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Sample records for incident brain lacunes

  1. Incidence of brain metastasis from esophageal cancer.

    PubMed

    Welch, G; Ross, H J; Patel, N P; Jaroszewski, D E; Fleischer, D E; Rule, W G; Paripati, H R; Ramirez, F C; Ashman, J B

    2017-09-01

    We investigated whether the incidence of brain metastasis (BM) from primary esophageal and esophagogastric cancer is increasing. A single-institution retrospective review identified 583 patients treated from January 1997 to January 2016 for stages I through IV cancer of the esophagus and esophagogastric junction (follow-up, ≥3 months). Collected data included demographic information, date and staging at primary diagnosis, histologic subtype, treatment regimen for primary lesion, date of BM diagnosis, presence or absence of central nervous system symptoms, presence or absence of extracranial disease, treatment regimen for intracranial lesions, and date of death. The overall cohort included 495 patients (85%) with adenocarcinoma and 82 (14%) with squamous cell carcinoma (492 [84%] were male; median age at diagnosis, 68 years [range: 26-90 years]). BM was identified in 22 patients (3.8%) (median latency after primary diagnosis, 11 months). Among patients with BM, the primary histology was adenocarcinoma in 21 and squamous cell carcinoma in 1 (P = 0.30). BM developed in 12 who were initially treated for locally advanced disease and in 10 stage IV patients who presented with distant metastases. Overall survival (OS) after BM diagnosis was 18% at 1 year (median, 4 months). No difference in OS after BM diagnosis was observed in patients initially treated for localized disease compared to patients who presented with stage IV disease; however, OS was superior for patients who initially had surgical resection compared to patients treated with whole brain radiotherapy or stereotactic radiosurgery alone (1-year OS, 67% vs. 0%; median OS, 13.5 vs. 3 months; P = 0.003). The incidence of BM is low in patients with esophageal cancer. Outcomes were poor overall for patients with BM, but patients who underwent neurosurgical resection had improved survival. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus

  2. Obesity, insulin resistance and incident small vessel disease on MRI: the Atherosclerosis Risk in Communities Study

    PubMed Central

    Dearborn, Jennifer L.; Schneider, Andrea L. C.; Sharrett, A. Richey; Mosley, Thomas H.; Bezerra, Daniel C; Knopman, David S.; Selvin, Elizabeth; Jack, Clifford R.; Coker, Laura H.; Alonso, Alvaro; Wagenknecht, Lynne E.; Windham, Beverly G.; Gottesman, Rebecca F.

    2015-01-01

    Background and purpose The term “metabolic syndrome” (MetS) describes the clustering of risk factors found in many individuals with obesity. Due to their pathophysiology, we hypothesized that two features of MetS, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on MRI, and specifically with incident lacunar disease and not white matter hyperintensity progression (WMH). Methods Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study who completed two brain MRIs approximately ten years apart. WMH progression and incident lacunes between the two MRIs were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, HOMA-IR, body mass index (BMI) and waist circumference. MetS (presence/absence), using standard clinical definitions, and IR score at the first MRI, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 vs. Q1–4) and incident lacunes. Results MetS (adjusted OR 1.98; 95% confidence interval (CI) 1.28, 3.05) and IR score (adjusted OR per 1-standard deviation increase: 1.33, 95% CI 1.05, 1.68) were associated with incident lacunes but not with WMH progression. Insulin, HOMA-IR and BMI were not associated with incident lacunes or WMH progression in separate models. Conclusions The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease. PMID:26451022

  3. Deep multi-scale location-aware 3D convolutional neural networks for automated detection of lacunes of presumed vascular origin.

    PubMed

    Ghafoorian, Mohsen; Karssemeijer, Nico; Heskes, Tom; Bergkamp, Mayra; Wissink, Joost; Obels, Jiri; Keizer, Karlijn; Leeuw, Frank-Erik de; Ginneken, Bram van; Marchiori, Elena; Platel, Bram

    2017-01-01

    Lacunes of presumed vascular origin (lacunes) are associated with an increased risk of stroke, gait impairment, and dementia and are a primary imaging feature of the small vessel disease. Quantification of lacunes may be of great importance to elucidate the mechanisms behind neuro-degenerative disorders and is recommended as part of study standards for small vessel disease research. However, due to the different appearance of lacunes in various brain regions and the existence of other similar-looking structures, such as perivascular spaces, manual annotation is a difficult, elaborative and subjective task, which can potentially be greatly improved by reliable and consistent computer-aided detection (CAD) routines. In this paper, we propose an automated two-stage method using deep convolutional neural networks (CNN). We show that this method has good performance and can considerably benefit readers. We first use a fully convolutional neural network to detect initial candidates. In the second step, we employ a 3D CNN as a false positive reduction tool. As the location information is important to the analysis of candidate structures, we further equip the network with contextual information using multi-scale analysis and integration of explicit location features. We trained, validated and tested our networks on a large dataset of 1075 cases obtained from two different studies. Subsequently, we conducted an observer study with four trained observers and compared our method with them using a free-response operating characteristic analysis. Shown on a test set of 111 cases, the resulting CAD system exhibits performance similar to the trained human observers and achieves a sensitivity of 0.974 with 0.13 false positives per slice. A feasibility study also showed that a trained human observer would considerably benefit once aided by the CAD system.

  4. Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study.

    PubMed

    Dearborn, Jennifer L; Schneider, Andrea L C; Sharrett, A Richey; Mosley, Thomas H; Bezerra, Daniel C; Knopman, David S; Selvin, Elizabeth; Jack, Clifford R; Coker, Laura H; Alonso, Alvaro; Wagenknecht, Lynne E; Windham, Beverly G; Gottesman, Rebecca F

    2015-11-01

    The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression. Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings≈10 years apart. WMH progression and incident lacunes between the 2 magnetic resonance imagings were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, homeostatic model assessment-IR, body mass index, and waist circumference. Metabolic syndrome (presence/absence), using standard clinical definitions, and IR score at the first magnetic resonance imaging, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 versus Q1-Q4) and incident lacunes. Metabolic syndrome (adjusted odds ratio, 1.98; 95% confidence interval, 1.28-3.05) and IR score (adjusted odds ratio per 1-SD increase, 1.33; 95% confidence interval, 1.05-1.68) were associated with incident lacunes but not with WMH progression. Insulin, homeostatic model assessment-IR, and body mass index were not associated with incident lacunes or WMH progression in separate models. The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease. © 2015 American Heart Association, Inc.

  5. Residential Radon and Brain Tumour Incidence in a Danish Cohort

    PubMed Central

    Bräuner, Elvira V.; Andersen, Zorana J.; Andersen, Claus E.; Pedersen, Camilla; Gravesen, Peter; Ulbak, Kaare; Hertel, Ole; Loft, Steffen; Raaschou-Nielsen, Ole

    2013-01-01

    Background Increased brain tumour incidence over recent decades may reflect improved diagnostic methods and clinical practice, but remain unexplained. Although estimated doses are low a relationship between radon and brain tumours may exist. Objective To investigate the long-term effect of exposure to residential radon on the risk of primary brain tumour in a prospective Danish cohort. Methods During 1993–1997 we recruited 57,053 persons. We followed each cohort member for cancer occurrence from enrolment until 31 December 2009, identifying 121 primary brain tumour cases. We traced residential addresses from 1 January 1971 until 31 December 2009 and calculated radon concentrations at each address using information from central databases regarding geology and house construction. Cox proportional hazards models were used to estimate incidence rate-ratios (IRR) and 95% confidence intervals (CI) for the risk of primary brain tumours associated with residential radon exposure with adjustment for age, sex, occupation, fruit and vegetable consumption and traffic-related air pollution. Effect modification by air pollution was assessed. Results Median estimated radon was 40.5 Bq/m3. The adjusted IRR for primary brain tumour associated with each 100 Bq/m3 increment in average residential radon levels was 1.96 (95% CI: 1.07; 3.58) and this was exposure-dependently higher over the four radon exposure quartiles. This association was not modified by air pollution. Conclusions We found significant associations and exposure-response patterns between long-term residential radon exposure radon in a general population and risk of primary brain tumours, adding new knowledge to this field. This finding could be chance and needs to be challenged in future studies. PMID:24066143

  6. The incidence of second brain tumors related to cranial irradiation.

    PubMed

    Marta, Gustavo Nader; Murphy, Erin; Chao, Samuel; Yu, Jennifer S; Suh, John H

    2015-03-01

    Secondary brain tumor (SBT) is a devastating complication of cranial irradiation (CI). We reviewed the literature to determine the incidence of SBT as related to specific radiation therapy (RT) treatment modalities. The relative risk of radiation-associated SBT after conventional and conformal RT is well established and ranges from 5.65 to 10.9; latent time to develop second tumor ranges from 5.8 to 22.4 years, depending on radiation dose and primary disease. Theories and dosimetric models suggest that intensity-modulated radiation therapy may result in an increased risk of SBT, but clinical evidence is limited. The incidence of stereotactic radiosurgery-related SBT is low. Initial data suggest that no increased risk from proton therapy and dosimetric models predict a lower incidence of SBT compared with photons. In conclusion, the incidence of SBT related to CI is low. Longer follow-up is needed to clarify the impact of intensity-modulated radiation therapy, proton therapy and other developing technologies.

  7. Incidence of brain metastasis at initial presentation of lung cancer

    PubMed Central

    Villano, J. Lee; Durbin, Eric B.; Normandeau, Chris; Thakkar, Jigisha P.; Moirangthem, Valentina; Davis, Faith G.

    2015-01-01

    Background No reliable estimates are available on the incidence of brain metastasis (BM) in cancer patients. This information is valuable for planning patient care and developing measures that may prevent or decrease the likelihood of metastatic brain disease. Methods We report the first population-based analysis on BM incidence at cancer diagnosis using the Kentucky Cancer Registry (KCR) and Alberta Cancer Registry (ACR). All cancer cases with BM were identified from KCR and ACR, with subsequent focus on metastases from lung primaries; the annual number of BMs at initial presentation was derived. Comparisons were made between Kentucky and Alberta for the stage and site of organ involvement of lung cancer. Results Low incidence of BM was observed in the United States until mandatory reporting began in 2010. Both the KCR and ACR recorded the highest incidence of BM from lung cancer, with total BM cases at initial presentation occurring at 88% and 77%, respectively. For lung cancer, stage IV was the most common stage at presentation for both registries and ranged from 45.9% to 57.2%. When BM from lung was identified, the most common synchronous organ site of metastasis was osseous, occurring at 28.4%. Conclusion Our analysis from the Kentucky and Alberta cancer registries similarly demonstrated the aggressive nature of lung cancer and its propensity for BM at initial presentation. Besides widespread organ involvement, no synchronous organ site predicted BM in lung cancer. BM is a common and important clinical outcome, and use of registry data is becoming more available. PMID:24891450

  8. Incidence of ischemic brain lesions in hyperbaric chamber inside attendants.

    PubMed

    Ors, Fatih; Sonmez, Guner; Yildiz, Senol; Uzun, Gunalp; Senol, Mehmet Guney; Mutlu, Hakan; Saracoglu, Mehmet

    2006-01-01

    Concern is growing about the negative long-term effects of hyperbaric exposure on the central nervous system of divers. This study was conducted with magnetic resonance imaging (MRI) to evaluate attendants that work inside hyperbaric chambers (known as inside attendants) for hyperintense brain lesions. Ten inside attendants and 10 healthy nondiving subjects were included in the study. A questionnaire was used to obtain information about subjects' medical history, hyperbaric exposure history, alcohol intake, and smoking habits. T1-weighted, T2-weighted, and fluid-attenuated inversion recovery images were acquired with a 1.5-T MRI device. A lesion was included in the count if it was hyperintense on both T2-weighted and fluid-attenuated inversion recovery images. Although MRI revealed 3 hyperintense brain lesions in 2 of 10 inside attendants and in none of the controls, the differences between groups were not statistically significant (P=.147). The number of brain lesions counted did not correlate with the age of the inside attendants (r=0.007; P=.978), the number of hyperbaric exposures (r=-0.203; P=.574), or the duration of work as an inside attendant (r=0.051; P=.890). Investigators found a correlation, however, between the number of cigarettes smoked in a day and the number of brain lesions identified (r=0.779; P<.01). An increased incidence of hyperintense brain lesions was not observed in inside attendants who had never experienced decompression sickness compared with nondiving controls. Additional multicenter epidemiologic studies are needed if the occupational safety of inside attendants is to be enhanced.

  9. Incidence of leukaemia and brain tumours in some "electrical occupations".

    PubMed Central

    Törnqvist, S; Knave, B; Ahlbom, A; Persson, T

    1991-01-01

    A 19 year follow up study was conducted to explore the association between occupations expected to be exposed to electromagnetic fields and the occurrence of leukaemia and brain tumours. Incidence of cancer between 1961-79 was calculated and the standardised morbidity ratio (SMR) with a 95% confidence interval (95% CI) was related to that of all Swedish working men. For all the selected "electrical occupations" the SMRs for total leukaemia and brain tumours were near unity. Increased risks were noted for all leukaemia among electrical/electronic engineers and technicians, (SMR 1.3; 95% CI 1.0-1.7) as well as in the sub-groups of telegraph/telephone (2.1; 1.1-3.6) and machine (2.6; 1.0-5.8) industries. Risk for chronic lymphoid leukaemia was increased in the same occupational category (1.7; 1.1-2.5) and in the sub-group of machine industry (4.8; 1.0-14.0), as well as for all linesmen (2.0; 1.0-3.5) and power linesmen (2.8; 1.1-5.7). Risk for acute myeloid leukaemia was increased among all miners (2.2; 1.0-4.1) and miners working in iron/ore mines (5.7; 2.1-12.4). Increased risk for all brain tumours (2.9; 1.2-5.9) and glioblastomas (3.4; 1.1-8.0) appeared among assemblers and repairmen in radio and TV industry. Raised risk for all brain tumours was seen for all welders (1.3; 1.0-1.7) and welders in iron/steel works (3.2; 1.0-7.4) and risk for glioblastomas was also increased for all welders (1.5; 1.1-2.1). No major changes in relative risk estimates were noted after the exclusion of persons who were over 65 at the time of diagnosis. Although a homogeneous pattern of increased risks of leukaemia or brain tumour was not noted, the hypothesis that magnetic fields might play a part in the origin of cancer cannot be rejected. PMID:1911402

  10. Cerebral Infarction after Traumatic Brain Injury: Incidence and Risk Factors.

    PubMed

    Bae, Dong-Hyeon; Choi, Kyu-Sun; Yi, Hyeong-Joong; Chun, Hyoung-Joon; Ko, Yong; Bak, Koang Hum

    2014-10-01

    Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI. We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a well-demarcated or fairly discernible region of low attenuation following specific vascular territory with normal initial CT. Clinical and radiological findings that related to patients' outcome were reviewed and statistically compared. PTCI was observed in 21 (2.1%) patients. Of various parameters, age (p=0.037), initial Glasgow coma scale score (p<0.01), brain herniation (p=0.044), and decompressive craniectomy (p=0.012) were significantly higher in patients with PTCI than patients who do not have PTCI. Duration between accident and PTCI, patterns of TBI and vascular territory of PTCI were not specific. The mortality rates were significantly higher in patients with PTCI than without PTCI. The development of PTCI is rare after TBI, but it usually results in serious outcome and high mortality. Early recognition for risks and aggressive managements is mandatory to prevent PTCI.

  11. Incidence of Leukoencephalopathy After Whole-Brain Radiation Therapy for Brain Metastases

    SciTech Connect

    Ebi, Junko; Sato, Hisashi; Nakajima, Masaru; Shishido, Fumio

    2013-04-01

    Purpose: To evaluate the incidence of leukoencephalopathy after whole-brain radiation therapy (WBRT) in patients with brain metastases. Methods and Materials: We retrospectively reviewed 111 patients who underwent WBRT for brain metastases from April 2001 through March 2008 and had evaluable computed tomography (CT) and/or magnetic resonance imaging (MRI) at least 1 month after completion of WBRT. We evaluated the leukoencephalopathy according to the Common Terminology Criteria for Adverse Events, version 3.0. The patients who had brain tumor recurrence after WBRT were censored at the last follow-up CT or MRI without recurrence. To evaluate the risk factors for leukoencephalopathy, bivariate analysis was performed using a logistic regression analysis adjusted for follow-up time. Factors included in the analysis were age, gender, dose fractionation, 5-fluorouracil, methotrexate, cisplatin, and other chemotherapeutic agents. Results: The median age of the 111 patients was 60.0 years (range, 23-89 years). The median follow-up was 3.8 months (range, 1.0-38.1 months). Leukoencephalopathy developed in 23 of the 111 patients. Grades 1, 2, and 3 were observed in 8, 7, and 8 patients, respectively. The incidence was 34.4% (11 of 32), 42.9% (6 of 14), 66.7% (2 of 3), and 100% (2 of 2) of the patients who were followed up for ≥6, ≥12, ≥24, and ≥36 months, respectively. In the bivariate analysis, older age (≥65 years) was significantly correlated with higher risk of leukoencephalopathy (odds ratio 3.31; 95% confidence interval 1.15-9.50; P=.03). Conclusions: The incidence of leukoencephalopathy after WBRT was 34.4% with ≥6 months follow-up, and increased with longer follow-up. Older age was a significant risk factor. The schedule of WBRT for patients with brain metastases should be carefully determined, especially for favorable patients.

  12. Cerebral small vessel disease and incident parkinsonism

    PubMed Central

    van der Holst, Helena M.; van Uden, Inge W.M.; Tuladhar, Anil M.; de Laat, Karlijn F.; van Norden, Anouk G.W.; Norris, David G.; van Dijk, Ewoud J.; Esselink, Rianne A.J.; Platel, Bram

    2015-01-01

    Objective: To investigate the relation between baseline cerebral small vessel disease (SVD) and the risk of incident parkinsonism using different MRI and diffusion tensor imaging (DTI) measures. Methods: In the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) study, a prospective cohort study, 503 elderly participants with SVD and without parkinsonism were included in 2006. During follow-up (2011–2012), parkinsonism was diagnosed according to UK Brain Bank criteria. Cox regression analysis was used to investigate the association between baseline imaging measures and incident all-cause parkinsonism and vascular parkinsonism (VP). Tract-based spatial statistics analysis was used to identify differences in baseline DTI measures of white matter (WM) tracts between participants with VP and without parkinsonism. Results: Follow-up was available from 501 participants (mean age 65.6 years; mean follow-up duration 5.2 years). Parkinsonism developed in 20 participants; 15 were diagnosed with VP. The 5-year risk of (any) parkinsonism was increased for those with a high white matter hyperintensity (WMH) volume (hazard ratio [HR] 1.8 per SD increase, 95% confidence interval [CI] 1.3–2.4) and a high number of lacunes (HR 1.4 per number increase, 95% CI 1.1–1.8) at baseline. For VP, this risk was also increased by the presence of microbleeds (HR 5.7, 95% CI 1.9–16.8) and a low gray matter volume (HR 0.4 per SD increase, 95% CI 0.2–0.8). Lower fractional anisotropy values in bifrontal WM tracts involved in movement control were observed in participants with VP compared to participants without parkinsonism. Conclusions: SVD at baseline, especially a high WMH volume and a high number of lacunes, is associated with incident parkinsonism. Our findings favor a role of SVD in the etiology of parkinsonism. PMID:26446068

  13. Brain Metastases from Colorectal Cancer: Risk Factors, Incidence, and the Possible Role of Chemokines

    PubMed Central

    Mongan, John P.; Fadul, Camilo E.; Cole, Bernard F.; Zaki, Bassem I.; Suriawinata, Arief A.; Ripple, Gregory H.; Tosteson, Tor D.; Pipas, J. Marc

    2014-01-01

    Background Brain metastases from colorectal cancer (CRC) are uncommon. There has been relatively little published on the host and tumor factors that might lead to this clinical scenario. We reviewed all cases of brain metastases from CRC at Dartmouth-Hitchcock Medical Center over a more than 20-year period to establish incidence and to identify patient and cancer characteristics which were associated with their development. Patients and Methods We present a retrospective review of 39 confirmed cases of brain metastases from CRC diagnosed between 1984 and 2006. Immunohistochemical staining for CXCR4 was performed on all available brain metastasis biopsy specimens. Results The incidence of brain metastases from CRC was 2.3%. Left-sided primary colon tumors predominated. The majority of patients had pulmonary metastases at the time brain metastases were identified, and those with preexisting pulmonary metastases had progression of that disease. All patients were symptomatic from brain metastases, and the cerebellum was the most common area of brain involvement. Immunohistochemical analysis confirmed strong expression of CXCR4 in all brain metastases sampled. Conclusion The incidence of brain metastases from CRC is low. Primary tumor in the left colon, long-standing pulmonary metastases, especially those with recent progression, and CXCR4 expression by tumor cells are all associated with increased risk of brain metastases. Increased survival among patients with metastatic CRC will likely result in an increased incidence of brain metastases. Further characterization of the role of tumor and host factors might yield better insight into the development, and potentially the prevention, of this devastating situation. PMID:19739271

  14. Brain but not lung functions impaired after a chlorine incident.

    PubMed

    Kilburn, Kaye H

    2003-10-01

    A workplace bleach exposure incident was studied in 13 women to determine whether chlorine caused neurobehavioral and pulmonary functional effects. We compared neurophysiological and neuropsychological measurements in 13 chlorine-exposed women, 4.5 years after exposure, and 41 unexposed women. Reaction times, balance, blink reflex latency, color discrimination and several psychological tests were measured. Pulmonary function was assessed by spirometry. A profile of mood states and frequencies of 35 symptoms were obtained. Chlorine exposed women performed statistically significantly below unexposed women for simple and choice reaction times, balance with eyes open and eyes closed, color discrimination, grip strength, Culture Fair, digit symbol substitution, vocabulary, trail making B and pegboard. Profile of mood states scores and frequency symptoms were elevated. Respiratory symptoms were elevated but pulmonary volumes and flows were not reduced. Chlorine bleach exposure was associated with impaired neurobehavioral functions and elevated POMS scores and symptom frequencies. Alternatives to chlorine should be used.

  15. Population estimates of undocumented incident traumatic brain injuries among combat-deployed US military personnel.

    PubMed

    Chase, Rachel P; Nevin, Remington L

    2015-01-01

    To estimate the number of undocumented incident traumatic brain injuries (TBIs) among active component US military personnel serving in Iraq and Afghanistan prior to policy changes implemented in late 2006 and 2010 that improved TBI documentation. Negative binomial regression was used to model monthly incident TBI counts between December 2010 and June 2012 (N = 19) and then estimate expected monthly counts of incident TBIs during 2 periods: January 2003-October 2006 and November 2006-November 2010. Monthly amputation counts from Department of Defense surveillance data were used as a proxy for changing injury rates. Monthly active component deployment estimates derived from the Congressional Research Service, Brookings Institution, and Defense Manpower Data Center were used to estimate the size of the at-risk population each month. The difference between expected monthly incident TBI counts and reported counts is presented as the estimated number of undocumented incident TBIs. The full model estimates that 21 257 active component military personnel experienced undocumented incident TBIs while deployed in Iraq or Afghanistan between January 2003 and October 2006, more than 4 times the 5272 incident TBIs documented during that period. A sizeable majority of Iraq and Afghanistan combat veterans who experienced incident TBI while deployed prior to November 2006 are likely to have had their injuries undocumented, creating challenges for clinical care, disability evaluation, and future research.

  16. Systematic review: brain metastases from colorectal cancer--Incidence and patient characteristics.

    PubMed

    Christensen, Troels Dreier; Spindler, Karen-Lise Garm; Palshof, Jesper Andreas; Nielsen, Dorte Lisbet

    2016-04-01

    Brain metastases (BM) from colorectal cancer (CRC) are a rare event. However, the implications for affected patients are severe, and the incidence has been reported to be increasing. For clinicians, knowledge about the characteristics associated with BM is important and could lead to earlier diagnosis and improved survival. In this paper, we describe the incidence as well as characteristics associated with BM based on a systematic review of the current literature, following the PRISMA guidelines. We show that the incidence of BM in CRC patients ranges from 0.6 to 3.2%. BM are a late stage phenomenon, and young age, rectal primary and lung metastases are associated with increased risk of developing BM. Molecular markers such as KRAS, BRAF, NRAS mutation as well as an increase in CEA and CA19.9 levels are suggested predictors of brain involvement. However, only KRAS mutations are reasonably well investigated and associated with an increased risk of BM. The incidence of BM from CRC is 0.6 to 3.2% and did not seem to increase over time. Development of BM is associated with young age, lung metastases, rectal primary and KRAS mutation. Increased awareness of brain involvement in patients with these characteristics is necessary.

  17. Longitudinal change of small-vessel disease-related brain abnormalities.

    PubMed

    Schmidt, Reinhold; Seiler, Stephan; Loitfelder, Marisa

    2016-01-01

    Knowledge about the longitudinal change of cerebral small-vessel disease–related magnetic resonance imaging abnormalities increases our pathophysiologic understanding of cerebral microangiopathy. The change of specific lesion types may also serve as secondary surrogate endpoint in clinical trials. A surrogate endpoint needs to progress fast enough to allow monitoring of treatment effects within a reasonable time period, and change of the brain abnormality needs to be correlated with clinical change. Confluent white matter lesions show fast progression and correlations with cognitive decline. Thus, the change of confluent white matter lesions may be used as a surrogate marker in proof-of-concept trials with small patient numbers needed to show treatment effects on lesion progression. Nonetheless if the expected change in cognitive performance resulting from treatment effects on lesion progression is used as outcome, the sample size needed to show small to moderate treatment effects becomes very large. Lacunes may also fulfill the prerequisites of a surrogate marker, but in the general population the incidence of lacunes over short observational periods is small. For other small-vessel disease–related brain abnormalities including microbleeds and microstructural changes in normal-appearing white matter longitudinal change and correlations with clinical decline is not yet fully determined.

  18. Brain cancer incidence trends in relation to cellular telephone use in the United States.

    PubMed

    Inskip, Peter D; Hoover, Robert N; Devesa, Susan S

    2010-11-01

    The use of cellular telephones has grown explosively during the past two decades, and there are now more than 279 million wireless subscribers in the United States. If cellular phone use causes brain cancer, as some suggest, the potential public health implications could be considerable. One might expect the effects of such a prevalent exposure to be reflected in general population incidence rates, unless the induction period is very long or confined to very long-term users. To address this issue, we examined temporal trends in brain cancer incidence rates in the United States, using data collected by the Surveillance, Epidemiology, and End Results (SEER) Program. Log-linear models were used to estimate the annual percent change in rates among whites. With the exception of the 20-29-year age group, the trends for 1992-2006 were downward or flat. Among those aged 20-29 years, there was a statistically significant increasing trend between 1992 and 2006 among females but not among males. The recent trend in 20-29-year-old women was driven by a rising incidence of frontal lobe cancers. No increases were apparent for temporal or parietal lobe cancers, or cancers of the cerebellum, which involve the parts of the brain that would be more highly exposed to radiofrequency radiation from cellular phones. Frontal lobe cancer rates also rose among 20-29-year-old males, but the increase began earlier than among females and before cell phone use was highly prevalent. Overall, these incidence data do not provide support to the view that cellular phone use causes brain cancer.

  19. Incidence and extent of TDP-43 accumulation in aging human brain.

    PubMed

    Uchino, Akiko; Takao, Masaki; Hatsuta, Hiroyuki; Sumikura, Hiroyuki; Nakano, Yuta; Nogami, Akane; Saito, Yuko; Arai, Tomio; Nishiyama, Kazutoshi; Murayama, Shigeo

    2015-06-20

    The transactivation response element DNA-binding protein 43 kDa (TDP-43) is a major component of the ubiquitin-positive and tau-negative inclusions in frontotemporal lobar degeneration and sporadic amyotrophic lateral sclerosis (ALS). TDP-43 may accumulate in cases of Alzheimer's disease (AD), Lewy body disease (LBD), and argyrophilic grain disease (AGD). However, few studies have focused on the incidence and extent of TDP-43 deposition in aging. We analyzed 286 consecutive autopsy brains neuropathologically. Of these, 136 brains with pathologically minimal senile changes were designated as control elderly brains (78.5 ± 9.7 y). For comparison, we selected 29 AD, 11 LBD, and 11 AGD patients from this series of autopsy brains. Sections of the hippocampus, amygdala, medulla oblongata, and lumbar spinal cord were immunostained with anti-phosphorylated TDP-43 antibody (PSer409/410). TDP-43 immunoreactive structures were classified into four types: dystrophic neurites (DNs), neuronal or glial cytoplasmic inclusions, and intranuclear inclusions. TDP-43 immunoreactive structures were observed in 55/136 control elderly (40.0%), 21/29 AD (72.4%), 8/11 LBD (72.7%), and 6/11 AGD (54.5%) brains. TDP-43 immunoreactive structures in control elderly brains were mostly DNs. These DNs were predominantly present in the uncus of the anterior hippocampus over age 65. The frequency of cases with DNs in the amygdala of control elderly brains was less than that of AD, LBD, and AGD brains. The mean age at death was significantly higher in cases with TDP-43 immunoreactive structures than cases without them. In conclusion, TDP-43 immunoreactive DNs may develop as a consequence of aging processes in the human brain. In particular, the uncus of the anterior hippocampus is an area highly susceptible to TDP-43 accumulation over age 65.

  20. Incidence and sequelae of symptomatic venous thromboembolic disease among patients with traumatic brain injury.

    PubMed

    Lai, J M; Yablon, S A; Ivanhoe, C B

    1997-05-01

    Venous thromboembolism (VTE) is a potentially life-threatening complication among patients with traumatic brain injury (TBI). However, few reports describe the incidence of this important disease. We reviewed the incidence of symptomatic VTE among 124 consecutive admissions with TBI to a free-standing rehabilitation hospital over an 18-month period. Four patients manifested evidence of VTE within 2 months of injury: two with leg swelling, one with an oedematous arm, and one with respiratory distress. None of the patients with suspected VTE received prophylactic anticoagulant therapy. Diagnosis of VTE was confirmed with venograph in two of the four patients. Although VTE is frequently asymptomatic, the incidence of symptomatic VTE (1.6%) among this series of rehabilitation inpatients with TBI still appears surprisingly low. These results have implications regarding the utility of non-invasive diagnostic screening of asymptomatic VTE and routine anticoagulant prophylaxis of high-risk patients with TBI.

  1. Surviving severe traumatic brain injury in Denmark: incidence and predictors of highly specialized rehabilitation

    PubMed Central

    Odgaard, Lene; Poulsen, Ingrid; Kammersgaard, Lars Peter; Johnsen, Søren Paaske; Nielsen, Jørgen Feldbæk

    2015-01-01

    Purpose To identify all hospitalized patients surviving severe traumatic brain injury (TBI) in Denmark and to compare these patients to TBI patients admitted to highly specialized rehabilitation (HS-rehabilitation). Patients and methods Patients surviving severe TBI were identified from The Danish National Patient Registry and The Danish Head Trauma Database. Overall incidence rates of surviving severe TBI and incidence rates of admission to HS-rehabilitation after severe TBI were estimated and compared. Patient-related predictors of no admission to HS-rehabilitation among patients surviving severe TBI were identified using multivariable logistic regression. Results The average incidence rate of surviving severe TBI was 2.3 per 100,000 person years. Incidence rates of HS-rehabilitation were generally stable around 2.0 per 100,000 person years. Overall, 84% of all patients surviving severe TBI were admitted to HS-rehabilitation. Female sex, older age, and non-working status pre-injury were independent predictors of no HS-rehabilitation among patients surviving severe TBI. Conclusion The incidence rate of hospitalized patients surviving severe TBI was stable in Denmark and the majority of the patients were admitted to HS-rehabilitation. However, potential inequity in access to HS-rehabilitation may still be present despite a health care system based on equal access for all citizens. PMID:25848317

  2. Association of Ideal Cardiovascular Health With Vascular Brain Injury and Incident Dementia.

    PubMed

    Pase, Matthew P; Beiser, Alexa; Enserro, Danielle; Xanthakis, Vanessa; Aparicio, Hugo; Satizabal, Claudia L; Himali, Jayandra J; Kase, Carlos S; Vasan, Ramachandran S; DeCarli, Charles; Seshadri, Sudha

    2016-05-01

    The American Heart Association developed the ideal cardiovascular health (CVH) index as a simple tool to promote CVH; yet, its association with brain atrophy and dementia remains unexamined. Our aim was to investigate the prospective association of ideal CVH with vascular brain injury, including the 10-year risks of incident stroke and dementia, as well as cognitive decline and brain atrophy on magnetic resonance imaging, measured for ≈7 years. We studied 2750 stroke- and dementia-free Framingham Heart Study Offspring cohort participants (mean age, 62±9 years; 45% men). Ideal CVH was quantified on a 7-point scale with 1 point awarded for each of the following: nonsmoking status, ideal body mass index, regular physical activity, healthy diet, as well as optimum blood pressure, cholesterol, and fasting blood glucose. Both recent (baseline) and remote (6.9 years earlier) ideal CVH scores were examined. Recent ideal CVH was associated with stroke (hazard ratio, 0.80; 95% confidence interval, 0.67-0.95), vascular dementia (hazard ratio, 0.49; 95% confidence interval, 0.30-0.81), frontal brain atrophy (P=0.003), and cognitive decline on tasks measuring visual memory and reasoning (P<0.05). In addition to predicting stroke, vascular dementia, whole-brain atrophy, and cognitive decline, remote ideal CVH was associated with the incidence of all-cause dementia (hazard ratio, 0.80; 95% confidence interval, 0.67-0.97) and Alzheimer disease (hazard ratio, 0.79; 95% confidence interval, 0.64-0.98). Adherence to the American Heart Association's ideal CVH factors and behaviors, particularly in midlife, may protect against cerebrovascular disease and dementia. © 2016 American Heart Association, Inc.

