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6. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study

Author

Skrobot, Olivia A., Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., O'Brien, John, Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, VICCCS Group, Taragano, F. E., Kril, J., Cavalieri, M., Jellinger, K. A., Kovacs, G. G., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., De Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R. F., Korczyn, A. D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D. V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S. Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A. J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L. S., Ikram, M. K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A. J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E. J., Qiu, C., Viitanen, M., Biessels, G. J., De Leeuw, F.-E., Den Heijer, T., Exalto, L. G., Kappelle, L. J., Prins, N. D., Richard, E., Schmand, B., Van Den Berg, E., Van Der Flier, W. M., Bilgic, B., Allan, L. M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P. J., Farrant, A., Fish, M., Harkness, K., Ince, P. G., Langhorne, P., Mann, J., Matthews, F. E., Mayer, P., Pendlebury, S. T., Perneczky, R., Peters, R., Smithard, D., Stephan, B. C., Swartz, J. E., Todd, S., Werring, D. J., Wijayasiri, S. N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J. N., Corrada, M. M., Crane, P. K., Diniz, B. S., Etcher, L., Fillit, H., Greenberg, S. M., Grinberg, L. T., Hurt, S. W., Lamar, M., Mielke, M., Ott, B. R., Perry, G., Powers, W. J., Ramos-Estebanez, C., Reed, B., Roberts, R. O., Romero, J. R., Saykin, A. J., Seshadri, S., Silbert, L., Stern, Yaakov, Zarow, C., Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, and Kehoe, Patrick G.

Subjects
Cognition disorders, Cognition disorders--Diagnosis, FOS: Clinical medicine, Neurosciences
Abstract

Introduction: Progress in understanding and management of vascular cognitive impairment (VCI) has been hampered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. Methods: We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Results: Six survey rounds comprising 65–79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders–Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. Discussion: The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders–Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration.

Published
2018
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7. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study

Author

Skrobot, O. A., Black, S. E., Chen, C., Decarli, C., Erkinjuntti, T., Ford, G. A., Kalaria, R. N., O'Brien, J., Pantoni, L., Pasquier, F., Roman, G. C., Wallin, A., Sachdev, P., Skoog, I., Taragano, F. E., Kril, J., Cavalieri, M., Jellinger, K. A., Kovacs, G. G., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R. F., Korczyn, A. D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, Guido, Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D. V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S. Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A. J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L. S., Ikram, M. K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A. J., Lopez-Pousa, S., Martinez-Lage, P., Mataro, M., Borjesson-Hanson, A., Englund, E., Laukka, E. J., Qiu, C., Viitanen, M., Biessels, G. J., de Leeuw, F. -E., den Heijer, T., Exalto, L. G., Kappelle, L. J., Prins, N. D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W. M., Bilgic, B., Allan, L. M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P. J., Farrant, A., Fish, M., Harkness, K., Ince, P. G., Langhorne, P., Mann, J., Matthews, F. E., Mayer, P., Pendlebury, S. T., Perneczky, R., Peters, R., Smithard, D., Stephan, B. C., Swartz, J. E., Todd, S., Werring, D. J., Wijayasiri, S. N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J. N., Corrada, M. M., Crane, P. K., Diniz, B. S., Etcher, L., Fillit, H., Greenberg, S. M., Grinberg, L. T., Hurt, S. W., Lamar, M., Mielke, M., Ott, B. R., Perry, G., Powers, W. J., Ramos-Estebanez, C., Reed, B., Roberts, R. O., Romero, J. R., Saykin, A. J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Ben-Shlomo, Y., Passmore, A. P., Love, S., Kehoe, P. G., Gainotti G., Skrobot, O. A., Black, S. E., Chen, C., Decarli, C., Erkinjuntti, T., Ford, G. A., Kalaria, R. N., O'Brien, J., Pantoni, L., Pasquier, F., Roman, G. C., Wallin, A., Sachdev, P., Skoog, I., Taragano, F. E., Kril, J., Cavalieri, M., Jellinger, K. A., Kovacs, G. G., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R. F., Korczyn, A. D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, Guido, Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D. V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S. Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A. J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L. S., Ikram, M. K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A. J., Lopez-Pousa, S., Martinez-Lage, P., Mataro, M., Borjesson-Hanson, A., Englund, E., Laukka, E. J., Qiu, C., Viitanen, M., Biessels, G. J., de Leeuw, F. -E., den Heijer, T., Exalto, L. G., Kappelle, L. J., Prins, N. D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W. M., Bilgic, B., Allan, L. M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P. J., Farrant, A., Fish, M., Harkness, K., Ince, P. G., Langhorne, P., Mann, J., Matthews, F. E., Mayer, P., Pendlebury, S. T., Perneczky, R., Peters, R., Smithard, D., Stephan, B. C., Swartz, J. E., Todd, S., Werring, D. J., Wijayasiri, S. N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J. N., Corrada, M. M., Crane, P. K., Diniz, B. S., Etcher, L., Fillit, H., Greenberg, S. M., Grinberg, L. T., Hurt, S. W., Lamar, M., Mielke, M., Ott, B. R., Perry, G., Powers, W. J., Ramos-Estebanez, C., Reed, B., Roberts, R. O., Romero, J. R., Saykin, A. J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Ben-Shlomo, Y., Passmore, A. P., Love, S., Kehoe, P. G., and Gainotti G.

