Yale Neurons

Highlights of Resident Activities

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Career Night!

Yale Neurology hosted its second annual Neurology Career Night during which residents were able to chat over dinner and drinks with attendings representing a wide variety of subspecialties, practice types, and training pathways. Attendings shared their pathways, offered insight and valuable career advice, and answered residents’ burning questions about everything from how to choose a specialty to lifestyle to negotiating a contract. It was a huge success, and another career night is in the works for a couple of months from now for those who were unable to attend.

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Dinner with the Chair

 

Dr. Hafler, our department Chair, and his wife, Dr. Janet Hafler, Associate Dean for Educational Scholarship for Yale Medical School, hosted another successful dinner party for our residents. It was a wonderful night full of delicious food and drink, catching up, and discussions about the direction of the department and resident career goals. It was also a nice opportunity to celebrate another successful match, with 10 incredible new residents joining our program in the coming academic year.

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Yale Neurons Being International Bosses- UPDATE

German Society for NeuroIntensive and Emergency Medicine and the German Stroke Society 34th Annual Meeting 2018 (ANIM 2018)

Our very own Jens Witsch, PGY2, was personally invited to give a talk entitled, “Subarachnoid Hemorrhage Prognostication Scores” at the ANIM 2018 (Annual Mtg for German Emergency, Neurointensive and Stroke societies). Jens studied neurology in Germany prior to joining us at Yale, and they obviously loved his work so much, they want to bring him back. Congrats on that great honor, Jens!

UPDATE-  Through the love and support of his co-residents and program leadership, Jens was able to rearrange his schedule to allow him to attend this conference. He did an outstanding job giving his talk on SAH prognostication, and it was received incredibly well by a crowd of emergency medicine, stroke and neurocritical care physicians. We are so proud of you, Jens!

 

 

 

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Yale Neurology Residents Abroad- Feat. Idaira Aguilar

 

 

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Idaira Aguilar, one of our incredible PGY3 residents, just returned from her international neurology rotation at Complejo Hospitalario Universitario Insular-Materno Infantil in Las Palmas Gran Canaria. Idaira grew up in the Canary Islands and hopes to practice both there and in the USA after residency. This was her first time practicing as a physician there, and she loved it. Thank you for representing Yale so incredibly well overseas, Idaira. We are glad to have you back!

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Yale Neuro Residents Advancing the Knowledge of Our Collective Brain – Feat. Stacy Chu, PGY4

Congrats to Stacy Chu on another great publication with Dr. Lauren Sansing, Evolution of blood pressure management in acute intracerebral hemorrhage. Keep up the awesome work, Stacy!

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Yale Neurons on the Cutting Edge

Congratulations to our very own, Amanda Hernandez, PGY2, for being selected to attend the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Neurology Resident Summit in Multiple Sclerosis in gorgeous San Diego January 2018. Amanda was selected from a number of qualified applicants to attend this incredible conference (all expenses paid) where she will learn about cutting edge MS research and have the opportunity to meet and learn from leaders in the field. Congrats on this incredible opportunity, Amanda!

 

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Yale Neuro Residents Advancing the Knowledge of Our Collective Brain – Feat. Justine Cormier, PGY3

Congratulations to Justine Cormier, PGY3 for having her recent manuscript, The Ictal-Interictal Continuum: When to Worry About the Continuous EEG Pattern, accepted for publication in Seminars in Respiratory and Critical Care Medicine. Guest editors for this journal edition are Dr. David Hwang and Dr. David Greer.  A link to the article will be put up when it is released (currently submitted to publisher). For now, the abstract is copied below.

 

Continuous electroencephalography (cEEG) monitoring is an invaluable tool in the evaluation of encephalopathy and coma in critically ill patients. Marked increases in cEEG monitoring, coinciding with several societal guideline statements in the last decade, have allowed for the earlier detection and treatment of clearly harmful patterns, including non-convulsive seizures (NCSz) and non-convulsive status epilepticus (NCSE). However, it has also unmasked a range of EEG patterns of less clear clinical significance, with some more “malignant” than others given their potential association with increased neuronal stress and secondary brain injury. These patterns lay on a spectrum often referred to as the Ictal-Interictal Continuum (IIC). To date, no definitive guidelines exist for the management of these potentially harmful EEG patterns, thus presenting a clinical dilemma for critical care physicians. Here we review the various IIC patterns, their associated features, seizure risk, and outcomes and propose a clinical approach to management based on available data and expert opinion.

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Yale Neurology Residents Abroad

One of our current PGY4 residents, Monica Diaz, will be carrying on a tradition of Yale Neurology residents traveling abroad as part of their clinical neurology training. As a PGY3, Monica spent 6 weeks at Mulago Hospital in Uganda as part of her journey through the Yale Neurology Residency Global Health Track.

In late October, she will be traveling to Salpetriere Hospital, one of the largest hospitals in Europe with a long history of influential minds in Neurology including in Jean-Martin Charcot, Sigmund Freud and Joseph Babinski. While there, Monica will be working in a variety of clinics including MS, Movement Disorders, and Neuromuscular clinic. Monica will learn from a number of brilliant minds and get to brush up on her French skills. Stay tuned for details and photos from her trip!

Prior residents who had rotated at Salpêtrière include Drs. Ilena George, Sara Schaefer, Emmanuelle Schindler, Vincent Lau, and Diane Chan.

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Yale Neuro Residents Advancing the Knowledge of Our Collective Brain – Feat. Rachel Beekman, PGY4


Rachel Beekman, PGY4 has had an incredibly productive year with several publications, a few of which are mentioned below:

Beekman R, Greer D, Brooks D, Maciel C. Clinical Reasoning: Prognostication after cardiac arrest: What do we really know? Neurology Resident and Fellow Section. Neurology, November 14, 2017; 89; 239-e244.

Hehir MK, Hobson-Webb LD, Benatar M, Barnett C, Silvestri NJ, Howard JF Jr, Howard D, Visser A, Crum BA, Nowak R, Beekman R, et al. Rituximab as treatment for anti-MUSK myasthenia gravis: Multicenter blinded prospective review. Neurology 2017;89:1069-1077.

*This study provides Class IV evidence that for patients with anti-MuSK MG, rituximab increased the probability of a favorable outcome.

 

Rachel Beekman, David M. Greer, Carolina B. Maciel. Poor neurologic outcomes after cardiac arrest: a spectrum with individual implications.. Epilepsy and Behavior Case Reports 2017;8:85-6.

 

 

Rachel Beekman, MD, Jessica M. Hu, MD, Steven I. Aronin, MD, Marican F. Malinis, MD. Diagnosing Ring-Enhancing Lesions in the Brain of a Patient With AIDS Without Brain Biopsy: A Case of Central Nervous System Histoplasmoma. Neurohospitalist 2017.

 

 

Rachel will be doing a Neurocritical Care Fellowship here at Yale next year, and we are so lucky she will be staying with us. Congrats, Rachel!

 

 

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Yale Neurology in the News!

Yale Neurology was recently featured in an article in The New York Times by Dr. Lisa Sanders as part of her popular “Diagnosis” column. In the article she describes a 95 year-old woman who presented with dysarthria, dysphagia and double vision. Her story was a bit complex with multiple red herrings, and it was initially suspected that she may have suffered a stroke. Through the good instincts, dedication and persistence of several of our residents and faculty, she was ultimately diagnosed with myasthenia graves and treated appropriately. Dr. Paul Sanmartin, a PGY-3 resident in the program, was featured prominently in the article, as was one of Yale’s neuromuscular faculty members, Dr. Richard Nowak.
 
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