  3. Geographical pattern of brain cancer incidence in the Navarre and Basque Country regions of Spain

    PubMed Central

    Lopez-Abente, G; Pollan, M; Ardanaz, E; Errezola, M

    2003-01-01

    Background: The study of the distribution of brain cancer mortality in Spain shows a grouping of highest risk provinces corresponding to the autonomous regions of Navarre and the Basque Country. Aim: To explore the possible existence of geographical patterns in these areas. Methods: Municipal maps of brain cancer incidence were drawn up and the influence of land use related variables on the distribution of the disease duly analysed. Autoregressive conditional models were used to plot smoothed municipal maps. The influence of explanatory land use variables, ascertained by remote sensing, was assessed. Results: The maps revealed that certain towns situated in the "Media" and "Cantábrica-Baja Montaña" districts of Navarre were areas of highest risk. Among the towns in question, those in the "Media" district lie very close to the city of Pamplona. However, the pattern of brain cancer incidence in Navarre and the Basque Country could not be conclusively said to be determined by any specific type of land cover and/or crop. Conclusions: Results suggest a possible increase of risk linked to areas devoted to a high percentage of non-irrigated arable land. PMID:12819284

  4. Incidence and risk factors of posttraumatic seizures following traumatic brain injury: A Traumatic Brain Injury Model Systems Study.

    PubMed

    Ritter, Anne C; Wagner, Amy K; Fabio, Anthony; Pugh, Mary Jo; Walker, William C; Szaflarski, Jerzy P; Zafonte, Ross D; Brown, Allen W; Hammond, Flora M; Bushnik, Tamara; Johnson-Greene, Douglas; Shea, Timothy; Krellman, Jason W; Rosenthal, Joseph A; Dreer, Laura E

    2016-12-01

    Determine incidence of posttraumatic seizure (PTS) following traumatic brain injury (TBI) among individuals with moderate-to-severe TBI requiring rehabilitation and surviving at least 5 years. Using the prospective TBI Model Systems National Database, we calculated PTS incidence during acute hospitalization, and at years 1, 2, and 5 postinjury in a continuously followed cohort enrolled from 1989 to 2000 (n = 795). Incidence rates were stratified by risk factors, and adjusted relative risk (RR) was calculated. Late PTS associations with immediate (<24 h), early (24 h-7 day), or late seizures (>7 day) versus no seizure prior to discharge from acute hospitalization was also examined. PTS incidence during acute hospitalization was highest immediately (<24 h) post-TBI (8.9%). New onset PTS incidence was greatest between discharge from inpatient rehabilitation and year 1 (9.2%). Late PTS cumulative incidence from injury to year 1 was 11.9%, and reached 20.5% by year 5. Immediate/early PTS RR (2.04) was increased for those undergoing surgical evacuation procedures. Late PTS RR was significantly greater for individuals who self-identified as a race other than black/white (year 1 RR = 2.22), and for black individuals (year 5 RR = 3.02) versus white individuals. Late PTS was greater for individuals with subarachnoid hemorrhage (year 1 RR = 2.06) and individuals age 23-32 (year 5 RR = 2.43) and 33-44 (year 5 RR = 3.02). Late PTS RR years 1 and 5 was significantly higher for those undergoing surgical evacuation procedures (RR: 3.05 and 2.72, respectively). In this prospective, longitudinal, observational study, PTS incidence was similar to that in studies published previously. Individuals with immediate/late seizures during acute hospitalization have increased late PTS risk. Race, intracranial pathologies, and neurosurgical procedures also influenced PTS RR. Further studies are needed to examine the impact of seizure prophylaxis in high-risk subgroups and to delineate

  5. Incidence of neuroepithelial primary brain tumors among adult population of Emilia-Romagna Region, Italy.

    PubMed

    Baldin, Elisa; Testoni, Stefania; de Pasqua, Silvia; Ferro, Salvatore; Albani, Fiorenzo; Baruzzi, Agostino; D'Alessandro, Roberto

    2017-02-01

    Incidence of neuroepithelial Primary Brain Tumors (nPBT) varies, ranging from 7.3 to 11.6 cases/100,000/year across Europe. We present incidence and survival of nPBT in the Emilia-Romagna region (ER), Italy. This study is the largest in Southern Europe. Specialists in neurosurgery, neurology, neuroradiology, oncology, radiotherapy, genetics, and pathology of ER notified all suspected nPBT adult cases residing in ER (4,337,966 inhabitants) observed during 2009. Furthermore, through ICD-9 discharge codes, we identified and reviewed all possible cases. Neuroepithelial PBT diagnosis was based on histological or radiological findings. We included 400 incident nPBT cases, of which 102 (25%) were retrospectively identified. These latter were significantly older. The standardized incidence was 10.5/100,000/year (95% CI 9.4-11.5), higher for men. It was 9.2/100,000/year (95% CI 8.3-10.2) for astrocytic tumors, 0.6/100,000/year (95% CI 0.4-0.9) for oligodendroglial tumors, and 7.1 (95% CI 6.3-8.0) for glioblastoma (GBM). Among GBM patients, median survival was 249 days if prospectively identified vs. 132 days when identified through ICD-9 codes (p < 0.0001). The incidence of nPBT in the ER region is among the highest in the literature. Older patients were more likely to escape an active surveillance system. This should be considered when comparing incidence rates across studies, giving the increasing number of elderly people in the general population.

  6. Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands.

    PubMed

    Scholten, Annemieke C; Polinder, Suzanne; Panneman, Martien J M; van Beeck, Ed F; Haagsma, Juanita A

    2015-08-01

    The main cause of death and serious disability in bicycle accidents is traumatic brain injury (TBI). The aim of this population-based study was to assess the incidence and costs of bicycle-related TBI across various age groups, and in comparison to all bicycle-related injuries, to identify main risk groups for the development of preventive strategies. Data from the National Injury Surveillance System and National Medical Registration were used for all patients with bicycle-related injuries and TBI who visited a Dutch emergency department (ED) between 1998 and 2012. Demographics and national, weighted estimates of injury mechanism, injury severity and costs were analysed per age group. Direct healthcare costs and indirect costs were determined using the incidence-based Dutch Burden of Injury Model. Between 1998 and 2012, the incidence of ED treatments due to bicycle-related TBI strongly increased with 54%, to 43 per 100,000 persons in 2012. However, the incidence of all bicycle-related injuries remained stable, from 444 in 1998 to 456/100,000 in 2012. Incidence of hospital admission increased in both TBI (92%) and all injuries from cycling (71%). Highest increase in incidence of both ED treatments and hospital admissions was seen in adults aged 55+. The injury rate of TBI per kilometre travelled increased (44%) except in children, but decreased (-4%) for all injuries, showing a strong decrease in children (-36%) but an increase in men aged 25+, and women aged 15+. Total costs of bicycle-related TBI were €74.5 million annually. Although bicycle-related TBI accounted for 9% of the incidence of all ED treatments due to cycling, it accounted for 18% of the total costs due to all bicycle-related injuries (€410.7 million). Children and adolescents (aged 0-24) had highest incidence of ED treatments due to bicycle-related injuries. Men in the working population (aged 15-64) had highest indirect costs following injuries from cycling, including TBI. Older cyclists (aged

  7. High incidence of carpal tunnel syndrome after deep brain stimulation in Parkinson's disease.

    PubMed

    Loizon, Marine; Laurencin, Chloé; Vial, Christophe; Danaila, Teodor; Thobois, Stéphane

    2016-12-01

    We observed several cases of carpal tunnel syndrome (CTS) revealed after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD). 115 consecutive PD patients who underwent STN-DBS between 2010 and 2014 at the Neurological Hospital in Lyon were retrospectively included. CTS was accepted as the diagnosis only if clinical examination and ENMG both confirmed it. Nine patients (7.8 %) developed CTS in the 2 years following surgery, which is far beyond the 2.7/1000 incidence in the general population. The present study shows an overrepresentation of CTS occurrence after STN-DBS in PD.

  8. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data

    PubMed Central

    Davis, Faith G.; Dolecek, Therese A.; McCarthy, Bridget J.; Villano, John L.

    2012-01-01

    Few population estimates of brain metastasis in the United States are available, prompting this study. Our objective was to estimate the expected number of metastatic brain tumors that would subsequently develop among incident cancer cases for 1 diagnosis year in the United States. Incidence proportions for primary cancer sites known to develop brain metastasis were applied to United States cancer incidence data for 2007 that were retrieved from accessible data sets through Centers for Disease Control and Prevention (CDC Wonder) and Surveillance, Epidemiology, and End Results (SEER) Program Web sites. Incidence proportions were identified for cancer sites, reflecting 80% of all cancers. It was conservatively estimated that almost 70 000 new brain metastases would occur over the remaining lifetime of individuals who received a diagnosis in 2007 of primary invasive cancer in the United States. That is, 6% of newly diagnosed cases of cancer during 2007 would be expected to develop brain metastasis as a progression of their original cancer diagnosis; the most frequent sites for metastases being lung and bronchus and breast cancers. The estimated numbers of brain metastasis will be expected to be higher among white individuals, female individuals, and older age groups. Changing patterns in the occurrence of primary cancers, trends in populations at risk, effectiveness of treatments on survival, and access to those treatments will influence the extent of brain tumor metastasis at the population level. These findings provide insight on the patterns of brain tumor metastasis and the future burden of this condition in the United States. PMID:22898372

  9. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data.

    PubMed

    Davis, Faith G; Dolecek, Therese A; McCarthy, Bridget J; Villano, John L

    2012-09-01

    Few population estimates of brain metastasis in the United States are available, prompting this study. Our objective was to estimate the expected number of metastatic brain tumors that would subsequently develop among incident cancer cases for 1 diagnosis year in the United States. Incidence proportions for primary cancer sites known to develop brain metastasis were applied to United States cancer incidence data for 2007 that were retrieved from accessible data sets through Centers for Disease Control and Prevention (CDC Wonder) and Surveillance, Epidemiology, and End Results (SEER) Program Web sites. Incidence proportions were identified for cancer sites, reflecting 80% of all cancers. It was conservatively estimated that almost 70 000 new brain metastases would occur over the remaining lifetime of individuals who received a diagnosis in 2007 of primary invasive cancer in the United States. That is, 6% of newly diagnosed cases of cancer during 2007 would be expected to develop brain metastasis as a progression of their original cancer diagnosis; the most frequent sites for metastases being lung and bronchus and breast cancers. The estimated numbers of brain metastasis will be expected to be higher among white individuals, female individuals, and older age groups. Changing patterns in the occurrence of primary cancers, trends in populations at risk, effectiveness of treatments on survival, and access to those treatments will influence the extent of brain tumor metastasis at the population level. These findings provide insight on the patterns of brain tumor metastasis and the future burden of this condition in the United States.

  10. Brain and central nervous system cancer incidence in navarre (Spain), 1973-2008 and projections for 2014.

    PubMed

    Etxeberria, J; Román, E San; Burgui, R; Guevara, M; Moreno-Iribas, C; Urbina, M J; Ardanaz, E

    2015-01-01

    Different studies have pointed out Navarre as one of the regions of Spain with the highest incidence rates of brain and other central nervous system (CNS) cancer. Trend analysis for cancer incidence rates for long periods of time, might help determining risk factors as well as, assessing prevention actions involved in this disease. The objective of this study was to describe the incidence of brain and CNS cancer using data from the population-based cancer registry of Navarre, (Spain) during the period 1973-2008 and provide forecast figures up to-2014. Crude and age-standardized (world population) incidence rates of brain cancer per 100,000 person-years were calculated by the direct method separately by gender, area (Pamplona and others), and age-groups. Penalized splines for smoothing rates in the temporal dimensions were applied in order to estimate and forecast cancer incidence rates. Age-adjusted incidence rates showed an increase over the study and forecast periods in both sexes more marked in women than in men. Higher incidence rates were observed in men compared with women but the differences became smaller with time. The increase was due to the rise of rates in the oldest age groups since the rates for younger age groups remained stable or decreased over time. As the entire aetiology of brain and other CNS cancer is not still clear, keep promoting healthful lifestyles for cancer primary prevention among the whole population is necessary.

  11. Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study

    SciTech Connect

    Shibamoto, Yuta Baba, Fumiya; Oda, Kyota; Hayashi, Shinya; Kokubo, Masaki; Ishihara, Shun-Ichi; Itoh, Yoshiyuki; Ogino, Hiroyuki; Koizumi, Masahiko

    2008-11-15

    Purpose: To determine the incidence of brain atrophy and dementia after whole-brain radiotherapy (WBRT) in patients with brain metastases not undergoing surgery. Methods and Materials: Eligible patients underwent WBRT to 40 Gy in 20 fractions with or without a 10-Gy boost. Brain magnetic resonance imaging or computed tomography and Mini-Mental State Examination (MMSE) were performed before and soon after radiotherapy, every 3 months for 18 months, and every 6 months thereafter. Brain atrophy was evaluated by change in cerebrospinal fluid-cranial ratio (CCR), and the atrophy index was defined as postradiation CCR divided by preradiation CCR. Results: Of 101 patients (median age, 62 years) entering the study, 92 completed WBRT, and 45, 25, and 10 patients were assessable at 6, 12, and 18 months, respectively. Mean atrophy index was 1.24 {+-} 0.39 (SD) at 6 months and 1.32 {+-} 0.40 at 12 months, and 18% and 28% of the patients had an increase in the atrophy index by 30% or greater, respectively. No apparent decrease in mean MMSE score was observed after WBRT. Individually, MMSE scores decreased by four or more points in 11% at 6 months, 12% at 12 months, and 0% at 18 months. However, about half the decrease in MMSE scores was associated with a decrease in performance status caused by systemic disease progression. Conclusions: Brain atrophy developed in up to 30% of patients, but it was not necessarily accompanied by MMSE score decrease. Dementia after WBRT unaccompanied by tumor recurrence was infrequent.

  12. Brain stem auditory evoked potentials: effects of ovarian steroids correlated with increased incidence of Bell's palsy in pregnancy.

    PubMed

    Ben David, Y; Tal, J; Podoshin, L; Fradis, M; Sharf, M; Pratt, H; Faraggi, D

    1995-07-01

    To investigate the effect of ovarian steroids on the brain stem during changes of estrogen and progesterone blood levels, we recorded brain stem auditory evoked potentials with increased stimulus rates from 26 women treated for sterility by menotropins (Pergonal and Metrodin). These women were divided into three groups according to their estrogen and progesterone blood levels. The brain stem auditory evoked potential results revealed a significant delay of peak III only, with an increased stimulus rate in the group with the highest estrogen level. Estrogen may cause a brain stem synaptic impairment, presumably because of ischemic changes, and thus also may be responsible for a higher incidence of Bell's palsy during pregnancy.

  13. Incidence and treatment of brain metastasis in patients with esophageal carcinoma

    PubMed Central

    Feng, Wei; Zhang, Peng; Zheng, Xiao; Chen, Ming; Mao, Wei-Min

    2015-01-01

    Brain metastasis from esophageal carcinoma (BMEC) is very rare, but its incidence has increased in the United States, Japan, China and other counties. Reports on BMEC have largely been focused on examining whether adjuvant therapy for esophageal cancer influences the survival duration of BMEC patients and on the imaging characteristics of BMEC determined using new medical equipment. The difference between different pathological types of esophageal cancer, especially adenocarcinoma and squamous cell carcinoma, is one important factor used to assess the influence of BMEC. Adjuvant therapy, including radiotherapy and chemotherapy, for esophageal cancer with different characteristics in different countries may affect BMEC treatment outcomes. The degree of popularization of advanced medical equipment is a major concern related to the prevalence of BMEC. Furthermore, targeted BMEC treatment is under development in developed countries. In this article, we reviewed the debate surrounding BMEC and analyzed BMEC studies from different perspectives. PMID:26019444

  14. Infant Brain Tumors: Incidence, Survival, and the Role of Radiation Based on Surveillance, Epidemiology, and End Results (SEER) Data

    SciTech Connect

    Bishop, Andrew J.; McDonald, Mark W.; Chang, Andrew L.; Esiashvili, Natia

    2012-01-01

    Purpose: To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables. Methods and Materials: The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age. Results: Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastoma and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs. 21.3 CPM). Infants with low-grade gliomas had the highest observed survival, and those with atypical teratoid rhabdoid tumors (ATRTs) or primary rhabdoid tumors of the brain had the lowest. Between 1979 and 1993, the annual rate of cases treated with radiation within the first 4 months from diagnosis declined from 20.5 CPM to <2 CPM. For infants with medulloblastoma, desmoplastic histology and treatment with both surgery and upfront radiation were associated with improved survival, but on multivariate regression, only combined surgery and radiation remained associated with improved survival, with a hazard ratio for death of 0.17 compared with surgery alone (p = 0.005). For ATRTs, those treated with surgery and upfront radiation had a 12-month survival of 100% compared with 24.4% for those treated with surgery alone (p = 0.016). For ependymomas survival was higher in patients treated in more recent decades (p = 0.001). Conclusion: The incidence of infant brain tumors has been stable since 1986. Survival outcomes varied markedly by histology. For infants with medulloblastoma and ATRTs, improved survival was observed in patients treated with both surgery and early radiation

  15. Impacts of EGFR mutation and EGFR-TKIs on incidence of brain metastases in advanced non-squamous NSCLC.

    PubMed

    Wang, Bao-Xiao; Ou, Wei; Mao, Xiao-Yong; Liu, Zui; Wu, Hui-Qi; Wang, Si-Yu

    2017-09-01

    Brain metastases remain lethal in lung cancer patients. The impacts of epidermal growth factor receptor (EGFR) mutations and EGFR tyrosine kinase inhibitors (TKIs) on the incidence of brain metastases in patients with advanced non-squamous non-small cell lung cancer (NSCLC) are still uncertain. A total of 1672 patients with advanced non-squamous NSCLC with a definitive report on EGFR mutation status between January 2005 and June 2013 were retrospectively analyzed. The impacts of EGFR mutation status and EGFR TKIs use on the incidence of brain metastases and survival were investigated. Of the 1672 patients, 465 (27.8%) had an EGFR mutation, and 1207 (72.2%) did not. Four hundred and eighteen (25.0%) patients had baseline brain metastases. The cumulative incidence of brain metastases for patients in EGFR+ group was significantly higher than patients in EGFR- group (HR, 1.27; 95% CI 1.06-1.52; P=0.008). The cumulative incidence of brain metastases was also higher for patients who received an EGFR-TKI as their first-line treatment than those who received other first-line treatment (HR, 1.36; 95% CI 1.14-1.64; P=0.001). Patients harboring EGFR mutations had prolonged overall survival (OS) than patients with wild-type EGFR (HR, 0.47; 95% CI 0.41-0.54; P<0.001; median, 25.2 vs. 12.9 months). Both the EGFR mutation-positive status and the use of a TKI are associated with higher incidence of brain metastases for patients with advanced non-squamous NSCLC. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Incidence of pituitary dysfunction following traumatic brain injury: A prospective study from a regional neurosurgical centre.

    PubMed

    Alavi, Seyed Alireza; Tan, Chin Lik; Menon, David K; Simpson, Helen L; Hutchinson, Peter J

    2016-06-01

    Patients with traumatic brain injury (TBI) may develop pituitary dysfunction. Although, there is now increasing awareness of and investigations into such post-traumatic hypopituitarism (PTHP), the exact prevalence and incidence remain uncertain. Here, we aim to identify the incidence of PTHP in a selected population of TBI patients deemed at risk of PTHP at a regional neurosurgical centre in the UK. A total of 105 patients have been assessed in two cohorts: (i) 58 patients in serial cohort and (ii) 47 patients in cross-sectional late cohort. We found that in serial cohort, 10.3% (6/58) of TBI patients had abnormalities of the pituitary-adrenal axis in the acute phase (Day 0-7 post injury). In comparison, in cross-sectional late cohort, 21.3% (10/47) of the patients developed dysfunction in at least one of their pituitary axes at 6 months or more post-TBI, with hypogonadotrophic hypogonadism being the most common. Twenty-two patients from these two cohorts had their growth hormone assessment at 12 months or more post-TBI and 9.1% (2/22) were found to have growth hormone deficiency. Our results suggest that PTHP is a common condition amongst sufferers of TBI, and appropriate measures should be taken to detect and manage it.

  17. The effect of alcohol on incidence, pattern, severity and outcome from traumatic brain injury.

    PubMed

    Gururaj, G

    2004-03-01

    Alcohol consumption is known to be a major contributing factor for the occurrence of traumatic brain injuries (TBIs) in both developed and developing countries. It also influences diagnosis, management and recovery from TBIs, subsequent to injury occurrence. The present report examines the association of alcohol in injury occurrence, and its impact on severity and outcome from TBIs. Subjects were identified from 7 major hospitals in the city of Bangalore, India with data collection undertaken by standardised methods. Alcohol users (n = 243) and non-users (n = 1310) were compared on various characteristics and injury details. Sixteen per cent of the injured patients were intoxicated at the time of hospital registration. While the incidence of road traffic injuries was similar in both the groups, falls were higher in the alcohol user group. Evening-and night-time consumption of alcohol was a major risk factor for injuries. Drivers and occupants of motorised two wheeler vehicles, and pedestrians were involved in crashes to a greater extent among alcohol users. Severity of brain injuries (based on Glasgow coma scale), duration of hospital stay, death and post-traumatic disabilities among alcohol users were significantly higher compared with non-users. With the emergence of injuries and alcohol as twin major public health problems, immediate efforts are required to reduce the burden in developing societies. Legislative and enforcement strategies along with education developed on epidemiological, clinical and public health research need to be co-ordinated, target oriented, visible and with stiffer penalties for achieving desired results.

  18. Childhood brain tumours and use of mobile phones: comparison of a case-control study with incidence data.

    PubMed

    Aydin, Denis; Feychting, Maria; Schüz, Joachim; Röösli, Martin

    2012-05-20

    The first case-control study on mobile phone use and brain tumour risk among children and adolescents (CEFALO study) has recently been published. In a commentary published in Environmental Health, Söderqvist and colleagues argued that CEFALO suggests an increased brain tumour risk in relation to wireless phone use. In this article, we respond and show why consistency checks of case-control study results with observed time trends of incidence rates are essential, given the well described limitations of case-control studies and the steep increase of mobile phone use among children and adolescents during the last decade. There is no plausible explanation of how a notably increased risk from use of wireless phones would correspond to the relatively stable incidence time trends for brain tumours among children and adolescents observed in the Nordic countries. Nevertheless, an increased risk restricted to heavy mobile phone use, to very early life exposure, or to rare subtypes of brain tumours may be compatible with stable incidence trends at this time and thus further monitoring of childhood brain tumour incidence rate time trends is warranted.

  19. Posttraumatic Hydrocephalus as a Confounding Influence on Brain Injury Rehabilitation: Incidence, Clinical Characteristics, and Outcomes.

    PubMed

    Weintraub, Alan H; Gerber, Donald J; Kowalski, Robert G

    2017-02-01

    To describe incidence, clinical characteristics, complications, and outcomes in posttraumatic hydrocephalus (PTH) after traumatic brain injury (TBI) for patients treated in an inpatient rehabilitation program. Cohort study with retrospective comparative analysis. Inpatient rehabilitation hospital. All patients admitted for TBI from 2009 to 2013 diagnosed with PTH (N=59), defined as ventriculomegaly, delayed clinical recovery discordant with injury severity, hydrocephalus symptoms, or positive lumbar puncture results. None. Primary measures were incidence of PTH and patient and injury characteristics. Secondary measures included frequency and timing of ventriculoperitoneal (VP) shunt, related complications, emergence from and duration of posttraumatic amnesia (PTA), Rancho Los Amigos Scale (RLAS) score, and FIM score at rehabilitation admission and discharge. Of 701 patients with TBI admitted, 59 (8%) were diagnosed with PTH. Of these, the median age was 25 years, with 73% being men. At initial presentation, 52 (88%) did not follow commands. Fifty-two (90%) patients with PTH had a VP shunt placed. Median time from injury to shunt placement was 69 (range, 9-366) days. Seven (12%) patients with PTH experienced postsurgical seizure, 3 (6%) had shunt infection, and 7 (12%) had shunt malfunction. Thirty-six (61%) patients with PTH emerged from PTA during rehabilitation. Median total FIM score at rehabilitation admission was 20 (range, 18-76), and at discharge it was 43 (range, 18-118). Injury severity predicted outcome at rehabilitation admission, whereas shunt timing predicted outcome at rehabilitation discharge. Incidence of PTH was observed in 8% of patients with TBI in inpatient rehabilitation. Earlier shunting predicted improved outcome during rehabilitation. Future studies should prospectively examine clinical decision rules, type, and timing of intervention and the coeffectiveness of rehabilitation treatment on outcomes. Copyright © 2016 American Congress of

  20. Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution.

    PubMed

    Esnault, Pierre; Cardinale, Mickaël; Boret, Henry; D'Aranda, Erwan; Montcriol, Ambroise; Bordes, Julien; Prunet, Bertrand; Joubert, Christophe; Dagain, Arnaud; Goutorbe, Philippe; Kaiser, Eric; Meaudre, Eric

    2016-07-29

    OBJECTIVE Blunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI. METHODS The authors conducted a prospective, observational, single-center study including all patients with severe TBI admitted in the trauma center. Diagnosis of BCVI was performed using a 64-channel multidetector CT. Characteristics of the patients, CT scan results, and outcomes were collected. A multivariate logistic regression model was developed to determine the risk factors of BCVI. Patients in whom BCVI was diagnosed were treated with systemic anticoagulation. RESULTS In total, 228 patients with severe TBI who were treated over a period of 7 years were included. The incidence of BCVI was 9.2%. The main risk factors were as follows: motorcycle crash (OR 8.2, 95% CI 1.9-34.8), fracture involving the carotid canal (OR 11.7, 95% CI 1.7-80.9), cervical spine injury (OR 13.5, 95% CI 3.1-59.4), thoracic trauma (OR 7.3, 95% CI 1.1-51.2), and hepatic lesion (OR 13.3, 95% CI 2.1-84.5). Among survivors, 82% of patients with BCVI received systemic anticoagulation therapy, beginning at a median of Day 1.5. The overall stroke rate was 19%. One patient had an intracranial hemorrhagic complication. CONCLUSIONS Blunt cerebrovascular injuries are frequent after severe TBI (incidence 9.2%). The main risk factors are high-velocity lesions and injuries near cervical arteries.

  1. Acute Ischemic Stroke After Moderate to Severe Traumatic Brain Injury: Incidence and Impact on Outcome.

    PubMed

    Kowalski, Robert G; Haarbauer-Krupa, Juliet K; Bell, Jeneita M; Corrigan, John D; Hammond, Flora M; Torbey, Michel T; Hofmann, Melissa C; Dams-O'Connor, Kristen; Miller, A Cate; Whiteneck, Gale G

    2017-07-01

    Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome. A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed. Outcome measures were AIS incidence, duration of posttraumatic amnesia, Functional Independence Measure, and Disability Rating Scale, at rehabilitation discharge. Between October 1, 2007, and March 31, 2015, 6488 patients with TBI were enrolled in the Traumatic Brain Injury Model Systems National Database. One hundred and fifty-nine (2.5%) patients had a concurrent AIS, and among these, median age was 40 years. AIS was associated with intracranial mass effect and carotid or vertebral artery dissection. High-velocity events more commonly caused TBI with dissection. AIS predicted poorer outcome by all measures, accounting for a 13.3-point reduction in Functional Independence Measure total score (95% confidence interval, -16.8 to -9.7; P<0.001), a 1.9-point increase in Disability Rating Scale (95% confidence interval, 1.3-2.5; P<0.001), and an 18.3-day increase in posttraumatic amnesia duration (95% confidence interval, 13.1-23.4; P<0.001). Ischemic stroke is observed acutely in 2.5% of moderate to severe TBI survivors and predicts worse functional and cognitive outcome. Half of TBI patients with AIS were aged ≤40 years, and AIS patients more often had cervical dissection. Vigilance for AIS is warranted acutely after TBI, particularly after high-velocity events. © 2017 American Heart Association, Inc.

  2. Incidence of brain metastases as a first site of recurrence among women with triple receptor-negative breast cancer

    PubMed Central

    Dawood, Shaheenah; Lei, Xiudong; Litton, Jennifer K.; Buchholz, Thomas A.; Hortobagyi, Gabriel N.; Gonzalez-Angulo, Ana M.

    2014-01-01

    Background The aim of this retrospective study was to define the incidence of brain metastases as a first site of recurrence among women with triple receptor-negative breast cancer (TNBC). Methods 2448 patients with stage I–III TNBC diagnosed between 1990 and 2010 were identified. We computed the cumulative incidence of developing brain metastases as a first site of recurrence at 2 and 5 years. Cox proportional hazards models were fitted to determine factors that could predict for the development of brain metastases as a first site of recurrence. Kaplan-Meier product limit method was used to compute survival following a diagnosis of brain metastases. Results At a median follow up of 39 months 115 (4.7%) patients had developed brain metastases as a first site of recurrence. The cumulative incidence at 2 and 5 years was 3.7% (95% CI 2.9%–4.5%) and 5.4% (95% CI 4.4%–6.5%), respectively. Among patients with stage I, II and III disease, the 2-year cumulative incidence of brain metastases was 0.8%, 3.1% and 8%, respectively (p<0.0001). 5-year cumulative incidence was 2.8%, 4.6% and 9.6% among patients with stage I, II and III disease, respectively (p<0.0001). In the multivariable model, patients with stage III disease had a significant increase in the risk of developing brain metastases as a first site of recurrence (HR = 3.51; 95% CI 1.85 – 6.67; p = .0001) compared to patients with stage I disease. Those with stage II disease had a non significant increased risk of developing brain metastases as a first site of recurrence (HR = 1.61; 95% CI 0.92 – 2.81; p = .10) compared to patients with stage I disease. Median survival following a diagnosis of brain metastases was 7.2 months (range 5.7 to 9.4 months). Conclusion Patients with non metastatic TNBC have a high early incidence of developing brain metastases as a first site of recurrence, which is associated with subsequent poor survival. Patients with stage III TNBC in particular would be an ideal cohort to

  3. Incidence of adult brain cancers is higher in countries where the protozoan parasite Toxoplasma gondii is common

    USGS Publications Warehouse

    Thomas, Frédéric; Lafferty, Kevin D.; Brodeur, Jacques; Elguero, Eric; Gauthier-Clerc, Michel; Missé, Dorothée

    2012-01-01

    We explored associations between the common protozoan parasite Toxoplasma gondii and brain cancers in human populations. We predicted that T. gondii could increase the risk of brain cancer because it is a long-lived parasite that encysts in the brain, where it provokes inflammation and inhibits apoptosis. We used a medical geography approach based on the national incidence of brain cancers and seroprevalence of T. gondii. We corrected reports of incidence for national gross domestic product because wealth probably increases the ability to detect cancer. We also included gender, cell phone use and latitude as variables in our initial models. Prevalence of T. gondii explained 19 per cent of the residual variance in brain cancer incidence after controlling for the positive effects of gross domestic product and latitude among nations. Infection with T. gondii was associated with a 1.8-fold increase in the risk of brain cancers across the range of T. gondii prevalence in our dataset (4–67%). These results, though correlational, suggest that T. gondii should be investigated further as a possible oncogenic pathogen of humans.