Abstract

Introduction: Progress in understanding and management of vascular cognitive impairment (VCI) has been hampered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. Methods: We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Results: Six survey rounds comprising 65–79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders–Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. Discussion: The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders–Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration.

Published
2018

8. The Vascular Impairment of Cognition Classification Consensus Study

Author

Skrobot, Olivia A., Love, Seth, Kehoe, Patrick G., O'Brien, John, Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder S., Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J-J., Lenoir, H., Tsatali, M., Tsolaki, Magda, Sundar, U., Ikram, M. K., Biessels, G. J., Exalto, L. G., Kappelle, L. J., van den Berg, E., Swartz, J. E., and VICCCS group

Subjects
Consensus, Epidemiology, Health Policy, Clinical Neurology, Guidelines, Criteria, Delphi, Vascular dementia, Cellular and Molecular Neuroscience, Psychiatry and Mental health, Developmental Neuroscience, Journal Article, Vascular cognitive impairment, Geriatrics and Gerontology
Abstract

Introduction Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. Methods The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. Results VICCCS had a mean of 122 (98–153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. Discussion VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research.

Published
2017

9. The Vascular Impairment of Cognition Classification Consensus Study

Author

ZL Cerebrovasculaire Ziekten Medisch, ZL Algemene Neurologie Medisch, Circulatory Health, Brain, Opleiding Neurologie, Projectafdeling VCI, MS KNO, Skrobot, Olivia A., Love, Seth, Kehoe, Patrick G., O'Brien, John, Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder S., Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J-J., Lenoir, H., Tsatali, M., Tsolaki, Magda, Sundar, U., Ikram, M. K., Biessels, G. J., Exalto, L. G., Kappelle, L. J., van den Berg, E., Swartz, J. E., VICCCS group, ZL Cerebrovasculaire Ziekten Medisch, ZL Algemene Neurologie Medisch, Circulatory Health, Brain, Opleiding Neurologie, Projectafdeling VCI, MS KNO, Skrobot, Olivia A., Love, Seth, Kehoe, Patrick G., O'Brien, John, Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder S., Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J-J., Lenoir, H., Tsatali, M., Tsolaki, Magda, Sundar, U., Ikram, M. K., Biessels, G. J., Exalto, L. G., Kappelle, L. J., van den Berg, E., Swartz, J. E., and VICCCS group

