’s mental status, function of the cranial nerves, strength, coordination, reflexes and sensation. There are over 600 known neurological disorders and conditions. Specialties within neurology include stroke or vascular neurology, interventional neurology, epilepsy, neuromuscular, neurorehabilitation, behavioral neurology, sleep medicine, and pain management. Neurological disorders are common and can be life threatening, like brain tumors and strokes, or less harmful but potentially debilitating like tension and headaches.

A stroke or “brain attack” occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. It is unpredictable and it can affect anyone. In the United States, stroke is the third leading cause of death, claiming about 137,000 lives each year, and a leading cause of serious, long-term adult disability. Smoking, obesity and alcohol are all stroke risk factors. Industry experts work hard every day to reduce the incidence and impact of stroke by developing compelling educational programs focused on prevention, treatment and rehabilitation support for all impacted by stroke. Every day, neurosurgeons and specially trained staff work tirelessly to bring the best stroke prevention and treatment services to San Antonio.

Institutions at the South Texas Medical Center provide patients in need of neurological intervention the highest level of care. The world-renowned Endoscopic Craniectomy was developed in one of our institutions and continues to improve the lives of patients suffering from this congenital defect. The cause of craniosynostosis is unknown, but thanks to this minimally invasive procedure patients can be treated with remarkable consistency and safety.

Epilepsy is one of the most common neurological disorders, affecting more than 2.5 million Americans. Patients at the South Texas Medical Center benefit from one of the highest accredited epilepsy programs in the nation, offering patients the most advanced medical, dietary and surgical therapies. Pediatric and adult epilepsy surgery is also offered at the South Texas Medical Center. Other special services include sophisticated neuroimaging (MRI), ictal single-photon-emission (SPECT) and position emission tomography (PET) testing.

Another common neurological disorder affecting many patients today is Parkinson’s Disease. Caused by a loss of nerve cells in the brain, Parkinson’s causes muscle rigidity, tremors at rest, the slowing down of movements, and instability. There is no treatment to cure Parkinson’s. However, patients with Parkinson’s can benefit from advanced services offered by our institutions. Utilizing the latest in technology and the latest treatments, our neurologists and neurosurgeons collaborate with a devoted team of healthcare experts to maximize the quality of life for our patients.

Neuroscience Articles

  • U.S. lawyer groups launch effort to prevent elder financial fraud

    By Michael Leibel

    NEW YORK (Reuters) - Lawyers will have access to training on identifying elderly clients who have fallen prey to financial scams under a continuing education program introduced Tuesday by the American Bar Association and two investor protection groups.

    The program will teach lawyers how to spot signs of cognitive impairment, identify possible cases of investment exploitation and report these suspected instances to the appropriate authorities.

    Sponsored by the ABA along with the Investor Protection Trust and the Investor Protection Institute, two nonprofit organizations devoted to investor education and protection, the new program is called the Elder Investment Fraud and Financial Exploitation Prevention Program Legal.

    Roughly one in five older Americans has been victimized by financial scams which cost them some $2.9 billion a year, according to studies from the Investor Protection Trust and MetLife Inc. Dementia caused by old age and other types of brain damage can make people more vulnerable to financial exploitation.

    "Our goal is to improve the communication among legal professionals, older Americans, adult children and state securities regulators in order to head off financial swindles before the damage is done," Don Blandin, president and chief executive of IPT, said in a press release announcing the program.

    Attorneys may not realize that they can get into trouble themselves if they don't recognize the signs of a scam, said Lori Stiegel, project director at the ABA.

    "A lawyer who is ignorant of (elder investment fraud and financial exploitation) and fails to recognize its signs may unwittingly participate in victimizing the client... and as a result may face professional discipline and liability for malpractice," Stiegel said in the release.

    When the three groups surveyed 674 practicing attorneys it found 91.4 percent considered elder financial fraud to be a "very serious" or "somewhat serious" problem, and 88.6 percent said they would participate in a program designed to prevent this exploitation.

    Other organizations plan to create resources to help financial professionals diagnose mental acuity in their clients. The North American Securities Administrators Association is developing guidelines for how brokerages can protect vulnerable clients. The Securities Industry and Financial Markets Association is also pushing for similar changes.

  • NCAA agrees to settle head injury suit for $70 million

    By Mary Wisniewski

    CHICAGO (Reuters) - The NCAA has agreed to settle a head injury lawsuit by providing $70 million for concussion testing and diagnosis of current and former student athletes in a move expected to change the way such injuries are handled at colleges nationwide, according to court documents filed in Chicago on Tuesday.

    The class-action agreement, if approved by a federal judge and class members, applies to student athletes in all sports who have played at NCAA member schools at any time in the past until 50 years in the future.