  4. Incidence and mortality of acquired brain injury in young Danish adults between 1994 and 2013: a nationwide study.

    PubMed

    Tibæk, Maiken; Forchhammer, Hysse Birgitte; Dehlendorff, Christian; Johnsen, Søren Paaske; Kammersgaard, Lars Peter

    2017-09-28

    We estimated the annually incidence and mortality of acquired brain injury (ABI) in people aged 15-30 years during 1994-2013. All Danes with a first-ever hospital diagnosis of ABI, including traumatic brain injury (TBI), encephalopathy, CNS-infection or brain tumour, were identified in the Danish National Patient Register. Incidence rates (IRs) and estimated annual percentage changes (EAPC) were estimated by Poisson regression. Mortality was estimated by the Kaplan-Meier estimator and adjusted hazard ratios (aHR) were computed using Cox regression with 1994-1998. A total of 10,542 individuals were hospitalized with a first-time diagnosis of ABI. The IR for ABI decreased from 63.36 to 33.91/100,000 person-years from 1994 to 2013 [EAPC: -2.78% (95% CI: -3.26 to -2.28)] mainly driven by a decreasing IR of TBI [EAPC: -6.53% (95% CI: -9.57 to -3.39)] during 2007-2013. IRs of brain tumour and CNS infections also decreased significantly. The mortality after ABI tended to be higher during 1999-2013 compared to 1994-1998. For brain tumour, the 1-year mortality decreased significantly [2009-2013 aHR: 0.41 (95% CI: 0.23-0.72)]. Incidence of hospitalisations for ABI and in particular TBI has decreased significantly. Overall, the mortality after ABI has not improved, but the mortality after brain tumour has decreased significantly.

  5. Negative impact of leukoaraiosis on the incidence of brain metastases in patients with lung cancer.

    PubMed

    Hayashi, Nakamasa; Mitsuya, Koichi; Nakasu, Yoko; Naito, Tateaki; Ohka, Fumiharu; Takahashi, Toshiaki

    2017-07-27

    The embolization of cancer cells to cerebral vessels occurs early in the multi-step metastatic process. We aimed to determine whether the presence of leukoaraiosis (LA) before treatment would predict the development of brain metastases (BM) in patients with lung cancer. Between January 2014 and June 2015, 1007 patients underwent initial (i.e., prior to any chemotherapy) or routine magnetic resonance (MR) imaging of the brain and exhibited no evidence of BM. Of these, 189 underwent repeat MR imaging; 34 of 189 patients (18%) developed new BM, whereas 155 patients did not. LA was retrospectively evaluated according to Fazekas scale on the initial screening MR images of these 189 patients. The frequency of grade 0 periventricular hyperintensity (PVH) was greater among patients with BM, compared to those without BM (p = 0.001). In a multivariate analysis, patients with adenocarcinoma (95% confidence interval [CI] 1.8-171.8) and small cell carcinoma (95% CI 1.4-172.4) respectively developed BM at 9.3- and 8.8-fold higher rates than those with squamous cell carcinoma. Patients with grade 0 PVH developed BM at a rate 3.5-, 8.6-, and 3.6-fold higher rates than those with grade 1 (95% CI 1.4-9.0), 2 (95% CI 2.4-41.9), and 3 (95% CI 1.02-15.0), respectively. Lung cancer patients with grade 0 PVH on initial MR images have a high subsequent incidence of BM. PVH is a useful method for evaluating risk of BM.

  6. B vitamins and magnetic resonance imaging-detected ischemic brain lesions in patients with recent transient ischemic attack or stroke: the VITAmins TO Prevent Stroke (VITATOPS) MRI-substudy.

    PubMed

    Cavalieri, Margherita; Schmidt, Reinhold; Chen, Christopher; Mok, Vincent; de Freitas, Gabriel R; Song, Swithin; Yi, Qilong; Ropele, Stefan; Grazer, Anja; Homayoon, Nina; Enzinger, Christian; Loh, Katherine; Wong, Ka Sing Lawrence; Wong, Adrian; Xiong, Yunyun; Chang, Hui Meng; Wong, Meng Cheong; Fazekas, Franz; Eikelboom, John W; Hankey, Graeme J

    2012-12-01

    Elevated concentrations of homocysteine are associated with cerebral small vessel disease (CSVD). B-vitamin supplementation with folate and vitamins B12 and B6 reduces homocysteine concentrations. In a substudy of the VITAmins TO Prevent Stroke (VITATOPS) trial, we assessed the hypothesis that the addition of once-daily supplements of B vitamins would reduce the progression of CSVD-related brain lesions. A total of 359 patients with recent stroke or transient ischemic attack, who were randomly allocated to double-blind treatment with placebo or b vitamins, underwent brain MRI at randomization and after 2 years of B-vitamin supplementation. MR images were analyzed blinded to treatment allocation. Outcomes related to the prespecified hypothesis were progression of white matter hyperintensities and incident lacunes. We also explored the effect of B-vitamin supplementation on the incidence of other ischemic abnormalities. After 2 years of treatment with b vitamins or placebo, there was no significant difference in white matter hyperintensities volume change (0.08 vs 0.13 cm3; P=0.419) and incidence of lacunes (8.0% vs 5.9%, P=0.434; odds ratio=1.38). In a subanalysis of patients with MRI evidence of severe CSVD at baseline, b-vitamin supplementation was associated with a significant reduction in white matter hyperintensities volume change (0.3 vs 1.7 cm3; P=0.039). Daily B-vitamin supplementation for 2 years did not significantly reduce the progression of brain lesions resulting from presumed CSVD in all patients with recent stroke or transient ischemic attack but may do so in the subgroup of patients with recent stroke or transient ischemic attack and severe CSVD. http://vitatops.highway1.com.au/. Unique identifier: NCT00097669 and ISRCTN74743444.

  7. Older Candidates for Subthalamic Deep Brain Stimulation in Parkinson's Disease Have a Higher Incidence of Psychiatric Serious Adverse Events

    PubMed Central

    Cozac, Vitalii V.; Ehrensperger, Michael M.; Gschwandtner, Ute; Hatz, Florian; Meyer, Antonia; Monsch, Andreas U.; Schuepbach, Michael; Taub, Ethan; Fuhr, Peter

    2016-01-01

    Objective: To investigate the incidence of serious adverse events (SAE) of subthalamic deep brain stimulation (STN-DBS) in elderly patients with Parkinson's disease (PD). Methods: We investigated a group of 26 patients with PD who underwent STN-DBS at mean age 63.2 ± 3.3 years. The operated patients from the EARLYSTIM study (mean age 52.9 ± 6.6) were used as a comparison group. Incidences of SAE were compared between these groups. Results: A higher incidence of psychosis and hallucinations was found in these elderly patients compared to the younger patients in the EARLYSTIM study (p < 0.01). Conclusions: The higher incidence of STN-DBS-related psychiatric complications underscores the need for comprehensive psychiatric pre- and postoperative assessment in older DBS candidates. However, these psychiatric SAE were transient, and the benefits of DBS clearly outweighed its adverse effects. PMID:27375478

  8. The incidence rate and mortality of malignant brain tumors after 10 years of intensive cell phone use in Taiwan.

    PubMed

    Hsu, Min-Huei; Syed-Abdul, Shabbir; Scholl, Jeremiah; Jian, Wen-Shan; Lee, Peisan; Iqbal, Usman; Li, Yu-Chuan

    2013-11-01

    The issue of whether cell phone usage can contribute toward the development of brain tumors has recently been reignited with the International Agency for Research on Cancer classifying radiofrequency electromagnetic fields as 'possibly' carcinogenic to humans in a WHO report. To our knowledge, this is the largest study reporting on the incidence and mortality of malignant brain tumors after long-term use of the cell phone by more than 23 million users. A population-based study was carried out the numbers of cell phone users were collected from the official statistics provided by the National Communication Commission. According to National Cancer Registry, there were 4 incidences and 4 deaths due to malignant neoplasms in Taiwan during the period 2000-2009. The 10 years of observational data show that the intensive user rate of cell phones has had no significant effect on the incidence rate or on the mortality of malignant brain tumors in Taiwan. In conclusion, we do not detect any correlation between the morbidity/mortality of malignant brain tumors and cell phone use in Taiwan. We thus urge international agencies to publish only confirmatory reports with more applicable conclusions in public. This will help spare the public from unnecessary worries.

  9. Incidence of Traumatic Brain Injury Across the Full Disease Spectrum: A Population-Based Medical Record Review Study

    PubMed Central

    Leibson, Cynthia L.; Brown, Allen W.; Ransom, Jeanine E.; Diehl, Nancy N.; Perkins, Patricia K.; Mandrekar, Jay; Malec, James F.

    2012-01-01

    Background Extremely few objective estimates of traumatic brain injury incidence include all ages, both sexes, all injury mechanisms, and the full spectrum from very mild to fatal events. Methods We used unique Rochester Epidemiology Project medical records-linkage resources, including highly sensitive and specific diagnostic coding, to identify all Olmsted County, MN, residents with diagnoses suggestive of traumatic brain injury regardless of age, setting, insurance, or injury mechanism. Provider-linked medical records for a 16% random sample were reviewed for confirmation as definite, probable, possible (symptomatic), or no traumatic brain injury. We estimated incidence per 100,000 person-years for 1987–2000 and compared these record-review rates with rates obtained using Centers for Disease Control and Prevention (CDC) data-systems approach. For the latter, we identified all Olmsted County residents with any CDC-specified diagnosis codes recorded on hospital/emergency department administrative claims or death certificates 1987–2000. Results Of sampled individuals, 1257 met record-review criteria for incident traumatic brain injury; 56% were ages 16–64 years, 56% were male, 53% were symptomatic. Mechanism, sex, and diagnostic certainty differed by age. The incidence rate per 100,000 person-years was 558 (95% confidence interval = 528–590) versus 341 (331–350) using the CDC data system approach. The CDC approach captured only 40% of record-review cases. Seventy-four percent of missing cases presented to hospital/emergency department; none had CDC-specified codes assigned on hospital/emergency department administrative claims or death certificates; 66% were symptomatic. Conclusions Capture of symptomatic traumatic brain injuries requires a wider range of diagnosis codes, plus sampling strategies to avoid high rates of false-positive events. PMID:21968774

  10. Brain metastases after breast-conserving therapy and systemic therapy: incidence and characteristics by biologic subtype.

    PubMed

    Arvold, Nils D; Oh, Kevin S; Niemierko, Andrzej; Taghian, Alphonse G; Lin, Nancy U; Abi-Raad, Rita F; Sreedhara, Meera; Harris, Jay R; Alexander, Brian M

    2012-11-01

    The characteristics of brain metastases (BM) that develop after breast-conserving therapy (BCT) for early-stage breast cancer (BC) remain incompletely defined. We examined 1,434 consecutive patients with stage I/II invasive BC who received BCT from 1997 to 2006, 91 % of whom received adjuvant systemic therapy, according to BC subtype. Median follow-up was 85 months. Overall 5-year cumulative incidence of BM was 1.7 %; 0.1 % for luminal A, 3.3 % for luminal B, 3.2 % for luminal-HER2, 3.7 % for HER2, and 7.4 % for triple negative (TN). Women who developed BM were more likely at BC diagnosis to be younger (P < .0001) and have node-positive (P < .0001), grade 3 (P < .0001), hormone receptor-negative (P = .006), and HER2-positive (P = .01) tumors. Median time from BC diagnosis to BM was 51.4 months (range, 7.6-108 months), which was longer among luminal versus non-luminal subtypes (P = .0002; median, 61.4 vs. 34.5 months). Thirty-four percent of patients who developed distant metastases (DM) eventually developed BM. Median time from DM to BM was 12.8 months but varied by subtype, including 7.4 months for TN, 9.6 months for luminal B, and 27.1 months for HER2. Eighty-one percent of all BM patients presented with neurologic symptoms. Median number of BM at diagnosis was two, and median BM size was 15 mm, with TN (27 mm) and luminal B (16 mm) exhibiting the largest median sizes. In conclusion, the risk of BM after BCT varies significantly by subtype. Given the large size and symptomatic presentation among luminal B and TN subtypes, earlier BM detection might improve quality of life or increase eligibility for non-invasive treatments including stereotactic radiosurgery. Women with DM from these two BC subtypes have a high incidence of BM with a short latency, suggesting an ideal target population for trials evaluating the utility of MRI screening.

  11. The relation between the incidence of hypernatremia and mortality in patients with severe traumatic brain injury

    PubMed Central

    2009-01-01

    Introduction The study was aimed at verifying whether the occurrence of hypernatremia during the intensive care unit (ICU) stay increases the risk of death in patients with severe traumatic brain injury (TBI). We performed a retrospective study on a prospectively collected database including all patients consecutively admitted over a 3-year period with a diagnosis of TBI (post-resuscitation Glasgow Coma Score ≤ 8) to a general/neurotrauma ICU of a university hospital, providing critical care services in a catchment area of about 1,200,000 inhabitants. Methods Demographic, clinical, and ICU laboratory data were prospectively collected; serum sodium was assessed an average of three times per day. Hypernatremia was defined as two daily values of serum sodium above 145 mmol/l. The major outcome was death in the ICU after 14 days. Cox proportional-hazards regression models were used, with time-dependent variates designed to reflect exposure over time during the ICU stay: hypernatremia, desmopressin acetate (DDAVP) administration as a surrogate marker for the presence of central diabetes insipidus, and urinary output. The same models were adjusted for potential confounding factors. Results We included in the study 130 TBI patients (mean age 52 years (standard deviation 23); males 74%; median Glasgow Coma Score 3 (range 3 to 8); mean Simplified Acute Physiology Score II 50 (standard deviation 15)); all were mechanically ventilated; 35 (26.9%) died within 14 days after ICU admission. Hypernatremia was detected in 51.5% of the patients and in 15.9% of the 1,103 patient-day ICU follow-up. In most instances hypernatremia was mild (mean 150 mmol/l, interquartile range 148 to 152). The occurrence of hypernatremia was highest (P = 0.003) in patients with suspected central diabetes insipidus (25/130, 19.2%), a condition that was associated with increased severity of brain injury and ICU mortality. After adjustment for the baseline risk, the incidence of hypernatremia over the

  12. Incidence of seizures on continuous EEG monitoring following traumatic brain injury in children.

    PubMed

    O'Neill, Brent R; Handler, Michael H; Tong, Suhong; Chapman, Kevin E

    2015-08-01

    OBJECT Seizures may cause diagnostic confusion and be a source of metabolic stress after traumatic brain injury (TBI) in children. The incidence of electroencephalography (EEG)-confirmed seizures and of subclinical seizures in the pediatric population with TBI is not well known. METHODS A routine protocol for continuous EEG (cEEG) monitoring was initiated for all patients with moderate or severe TBI at a Level 1 pediatric trauma center. Over a 3.5-year period, all patients with TBI who underwent cEEG monitoring, both according to protocol and those with mild head injuries who underwent cEEG monitoring at the discretion of the treating team, were identified prospectively. Clinical data were collected and analyzed. RESULTS Over the study period, 594 children were admitted with TBI, and 144 of these children underwent cEEG monitoring. One hundred two (71%) of these 144 children had moderate or severe TBI. Abusive head trauma (AHT) was the most common mechanism of injury (65 patients, 45%) in children with cEEG monitoring. Seizures were identified on cEEG in 43 patients (30%). Forty (93%) of these 43 patients had subclinical seizures, including 17 (40%) with only subclinical seizures and 23 (53%) with both clinical and subclinical seizures. Fifty-three percent of patients with seizures experienced status epilepticus. Age less than 2.4 years and AHT mechanism were strongly correlated with presence of seizures (odds ratios 8.7 and 6.0, respectively). Those patients with only subclinical seizures had the same risk factors as the other groups. The presence of seizures did not correlate with discharge disposition but was correlated with longer hospital stay and intensive care unit stay. CONCLUSIONS Continuous EEG monitoring identifies a significant number of subclinical seizures acutely after TBI. Children younger than 2.4 years of age and victims of AHT are particularly vulnerable to subclinical seizures, and seizures in general. Continuous EEG monitoring allows for

  13. Association between resting-state brain functional connectivity and muscle sympathetic burst incidence

    PubMed Central

    Kucyi, Aaron; Millar, Philip J.; Murai, Hisayoshi; Kimmerly, Derek S.; Morris, Beverley L.; Bradley, T. Douglas; Floras, John S.

    2015-01-01

    The insula (IC) and cingulate are key components of the central autonomic network and central nodes of the salience network (SN), a set of spatially distinct but temporally correlated brain regions identified with resting-state (task free) functional MRI (rsMRI). To examine the SN's involvement in sympathetic outflow, we tested the hypothesis that individual differences in intrinsic connectivity of the SN correlate positively with resting postganglionic muscle sympathetic nerve activity (MSNA) burst incidence (BI) in subjects without and with obstructive sleep apnea (OSA). Overnight polysomnography, 5-min rsMRI, and fibular MSNA recording were performed in 36 subjects (mean age 57 yr; 10 women, 26 men). Independent component analysis (ICA) of the entire cohort identified the SN as including bilateral IC, pregenual anterior cingulate cortex (pgACC), midcingulate cortex (MCC), and the temporoparietal junction (TPJ). There was a positive correlation between BI and the apnea-hypopnea index (AHI) (P < 0.001), but dual-regression analysis identified no differences in SN functional connectivity between subjects with no or mild OSA (n = 17) and moderate or severe (n = 19) OSA. Correlation analysis relating BI to the strength of connectivity within the SN revealed large (i.e., spatial extent) and strong correlations for the left IC (P < 0.001), right pgACC/MCC (P < 0.006), left TPJ (P < 0.004), thalamus (P < 0.035), and cerebellum (P < 0.013). Indexes of sleep apnea were unrelated to BI and the strength of SN connectivity. There were no relationships between BI and default or sensorimotor network connectivity. This study links connectivity within the SN to MSNA, demonstrating several of its nodes to be key sympathoexcitatory regions. PMID:26538607

  14. Time trends (1998-2007) in brain cancer incidence rates in relation to mobile phone use in England.

    PubMed

    de Vocht, Frank; Burstyn, Igor; Cherrie, John W

    2011-07-01

    Mobile phone use in the United Kingdom and other countries has risen steeply since the early 1990's when the first digital mobile phones were introduced. There is an ongoing controversy about whether radio frequency (RF) exposure from mobile phones increases the risk of brain cancer. However, given the widespread use and nearly two decades elapsing since mobile phones were introduced, an association should have produced a noticeable increase in the incidence of brain cancer by now. Trends in rates of newly diagnosed brain cancer cases in England between 1998 and 2007 were examined. There were no time trends in overall incidence of brain cancers for either gender, or any specific age group. Systematic increases in rates for cancers of the temporal lobe in men (0.04 new cases/year) and women (0.02/year) were observed, along with decreases in the rates of cancers of the parietal lobe (-0.03/year), cerebrum (-0.02/year) and cerebellum (-0.01/year) in men only. The increased use of mobile phones between 1985 and 2003 has not led to a noticeable change in the incidence of brain cancer in England between 1998 and 2007. The observed increase in the rate of cancers in the temporal lobe, if caused by mobile phone use, would constitute <1 additional case per 100,000 people in that period. These data do not indicate a pressing need to implement a precautionary principle by means of population-wide interventions to reduce RF exposure from mobile phones.

  15. Association between number of cell phone contracts and brain tumor incidence in nineteen U.S. States.

    PubMed

    Lehrer, Steven; Green, Sheryl; Stock, Richard G

    2011-02-01

    Some concern has arisen about adverse health effects of cell phones, especially the possibility that the low power microwave-frequency signal transmitted by the antennas on handsets might cause brain tumors or accelerate the growth of subclinical tumors. We analyzed data from the Statistical Report: Primary Brain Tumors in the United States, 2000-2004 and 2007 cell phone subscription data from the Governing State and Local Sourcebook. There was a significant correlation between number of cell phone subscriptions and brain tumors in nineteen US states (r = 0.950, P < 0.001). Because increased numbers of both cell phone subscriptions and brain tumors could be due solely to the fact that some states, such as New York, have much larger populations than other states, such as North Dakota, multiple linear regression was performed with number of brain tumors as the dependent variable, cell phone subscriptions, population, mean family income and mean age as independent variables. The effect of cell phone subscriptions was significant (P = 0.017), and independent of the effect of mean family income (P = 0.894), population (P = 0.003) and age (0.499). The very linear relationship between cell phone usage and brain tumor incidence is disturbing and certainly needs further epidemiological evaluation. In the meantime, it would be prudent to limit exposure to all sources of electro-magnetic radiation.

  16. Oxidative Stress Increases the Blood Brain Barrier Permeability Resulting in Increased Incidence of Brain Metastasis in BRCA Mutation Carriers

    DTIC Science & Technology

    2014-08-01

    permeability and integrity of the brain endothelium using in vitro and in vivo models. 3) Determine the protective effects of PARP inhibitors and/or selenium ...in preventing BBB-induced damage by oxidative stress, and in inhibiting breast cancer metastasis to the brain. Further, since selenium has anti...inhibitor and ROS inhibitor of BMEC-TJs HBMEC cocultures were preincubated with PARP inhibitor (30mM) or with ROS inhibitor (10mM selenium ) for 6

  17. A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: incidence and aetiology.

    PubMed

    Salentijn, Erik G; Peerdeman, Saskia M; Boffano, Paolo; van den Bergh, Bart; Forouzanfar, Tymour

    2014-09-01

    In the literature it is questioned if the presence of maxillofacial trauma is associated with the presence of brain injury. The aim of this study is to present a 10-year retrospective study of the incidence and aetiology of maxillofacial trauma associated with brain injury that required both oral and maxillofacial and neurosurgical intervention during the same hospital stay. Forty-seven patients from a population of 579 trauma patients undergoing maxillofacial surgery were identified. The main cause of injury was road traffic collision, followed by falls. Interpersonal violence correlated less well with traumatic brain injury. Most of the patients were males, aged 20-39 years. Frontal sinus fractures were the most common maxillofacial fractures (21.9%) associated with neurosurgical input, followed by mandibular fractures and zygomatic complex fractures. In the general maxillofacial trauma population, frontal sinus fractures were only found in 2.2% of the cases. At presentation to the Emergency Department the majority of the patients were diagnosed with severe traumatic brain injury and a Marshall CT class 2. Intracranial pressure monitoring was the most common neurosurgical intervention, followed by reconstruction of a bone defect and haematoma evacuation. Although it is a small population, our data suggest that maxillofacial trauma does have an association with traumatic brain injury that requires neurosurgical intervention (8.1%). In comparison with the overall maxillofacial trauma population, our results demonstrate that frontal sinus fractures are more commonly diagnosed in association with brain injury, most likely owing to the location of the impact of the trauma. In these cases the frontal sinus seems not specifically to act as a barrier to protect the brain. This report provides useful data concerning the joint management of oral and maxillofacial surgeons and neurosurgeons for the treatment of cranio-maxillofacial trauma and brain injury patients in

  18. Incidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population: The AGES-Reykjavik Study (Age Gene/Environment Susceptibility-Reykjavik Study).

    PubMed

    Sigurdsson, Sigurdur; Aspelund, Thor; Kjartansson, Olafur; Gudmundsson, Elias F; Jonsdottir, Maria K; Eiriksdottir, Gudny; Jonsson, Palmi V; van Buchem, Mark A; Gudnason, Vilmundur; Launer, Lenore J

    2017-09-01

    The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5-2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3-2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9-3.4). Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels. © 2017 American Heart Association, Inc.

  19. Characteristics and Incidence of Traumatic Brain Injury in Older Adults Using Home Care in Ontario from 2003–2013

    PubMed Central

    McGuire, Connor; Kristman, Vicki L.; Martin, Lynn; Bédard, Michel

    2017-01-01

    Objectives Describe the characteristics and determine the annual cumulative incidence of traumatic brain injury (TBI) in older adults receiving home care in Ontario from 2003 to 2013. Methods A retrospective cohort study of longitudinal data from the Ontario Association of Community Care Access Centers (N = 554,313). TBI, demographic variables, depression, neurological conditions, and recent falls were measured from the Resident Assessment Instrument–Home Care. Comparisons were made between service users with and without TBI using odds ratios. Standardized incidence rates were calculated and the 10-year trend of annual cumulative incidence rates was examined. Results Characteristics associated with TBI: male sex (OR: 1.54), aboriginal origin (OR: 1.98), increasing age (low of OR: 1.22, in 70–74 years; high of OR: 2.31, in 90 years and older; comparison 65–69 years), being widowed (OR: 1.59), having one or more falls (OR: 2.31), the use of antidepressants (OR: 1.49) and the presence of depression (OR: 1.57), dementia (OR: 1.65), hemiplegia (OR: 4.34), multiple sclerosis (OR: 3.19) or parkinsonism (OR: 1.22). TBI incidence was significantly higher than rates previously reported in the literature. There was no change in the overall annual cumulative incidence over the 10-year period (p = .13). Conclusions Certain demographic characteristics, neurological diseases, antidepressant use, and a recent fall are associated with TBI. Incidence of TBI is higher than previous estimates and the overall incidence is not changing over time. These results can be used to improve care of the elderly and to generate hypotheses for future research regarding TBI in the home care setting. PMID:28396703

  20. The incidence of radiation necrosis following stereotactic radiotherapy for melanoma brain metastases: the potential impact of immunotherapy.

    PubMed

    Kaidar-Person, Orit; Zagar, Timothy M; Deal, Allison; Moschos, Stergios J; Ewend, Matthew G; Sasaki-Adams, Deanna; Lee, Carrie B; Collichio, Frances A; Fried, David; Marks, Lawrence B; Chera, Bhishamjit S

    2017-07-01

    Stereotactic radiotherapy (SRT) is the standard treatment for patients with limited number of brain metastases. In the past few years, newer immunotherapies (immune checkpoint inhibitors) have been proven to prolong survival in patients with metastatic melanoma. The safety of the combination of SRT and immunotherapy for brain metastases is unknown. We retrospectively identified patients with melanoma brain metastases treated with SRT between 2007 and 2015. Patients who did not have at least 3 months of follow-up with imaging after SRT were excluded from the analysis. Outcomes were compared between patients who were treated with or without immunotherapy. A total of 58 patients were included; of these, 29 were treated with SRT and immunotherapy. MAPK inhibitors (BRAF, MEK inhibitors) were used more often in the immunotherapy group (nine vs. two patients). There was a higher incidence of intracranial complications in patients treated with immunotherapy and SRT. Eight patients had radiation necrosis; all occurred in patients who were treated with immunotherapy. Nine patients had hemorrhage, of which seven occurred in patients who were treated with immunotherapy (P=0.08). However, patients treated with immunotherapy and SRT had a significant overall survival advantage compared with SRT without immunotherapy (15 vs. 6 months, P=0.0013). Patients treated with SRT and immunotherapy have a higher incidence/risk of intracranial complications, but a longer overall survival.

  1. Role of mouthguards in reducing mild traumatic brain injury/concussion incidence in high school football athletes.

    PubMed

    Winters, Jackson; DeMont, Richard

    2014-01-01

    There is continued speculation on the value of mouthguards (MGs) in preventing mild traumatic brain injury (MTBI)/concussion injuries. The purpose of this randomized prospective study was to compare the impact of pressure-laminated (LM), custom-made, properly fitted MGs to over-the-counter (OTC) MGs on the MTBI/concussion incidence in high school football athletes over a season of play. Four hundred twelve players from 6 high school football teams were included in the study. Twenty-four MTBI/concussion injuries (5.8%) were recorded. When examining the MTBI/concussion injury rate by MG type, there was a significant difference (P = 0.0423) with incidence rates of 3.6% and 8.3% in the LM MG and OTC MG groups, respectively.

  2. Traumatic brain injury (TBI) in older adults: aging with a TBI versus incident TBI in the aged.

    PubMed

    Peters, Matthew E

    2016-12-01

    Approximately 39 million older adults (age >65) were evaluated for traumatic brain injury (TBI) in United States emergency departments during the 2-year period from 2009 to 2010, representing a 61% increase in estimates from prior years (Albrecht et al., 2015a). Across the lifespan, an estimated 5.3 million Americans are living with a TBI-related disability (Centers for Disease Control and Prevention (CDC), 2003). With improved recognition and management, more individuals experiencing TBI are surviving to die of other causes later in life (Flanagan et al., 2005). Taken together, these statistics highlight two important populations: those who are "aging with a TBI" and "incident TBI in the aged."

  3. After-discharges and seizures during pediatric extra-operative electrical cortical stimulation functional brain mapping: Incidence, thresholds, and determinants.

    PubMed

    Aungaroon, Gewalin; Zea Vera, Alonso; Horn, Paul S; Byars, Anna W; Greiner, Hansel M; Tenney, Jeffrey R; Arthur, Todd M; Crone, Nathan E; Holland, Katherine D; Mangano, Francesco T; Arya, Ravindra

    2017-10-01

    This study examined the incidence, thresholds, and determinants of electrical cortical stimulation (ECS)-induced after-discharges (ADs) and seizures. Electrocorticograph recordings were reviewed to determine incidence of ECS-induced ADs and seizures. Multivariable analyses for predictors of AD/seizure occurrence and their thresholds were performed. In 122 patients, the incidence of ADs and seizures was 77% (94/122) and 35% (43/122) respectively. Males (odds ratio [OR] 2.92, 95% CI 1.21-7.38, p=0.02) and MRI-negative patients (OR 3.69, 95% CI 1.24-13.7, p=0.03) were found to have higher odds of ECS-induced ADs. A significant trend for decreasing AD thresholds with age was seen (regression co-efficient -0.151, 95% CI -0.267 to -0.035, p=0.011). ECS-induced seizures were more likely in patients with lateralized functional imaging (OR 6.62, 95% CI 1.36-55.56, p=0.036, for positron emission tomography) and presence of ADs (OR 3.50, 95% CI 1.12-13.36, p=0.043). ECS is associated with a high incidence of ADs and seizures. With age, current thresholds decrease and the probability for AD/seizure occurrence increases. ADs and seizures during ECS brain mapping are potentially hazardous and affect its functional validity. Thus, safer method(s) for brain mapping with improved neurophysiologic validity are desirable. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  4. Investigation of the Association between Genetic Polymorphism of Microsomal Epoxide Hydrolase and Primary Brain Tumor Incidence

    PubMed Central

    Aydin, Ali; Pinarbasi, Hatice; Gurelik, Mustafa

    2013-01-01

    mEH is a critical biotransformation enzyme that catalyzes the conversion of xenobiotic epoxide substrates into more polar diol metabolites: it is also capable of inactivating a large number of structurally different molecules. Two polymorphisms affecting enzyme activity have been described in the exon 3 and 4 of the mEH gene. The hypothesis of this study is that inherent genetic susceptibility to a primary brain tumor is associated with mEH gene polymorphisms. The polymorphisms of the mEH gene were determined with PCR-RFLP techniques and 255 Turkish individuals. Our results indicate that the frequency of the mEH exon 4 polymorphism (in controls) is significantly higher than that of primary brain tumor patients (OR = 1.8, 95% CI = 1.0–3.4). This report, however, failed to demonstrate a significant association between mEH exon 3 polymorphism and primary brain tumor susceptibility in this population. Analysis of patients by both histological types of primary brain tumor and gene variants showed no association, although analysis of family history of cancer between cases and controls showed a statistically significant association (χ 2 = 7.0, P = 0.01). Our results marginally support the hypothesis that genetic susceptibility to brain tumors may be associated with mEPHX gene polymorphisms. PMID:24455257

  5. Incidence and injury characteristics of traumatic brain injury: Comparison between children, adults and seniors in Israel.

    PubMed

    Siman-Tov, Maya; Radomislensky, Irina; Knoller, Nachshon; Bahouth, Hany; Kessel, Boris; Klein, Yoram; Michaelson, Moshe; Avraham Rivkind, Bala Miklosh; Shaked, Gad; Simon, Daniel; Soffer, Dror; Stein, Michael; Jeroukhimov, Igor; Peleg, Kobi

    2016-01-01

    To assess the incidence and injury characteristics of hospitalized trauma patients diagnosed with TBI. A retrospective study of all injured hospitalized patients recorded in the National Trauma Registry at 19 trauma centres in Israel between 2002-2011. Incidence and injury characteristics were examined among children, adults and seniors. The annual incidence rate of hospitalized TBI for the Israeli population in 2011 was 31.8/100,000. Age-specific incidence was highest among seniors with a dramatic decrease in TBI-related mortality rate among them. Adults, in comparison to children and seniors, had higher rates of severe TBI, severe and critical injuries, more admission to the intensive care unit, underwent surgery, were hospitalization for more than 2 weeks and were discharged to rehabilitation. After adjusting for age, gender, ethnicity, mechanism of injury and injury severity score, TBI-related in-hospital mortality was higher among seniors and adults compared to children. Seniors are at high risk for TBI-related in-hospital mortality, although adults had more severe and critical injuries and utilized more hospital resources. However, seniors showed the most significant reduction in mortality rate during the study period. Appropriate intervention programmes should be designed and implemented, targeted to reduce TBI among high risk groups.