Published
2017

10. The Vascular Impairment of Cognition Classification Consensus Study

Author

Skrobot, O. A., Love, S., Kehoe, P. G., O'Brien, J., Black, S., Chen, C., DeCarli, C., Erkinjuntti, T., Ford, G. A., Kalaria, R. N., Pantoni, L., Pasquier, F., Roman, G. C., Wallin, A., Sachdev, P., Kril, J., Skoog, I., Ben-Shlomo, Y., Passmore, A. P., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R. F., Korczyn, A. D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., DI Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D. V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S. Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A. J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L. S., Ikram, M. K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A. J., Lopez-Pousa, S., Martinez-Lage, P., Mataro, M., Borjesson-Hanson, A., Englund, E., Laukka, E. J., Qiu, C., Viitanen, M., Biessels, G. J., de Leeuw, F. -E., den Heijer, T., Exalto, L. G., Kappelle, L. J., Prins, N. D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W. M., Bilgic, B., Allan, L. M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P. J., Farrant, A., Fish, M., Harkness, K., Ince, P. G., Langhorne, P., Mann, J., Matthews, F. E., Mayer, P., Pendlebury, S. T., Perneczky, R., Peters, R., Smithard, D., Stephan, B. C., Swartz, J. E., Todd, S., Werring, D. J., Wijayasiri, S. N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J. N., Corrada, M. M., Crane, P. K., Diniz, B. S., Etcher, L., Fillit, H., Greenberg, S. M., Grinberg, L. T., Hurt, S. W., Lamar, M., Mielke, M., Ott, B. R., Perry, G., Powers, W. J., Ramos-Estebanez, C., Reed, B., Roberts, R. O., Romero, J. R., Saykin, A. J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Gainotti G., Logroscino G. (ORCID:0000-0003-1301-5343), Skrobot, O. A., Love, S., Kehoe, P. G., O'Brien, J., Black, S., Chen, C., DeCarli, C., Erkinjuntti, T., Ford, G. A., Kalaria, R. N., Pantoni, L., Pasquier, F., Roman, G. C., Wallin, A., Sachdev, P., Kril, J., Skoog, I., Ben-Shlomo, Y., Passmore, A. P., Engelborghs, S., Lafosse, C., Bertolucci, P. H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T. C., Bocti, C., Fulop, T., Hogan, D. B., Hsiung, G. R., Kirk, A., Leach, L., Robillard, A., Sahlas, D. J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R. F., Korczyn, A. D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., DI Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D. V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S. Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A. J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L. S., Ikram, M. K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A. J., Lopez-Pousa, S., Martinez-Lage, P., Mataro, M., Borjesson-Hanson, A., Englund, E., Laukka, E. J., Qiu, C., Viitanen, M., Biessels, G. J., de Leeuw, F. -E., den Heijer, T., Exalto, L. G., Kappelle, L. J., Prins, N. D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W. M., Bilgic, B., Allan, L. M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P. J., Farrant, A., Fish, M., Harkness, K., Ince, P. G., Langhorne, P., Mann, J., Matthews, F. E., Mayer, P., Pendlebury, S. T., Perneczky, R., Peters, R., Smithard, D., Stephan, B. C., Swartz, J. E., Todd, S., Werring, D. J., Wijayasiri, S. N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J. N., Corrada, M. M., Crane, P. K., Diniz, B. S., Etcher, L., Fillit, H., Greenberg, S. M., Grinberg, L. T., Hurt, S. W., Lamar, M., Mielke, M., Ott, B. R., Perry, G., Powers, W. J., Ramos-Estebanez, C., Reed, B., Roberts, R. O., Romero, J. R., Saykin, A. J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Gainotti G., and Logroscino G. (ORCID:0000-0003-1301-5343)

Abstract

Introduction Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. Methods The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. Results VICCCS had a mean of 122 (98–153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. Discussion VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research.

Published
2017

11. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack

Author

Perry, J. J., primary, Sharma, M., additional, Sivilotti, M. L. A., additional, Sutherland, J., additional, Symington, C., additional, Worster, A., additional, Emond, M., additional, Stotts, G., additional, Jin, A. Y., additional, Oczkowski, W. J., additional, Sahlas, D. J., additional, Murray, H. E., additional, MacKey, A., additional, Verreault, S., additional, Wells, G. A., additional, and Stiell, I. G., additional

Published
2011
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15. Distribution of snRNPs, splicing factor SC-35 and actin in interphase nuclei: immunocytochemical evidence for differential distribution during changes in functional states.

