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Rocha MF, Sacks B, Al Lamki A, Koohi N, Kaski D. Correction to: Acute vestibular migraine: a ghost diagnosis in patients with acute vertigo. J Neurol 2024; 271:627. [PMID: 37891418 DOI: 10.1007/s00415-023-12029-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Affiliation(s)
- Maria Francisca Rocha
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Benjamin Sacks
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Amira Al Lamki
- The Ear Institute, University College London, London, UK
| | - Nehzat Koohi
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- The Ear Institute, University College London, London, UK
- SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, 33 Queen Square, London, WC1N 3BG, UK
| | - Diego Kaski
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
- The Ear Institute, University College London, London, UK.
- SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, 33 Queen Square, London, WC1N 3BG, UK.
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Chan E, Bonifacio GB, Harrison C, Banerjee G, Best JG, Sacks B, Harding N, Del Rocio Hidalgo Mas M, Jäger HR, Cipolotti L, Werring DJ. Domain-specific neuropsychological investigation of CAA with and without intracerebral haemorrhage. J Neurol 2023; 270:6124-6132. [PMID: 37672105 PMCID: PMC10632296 DOI: 10.1007/s00415-023-11977-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Cerebral amyloid angiopathy (CAA) is associated with cognitive impairment, but the contributions of lobar intracerebral haemorrhage (ICH), underlying diffuse vasculopathy, and neurodegeneration, remain uncertain. We investigated the domain-specific neuropsychological profile of CAA with and without ICH, and their associations with structural neuroimaging features. METHODS Data were collected from patients with possible or probable CAA attending a specialist outpatient clinic. Patients completed standardised neuropsychological assessment covering seven domains. MRI scans were scored for markers of cerebral small vessel disease and neurodegeneration. Patients were grouped into those with and without a macro-haemorrhage (CAA-ICH and CAA-non-ICH). RESULTS We included 77 participants (mean age 72, 65% male). 26/32 (81%) CAA-non-ICH patients and 41/45 (91%) CAA-ICH patients were impaired in at least one cognitive domain. Verbal IQ and non-verbal IQ were the most frequently impaired, followed by executive functions and processing speed. We found no significant differences in the frequency of impairment across domains between the two groups. Medial temporal atrophy was the imaging feature most consistently associated with cognitive impairment (both overall and in individual domains) in both univariable and multivariable analyses. DISCUSSION Cognitive impairment is common in CAA, even in the absence of ICH, suggesting a key role for diffuse processes related to small vessel disease and/or neurodegeneration. Our findings indicate that neurodegeneration, possibly due to co-existing Alzheimer's disease pathology, may be the most important contributor. The observation that general intelligence is the most frequently affected domain suggests that CAA has a generalised rather than focal cognitive impact.
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Affiliation(s)
- Edgar Chan
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK.
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK.
| | - Guendalina B Bonifacio
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Corin Harrison
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Gargi Banerjee
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Jonathan G Best
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Benjamin Sacks
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Nicola Harding
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Maria Del Rocio Hidalgo Mas
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - H Rolf Jäger
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Lisa Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - David J Werring
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
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Rocha MF, Sacks B, Al-Lamki A, Koohi N, Kaski D. Acute vestibular migraine: a ghost diagnosis in patients with acute vertigo. J Neurol 2023; 270:6155-6158. [PMID: 37597072 DOI: 10.1007/s00415-023-11930-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Affiliation(s)
- Maria Francisca Rocha
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Benjamin Sacks
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Amira Al-Lamki
- The Ear Institute, University College London, London, UK
| | - Nehzat Koohi
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- The Ear Institute, University College London, London, UK
- SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, 33 Queen Square, London, WC1N 3BG, UK
| | - Diego Kaski
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
- The Ear Institute, University College London, London, UK.
- SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, 33 Queen Square, London, WC1N 3BG, UK.
