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Article ; Online: Functional seizures are associated with cerebrovascular disease and functional stroke is more common in patients with functional seizures than epileptic seizures.

Fox, Jonah / Goleva, Slavina B / Haas, Kevin F / Davis, Lea K

2022 Volume 128, Page(s) 108582

Abstract: Purpose: To characterize the relationship between functional seizures (FSe), cerebrovascular disease (CVD), and functional stroke.: Method: A retrospective case-control study of 189 patients at a single large tertiary medical center. We performed a ... ...

Abstract	Purpose: To characterize the relationship between functional seizures (FSe), cerebrovascular disease (CVD), and functional stroke. Method: A retrospective case-control study of 189 patients at a single large tertiary medical center. We performed a manual chart review of medical records of patients with FSe or epileptic seizures (ES), who also had ICD code evidence of CVD. The clinical characteristics of FSe, ES, CVD, and functional stroke were recorded. Logistic regression and Welch's t-tests were used to evaluate the differences between the FSe and ES groups. Results: Cerebrovascular disease was confirmed in 58.7% and 87.6% of patients with FSe or ES through manual chart review. Stroke was significantly more common in patients with ES (76.29%) than FSe (43.48%) (p = 4.07 × 10 Conclusion: Our results confirm the initial observation of increased CVD in patients with FSe and further suggest that patients with FSe may be predisposed to developing another functional neurological disorder (FND) (i.e., functional stroke). We speculate that this may be due to shared risk factors and pathophysiological processes that are common to various manifestations of FND.
MeSH term(s)	Case-Control Studies ; Cerebrovascular Disorders/complications ; Cerebrovascular Disorders/epidemiology ; Electroencephalography/methods ; Female ; Humans ; Male ; Retrospective Studies ; Seizures/complications ; Seizures/epidemiology ; Stroke/complications ; Stroke/epidemiology
Language	English
Publishing date	2022-02-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2022.108582
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Article ; Online: Altered 5-HT2A/C receptor binding in the medulla oblongata in the sudden infant death syndrome (SIDS): Part II. Age-associated alterations in serotonin receptor binding profiles within medullary nuclei supporting cardiorespiratory homeostasis.

Cummings, Kevin J / Leiter, James C / Trachtenberg, Felicia L / Okaty, Benjamin W / Darnall, Robert A / Haas, Elisabeth A / Harper, Ronald M / Nattie, Eugene E / Krous, Henry F / Mena, Othon J / Richerson, George B / Dymecki, Susan M / Kinney, Hannah C / Haynes, Robin L

Journal of neuropathology and experimental neurology

2024 Volume 83, Issue 3, Page(s) 144–160

Abstract: The failure of chemoreflexes, arousal, and/or autoresuscitation to asphyxia may underlie some sudden infant death syndrome (SIDS) cases. In Part I, we showed that some SIDS infants had altered 5-hydroxytryptamine (5-HT)2A/C receptor binding in medullary ... ...

Abstract	The failure of chemoreflexes, arousal, and/or autoresuscitation to asphyxia may underlie some sudden infant death syndrome (SIDS) cases. In Part I, we showed that some SIDS infants had altered 5-hydroxytryptamine (5-HT)2A/C receptor binding in medullary nuclei supporting chemoreflexes, arousal, and autoresuscitation. Here, using the same dataset, we tested the hypotheses that the prevalence of low 5-HT1A and/or 5-HT2A/C receptor binding (defined as levels below the 95% confidence interval of controls-a new approach), and the percentages of nuclei affected are greater in SIDS versus controls, and that the distribution of low binding varied with age of death. The prevalence and percentage of nuclei with low 5-HT1A and 5-HT2A/C binding in SIDS were twice that of controls. The percentage of nuclei with low 5-HT2A/C binding was greater in older SIDS infants. In >80% of older SIDS infants, low 5-HT2A/C binding characterized the hypoglossal nucleus, vagal dorsal nucleus, nucleus of solitary tract, and nuclei of the olivocerebellar subnetwork (important for blood pressure regulation). Together, our findings from SIDS infants and from animal models of serotonergic dysfunction suggest that some SIDS cases represent a serotonopathy. We present new hypotheses, yet to be tested, about how defects within serotonergic subnetworks may lead to SIDS.
MeSH term(s)	Infant ; Animals ; Humans ; Aged ; Sudden Infant Death ; Medulla Oblongata/metabolism ; Serotonin/metabolism ; Receptors, Serotonin/metabolism
Chemical Substances	Serotonin (333DO1RDJY) ; Receptors, Serotonin
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3088-0
ISSN	1554-6578 ; 0022-3069
ISSN (online)	1554-6578
ISSN	0022-3069
DOI	10.1093/jnen/nlae004
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Article ; Online: Experience From 211 Transcortical Selective Amygdalohippocampectomy Procedures: Relevant Surgical Anatomy and Review of the Literature.