  6. The Incidence of Traumatic Brain Injury in the United States. Disability Statistics Abstract, Number 14.

    ERIC Educational Resources Information Center

    Forkosch, Joel Anton; And Others

    This abstract summarizes recent statistics on the prevalence and causes of traumatic brain injuries (TBI), the populations it affects, and the degree of disability it causes. Estimates are based on 1985-1987 data from the National Health Interview Survey, a household survey of the noninstitutionalized U.S. population. Analysis indicates: the…

  7. Increased incidence and impact of nonconvulsive and convulsive seizures after traumatic brain injury as detected by continuous electroencephalographic monitoring

    PubMed Central

    VESPA, PAUL M.; NUWER, MARC R.; NENOV, VALERIY; RONNE-ENGSTROM, ELISABETH; HOVDA, DAVID A.; BERGSNEIDER, MARVIN; KELLY, DANIEL F.; MARTIN, NEIL A.; BECKER, DONALD P.

    2014-01-01

    Object The early pathophysiological features of traumatic brain injury observed in the intensive care unit (ICU) have been described in terms of altered cerebral blood flow, altered brain metabolism, and neurochemical excitotoxicity. Seizures occur in animal models of brain injury and in human brain injury. Previous studies of posttraumatic seizures in humans have been based principally on clinical observations without a systematic approach to electroencephalographic (EEG) recording of seizures. The purpose of this study was to determine prospectively the incidence of convulsive and nonconvulsive seizures by using continuous EEG monitoring in patients in the ICU during the initial 14 days post-injury. Methods Ninety-four patients with moderate-to-severe brain injuries underwent continuous EEG monitoring beginning at admission to the ICU (mean delay 9.6 ± 5.4 hours) and extending up to 14 days postinjury. Convulsive and non-convulsive seizures occurred in 21 (22%) of the 94 patients, with six of them displaying status epilepticus. In more than half of the patients (52%) the seizures were nonconvulsive and were diagnosed on the basis of EEG studies alone. All six patients with status epilepticus died, compared with a mortality rate of 24% (18 of 73) in the nonseizure group (p < 0.001). The patients with status epilepticus had a shorter mean length of stay (9.14 ± 5.9 days compared with 14 ± 9 days [t-test, p < 0.03]). Seizures occurred despite initiation of prophylactic phenytoin on admission to the emergency room, with maintenance at mean levels of 16.6 ± 2.8 mg/dl. No differences in key prognostic factors (such as the Glasgow Coma Scale score, early hypoxemia, early hypotension, or 1-month Glasgow Outcome Scale score) were found between the patients with seizures and those without. Conclusions Seizures occur in more than one in five patients during the 1st week after moderate-to-severe brain injury and may play a role in the pathobiological conditions

  8. Incidence of sport-related traumatic brain injury and risk factors of severity: a population-based epidemiologic study

    PubMed Central

    Selassie, Anbesaw W.; Wilson, Dulaney A.; Pickelsimer, E. Elisabeth; Voronca, Delia C.; Williams, Nolan R.; Edwards, Jonathan C.

    2014-01-01

    Purpose Few studies of sport-related traumatic brain injury (TBI) are population-based or rely on directly observed data on cause, demographic characteristics, and severity. This study addresses the epidemiology of sport-related TBI in a large population. Methods Data on all South Carolina hospital and emergency department encounters for TBI, 1998–2011, were analyzed. Annual incidence rate of sport-related TBI was calculated, and rates were compared across demographic groups. Sport-related TBI severity was modeled as a function of demographic and TBI characteristics using logistic regression. Results A total of 16,642 individuals with sport-related TBI yielded an average annual incidence rate of 31.5/100,000 population with a steady increase from 19.7 in 1998 to 45.6 in 2011. The most common mechanisms of sport-related TBI were kicked in football (38.1%), followed by fall injuries in sports (20.3%). Incidence rate was greatest in adolescents ages 12–18 (120.6/100,000/persons). Severe sport-related TBI was strongly associated with off-road vehicular sport (odds ratio [OR], 4.73; 95% confidence interval [95% CI], 2.92–7.67); repeated head trauma (OR, 4.36; 95% CI, 3.69–5.15); equestrian sport (OR, 2.73; 95% CI, 1.64–4.51); and falls during sport activities (OR, 2.72; 95% CI, 1.67–4.46). Conclusions The high incidence of sport-related TBI in youth, potential for repetitive mild TBI, and its long-term consequences on learning warrants coordinated surveillance activities and population-based outcome studies. PMID:24060276

  9. The incidence of seizures following Deep Brain Stimulating electrode implantation for movement disorders, pain and psychiatric conditions.

    PubMed

    Coley, E; Farhadi, R; Lewis, S; Whittle, I R

    2009-04-01

    Deep Brain Stimulation (DBS) for neuromodulation is now commonplace. However little is known about the incidence of either procedural related seizures or epilepsy following chronic DBS. This study aims to provide estimates of these complications for movement disorders, pain and psychiatric conditions. A literature review was performed. Because searches using the terms seizure, epilepsy, and deep brain stimulation revealed only papers dealing with experimental and clinical application of DBS to treat chronic seizures disorders, a search strategy trawling through papers that described clinical case series of DBS was used. Thirty-two papers were reviewed that described stereotactic placement of DBS electrodes for movement disorders, pain syndromes and psychiatric conditions with cohorts of n > 5. Sixteen of these papers describing at least 1418 DBS electrode placements in 1254 patients did not mention seizures as a complication (i.e., it was not possible to know whether seizures had or had not occurred). In 16 papers, describing at least 2101 electrode placements in 1555 patients, seizures were described in 42 patients (incidence 2.7%). The range of seizure incidence varied from 0% (three series encompassing 317 patients and 576 electrode placements) up to 10% (n = 130) and 13% (n = 15). The reasons for this variance were not obvious. At least 74% of seizures occurred around the time of electrode implantation and many of these patients also suffered intracranial hemorrhage. Follow up times were variable (range 6 mths to 5 years). The analysis was complicated by multiple publications from some centres with duplication of some data. The quality of literature on seizures following DBS insertion for neuromodulation is highly variable. Analysis of the available data, after making corrections for publication of duplicate data, suggests strongly that the risk of seizures associated with DBS placement is probably lower than 2.4% (95% CI 1.7 to 3.3 %). The risk of

  10. Incidence of leukaemia and brain tumours in Finnish workers exposed to ELF magnetic fields.

    PubMed

    Juutilainen, J; Läärä, E; Pukkala, E

    1990-01-01

    The relative incidence of leukaemia, acute myeloid leukaemia (AML) and central nervous system (CNS) tumours among workers presumably exposed to extremely low frequency (ELF) magnetic fields (MFs) was studied. The study population consisted of all male industrial workers in Finland aged 25 to 64 years during 1971-1980 according to the Population Census in 1970. The occupations were grouped into three exposure categories according to the probability of exposure. The category of "probable" exposure included electrical occupations and the category of "possible" exposure included occupations where electric motors or welding are common. All other occupations were included to the category of "no exposure". Cancer incidence rates in different occupational groups during 1971-1980 were obtained after linking the census records with the national death certificates and the files of the Finnish Cancer Registry. The adjusted relative risks (with 95% confidence limits) in the categories of "probable" and "possible" exposure were for all leukaemia 1.9 (1.0-3.5) and 1.4 (1.1-1.8), for AML 1.5 (0.5-4.7) and 1.4 (0.9-2.1), and for CNS tumours 1.3 (0.7-2.3) and 1.3 (1.0-1.6), respectively. The results are concordant with earlier studies suggesting elevated risk among workers exposed to ELF magnetic fields.

  11. Hydrocephalus following severe traumatic brain injury in adults. Incidence, timing, and clinical predictors during rehabilitation.

    PubMed

    Kammersgaard, Lars Peter; Linnemann, Mia; Tibæk, Maiken

    2013-01-01

    To investigate timing and clinical predictors that might predict hydrocephalus emerging during rehabilitation until 1 year following severe traumatic brain injury (TBI). Posttraumatic hydrocephalus (PTH) may lead to clinical deterioration and poor outcome if untreated. However, PTH can be successfully treated if detected. Nevertheless, PTH is easily overlooked during rehabilitation, particularly in severe cases. We prospectively followed all patients (n = 444) in Eastern Denmark (population 2.5 mill) sustaining severe TBI, who required lengthy rehabilitation between 2000 and 2010. All patients with PTH were tracked retrospectively. Demographics, surgery, injury severity, consciousness level, and disability were compared for patients with versus without PTH. Independent predictors of PTH during rehabilitation were identified through multiple logistic regression models. PTH occurred in 14.2% and 3/4 emerged during rehabilitation. Patients with PTH were older, had more severe brain injuries, were more frequently in vegetative state, and needed longer rehabilitation stays. After adjusted analyses, however, only older age and low level of consciousness were independently associated with PTH. Most cases of PTH emerge during rehabilitation. Therefore, attention towards this complication should be present also beyond the acute stage after TBI, particularly among older patients and patients with severe disordered consciousness.

  12. Correlation between EGFR mutation status and the incidence of brain metastases in patients with non-small cell lung cancer.

    PubMed

    Li, Lina; Luo, Shuimei; Lin, Heng; Yang, Haitao; Chen, Huijuan; Liao, Ziyuan; Lin, Wanzun; Zheng, Weili; Xie, Xianhe

    2017-08-01

    Lung cancer is the leading cause of cancer-related death worldwide. Numerous studies have been performed to investigate the correlation between epidermal growth factor receptor (EGFR) mutation status and the incidence of brain metastases (BMs) in patients with non-small cell lung cancer (NSCLC), however, the outcomes were inconsistent. Thus, we performed this study to establish the role of EGFR mutation status in BMs. Electronic databases PubMed, Embase, Cochrane Library, CBM, WanFang, CNKI were searched to identify relevant trials. The primary endpoint was the incidence of BMs in EGFR mutations or wild type NSCLC and the secondary endpoint was overall survival calculated from the BMs emerging (BMOS). Twenty-two studies incorporating 8,152 participants were eligible. EGFR mutations group possessed a significantly higher risk of BMs (OR =1.99; 95% CI, 1.59-2.48; P=0.000) than EGFR wild type group. In the stratified analysis, compared with EGFR wild type group, EGFR mutations group had a significant higher incidence (OR =2.01; 95% CI, 1.56-2.59; P=0.000) of subsequent BMs while only a trend of increasing the incidence of initial BMs (OR =1.38; 95% CI, 0.98-1.94; P=0.066). Moreover, exon 19 deletion had a trend of increasing the incidence of BMs than exon 21 mutation (OR =1.44; 95% CI, 0.77-2.68; P=0.252). Compared with EGFR wild type group, EGFR mutations group possessed a prolonged overall BMOS (HR =0.68; 95% CI, 0.47-0.98; P=0.038) and a longer BMOS in initial BMs (HR =0.50; 95% CI, 0.31-0.80; P=0.004) but no significant difference in NSCLC with subsequent BMs (HR =0.95; 95% CI, 0.42-2.15; P=0.901). Patients with EGFR mutations were more susceptible to develop into BMs than those with EGFR wild type, especially during the course of disease.

  13. Traumatic Brain Injury Incidence, Clinical Overview, and Policies in the US Military Health System Since 2000.

    PubMed

    Swanson, Thomas M; Isaacson, Brad M; Cyborski, Cherina M; French, Louis M; Tsao, Jack W; Pasquina, Paul F

    Exposure to explosive armaments during Operation Iraqi Freedom and Operation Enduring Freedom contributed to approximately 14% of the 352 612 traumatic brain injury (TBI) diagnoses in the US military between 2000 and 2016. The US Department of Defense issued guidelines in 2009 to (1) standardize TBI diagnostic criteria; (2) classify TBI according to mechanism and severity; (3) categorize TBI symptoms as somatic, psychological, or cognitive; and (4) systematize types of care given during the acute and rehabilitation stages of TBI treatment. Polytrauma and associated psychological and neurologic conditions may create barriers to optimal rehabilitation from TBI. Given the completion of recent combat operations and the transition of TBI patients into long-term care within the US Department of Veterans Affairs system, a review of the literature concerning TBI is timely. Long-term follow-up care for patients who have sustained TBI will remain a critical issue for the US military.

  14. EGFR and KRAS Mutations Predict the Incidence and Outcome of Brain Metastases in Non-Small Cell Lung Cancer

    PubMed Central

    Tomasini, Pascale; Serdjebi, Cindy; Khobta, Nataliya; Metellus, Philippe; Ouafik, L’Houcine; Nanni, Isabelle; Greillier, Laurent; Loundou, Anderson; Fina, Frederic; Mascaux, Celine; Barlesi, Fabrice

    2016-01-01

    Background: Lung cancer is the leading cause of brain metastases (BM). The identification of driver oncogenes and matched targeted therapies has improved outcome in non-small cell lung cancer (NSCLC) patients; however, a better understanding of BM molecular biology is needed to further drive the process in this field. Methods: In this observational study, stage IV NSCLC patients tested for EGFR and KRAS mutations were selected, and BM incidence, recurrence and patients’ outcome were assessed. Results: A total of 144 patients (142 Caucasian and two Asian) were selected, including 11.27% with EGFR-mutant and 33.10% with KRAS-mutant tumors, and 57.04% patients had developed BM. BM incidence was more frequent in patients with EGFR mutation according to multivariate analyses (MVA) (Odds ratio OR = 8.745 [1.743–43.881], p = 0.008). Among patients with treated BM, recurrence after local treatment was less frequent in patients with KRAS mutation (OR = 0.234 [0.078–0.699], p = 0.009). Among patients with untreated BM, overall survival (OS) was shorter for patients with KRAS mutation according to univariate analysis (OR = 7.130 [1.240–41.012], p = 0.028), but not MVA. Conclusions: EGFR and KRAS mutations have a predictive role on BM incidence, recurrence and outcome in Caucasian NSCLC patients. These results may impact the routine management of disease in these patients. Further studies are required to assess the influence of other biomarkers on NSCLC BM. PMID:27999344

  15. WE-EF-BRA-10: Prophylactic Cranial Irradiation Reduces the Incidence of Brain Metastasis in a Mouse Model of Metastatic Breast Cancerr

    SciTech Connect

    Smith, D; Debeb, B; Larson, R; Diagaradjane, P; Woodward, W

    2015-06-15

    Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with acute lymphoblastic leukemia and small-cell lung cancer. We examined whether PCI could benefit breast cancer patients at high risk of developing brain metastases. Methods: We utilized our mouse model in which 500k green fluorescent protein (GFP)-labeled breast cancer cells injected into the tail vein of SCID/Beige mice resulted in brain metastases in approximately two-thirds of untreated mice. To test the efficacy of PCI, one set of mice was irradiated five days after cell injection with a single fraction of 4-Gy (two 2-Gy opposing fields) whole-brain irradiation on the XRAD 225Cx small-animal irradiator. Four controls were included: a non-irradiated group, a group irradiated two days prior to cell injection, and two groups irradiated 3 or 6 weeks after cell injection. Mice were sacrificed four and eight weeks post-injection and were evaluated for the presence of brain metastases on a fluorescent stereomicroscope. Results: The incidence of brain metastasis in the non-irradiated group was 77% and 90% at four and eight weeks, respectively. The PCI group had a significantly lower incidence, 20% and 30%, whereas the other three control groups had incidence rates similar to the non-treated control (70% to 100%). Further, the number of metastases and the metastatic burden were also significantly lower in the PCI group compared to all other groups. Conclusion: The timing of irradiation to treat subclinical disease is critical, as a small dose of whole-brain irradiation given five days after cell injection abrogated tumor burden by greater than 90%, but had no effect when administered twenty-one days after cell injection. PCI is likely to benefit breast cancer patients at high risk of developing brain metastases and should be strongly considered in the clinic.

  16. Causation, incidence, and costs of traumatic brain injury in the U.S. military medical system.

    PubMed

    Ommaya, A K; Ommaya, A K; Dannenberg, A L; Salazar, A M

    1996-02-01

    Hospital discharge records from military facilities and private facilities reimbursed by Civilian Health and Medical Program of the Uniformed Services for fiscal year 1992 were reviewed to identify head injury admissions. Incidence rates, case fatality rates, causes of head injuries, and direct cost for hospital admissions were computed in this well-defined population. For fiscal year 1992, there were 5,568 hospitalized cases of noncombat head injury in the military medical system. The age-adjusted head injury rates for ages 15-44 years are higher in active-duty individuals compared with other beneficiaries (1.6 times greater for men and 2.5 times greater for women). The total cost for hospitalization in this population was $43 million. Private facility rehabilitation accounted for 26% of all private facility costs but only 6% of head injury cases. Firearms and motor vehicle crashes caused the most severe injuries for cases admitted to military facilities. Motor vehicle crashes, falls, and fighting accounted for 80% of the total military facility cost for head injuries. Military active-duty individuals are at increased risk for noncombat head injury. Prevention of head injury in military settings should focus on motor vehicle crashes, fist fights (assault), and falls.

  17. Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy.

    PubMed

    Kulkarni, A V; Guha, A; Lozano, A; Bernstein, M

    1998-07-01

    Many neurosurgeons routinely obtain computerized tomography (CT) scans to rule out hemorrhage in patients after stereotactic procedures. In the present prospective study, the authors investigated the rate of silent hemorrhage and delayed deterioration after stereotactic biopsy sampling and the role of postbiopsy CT scanning. A subset of patients (the last 102 of approximately 800 patients) who underwent stereotactic brain biopsies at the Toronto Hospital prospectively underwent routine postoperative CT scanning within hours of the biopsy procedure. Their medical charts and CT scans were then reviewed. A postoperative CT scan was obtained in 102 patients (aged 17-87 years) who underwent stereotactic biopsy between June 1994 and September 1996. Sixty-one patients (59.8%) exhibited hemorrhages, mostly intracerebral (54.9%), on the immediate postoperative scan. Only six of these patients were clinically suspected to have suffered a hemorrhage based on immediate postoperative neurological deficit: in the remaining 55 (53.9%) of 102 patients, the hemorrhage was clinically silent and unsuspected. Among the clinically silent intracerebral hemorrhages, 22 measured less than 5 mm. 20 between 5 and 10 mm, five between 10 and 30 mm, and four between 30 and 40 mm. Of the 55 patients with clinically silent hemorrhages, only three demonstrated a delayed neurological deficit (one case of seizure and two cases of progressive loss of consciousness) and these all occurred within the first 2 postoperative days. Of the neurologically well patients in whom no hemorrhage was demonstrated on initial postoperative CT scan, none experienced delayed deterioration. Clinically silent hemorrhage after stereotactic biopsy is very common. However, the authors did not find that knowledge of its existence ultimately affected individual patient management or outcome. The authors, therefore, suggest that the most important role of postoperative CT scanning is to screen for those neurologically well

  18. Exposure to 50-Hz electric field and incidence of leukemia, brain tumors, and other cancers among French electric utility workers.

    PubMed

    Guénel, P; Nicolau, J; Imbernon, E; Chevalier, A; Goldberg, M

    1996-12-15

    Recent studies on the association between exposure to 50- to 60-Hz fields and cancer carried out among electric utility workers have focused mainly on the magnetic field component of exposure. The authors have investigated tumor risks specifically associated with electric fields, as this exposure is distinct from magnetic fields. The study design is a case-control study nested within a cohort of 170,000 workers employed at Electricité de France-Gaz de France (EDF) between 1978 and 1989. All incident cases of cancer and benign tumor of the brain diagnosed in 1978-1989 among workers before the age of retirement were included. Four randomly selected controls were individually matched to each case by year of birth. The exposure to electric fields was assessed from measurements collected in 850 EDF workers for a full work week. Arithmetic and geometric mean exposures were included in a job-exposure matrix to determine the cumulative exposure of the cases and the controls. Exposures to potentially carcinogenic chemicals found at the workplace were also evaluated through expert judgment. The analysis by site of tumor did not show any increased risk for leukemia (72 cases). An odds ratio of 3.08 (95% confidence interval 1.08-8.74) was observed for all brain tumors (69 cases) for exposure above the 90th percentile (> or = 387 V/m-year), and there was some indication of a dose-response relation, although the risk did not increase monotonically with exposure. No confounding from magnetic fields or from other potentially carcinogenic hazards was apparent. The observed association was somewhat stronger after allowing a 5-year latency period before diagnosis (odds ratio = 3.69, 95% confidence interval 1.10-12.43) for exposure above the 90th percentile. However, the risk of brain tumor could not be linked to a specific type of tumor. An unexpected association was also observed for colon cancer, using geometric indexes of exposure, but no other association was seen for any other

  19. Incidence of normal pineal and chroids plexus calcification on brain CT (computerized tomography) at Tikur Anbessa Teaching Hospital Addis Ababa, Ethiopia.

    PubMed

    Admassie, Daniel; Mekonnen, Abebe

    2009-01-01

    To determine the incidence of normal calcification of pineal gland and choroids plexus on Brain -CT (computerized Tomography) and to see its association with age and sex. A cross-sectional descriptive study was conducted at Radiology Department, Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia from May 2001 to August 2002. A total of 518 patients; 312 males and 206 females underwent brain-CT without pineal or choroids plexus pathology. The over all incidence of normal pineal gland calcification was 72.0 % and that of choroid plexus 43.3 %. The incidence of normal pineal gland and choroids plexus calcification were higher in males than in females by 13.1% and 6.0% respectively. The frequency of pineal gland and choroids plexus calcification showed a steady increase with age on both sex groups. The incidence of normal pineal gland calcification in this study is similar to most of the findings of other studies while the incidence of choroids plexus calcification was lower as compared the finding of other studies.

  20. Trends in the incidence of physician-diagnosed mild traumatic brain injury among active duty U.S. military personnel between 1997 and 2007.

    PubMed

    Cameron, Kenneth L; Marshall, Stephen W; Sturdivant, Rodney X; Lincoln, Andrew E

    2012-05-01

    Mild traumatic brain injury (mTBI) has been described as the most common form of traumatic brain injury within military populations; however, few epidemiologic studies have examined incidence rates for mTBI in this population. The objective of this study was to examine trends in the incidence of mTBI among active-duty U.S. service members between 1997 and 2007. Specifically, we were interested in evaluating trends in the incidence rates in relation to the initiation of combat operations in Iraq and Afghanistan. A retrospective cohort study was conducted utilizing data extracted from the Defense Medical Surveillance System to identify all incident cases of mTBI within the study population. The primary outcome of interest was the incidence rate of mTBI per 1000 person-years. Multivariable Poisson regression was used to analyze the data. There were 98,012 mTBI cases and 14,956,955 person-years of follow-up, for an overall incidence rate of 6.55 (95% CI 6.51,6.59) per 1000 person-years. There was a steady increase in the mTBI rate over time. The average change in the mTBI rate was 8.5% (95% CI 8.2%,8.8%) per year; however, the rate rose dramatically in the last 2 years of the study period. Overall, for 2006-2007 versus 1997-2005, the rate ratio was 1.61 (95% CI 1.58,1.65). The greatest increase in the rate of mTBI was observed among those serving in Iraq, who experienced a 38.4% (95% CI 35.4%,41.1%) annual increase in new cases. The observed increase in the incidence of mTBI in this population has significant policy implications in terms of allocating appropriate health care resources.

  1. Incidence of Brain Metastases on Follow-up (18)F-FDG PET/CT Scans of Non-Small Cell Lung Cancer Patients: Should We Include the Brain?

    PubMed

    Nia, Emily S; Garland, Linda L; Eshghi, Naghmehossadat; Nia, Benjamin B; Avery, Ryan J; Kuo, Phillip H

    2017-09-01

    The brain is the most common site of distant metastasis from lung cancer. Thus, MRI of the brain at initial staging is routinely performed, but if this examination is negative a follow-up examination is often not performed. This study evaluates the incidence of asymptomatic brain metastases in non-small cell lung cancer patients detected on follow-up (18)F-FDG PET/CT scans. Methods: In this Institutional Review Board-approved retrospective review, all vertex to thigh (18)F-FDG PET/CT scans in patients with all subtypes of lung cancer from August 2014 to August 2016 were reviewed. A total of 1,175 (18)F-FDG PET/CT examinations in 363 patients were reviewed. Exclusion criteria included brain metastases on initial staging, histologic subtype of small-cell lung cancer, and no follow-up (18)F-FDG PET/CT examinations. After our exclusion criteria were applied, a total of 809 follow-up (18)F-FDG PET/CT scans in 227 patients were included in the final analysis. The original report of each (18)F-FDG PET/CT study was reviewed for the finding of brain metastasis. The finding of a new brain metastasis prompted a brain MRI, which was reviewed to determine the accuracy of the (18)F-FDG PET/CT. Results: Five of 227 patients with 809 follow-up (18)F-FDG PET/CT scans reviewed were found to have incidental brain metastases. The mean age of the patients with incidental brain metastasis was 68 y (range, 60-77 y). The mean time from initial diagnosis to time of detection of incidental brain metastasis was 36 mo (range, 15-66 mo). When MRI was used as the gold standard, our false-positive rate was zero. Conclusion: By including the entire head during follow-up (18)F-FDG PET/CT scans of patients with non-small cell lung cancer, brain metastases can be detected earlier while still asymptomatic. But, given the additional scan time, radiation, and low incidence of new brain metastases in asymptomatic patients, the cost-to-benefit ratio should be weighed by each institution. © 2017 by the

  2. Brain atrophy and white matter hyperintensities are not significantly associated with incidence and severity of postoperative delirium in older persons without dementia

    PubMed Central

    Cavallari, Michele; Hshieh, Tammy T.; Guttmann, Charles R.G.; Ngo, Long H.; Meier, Dominik S.; Schmitt, Eva M.; Marcantonio, Edward R.; Jones, Richard N.; Kosar, Cyrus M.; Fong, Tamara G.; Press, Daniel; Inouye, Sharon K.; Alsop, David C.

    2015-01-01

    Postoperative delirium is a common complication in older people, and is associated with increased mortality, morbidity, institutionalization and caregiver burden. Although delirium is an acute confusional state characterized by global impairments in attention and cognition, it has been implicated in permanent cognitive impairment and dementia. The pathogenesis of delirium, as well as the mechanisms leading to these disabling consequences, remains unclear. The present study is the first to address the potential predisposing role of brain morphological changes towards postoperative delirium in a large prospective cohort of patients undergoing elective surgery using state-of-the-art magnetic resonance imaging (MRI) techniques conducted before admission. We investigated the association of MRI-derived quantitative measures of white matter damage, global brain and hippocampal volume with the incidence and severity of delirium. Pre-surgical white matter hyperintensities (WMH), whole brain and hippocampal volume were measured in 146 consecutively enrolled subjects, ≥70 years old, without dementia who were undergoing elective surgery. These three pre-surgical MRI indices were tested as predictors of incidence and severity of subsequent delirium. Out of 146 subjects, 32 (22%) developed delirium. We found no statistically significant differences in WMH, whole brain or hippocampal volume between subjects with and without delirium. Both unadjusted and adjusted (age, gender, vascular comorbidity, general cognitive performance) regression analyses demonstrated no statistically significant association between any of the MRI measures with respect to delirium incidence or severity. In persons without dementia, preexisting cerebral white matter hyperintensities, general and hippocampal atrophy may not predispose to postoperative delirium or worsen its severity. PMID:25824618

  3. Association of Serum Vitamin D with the Risk of Incident Dementia and Subclinical Indices of Brain Aging: The Framingham Heart Study.

    PubMed

    Karakis, Ioannis; Pase, Matthew P; Beiser, Alexa; Booth, Sarah L; Jacques, Paul F; Rogers, Gail; DeCarli, Charles; Vasan, Ramachandran S; Wang, Thomas J; Himali, Jayandra J; Annweiler, Cedric; Seshadri, Sudha

    2016-01-01

    Identifying nutrition- and lifestyle-based risk factors for cognitive impairment and dementia may aid future primary prevention efforts. We aimed to examine the association of serum vitamin D levels with incident all-cause dementia, clinically characterized Alzheimer's disease (AD), MRI markers of brain aging, and neuropsychological function. Framingham Heart Study participants had baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations measured between 1986 and 2001. Vitamin D status was considered both as a continuous variable and dichotomized as deficient (<10 ng/mL), or at the cohort-specific 20th and 80th percentiles. Vitamin D was related to the 9-year risk of incident dementia (n = 1663), multiple neuropsychological tests (n = 1291) and MRI markers of brain volume, white matter hyperintensities and silent cerebral infarcts (n = 1139). In adjusted models, participants with vitamin D deficiency (n = 104, 8% of the cognitive sample) displayed poorer performance on Trail Making B-A (β= -0.03 to -0.05±0.02) and the Hooper Visual Organization Test (β= -0.09 to -0.12±0.05), indicating poorer executive function, processing speed, and visuo-perceptual skills. These associations remained when vitamin D was examined as a continuous variable or dichotomized at the cohort specific 20th percentile. Vitamin D deficiency was also associated with lower hippocampal volumes (β= -0.01±0.01) but not total brain volume, white matter hyperintensities, or silent brain infarcts. No association was found between vitamin D deficiency and incident all-cause dementia or clinically characterized AD. In this large community-based sample, low 25(OH)D concentrations were associated with smaller hippocampal volume and poorer neuropsychological function.

  4. Changes in brain glioma incidence and laterality correlates with use of mobile phones--a nationwide population based study in Israel.

    PubMed

    Barchana, Micha; Margaliot, Menahem; Liphshitz, Irena

    2012-01-01

    Mobile phones are in extensive use worldwide and concerns regarding their role in tumor formation were raised. Over the years multiple studies were published in order to investigate this issue using several approaches. The current study looks at secular trends of brain gliomas (low and high grade) incidence and changes in tumor's laterality over 30 years in a population extensively using this technology with a possible correlation to the spread of use of mobile phones. All brain gliomas that were diagnosed from 1980-2009 were included and subdivided into two groups--low and high grade. Secular and periodic time trend analyses of incidence rates and changes in laterality were performed. Preferred side of head using mobile phones was assessed with a questionnaire in a sample of adult individuals. A decrease in incidence of low grade giomas (LGG) that correlated with introduction of mobile technology was found from 2.57, 2.34 and 2.79 for every 100,000 in the period 1980 to the end of 1994 to 1.72, 1.82 and 1.57, respectively, over the last three 5-years periods (1995-2009). High-grade glioma incidences increased significantly from 1980-2009 but in the period after mobile phones were introduced (1994-2009) a lower, non significant, rate of increase was observed in males and a lower one (significant) in females. A shift towards left sided tumor location for all adult gliomas combined and separately for LGG and HGG was noted from 1995 onward. The shift was more marked for those who were diagnosed in ages 20-49 (p=0.03). We found a statistically significant decrease in LGG's over 30-years period that correlates with introducing of mobile phones technology and a shift in laterality towards left-sided tumors, the latter occurred in both low and high-grade gliomas.

  5. Increased Incidence of Herpes Zoster and Postherpetic Neuralgia in Adult Patients following Traumatic Brain Injury: A Nationwide Population-Based Study in Taiwan.

    PubMed

    Tung, Yi-Ching; Tu, Hung-Pin; Tsai, Wen-Chan; Chen, Cheng-Sheng; Su, Chen-Hsiang; Shi, Hon-Yi; Lin, Chih-Lung

    2015-01-01

    The aims of this study were to estimate the incidences of herpes zoster (HZ) and postherpetic neuralgia (PHN) in patients after traumatic brain injury (TBI). Furthermore, we aimed to explore the risk factors of the development of HZ and PHN in patients after TBI. This population-based, longitudinal analysis was conducted using the Taiwan National Health Insurance Research Database (consisting of 1,000,000 beneficiaries) from 1996 to 2010. Using the longitudinal National Health Insurance Research Database, we conducted a retrospective population-based cohort study to evaluate the incidence of HZ and PHN in adult TBI patients and controls. Kaplan-Meier analysis and Cox regression were used to compare differences in the development of HZ and PHN. The effects of gender, comorbidity and surgery on the risk of HZ and PHN development were assessed by subgroup analyses. Over a 15-year follow-up, the cumulative incidence of HZ in 28,234 TBI patients (604.00/100,000 person-years) was significantly higher than 34,085 controls (322.21/100,000 person-years) (P<0.0001, by log-rank test). Females showed a significantly higher incidence of HZ than males (p for interaction = 0.0010). The time to HZ development in the follow-up period was 5.9 years in TBI patients compared to 9.9 years in the control set (p <0.0001). TBI patients were 2.93 and 2.11 times likely to develop HZ and PHN, respectively, than the general population. The incidences of HZ and PHN in TBI patients were also significantly greater than for controls in the CCI = 0 subgroup. To our knowledge, this is the first population-based cohort study to reveal that TBI is an independent risk factor for HZ and PHN in TBI patients, especially in females. Physician should pay attention to the possibility of HZ and PHN in TBI patients and be aware that HZ vaccination early after brain trauma may lower the incidence of HZ and PHN.

  6. Cancer dose--response assessment for acrylonitrile based upon rodent brain tumor incidence: use of epidemiologic, mechanistic, and pharmacokinetic support for nonlinearity.