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Zumstein V, Parsons BA, Dabestani S, Baranowski AP, Tidman V, Berghmans B, Borovicka J, Cottrell AM, Dinis-Oliveira P, Elneil S, Hughes J, Messelink BE, Abreu-Mendes P, Sacks B, Yuan Y, Engeler DS. The Benefits and Harms of Pharmacological Treatment for Postradiation Pelvic Pain: A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel with Recommendations for Clinical Practice. EUR UROL SUPPL 2023; 56:29-38. [PMID: 37711669 PMCID: PMC10497785 DOI: 10.1016/j.euros.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/16/2023] Open
Abstract
Context Radiotherapy of the pelvis is a widely used method for the treatment of malignancies, and local complications including pain following pelvic radiation therapy are acknowledged complications. Objective The primary objective is to assess the clinical effectiveness and safety of pharmacological therapies on postradiation pelvic pain. Evidence acquisition A systematic review of the use of different pharmacological treatments in the management of post-radiation pelvic pain was conducted (PROSPERO-ID: CRD42021249026). Comprehensive searches of EMBASE, Medline, and Cochrane library were performed for publications between January 1980 and April 2021. The primary outcomes were improvement in pain and adverse events following treatment. The secondary outcomes included quality of life, bowel function, and urinary function. Evidence synthesis After screening 1514 abstracts, four randomised controlled trials were identified, enrolling 355 patients with bladder and anorectal subtypes of postradiotherapy chronic pelvic pain (CPP). A narrative synthesis was performed as heterogeneity of included studies precluded a meta-analysis. A single study reported a significant reduction in pain after 6 mo in patients with bladder pain syndrome treated with hyaluronic acid or hyperbaric oxygen. Anorectal pain was reported to be reduced by the application of 4% formalin, but the use of hyperbaric oxygen in postradiotherapy anorectal pain remains controversial. Adverse event reporting was generally poor. Studies looking at medications used routinely in guidelines for neuropathic pain, such as gabapentin, pregabalin, amitriptyline, and duloxetine, were absent or of poor quality when it came to postradiation pelvic pain. Conclusions Beneficial effects of hyperbaric oxygen or formalin on pain, quality of life, and functional symptoms were seen in patients with certain CPP subtypes, but the current evidence level is too weak to allow recommendations about the use of any pharmacological treatment for postradiation pelvic pain. Patient summary Different pharmacological treatments are used to treat pain after radiotherapy, but current studies are of insufficient quality to determine whether these should be recommended and many chronic pelvic pain subtypes are not covered. Further research is needed.
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Affiliation(s)
- Valentin Zumstein
- Department of Urology, Cantonal Hospital of St. Gallen, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | | | - Saeed Dabestani
- Department of Translational Medicine, Division of Urological Cancers, Lund University, Kristianstad Central Hospital, Lund, Sweden
| | - Andrew P. Baranowski
- University College London and the National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation Trust, London, UK
| | - Victoria Tidman
- University College London and the National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation Trust, London, UK
| | - Bary Berghmans
- Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan Borovicka
- Department of Gastroenterology/Hepatology, Cantonal Hospital of St. Gallen, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | | | - Paolo Dinis-Oliveira
- Department of Urology, Hospital de Sao Joao, University of Porto Faculty of Medicine, Porto, Portugal
| | - Sohier Elneil
- University College Hospital and the Hospital for Neurology and Neurosurgery, London, UK
| | - John Hughes
- The James Cook University Hospital, Middlesbrough, UK
| | - Bert E.J. Messelink
- Department of Urology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Pedro Abreu-Mendes
- Department of Urology, Hospital de Sao Joao, University of Porto Faculty of Medicine, Porto, Portugal
| | | | - Yuhong Yuan
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Daniel S. Engeler
- Department of Urology, Cantonal Hospital of St. Gallen, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
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Japzon N, Han R, Sacks B, Levee V, Rosser S, Samaroo Y, Westwood JP, Zambreanu L, Lunn MP, Spillane J. 099 Thrombotic and haemorrhagic complications associated with PLEX, reducing the risks. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPlasma Exchange (PLEX) is an increasingly used therapy for various immune-mediated neu- rological diseases. Treatment can be complicated by potentially life-threatening clots and bleeds but there is limited data available regarding these risks.Method and Intervention: A retrospective audit of the records of patients receiving PLEX in the NHNN for neurological disease from May 2019 – October 2020 was performed to identify thrombotic and haemor- rhagic complications. A multi-disciplinary PLEX working group was created to set guidelines for all aspects of the PLEX process including mode of vascular access, use of prophylactic heparin and fluid replace- ment. The service was subsequently re-audited.Results46 patients were treated with plasma exchange between May 2019 and Oct 2020. 11% developed a thrombus requiring anticoagulation. 41% developed a haemorrhage, 42% of which required intervention.Following protocol change a review of 32 patients between November 2020 to October 2021 showed that there was a reduction of 27% in the incidence of thrombus and a 17% reduction in the incidence of haemorrhage.ConclusionPLEX is integral to the treatment of disabling and potentially fatal immune-mediated neuro-logical diseases. Careful consideration of all aspects of the PLEX process, reduces risks associated with treatment and improves patient safety.