Ali, Rushna / Englot, Dario J / Yu, Hong / Naftel, Robert / Haas, Kevin F / Konrad, Peter E

Operative neurosurgery (Hagerstown, Md.)

2021 Volume 21, Issue 4, Page(s) 181–188

Abstract: Background: Selective amygdalohippocampectomy (SelAH) is designed to treat medically refractory mesial temporal lobe epilepsy with reduced morbidity compared to standard anterior temporal lobectomy. At our institution, we perform SelAH via a ... ...

Abstract	Background: Selective amygdalohippocampectomy (SelAH) is designed to treat medically refractory mesial temporal lobe epilepsy with reduced morbidity compared to standard anterior temporal lobectomy. At our institution, we perform SelAH via a transcortical approach via small corticectomy in the middle temporal gyrus. Objective: To discuss the surgical anatomy and nuances of SelAH, share our institutional experience, and perform a review of literature. Methods: Institutional experience was recorded by collecting demographic and outcome data from 1999 to 2017 under an Institutional Review Board protocol in a prospective manner using a REDCap database. Results: A total of 211 SelAH procedures were performed at our institution between 1999 and 2017. Of these patients, 54% (113/211) were females. The average age at surgery was 39.4 yr. Two-year Engel outcome data were available for 168 patients, of which 73% (123/168) had Engel I outcomes. Engel II outcomes were reported in 16.6% (28/168), III in 4.7% (8/168), and IV in 5.3% (9/168). Our review of literature showed that this is comparable to the seizure freedom rates reported by other groups. We then reviewed our surgical methodology based on operative reports and created illustrations of the surgical anatomy of temporal lobe approach. These illustrations were compared with postoperative magnetic resonance imaging to provide a better 3D understanding of the complex architecture of mesial temporal structures. Conclusion: SelAH is a minimally invasive, safe, and effective approach for the treatment of medically refractory epilepsy with good surgical outcomes and low morbidity. We feel that mastering the complex anatomy of this approach helps achieve successful outcomes.
MeSH term(s)	Amygdala/surgery ; Epilepsy, Temporal Lobe/diagnostic imaging ; Epilepsy, Temporal Lobe/surgery ; Female ; Hippocampus/surgery ; Humans ; Prospective Studies ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-07-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1093/ons/opab206
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Zs.A 1424 -ON-: Show issues

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Article ; Online: Risk of Cancer After Diagnosis of Cardiovascular Disease.

Bell, Caitlin F / Lei, Xiudong / Haas, Allen / Baylis, Richard A / Gao, Hua / Luo, Lingfeng / Giordano, Sharon H / Wehner, Mackenzie R / Nead, Kevin T / Leeper, Nicholas J

JACC. CardioOncology

2023 Volume 5, Issue 4, Page(s) 431–440

Abstract: Background: Cardiovascular disease (CVD) and cancer share several risk factors. Although preclinical models show that various types of CVD can accelerate cancer progression, clinical studies have not determined the impact of atherosclerosis on cancer ... ...

Abstract	Background: Cardiovascular disease (CVD) and cancer share several risk factors. Although preclinical models show that various types of CVD can accelerate cancer progression, clinical studies have not determined the impact of atherosclerosis on cancer risk. Objectives: The objective of this study was to determine whether CVD, especially atherosclerotic CVD, is independently associated with incident cancer. Methods: Using IBM MarketScan claims data from over 130 million individuals, 27 million cancer-free subjects with a minimum of 36 months of follow-up data were identified. Individuals were stratified by presence or absence of CVD, time-varying analysis with multivariable adjustment for cardiovascular risk factors was performed, and cumulative risk of cancer was calculated. Additional analyses were performed according to CVD type (atherosclerotic vs nonatherosclerotic) and cancer subtype. Results: Among 27,195,088 individuals, those with CVD were 13% more likely to develop cancer than those without CVD (HR: 1.13; 95% CI: 1.12-1.13). Results were more pronounced for individuals with atherosclerotic CVD (aCVD), who had a higher risk of cancer than those without CVD (HR: 1.20; 95% CI: 1.19-1.21). aCVD also conferred a higher risk of cancer compared with those with nonatherosclerotic CVD (HR: 1.11; 95% CI: 1.11-1.12). Cancer subtype analyses showed specific associations of aCVD with several malignancies, including lung, bladder, liver, colon, and other hematologic cancers. Conclusions: Individuals with CVD have an increased risk of developing cancer compared with those without CVD. This association may be driven in part by the relationship of atherosclerosis with specific cancer subtypes, which persists after controlling for conventional risk factors.
Language	English
Publishing date	2023-04-11
Publishing country	United States
Document type	Journal Article
ISSN	2666-0873
ISSN (online)	2666-0873
DOI	10.1016/j.jaccao.2023.01.010
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Article ; Online: Pathways to IUD and implant insertion in general practice: a secondary analysis of the ACCORd study.