    PubMed

    Kirman, C R; Gargas, M L; Marsh, G M; Strother, D E; Klaunig, J E; Collins, J J; Deskin, R

    2005-10-01

    A cancer dose-response assessment was conducted for acrylonitrile (AN) using updated information on mechanism of action, epidemiology, toxicity, and pharmacokinetics. Although more than 10 chronic bioassays indicate that AN produces multiple tumors in rats and mice, a number of large, well-conducted epidemiology studies provide no evidence of a causal association between AN exposure and cancer mortality of any type. The epidemiological data include early industry exposures that are far higher than occur today and that approach or exceed levels found to be tumorigenic in animals. Despite the absence of positive findings in the epidemiology data, a dose-response assessment was conducted for AN based on brain tumors in rats. Mechanistic studies implicate the involvement of oxidative stress in rat brain due to a metabolite (2-cyanoethylene oxide or CEO, cyanide), but do not conclusively rule out a potential role for the direct genotoxicity of CEO. A PBPK model was used to predict internal doses (peak CEO in brain) for 12 data sets, which were pooled together to provide a consistent characterization of the dose-response relationship for brain tumor incidence in the rat. The internal dose corresponding to a 5% increase in extra risk (ED 05=0.017 mg/L brain) and its lower confidence limit (LED 05=0.014 mg/L brain) was used as the point of departure. The weight-of-evidence supports the use of a nonlinear extrapolation for the cancer dose-response assessment. A quantitative comparison of the epidemiology exposure-response data (lung and brain cancer mortality) to the rat brain tumor data in terms of internal dose adds to the confidence in the nonlinear extrapolation. Uncertainty factors of 200 and 220 (for the oral and inhalation routes, respectively) were applied to the LED 05 to account for interspecies variation, intraspecies variation, and the severity of the response measure. Accordingly, oral doses below 0.009 mg/kg-day and air concentrations below 0.1mg/m(3) are not

  7. Risk factors of cerebral microbleeds in strictly deep or lobar brain regions differed.

    PubMed

    Zhang, Changqing; Li, Zixiao; Wang, Yilong; Zhao, Xingquan; Wang, Chunxue; Liu, Liping; Pu, Yuehua; Zou, Xinying; Pan, Yuesong; Du, Wanliang; Jing, Jing; Wang, Dongxue; Luo, Yang; Wong, Ka Sing; Wang, Yongjun

    2015-01-01

    T2*-weighted gradient echo magnetic resonance imaging is sensitive in detecting cerebral microbleeds (MBs), but there are few reports on the risk factors of MBs in different brain regions. Therefore, we aimed to investigate whether the risk factors associated with the presence of MBs in strictly deep or lobar brain regions were different. This study consisted of 696 consecutive acute ischemic stroke patients from 6 hospitals in the Chinese IntraCranial AtheroSclerosis Study. We evaluated the number and location of MBs, severity of lacune and leukoaraiosis (LA), and etiologic subtype of ischemic stroke. Multivariable logistic regression was used to analyze risk factors of MBs in different brain regions. Among 696 acute ischemic stroke patients, 162 patients (23.3%) had MBs. Of them, 62 patients had strictly deep brain MBs, 49 patients had strictly lobar MBs. There was a significant correlation between the number of MBs, the number of lacune, and the severity of LA (P < .0001). In multivariable logistic regression analysis, both strictly deep and strictly lobar brain, MBs were significantly associated with history of cerebral hemorrhage (P = .037 and P = .026, respectively), presence of lacune (P = .004 and P = .032, respectively), and severe LA (P = .002 and P = .008, respectively). However, MBs in strictly deep regions were significantly associated with higher mean arterial pressure (P = .030), and those in strictly lobar brain regions were significantly associated with older age (P = .023). The risk factors of MBs in strictly deep or lobar regions differ modestly, which may be related to heterogeneous vascular pathologic changes. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. Incidence of cardioembolic stroke including paradoxical brain embolism in patients with acute ischemic stroke before and after the Great East Japan Earthquake.

    PubMed

    Itabashi, Ryo; Furui, Eisuke; Sato, Shoichiro; Yazawa, Yukako; Kawata, Kenta; Mori, Etsuro

    2014-01-01

    The incidence of heart disease or deep vein thrombosis (DVT) reportedly increased after the Great East Japan Earthquake. We hypothesized that the incidence of cardioembolic stroke (CES) including paradoxical brain embolism (PBE) among patients with acute stroke would increase after the earthquake due to cessation of antithrombotic therapy or the increase in heart disease and DVT associated with the evacuation. The aim of this study is to evaluate the changes in the prevalence of DVT and the incidence of CES including PBE in acute ischemic stroke before and after the earthquake. We retrospectively studied 1,044 consecutive ischemic stroke patients (73.1 ± 12.5 years old, male 61.5%) who were admitted to a comprehensive stroke center (from January 2010 through March 2012) located in the earthquake disaster area within 7 days after stroke onset. The prevalence of DVT and the incidence of CES including PBE were compared before and after the earthquake of 11 March 2011. The median of the initial National Institutes of Health Stroke Scale (NIHSS) scores was 4 (interquartile range: 1-8). Two hundred and eighty-two patients (27.0% of those surveyed) were diagnosed with CES. After adjustment for sex, age, NIHSS score, and patient's residential address, the proportion of CES patients was significantly increased after the earthquake (odds ratio, OR 1.61, 95% confidence interval, 95% CI: 1.20-2.17). Eighty-nine patients (8.5% of those surveyed) had DVT. Compared with 2010 findings, the prevalence of DVT was significantly increased in the fourth quarter of 2011 and the first quarter of 2012 (OR 1.85, 95% CI: 1.05-3.24). Nineteen (1.8% of those surveyed) were diagnosed with PBE. The proportion of PBE patients was also significantly increased in the second half of 2011 (OR 3.69, 95% CI: 1.28-12.1). The incidence of CES was significantly increased after the earthquake, compared with the period before the earthquake. We encountered more PBE in the period from 3 to 9 months after

  9. Incidence, prevalence, and occurrence rate of infection among adults hospitalized after traumatic brain injury: study protocol for a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Infection occurs commonly among patients hospitalized after traumatic brain injury (TBI) and has been associated with increased intensive care unit and hospital lengths of stay and an elevated risk of poor neurological outcome and mortality. However, as many relevant published studies to date have varied in the type and severity of TBI among included patients as well as in their design (randomized versus non-randomized), risk of bias, and setting (hospital ward versus intensive care unit), their reported estimates of infection occurrence vary considerably. Thus, the purpose of this systematic review and meta-analysis is to estimate the incidence, prevalence, and occurrence rate of infection among patients hospitalized after TBI. Methods/Design We will search electronic bibliographic databases (MEDLINE, EMBASE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews) from their first available date as well as personal files, reference lists of included articles, and conference proceedings. Two investigators will independently screen titles and abstracts and select cohort studies, cross-sectional studies, and randomized controlled trials involving adults hospitalized after TBI that reported estimates of cumulative incidence, incidence rate, prevalence, or occurrence rate of infection for inclusion in the systematic review. These investigators will also independently extract data and assess risk of bias. We will exclude studies with fewer than ten patients; experimental groups allocated to treatment with antibiotics, glucocorticoids, immunosuppressants, barbiturates, or hypothermia; and studies focused on military/combat-related TBI. Pooled estimates of cumulative incidence, incidence rate, prevalence, and occurrence rate will be calculated using random effects models. We will also calculate I2 and Cochran

  10. Incidence of New Ischaemic Brain Lesions After Carotid Artery Stenting with the Micromesh Roadsaver Carotid Artery Stent: A Prospective Single-Centre Study.

    PubMed

    Ruffino, Maria Antonella; Faletti, Riccardo; Bergamasco, Laura; Fonio, Paolo; Righi, Dorico

    2016-11-01

    Several randomized trials of patients with carotid stenosis show increased adverse neurological events with stenting versus endarterectomy in the 30-day post-procedure. This study examines the incidence of new ischaemic lesions in patients treated in our centre using the new Roadsaver stent. Between September 2015 and January 2016, 23 consecutive patients (age 74.3 ± 7.3 years, 17.4 % female) underwent carotid artery stenting with the Roadsaver stent, a nitinol double-layer micromesh device. A distal protection device was used in all cases. Diffusion-weighted magnetic resonance imaging was performed 24 h before, and 24 h and 30 days after the procedure. The 24-h post-procedure imaging showed 15 new ipsilateral ischaemic lesions in 7 (30.4 %) patients: median volume 0.076 cm(3) (interquartile range 0.065-0.146 cm(3)). All lesions were asymptomatic. The 30-day imaging showed complete resolution of all lesions and no new ischaemic lesions. Follow-up clinical and ultrasound examinations at 30 days and 6 months recorded no adverse cardiac or cerebrovascular events. Protected stenting with micromesh Roadsaver stent showed good safety and efficacy in the treatment of carotid stenosis, with a low incidence of delayed embolic events and new ipsilateral ischaemic brain lesions. These preliminary results are encouraging, but need to be confirmed with larger populations.

  11. Effects of Neurosurgical Treatment and Severity of Head Injury on Cognitive Functioning, General Health and Incidence of Mental Disorders in Patients With Traumatic Brain Injury

    PubMed Central

    Rezaei, Sajjad; Asgari, Karim; Yousefzadeh, Shahrokh; Moosavi, Heshmat-Allah; Kazemnejad, Ehsan

    2012-01-01

    Background Neurosurgical treatment and the severity of head injury (HI) can have remarkable effect on patients’ neuropsychiatric outcomes. Objectives This research aimed to study the effect of these factors on cognitive functioning, general health and incidence of mental disorders in patients with a traumatic brain injury (TBI). Patients and Methods In this descriptive, longitudinal study, 206 TBI patients entered the study by consecutive sampling; they were then compared according to neurosurgery status and severity of their HI. Both groups underwent neurosurgical and psychological examinations. The mini mental state examination (MMSE) and general health questionnaire–28 items (GHQ-28) were administered to the study participants. At follow-up, four months later, the groups underwent a structured clinical interview by a psychiatrist based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) diagnostic criteria regarding the presence of mental disorders. Results Analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) were performed and adjusted for the effect of confounding variables (age, gender, Glasgow outcome scale (GOS) , and level of education). The severity of HI had the most significant effect for the following variables; cognitive functioning and physical symptoms (P < 0.05). The effect of the neurosurgical treatment factor was not significant; however, the interaction effect of the two variables on social dysfunction, and total score of the GHQ-28 questionnaire appeared to be significant (P < 0.05). Fisher's exact test indicated that after a four month follow-up period, no significant differences were seen between the two groups (with or without neurosurgery) in the incidence of mental disorders, while χ2 Test showed that having a more severe HI is significantly correlated with the incidence of mental disorders (P < 0.01). Conclusions The implications of this study should be discussed with an

  12. The effect of treating people with reversible ischaemic attacks of the brain and eye on the incidence of stroke in Australia.

    PubMed

    Hankey, G J

    1997-08-01

    Reversible ischaemic attacks of the brain or eye (RIA) are a risk factor for stroke. Strategies of stroke prevention include vascular risk factor control, antithrombotic therapy, and carotid surgery. To determine the effectiveness, risks and costs of each stroke prevention strategy for patients with RIA and the Australian community, and the effect of treating people with RIA on the incidence of stroke in Australia. Review of data from prospective community-based studies to determine the prevalence of RIA, the incidence of stroke, and the proportion of stroke patients who report a RIA before their stroke; and data from randomised trials to determine the effectiveness, risks and costs of treatments for RIA. About 111,000 Australians have had a prior RIA. Each year, about 37,000 Australians suffer a stroke, of whom up to 8000 (22%) have had a prior ('warning') RIA. Targeting effective stroke prevention strategies to RIA patients with relevant treatable conditions may reduce the individual's stroke risk by two-thirds (individual strategies) and possibly further (combination strategies). However, because the attributable risk of RIA for stroke is only about 22% (and may be less, given the role of other causal risk factors for stroke), strategies of stroke prevention in RIA patients can only reduce stroke incidence by up to 15% (from 22% to 7%). The potential benefits of the 'high risk' approach to stroke prevention appear to be less than the 'population' approach, but both approaches are necessary and complementary. Indeed, the cost of implementing the 'high risk' approach may be less than the cost of the strokes prevented ($255 million; i.e. 15% of $1.7 billion).

  13. Incidence of functional bi-temporal connections in the human brain in vivo and their relevance to epilepsy surgery.

    PubMed

    Jiménez-Jiménez, Diego; Abete-Rivas, Margely; Martín-López, David; Lacruz, María Elena; Selway, Richard P; Valentín, Antonio; Alarcón, Gonzalo

    2015-04-01

    The incidence of functional connections between human temporal lobes and their latencies were investigated using intracranial EEG responses to electrical stimulation with 1 msec single pulses in 91 patients assessed for surgery for treatment of epilepsy. The areas studied were amygdala, hippocampus, parahippocampal gyrus, fusiform gyrus, inferior and mid temporal gyrus. Furthermore, we assessed whether the presence of such connections are related to seizure onset extent and postsurgical seizure control. Responses were seen in any region of the contralateral temporal lobe when stimulating temporal regions in 30 patients out of the 91 (32.96%). Bi-hippocampal or bi-amygdalar projections were seen in only 5% of temporal lobes (N = 60) and between both fusiform gyri in 7.1% (N = 126). All other bilateral connections occurred in less than 5% of hemispheres. Depending on the structures, latencies ranged between 20 and 90 msec, with an average value of 60.2 msec. There were no statistical difference in the proportion of patients showing Engel Class I between patients with and without contralateral temporal connections. No difference was found in the proportion of patients showing bilateral or unilateral seizure onset among patients with and without contralateral temporal projections. The present findings corroborate that the functionality of bilateral temporal connections in humans is limited and does not affect the surgical outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. The incidence and risk factors for hypotension during emergent decompressive craniotomy in children with traumatic brain injury.

    PubMed

    Miller, Patrick; Mack, Christopher D; Sammer, Marla; Rozet, Irene; Lee, Lorri A; Muangman, Saipin; Wang, Marjorie; Hollingworth, Will; Lam, Arthur M; Vavilala, Monica S

    2006-10-01

    We conducted a retrospective cohort study in children <13 yr with traumatic brain injury (TBI) at a Level 1 pediatric trauma center to describe risk factors for intraoperative hypotension (IH) during emergent decompressive craniotomy. Between 1994 and 2004, 108 children underwent emergent decompressive craniotomy for TBI. Overall, 56 (52%) patients had IH. Independent risk factors for IH were each 10 mL estimated blood loss/kg (ARR 1.15 95% CI 1.08-1.22), each mm of computed tomography (CT) midline shift (ARR 1.04 95%CI 1.01-1.07), each 10 mL of CT lesion volume (ARR 1.03 95%CI 1.01-1.05), and emergency department (ED) hypotension (5/5 patients with ED hypotension had IH). CT midline shift > or =4 mm predicted IH (ARR 1.67 95% CI 1.06-2.63), independent of blood loss. IH occurred frequently during emergent decompressive craniotomy in children with TBI. ED hypotension, blood loss, CT lesion volume, and CT midline shift predicted IH. Anesthesiologists can expect children with preoperative CT midline shift > or =4 mm to have IH during this procedure.

  15. Arterial aneurysms associated with arteriovenous malformations of the brain: classification, incidence, risk of hemorrhage, and treatment-a systematic review.

    PubMed

    Cagnazzo, Federico; Brinjikji, Waleed; Lanzino, Giuseppe

    2016-11-01

    Aneurysms associated with brain arteriovenous malformations (bAVMs) influence the natural history of these lesions and pose important therapeutic challenges. However, the epidemiology, natural history, and appropriate management of the aneurysms associated with bAVMs are not completely understood due to the paucity of large and uniform studies. We performed a systematic review of published series examining the association between aneurysms and bAVMs with the purpose of clarifying the prevalence, risk of hemorrhage, and appropriate management of these lesions. PRISMA/MOOSE guidelines were followed. We conducted a comprehensive literature search of three databases (PubMed, Ovid MEDLINE, and Ovid EMBASE) on aneurysms associated with bAVMs. Only studies examining consecutive case series of aneurysms associated with bAVMs were included. From the collected studies, we extracted data regarding prevalence of bAVM-associated aneurysms, risk of aneurysm rupture in relation to bAVM location and aneurysm characteristics, and treatment-related outcomes. Our systematic review included 44 articles with a total of 10,093 bAVMs. The proportion of bAVMs with an associated aneurysm was 20.2 % (95 % CI = 19.4-20.9 %). Among ruptured bAVMs with associated aneurysms, the aneurysm was the source of hemorrhage in 49.2 % (95 % CI = 43.7-54.7 %) of cases. Flow-related aneurysms were the most common source of aneurysm rupture (78.5 %, 95 % CI = 70.6-84.9 %). Infratentorial bAVM-associated aneurysms presented a higher risk of rupture (60 %, 95 % CI = 47.4-71.9 %) when compared with supratentorial lesions (29 %, 95 % CI = 21.4-38.5 %). Endovascular treatment of aneurysms associated with bAVMs had a cure rate of 80.0 % (95 % CI = 73.3-85.3 %), complication rate of 8.7 % (95 % CI = 5.5-13.1 %), and a good neurological outcome rate of 78.8 % (95 % CI = 72.5-83.9 %). Twenty percent of bAVMs harbored arterial aneurysms. The presence of

  16. The incidence of deep brain stimulator hardware infection: the effect of change in antibiotic prophylaxis regimen and review of the literature.

    PubMed

    Bhatia, Robin; Dalton, Arthur; Richards, Mike; Hopkins, Chris; Aziz, Tipu; Nandi, Dipankar

    2011-10-01

    The complication of hardware infection related to deep brain stimulator implantation (or revision) varies between 0 and 15.2% in the literature. However, no national guidelines exist at present to define an average or acceptable rate of infection associated with, nor the preferred antibiotic prophylaxis required for, this procedure. The aim of this study was to examine the effect of changing the antibiotic prophylaxis regimen used in a single neurosurgical centre on the incidence and outcome of hardware infection. A prospective cohort of 38 patients undergoing deep brain stimulation (DBS) implantation or internal pulse generator (IPG) replacement and receiving perioperative vancomycin (including intravenous gentamicin on induction) and pouch-installed gentamicin, was compared to a historical cohort of 35 patients receiving perioperative cefuroxime in the same unit. The infection rate over 2 years in the prospective group for DBS surgery was 0 compared to 1 (5.6%) in the historical cohort (p = 0.11, χ(2)); the infection rate for IPG replacements was 1(3.6%) in the prospective cohort, versus 3 (17.6%) in the historical (p = 0.44, χ(2)). In this article, we have also systematically reviewed the literature to date and derived an average infection rate of 4.7% (PI 0.9-22%, Random Effects Meta-analysis, Stata) for 35 studies comprising 3550 patients. There is no significant difference in infection rates between DBS procedures that are primarily internalised (n = 9) compared to those in which there is a period of electrode externalisation (n = 23) (p = 0.9, Meta-regression analysis, Stata).

  17. Caractérisation du dipôle lacune-calcium par relaxations électrique et mécanique dans des mononcristaux de zircones calciées

    NASA Astrophysics Data System (ADS)

    Pautrot, S.; Mazot, Ph.; de Fouquet, J.

    1993-05-01

    Complex impedance measurements have been performed on calcia doped zirconia single crystals for three different dopant concentrations. A maximum of the dielectric loss is observed at a frequency which is thermally activated. The activation energy is slightly lower than the one derived from the study of the dc electrical conductivity with temperature. The experimental results depend very little on composition. Resonant method experiments have been used to measure internal friction and Young's modulus for different orientations [100], [110] and [111] in he case of one composition. The study with temperature confirms that [111] is the preferential orientation of the vacancy-calcium dipole. Des mesures isothermes d'impédance complexe ont été réalisées sur des échantillons monocristallins de zircone cuhique stabilisée à la chaux, pour trois compositions différentes. L'étude de la conductivité en courant continu conduit à la détermination d'une énergie d'activation légèrement superieure à celle obtenue lors de l'étude en fréquence de l'angle de pertes diélectriques. Pour une concentration donnée, nous avons également mesuré, par une méthode de résonance, le frottement intérieur ainsi que le module d'Young d'un échantillon selon les trois orientations cristallographiques [100], [111] et [110]. Cette étude confirme la direction du dipôle lacune-calcium selon un axe [111].

  18. The curious incident of the photo that was accused of being false: issues of domain specificity in development, autism, and brain imaging.

    PubMed

    Perner, Josef; Leekam, Susan

    2008-01-01

    We resume an exchange of ideas with Uta Frith that started before the turn of the century. The curious incident responsible for this exchange was the finding that children with autism fail tests of false belief, while they pass Zaitchik's (1990) photograph task (Leekam & Perner, 1991). This finding led to the conclusion that children with autism have a domain-specific impairment in Theory of Mind (mental representations), because the photograph task and the false-belief task are structurally equivalent except for the nonmental character of photographs. In this paper we argue that the false-belief task and the false-photograph task are not structurally equivalent and are not empirically associated. Instead a truly structurally equivalent task is the false-sign task. Performance on this task is strongly associated with the false-belief task. A version of this task, the misleading-signal task, also poses severe problems for children with autism (Bowler, Briskman, Gurvidi, & Fornells-Ambrojo, 2005). These new findings therefore challenge the earlier interpretation of a domain-specific difficulty in inferring mental states and suggest that children with autism also have difficulty understanding misleading nonmental objects. Brain imaging data using false-belief, "false"-photo, and false-sign scenarios provide further supporting evidence for our conclusions.

  19. Incident Cerebral Microbleeds in a Cohort of Intracerebral Hemorrhage.

    PubMed

    Pasquini, Marta; Benedictus, Marije R; Boulouis, Grégoire; Rossi, Costanza; Dequatre-Ponchelle, Nelly; Cordonnier, Charlotte

    2016-03-01

    We aimed to identify prognostic and associated factors of incident cerebral microbleeds (CMBs) in intracerebral hemorrhage (ICH) survivors. Observational prospective cohort of 168 ICH survivors who underwent 1.5T magnetic resonance imaging at ICH onset and during follow-up (median scan interval, 3.4; interquartile range, 1.4-4.7) years. We used logistic regression adjusted for age, sex, and scan interval. Analyses were stratified according to the index ICH location (58 lobar ICH, 103 nonlobar ICH, excluding patients with multiple or unclassifiable ICH). Eighty-nine (53%) patients had CMBs at ICH onset, and 80 (48%) exhibited incident CMBs during follow-up. Predictors of incident CMBs at ICH onset were ≥1 CMBs (adjusted odds ratio [aOR], 2.27; 95% confidence interval [CI], 1.18-4.35), old radiological macrohemorrhage (aOR, 6.78; 95% CI, 2.76-16.68), and CMBs in mixed location (aOR, 3.73; 95% CI, 1.67-8.31). When stratifying by ICH location, incident CMBs were associated in nonlobar ICH with incident lacunes (aOR, 2.86; 95% CI, 1.04-7.85) and with the use of antiplatelet agents (aOR, 2.89; 95% CI, 1.14-7.32). In lobar ICH, incident CMBs were associated with incident radiological macrohemorrhage (aOR, 9.76; 95% CI, 1.07-88.77). Prognostic and associated factors of incident CMBs differed according to the index ICH location. Whereas in lobar ICH, incident CMBs were associated with hemorrhagic biomarkers, in nonlobar ICH, ischemic burden also increased. CMBs may be interesting biomarkers to monitor in randomized trials on restarting antithrombotic drugs after ICH. © 2016 American Heart Association, Inc.

  20. The incidence of T2-weighted MR imaging signal abnormalities in the brain of cocaine-dependent patients is age-related and region-specific.

    PubMed

    Bartzokis, G; Goldstein, I B; Hance, D B; Beckson, M; Shapiro, D; Lu, P H; Edwards, N; Mintz, J; Bridge, P

    1999-10-01

    Cocaine and its metabolites can produce vasospasm, and cocaine-dependent patients are at increased risk for stroke. Based on previous case reports, we hypothesized that the incidence of hyperintense brain lesions observed on T2-weighted MR images would also be increased in asymptomatic cocaine-dependent individuals. Sixty-two male "crack" (smoked) cocaine-dependent participants ranging in age from 25 to 66 years were compared with 116 normal male control participants ranging in age from 25 to 80 years. Those with histories of neurologic symptoms or illnesses were excluded. The severity of hyperintense lesions was rated on a 0- to 3-point scale, and ratings of 3 were used in the data analysis as an indicator of a probable pathologic process. Three regions were separately rated: the cerebral white matter, insular subcortex white matter, and subcortical gray matter (basal ganglia and thalamus region). Significantly increased risk of severe lesions was observed in the two white matter regions of the cocaine-dependent group (odds ratio of 16.7 and 20.3) but not in the subcortial gray matter region (odds ratio of 1.4). In the insula subcortex white matter, the risk of lesions increased with age in the cocaine-dependant sample, but remained essentially absent among normal controls through the age of 80 years. In the cerebral white matter, the relationship of age and risk of lesion among normal participants was similar in shape to that in cocaine-dependent participants, but equivalent risk was seen 20 years earlier among cocaine-dependent participants. Cocaine-dependent participants had a significantly increased age-related risk of white matter damage. The possible clinical implications of this damage are discussed.

  1. Preoperative steroid use and the incidence of perioperative complications in patients undergoing craniotomy for definitive resection of a malignant brain tumor.

    PubMed

    Alan, Nima; Seicean, Andreea; Seicean, Sinziana; Neuhauser, Duncan; Benzel, Edward C; Weil, Robert J

    2015-09-01

    We studied the impact of preoperative steroids on 30 day morbidity and mortality of craniotomy for definitive resection of malignant brain tumors. Glucocorticoids are used to treat peritumoral edema in patients with malignant brain tumors, however, prolonged (⩾ 10 days) use of preoperative steroids as a risk factor for perioperative complications following resection of brain tumors has not been studied comprehensively. Therefore, we identified 4407 patients who underwent craniotomy to resect a malignant brain tumor between 2007 and 2012, who were reported in the National Surgical Quality Improvement Program, a prospectively collected clinical database. Metastatic brain tumors constituted 37.5% (n=1611) and primary malignant gliomas 62.5% (n=2796) of the study population. We used logistic regression to assess the association between preoperative steroid use and perioperative complications before and after 1:1 propensity score matching. Patients who received steroids constituted 22.8% of the population (n=1009). In the unmatched cohort, steroid use was associated with decreased length of hospitalization (odds ratio [OR] 0.7; 95% confidence interval [CI] 0.6-0.8), however, the risk for readmission (OR 1.5; 95% CI 1.2-1.8) was increased. In the propensity score matched cohort (n=465), steroid use was not statistically associated with any adverse outcomes. Patients who received steroids were less likely to stay hospitalized for a protracted period of time, but were more likely to be readmitted after discharge following craniotomy. As an independent risk factor, preoperative steroid use was not associated with any observed perioperative complications. The findings of this study suggest that preoperative steroids do not independently compromise the short term outcome of craniotomy for resection of malignant brain tumors.

  2. Association of serum vitamin D with the risk of incident dementia and subclinical indices of brain aging the framingham heart study

    USDA-ARS?s Scientific Manuscript database

    Background: Identifying nutrition- and lifestyle-based risk factors for cognitive impairment and dementia may aid future primary prevention efforts. Objective: We aimed to examine the association of serum vitamin D levels with incident all-cause dementia, clinically characterized Alzheimer's disease...

  3. Door-to-door capture of incident and prevalent stroke cases in Durango, Mexico – the Brain Attack Surveillance in Durango (BASID) Study

    PubMed Central

    Cantu-Brito, Carlos; Majersik, Jennifer J; Sánchez, Brisa N; Ruano, Angel; Becerra-Mendoza, Daniela; Wing, Jeffrey J; Morgenstern, Lewis B

    2011-01-01

    Background and Purpose Stroke incidence and prevalence estimates in developing countries should include stroke cases not presenting to hospital. We performed door-to-door stroke case ascertainment in Durango Municipality, Mexico to estimate stroke incidence and prevalence, and to determine the error made by only ascertaining hospital cases. Methods Between September 2008 and March 2009, 1996 housing units were randomly sampled to screen for stroke in Durango Municipality residents ≥35 years of age. Field workers utilized a validated screening tool. Those screening positive were referred to a neurologist for history and examination and if confirmed, a head CT scan. Prevalence and cumulative incidence from the door-to-door surveillance were calculated and compared with previously reported hospitalization rates during the same defined time. Results Respondents included 2437 subjects from 1419 homes. The refusal rate was 3.8%. Twenty subjects had verified or probable stroke. The prevalence of probable or verified stroke was 7.7/1000 (95% CI: 4.3/1000, 11.2/1000). Five patients had a stroke during the time of the hospital surveillance, yielding a cumulative incidence of 232.3/100,000 (95% CI: 27.8, 436.9). Two of the 5 cases were captured by door-to-door surveillance but not by hospital surveillance. Conclusions This study provides the first community-based stroke prevalence and incidence estimates in Mexico. The wide confidence intervals, despite the large number of surveyed housing units, suggest the need for more advanced sampling strategies for stroke surveillance in the developing world. PMID:21212398

  4. Door-to-door capture of incident and prevalent stroke cases in Durango, Mexico: the Brain Attack Surveillance in Durango Study.

    PubMed

    Cantu-Brito, Carlos; Majersik, Jennifer J; Sánchez, Brisa N; Ruano, Angel; Becerra-Mendoza, Daniela; Wing, Jeffrey J; Morgenstern, Lewis B

    2011-03-01

    Stroke incidence and prevalence estimates in developing countries should include stroke cases not presenting to hospital. We performed door-to-door stroke case ascertainment in Durango Municipality, Mexico, to estimate stroke incidence and prevalence and to determine the error made by only ascertaining hospital cases. Between September 2008 and March 2009, 1996 housing units were randomly sampled to screen for stroke in Durango Municipality residents 35 years of age and older. Field workers utilized a validated screening tool. Those screening positive were referred to a neurologist for history and examination and a head CT scan. Prevalence and cumulative incidence from the door-to-door surveillance were calculated and compared with previously reported hospitalization rates during the same defined time. Respondents included 2437 subjects from 1419 homes. The refusal rate was 3.8%. Twenty subjects had verified or probable stroke. The prevalence of probable or verified stroke was 7.7 per 1000 (95% CI, 4.3 per 1000-11.2 per 1000). Five patients had a stroke during the time of the hospital surveillance, yielding a cumulative incidence of 232.3 per 100 000 (95% CI, 27.8-436.9). Two of the 5 cases were captured by door-to-door surveillance but not by hospital surveillance. This study provides the first community-based stroke prevalence and incidence estimates in Mexico. The wide confidence intervals, despite the large number of surveyed housing units, suggest the need for more advanced sampling strategies for stroke surveillance in the developing world.

  5. Cardiorespiratory fitness, cognition and brain structure after TIA or minor ischemic stroke.

    PubMed

    Boss, H Myrthe; Van Schaik, Sander M; Witkamp, Theo D; Geerlings, Mirjam I; Weinstein, Henry C; Van den Berg-Vos, Renske M

    2017-10-01

    Background It is not known whether cardiorespiratory fitness is associated with better cognitive performance and brain structure in patients with a TIA or minor ischemic stroke. Aims To examine the association between cardiorespiratory fitness, cognition and brain structure in patients with a TIA and minor stroke. Methods The study population consisted of patients with a TIA or minor stroke with a baseline measurement of the peak oxygen consumption, a MRI scan of brain and neuropsychological assessment. Composite z-scores were calculated for the cognitive domains attention, memory and executive functioning. White matter hyperintensities, microbleeds and lacunes were rated visually. The mean apparent diffusion coefficient was measured in regions of interest in frontal and occipital white matter and in the centrum semiovale as a marker of white matter structure. Normalized brain volumes were estimated by use of Statistical Parametric Mapping. Results In 84 included patients, linear regression analysis adjusted for age, sex and education showed that a higher peak oxygen consumption was associated with higher cognitive z-scores, a larger grey matter volume (B = 0.15 (95% CI 0.05; 0.26)) and a lower mean apparent diffusion coefficient (B = -.004 (95% CI -.007; -.001)). We found no association between the peak oxygen consumption and severe white matter hyperintensities, microbleeds, lacunes and total brain volume. Conclusions These data suggest that cardiorespiratory fitness is associated with better cognitive performance, greater grey matter volume and greater integrity of the white matter in patients with a TIA or minor ischemic stroke. Further prospective trials are necessary to define the effect of cardiorespiratory fitness on cognition and brain structure in patients with TIA or minor stroke.