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Basgaran A, McColgan P, Sacks B, Oommen G, Koay S, Alsukhni R, Hagen EM, Ingle G, Iodice V, McNamara P. 121 Autoimmune autonomic neuropathy on the Adie spectrum: ‘Ross syndrome?’. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Ross syndrome is a rare syndrome of segmental autonomic dysfunction, characterised by a triad of tonic pupils, hyporeflexia and anhidrosis. We present an atypical case of such a patient, presenting with added features of cardiovascular autonomic dysfunction.Our case concerns a 66-year-old female, who experienced progressive stepwise deterioration in the functionality of her autonomic nervous system. Her symptoms began with a left Adie’s pupil, followed by a chronic dry cough and diarrhoea. The onset of anhidrosis and orthostatic hypotension subsequently occurred 30 and 40 years later, respectively.Autonomic function testing confirmed cardiovascular autonomic failure as well as deficiencies of sudomotor, salivary and tear function. Severe orthostatic hypotension was demonstrated along with an abnormal Valsalva response, and loss of the nocturnal circadian rhythm. Thermoregulatory and dynamic sweat testing further confirmed global anhidrosis.Our case highlights that patients do not always fit diagnostic criteria of eponymous syndromes, and usually demonstrate varying levels of autonomic dysfunction. We propose diagnosis of such atypical cases to be part of an Adie spectrum ganglionopathy, rather than attempting to fit into an eponymous syndrome phenotype. We further believe there to be an autoimmune basis to the Adie spectrum of disorders and have proposed immunotherapy as definitive management.a.basgaran@nhs.net|ABN Bursary
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Shipa MRA, Langley L, Sacks B, Yeoh SA, Mainuddin MD, Mukerjee D, Castelino M, Ehrenstein MR. Increased erythrocyte mean corpuscular volume by methotrexate predicts clinical response in psoriatic arthritis. Rheumatology (Oxford) 2022; 61:e270-e273. [PMID: 35532065 PMCID: PMC9434146 DOI: 10.1093/rheumatology/keac276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Lawrence Langley
- Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Benjamin Sacks
- Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Su-Ann Yeoh
- Department of Rheumatology, University College London, London, UK
| | - M D Mainuddin
- Department of Rheumatology, North Middlesex University Hospital NHS Trust, Sterling Way, London, N18 1QX, UK, London
| | - Dev Mukerjee
- Department of Rheumatology, North Middlesex University Hospital NHS Trust, Sterling Way, London, N18 1QX, UK, London
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Castle ST, Allan N, Clifford D, Aylward CM, Ramsey J, Fascetti AJ, Pesapane R, Roy A, Statham M, Sacks B, Foley J. Diet composition analysis provides new management insights for a highly specialized endangered small mammal. PLoS One 2020; 15:e0240136. [PMID: 33007017 PMCID: PMC7531790 DOI: 10.1371/journal.pone.0240136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/20/2020] [Indexed: 01/04/2023] Open
Abstract
The critically endangered Amargosa vole (Microtus californicus scirpensis) is found only in rare marsh habitat near Tecopa, California in a plant community dominated by three-square bulrush (Schoenoplectus americanus). Since the earliest research on the Amargosa vole, the existing paradigm has been that these voles are obligatorily dependent on bulrush as their only food source and for the three-dimensional canopy and litter structure it provides for predator avoidance. However, no prior research has confirmed the diet of the Amargosa vole. In this study we characterized the Amargosa vole' nutritional needs, analyzed the quality of bulrush by forage analysis, and performed microhistological and metabarcoding analyses of vole feces to determine what foods were consumed in the wild. All bulrush plant tissues analyzed were low in fat (from 0.9% of dry matter in roots to 3.6% in seeds), high in neutral detergent fiber (from 5.9% in rhizomes to 33.6% in seeds), and low in protein (7.3-8.4%). These findings support the conclusion that bulrush alone is unlikely to support vole survival and reproduction. Fecal microhistology and DNA metabarcoding revealed relatively diverse