Mazza, Danielle / Watson, Cathy J / Taft, Angela / Lucke, Jayne / McGeechan, Kevin / Haas, Marion / McNamee, Kathleen / Peipert, Jeffrey F / Black, Kirsten I

Australian journal of primary health

2023 Volume 29, Issue 3, Page(s) 222–228

Abstract: Background: Despite recommendations, long-acting reversible contraceptives (LARC) are not always offered as first-line contraceptives in general practice. This study aimed to describe pathways used by women for insertion of LARC.: Methods: This is a ... ...

Abstract	Background: Despite recommendations, long-acting reversible contraceptives (LARC) are not always offered as first-line contraceptives in general practice. This study aimed to describe pathways used by women for insertion of LARC. Methods: This is a secondary analysis of data from the Australian Contraceptives ChOice pRoject (ACCORd), a cluster randomised controlled trial set in 57 general practices in Melbourne, Australia. We investigated whether an educational intervention for general practitioners (GPs) and a rapid LARC insertion clinic increased LARC uptake. The main outcome measures were the type of health service, location/provider of intrauterine device (IUD) insertion; time to insertion; and distance travelled for IUD insertion. Results: During ACCORd, 149 women had LARC insertion. IUD training was reported by 37% of GPs, but only 12% inserted them. In contrast, 70% of GPs inserted implants and 95% of women accessed implant insertion through their own general practice. LARC rapid referral clinics were used by 52% (13/25) of intervention GPs, where 71% (41/56) of IUD insertions occurred in these clinics (but no implants). There was no difference in the mean time from referral to IUD insertion between women attending intervention and control GPs (mean days 37.6vs 32.7; P =0.61). GPs (including IUD inserters) used a variety of referral pathways for IUD insertion, including public and private clinics, and other GPs. Women travelled up to 90km for IUD insertion. Conclusions: Although implant insertion has been integrated into general practice, few GPs insert IUDs. Where the option exists for GPs to refer to a LARC rapid referral clinic, the majority of IUD insertions will take place there. Establishing a network of such clinics Australia wide may both increase IUD uptake and address the extensive need for GP training in IUD insertion.
MeSH term(s)	Humans ; Female ; Australia ; Intrauterine Devices ; General Practice ; Family Practice ; Contraceptive Agents
Chemical Substances	Contraceptive Agents
Language	English
Publishing date	2023-04-30
Publishing country	Australia
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2566332-X
ISSN	1836-7399 ; 1448-7527
ISSN (online)	1836-7399
ISSN	1448-7527
DOI	10.1071/PY22265
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Article ; Online: Enhanced rates of detection and treatment of depression and anxiety disorders among adult patients with epilepsy using automated EMR-based screening.

Fox, Jonah / Wood, Mitchell F / Phillips, Sharon E / Crudele, Angela / Haas, Kevin F / Abou-Khalil, Bassel W / Sonmezturk, Hasan H

Epilepsy & behavior : E&B

2021 Volume 123, Page(s) 108259

Abstract: Objective: Depression and anxiety disorders are common among patients with epilepsy (PWE). These comorbidities have been shown to influence prognosis and may have a greater impact on quality of life than seizure control. Despite guideline ... ...