  6. Deployment-Related Mild Traumatic Brain Injury (mTBI): Incidence, Natural History, and Predictors of Recovery in Soldiers Returning from OIF/OEF

    DTIC Science & Technology

    2012-05-01

    clinical efforts at these locations by expanding the post-deployment assessment of traumatic brain injury ( TBI ) and TBI -related exposures...employment, including fitness for military duty, functional status, and quality of life. 15. SUBJECT TERMS TBI , mild TBI , deployment, longitudinal 16... TBI ) and TBI -related exposures; identifying pre-existing and deployment-related exposures and comorbid conditions that may influence the risk or

  7. Degenerative and vascular lesions of the brain have synergistic effects in dementia of the elderly.

    PubMed

    Zekry, Dina; Duyckaerts, Charles; Moulias, Robert; Belmin, Joël; Geoffre, Caroline; Herrmann, François; Hauw, Jean-Jacques

    2002-05-01

    The relative importance of vascular and Alzheimer's disease (AD) lesions, their interaction in the development of cognitive impairment and the very existence of mixed dementia induced by the potentiation of both mechanisms remain controversial. The aim of this study was to assess whether the patients with infarcts and lacunes have fewer plaques and tangles than those without vascular lesions, for similar severity of clinical dementia. We performed a prospective clinicopathological study in elderly patients of a long-stay care unit. The severity of clinical dementia was assessed by psychometry performed according to standardized methods less than 6 months before death. A volumetric study of cerebral vascular lesions was performed at post-mortem study of the brain. The density of neuritic plaques (SP), Amyloid beta focal deposits (A beta FD), and neurofibrillary tangles (NFT) in the temporal and frontal isocortex was quantified. According to DSM III criteria, 28 of the 33 patients for whom autopsies were performed had dementia. Twenty-four of the included patients had degenerative or vascular lesions, or both. The volume of infarcts and lacunes was significantly correlated with the severity of cognitive impairment. The density of SP, A beta FD and NFT in the temporal and frontal isocortex was significantly lower when vascular lesions were present. For similar clinical severity of dementia, there were fewer AD lesions in patients with vascular lesions than in those without vascular lesions.

  8. Disorders of consciousness after severe traumatic brain injury: a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways.

    PubMed

    Godbolt, Alison K; Deboussard, Catharina Nygren; Stenberg, Maud; Lindgren, Marie; Ulfarsson, Trandur; Borg, Jörgen

    2013-09-01

    Very severe traumatic brain injury may cause disorders of consciousness in the form of coma, unresponsive wakefulness syndrome (also known as vegetative state) or minimally conscious state. Previous studies of outcome for these patients largely pre-date the 2002 definition of minimally conscious state. To establish the numbers of patients with disorder of consciousness at 3 weeks, 3 months and 1 year after severe traumatic brain injury, and to relate conscious state 3 weeks after injury to outcomes at 1 year. Multi-centre, prospective, observational study of severe traumatic brain injury. lowest (non-sedated) Glasgow Coma Scale 3-8 during the first 24 h; requirement for neurosurgical intensive care; age 18-65 years; alive 3 weeks after injury. Diagnosis of coma, unresponsive wakefulness syndrome, minimally conscious state or emerged from minimally conscious state was based on clinical and Coma Recovery Scale Revised assessments 3 weeks, 3 months and 1 year after injury. One-year outcome was measured with Glasgow Outcome Scale Extended (GOSE). A total of 103 patients was included in the study. Of these, 81% were followed up to 1 year (76% alive, 5% dead). Three weeks after injury 36 were in coma, unresponsive wakefulness syndrome or minimally conscious state and 11 were anaesthetized. Numbers of patients who had emerged from minimally conscious state 1 year after injury, according to status at 3 weeks were: coma (0/6), unresponsive wakefulness syndrome (9/17), minimally conscious state (13/13), anaesthetized (9/11). Outcome at 1 year was good (GOSE > 4) for half of patients in minimally conscious state or anaesthetized at 3 weeks, but for none of the patients in coma or unresponsive wakefulness syndrome. These differences in outcome were not revealed by prognostic predictions based on acute data. Patients in minimally conscious state or anaesthetized 3 weeks after injury have a better prognosis than patients in coma or unresponsive wakefulness syndrome, which

  9. High incidence of benign brain meningiomas among Iranian- born Jews in Israel may be linked to both hereditary and environmental factors.

    PubMed

    Barchana, Micha; Liphshitz, Irena

    2013-01-01

    Following research demonstrating an increased risk for meningiomas in the Jewish population of Shiraz (Iran) we conducted a cohort analysis of meningiomas among Jews originating in Iran and residing in Israel. We use the population-based registry data of the Israeli National Cancer Registry (INCR) for the main analysis. All benign meningioma cases diagnosed in Israel from January 2000 to the end of 2009 were included. Patients that were born in Iran, Iraq, Turkey, Bulgaria and Greece were used for the analysis, whereby we calculated adjusted incidence rates per 100,000 people and computed standardized incidence ratios (SIRs) comparing the Iranian-born to each of the three other groups. Iranian-born Jews had statistically significant higher meningioma rates rates compared to other Jews originating in Balkan states: 1.46 fold compared to Turkish Jews and 1.86 fold compared to the Bulgaria-Greece group. There was a small increase in risk for the Iranian born group compared to those who were born in Iraq (1.06, not significant). Higher rates of meningiomas were seen in Jews originating in Iran that are living in Israel as compared to rates in neighboring countries of origin. These differences can be in part attributed to early life environmental exposures in Iran but probably in larger amount are due to genetic and hereditary factors in a closed community like the Iranian Jews. Some support for this conclusion was also found in other published research.

  10. Obstructive carotid and/or intracranial artery disease rarely affects the incidence of haemodynamic ischaemic stroke during cardiac surgery: a study on brain perfusion single-photon emission computed tomography with acetazolamide.

    PubMed

    Imasaka, Ken-ichi; Yasaka, Masahiro; Tayama, Eiki; Tomita, Yukihiro

    2015-11-01

    Ischaemic stroke is a major complication of cardiac surgery. The optimal strategies for operating on patients with obstructive carotid and/or intracranial artery disease (CIAD) are controversial. We aimed to clarify whether single-photon emission computed tomography (SPECT) with acetazolamide, to quantify the cerebral perfusion reserve, could predict the risk of haemodynamic ischaemic stroke during cardiac surgery. The incidence of stroke related to obstructive CIAD and the corresponding autoregulatory reserve were prospectively assessed in 514 consecutive patients who underwent elective cardiac surgery with cardiopulmonary bypass (n = 484) and off-pump coronary artery bypass grafting (n = 30) between 2009 and 2013. Preoperative cerebral blood flow and its reactivity to acetazolamide were quantitatively determined in patients (n = 88) with obstructive CIAD, diagnosed by carotid ultrasonography and/or magnetic resonance angiography. An impaired cerebral perfusion reserve was identified in 1 (1.1%) of the 88 patients. This patient underwent prophylactic superficial temporal artery to middle cerebral artery anastomosis 1 month before coronary artery bypass surgery. Subsequently, the patient underwent conventional coronary artery bypass surgery, without experiencing perioperative stroke. Seven (1.4%) patients died in-hospital mortality and 5 (1.0%) experienced perioperative stroke. However, no patients experienced perioperative haemodynamic ischaemic stroke. It is unusual for CIAD to affect the incidence of haemodynamic ischaemic stroke during cardiac surgery. Brain perfusion SPECT with acetazolamide is effective for narrowing down patients at high risk of ischaemic stroke during cardiac surgery. Meanwhile, the application of brain perfusion single-photon emission tomography should be confined only to patients with obstructive CIAD because it is an expensive examination tool. © The Author 2014. Published by Oxford University Press on behalf of the European Association

  11. The Incidence, Prevalence, Costs and Impact on Disability of Common Conditions Requiring Rehabilitation in the US: Stroke, Spinal Cord Injury, Traumatic Brain Injury, Multiple Sclerosis, Osteoarthritis, Rheumatoid Arthritis, Limb Loss, and Back Pain

    PubMed Central

    Ma, Vincent Y; Chan, Leighton; Carruthers, Kadir J

    2014-01-01

    Objective To determine the relative incidence, prevalence, costs and impact on disability of 8 common conditions treated by rehabilitation professionals. Design Structured review of the literature Setting United States Participants N/A Interventions N/A Main Outcome Measures disease associated incidence, prevalence, direct and indirect costs and impact on activity and work limitations. Results Back pain and arthritis (osteoarthritis and rheumatoid arthritis) are the most common and costly conditions that we examined, affecting over 100 million individuals and costing over $200 billion per year. Traumatic brain injury, while less common than arthritis and back pain, carries enormous per capita direct and indirect costs, mostly due to the young age of those involved and the severe disability that it may cause. Finally, stroke, which is often listed as the most common cause of disability, is likely second to both arthritis and back pain in its impact on functional limitations. Conclusions Of the common rehabilitation diagnoses we studied, musculoskeletal conditions such and back pain and arthritis likely have the most impact on the health care system due to their high prevalence and impact on disability. PMID:24462839

  12. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain.

    PubMed

    Ma, Vincent Y; Chan, Leighton; Carruthers, Kadir J

    2014-05-01

    To determine the relative incidence, prevalence, costs, and impact on disability of 8 common conditions treated by rehabilitation professionals. Comprehensive bibliographic searches using MEDLINE, Google Scholar, and UpToDate, (June, 2013). Two review authors independently screened the search results and performed data extraction. Eighty-two articles were identified that had relevant data on the following conditions: Stroke, Spinal Cord Injury, Traumatic Brain Injury, Multiple Sclerosis, Osteoarthritis, Rheumatoid Arthritis, Limb Loss, and Back Pain. Back pain and arthritis (osteoarthritis, rheumatoid arthritis) are the most common and costly conditions we analyzed, affecting more than 100 million individuals and costing greater than $200 billion per year. Traumatic brain injury, while less common than arthritis and back pain, carries enormous per capita direct and indirect costs, mostly because of the young age of those involved and the severe disability that it may cause. Finally, stroke, which is often listed as the most common cause of disability, is likely second to both arthritis and back pain in its impact on functional limitations. Of the common rehabilitation diagnoses we studied, musculoskeletal conditions such as back pain and arthritis likely have the most impact on the health care system because of their high prevalence and impact on disability. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Blood brain barrier breakdown as the starting point of cerebral small vessel disease? - New insights from a rat model

    PubMed Central

    2013-01-01

    Cerebral small vessel disease (CSVD, cerebral microangiopathy) leads to dementia and stroke-like symptoms. Lacunes, white matter lesions (WML) and microbleeds are the main pathological correlates depicted in in-vivo imaging diagnostics. Early studies described segmental arterial wall disorganizations of small penetrating cerebral arteries as the most pronounced underlying histopathology of lacunes. Luminal narrowing caused by arteriolosclerosis was supposed to result in hypoperfusion with WML and infarcts. We have used the model of spontaneously hypertensive stroke-prone rats (SHRSP) for a longitudinal study to elucidate early histological changes in small cerebral vessels. We suggest that endothelial injuries lead to multiple sites with blood brain barrier (BBB) leakage which cause an ongoing damage of the vessel wall and finally resulting in vessel ruptures and microbleeds. These microbleeds together with reactive small vessel occlusions induce overt cystic infarcts of the surrounding parenchyma. Thus, multiple endothelial leakage sites seem to be the starting point of cerebral microangiopathy. The vascular system reacts with an activated coagulatory state to these early endothelial injuries and by this induces the formation of stases, accumulations of erythrocytes, which represent the earliest detectable histological peculiarity of small vessel disease in SHRSP. In this review we focus on the meaning of the BBB breakdown in CSVD and finally discuss possible consequences for clinicians. PMID:23497521

  14. Traumatic Brain Injuries. Guidelines Paper.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver. Special Education Services Unit.

    This paper on traumatic brain injuries begins with statistics on the incidence of the disorder, especially as they relate to Colorado. Traumatic brain injury is then defined, and problems caused by traumatic brain injury are discussed. The components of effective programming for students with traumatic brain injuries are described, followed by the…

  15. Epidemiology of Brain Tumors.

    PubMed

    McNeill, Katharine A

    2016-11-01

    Brain tumors are the commonest solid tumor in children, leading to significant cancer-related mortality. Several hereditary syndromes associated with brain tumors are nonfamilial. Ionizing radiation is a well-recognized risk factor for brain tumors. Several industrial exposures have been evaluated for a causal association with brain tumor formation but the results are inconclusive. A casual association between the common mutagens of tobacco, alcohol, or dietary factors has not yet been established. There is no clear evidence that the incidence of brain tumors has changed over time. This article presents the descriptive epidemiology of the commonest brain tumors of children and adults.

  16. Delay Adjusted Incidence

    Cancer.gov

    This Infographic shows the National Cancer Institute SEER Incidence Trends. The graphs show the Average Annual Percent Change (AAPC) 2002-2011. For Men, Thyroid: 5.3*,Liver & IBD: 3.6*, Melanoma: 2.3*, Kidney: 2.0*, Myeloma: 1.9*, Pancreas: 1.2*, Leukemia: 0.9*, Oral Cavity: 0.5, Non-Hodgkin Lymphoma: 0.3*, Esophagus: -0.1, Brain & ONS: -0.2*, Bladder: -0.6*, All Sites: -1.1*, Stomach: -1.7*, Larynx: -1.9*, Prostate: -2.1*, Lung & Bronchus: -2.4*, and Colon & Rectum: -3/0*. For Women, Thyroid: 5.8*, Liver & IBD: 2.9*, Myeloma: 1.8*, Kidney: 1.6*, Melanoma: 1.5, Corpus & Uterus: 1.3*, Pancreas: 1.1*, Leukemia: 0.6*, Brain & ONS: 0, Non-Hodgkin Lymphoma: -0.1, All Sites: -0.1, Breast: -0.3, Stomach: -0.7*, Oral Cavity: -0.7*, Bladder: -0.9*, Ovary: -0.9*, Lung & Bronchus: -1.0*, Cervix: -2.4*, and Colon & Rectum: -2.7*. * AAPC is significantly different from zero (p<.05). Rates were adjusted for reporting delay in the registry. www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011.

  17. Delay Adjusted Incidence Infographic

    Cancer.gov

    This Infographic shows the National Cancer Institute SEER Incidence Trends. The graphs show the Average Annual Percent Change (AAPC) 2002-2011. For Men, Thyroid: 5.3*,Liver & IBD: 3.6*, Melanoma: 2.3*, Kidney: 2.0*, Myeloma: 1.9*, Pancreas: 1.2*, Leukemia: 0.9*, Oral Cavity: 0.5, Non-Hodgkin Lymphoma: 0.3*, Esophagus: -0.1, Brain & ONS: -0.2*, Bladder: -0.6*, All Sites: -1.1*, Stomach: -1.7*, Larynx: -1.9*, Prostate: -2.1*, Lung & Bronchus: -2.4*, and Colon & Rectum: -3/0*. For Women, Thyroid: 5.8*, Liver & IBD: 2.9*, Myeloma: 1.8*, Kidney: 1.6*, Melanoma: 1.5, Corpus & Uterus: 1.3*, Pancreas: 1.1*, Leukemia: 0.6*, Brain & ONS: 0, Non-Hodgkin Lymphoma: -0.1, All Sites: -0.1, Breast: -0.3, Stomach: -0.7*, Oral Cavity: -0.7*, Bladder: -0.9*, Ovary: -0.9*, Lung & Bronchus: -1.0*, Cervix: -2.4*, and Colon & Rectum: -2.7*. * AAPC is significantly different from zero (p<.05). Rates were adjusted for reporting delay in the registry. www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011.

  18. Brain Injury: A Manual For Educators.

    ERIC Educational Resources Information Center

    Connor, Karen; Dettmer, Judy; Dise-lewis, Jeanne E.; Murphy, Mary; Santistevan, Barbette; Seckinger, Barbara

    This manual provides Colorado educators with guidelines for serving students with brain injuries. Following an introductory chapter, chapter 2 provides basic information on the brain including definitions of brain injury and its severity, incidence of brain injury, and characteristics of students with brain injury. Chapter 3 considers…

  19. Longitudinal patterns of leukoaraiosis and brain atrophy in symptomatic small vessel disease.

    PubMed

    Lambert, Christian; Benjamin, Philip; Zeestraten, Eva; Lawrence, Andrew J; Barrick, Thomas R; Markus, Hugh S

    2016-04-01

    Cerebral small vessel disease is a common condition associated with lacunar stroke, cognitive impairment and significant functional morbidity. White matter hyperintensities and brain atrophy, seen on magnetic resonance imaging, are correlated with increasing disease severity. However, how the two are related remains an open question. To better define the relationship between white matter hyperintensity growth and brain atrophy, we applied a semi-automated magnetic resonance imaging segmentation analysis pipeline to a 3-year longitudinal cohort of 99 subjects with symptomatic small vessel disease, who were followed-up for ≥1 years. Using a novel two-stage warping pipeline with tissue repair step, voxel-by-voxel rate of change maps were calculated for each tissue class (grey matter, white matter, white matter hyperintensities and lacunes) for each individual. These maps capture both the distribution of disease and spatial information showing local rates of growth and atrophy. These were analysed to answer three primary questions: first, is there a relationship between whole brain atrophy and magnetic resonance imaging markers of small vessel disease (white matter hyperintensities or lacune volume)? Second, is there regional variation within the cerebral white matter in the rate of white matter hyperintensity progression? Finally, are there regionally specific relationships between the rates of white matter hyperintensity progression and cortical grey matter atrophy? We demonstrate that the rates of white matter hyperintensity expansion and grey matter atrophy are strongly correlated (Pearson's R = -0.69, P < 1 × 10(-7)), and significant grey matter loss and whole brain atrophy occurs annually (P < 0.05). Additionally, the rate of white matter hyperintensity growth was heterogeneous, occurring more rapidly within long association fasciculi. Using voxel-based quantification (family-wise error corrected P < 0.05), we show the rate of white matter hyperintensity

  20. Introduction to Pesticide Incidents

    EPA Pesticide Factsheets

    Pesticides incidents must be reported by pesticide registrants. Others, such as members of the public and environmental professionals, would like to report pesticide incidents. This website will explain and facilitate such incident reporting.

  1. Impact of small vessel disease in the brain on gait and balance

    PubMed Central

    Pinter, Daniela; Ritchie, Stuart J.; Doubal, Fergus; Gattringer, Thomas; Morris, Zoe; Bastin, Mark E.; del C. Valdés Hernández, Maria; Royle, Natalie A.; Corley, Janie; Muñoz Maniega, Susana; Pattie, Alison; Dickie, David A.; Staals, Julie; Gow, Alan J.; Starr, John M.; Deary, Ian J.; Enzinger, Christian; Fazekas, Franz; Wardlaw, Joanna

    2017-01-01

    Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71–74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity – WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients’ performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects. PMID:28134332

  2. Impact of small vessel disease in the brain on gait and balance.

    PubMed

    Pinter, Daniela; Ritchie, Stuart J; Doubal, Fergus; Gattringer, Thomas; Morris, Zoe; Bastin, Mark E; Del C Valdés Hernández, Maria; Royle, Natalie A; Corley, Janie; Muñoz Maniega, Susana; Pattie, Alison; Dickie, David A; Staals, Julie; Gow, Alan J; Starr, John M; Deary, Ian J; Enzinger, Christian; Fazekas, Franz; Wardlaw, Joanna

    2017-01-30

    Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity - WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.

  3. Longitudinal patterns of leukoaraiosis and brain atrophy in symptomatic small vessel disease

    PubMed Central

    Benjamin, Philip; Zeestraten, Eva; Lawrence, Andrew J.; Barrick, Thomas R.; Markus, Hugh S.

    2016-01-01

    Cerebral small vessel disease is a common condition associated with lacunar stroke, cognitive impairment and significant functional morbidity. White matter hyperintensities and brain atrophy, seen on magnetic resonance imaging, are correlated with increasing disease severity. However, how the two are related remains an open question. To better define the relationship between white matter hyperintensity growth and brain atrophy, we applied a semi-automated magnetic resonance imaging segmentation analysis pipeline to a 3-year longitudinal cohort of 99 subjects with symptomatic small vessel disease, who were followed-up for ≥1 years. Using a novel two-stage warping pipeline with tissue repair step, voxel-by-voxel rate of change maps were calculated for each tissue class (grey matter, white matter, white matter hyperintensities and lacunes) for each individual. These maps capture both the distribution of disease and spatial information showing local rates of growth and atrophy. These were analysed to answer three primary questions: first, is there a relationship between whole brain atrophy and magnetic resonance imaging markers of small vessel disease (white matter hyperintensities or lacune volume)? Second, is there regional variation within the cerebral white matter in the rate of white matter hyperintensity progression? Finally, are there regionally specific relationships between the rates of white matter hyperintensity progression and cortical grey matter atrophy? We demonstrate that the rates of white matter hyperintensity expansion and grey matter atrophy are strongly correlated (Pearson’s R = −0.69, P < 1 × 10−7), and significant grey matter loss and whole brain atrophy occurs annually (P < 0.05). Additionally, the rate of white matter hyperintensity growth was heterogeneous, occurring more rapidly within long association fasciculi. Using voxel-based quantification (family-wise error corrected P < 0.05), we show the rate of white matter hyperintensity

  4. Critical incident reporting systems.

    PubMed

    Ahluwalia, Jag; Marriott, Lin

    2005-02-01

    Approximately 10% of all hospital admissions are complicated by critical incidents in which harm is caused to the patient - this amounts to more than 850,000 incidents annually. Critical incident reporting (CIR) systems refer to the structured reporting, collation and analysis of such incidents. This article describes the attributes required for an effective CIR system. Example neonatal trigger events and a management pathway for handling a critical incident report are described. The benefits and limitations of CIR systems, reactive and prospective approaches to the analysis of actual or potential critical incidents and the assessment of risk are also reviewed. Individual human error is but one contributor in the majority of critical incidents. Recognition of this and the fostering of an organisational culture that views critical incident reports as an opportunity to learn and to improve future patient care is vital if CIR systems are to be effective.

  5. Incidents of Security Concern

    SciTech Connect

    Atencio, Julian J.

    2014-05-01

    This presentation addresses incidents of security concern and an incident program for addressing them. It addresses the phases of an inquiry, and it divides incidents into categories based on severity and interest types based on whether security, management, or procedural interests are involved. A few scenarios are then analyzed according to these breakdowns.

  6. Brain involvement in Alström syndrome

    PubMed Central

    2013-01-01

    Background Alström Syndrome (AS) is a rare ciliopathy characterized by cone–rod retinal dystrophy, sensorineural hearing loss, obesity, type 2 diabetes mellitus and cardiomyopathy. Most patients do not present with neurological issues and demonstrate normal intelligence, although delayed psychomotor development and psychiatric disorders have been reported. To date, brain Magnetic Resonance Imaging (MRI) abnormalities in AS have not been explored. Methods We investigated structural brain changes in 12 genetically proven AS patients (mean-age 22 years; range: 6–45, 6 females) and 19 matched healthy and positive controls (mean-age 23 years; range: 6–43; 12 females) using conventional MRI, Voxel-Based Morphometry (VBM) and Diffusion Tensor Imaging (DTI). Results 6/12 AS patients presented with brain abnormalities such as ventricular enlargement (4/12), periventricular white matter abnormalities (3/12) and lacune-like lesions (1/12); all patients older than 30 years had vascular-like lesions. VBM detected grey and white matter volume reduction in AS patients, especially in the posterior regions. DTI revealed significant fractional anisotropy decrease and radial diffusivity increase in the supratentorial white matter, also diffusely involving those regions that appeared normal on conventional imaging. On the contrary, axial and mean diffusivity did not differ from controls except in the fornix. Conclusions Brain involvement in Alström syndrome is not uncommon. Early vascular-like lesions, gray and white matter atrophy, mostly involving the posterior regions, and diffuse supratentorial white matter derangement suggest a role of cilia in endothelial cell and oligodendrocyte function. PMID:23406482

  7. Antiepileptic drugs and brain development.

    PubMed

    Ikonomidou, Chrysanthy; Turski, Lechoslaw

    2010-01-01

    Epilepsy, the most common neurological disorder in young humans, has its highest incidence during the first year of life. Antiepileptic drugs (AEDs) which are used to treat seizures in infants, children and pregnant women target ion channels, neurotransmitters and second messenger systems in the brain. The same targets regulate brain processes essential both for propagation of seizures and for brain development, learning, memory and emotional behavior. Here we review adverse effects of AEDs in the developing mammalian brain. In addition, we discuss mechanisms explaining adverse effects of AEDs in the developing mammalian brain including interference with cell proliferation and migration, neurogenesis, axonal arborization, synaptogenesis, synaptic plasticity and physiological apoptotic cell death.

  8. Brain herniation

    MedlinePlus

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  9. Coping with brain damage

    NASA Technical Reports Server (NTRS)

    Waring, W.

    1974-01-01

    Two neurological disorders, cerebral palsy, and traumatic brain damage as from an accident, are considered. The discussion covers the incidence of disabilities, their characteristics, and what is now being done to deal with them, particularly in reference to areas in which the capabilities of the engineer can be effectively applied.

  10. Coping with brain damage

    NASA Technical Reports Server (NTRS)

    Waring, W.

    1974-01-01

    Two neurological disorders, cerebral palsy, and traumatic brain damage as from an accident, are considered. The discussion covers the incidence of disabilities, their characteristics, and what is now being done to deal with them, particularly in reference to areas in which the capabilities of the engineer can be effectively applied.

  11. Reflections on Critical Incidents.

    ERIC Educational Resources Information Center

    Thiel, Teresa

    1999-01-01

    Focuses on the reporting of critical incidents as a tool for self-reflection in a program to train English-as-a-Second-language (ESL) secondary school teachers in Malaysia. Case studies of critical incidents highlight the potential value of encouraging ESL trainee teachers to record, analyze, and reflect on significant personal events in their…

  12. Incident analysis report

    SciTech Connect

    Gregg, D.W.; Buerer, A.; Leeds, S.

    1996-02-20

    This document presents information about a fire that occurred in January 1996 at Lawrence Livermore National Laboratory. This fire was caused by the spontaneous combustion of 100% fuming nitric acid. Topics discussed include: Summary of the incident; technical background; procedural background; supervision; previous incidents with 100% fuming nitric acid; and judgment of potential hazards.

  13. Incidence of Menkes disease.

    PubMed

    Tønnesen, T; Kleijer, W J; Horn, N

    1991-02-01

    We have calculated the incidence of Menkes disease for Denmark, France, The Netherlands, the United Kingdom and West Germany, based on known Menkes patients born during the time period 1976-87. Considering live-born Menkes patients, the combined incidence for these five countries is 1 Menkes patient per 298,000 live-born babies. If the number of affected aborted fetuses are taken into account, the incidence is 1 Menkes per 254,000 live-born babies. This incidence, which is 2-4 times lower than earlier published incidence figures, places Menkes disease as an extremely rare disease. The mutation rate for Menkes disease is estimated to be 1.96 x 10(-6), based on the number of isolated Menkes cases born during the time period 1976-87 and the total number of newborn males during this time.

  14. Dutch perfusion incident survey.

    PubMed

    Groenenberg, Ingrid; Weerwind, Patrick W; Everts, Peter A M; Maessen, Jos G

    2010-09-01

    Cardiopulmonary bypass procedures remain complex, involving many potential risks. Therefore, a nationwide retrospective study was conducted to gain insight into the number of incidents and accidents in Dutch adult perfusion practice. An anonymous postal survey (85 questions about hardware, disposables, fluids and medication, air emboli, anticoagulation, practice, and safety measures) was sent to all Dutch perfusionists involved in adult cardiovascular perfusion during 2006 and 2007. To guarantee complete anonymity, respondents were asked to return the survey to a notary who discarded personal information. The net response rate was 72% and covered 23,500 perfusions. Individual respondents performed 240 ± 103 perfusions during the 2-year study period and had 13.8 ± 8.7 years of practical experience. The incident rate was 1 per 15.6 perfusions and the adverse event rate was 1 per 1,236 perfusions. The three most reported incidents were: (1) persistent inability to raise the activated coagulation time above 400s during perfusion (184 incidents); (2) an allergic or anaphylactic reaction to drugs, fluids, or blood products (114 incidents); and (3) clotting formation in the extracorporeal circuit (74 incidents). Furthermore, pre-bypass safety measures showed no statistically significant association with the reported incidents. In comparison with data from the recent literature, the reported number of incidents is high. Nevertheless, the adverse outcome rate is well matched to other published surveys. The relatively high response rate conveys the impression that the Dutch perfusionist is vigilant and willing to report incidents. Hence, a web-based Dutch perfusion incident registration system is recommended.

  15. Assessment of Students with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Chesire, David J.; Buckley, Valerie A.; Canto, Angela I.

    2011-01-01

    The incidence of brain injuries, as well as their impact on individuals who sustain them, has received growing attention from American media in recent years. This attention is likely the result of high profile individuals suffering brain injuries. Greater public awareness of traumatic brain injuries (TBIs) has also been promoted by sources such as…

  16. Assessment of Students with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Chesire, David J.; Buckley, Valerie A.; Canto, Angela I.

    2011-01-01

    The incidence of brain injuries, as well as their impact on individuals who sustain them, has received growing attention from American media in recent years. This attention is likely the result of high profile individuals suffering brain injuries. Greater public awareness of traumatic brain injuries (TBIs) has also been promoted by sources such as…

  17. 2011 Japanese Nuclear Incident

    EPA Pesticide Factsheets

    EPA’s RadNet system monitored the environmental radiation levels in the United States and parts of the Pacific following the Japanese Nuclear Incident. Learn about EPA’s response and view historical laboratory data and news releases.

  18. INCIDENCE OF ENDOMETRIAL HYPERPLASIA

    PubMed Central

    REED, Susan D.; NEWTON, Katherine M.; CLINTON, Walter L.; EPPLEIN, Meira; GARCIA, Rochelle; ALLISON, Kimberly; VOIGT, Lynda F.; Weiss, Noel S.

    2009-01-01

    Objective Estimate age-specific incidence of endometrial hyperplasia: simple, complex, and atypical, in order of increasing likelihood of progression to carcinoma. Study design Women ages 18–90 years with endometrial pathology specimens (1985–2003) at a large integrated health plan were identified using automated data. Incidence rates were obtained by dividing the number of cases by the estimated number of female health plan enrollees who retained a uterus. Results Endometrial hyperplasia peak incidence was: simple-142/100,000 woman-years, complex-213/100,000 woman-years, both in the early 50s; and atypical-56/100,000 woman-years in the early 60s. Age-adjusted incidence decreased over the study period, especially for atypical hyperplasia. Conclusions Endometrial hyperplasia incidence without and with atypia peaks in the early postmenopausal years and in the early 60s, respectively. Given that some cases of endometrial hyperplasia likely go undiagnosed, the figures provided should be viewed as minimum estimates of the true incidence. PMID:19393600

  19. Concussion Incidence in Professional Football

    PubMed Central

    Nathanson, John T.; Connolly, James G.; Yuk, Frank; Gometz, Alex; Rasouli, Jonathan; Lovell, Mark; Choudhri, Tanvir

    2016-01-01

    Background: In the United States alone, millions of athletes participate in sports with potential for head injury each year. Although poorly understood, possible long-term neurological consequences of repetitive sports-related concussions have received increased recognition and attention in recent years. A better understanding of the risk factors for concussion remains a public health priority. Despite the attention focused on mild traumatic brain injury (mTBI) in football, gaps remain in the understanding of the optimal methodology to determine concussion incidence and position-specific risk factors. Purpose: To calculate the rates of concussion in professional football players using established and novel metrics on a group and position-specific basis. Study Design: Case-control study; Level of evidence, 3. Methods: Athletes from the 2012-2013 and 2013-2014 National Football League (NFL) seasons were included in this analysis of publicly available data. Concussion incidence rates were analyzed using established (athlete exposure [AE], game position [GP]) and novel (position play [PP]) metrics cumulatively, by game unit and position type (offensive skill players and linemen, defensive skill players and linemen), and by position. Results: In 480 games, there were 292 concussions, resulting in 0.61 concussions per game (95% CI, 0.54-0.68), 6.61 concussions per 1000 AEs (95% CI, 5.85-7.37), 1.38 concussions per 100 GPs (95% CI, 1.22-1.54), and 0.17 concussions per 1000 PPs (95% CI, 0.15-0.19). Depending on the method of calculation, the relative order of at-risk positions changed. In addition, using the PP metric, offensive skill players had a significantly greater rate of concussion than offensive linemen, defensive skill players, and defensive linemen (P < .05). Conclusion: For this study period, concussion incidence by position and unit varied depending on which metric was used. Compared with AE and GP, the PP metric found that the relative risk of concussion for

  20. Medical Perspectives on Brain Damage and Development. Revised.

    ERIC Educational Resources Information Center

    McCrae, Marcia Q.

    The author describes damage and normal development of the brain, as well as assessment and intervention with brain-damaged children. After a brief introduction on the complex and delicate process of brain development and a review of incidence, aspects of etiology such as genetic and postnatal causes are discussed. Brain development is examined…

  1. Anatomy of an incident

    SciTech Connect

    Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.; Land, Whitney M.; Schreiber, Stephen B.