diets including plants in 14 families, with rushes (Juncaceae), bulrushes (Cyperaceae), and grasses (Poaceae) being the most common diet items. On microhistology, all analyzed samples contained bulrush, sedges (Carex sp.), rushes (Juncus sp.), and beaked spikerush (Eleocharis rostrellata) even from marshes where non-bulrush plants were uncommon. There was evidence of insects at <1% in two marshes but none in the remaining marshes. Metabarcoding detected ten genera of plants. When considering non-Schoenoplectus targets, for which metabarcoding had poor sensitivity, saltgrass (Distichlis spicata) was the most commonly detected species, with prominent contributions from seaside arrowgrass (Triglochin concinna) and yerba mansa (Anemopsis californica) as well. Diversity of vole diets generally increased with increasing site plant diversity, but differences were not statistically significant. Confirming details about dietary behaviors is critical for informing appropriate conservation planning including habitat management and reintroduction of voles into new sites.
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Affiliation(s)
- Stephanie T. Castle
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States of America
- Wildlife Investigations Lab, California Department of Fish and Wildlife, Rancho Cordova, CA, United States of America
| | - Nora Allan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States of America
| | - Deana Clifford
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States of America
- Wildlife Investigations Lab, California Department of Fish and Wildlife, Rancho Cordova, CA, United States of America
| | - Cody M. Aylward
- Department of Fish, Wildlife and Conservation Biology, University of California, Davis, CA, United States of America
- Mammalian Ecology and Conservation Unit, Veterinary Genetics Laboratory, University of California, Davis, CA, United States of America
| | - Jon Ramsey
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, United States of America
| | - Andrea J. Fascetti
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, United States of America
| | - Risa Pesapane
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States of America
| | - Austin Roy
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States of America
| | - Mark Statham
- Mammalian Ecology and Conservation Unit, Veterinary Genetics Laboratory, University of California, Davis, CA, United States of America
| | - Benjamin Sacks
- Mammalian Ecology and Conservation Unit, Veterinary Genetics Laboratory, University of California, Davis, CA, United States of America
- Department of Population Health, and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, United States of America
| | - Janet Foley
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States of America
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Affiliation(s)
- Kohilan Gananandan
- General Medicine, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Benjamin Sacks
- Gastroenterology, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Iain Ewing
- Gastroenterology, Homerton University Hospital NHS Foundation Trust, London, UK
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Bobo E, Schroeppel DeBacker S, Fudim T, Underhill J, Sacks A, Vaidya A, Sacks B. 03:54 PM Abstract No. 99 Baseline Selectivity Index (SI) in adrenal venous sampling (AVS) is not necessarily invalid when <2. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Hynson J, Willims M, Sacks B, Gillam L. O-84 Triggers, tools and ‘tips for talking’ about ACP in paediatrics. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sarwar A, Brook O, Sacks A, Brennan I, Faintuch S, Ahmed M, Vaidya A, Sacks B. Comparison of simultaneous and simulated sequential adrenal venous sampling: all patients versus patients with treated lateralized disease. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Nguyen Q, Brook O, Faintuch S, Brennan I, Collares F, Sacks B, Ahmed M, Sarwar A. History and physical exam for the interventional radiologist: key clinical assessments and decision making prior to and following common IR procedures. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gupta E, Brook O, Brook A, Ahmed M, Goldberg S, Sacks B, Faintuch S. Radiofrequency ablation of aldosterone producing adenomas – long-term effects. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2014.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Johnson M, Brennan I, Ahmed M, Sacks B. Cone beam CT in percutaneous biliary interventions: a pictorial review. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Pedersen N, Liu H, Theilen G, Sacks B. The effects of dog breed development on genetic diversity and the relative influences of performance and conformation breeding. J Anim Breed Genet 2012; 130:236-48. [PMID: 23679949 DOI: 10.1111/jbg.12017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/02/2012] [Indexed: 12/22/2022]
Abstract
Genetic diversity was compared among eight dog breeds selected primarily for conformation (Standard Poodle, Italian Greyhound and show English Setter), conformation and performance (Brittany), predominantly performance (German Shorthaired and Wirehaired Pointers) or solely performance (field English Setter and Red Setter). Modern village dogs, which better reflect ancestral genetic diversity, were used as the standard. Four to seven maternal and one to two Y haplotypes were found per breed, with one usually dominant. Diversity of maternal haplotypes was greatest in village dogs, intermediate in performance breeds and lowest in conformation breeds. Maternal haplotype sharing occurred across all breeds, while Y haplotypes were more breed specific. Almost all paternal haplotypes were identified among village dogs, with the exception of the dominant Y haplotype in Brittanys, which has not been identified heretofore. The highest heterozygosity based on 24 autosomal microsatellites was found in village dogs and the lowest in conformation (show) breeds. Principal coordinate analysis indicated that conformation-type breeds were distinct from breeds heavily used for performance, the latter clustering more closely with village dogs. The Brittany, a well-established dual show and field breed, was also genetically intermediate between the conformation and performance breeds. The number of DLA-DRB1 alleles varied from 3 to 10 per breed with extensive sharing. SNPs across the wider DLA region were more frequently homozygous in all pure breeds than in village dogs. Compared with their village dog relatives, all modern breed dogs exhibit reduced genetic diversity. Genetic diversity was even more reduced among breeds under selection for show/conformation.
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Affiliation(s)
- N Pedersen
- Koret Foundation Center for Veterinary Genetics of the Center for Companion Animal Health, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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Salenius JP, Brennan JF, Miller A, Wang Y, Aretz T, Sacks B, Dasari RR, Feld MS. Biochemical composition of human peripheral arteries examined with near-infrared Raman spectroscopy. J Vasc Surg 1998; 27:710-9. [PMID: 9576085 DOI: 10.1016/s0741-5214(98)70237-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Near-infrared Raman spectroscopy provides an important new means of analyzing the chemical composition of the arterial wall. The objective of this study was to show that Raman spectroscopy can be used to evaluate the lipid and calcium salt contents of human peripheral arteries. The results extend a recently developed Raman-based method for analyzing the chemical composition of coronary arteries. METHODS AND RESULTS We studied 167 segments of carotid and femoral artery wall in various pathologic states. The Raman spectra from these samples was accurately modeled. The resulting chemical concentrations were compared with the amounts of cholesterol and calcium mineral determined at histologic evaluation by an experienced cardiovascular pathologist. Strong correlations between spectroscopic measurements and morphologic findings were demonstrated and validated the applicability of the method to peripheral arteries. CONCLUSIONS Raman spectroscopy can provide reliable histochemical information about peripheral and coronary arteries. Such information may help identify rupture-prone plaques before the onset of symptoms and allow aggressive and directed intervention. Accurate knowledge of the chemical composition of a lesion may be useful in selecting the most appropriate treatment.
