Neurology
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In 1968, publication of the Harvard committee's report concerning "irreversible coma" established a paradigm for defining death by neurologic criteria (brain death [BD]). Five years earlier, Dr. ⋯ To put those events into present-day perspective, the author reviewed the proceedings of a Ciba Symposium held in London in 1966 at which Alexandre introduced his pioneering view, obtaining information and documents from Alexandre and others who attended that meeting. Comparing Alexandre's approach with the Harvard report and later advances helps in understanding how both defining death by brain criteria and transplanting organs from a brain-dead donor have become morally tolerable today.
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To describe the diagnostic classification of subjects with incident vascular dementia (VaD) participating in the Cardiovascular Health Study (CHS) Cognition Study. ⋯ None of the clinical criteria for VaD identified the same group of subjects. The diagnosis of vascular dementia is difficult in epidemiologic studies because poststroke dementia can be due to Alzheimer disease (AD) and evidence of vascular disease can be found in the MRI of dementia cases without clinical strokes. Whether the clinical progression is related to AD pathology or vascular disease is difficult to establish.
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To examine the severity of impairments in the decision-making abilities (understanding, appreciation, reasoning, and choice) and competency to make a decision to use an Alzheimer disease (AD)-slowing medication in patients with AD and the relationships between these impairments, insight, and overall cognition. ⋯ Persons with mild to moderate Alzheimer disease (AD) have notable impairments in their ability to make an AD treatment decision, especially persons with moderate AD and persons who lack awareness of symptoms, prognosis, or diagnosis.