Abstract	Objective: Depression and anxiety disorders are common among patients with epilepsy (PWE). These comorbidities have been shown to influence prognosis and may have a greater impact on quality of life than seizure control. Despite guideline recommendations and expert consensus to regularly screen for and treat both conditions, there is evidence that they are underdiagnosed and undertreated. Our goal was to test a novel screening method to determine if it would increase the rate of detecting and treating depression and anxiety disorders among PWE. Method: The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the Brief Epilepsy Anxiety Survey Instrument (brEASI) were selected as validated screening instruments for depression and anxiety disorders, respectively. They were sent via an electronic medical record-linked patient portal to all patients of four epileptologists 48 h prior to their clinic appointment. We evaluated whether this increased the rate of detecting and treating depression and anxiety disorders relative to a historical control group. Results: A total of 563 patients were included of whom 351 were sent the screening instruments. 62.7% of patients completed the screening instruments of whom 47.7% screened positive for either depression only (16.4%), anxiety disorders only (5.5%) or both (25.9%); a statistically significant increase relative to the control group. There was also a significantly increased proportion of patients for whom treatment was initiated for depression (p < 0.01), anxiety disorders (p < 0.01), or both (p < 0.01). Conclusions: We identified an easily applicable and efficient means of enhancing detection and treatment rates for depression and anxiety disorders among PWE in a busy clinic setting.
MeSH term(s)	Adult ; Anxiety/diagnosis ; Anxiety/epidemiology ; Anxiety Disorders/diagnosis ; Anxiety Disorders/epidemiology ; Anxiety Disorders/therapy ; Depression/diagnosis ; Depression/epidemiology ; Electronic Health Records ; Epilepsy/complications ; Epilepsy/diagnosis ; Epilepsy/epidemiology ; Humans ; Psychiatric Status Rating Scales ; Quality of Life ; Reproducibility of Results
Language	English
Publishing date	2021-08-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2021.108259
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Article ; Online: Epidemiology of Functional Seizures Among Adults Treated at a University Hospital.

Goleva, Slavina B / Lake, Allison M / Torstenson, Eric S / Haas, Kevin F / Davis, Lea K

JAMA network open

2020 Volume 3, Issue 12, Page(s) e2027920

Abstract: Importance: Functional seizures (formerly psychogenic nonepileptic seizures), paroxysmal episodes that are often similar to epileptic seizures in their clinical presentation and display no aberrant brain electrical patterns, are understudied. Patients ... ...

Abstract	Importance: Functional seizures (formerly psychogenic nonepileptic seizures), paroxysmal episodes that are often similar to epileptic seizures in their clinical presentation and display no aberrant brain electrical patterns, are understudied. Patients experience a long diagnostic delay, few treatment modalities, a high rate of comorbidities, and significant stigma due to the lack of knowledge about functional seizures. Objective: To characterize the clinical epidemiology of a population of patients with functional seizures observed at Vanderbilt University Medical Center (VUMC). Design, setting, and participants: This case-control study included patients with functional seizures identified in the VUMC electronic health record (VUMC-EHR) system from October 1989 to October 2018. Patients with epilepsy were excluded from the study and all remaining patients in the VUMC medical center system were used as controls. In total, the study included 1431 patients diagnosed with functional seizures, 2251 with epilepsy and functional seizures, 4715 with epilepsy without functional seizures, and 502 200 control patients who received treatment at VUMC for a minimum of a 3 years. Data were analyzed from November 2018 to March 2020. Exposure: Diagnosis of functional seizures, as identified from the VUMC-EHR system by an automated phenotyping algorithm that incorporated International Classification of Diseases, Ninth Revision (ICD-9) codes, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, Current Procedural Terminology codes, and natural language processing. Main outcomes and measures: Associations of functional seizures with comorbidities and risk factors, measured in odds ratios (ORs). Results: Of 2 346 808 total patients in the VUMC-EHR aged 18 years or older, 3341 patients with functional seizures were identified (period prevalence, 0.14%), 1062 (74.2%) of whom were women and for which the median (interquartile range) age was 49.3 (39.4-59.9) years. This assessment replicated previously reported associations with psychiatric disorders including posttraumatic stress disorder (PTSD) (OR, 1.22; 95% CI, 1.21-1.24; P < 3.02 × 10-5), anxiety (OR, 1.14; 95% CI, 1.13-1.15; P < 3.02 × 10-5), and depression (OR, 1.14; 95% CI, 1.13-1.15; P < 3.02 × 10-5), and identified novel associations with cerebrovascular disease (OR, 1.08; 95% CI, 1.06-1.09; P < 3.02 × 10-5). An association was found between functional seizures and the known risk factor sexual assault trauma (OR, 10.26; 95% CI, 10.09-10.44; P < 3.02 × 10-5), and sexual assault trauma was found to mediate nearly a quarter of the association between female sex and functional seizures in the VUMC-EHR. Conclusions and relevance: This case-control study found evidence to support previously reported associations, discovered new associations between functional seizures and PTSD, anxiety, and depression. An association between cerebrovascular disease and functional seizures was also found. Results suggested that sexual trauma may be a mediating factor in the association between female sex and functional seizures.
MeSH term(s)	Adult ; Anxiety/epidemiology ; Case-Control Studies ; Comorbidity ; Delayed Diagnosis ; Depression/epidemiology ; Female ; Hospitals, University/statistics & numerical data ; Humans ; Male ; Mental Disorders/epidemiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Seizures/epidemiology ; Seizures/etiology ; Seizures/psychology ; Stress Disorders, Post-Traumatic/epidemiology
Language	English
Publishing date	2020-12-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2020.27920
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Article: Professional Values: Results of a Scoping Review and Preliminary Canadian Survey.