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Affiliation(s)
- J P Salenius
- Department of Surgery, MetroWest Medical Center, Framingham, MA 01701, USA
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Chalhoub N, Gilluley P, Sacks B. A possible marker for Alzheimer's disease: In vivo detection with anticholinergic eye drops. Eur Psychiatry 1996. [DOI: 10.1016/0924-9338(96)88836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Abstract
The mydriatic response to eyedrops of the anticholinergic agent tropicamide at very low concentration (0.01%) has been studied in people with Down's syndrome. By comparison with healthy subjects people with Down's syndrome had responses approximately three times greater, suggesting a peripheral imbalance between cholinergic and adrenergic autonomic influences.
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Affiliation(s)
- B Sacks
- Department of Psychiatry, Charing Cross and Westminster Medical School, London
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Eisenberg H, Pallotta J, Sacks B, Brickman AS. Parathyroid localization, three-dimensional modeling, and percutaneous ablation techniques. Endocrinol Metab Clin North Am 1989; 18:659-700. [PMID: 2673767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
When available, state of the art noninvasive localization studies should be utilized routinely in previously unexplored patients for localizing parathyroid pathology, even when exceptional surgical experience exists. These studies can both minimize the 3 to 20% incidence of missed pathology and promote an approach of limited neck exploration with consequent lowering of morbidity, complications, and costs. Choice of imaging modalities for localizing these small masses is largely dependent on the level of state of the art of available equipment, the interest and experience of the performing physicians, and the attention to technical detail for each of the modalities at an individual institution. In choosing a single test, CT, and most recently cine CT with three-dimensional modeling, is favored because of higher probability of providing the kinds of information most useful to the surgeon. This includes precise anatomic localization and identification of locations likely to be missed by the surgeon (such as mediastinum, deep neck) and the capability for predicting multiple gland disease, for detecting smaller lesions, and for lower incidence of false-positive results. Ultrasound is attractive because of the low cost and noninvasiveness, and it is particularly sensitive in the thyroid region and upper neck. In difficult cases, CT, cine CT, and ultrasound may be augmented by needle aspiration of fluid for PTH assay. Thallium-technetium scanning and MRI are useful alternatives. In the previously explored patient and in patients with difficult diagnostic problems (such as ectopic adenoma, parathyroid carcinoma), the use of multiple noninvasive studies is strongly recommended, preferably CT (particularly, cine CT with three-dimensional imaging) and isotope scanning or MRI. The concurrence of two or more of these studies has a relatively high predictive value (82 to 88%) for localization. However, highly selective venous catheterization and selective magnification arteriography remain the most accurate modalities in these patients (91 to 95% sensitivity with few false-positive results) and may be combined with interventional radiologic techniques for tumor ablation in selected patients without compromising subsequent surgical alternatives. Stereotactic ablation techniques are in development.
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Pisanty S, Shoshan S, Chajek T, Maftsir G, Sacks B, BenEzra D. The effect of cyclosporin A (CsA) treatment on gingival tissue of patients with Behçet's disease. J Periodontol 1988; 59:599-603. [PMID: 3183921 DOI: 10.1902/jop.1988.59.9.599] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Gingival biopsies were obtained at various intervals for a period of two years from 12 patients suffering from Behçet's disease who were under a clinical trial of cyclosporin A (CsA) treatment. The levels of nondialyzable hydroxyproline (Hypro) were determined in the medium of the cultured tissues. Histologic examinations were also performed every three months. Correlations between the CsA blood levels and the levels of nondialyzable Hypro indicated a reciprocal relationship, especially at blood levels of CsA higher than 600 ng/ml. Histologic examination of gingival sections from CsA-treated patients showed swelling of the epithelial cells, formation of perinuclear clear zones, widening of intercellular gaps and formation of several basal cell layers. In addition, foci of PAS-positive material were found in both the epithelium and stroma. It is assumed that the gingival enlargement observed in the CsA-treated patients was not due to an increase in tissue collagen but rather to an increase in epithelium combined with an accumulation of noncollagenous extracellular matrix material.
