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SUNY Downstate joins NIH initiative to develop better care for neurological emergencies

October 22, 2012

SUNY Downstate Medical Center has been selected by the National Institutes of Health (NIH) to join the Neurological Emergencies Treatment Trials (NETT) network, which is dedicated to improving emergency care for neurological injuries that require immediate care, such as stroke, seizures, and traumatic brain injury, as well as other illnesses affecting the brain, spinal cord, and peripheral nervous system.

"It is gratifying that SUNY Downstate's expertise in the neurosciences and emergency medicine is being recognized by this important designation," says John F. Williams, MD, EdD, MPH, FCCM, president of SUNY Downstate Medical Center. "We are well situated to make major contributions to this critical field of medical study."

SUNY Downstate is one of 17 prestigious academic medical centers chosen this year to be a NETT "Hub" and is the only newly funded site in New York State. As part of NETT, Downstate brings advanced medical treatment to residents of New York City's five boroughs, Nassau County, and elsewhere in New York State through a series of national clinical trials geared towards evaluating treatments given during neurological emergencies. Oversight of NETT is provided by an advisory group appointed by the National Institute of Neurological Disorders and Stroke (NINDS), a component of the NIH.

"Frequently, there is a narrow window of opportunity to successfully treat neurological damage," says Steven R. Levine, MD, principal investigator for Downstate's NETT site. "This makes it difficult to conduct studies that help evaluate best or new treatments. As a part of NETT, we can work with paramedics and ER physicians to better study rapid interventions."

"For patients with acute neurological disorders, hospital emergency departments are very often the port of entry to getting care and embarking on the road to recovery," says Richard H. Sinert, DO, co-principal investigator for NETT at Downstate. Dr. Sinert is also professor and research director in Downstate's Department of Emergency Medicine. "The prospect of identifying more effective ways to treat these neurological emergencies is inspiring."

One of the NETT studies Dr. Levine is conducting is POINT (Platelet-oriented Inhibition in New TIA and Minor Ischemic Stroke). TIAs - transient ischemic attacks - are common, and can be a warning sign of potential disabling strokes. TIA symptoms are often similar to those of stroke (numbness or weakness, confusion, dizziness, loss of balance), but there is no way that a patient can tell if the symptoms are from a TIA or an acute stroke.

"POINT will help physicians evaluate whether adding another anti-blood clotting medication to aspirin will help reduce the risk of stroke and heart attack in the three months following the TIA," Dr. Levine notes. "It is using highly rigorous scientific clinical trial methods whereby neither the patient nor the research team knows which treatment the patient is on. A separate safety monitoring committee will know which treatment patients are on and will insure overall safety in the study," he adds.

Dr. Levine is professor of neurology and of emergency medicine, and vice chair of the Department of Neurology at Downstate. Concurrent with overseeing NETT protocols, Dr. Levine is part of a research team developing mobile phone applications for stroke patients and their caregivers to monitor patients' health, and is the principal investigator at SUNY for NeuroNEXT, an NIH initiative to speed the development of promising new therapies. Dr. Levine plans to add several other studies to Downstate's NETT within the next year.

NETT consists of regional Hubs, each with hospital Spokes, and a Statistical and Data Management Center and Clinical Coordinating Center. The Downstate Hub consists of academic teaching hospital sites at University Hospital in Central Brooklyn, Downstate LICH, and Kings County Hospital Center, and its Spokes include Maimonides Medical Center in Brooklyn and Lincoln Medical and Mental Health Center in the Bronx. A Spoke is an affiliated hospital enrolling patients in a clinical trial as part of a specific Hub Complex. NINDS leadership of the NETT program includes Scott Janis, PhD, administrative program director, and Robin Conwit, MD, scientific program director.

According to NETT, 1.1 million patients are affected each year in the United States by one of the eight most common devastating neurological emergencies, about one person every 28 seconds. Of that number, about 250,000 die, one every two minutes. The annual cost is more than $115 billion. These neurological emergencies include stroke (ischemic, intracranial hemorrhage, or subarachnoid hemorrhage), traumatic brain injury, status epilepticus, anoxic encephalopathy, spinal cord injury, and bacterial meningitis. Less common neurological emergencies cause additional morbidity and cost.
The NIH grant number for the SUNY Downstate Hub is NS080377 and for POINT is NS062835.

SUNY Downstate Medical Center, founded in 1860, was the first medical school in the United States to bring teaching out of the lecture hall and to the patient's bedside. A center of innovation and excellence in research and clinical service delivery, SUNY Downstate Medical Center comprises a College of Medicine, Colleges of Nursing and Health Related Professions, a School of Graduate Studies, a School of Public Health, University Hospital of Brooklyn, and an Advanced Biotechnology Park and Biotechnology Incubator.

SUNY Downstate ranks eighth nationally in the number of alumni who are on the faculty of American medical schools. More physicians practicing in New York City have graduated from SUNY Downstate than from any other medical school.

SUNY Downstate Medical Center

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