    The settlement does not include bodily injury claims, which plaintiff's attorney Steve Berman said should be handled on an individual basis. He said the settlement is aimed at protecting student athletes on the field.

    "The whole goal of my clients is to change the way the NCAA handles concussions," Berman said. "We're very hopeful this will cut down on the number of concussions and people returning to play too early."

    A hearing on the NCAA agreement is scheduled for 2 p.m. CDT (1900 GMT) in Chicago but U.S. District Judge John Lee is not expected to make a decision on whether to grant the settlement preliminary approval until sometime in August, Berman said.

    The danger of concussions and other head injuries has received increased attention in college and professional sports in recent years. A settlement between the National Football League and thousands of former players, who contend the league played down the risk of concussions, was granted preliminary approval by a federal judge earlier this month.

  • Short jogs linked to lower risk of death from heart disease

    By Kathryn Doyle

    NEW YORK (Reuters Health) - People who run in their spare time, even if it's not very fast or very far, tend to have a lower risk of dying from heart disease or from any cause than non-runners, according to a new study.

    The study was large but was observational, meaning the researchers asked participants about their running habits rather than randomly assigning them to running and non-running groups. So they cannot conclude that running, and not other differences between participants, was responsible for the lower risks.

    It's difficult to use more rigorous randomized controlled trials to look at outcomes like death, because that takes so long to track, said lead author Duck-chul Lee, from the College of Human Sciences at Iowa State University in Ames.

    He said the current study is the largest on this topic, but it would still be useful to conduct randomized trials to look at the effects of running on blood pressure and cholesterol, for instance.

    The researchers studied more than 55,000 generally healthy adults between ages 18 and 100. Participants answered questions about their physical activity habits over the past three months, including running speed, duration and frequency. Some were not runners at all; the rest were divided into five groups based on how much they ran each week.

    The researchers then tracked the participants using their medical records for an average of 15 years.

    About 3,400 people died during that time, including roughly 1,200 from cardiovascular causes, including heart disease and stroke.

    At the start, runners were more often male, younger and leaner. Compared to non-runners, people who ran at all were 30 percent less likely to die during the study period and 45 percent less likely to die from cardiovascular disease.

    Runners had a reduced risk of death even if they ran for less than 51 minutes or less than six miles per week, and even if they ran at a pace slower than six miles per hour, according to results published in the Journal of the American College of Cardiology.

    "I think the findings are very encouraging since the study suggests that you don't necessarily have to aim for a marathon in order to obtain the health benefits of physical activity," said Dr. Kasper Andersen of Uppsala University Hospital in Sweden.

    Andersen was not involved in the new study.

    "I guess you can interpret this as every time you go running you are putting savings in your own health bank - an investment that gives you a longer life," he told Reuters Health by email.

    Running was linked to better health regardless of sex, age, smoking status or weight, the researchers found. Runners had life expectancies three years longer than non-runners, on average.

    "The (World Health Organization) guidelines recommend at least 75 minutes per week of vigorous aerobic activity such as running," Lee told Reuters Health in an email. "However, we found mortality benefits in runners who ran even as little as 30 to 60 minutes per week."

    There haven't been as many studies on the benefits of vigorous activity as there have been for moderate activity, he said.

    "As far as recommending that people go for short jogs everyday, I do think this is something we could recommend, although with a couple caveats," said Andrea Chomistek, from the School of Public Health at Indiana University Bloomington.

    "For individuals who are currently inactive, they should probably start with walking and ease into running," she told Reuters Health in an email. "For inactive individuals who are older or have medical issues, they may want to check in with their physician before starting a running program, although walking is just fine."

    Finding a running buddy can be good motivation, Chomistek said.

    "If you know that someone is counting on you to show up, you'll be more likely to go," she said. "And longer runs are definitely more fun if you have company."

    SOURCE: http://bit.ly/1nND4lC Journal of the American College of Cardiology, online July 28, 2014.

  • Dementia patients more likely to get pacemakers: study

    By Andrew M. Seaman

    NEW YORK (Reuters Health) - People with dementia are more likely to get pacemakers than people without any cognitive impairment, according to a new study.

    The study can't explain why people with dementia are more likely to get the devices, which help control irregular heart rhythms, according to the lead author.

    "It may be completely appropriate," Nicole Fowler said. "There may be something that we haven't been able to measure that makes people with dementia need them more."

    Alternatively, she told Reuters Health that the difference could represent family members or doctors choosing more aggressive treatment for people with dementia.

    Fowler worked on the new study while at the University of Pittsburgh School of Medicine. She's now affiliated with the Indiana University Center for Aging Research in Indianapolis.

    She and her colleagues write in a research letter in JAMA Internal Medicine that people with dementia and a lesser form of thinking and memory trouble known as mild cognitive impairment can also have heart problems.