Author

Sahlas, D J, Milankov, K, Park, P C, and De Boni, U

Abstract

Small nuclear ribonucleoproteins (snRNPs) play an integral role in the processing of pre-mRNA in eukaryotic nuclei. snRNPs often occur in a speckled intranuclear distribution, together with the non-snRNP splicing factor SC-35. snRNPs have also been shown to be associated with actin in the nuclear matrix, suggesting that both actin and snRNPs may be involved in the processing and transport of transcripts. The work reported here was undertaken to compare the spatial relationship of snRNPs, SC-35, and intranuclear actin in neuronal and non-neuronal cell types. In undifferentiated PC12 cells and in non-neuronal cells growing in association with dorsal root ganglion neurons, confocal immunocytochemistry revealed a typical, speckled distribution of snRNP aggregates, which colocalized with the SC-35 splicing factor. In contrast, a unique snRNP distribution was observed in dorsal root ganglion neurons in vitro and in PC12 cells differentiated by nerve growth factor. In nuclei of these cells, snRNPs were predominantly located at the periphery where they formed a spherical shell apposed to the nuclear envelope. Ultrastructural immunogold labelling of snRNPs in dorsal root ganglion neurons in vitro confirmed this distribution. In contrast, SC-35 remained distributed in a speckled pattern throughout nuclei of dorsal root ganglion neurons and PC12 cells, even in cases where snRNPs were almost exclusively positioned at the nuclear periphery. In non-neuronal cells in dorsal root ganglion cultures and in undifferentiated PC12 cells, snRNP aggregates were frequently associated with actin aggregates, as determined by Nearest Neighbor Analyses. In PC12 cells, this spatial relationship was altered during nerve growth factor-induced differentiation, prior to the time at which these cells showed morphological evidence of differentiation. Specifically, Nearest Neighbor Analyses between snRNP and actin aggregates in PC12 cells exposed to nerve growth factor for 4 hours revealed that snRNP and actin aggregates exhibited a closer association than in undifferentiated cells. These results suggest that sites of pre-mRNA processing and transcription may differ between cell types, and that the functions of snRNPs and actin within interphase nuclei may be related. The results also indicate that the distribution of snRNPs is dynamic and that it may depend upon the functional state of the cell as well as upon its state of differentiation.

Published
1993

16. Covert stroke after non-cardiac surgery: a prospective cohort study.

Author

Mrkobrada, M, Hill, M D, Chan, M T V, Sigamani, A, Cowan, D, Kurz, A, Sessler, D I, Jacka, M, Graham, M, Dasgupta, M, Dunlop, V, Emery, D J, Gulka, I, Guyatt, G, Heels-Ansdell, D, Murkin, J, Pettit, S, Sahlas, D J, Sharma, M, and Srinathan, S

Subjects
*BRAIN, *COMPARATIVE studies, *INTERNATIONAL relations, *LONGITUDINAL method, *MAGNETIC resonance imaging, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *STROKE, *SURGICAL complications, *EVALUATION research, *RELATIVE medical risk
Abstract

Background: Overt stroke after non-cardiac surgery has a substantial impact on the duration and quality of life. Covert stroke in the non-surgical setting is much more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardiac, non-carotid artery surgery.Methods: We undertook a prospective, international cohort study to determine the incidence of covert stroke after non-cardiac, non-carotid artery surgery. Eligible patients were ≥65 yr of age and were admitted to hospital for at least three nights after non-cardiac, non-carotid artery surgery. Patients underwent a brain magnetic resonance study between postoperative days 3 and 10. The main outcome was the incidence of perioperative covert stroke.Results: We enrolled a total of 100 patients from six centres in four countries. The incidence of perioperative covert stroke was 10.0% (10/100 patients, 95% confidence interval 5.5-17.4%). Five of the six centres that enrolled patients reported an incident covert stroke, and covert stroke was found in patients undergoing major general (3/27), major orthopaedic (3/41), major urological or gynaecological (3/22), and low-risk surgery (1/12).Conclusions: This international multicentre study suggests that 1 in 10 patients ≥65 yr of age experiences a perioperative covert stroke. A larger study is required to determine the impact of perioperative covert stroke on patient-important outcomes.Clinical Trial Registration: NCT01369537. [ABSTRACT FROM AUTHOR]

Published
2016
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17. CT perfusion quantification of small-vessel ischemic severity.

