Age Related Outcome in Acute Subdural Haematoma Following Traumatic Head Injury

Acute subdural haematoma (ASDH) is one of the conditions most strongly associated with severe brain injury. Reports prior to 1980 describe overall mortality rates for acute subdural haematomas (SDH's) ranging from 40% to 90% with poor outcomes observed in all age groups. Recently, improved results have been reported with rapid diagnosis and surgical treatment. The elderly are predisposed to bleeding due to normal cerebral atrophy related to aging, stretching the bridging veins from the dura. Prognosis in ASDH is associated with age, time from injury to treatment, presence of pupillary abnormalities, Glasgow Coma Score (GCS) or motor score on admission, immediate coma or lucid interval, computerized tomography findings (haematoma volume, degree of midline shift, associated intradural lesion, compression of basal cisterns), post-operative intracranial pressure and type of surgery. Advancing age is known to be a determinant of outcome in head injury. The authors present the results of a retrospective study carried out in Beaumont Hospital, Dublin, Ireland's national neurosurgical centre. The aim of this study was to examine the impact of age on outcome in patients with ASDH following severe head injury. Only cases with acute subdural haematoma requiring surgical evacuation were recruited.

Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders

Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders - NICE Guidance

Health Related Behaviour Questionnaire

The Health-Related Behaviour Questionnaire (HRBQ) was first developed in 1976 for use in secondary schools [PDF] and adapted for use in primary schools [PDF] in 1988. The HRBQ provides baseline data to identify priorities for health education planning, assessments and intervention programmes. Teachers and the medical professions have shaped the content of the HRBQ to reflect the needs of the users. http://sheu.org.uk/content/page/secondary-schools-health-related-behavio...

Choosing health. A briefing on reducing alcohol-related harm and encouraging sensible drinking in London

A briefing on reducing alcohol-related harm and encouraging sensible drinking in London. It forms part of the LHO's series of briefings on Choosing Health. It focuses on inequalities in alcohol use, alcohol related health inequalities, and alcohol-related harm and areas of best practice. It also summaries areas of possible action.

The tobacco industry's past role in weight control related to smoking.

BACKGROUND: Smoking is thought to produce an appetite-suppressing effect by many smokers. Thus, the fear of body weight gain often outweighs the perception of health benefits associated with smoking cessation, particularly in adolescents. We examined whether the tobacco industry played a role in appetite and body weight control related to smoking and smoking cessation. METHODS: We performed a systematic search within the archives of six major US and UK tobacco companies (American Tobacco, Philip Morris, RJ Reynolds, Lorillard, Brown & Williamson and British American Tobacco) that were Defendants in tobacco litigation settled in 1998. Findings are dated from 1949 to 1999. RESULTS: The documents revealed the strategies planned and used by the industry to enhance effects of smoking on weight and appetite, mostly by chemical modifications of cigarettes contents. Appetite-suppressant molecules, such as tartaric acid and 2-acetylpyridine were added to some cigarettes. CONCLUSION: These tobacco companies played an active and not disclaimed role in the anti-appetite effects of smoking, at least in the past, by adding appetite-suppressant molecules into their cigarettes.

Postmortem findings in bone cement implantation syndrome-related deaths.

Several mechanisms have been postulated as potentially involved in life-threatening complications during cemented surgery. In this study, we evaluated the role of anaphylaxis and pulmonary fat embolism in the pathophysiology of bone cement implantation syndrome in a series of fatal cases that underwent medicolegal investigations. Postmortem findings in these cases were compared with those obtained from individuals who died after other injuries and/or interventions and in which activated mast cells and pulmonary fat embolism were involved in the pathogenesis of death. Fifty subjects were selected including 6 individuals who had undergone cemented total hip arthroplasty and died intraoperatively, 32 subjects who died shortly after being involved in traffic accidents, 8 individuals who died shortly after the injection of contrast material, and 4 subjects who had undergone orthopedic surgery and died postoperatively. Massive pulmonary fat embolism was determined to be the cause of death in all the 6 subjects who died intraoperatively as well as the main cause of death in traffic-road victims with rapid respiratory function deterioration. Mast cell activation was identified exclusively in the group of subjects who died shortly after contrast material administration. Massive pulmonary fat embolism appears to be the most important factor responsible for severe cardiorespiratory function deterioration during cemented arthroplasty. Cardiac comorbidities can also significantly influence the severity of intraoperative complications, thus corroborating the hypothesis of a multifactorial model in the pathogenesis of bone cement implantation syndrome.

