Association between Head Injury and Helmet Use in Alpine Skiers: Cohort Study from a Swiss Level I Trauma Center.

The association between helmet use during alpine skiing and incidence and severity of head injuries was analyzed. All patients admitted to a level 1 trauma center for traumatic brain injuries (TBIs) sustained from skiing accidents during the seasons 2000-2001 and 2010-2011 were eligible. Primary outcome was the association between helmet use and severity of TBI measured by Glasgow Coma Scale (GCS), computed tomography (CT) results, and necessity of neurosurgical intervention. Of 1362 patients injured during alpine skiing, 245 (18%) sustained TBI and were included. TBI was fatal in 3%. Head injury was in 76% minor (Glasgow Coma Scale, 13-15), 6% moderate, and 14% severe. Number and percentage of TBI patients showed no significant trend over the investigated seasons. Forty-five percent of the 245 patients had pathological CT findings and 26% of these required neurosurgical intervention. Helmet use increased from 0% in 2000-2001 to 71% in 2010-2011 (p<0.001). The main analysis, comparing TBI in patients with or without a helmet, showed an adjusted odds ratio (OR) of 1.44 (p=0.430) for suffering moderate-to-severe head injury in helmet users. Analyses comparing off-piste to on-slope skiers revealed a significantly increased OR among off-piste skiers of 7.62 (p=0.004) for sustaining a TBI requiring surgical intervention. Despite increases in helmet use, we found no decrease in severe TBI among alpine skiers. Logistic regression analysis showed no significant difference in TBI with regard to helmet use, but increased risk for off-piste skiers. The limited protection of helmets and dangers of skiing off-piste should be targeted by prevention programs.

Improvement of platelets after SVR among patients with chronic HCV infection and advanced hepatic fibrosis.

BACKGROUND & AIMS Patients with chronic hepatitis C virus (HCV) infection may develop cirrhosis with portal hypertension, reflected by decreased platelet count and splenomegaly. This retrospective cohort study aimed to assess changes in platelet counts after antiviral therapy among chronic HCV-infected patients with advanced fibrosis. METHODS Platelet counts and spleen sizes were recorded in an international cohort of patients with Ishak 4-6 fibrosis who started antiviral therapy between 1990 and 2003. Last measured platelet counts and spleen sizes were compared to their pre-treatment values (within 6 six months prior to the start of therapy). All registered platelet count measurements from 24 week following cessation of antiviral therapy were included in repeated measurement analyses. RESULTS This study included 464 patients; 353 (76%) had cirrhosis and 187 (40%) attained sustained virological response (SVR). Among patients with SVR, median platelet count, increased by 35 x10(9) /L (IQR 7-62, p<0.001). In comparison, patients without SVR showed a median decline of 17 x10(9) /L (IQR -5-47, p<0.001). In a subgroup of 209 patients, median decrease in spleen size was 1.0 cm (IQR 0.3-2.0) for patients with SVR, while median spleen size increased with 0.6 cm (IQR -0.1-2.0, p<0.001) among those without SVR. The changes in spleen size and platelet count were significantly correlated (R=-0.41, p<0.001). CONCLUSIONS Among chronic HCV-infected patients with advanced hepatic fibrosis the platelet counts improved following SVR and the change in platelets correlated with the change in spleen size following antiviral therapy. These results suggest that HCV eradication leads to reduced portal pressure. This article is protected by copyright. All rights reserved.

Na 1 Nachlass Max Horkheimer, 629 - Nachschriften der Vorlesungsreihe "Praktische Philosophie" (p. VIII 50a.1)

"Praktische Philosophie" (Zur Genealogie der Moral), Vorlesung Sommersemester 1962, Nachschrift (von Hilmar Tillack?): Nachschrift von 20 Vorlesungen 7.5.- 23.7.62, Typoskript, 224 Blatt;

Na 1 Nachlass Max Horkheimer, 630 - Typoskripte zur Vorlesung "Praktische Philosophie" und zu zwei Referaten (p. VIII 50a.2-VIII 51)

"Praktische Philosophie" (Zur Genealogie der Moral), Vorlesung Sommersemester 1962, Nachschrift (von Hilmar Tillack?): Nachschrift von 20 Vorlesungen 7.5.- 23.7.62, Durchschläge (unvollständig), Typoskript, 135 Blatt; N.N.: "Probleme der Geschichtsphilosophie bei Kant", Referat, Typoskript, 8 Blatt; N.N.: "Geschichtsphilosophie der Südwestdeutschen Schule", Referat, Typoskript mit handschriftlichen Randbemerkungen von Max Horkheimer, 18 Blatt;