Author

Huynh TJ, Murphy B, Pettersen JA, Tu H, Sahlas DJ, Zhang L, Symons SP, Black S, Lee TY, and Aviv RI

Subjects
Aged, Female, Humans, Male, Reproducibility of Results, Sensitivity and Specificity, Severity of Illness Index, Brain Ischemia diagnostic imaging, Demyelinating Diseases diagnostic imaging, Nerve Fibers, Myelinated diagnostic imaging, Tomography, X-Ray Computed methods
Abstract

Background and Purpose: Cerebral blood flow (CBF) abnormalities are previously demonstrated in white matter disease. A gradation of change may exist between patients with mild and more severe white matter disease. An association between blood brain barrier dysfunction, increasing age and white matter disease is also suggested. The purpose of this study was to quantify and correlate white matter disease severity and CT perfusion (CTP)-derived CBF and to determine whether permeability surface abnormality increases with white matter disease severity., Materials and Methods: One hundred twenty patients with strokelike symptoms underwent CTP and MR imaging. Of these, 35 patients (15 women, 20 men; age, 66 +/- 15.7 years) with rapidly resolving symptoms and normal imaging characteristics consistent with transient ischemic attack were retrospectively reviewed and constituted the study cohort. Two blinded neurologists rated white matter severity, assigning age-related white matter change (ARWMC) scores. Patients were dichotomized a priori into mild and moderate-to-severe. CBF, cerebral blood volume (CBV), mean transit time (MTT), and permeability surface product maps were calculated for periventricular and subcortical white matter regions and average white and gray matter. Associations with white matter severity were tested by uni- and multivariate logistic regression analyses. Receiver operating characteristic analysis was performed., Results: White matter disease was mild in 26 patients and moderate-to-severe in 9. Age was associated with increased likelihood of having moderate-to-severe white matter disease (P = .02). ARWMC correlated with subcortical (r = -0.50, P < .001) and average CBF (r = -0.55, P < .001). White matter severity was associated with subcortical (P = .03) and average (P = .03) white matter CBF, with a trend toward periventricular white matter CBF (P = .05). Uni- and multivariate analysis controlling for the confounding effect of age demonstrated significant association between white matter severity and subcortical (P = .032) white matter CBF. Area under the curve was 0.82. No permeability surface abnormality was found., Conclusions: CTP-derived subcortical white matter CBF is independently associated with white matter disease severity.

Published
2008
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18. Early stroke detection and extent: impact of experience and the role of computed tomography angiography source images.

Author

Aviv RI, Shelef I, Malam S, Chakraborty S, Sahlas DJ, Tomlinson G, Symons S, and Fox AJ

Subjects
Adult, Aged, Aged, 80 and over, Clinical Competence, Early Diagnosis, Female, Humans, Male, Middle Aged, Observer Variation, Prognosis, Sensitivity and Specificity, Cerebral Angiography methods, Stroke diagnostic imaging, Tomography, X-Ray Computed methods
Abstract

Aim: To test the performance of computed tomography angiography "source images" (CTA-SI) versus unenhanced CT (NCCT) for stroke detection and extent using the Alberta Stroke Programme Early CT Score (ASPECTS), and examine the effect of experience and clinical history., Materials and Methods: Studies of 23 consecutive patients presenting within 4.5h were analysed by three reviewers of varying experience. Each reviewer, blinded to clinical information reviewed a random order of NCCT and CTA-SI and documented side of infarct and the ASPECTS. The readings were repeated for CTA-SI with and without clinical information. Performance measures and observer agreement were calculated. Applying an ASPECTS threshold of

Published
2007
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19. Functional neuroanatomy in the pre-Hippocratic era: observations from the Iliad of Homer.