Version brève du DISCERN, une voie d'amélioration de la recherche d'information médicale sur le net [Brief-DISCERN, a possible way to improve patient's search on the health-related web]

Internet is increasingly used as a source of information on health issues and is probably a major source of patients' empowerment. This process is however limited by the frequently poor quality of web-based health information designed for consumers. A better diffusion of information about criteria defining the quality of the content of websites, and about useful methods designed for searching such needed information, could be particularly useful to patients and their relatives. A brief, six-items DISCERN version, characterized by a high specificity for detecting websites with good or very good content quality was recently developed. This tool could facilitate the identification of high-quality information on the web by patients and may improve the empowerment process initiated by the development of the health-related web.

The tobacco industry's past role in weight control related to smoking

Résumé (français)ContexteLe tabagisme est connu pour produire un effet coupe-faim chez la plupart des fumeurs. La crainte de la prise de poids à l'arrêt de la cigarette l'emporte souvent sur la perception des bénéfices sur la santé associés à l'abandon du tabac, particulièrement chez les adolescents. Nous avons examiné quel a été le rôle de l'industrie du tabac dans cet effet de la fumée sur l'appétit et sur le contrôle du poids.MéthodesNous avons réalisé une recherche systématique dans les archives de six grandes compagnies de tabac américaines et du Royaume-Uni (American Tobacco, Philip Morris, RJ Reynolds, Lorillard, Brown & Williamson et British American Tobacco) qui avaient été mises en cause dans les procès du tabac en 1998 aux Etats-Unis. Les résultats concernent les années 1949 à 1999.RésultatsLes archives de ces industries montrent qu'elles ont mis au point et ont utilisé diverses stratégies pour améliorer les effets du tabagisme sur le poids et l'appétit, la plupart du temps en réalisant des modifications chimiques des cigarettes. Des substances coupe-faim, telles que l'acide tartrique et le 2-acétylpyridine ont notamment été ajoutées aux cigarettes.ConclusionEn tout cas par le passé, ces compagnies de tabac ont activement modifié leurs cigarettes afin d'en augmenter l'effet de diminution de l'appétit, notamment en y ajoutant des substances coupe-faim.

Jasmonates and related oxylipins in plant responses to pathogenesis and herbivory.

The vigorous production of oxygenated fatty acids (oxylipins) is a characteristic response to pathogenesis and herbivory, and is often accompanied by the substantial release of small and reactive lipid-fragmentation products. Some oxylipins, most notably those of the jasmonate family, have key roles as potent regulators. Recent advances have been made in understanding oxylipin-regulated signal transduction in response to attack. Much jasmonate signaling takes place via a genetically defined signal network that is linked to the ethylene, auxin, and salicylic acid signal pathways, but a second aspect of jasmonate signaling is emerging. Some jasmonates and several newly discovered cyclopentenone lipids can activate or repress gene expression through the activities of a conserved electrophilic atom group.

Related factors to human toxocariasis in a rural community of Argentina

The objective of this study was to evaluate the relationship between toxocariasis frequency and demographic, environmental, sanitary variables, eosinophylia, and other intestinal parasites in a rural population of Argentina. Serological examination of 100 individuals was carried out by using ELISA technique for the detection of anti-toxocara antibodies. Eosinophiles in peripheral blood, presence of intestinal parasites, and demographic, environmental, and socio-cultural data were evaluated. Eighty-one feces samples of dogs belonging to the studied people were analyzed to detect eggs of Toxocara canis. Thirty of them were from 30 dogs and 51 were pools from dog feces. Samples of dirt from around the homes (n: 47) and from public park (n: 4) were taken. To determine the associations, the c² and Fisher tests were used. The seroprevalence was 23%. Eosinophilia in peripheral blood was detected in 86.95% seropositive individuals and in 37.66% seronegative individuals (p < 0.001, OR = 11.03). Of the 23 people with positive serology, 69.56% had at least one intestinal parasite. All individuals with positive serology had dogs in their homes. Among the dog owners there was a significant association between the presence of anti-toxocara antibodies and home flooding. Eggs of T. canis were detected in the feces of 5/81 dogs and three of these dogs belonged to individuals with positive serology. Eggs of Toxocara spp. were found in 41.17% of the dirt samples, eight of which came from the area surrounding the homes of individuals with positive serology (p = 0.032; OR = 4.36). Taking into account all the variables influencing the frequency of toxocariasis in this population, the implementation of Public Health programs specifically focused on anti-parasitic treatment of dogs is recommended.

Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella spp. infection among hospitalized patients

Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. have become a major problem all around the world. This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens, and also because this kind of resistance can spread to a wide variety of Gram-negative bacilli. Our objectives wereto evaluate among in-patients at a publicuniversity tertiary-care hospital with documented infection due to Klebsiella spp., which were the risk factors (cross-sectional analysis) and the clinical impact (prospective cohort) associated with an ESBL-producing strain. Study subjects were all patients admitted at the study hospital between April 2002 and October 2003, with a clinically and microbiologically confirmed infection caused by Klebsiella spp. at any body site, except infections restricted to the urinary tract. Of the 104 patients studied, 47 were infected with an ESBL-producing strain and 57 with a non-ESBL-producing strain. Independent risk factors associated with infection with an ESBL-producing strain were young age, exposure to mechanical ventilation, central venous catheter, use of any antimicrobial agent, and particularly use of a 4th generation cephalosporin or a quinolone. Length of stay was significant longer for patients infected with ESBL-producing strains than for those infected with non-ESBL-producing strains, although fatality rate was not significantly affected by ESBL-production in this cohort. In fact, mechanical ventilation and bacteremia were the only variables withindependent association withdeath detected in this investigation.

Mutations in the SPARC-Related Modular Calcium-Binding Protein 1 Gene, SMOC1, Cause Waardenburg Anophthalmia Syndrome.

Waardenburg anophthalmia syndrome, also known as microphthalmia with limb anomalies, ophthalmoacromelic syndrome, and anophthalmia-syndactyly, is a rare autosomal-recessive developmental disorder that has been mapped to 10p11.23. Here we show that this disease is heterogeneous by reporting on a consanguineous family, not linked to the 10p11.23 locus, whose two affected children have a homozygous mutation in SMOC1. Knockdown experiments of the zebrafish smoc1 revealed that smoc1 is important in eye development and that it is expressed in many organs, including brain and somites.

An analysis of the components of pain, function, and health-related quality of life in patients with failed back surgery syndrome treated with spinal cord stimulation or conventional medical management

Objectives: Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being. Materials and Methods: The international multicenter PROCESS trial collected detailed HRQoL (EuroQol-5D; Short-Form 36) and function (Oswestry Disability Index) information on 100 FBSS patients. Results: At baseline, patients reported moderate-to-severe leg and back pain adversely affecting all dimensions of function and HRQoL. Compared with conventional medical management alone, patients also receiving spinal cord stimulation (SCS) reported superior pain relief, function, and HRQoL at six months on overall and most sub-component scores. The majority of these improvements with SCS were sustained at 24 months. Nonetheless, 36-40% of patients experienced ongoing marked disability (standing, lifting) and HRQoL problems (pain/discomfort). Conclusions: Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes.

Characterization of the gene expression related to the process of DNA damage tolerance in Schistosoma mansoni

In the course of its complex life cycle, the parasite Schistosoma mansoni need to adapt to distinct environments, and consequently is exposed to various DNA damaging agents. The Schistosoma genome sequencing initiative has uncovered sequences from genes and transcripts related to the process of DNA damage tolerance as the enzymes UBC13, MMS2, and RAD6. In the present work, we evaluate the importance of this process in different stages of the life cycle of this parasite. The importance is evidenced by expression and phylogenetic profiles, which show the conservation of this pathway from protozoa to mammalians on evolution.

Reducing alcohol-related harm by addressing alcohol availability - maximising benefits for North South cooperation

This report presents data on alcohol consumption and related harms in both Northern Ireland and the Republic of Ireland. The report sets out a framework for considering alcohol availability, under which the current policy landscape is presented as well as evidence from nation and international studies. The report concludes with policy implications and proposals to consolidate North South cooperation.