Distribution of the planktonic foraminifer genus Streptochilus in Neogene sediments

Study of four species of the biserial planktonic foraminifer Streptochitus from Deep Sea Drilling Project cores of the Eauripik Rise, western equatorial Pacific, and Ninety-east Ridge, Indian Ocean, shows that both the stratigraphic distribution of species and their frequency patterns (though not actual frequencies or abundances) are correlative in the two areas, supporting their use as stratigraphic and paleoecologic index fossils. Their distributional trends are linked to eustatic sea level changes and to changes in the mixing of surface waters; low frequencies and species turnovers occur during regressive phases when strong circulation of oxygenated waters could lead to the subsequent decline of their oxygen-minimum habitat. The species S. subglobigerum. S. latum. S. globigerum, and S. globulosum succeed one another at intervals averaging 2,5 my from late middle Miocene Zone N15 through Quaternary Zone N23. The new species, Streptochilus suhglobigerum, is described for what was formerly thought to be a stratiraphically lower, disjunct part of the range of S. globigerum. These four species most likely belong to a single phylogenetic lineage as evidenced by some transitional morphologies.

Foraminifera abundances and biostratigraphy of Cenozoic sediments from the Ontong Java Plateau

The Ontong Java Plateau in the western equatorial Pacific contains a deposition record of biserial planktonic foraminifers concentrated in the Paleogene, in which frequencies up to 67% of the planktonic foraminifers are reported, and in the late Neogene, in which a maximum frequency of 48% is reported. Biserial planktonic foraminifers are rare or absent in the latest Oligocene and early Miocene, an interval characterized by warm bottom water and low temperature gradients. These conditions supported a surface assemblage rather than the biserial planktonic foraminifers, whose Neogene species inhabited the oxygen minimum at intermediate depths in the upper water column. Biserial planktonic foraminifers tend to be of high frequency during high sea stands and low frequency during low sea level, presumably in response to the strengthening or weakening of the oxygen minimum. Species extinction and evolution events occur during low sea stands in the Neogene and sometimes correspond to strong reflection horizons of the plateau's seismic stratigraphy. The biserial species are useful biostratigraphic indexes in the plateau section. The last occurrence (LO) of Streptochilus martini corresponds with the Eocene/Oligocene boundary; S. subglobigerum without Neogloboquadrina acostaensis indicates Zone N15; S. latum occurs from the middle of Zone N16 to near the top of Zone N17; S. globigerum ranges from near the top of Zone N17 to the middle of Zone N19/N20; and the S. globulosum continuous range begins just before the first left-to-right coiling change of Pulleniatina, but the species becomes rare in the Pleistocene section.

Comparison of fecal indicators with pathogenic bacteria and rotavirus in rural Bangladesh groundwater

Groundwater is routinely analyzed for fecal indicators but direct comparisons of fecal indicators to the presence of bacterial and viral pathogens are rare. This study was conducted in rural Bangladesh where the human population density is high, sanitation is poor, and groundwater pumped from shallow tubewells is often contaminated with fecal bacteria. Five indicator microorganisms (E. coli, total coliform, F+RNA coliphage, Bacteroides and human-associated Bacteroides (HuBacteroides)) and various environmental parameters were compared to the direct detection of waterborne pathogens by quantitative PCR in groundwater pumped from 50 tubewells. Rotavirus was detected in groundwater filtrate from the largest proportion of tubewells (40%), followed by Shigella (10%), Vibrio (10%), and pathogenic E. coli (8%). Spearman rank correlations and sensitivity-specificity calculations indicate that some, but not all, combinations of indicators and environmental parameters can predict the presence of pathogens. Culture-dependent fecal indicator bacteria measured on a single date did not predict bacterial pathogens, but annually averaged monthly measurements of culturable E. coli did improve prediction for total bacterial pathogens. F+RNA coliphage were neither correlated nor sufficiently sensitive towards rotavirus, but were predictive of bacterial pathogens. A qPCR-based E. coli assay was the best indicator for the bacterial pathogens, rotavirus and all pathogens combined. Since groundwater cannot be excluded as a significant source of diarrheal disease in Bangladesh and neighboring countries with similar characteristics, the need to develop more effective methods for screening tubewells with respect to microbial contamination is necessary.