    People with dementia, their family members and their doctors should weigh the risks and benefits of using pacemakers, they add.

    For the new study, the researchers analyzed data on 16,245 people seen at 33 Alzheimer's Disease Centers from September 2005 through December 2011.

    At their first visit to the centers, about 46 percent of people had no evidence of dementia. Another 21 percent had mild cognitive impairment and 33 percent had dementia.

    Over the course of the study, four people out of every 1,000 who didn't have signs of dementia at their first visit received a pacemaker each year. The rate increased to 4.7 per 1,000 people among those with mild cognitive impairment and 6.5 per 1,000 people among those with dementia.

    The researchers found that people with dementia were 60 percent more likely to receive a pacemaker than those without dementia after taking into account their age, sex, race, location, heart health, blood pressure, stroke risk and cognitive decline during the study.

    They write that the findings are counter to expectations that people with serious and often fatal conditions might be treated less aggressively.

    Additional studies will be required to find out exactly why people with dementia are more likely to receive pacemakers, Fowler said.

    "Medical decisions for patients with dementia are really hard," she said. "We know from the data that families really struggle to make medical decisions . . . It's important to find out what are some of the things patients and families need to support their decision making."

    SOURCE: http://bit.ly/1qHE3Wz JAMA Internal Medicine, online July 28, 2014.

  • Drugs to increase "good" cholesterol may not cut deaths

    By Andrew M. Seaman

    NEW YORK (Reuters Health) - Drugs that have been investigated to increase so-called "good" cholesterol may not prevent deaths, heart attacks or strokes as many hoped, according to a new analysis.

    Due to limitations in existing studies and ongoing experiments involving these and other drugs, researchers not involved with the analysis caution that it's too early to give up on medications that increase high-density lipoprotein (HDL) cholesterol, however.

    "In the time before statins were available, there were several pieces of evidence that HDL-raising drugs reduce cardiovascular events, but since the time statins have been used there is now evidence that HDL-targeted therapies don't do anything to decrease mortality," said Dr. Darrel Francis, the study's senior author from Imperial College London.

    Unlike low-density lipoprotein (LDL), which is the so-called "bad" cholesterol that piles up in blood vessels, HDL is considered good because it's thought to chip away LDL cholesterol.

    People with low HDL levels and high LDL levels are known to be at an increased risk of death, the researchers write in the journal The BMJ.

    Drugs known as statins - such as Pfizer's Lipitor - that lower LDL have been found to be effective at reducing deaths. Attention has turned to the development of drugs that increase levels of HDL to achieve added benefits.

    Francis and his colleagues examined the results of 39 randomized controlled trials - the gold standard in medical research - that evaluated the use of three drugs known as niacin, fibrates and cholesterylester transfer protein (CETP) inhibitors.

    While the drugs differ in how they work, all three increase the amount of HDL cholesterol in the body.

    Overall, the drugs did not reduce the number of deaths from any cause or deaths from heart disease before or after statins became common.

    Before statins, fibrates reduced heart attacks and niacin reduced heart attacks and strokes. After statins, the benefit from the two HDL-increasing drugs disappeared.

    The researchers write that the simple idea that a drug that raises HDL levels should also decrease the number of heart attacks and strokes may not be correct.

    "Even if HDL is carrying cholesterol away from the coronary arteries, that doesn't mean that any therapy that raises HDL is automatically protective," Francis said. "After all, the therapy could just be blocking cholesterol traveling on HDL from exiting."

    But a closer look should be given to specific groups of patients before researchers abandon work on drugs targeting HDL cholesterol levels, cautioned Dr. Leonard Kritharides in an editorial accompanying the new study.

    Kritharides, the head of cardiology at Concord Repatriation General Hospital in Sydney, Australia, said other research has suggested there may be a benefit among people with low HDL cholesterol and high triglycerides, which is another type of fat in blood.

    "The possibility of important benefits for some patients should not be dismissed too lightly," he wrote.

    Dr. Steven Nissen, the chair of cardiovascular medicine at the Cleveland Clinic in Ohio, also said the studies included in the analysis had limitations and there are more studies on HDL-increasing drugs underway.

    "I think the science here hasn't been fully worked out and the only way to answer it is with randomized controlled trials and that's what a number of people are doing," said Nissen, who wasn't involved with the new study. He is the head of a trial for a CETP inhibitor from Eli Lilly.

    "If every study underway fails, we'll have to give up on HDL at some point," he said, adding that researchers aren't there yet.

    "What we don't need here is to prejudge ongoing research," Nissen said.

    SOURCE: http://bit.ly/1o0aGXw and http://bit.ly/1zcpif4 The BMJ, July 18, 2014.