Search

Objective To examine headache and depression over time in individuals who sustained mild traumatic brain injury (mTBI). Prevalence of headache and depression early after mTBI and at 1 year postinjury as well as the relationship between the two are evaluated. Background Headache is the most common physical symptom and depression is among the most common psychiatric diagnosis after traumatic brain injury regardless of severity. Headache and depression have been found to be two independent factors related to poor outcome after mTBI, yet there appears to be a paucity of research exploring the comorbidity of these two conditions after injury. Method/Design Longitudinal survey design over 1 year of 212 participants with mTBI who were admitted to a Level 1 trauma center for observation or other system injuries. Depression was based on a score ≥10 on the Patient Health Questionnaire-9. Headache was based on participant report of new or worse-than-preinjury headache since hospitalization (baseline) or within the previous 3 months at 1 year postinjury. Results The prevalence of headache and depression at baseline was 64% (135/212) and 15% (31/212), respectively. The prevalence of headache and depression at 1 year was 68% (127/187) and 27% (50/187), respectively. The co-occurrence of headache and depression increased from 11% (23/212) at baseline to 25% (46/187) at 1 year. At 1 year, the risk ratio of individuals who had headache to be depressed was 5.43 (95% CI 2.05-14.40) compared to those without headache ( P < .001). The corresponding risk ratio at baseline was 1.64 (95% CI .77-3.49; P = .23). Conclusions While prevalence of headache is consistently high over the first year after injury, rate of depression increased over the first year for those who were followed. Given the high rate of comorbidity, those with headache may develop depression over time. Evaluation for possible depression in those with headache after mTBI should be conducted to address both conditions over the year following injury. [ABSTRACT FROM AUTHOR]

Dietary patterns with cardiovascular benefits have been recommended, but the relative contributions of individual foods and food components, alone or in combination, remain undefined. Male ApoE−/− mice were fed either a purified AIN-93G control diet, a Western diet (WD), or a WD with 10% tomato powder (TP), 2% soy germ (SG), or the combination, for 4 wk ( n = 10 per group). Plasma total cholesterol and triglycerides were measured with enzymatic colorimetric kits, and serum amyloid A (SAA) was measured by ELISA. Liver lipids were extracted with chloroform:methanol, and triglycerides, free and esterified cholesterol measured with enzymatic colorimetric kits. Expression of Cyp27a1, Cyp7a1, Abcg5, and Abcg8 in the liver was determined by quantitative polymerase chain reaction. Sections of the aortic root and aorta were cut and stained with hematoxylin and eosin (H&E) to assess extent of atherosclerotic lesions. WD-fed animals had greater liver and adipose weights, plasma cholesterol and SAA, hepatic lipids, and atherosclerosis than AIN-93G animals. TP and SG did not decrease atherosclerosis as measured by H&E-stained sections of the aortic root, aortic arch, and descending aorta. The TP diets further increased plasma cholesterol, but also led to increased expression of the Abcg5/8 transporters involved in cholesterol efflux. Addition of SG alone to the WD attenuated WD-induced increases in plasma cholesterol, liver lipids, and gonadal adipose weight. The results of this study do not support the use of either TP or SG for reduction of atherosclerosis, but suggest some beneficial effects of SG on lipid metabolism in this model of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: Achieving optimal tumour coverage during craniospinal irradiation (CSI) is a challenge. Whilst several critical organs are at risk of radiation-induced toxicity, if target volume structures like the cribriform plate receive less than 95% of the prescribed dose, tumours could recur. Aim: This single-institution study seeks to establish the most effective craniospinal radiotherapy amongst 3D conformal radiation therapy (CRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) by comparing dosimetry across target volumes, organs at risk (OARs) and total irradiated volume. Time taken for contouring, generation and evaluation of treatment plans, quality assurance and treatment beam delivery is assessed. Setting: The demographics of patients comprised of six children and one adult who underwent 3D CRT craniospinal radiotherapy at a Western Cape hospital. Methods: Approval from the Human Research Ethics Committee was obtained. The 3D CRT plan consisted of two parallel opposing lateral fields at the cranial isocentre and a single posterior field at the spinal isocentre. Both the IMRT and VMAT plans comprised three isocentres, one cranial and two spinal, with a total of 15 fields. Results: Volumetric modulated arc therapy was the most conformal (CI = 0.48) and IMRT the most homogeneous (HI = 0.06). Although the VMAT low-dose bath (58.1%) was highest at 2 Gy, OARs were least exposed with VMAT. The total time taken for VMAT was the shortest. Conclusion: Volumetric modulated arc therapy was recommended as the most effective CSI technique owing to its superior conformality, least OARs exposure and fastest planning times. Clinical investigation into possible late adverse effects arising from the VMAT low-dose bath should be conducted. Contribution: This study will establish which of the three radiation therapy (RT) techniques is most effective in the treatment of craniospinal tumours, as well as, which technique offers the fastest turn around time. [ABSTRACT FROM AUTHOR]

The article describes the case of a vehicular accident patient who died because he did not undergo neurosurgeon based on the advise of the physician. Topics include the lack of trauma infrastructure of the doctors on duty, the reluctance of physicians to accept advice over the telephone, and the need for the speedy facilitation of urgent transfer of major trauma by consultants.

Discrete particle dynamics is one of the least understood aspects of river bedload transport, but in situ measurement of stone movement during floods poses a significant technical challenge. A promising approach to address this knowledge gap is to use sensors embedded within stones. Sensors must be waterproof and recoverable after being transported downstream and potentially buried by other sediment. To address this challenge rugged sensors (Kinematic Loggers) were developed for deployment inside stones (ranging in size from cobbles to boulders) during floods. The sensors feature a 9-axis inertial measurement unit, 3-axis high-g accelerometer, 128 MB flash memory, and a 433 MHz LoRa radio transmission module for sensor recovery. The sensors are enclosed in rugged waterproof housings for deployment in extreme conditions (i.e., bedload transport during floods). Novel relay units and drone-based recovery systems were also developed for finding the sensors after field deployments. Firmware to control the sensors and relay units was developed, as well as software for configuring the sensors and an android application for communicating with the sensors via the LoRa radio transmission module. This paper covers the technical development of the sensors, mounting them inside stones, and field recovery tests. Although designed for measurement of coarse bedload transport and particle dynamics during floods, the sensors are equally applicable for deployment in other harsh environments, such as to study landslide and rockfall dynamics. [ABSTRACT FROM AUTHOR]