    2016-03-23

    A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identified as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.

  2. Anatomy of an incident

    DOE PAGES

    Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.; ...

    2016-03-23

    A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identifiedmore » as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.« less

  3. Brain abscess

    MedlinePlus

    ... with certain heart disorders, may receive antibiotics before dental or other procedures to help reduce the risk of infection. Alternative Names Abscess - brain; Cerebral abscess; CNS abscess Patient Instructions Brain surgery - discharge Images Amebic brain abscess ...

  4. Brain components

    MedlinePlus Videos and Cool Tools

    The brain is composed of more than a thousand billion neurons. Specific groups of them, working in concert, provide ... of information. The 3 major components of the brain are the cerebrum, cerebellum, and brain stem. The ...

  5. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  6. Brain Malformations

    MedlinePlus

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  7. Meteorite incidence angles

    NASA Astrophysics Data System (ADS)

    Hughes, D. W.

    1993-06-01

    Think about an asteroid smashing into the surface of the Moon and excavating a crater; or hitting Earth and scattering meteorite fragments over a strewn field. Imagine a fragment of cometary dust burning out in the Earth's atmosphere and producing a meteor. These bodies have paths that are inclined at some angle to the vertical. But what is the predominant value of this angle of incidence, i? How does the number of incident bodies vary as a function of angle i? And how do both these affect the prevalence of non- circular lunar craters and the ellipticity of meteorite strewn fields?

  8. Familiality in brain tumors

    PubMed Central

    Blumenthal, Deborah T.; Cannon-Albright, Lisa A.

    2008-01-01

    Background: Familiality in brain tumors is not definitively substantiated. Methods: We used the Utah Population Data Base (UPDB), a genealogy representing the Utah pioneers and their descendants, record-linked to statewide cancer records, to describe the familial nature of primary brain cancer. We examined the familial clustering of primary brain tumors, including subgroups defined by histologic type and age at diagnosis. The UPDB includes 1,401 primary brain tumor cases defined as astrocytoma or glioblastoma, all with at least three generations of genealogy data. We tested the hypothesis of excess relatedness of brain tumor cases using the Genealogical Index of Familiality method. We estimated relative risks for brain tumors in relatives using rates of brain tumors estimated internally. Results: Significant excess relatedness was observed for astrocytomas and glioblastomas considered as a group (n = 1,401), for astrocytomas considered separately (n = 744), but not for glioblastomas considered separately (n = 658). Significantly increased risks to first- and second-degree relatives for astrocytomas were identified for relatives of astrocytomas considered separately. Significantly increased risks to first-degree relatives, but not second degree, were observed for astrocytoma and glioblastoma cases considered together, and for glioblastoma cases considered separately. Conclusions: This study provides strong evidence for a familial contribution to primary brain cancer risk. There is evidence that this familial aspect includes not only shared environment, but also a heritable component. Extended high-risk brain tumor pedigrees identified in the UPDB may provide the opportunity to identify predisposition genes responsible for familial brain tumors. GLOSSARY GBM = glioblastoma; GIF = Genealogical Index of Familiality; HGG = high-grade gliomas; ICD-O = International Classification of Disease–Oncology; LGG = low-grade gliomas; RR = relative risks; SEER = Surveillance

  9. RAPID INCIDENT RESPONSE FRAMEWORK

    EPA Science Inventory

    Will discuss WERF Contract (RFP# 03-HHE-5PP), Protocols for the Timely Investigation of Potential Health Incidents Associated with Biosolids Land Application, as a member of the project advisory committee. The contractor, University of North Carolina, started work in early June, ...

  10. RAPID INCIDENT RESPONSE FRAMEWORK

    EPA Science Inventory

    Will discuss WERF Contract (RFP# 03-HHE-5PP), Protocols for the Timely Investigation of Potential Health Incidents Associated with Biosolids Land Application, as a member of the project advisory committee. The contractor, University of North Carolina, started work in early June, ...

  11. New model for predicting freeway incidents and incident delays

    SciTech Connect

    Sullivan, E.C.

    1997-08-01

    This paper presents a new model that predicts the number of freeway incidents and associated delays based on general freeway segment characteristics, traffic volumes, and incident management procedures. The model is intended to be used in planning capacity-enhancing freeway improvements and incident management programs. Estimates of incident frequencies, severity, durations, and delays are provided for seven standard incident types, each of which represents a significant fraction of total unplanned incidents and has severity and/or duration characteristics substantially different from the others. In addition to describing the incident prediction model, the paper addresses the need for a coordinated national strategy for collecting incident data, with particular attention to urban freeways. It concludes that the incident data systems that have evolved in several urban areas, often in connection with freeway service patrols and incident response team activities, already provide a valuable nationwide data resource for understanding incident patterns and their variations. However, better national coordination of locally collected incident data would be helpful for addressing issues beyond the scope of the local concerns for which virtually all current systems were originally designed. Specific areas for improvement include the definitions of incident types, descriptions of incident locations (relative to both the length and breadth of the highway), and data recording the critical times during incidents such as when detection, response, and clearing occur.

  12. Constipation and Incident CKD.

    PubMed

    Sumida, Keiichi; Molnar, Miklos Z; Potukuchi, Praveen K; Thomas, Fridtjof; Lu, Jun Ling; Matsushita, Kunihiro; Yamagata, Kunihiro; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2017-04-01

    Constipation is one of the most prevalent conditions in primary care settings and increases the risk of cardiovascular disease, potentially through processes mediated by altered gut microbiota. However, little is known about the association of constipation with CKD. In a nationwide cohort of 3,504,732 United States veterans with an eGFR ≥60 ml/min per 1.73 m(2), we examined the association of constipation status and severity (absent, mild, or moderate/severe), defined using diagnostic codes and laxative use, with incident CKD, incident ESRD, and change in eGFR in Cox models (for time-to-event analyses) and multinomial logistic regression models (for change in eGFR). Among patients, the mean (SD) age was 60.0 (14.1) years old; 93.2% of patients were men, and 24.7% were diabetic. After multivariable adjustments, compared with patients without constipation, patients with constipation had higher incidence rates of CKD (hazard ratio, 1.13; 95% confidence interval [95% CI], 1.11 to 1.14) and ESRD (hazard ratio, 1.09; 95% CI, 1.01 to 1.18) and faster eGFR decline (multinomial odds ratios for eGFR slope <-10, -10 to <-5, and -5 to <-1 versus -1 to <0 ml/min per 1.73 m(2) per year, 1.17; 95% CI, 1.14 to 1.20; 1.07; 95% CI, 1.04 to 1.09; and 1.01; 95% CI, 1.00 to 1.03, respectively). More severe constipation associated with an incrementally higher risk for each renal outcome. In conclusion, constipation status and severity associate with higher risk of incident CKD and ESRD and with progressive eGFR decline, independent of known risk factors. Further studies should elucidate the underlying mechanisms.

  13. Incidence of vestibular schwannomas in the United States.

    PubMed

    Kshettry, Varun R; Hsieh, Jason K; Ostrom, Quinn T; Kruchko, Carol; Barnholtz-Sloan, Jill S

    2015-09-01

    There is a paucity of population-based data evaluating the incidence of vestibular schwannomas according to age, gender, race, and ethnicity. Such data are necessary to assess the burden of vestibular schwannomas on varying populations and to inform future research and healthcare planning. The Central Brain Tumor Registry of the United States, which contains the largest aggregation of population-based data on the incidence of primary central nervous system tumors in the US, was used. Age-adjusted incidence rates and incidence rate ratios (IRR) of vestibular schwannomas from 2004 to 2010 were calculated by age at diagnosis, gender, race, and ethnicity. Annual percent change (APC) was calculated using Joinpoint to characterize temporal trends. From 2004 to 2010, there were 23,729 newly diagnosed vestibular schwannomas in the US; overall incidence was 1.09 per 100,000 population. Incidence was stable over time (APC -0.41 %, 95 % confidence interval -3.4, 2.7). Incidence increased with age to a peak of 2.93 per 100,000 in the 65-74 year old age group. Overall, there was no difference in incidence by gender. Compared to Whites, incidence was highest in Asian Pacific Islanders (IRR 1.37, p < 0.001) and lowest in African Americans (IRR 0.36, p < 0.001). Incidence was lower in Hispanics than non-Hispanics (IRR 0.69, p < 0.001). Over 3300 vestibular schwannomas are diagnosed per year in the US and incidence is 1.09 per 100,000 population. Incidence increases with age up to the 65-74 year old age group. Incidence is higher in Asian Pacific Islanders and lower in African Americans and Hispanics.

  14. Incidence of CNS tumors in Appalachian children.

    PubMed

    Huang, Bin; Luo, Alice; Durbin, Eric B; Lycan, Ellen; Tucker, Thomas; Chen, Quan; Horbinski, Craig; Villano, John L

    2017-03-11

    Determine whether the risk of astrocytomas in Appalachian children is higher than the national average. We compared the incidence of pediatric brain tumors in Appalachia versus non-Appalachia regions, covering years 2000-2011. The North American Association of Central Cancer Registries (NAACCR) collects population-based data from 55 cancer registries throughout U.S. and Canada. All invasive primary (i.e. non-metastatic tumors), with age at diagnosis 0-19 years old, were included. Nearly 27,000 and 2200 central nervous system (CNS) tumors from non-Appalachia and Appalachia, respectively comprise the cohorts. Age-adjusted incidence rates of each main brain tumor subtype were compared. The incidence rate of pediatric CNS tumors was 8% higher in Appalachia, 3.31 [95% CI 3.17-3.45] versus non-Appalachia, 3.06, [95% CI 3.02-3.09] for the years 2001-2011, all rates are per 100,000 population. Astrocytomas accounted for the majority of this difference, with the rate being 16% higher in Appalachian children, 1.77, [95% CI 1.67-1.87] versus non-Appalachian children, 1.52, [95% CI 1.50-1.55]. Among astrocytomas, World Health Organization (WHO) grade I astrocytomas were 41% higher in Appalachia, 0.63 [95% CI 0.56-0.70] versus non-Appalachia 0.44 [95% CI 0.43-0.46] for the years 2004-2011. This is the first study to demonstrate that Appalachian children are at greater risk of CNS neoplasms, and that much of this difference is in WHO grade I astrocytomas, 41% more common. The cause of this increased incidence is unknown and we discuss the importance of this in relation to genetic and environmental findings in Appalachia.

  15. Behavior: Sexual Differences in the Brain

    ERIC Educational Resources Information Center

    Science News, 1976

    1976-01-01

    Recent research indicates that early right brain hemisphere specialization for spatial tasks may be due to sex differences. Early specialization has been demonstrated in males asked to perform spatial tasks. An apparently longer period of female brain plasticity may explain why males have a higher incidence of developmental language problems. (MA)

  16. Traumatic Brain Injury. Fact Sheet Number 18.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet describes traumatic brain injury (TBI), an injury of the brain caused by the head being hit by something or being shaken violently. It discusses the incidence of TBI, and describes its symptoms as changes in thinking and reasoning, understanding words, remembering things, paying attention, solving problems, thinking abstractly,…

  17. Behavior: Sexual Differences in the Brain

    ERIC Educational Resources Information Center

    Science News, 1976

    1976-01-01

    Recent research indicates that early right brain hemisphere specialization for spatial tasks may be due to sex differences. Early specialization has been demonstrated in males asked to perform spatial tasks. An apparently longer period of female brain plasticity may explain why males have a higher incidence of developmental language problems. (MA)

  18. Prevalence Incidence Mixture Models

    Cancer.gov

    The R package and webtool fits Prevalence Incidence Mixture models to left-censored and irregularly interval-censored time to event data that is commonly found in screening cohorts assembled from electronic health records. Absolute and relative risk can be estimated for simple random sampling, and stratified sampling (the two approaches of superpopulation and a finite population are supported for target populations). Non-parametric (absolute risks only), semi-parametric, weakly-parametric (using B-splines), and some fully parametric (such as the logistic-Weibull) models are supported.

  19. Brain Edema After Ischaemic Stroke

    PubMed Central

    Dostovic, Zikrija; Dostovic, Ernestina; Smajlovic, Dzevdet; Ibrahimagic, Omer C.; Avdic, Leila

    2016-01-01

    Objectives: To determine the incidence of brain edema after ischaemic stroke and its impact on the outcome of patients in the acute phase of ischaemic stroke. Patients and Methods: We retrospectively analyzed 114 patients. Ischaemic stroke and brain edema are verified by computed tomography. The severity of stroke was determined by National Institutes of Health Stroke Scale. Laboratory findings were made during the first four days of hospitalization, and complications were verified by clinical examination and additional tests. Results: In 9 (7.9%) patients developed brain edema. Pneumonia was the most common complication (12.3%). Brain edema had a higher incidence in women, patients with hypertension and elevated serum creatinine values, and patients who are suffering from diabetes. There was no significant correlation between brain edema and survival in patients after acute ischaemic stroke. Patients with brain edema had a significantly higher degree of neurological deficit as at admission, and at discharge (p = 0.04, p = 0.004). Conclusion: The cerebral edema is common after acute ischaemic stroke and no effect on survival in the acute phase. The existence of brain edema in acute ischaemic stroke significantly influence the degree of neurological deficit. PMID:27994292

  20. Common Causes of Pesticide Incidents

    EPA Pesticide Factsheets

    There are many types of pesticide incidents. EPA staff analyze pesticide incident reports involving people (including children and farm workers), pets, domestic animals, wildlife including bees and other pollinators, and the environment.

  1. Brain metastasization of breast cancer.

    PubMed

    Custódio-Santos, Tânia; Videira, Mafalda; Brito, Maria Alexandra

    2017-08-01

    Central nervous system metastases have been reported in 15-25% of breast cancer patients, and the incidence is increasing. Moreover, the survival of these patients is generally poor, with reports of a 1-year survival rate of 20%. Therefore, a better knowledge about the determinants of brain metastasization is essential for the improvement of the clinical outcomes. Here, we summarize the current data about the metastatic cascade, ranging from the output of cancer cells from the primary tumour to their colonization in the brain, which involves the epithelial-mesenchymal transition, invasion of mammary tissue, intravasation into circulation, and homing into and extravasation towards the brain. The phenotypic change in malignant cells, and the importance of the microenvironment in the formation of brain metastases are also inspected. Finally, the importance of genetic and epigenetic changes, and the recently disclosed effects of microRNAs in brain metastasization of breast cancer are highlighted. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Brain Autopsy

    MedlinePlus

    ... that you contact a medical center or brain bank with experience in neurological disorders and, if at ... and Strokes also maintains a listing of brain banks on the research section of their website: www. ...

  3. Brain Power.

    ERIC Educational Resources Information Center

    Albrecht, Karl

    2002-01-01

    Reviews significant findings of recent brain research, including the concept of five minds: automatic, subconscious, practical, creative, and spiritual. Suggests approaches to training the brain that are related to this hierarchy of thinking. (JOW)

  4. Brain Diseases

    MedlinePlus

    The brain is the control center of the body. It controls thoughts, memory, speech, and movement. It regulates the function of many organs. When the brain is healthy, it works quickly and automatically. However, ...

  5. Brain Aneurysm

    MedlinePlus

    ... tests don't provide enough information. Screening for brain aneurysms The use of imaging tests to screen ... and occupational therapy to relearn skills. Treating unruptured brain aneurysms Surgical clipping or endovascular coiling can be ...

  6. Incident Management: Process into Practice

    ERIC Educational Resources Information Center

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  7. Incident Management: Process into Practice

    ERIC Educational Resources Information Center

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  8. The Brain.

    ERIC Educational Resources Information Center

    Hubel, David H.

    1979-01-01

    This article on the brain is part of an entire issue about neurobiology and the question of how the human brain works. The brain as an intricate tissue composed of cells is discussed based on the current knowledge and understanding of its composition and structure. (SA)

  9. Brain Aneurysm

    MedlinePlus

    A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they ... often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, ...

  10. The Brain.

    ERIC Educational Resources Information Center

    Hubel, David H.

    1979-01-01

    This article on the brain is part of an entire issue about neurobiology and the question of how the human brain works. The brain as an intricate tissue composed of cells is discussed based on the current knowledge and understanding of its composition and structure. (SA)

  11. Diabetes, Prediabetes, and Brain Volumes and Subclinical Cerebrovascular Disease on MRI: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).

    PubMed

    Schneider, Andrea L C; Selvin, Elizabeth; Sharrett, A Richey; Griswold, Michael; Coresh, Josef; Jack, Clifford R; Knopman, David; Mosley, Thomas; Gottesman, Rebecca F

    2017-09-15

    To examine the associations of prediabetes, diabetes, and diabetes severity (as assessed by HbA1c and diabetes duration) with brain volumes and vascular pathology on brain MRI and to assess whether the associations of diabetes with brain volumes are mediated by brain vascular pathology. Cross-sectional study of 1,713 participants in the Atherosclerosis Risk in Communities Neurocognitive Study (mean age 75 years, 60% female, 27% black, 30% prediabetes, and 35% diabetes) who underwent 3T brain MRI scans in 2011-2013. Participants were categorized by diabetes-HbA1c status as without diabetes (<5.7% [reference]), with prediabetes (5.7 to <6.5%), and with diabetes ([defined as prior diagnosis or HbA1c ≥6.5%] <7.0% vs. ≥7.0%), with further stratification by diabetes duration (<10 vs. ≥10 years). In adjusted analyses, compared with participants without diabetes and HbA1c <5.7%, participants with prediabetes and those with diabetes and HbA1c <7.0% did not have significantly different brain volumes or vascular pathology (all P > 0.05), but those with diabetes and HbA1c ≥7.0% had smaller total brain volume (β -0.20 SDs, 95% CI -0.31, -0.09), smaller regional brain volumes (including frontal, temporal, occipital, and parietal lobes; deep gray matter; Alzheimer disease signature region; and hippocampus [all P < 0.05]), and increased burden of white matter hyperintensities (WMH) (P = 0.016). Among participants with diabetes, those with HbA1c ≥7.0% had smaller total and regional brain volumes and an increased burden of WMH (all P < 0.05) compared with those with HbA1c <7.0%. Similarly, participants with longer duration of diabetes (≥10 years) had smaller brain volumes and higher burden of lacunes (all P < 0.05) than those with a diabetes duration <10 years. We found no evidence for mediation by WMH in associations of diabetes with smaller brain volumes by structural equation models (all P > 0.05). More-severe diabetes (defined by higher HbA1c and longer disease

  12. Left Brain. Right Brain. Whole Brain

    ERIC Educational Resources Information Center

    Farmer, Lesley S. J.

    2004-01-01

    As the United States student population is becoming more diverse, library media specialists need to find ways to address these distinctive needs. However, some of these differences transcend culture, touching on variations in the brain itself. Most people have a dominant side of the brain, which can affect their personality and learning style.…

  13. Left Brain. Right Brain. Whole Brain

    ERIC Educational Resources Information Center

    Farmer, Lesley S. J.

    2004-01-01

    As the United States student population is becoming more diverse, library media specialists need to find ways to address these distinctive needs. However, some of these differences transcend culture, touching on variations in the brain itself. Most people have a dominant side of the brain, which can affect their personality and learning style.…

  14. Brain Basics: Know Your Brain

    MedlinePlus

    ... Basics: Know Your Brain Request free mailed brochure Table of Contents Introduction The Architecture of the Brain ... Information Page NINDS Epilepsy Information Page NINDS Familial Periodic Paralyses Information Page NINDS Farber's Disease Information Page ...

  15. Grazing incidence beam expander

    SciTech Connect

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  16. Grazing incidence beam expander

    NASA Astrophysics Data System (ADS)

    Akkapeddi, P. R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V. K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  17. Brain abscess.

    PubMed

    Slazinski, Tess

    2013-09-01

    A brain abscess is defined as a localized collection of pus within the parenchyma of the brain or meninges. Brain abscesses are a complication of ear, sinus, and/or dental infections. Although they may occur in many brain locations, the most common sites are frontal and temporal lobes. Modern neuroimaging and laboratory analysis have led to prompt diagnosis and have decreased the mortality rates from brain abscess. Critical care nurses have a vital role in performing accurate neurologic assessments, timely administration of antibiotics, and management of fever. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Brain to music to brain!

    PubMed

    Azizi, S Ausim

    2009-07-31

    It has been implicitly understood that culture and music as collective products of human brain in turn influence the brain itself. Now, imaging and anatomical data add substance to this notion. The impact of playing piano on the brain of musicians and its possible effects on cultural and neurological evolution are briefly discussed.

  19. Incidence of gliomas by anatomic location

    PubMed Central

    Larjavaara, Suvi; Mäntylä, Riitta; Salminen, Tiina; Haapasalo, Hannu; Raitanen, Jani; Jääskeläinen, Juha; Auvinen, Anssi

    2007-01-01

    The anatomic location of a glioma influences prognosis and treatment options. The aim of our study was to describe the distribution of gliomas in different anatomic areas of the brain. A representative population-based sample of 331 adults with glioma was used for preliminary analyses. The anatomic locations for 89 patients from a single center were analyzed in more detail from radiologic imaging and recorded on a three-dimensional 1 × 1 × 1– cm grid. The age-standardized incidence rate of gliomas was 4.7 per 100,000 person-years. The most frequent subtypes were glioblastoma (47%) and grade II–III astrocytoma (23%), followed by oligodendroglioma and mixed glioma. The gliomas were located in the frontal lobe in 40% of the cases, temporal in 29%, parietal in 14%, and occipital lobe in 3%, with 14% in the deeper structures. The difference in distribution between lobes remained after adjustment for their tissue volume: the tumor:volume ratio was 4.5 for frontal, 4.8 for temporal, and 2.3 for parietal relative to the occipital lobe. The area with the densest occurrence was the anterior subcortical brain. Statistically significant spatial clustering was found in the three-dimensional analysis. No differences in location were found among glioblastoma, diffuse astrocytoma, and oligodendroglioma. Our results demonstrate considerable heterogeneity in the anatomic distribution of gliomas within the brain. PMID:17522333

  20. High incidence of meningioma among Hiroshima atomic bomb survivors.

    PubMed

    Shintani, T; Hayakawa, N; Hoshi, M; Sumida, M; Kurisu, K; Oki, S; Kodama, Y; Kajikawa, H; Inai, K; Kamada, N

    1999-03-01

    Since the atomic bomb explosions in Hiroshima and Nagasaki, high incidences of leukemia, thyroid cancer and other tumors have been reported as atomic bomb-induced tumors. We investigated the incidence of meningioma among Hiroshima atomic bomb survivors. Sixty-eight patients surgically treated for meningioma who had been within 2.0 km of the hypocenter of the explosion were identified. Six hundred and seven non-exposed patients with meningioma were also studied. Treatment dates were from 1975 to 1992. The incidences of meningioma among 68 subjects within 2.0 km and 607 non-exposed patients were 8.7 and 3.0 cases per 10(5) persons per year, respectively. The incidences of meningioma among the survivors of Hiroshima in 5-year intervals since 1975 were 5.3, 7.4, 10.1, and 14.9, respectively. The incidences of meningioma classified by distances from the hypocenter of 1.5-2.0 km, 1.0-1.5 km and less than 1.0 km were 6.3, 7.6 and 20.0, respectively. The incidences of meningioma classified by doses to the brain of 0-0.099 Sv, 0.1-0.99 Sv and more than 1.0 Sv were 7.7, 9.2 and 18.2, respectively. The incidence of meningioma among Hiroshima atomic bomb survivors has increased since 1975. There was a significant correlation between the incidence and the dose of radiation to the brain. The present findings strongly suggest that meningioma is one of the tumors induced by atomic bombing in Hiroshima.

  1. No increase in brain cancer rates during period of expanding cell phone use

    Cancer.gov

    In a new examination of United States cancer incidence data, investigators at the National Cancer Institute (NCI) reported that incidence trends have remained roughly constant for glioma, the main type of brain cancer hypothesized to be related to cell ph

  2. Childhood Brain Tumor Epidemiology: A Brain Tumor Epidemiology Consortium Review

    PubMed Central

    Johnson, Kimberly J.; Cullen, Jennifer; Barnholtz-Sloan, Jill S.; Ostrom, Quinn T.; Langer, Chelsea E.; Turner, Michelle C.; McKean-Cowdin, Roberta; Fisher, James L.; Lupo, Philip J.; Partap, Sonia; Schwartzbaum, Judith A.; Scheurer, Michael E.

    2014-01-01

    Childhood brain tumors are the most common pediatric solid tumor and include several histological subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors. PMID:25192704

  3. Brain surgery - discharge

    MedlinePlus

    ... to take these medicines. If you had a brain aneurysm , you may also have other symptoms or problems. ... chap 28. Read More Acoustic neuroma Brain abscess Brain aneurysm repair Brain surgery Brain tumor - children Brain tumor - ...

  4. Grazing Incidence Optics Technology

    NASA Technical Reports Server (NTRS)

    Ramsey, Brian; Smith, W. Scott; Gubarev, Mikhail; McCracken, Jeff

    2015-01-01

    This project is to demonstrate the capability to directly fabricate lightweight, high-resolution, grazing-incidence x-ray optics using a commercially available robotic polishing machine. Typical x-ray optics production at NASA Marshall Space Flight Center (MSFC) uses a replication process in which metal mirrors are electroformed on to figured and polished mandrels from which they are later removed. The attraction of this process is that multiple copies can be made from a single master. The drawback is that the replication process limits the angular resolution that can be attained. By directly fabricating each shell, errors inherent in the replication process are removed. The principal challenge now becomes how to support the mirror shell during all aspects of fabrication, including the necessary metrology to converge on the required mirror performance specifications. This program makes use of a Zeeko seven-axis computer-controlled polishing machine (see fig. 1) and supporting fabrication, metrology, and test equipment at MSFC. The overall development plan calls for proof-of-concept demonstration with relatively thick mirror shells (5-6 mm, fig. 2) which are straightforward to support and then a transition to much thinner shells (2-3 mm), which are an order of magnitude thinner than those used for Chandra. Both glass and metal substrates are being investigated. Currently, a thick glass shell is being figured. This has enabled experience to be gained with programming and operating the polishing machine without worrying about shell distortions or breakage. It has also allowed time for more complex support mechanisms for figuring/ polishing and metrology to be designed for the more challenging thinner shells. These are now in fabrication. Figure 1: Zeeko polishing machine.

  5. Monkey brain cortex imaging by photoacoustic tomography.

    PubMed

    Yang, Xinmai; Wang, Lihong V

    2008-01-01

    Photoacoustic tomography (PAT) is applied to image the brain cortex of a monkey through the intact scalp and skull ex vivo. The reconstructed PAT image shows the major blood vessels on the monkey brain cortex. For comparison, the brain cortex is imaged without the scalp, and then imaged again without the scalp and skull. Ultrasound attenuation through the skull is also measured at various incidence angles. This study demonstrates that PAT of the brain cortex is capable of surviving the ultrasound signal attenuation and distortion caused by a relatively thick skull.

  6. Altitude Modulates Concussion Incidence

    PubMed Central

    Smith, David W.; Myer, Gregory D.; Currie, Dustin W.; Comstock, R. Dawn; Clark, Joseph F.; Bailes, Julian E.

    2013-01-01

    Background: Recent research indicates that the volume and/or pressure of intracranial fluid, a physiology affected by one’s altitude (ie, elevation above sea level), may be associated with the likelihood and/or severity of a concussion. The objective was to employ an epidemiological field investigation to evaluate the relationship between altitude and concussion rate in high school sports. Hypothesis: Because of the physiologies that occur during acclimatization, including a decline in intracranial compliance (a “tighter fit”), increased altitude may be related to a reduction in concussion rates in high school athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Data on concussions and athlete exposures (AEs) between 2005-2006 and 2011-2012 were obtained from a large national sample of high schools (National High School Sports-Related Injury Surveillance System [High School RIO]) and were used to calculate total, competition, and practice concussion rates for aggregated sports and for football only. Results: Altitude of participating schools ranged from 7 to 6903 ft (median, 600 ft), and a total of 5936 concussions occurred in 20,618,915 exposures (2.88 per 10,000 AEs). When concussion rates were dichotomized by altitude using the median, elevated altitude was associated with a reduction in concussion rates overall (rate ratio [RR], 1.31; P < .001), in competition (RR, 1.31; P < .001), and in practice (RR, 1.29; P < .001). Specifically, high school sports played at higher altitude demonstrated a 31% reduction (95% confidence interval [CI], 25%-38%) in the incidence of total reported concussions. Likewise, concussion rates at increased altitude were reduced 30% for overall exposures, 27% for competition exposures, and 28% for practice exposures in football players (P < .001). Conclusion: The results of this epidemiological investigation indicate increased physiological responses to altitude may be associated with a reduction in sports

  7. Frailty and incident dementia.

    PubMed

    Gray, Shelly L; Anderson, Melissa L; Hubbard, Rebecca A; LaCroix, Andrea; Crane, Paul K; McCormick, Wayne; Bowen, James D; McCurry, Susan M; Larson, Eric B

    2013-09-01

    We sought to examine whether frailty is associated with dementia, Alzheimer's disease (AD), and non-AD dementia risk. This is a prospective population-based cohort derived from an integrated health maintenance organization. The sample consisted of 2,619 participants aged 65 and older without dementia at baseline followed from 1994 to 2010. Frailty was defined as having at least 3 of the following criteria: weakness (grip strength), slowness (walking speed), weight loss, low physical activity, and self-reported exhaustion. Follow-up occurred every 2 years to identify incident dementia, possible or probable AD, and non-AD dementia using standard research criteria. Covariates came from self-report and study measures. We used adjusted Cox proportional hazards models to examine the association between frailty and each outcome. Over a mean follow-up of 6.5 years, 521 participants developed dementia (of which 448 developed AD). In the model adjusted for age, sex, education, and race, the hazard ratio for frailty was 1.78 (95% confidence interval [CI] 1.32-2.40). In the fully adjusted models, the hazard ratio for frailty was 1.20 for all-cause dementia (95% CI 0.85-1.69), 1.08 for AD (95% CI 0.74-1.57), and 2.57 for non-AD dementia (95% CI 1.08-6.11). For all-cause dementia, we found an interaction between baseline cognitive score and frailty (p = .02); hazard ratio for frailty was 1.78 for those with higher global cognition (95% CI 1.14-2.78) and 0.79 for those with lower global cognition (95% CI 0.50-1.26). Frailty was associated with dementia when adjusting only for demographic variables but not in the fully adjusted model. Frailty was associated with higher risk of developing non-AD dementia but not AD. Although frailty was not associated with all-cause dementia in the entire sample, an association did exist in participants with higher cognitive scores. Mechanisms underlying these associations remain to be elucidated.

  8. Chemo Brain

    MedlinePlus

    ... risk of memory problems in cancer survivors include: Brain cancer Chemotherapy given directly to the central nervous system ... of chemotherapy or radiation Radiation therapy to the brain Younger age at time of cancer diagnosis and treatment Increasing age Complications The severity ...

  9. Brain Facts.

    PubMed

    Wright, Kerri

    2013-11-20

    The Brain Facts website is a treasure trove of information about neuroscience and the brain. It covers a range of diseases and disorders, as well as the science of ageing, and is relevant to practitioners and students in all branches of nursing and midwifery.

  10. The Brain.

    ERIC Educational Resources Information Center

    Callison, Daniel

    2001-01-01

    Discusses basic facts about the brain and new research findings concerning growth and development that may help reconsider how information literacy skills are taught. Explains Kovalik's Integrated Thematic Instruction Model that recommends taking into account brain research and tying into relevant activities for the entire school year. (LRW)

  11. Brain tumors in irradiated monkeys.

    NASA Technical Reports Server (NTRS)

    Haymaker, W.; Miquel, J.; Rubinstein, L. J.

    1972-01-01

    A study was made of 32 monkeys which survived one to seven years after total body exposure to protons or to high-energy X rays. Among these 32 monkeys there were 21 which survived two years or longer after exposure to 200 to 800 rad. Glioblastoma multiforme developed in 3 of the 10 monkeys surviving three to five years after receiving 600 or 800 rad 55-MeV protons. Thus, the incidence of tumor development in the present series was far higher than the incidence of spontaneously developing brain tumors in monkeys cited in the literature. This suggests that the tumors in the present series may have been radiation-induced.

  12. Brain banking: opportunities, challenges and meaning for the future.

    PubMed

    Kretzschmar, Hans

    2009-01-01

    Brain banks collect post-mortem human brains to foster research into human CNS function and disease. They have been indispensable for uncovering the secrets of many diseases, including Alzheimer's and Parkinson's. At a time when there are so many open questions in neuroscience and the incidence of brain diseases continues to increase in parallel with the aging of the population, brain banking remains at the heart of brain research. However, the major source of brain banks, the clinical autopsy, is rapidly falling into limbo. New strategies, including donor programmes, medico-legal autopsies and banking in networks, as well as fresh considerations of the ethics and public relations, are required.