Author

Sahlas DJ

Subjects
Greek World history, History, Ancient, Humans, Medicine in Literature, Neuroanatomy history, Neurophysiology history, Poetry as Topic history
Abstract

Objective: To describe observations of neurological significance made in the Iliad of Homer and to interpret these relative to pre-Hippocratic concepts of health and disease in Ancient Greece., Methods: English translations of the Iliad were analyzed for references of neurological significance, and the Homeric Greek was subsequently reviewed for accuracy. Findings are discussed in the context of ancient Greek ideas regarding anatomy and physiology, early descriptions and conceptualizations of the nervous system, ancient Greek theories concerning illness and disease, and the practice of medicine in the pre-Hippocratic era., Results: Descriptions of injuries sustained by soldiers fighting in the Trojan War represent some of the earliest case histories of neurotrauma. Passages in the Iliad describe immediate death after penetrating head trauma with injury to the brain or the brainstem, make reference to clinical signs of brain injury, and mention neurological signs and symptoms after damage to the spinal cord, brachial plexus, and peripheral nerves., Conclusion: The Iliad of Homer contains many descriptions of traumatic injury to the nervous system and provides us with 3,000-year-old references to some of the basic principles of functional neuroanatomy.

Published
2001
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20. Familial autoimmune myastenia gravis: four patients involving three generations.

Author

Marrie RA, Sahlas DJ, and Bray GM

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Myasthenia Gravis diagnosis, Myasthenia Gravis physiopathology, Pedigree, Myasthenia Gravis genetics
Abstract

Background: Familial autoimmune myasthenia gravis (MG) is rare, although a genetic role for the development of autoimmune MG is suggested by concordance in monozygotic twins and the increased frequency of other autoimmune diseases in family members of myasthenics., Methods: A patient with a family history of MG was evaluated in hospital. Relatives were interviewed and medical records examined for details regarding the diagnosis of MG in three other family members., Results: The index case first experienced symptoms of MG at age 75 years. She developed generalized MG and required corticosteroids and immunosuppressive therapy to control her disease. Her father developed predominantly bulbar symptoms of MG at age 75 years. He died of complications experienced following a gastrostomy placed for continued difficulty swallowing. His brother developed similar symptoms of MG in his early 60s and died shortly after thymectomy. A 46-year-old nephew of the index case is also beginning to exhibit signs of generalized MG. Acetylcholine receptor antibodies were strongly positive in the index case and her nephew. (The assay was not available for her father and uncle)., Conclusions: Four individuals in three successive generations had diagnoses of autoimmune MG. Study of familial cases such as these may clarify the contribution of genetic factors to the development of this disease.

Published
2000
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21. A case of thyrotoxicosis and reversible systolic cardiac dysfunction.

Author

Goldman LE, Sahlas DJ, and Sami M

Subjects
Arrhythmia, Sinus, Cardiomyopathy, Dilated diagnostic imaging, Electrocardiography, Female, Heart Failure diagnostic imaging, Humans, Middle Aged, Radiography, Thoracic, Systole, Tachycardia, Ventricular diagnosis, Ventricular Dysfunction, Left, Cardiomyopathy, Dilated complications, Heart Failure complications, Thyrotoxicosis complications
Abstract

A woman with congestive heart failure and reduced left ventricular ejection fraction associated with hyperthyroidism is reported. Congestive heart failure resolved and left ventricular ejection fraction normalized within three weeks of treatment of her hyperthyroidism. The literature on previously reported cases of reversible systolic heart failure associated with hyperthyroidism is reviewed and the possible mechanisms leading to systolic dysfunction and congestive heart failure in thyrotoxicosis are discussed. One such mechanism may be the action of thyroid hormone on altering gene expression in cardiac cells; another could be the chronic tachycardia associated with thyrotoxicosis. Although it is a not a common cause of systolic heart failure, thyrotoxicosis should be considered in the differential diagnosis of cardiomyopathies because it is a potentially reversible cause.

Published
1999

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