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Affiliation(s)
- S Pisanty
- Department of Oral Medicine, Hadassah-Hebrew University Hospital, Jerusalem, Israel
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Come PC, Bivas NK, Sacks B, Thurer RL, Weintraub RM, Axelrod P. Unusual echographic findings in aortic dissection: diastolic prolapse of intimal flap into left ventricle. Am Heart J 1984; 107:790-2. [PMID: 6702574 DOI: 10.1016/0002-8703(84)90334-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Sacks B. Aliens and Alienists. Ethnic Minorities and Psychiatry. Postgrad Med J 1983. [DOI: 10.1136/pgmj.59.691.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Markisz JA, Front D, Royal HD, Sacks B, Parker JA, Kolodny GM. An evaluation of 99mTc-labeled red blood cell scintigraphy for the detection and localization of gastrointestinal bleeding sites. Gastroenterology 1982; 83:394-8. [PMID: 6979489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
99mTechnetium-labeled red blood cell scintigraphy was performed upon 39 patients with clinical evidence for acute lower gastrointestinal bleeding from an unknown source. Seventeen of 39 patients (44%) had a scan became positive 6 or more h after injection, consistent with intermittent bleeding, in 8 of 17 patients (47%). In the 11 patients in whom the bleeding site was definitely identified by arteriography, surgery, or colonoscopy, scintigraphy correctly localized the bleeding site in 10 of 11 patients (91%). Four of 11 patients (36%) had an active bleeding site identified by arteriography. Ten of 17 patients (58%) with a positive scan required either gelfoam embolization (4 patients) or surgery (6 patients) to control the bleeding, whereas only 1 of 22 patients (5%) required surgery when the scan was negative. Six deaths occurred in the scan-positive patients compared with no deaths in the scan-negative patients. None of the 8 patients who had arteriography and no active bleeding site by scintigraphy had arteriographically demonstrable active bleeding. Scintigraphy provides a reliable noninvasive test to screen patients in whom arteriography is being considered to localize active bleeding sites. If the arteriogram is negative, the scintigraphic findings alone may guide the surgical or arteriographic intervention. In addition, scintigraphy identifies two patient populations which have considerably different morbidity and mortality.
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Ellison H, Sacks B, Vine H, Palestrant A, Bartek S. The use of angiographic techniques for gastrointestinal intubations. Surg Gynecol Obstet 1982; 154:727-8. [PMID: 7071711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Lerner MA, Sacks B, Shapiro G. Retrograde flow in the left gonadal vein at abdominal angiography: an anatomo-physiological review and clinical assessment. Urol Radiol 1981; 3:149-60. [PMID: 7041393 DOI: 10.1007/bf02938783] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Retrograde flow in the left gonadal vein may be visualized in the venous phase of aortography or renal arteriography. In none of 13 cases was this due to a mass lesion at the renal hilum. Although the Valsalva maneuver may cause this flow reversal in some, in most cases it is due to anatomical structures or variants compressing the renal vein. These are detailed. Left gonadal vein reflux incidentally detected on the aortogram may thus indicate impaired left renal venous drainage and its consequences. There are also clinical and urographic constellations which merit aortography to detect left gonadal vein reflux for their elucidation.
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Come PC, Sacks B, Vine H, McArdle C, Koretsky S, Weintraub R. Ultrasonic visualization of the posterior thoracic aorta in long axis: diagnosis of a saccular mycotic aneurysm. Chest 1981; 79:470-2. [PMID: 6894420 DOI: 10.1378/chest.79.4.470] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
A saccular aneurysm arising from the descending thoracic aorta was identified ultrasonically in a 60-year-old man with a subsequent pathologic diagnosis of a Listeria monocytogenes mycotic aneurysm. A cross-sectional scanning technique, which permitted visualization of the descending thoracic aorta in long axis, demonstrated a 3 X 5 cm relatively echo-free mass between the heart and the aorta. A communication between the mass and the aorta established the diagnosis of an aneurysm.