Boyczuk, Alana M / Deloyer, Jamie J / Ferrigan, Kyle F / Muncaster, Kevin M / Dal Bello-Haas, Vanina / Miller, Patricia A

Physiotherapy Canada. Physiotherapie Canada

2019 Volume 71, Issue 2, Page(s) 134–143

Abstract: ... ...

Abstract	Purpose
Language	English
Publishing date	2019-04-30
Publishing country	Canada
Document type	Journal Article
ZDB-ID	639189-8
ISSN	1708-8313 ; 0300-0508
ISSN (online)	1708-8313
ISSN	0300-0508
DOI	10.3138/ptc.2017-70.e
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Article ; Online: Sustainable and effective methods to increase long-acting reversible contraception uptake from the ACCORd general practice trial.

Taft, Angela / Watson, Cathy J / McCarthy, Edwina / Black, Kirsten I / Lucke, Jayne / McGeechan, Kevin / Haas, Marion / McNamee, Kathleen / Peipert, Jeffrey F / Mazza, Danielle

Australian and New Zealand journal of public health

2022 Volume 46, Issue 4, Page(s) 540–544

Abstract: Objective: Most Australian women access contraception through general practitioners (GPs) but choose oral methods rather than long-acting reversible contraceptives (LARCS). The Australian Contraceptive ChOice pRoject (ACCORd) successfully tested a ... ...

Abstract	Objective: Most Australian women access contraception through general practitioners (GPs) but choose oral methods rather than long-acting reversible contraceptives (LARCS). The Australian Contraceptive ChOice pRoject (ACCORd) successfully tested a complex intervention for LARC uptake. We aimed to explore the critical elements of this intervention to increase LARC uptake. Design: ACCORd was a cluster randomised control trial conducted in 57 GP clinics in Melbourne, Australia. To explore intervention impact, fidelity checks (n=21 GPs) and interviews with 37 GPs and 40 patients were undertaken 12 months after initial consultations. Data were inductively coded, thematically analysed and mapped to Normalization Process Theory constructs. Results: Doctors understood the importance of effectiveness-based contraceptive counselling (EBCC). GPs demonstrated cognitive engagement in the promotion of LARC and some appreciated the rapid referral pathways. GPs and women valued the effectiveness approach. GPs held varying views about having a rapid referral pathway, with many already having established pathways in place. Some GPs viewed intrauterine device insertion costs or insertion training as barriers to ongoing practice. Most GPs and women saw the ACCORD model as effective and sustainable. Conclusions: GP training in EBCC and the use of rapid referral pathways were critical features of an effective sustainable model for successful uptake of LARCs in primary care. Implications for public health: Improving Australian women's access to and use of LARCs is sustainable with EBCC training and support for general practitioners.
MeSH term(s)	Australia ; Contraception ; Contraceptive Agents, Female ; Female ; General Practice ; General Practitioners/psychology ; Humans ; Long-Acting Reversible Contraception
Chemical Substances	Contraceptive Agents, Female
Language	English
Publishing date	2022-05-12
Publishing country	Australia
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1323548-5
ISSN	1753-6405 ; 1326-0200
ISSN (online)	1753-6405
ISSN	1326-0200
DOI	10.1111/1753-6405.13242
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Article ; Online: Increasing the uptake of long-acting reversible contraception in general practice

Danielle Mazza / Kevin McGeechan / Kirsten I Black / Cathy J Watson / Marion Haas / Jeffrey F Peipert / Jayne Lucke

BMJ Open, Vol 10, Iss

the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial longitudinal follow-up protocol

2020 Volume 9

Keywords	Medicine ; R
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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