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Abstract
Left ventricular thrombi have not been commonly recognized by M-mode or by cross-sectional echocardiographic techniques despite their frequency at postmortem examination in patients dying of cardiovascular disease. We discuss two patients, with left ventricular throbmi recognized echocardiographically and confirmed by pathologic and/or angiographic evaluation, whose M-mode and cross-sectional echocardiographic abnormalities add to the variable spectrum of appearance of left ventricularl thrombi. The sensitivity and specificity of echocardiographic techniques in the diagnosis of intracardiac thrombi are discussed.
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Monchik JM, Pallotta JA, Sacks B, Shimkin PM. Role of selective venous catheterization of the small thyroid veins as a diagnostic study in hypercalcemic states. Am J Surg 1980; 139:575-80. [PMID: 7369465 DOI: 10.1016/0002-9610(80)90340-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Previous studies of selective venous catheterization stress its value in localizing hyperfunctioning parathyroid tissue in patients with an established diagnosis of hyperparathyroidism. Our study presents our experience with selective venous catheterization as a diagnostic aid in differential diagnosis of hypercalcemia. In our four patients, an extensive metabolic work-up did not resolve the differential diagnosis of hypercalcemia, and selective venous catheterization provided the ultimate data that led to the correct diagnosis of hypercalcemia in each patient. Selective venous catheterization can be an important diagnostic study in carefully selected patients with hypercalcemia.
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Heyman S, Sacks B, Khettry J, Steer ML. Localization of bleeding small intestinal lesions using scanning techniques. Surgery 1979; 85:372-6. [PMID: 311956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Gastrointestinal bleeding remains a major diagnostic problem, and the commonly employed techniques of contrast radiography, endoscopy, and arteriography may not successfully localize the site and/or define the cause of gastrointestinal hemorrhage. Technetium-99m pertechnetate scanning has been useful in identifying Meckel's diverticula, and modifications of this technique may successfully identify highly vascular lesions responsible for gastrointestinal bleeding. A patient with recurrent hemorrhage from a leiomyosarcoma of the ileum is described. The lesion was identified with flow studies and immediate static imaging after injection of technetium-99m pertechnetate. In addition, the lesion was demonstrated by scanning using in vivo technetium-99m pertechnetate labelled autologous erythrocytes. The potential value of these scanning techniques as noninvasive tools for the localization and identification of lesions responsible for gastrointestinal bleeding is discussed.
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Hosein EA, Lapalme M, Sacks B, Wiseman-Distler M. Biphasic changes in rat brain mitochondrial membrane structure and enzyme activity after acute opiate administration to rats. Biochem Pharmacol 1979; 28:7-14. [PMID: 215169 DOI: 10.1016/0006-2952(79)90262-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
The so-called desmoid tumour is an important member of a group of conditions termed "the fibromatoses" which are characterised by an infiltrating fibroblastic proliferation without features of an inflammatory response. While desmoids most frequently arise in the anterior abdominal wall, they may also be extra-abdominal or intra-abdominal in location. Mesenteric desmoids are relatively rare. They may occur in association with Gardner's syndrome, especially following colectomy, or as an isolated abnormality in otherwise normal patients. In the present paper the authors describe the clinical, radiological and pathological findings in two patients with isolated mesenteric desmoids. The radiological differential diagnosis is also briefly discussed.
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Sacks B. Ophthalmology in the War Years
. (Vol. 1.) Meyer Wiener. (Ed.) Chicago: Year Book Publishers, 1946. Pp. x + 1166. $13.50. Science 1947. [DOI: 10.1126/science.105.2730.447.b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sacks B. Ophthalmology in the War Years
. (Vol. 1.) Meyer Wiener. (Ed.) Chicago: Year Book Publishers, 1946. Pp. x + 1166. $13.50. Science 1947. [DOI: 10.1126/science.105.2730.447-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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