  13. Brain investigation and brain conceptualization

    PubMed Central

    Redolfi, Alberto; Bosco, Paolo; Manset, David; Frisoni, Giovanni B.

    Summary The brain of a patient with Alzheimer’s disease (AD) undergoes changes starting many years before the development of the first clinical symptoms. The recent availability of large prospective datasets makes it possible to create sophisticated brain models of healthy subjects and patients with AD, showing pathophysiological changes occurring over time. However, these models are still inadequate; representations are mainly single-scale and they do not account for the complexity and interdependence of brain changes. Brain changes in AD patients occur at different levels and for different reasons: at the molecular level, changes are due to amyloid deposition; at cellular level, to loss of neuron synapses, and at tissue level, to connectivity disruption. All cause extensive atrophy of the whole brain organ. Initiatives aiming to model the whole human brain have been launched in Europe and the US with the goal of reducing the burden of brain diseases. In this work, we describe a new approach to earlier diagnosis based on a multimodal and multiscale brain concept, built upon existing and well-characterized single modalities. PMID:24139654

  14. Surveillance of traumatic brain injuries in Utah.

    PubMed Central

    Thurman, D J; Jeppson, L; Burnett, C L; Beaudoin, D E; Rheinberger, M M; Sniezek, J E

    1996-01-01

    From 1990 through 1992 we conducted surveillance of cases requiring hospital admission and of fatal cases of traumatic brain injury among residents of Utah and found an annual incidence rate of 108.8 per 100,000 population. The greatest number of injuries occurred among men and persons aged 15 to 24 years. Motor vehicles were the leading cause of injury, followed by falls and assaults. The incidence rate we found is substantially lower than previously published rates of traumatic brain injury. This may be the result of a decrease in the incidence of these injuries in the decade since earlier studies were done, as well as changing hospital admission criteria that serve to exclude less severe cases of injury. Despite the apparent decline in rates, our findings indicate the continued importance of traumatic brain injury as a public health problem and the need to develop more effective prevention strategies that will address the major causes of these injuries. PMID:8987423

  15. Object caching in corvids: incidence and significance.

    PubMed

    Jacobs, Ivo F; Osvath, Mathias; Osvath, Helena; Mioduszewska, Berenika; von Bayern, Auguste M P; Kacelnik, Alex

    2014-02-01

    Food caching is a paramount model for studying relations between cognition, brain organisation and ecology in corvids. In contrast, behaviour towards inedible objects is poorly examined and understood. We review the literature on object caching in corvids and other birds, and describe an exploratory study on object caching in ravens, New Caledonian crows and jackdaws. The captive adult birds were presented with an identical set of novel objects adjacent to food. All three species cached objects, which shows the behaviour not to be restricted to juveniles, food cachers, tool-users or individuals deprived of cacheable food. The pattern of object interaction and caching did not mirror the incidence of food caching: the intensely food caching ravens indeed showed highest object caching incidence, but the rarely food caching jackdaws cached objects to similar extent as the moderate food caching New Caledonian crows. Ravens and jackdaws preferred objects with greater sphericity, but New Caledonian crows preferred stick-like objects (similar to tools). We suggest that the observed object caching might have been expressions of exploration or play, and deserves being studied in its own right because of its potential significance for tool-related behaviour and learning, rather than as an over-spill from food-caching research. This article is part of a Special Issue entitled: CO3 2013. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Incidence of immediate gadolinium contrast media reactions.

    PubMed

    Prince, Martin R; Zhang, Honglei; Zou, Zhitong; Staron, Ronald B; Brill, Paula W

    2011-02-01

    Our objective was to determine the incidence of immediate adverse events for gadolinium-based contrast agents. All gadolinium-based contrast agent adverse events reported to radiology quality assurance committees were graded according to American College of Radiology criteria and divided by the total number of injections to determine incidence during the past 10 years. For each event, an age- and examination-matched control patient was identified to compare sex, weight, creatinine, eosinophil count, allergic history and gadolinium-based contrast agent dose differences. The U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database was analyzed to compare local experience to national trends. Abdominal MRI had the highest rates of adverse events, 0.013% compared with brain (0.0045%, p < 0.001) or spine (0.0034%, p < 0.001). Adverse events were more likely in women, with a female to male ratio of 3.3, and in patients with history of prior allergic reactions (p < 0.001). Immediate adverse events rates were 0.2, 0.5, 1.2, and 3.3 per 1,000 injections for gadodiamide, gadopentetate dimeglumine, gadobenate dimeglumine, and gadoteridol, respectively. Gadobenate dimeglumine had more severe patient reactions, including three patients who arrested (defined as the patient becoming unresponsive and the code team being called), one of whom died. From 2004 to 2009, the FDA received reports on 40 gadolinium-based contrast agent U.S. deaths unrelated to nephrogenic systemic fibrosis, with an incidence per million doses of 0.15, 0.19, 0.97, 2.7, and 0.7 for gadodiamide, gadoversetimide, gadopentetate dimeglumine, gadobenate dimeglumine, and gadoteridol, respectively. This limited retrospective analysis shows that gadolinium-based contrast agents are very safe, with only rare reports of death, and raises the possibility that nonionic linear gadolinium-based contrast agents and gadopentetate dimeglumine may have fewer severe immediate adverse events

  17. [Brain concussion].

    PubMed

    Pälvimäki, Esa-Pekka; Siironen, Jari; Pohjola, Juha; Hernesniemi, Juha

    2011-01-01

    Brain concussion is a common disturbance caused by external forces or acceleration affecting the head. It may be accompanied by transient loss of consciousness and amnesia. Typical symptoms include headache, nausea and dizziness; these may remain for a week or two. Some patients may experience transient loss of inability to create new memories or other brief impairment of mental functioning. Treatment is symptomatic. Some patients may suffer from prolonged symptoms, the connection of which with brain concession is difficult to show. Almost invariably the prognosis of brain concussion is good.

  18. Traumatic brain injury

    PubMed Central

    Risdall, Jane E.; Menon, David K.

    2011-01-01

    There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad. PMID:21149359

  19. Brain Stimulation Therapies

    MedlinePlus

    ... Magnetic Seizure Therapy Deep Brain Stimulation Additional Resources Brain Stimulation Therapies Overview Brain stimulation therapies can play ... for a shorter recovery time than ECT Deep Brain Stimulation Deep brain stimulation (DBS) was first developed ...

  20. Right Hemisphere Brain Damage

    MedlinePlus

    ... Language and Swallowing / Disorders and Diseases Right Hemisphere Brain Damage [ en Español ] What is right hemisphere brain ... right hemisphere brain damage ? What is right hemisphere brain damage? Right hemisphere brain damage (RHD) is damage ...

  1. Brain radiation - discharge

    MedlinePlus

    Radiation - brain - discharge; Cancer-brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  2. Brain tumor - primary - adults

    MedlinePlus

    ... Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults) ... Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, ...

  3. Brain Basics

    MedlinePlus

    ... News & Events News & Events Home Science News Events Multimedia Social Media Press Resources Newsletters NIMH News Feeds ... affect many aspects of life. Scientists are continually learning more about how the brain grows and works ...

  4. Brain Lesions

    MedlinePlus

    ... uptodate.com/contents/search. Accessed Aug. 14, 2017. Sports-related concussion. Merck Manual Professional Version http://www.merckmanuals.com/professional/injuries-poisoning/traumatic-brain-injury-tbi/sports-related-concussion. Accessed Aug. 14, 2017. Oct. 04, 2017 Original ...

  5. Fragile Brains.

    ERIC Educational Resources Information Center

    Jensen, Eric

    2001-01-01

    Describes three types of brain disorders: the sluggish, the oppositional, and the depressed. Explains how to identify these disorders and offers educators strategies for dealing with each. (Contains 11 references.) (PKP)

  6. Idiot Savants: Rate of Incidence

    ERIC Educational Resources Information Center

    Hill, A. Lewis

    1977-01-01

    A survey of 300 public residential facilities for the mentally retarded revealed a .06 percent incidence rate for idiot savants, persons of low intelligence who possess an unusually high skill in some special task. (CL)

  7. Perioperative Hypothermia: Incidence and Prevention

    DTIC Science & Technology

    1990-01-01

    1990 Thesis/" Perioperative Hypothermia: Incidence and Prevention CRodney L. Fisher AFIT Student at: Columbia University AFIT/CI/CIA 90-120 AFT/I/I...Civilian Institution Programs DTIC CTELECTE 0 36 UNCLASSIFIFD 4 PERIOPERATIVE HYPOTHERMIA: INCIDENCE AND PREVENTION By Rodney L. Fisher, CAPT., USAF...Availability Codes Avall and/or Dit Special ABSTRACT Perioperative thermal regulation is discussed. A retrospective audit was conducted to identify the

  8. Incidence of Narcolepsy in Germany

    PubMed Central

    Oberle, Doris; Drechsel-Bäuerle, Ursula; Schmidtmann, Irene; Mayer, Geert; Keller-Stanislawski, Brigitte

    2015-01-01

    Study Objectives: Following the 2009 pandemic, reports of an association between an AS03 adjuvanted H1N1 pandemic influenza vaccine and narcolepsy were published. Besides determining background incidence rates for narcolepsy in Germany this study aimed at investigating whether there was a change in incidence rates of narcolepsy between the pre-pandemic, pandemic, and the post-pandemic period on the population level. Design: Retrospective epidemiological study on the incidence of narcolepsy with additional capture-recapture analysis. Setting: German sleep centers. Patients or Participants: Eligible were patients with an initial diagnosis of narcolepsy (ICD10 Code G47.4) within the period from January 1, 2007 to December 31, 2011. Interventions: None; observational study. Measurements and Results: A total of 342 sleep centers were invited to participate in the study. Adequate and suitable data were provided by 233 sleep centers (68.1%). A total of 1,198 patients with an initial diagnosis of narcolepsy within the observed period were included, of whom 106 (8.8%) were children and adolescents under the age of 18 years and 1,092 (91.2%) were adults. In children and adolescents, the age-standardized adjusted incidence rate significantly increased from 0.14/100,000 person-years in the pre-pandemic period to 0.50/100,000 person-years in the post-pandemic period (incidence density ratio, IDR 3.57; 95% CI 1.94–7.00). In adults, no significant change was detectable. This increase started in spring 2009. Conclusions: For the years 2007–2011, valid estimates for the incidence of narcolepsy in Germany were provided. In individuals under 18, the incidence rates continuously increased from spring 2009. Citation: Oberle D, Drechsel-Bäuerle U, Schmidtmann I, Mayer G, Keller-Stanislawski B. Incidence of narcolepsy in Germany. SLEEP 2015;38(10):1619–1628. PMID:25902804

  9. Near anastigmatic grazing incidence telescope

    NASA Technical Reports Server (NTRS)

    Korsch, D.

    1984-01-01

    A performance capability assessment is presently conducted for short versus long grazing incidence telescope designs, in view of the observation that the field curvature and astigmatism that are the primary residual aberrations of a Wolter-type incidence telescope can be substantially reduced through mirror length reduction. A major advantage of the short element telescope is that, if sufficiently short, both the paraboloid and hyperboloid surfaces may be fabricated as a single piece; this significantly facilitates the task of alignment.

  10. Near anastigmatic grazing incidence telescope

    NASA Technical Reports Server (NTRS)

    Korsch, D.

    1984-01-01

    A performance capability assessment is presently conducted for short versus long grazing incidence telescope designs, in view of the observation that the field curvature and astigmatism that are the primary residual aberrations of a Wolter-type incidence telescope can be substantially reduced through mirror length reduction. A major advantage of the short element telescope is that, if sufficiently short, both the paraboloid and hyperboloid surfaces may be fabricated as a single piece; this significantly facilitates the task of alignment.

  11. Cancer incidence in Spain, 2015.

    PubMed

    Galceran, J; Ameijide, A; Carulla, M; Mateos, A; Quirós, J R; Rojas, D; Alemán, A; Torrella, A; Chico, M; Vicente, M; Díaz, J M; Larrañaga, N; Marcos-Gragera, R; Sánchez, M J; Perucha, J; Franch, P; Navarro, C; Ardanaz, E; Bigorra, J; Rodrigo, P; Bonet, R Peris

    2017-07-01

    Periodic cancer incidence estimates of Spain from all existing population-based cancer registries at any given time are required. The objective of this study was to present the current situation of cancer incidence in Spain. The Spanish Network of Cancer Registries (REDECAN) estimated the numbers of new cancer cases occurred in Spain in 2015 by applying the incidence-mortality ratios method. In the calculus, incidence data from population-based cancer registries and mortality data of all Spain were used. In 2015, nearly a quarter of a million new invasive cancer cases were diagnosed in Spain, almost 149,000 in men (60.0%) and 99,000 in women. Globally, the five most common cancers were those of colon-rectum, prostate, lung, breast and urinary bladder. By gender, the four most common cancers in men were those of prostate (22.4%), colon-rectum (16.6%), lung (15.1%) and urinary bladder (11.7%). In women, the most common ones were those of breast (28.0%), colon-rectum (16.9%), corpus uteri (6.2%) and lung (6.0%). In recent years, cancer incidence in men seems to have stabilized due to the fact that the decrease in tobacco-related cancers compensates for the increase in other types of cancer like those of colon and prostate. In women, despite the stabilization of breast cancer incidence, increased incidence is due, above all, to the rise of colorectal and tobacco-related cancers. To reduce these incident cancer cases, improvement of smoking control policies and extension of colorectal cancer screening should be the two priorities in cancer prevention for the next years.

  12. Brain imaging and brain function

    SciTech Connect

    Sokoloff, L.

    1985-01-01

    This book is a survey of the applications of imaging studies of regional cerebral blood flow and metabolism to the investigation of neurological and psychiatric disorders. Contributors review imaging techniques and strategies for measuring regional cerebral blood flow and metabolism, for mapping functional neural systems, and for imaging normal brain functions. They then examine the applications of brain imaging techniques to the study of such neurological and psychiatric disorders as: cerebral ischemia; convulsive disorders; cerebral tumors; Huntington's disease; Alzheimer's disease; depression and other mood disorders. A state-of-the-art report on magnetic resonance imaging of the brain and central nervous system rounds out the book's coverage.

  13. Incidence of Radiologically Isolated Syndrome: A Population-Based Study.

    PubMed

    Forslin, Y; Granberg, T; Jumah, A Antwan; Shams, S; Aspelin, P; Kristoffersen-Wiberg, M; Martola, J; Fredrikson, S

    2016-06-01

    Incidental MR imaging findings resembling MS in asymptomatic individuals, fulfilling the Okuda criteria, are termed "radiologically isolated syndrome." Those with radiologically isolated syndrome are at high risk of their condition converting to MS. The epidemiology of radiologically isolated syndrome remains largely unknown, and there are no population-based studies, to our knowledge. Our aim was to study the population-based incidence of radiologically isolated syndrome in a high-incidence region for MS and to evaluate the effect on radiologically isolated syndrome incidence when revising the original radiologically isolated syndrome criteria by using the latest radiologic classification for dissemination in space. All 2272 brain MR imaging scans in 1907 persons obtained during 2013 in the Swedish county of Västmanland, with a population of 259,000 inhabitants, were blindly evaluated by a senior radiologist and a senior neuroradiologist. The Okuda criteria for radiologically isolated syndrome were applied by using both the Barkhof and Swanton classifications for dissemination in space. Assessments of clinical data were performed by a radiology resident and a senior neurologist. The cumulative incidence of radiologically isolated syndrome was 2 patients (0.1%), equaling an incidence rate of 0.8 cases per 100,000 person-years, in a region with an incidence rate of MS of 10.2 cases per 100,000 person-years. There was no difference in the radiologically isolated syndrome incidence rate when applying a modified version of the Okuda criteria by using the newer Swanton classification for dissemination in space. Radiologically isolated syndrome is uncommon in a high-incidence region for MS. Adapting the Okuda criteria to use the dissemination in space-Swanton classification may be feasible. Future studies on radiologically isolated syndrome may benefit from a collaborative approach to ensure adequate numbers of participants. © 2016 by American Journal of Neuroradiology.

  14. Cyber Incidents Involving Control Systems

    SciTech Connect

    Robert J. Turk

    2005-10-01

    The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this information available to

  15. Long-Term Blood-Brain Barrier Permeability Changes in Binswanger’s Disease

    PubMed Central

    Huisa, Branko N; Caprihan, Arvind; Thompson, Jeffrey; Prestopnik, Jillian; Qualls, Clifford R; Rosenberg, Gary A

    2015-01-01

    Background and Purpose The blood brain-barrier (BBB) is disrupted in small vessel disease (SVD) patients with lacunes and white matter hyperintensities (WMHs). The relationship of WMHs and regional BBB permeability changes has not been studied. We hypothesized that BBB disruption occurs in normal appearing WM (NAWM) and regions near the WMHs. To test the hypothesis, we repeated BBB permeability measurements in patients with extensive WMHs related to Binswanger’s disease (BD). Methods We selected a subset of 22 BD subjects from a well-characterized larger prospective vascular cognitive impairment cohort. We used 16 age-matched controls for comparison. The abnormal WM permeability (WMP) was measured twice over several years using dynamic contrast-enhanced MRI (DCEMRI). WMP maps were constructed from voxels above a predetermined threshold. Scans from first and second visits were co-registered. WM was divided into 3 regions: NAWM, WMH ring and WMH core. The ring was defined as 2mm on each side of the WMH border. WMP was calculated in each of the three specific regions. We used paired t-test, ANOVA and Fisher’s exact test to compare individual changes. Results WMP was significantly higher in subjects than controls (p<0.001). There was no correlation between WMH load and WMP. High permeability regions had minimal overlap between first and second scans. Nine percent of WMP was within the WMHs, 49% within the NAWM, and 52% within the WMH ring (p<0.001; ANOVA). Conclusions Increased BBB permeability in NAWM and close to the WMH borders supports a relationship between BBB disruption and development of WMHs. PMID:26205374

  16. A New Model For Understanding Incident Management

    DTIC Science & Technology

    2016-12-01

    49 Figure 6. Incident Management Knowledge , Skills and Abilities. ...........................50 Figure 7. Incident Management Levels...73 Figure 12. Understanding Incident Response Mission Space. ....................................81 Figure 13. Incident Management Knowledge ...team IRB Institutional Review Board ISPR incident specific preparedness review KSAs knowledge , skills, and abilities LL/CIP Lessons Learned

  17. Incidence of Narcolepsy in Germany.

    PubMed

    Oberle, Doris; Drechsel-Bäuerle, Ursula; Schmidtmann, Irene; Mayer, Geert; Keller-Stanislawski, Brigitte

    2015-10-01

    Following the 2009 pandemic, reports of an association between an AS03 adjuvanted H1N1 pandemic influenza vaccine and narcolepsy were published. Besides determining background incidence rates for narcolepsy in Germany this study aimed at investigating whether there was a change in incidence rates of narcolepsy between the pre-pandemic, pandemic, and the post-pandemic period on the population level. Retrospective epidemiological study on the incidence of narcolepsy with additional capture-recapture analysis. German sleep centers. Eligible were patients with an initial diagnosis of narcolepsy (ICD10 Code G47.4) within the period from January 1, 2007 to December 31, 2011. None; observational study. A total of 342 sleep centers were invited to participate in the study. Adequate and suitable data were provided by 233 sleep centers (68.1%). A total of 1,198 patients with an initial diagnosis of narcolepsy within the observed period were included, of whom 106 (8.8%) were children and adolescents under the age of 18 years and 1,092 (91.2%) were adults. In children and adolescents, the age-standardized adjusted incidence rate significantly increased from 0.14/100,000 person-years in the pre-pandemic period to 0.50/100,000 person-years in the post-pandemic period (incidence density ratio, IDR 3.57; 95% CI 1.94-7.00). In adults, no significant change was detectable. This increase started in spring 2009. For the years 2007-2011, valid estimates for the incidence of narcolepsy in Germany were provided. In individuals under 18, the incidence rates continuously increased from spring 2009. © 2015 Associated Professional Sleep Societies, LLC.

  18. True rise in anaphylaxis incidence

    PubMed Central

    Yang, Min-Suk; Kim, Ju-Young; Kim, Byung-Keun; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

    2017-01-01

    Abstract The incidence trend of anaphylaxis in Asia is not well investigated. The aim of this study is to estimate the entire population-based incidence of anaphylaxis in Korea using a nationwide administrative database. Data over a 7-year period (2008–2014) was obtained from the Korean National Health Insurance (NHI) claims database which covers 97.9% of the entire Korean population. Using diagnosis codes from the International Classification of Diseases-10 for anaphylaxis (T78.0, T78.2, T80.5, and T88.6), we identified the annual number of patients who had visited any hospital with a primary diagnosis of anaphylaxis. Incidence rates were calculated using the population distribution data of all NHI beneficiaries. The incidence of anaphylaxis in Korea was 32.19 episodes per 100,000 person-years in 2014, which nearly doubled from 2008 (16.02 episodes per 100,000 person-years). The incidence of anaphylaxis increased continuously throughout these years regardless of gender and age groups (P for trend < 0.001). Female was significantly less predisposed than male (adjusted odds ratio [OR], 0.69; 95% confident interval [CI], 0.66–0.72; P < 0.001). The incidence was the lowest in 0 to 19 age group and the highest in 40 to 69 age group (adjusted OR, 2.41; 95% CI, 2.29–2.54; P < 0.001). In conclusion, we report the increasing time trend of anaphylaxis incidence rates using nationwide claims database for the first time in Asia. PMID:28151851

  19. Getting My Bearings, Returning to School: Issues Facing Adolescents with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Schilling, Ethan J.; Getch, Yvette Q.

    2012-01-01

    Traumatic brain injury (TBI) is characterized by a blow to the head or other penetrating head injury resulting in impairment of the brain's functioning. Despite the high incidence of TBI in adolescents, many educators still consider TBI to be a low-incidence disability. In addition, school personnel often report receiving little to no pre-service…

  20. Getting My Bearings, Returning to School: Issues Facing Adolescents with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Schilling, Ethan J.; Getch, Yvette Q.

    2012-01-01

    Traumatic brain injury (TBI) is characterized by a blow to the head or other penetrating head injury resulting in impairment of the brain's functioning. Despite the high incidence of TBI in adolescents, many educators still consider TBI to be a low-incidence disability. In addition, school personnel often report receiving little to no pre-service…

  1. Brain death.

    PubMed

    Wijdicks, Eelco F M

    2013-01-01

    The diagnosis of brain death should be based on a simple premise. If every possible confounder has been excluded and all possible treatments have been tried or considered, irreversible loss of brain function is clinically recognized as the absence of brainstem reflexes, verified apnea, loss of vascular tone, invariant heart rate, and, eventually, cardiac standstill. This condition cannot be reversed - not even partly - by medical or surgical intervention, and thus is final. Many countries in the world have introduced laws that acknowledge that a patient can be declared brain-dead by neurologic standards. The U.S. law differs substantially from all other brain death legislation in the world because the U.S. law does not spell out details of the neurologic examination. Evidence-based practice guidelines serve as a standard. In this chapter, I discuss the history of development of the criteria, the current clinical examination, and some of the ethical and legal issues that have emerged. Generally, the concept of brain death has been accepted by all major religions. But patients' families may have different ideas and are mostly influenced by cultural attitudes, traditional customs, and personal beliefs. Suggestions are offered to support these families.

  2. Modeling wildfire incident complexity dynamics.

    PubMed

    Thompson, Matthew P

    2013-01-01

    Wildfire management in the United States and elsewhere is challenged by substantial uncertainty regarding the location and timing of fire events, the socioeconomic and ecological consequences of these events, and the costs of suppression. Escalating U.S. Forest Service suppression expenditures is of particular concern at a time of fiscal austerity as swelling fire management budgets lead to decreases for non-fire programs, and as the likelihood of disruptive within-season borrowing potentially increases. Thus there is a strong interest in better understanding factors influencing suppression decisions and in turn their influence on suppression costs. As a step in that direction, this paper presents a probabilistic analysis of geographic and temporal variation in incident management team response to wildfires. The specific focus is incident complexity dynamics through time for fires managed by the U.S. Forest Service. The modeling framework is based on the recognition that large wildfire management entails recurrent decisions across time in response to changing conditions, which can be represented as a stochastic dynamic system. Daily incident complexity dynamics are modeled according to a first-order Markov chain, with containment represented as an absorbing state. A statistically significant difference in complexity dynamics between Forest Service Regions is demonstrated. Incident complexity probability transition matrices and expected times until containment are presented at national and regional levels. Results of this analysis can help improve understanding of geographic variation in incident management and associated cost structures, and can be incorporated into future analyses examining the economic efficiency of wildfire management.

  3. 40 CFR 68.81 - Incident investigation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... appropriate knowledge and experience to thoroughly investigate and analyze the incident. (d) A report shall be... system to promptly address and resolve the incident report findings and recommendations. Resolutions and...) Incident investigation reports shall be retained for five years. ...

  4. 40 CFR 68.81 - Incident investigation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... appropriate knowledge and experience to thoroughly investigate and analyze the incident. (d) A report shall be... system to promptly address and resolve the incident report findings and recommendations. Resolutions and...) Incident investigation reports shall be retained for five years. ...

  5. 40 CFR 68.81 - Incident investigation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... appropriate knowledge and experience to thoroughly investigate and analyze the incident. (d) A report shall be... system to promptly address and resolve the incident report findings and recommendations. Resolutions and...) Incident investigation reports shall be retained for five years. ...

  6. 40 CFR 68.81 - Incident investigation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... appropriate knowledge and experience to thoroughly investigate and analyze the incident. (d) A report shall be... system to promptly address and resolve the incident report findings and recommendations. Resolutions and...) Incident investigation reports shall be retained for five years. ...

  7. 40 CFR 68.81 - Incident investigation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... appropriate knowledge and experience to thoroughly investigate and analyze the incident. (d) A report shall be... system to promptly address and resolve the incident report findings and recommendations. Resolutions and...) Incident investigation reports shall be retained for five years. ...

  8. Incidence of intracranial tumors following hospitalization for head injuries (Denmark).

    PubMed

    Inskip, P D; Mellemkjaer, L; Gridley, G; Olsen, J H

    1998-01-01

    The incidence of brain and other intracranial tumors following head trauma was evaluated in a cohort of 228,055 Danish residents hospitalized because of concussion, fractured skull, or other head injury between 1977 and 1992 and followed for an average of eight years (maximum, 17 years). Traffic accidents, falls, and sports-related incidents were the usual causes of the injury. Malignant and benign neoplasms were identified by linking the study roster with records of the Danish Cancer Registry for the years 1977 to 1993. This approach precludes differential reporting of injuries by study participants as an explanation for any associations seen. Intracranial tumors of the nervous system occurred more often than expected based on incidence rates for the Danish population; however, most of the excess occurred during the first year after the injury and likely was due to the detection of tumors that were present before the injury occurred. Excluding the first year of follow-up, the standardized incidence ratio (SIR) was 1.15 (95 percent confidence interval [CI] = 0.99-1.32). The same general temporal pattern was seen for the major subtypes of brain tumor as for all types combined. SIRs after the first year were 1.0 for glioma (CI = 0.8-1.2), 1.2 for meningioma (CI = 0.8-1.7), and 0.8 for neurilemmoma (CI = 0.4-1.7). However, hemangioblastoma and hemangioma were more frequent than expected, based on 15 cases (SIR = 2.6, CI = 1.4-4.2). Results indicate that head trauma causes, at most, a small increase in the overall risk of brain tumors during the ensuing 15 years; however, a possible association with intracranial vascular tumors warrants further evaluation.

  9. Mortality and cancer incidence in aluminum reduction plant workers

    SciTech Connect

    Spinelli, J.J.; Band, P.R.; Svirchev, L.M.; Gallagher, R.P. )

    1991-11-01

    An historical cohort study was conducted among 4,213 men who worked for 5 or more years at a Soderberg aluminum reduction plant in British Columbia (BC), Canada. Standardized mortality and incidence ratios were used to compare the mortality and cancer incidence of the cohort with that of the BC population and to examine risk by cumulative exposure to coal-tar pitch volatiles (CTPV) and electromagnetic fields. Significantly elevated rates were observed for bladder cancer incidence (standardized incidence ratio (SIR) = 1.69) and brain cancer mortality (standardized mortality ratio = 2.17). The risk of bladder cancer was strongly related to cumulative exposure to CTPV (P less than .01). The risk for non-Hodgkin's lymphoma also increased with increasing exposure (P less than .05), although the overall rate was similar to that of the general population (SIR = 1.06). The lung cancer rate was as expected (SIR = 0.97), but showed a weak association with CTPV exposure that was not statistically significant. No individual cause of death or incident cancer site was related to exposure to electromagnetic fields. Analysis of the joint effect of smoking and CTPV exposure on lung and bladder cancer showed the exposure response relationships to be independent of smoking.

  10. Incidence of scabies in Belgium

    PubMed Central

    LAPEERE, H.; NAEYAERT, J.-M.; De WEERT, J.; De MAESENEER, J.; BROCHEZ, L.

    2008-01-01

    SUMMARY A prospective survey on scabies in Ghent, Belgium was performed in 2004. Sixty-four individual cases were reported, corresponding to a crude incidence rate of 28/100 000 inhabitants. The incidence was higher in the elderly (51/100 000 in persons aged >75 years) and a higher incidence was also found in immigrants (88/100 000). More than 40% of the registered scabies patients had symptoms for more than 4 weeks at the time of presentation. In 54% of the consultations, the patient had already consulted a physician for his/her skin problem. Of this group, 44% had not yet received any scabicidal treatment, indicating that scabies was not yet diagnosed or that an inappropriate treatment was prescribed. The observations suggest that the diagnosis and/or treatment of scabies in this region can still be improved. PMID:17506916

  11. Brain heterotopia.

    PubMed

    Modarresifar, Homayoun; Ho, Linh

    2009-03-01

    We present a case with intractable partial complex seizures in a 14-year-old girl who was found to have brain heterotopia on MRI and PET-CT. The patient presented with intractable partial complex seizures and a normal electroencephalogram. Her brain magnetic resonance imaging showed heterotopic gray matter lining the ventricular margin of the right occipital horn. Subsequent PET-CT demonstrated moderate tracer localization in the heterotopic gray matter surrounding the ventricular margin of the right occipital horn. Heterotopia may demonstrate normal or increased FDG uptake on PET, therefore its appearance may be deceiving when other pathologies are being considered.

  12. Silent brain infarcts: a cause of depression in the elderly?

    PubMed

    Saavedra Perez, Heidi C; Direk, Nese; Hofman, Albert; Vernooij, Meike W; Tiemeier, Henning; Ikram, Mohammad Arfan

    2013-02-28

    The present study included 1047 elderly participants. At baseline, brain magnetic resonance imaging (MRI) was performed to detect infarcts and white matter lesions; further, depressive disorders were assessed. Participants were followed up during 3.6 years to determine incident and recurrent depression. We found an increased risk of recurrent depression associated with silent brain infarcts.

  13. Analyzing voluntary medical incident reports.

    PubMed

    Gong, Yang; Richardson, James; Zhijian, Luan; Alafaireet, Patricia; Yoo, Illhoi

    2008-11-06

    Voluntary medical incident reports lacking consistency and accuracy impede the ultimate use of the reports for patient safety research. To improve this, two coders examined harm score usage in a voluntary medical incident reporting system where the harm scores were selected from a predefined list by different reporters. The two coders inter-rater agreement percent was 82%. The major categories and reviewed harm score jointly demonstrate that this process is critical and necessary in preparing the voluntary reports for further content and semantics analysis.

  14. Smart Brains.

    ERIC Educational Resources Information Center

    Jones, Rebecca

    1995-01-01

    New techniques have opened windows to the brain. Although the biochemistry of learning remains largely a mystery, the following findings seem to have clear implications for education: (1) the importance of early-learning opportunities for the very young; (2) the connection between music and abstract reasoning; and (3) the importance of good…

  15. Smart Brains.

    ERIC Educational Resources Information Center

    Jones, Rebecca

    1995-01-01

    New techniques have opened windows to the brain. Although the biochemistry of learning remains largely a mystery, the following findings seem to have clear implications for education: (1) the importance of early-learning opportunities for the very young; (2) the connection between music and abstract reasoning; and (3) the importance of good…

  16. Animating Brains.

    PubMed

    Borck, Cornelius

    2016-07-01

    A recent paper famously accused the rising field of social neuroscience of using faulty statistics under the catchy title 'Voodoo Correlations in Social Neuroscience'. This Special Issue invites us to take this claim as the starting point for a cross-cultural analysis: in which meaningful ways can recent research in the burgeoning field of functional imaging be described as, contrasted with, or simply compared to animistic practices? And what light does such a reading shed on the dynamics and effectiveness of a century of brain research into higher mental functions? Reviewing the heated debate from 2009 around recent trends in neuroimaging as a possible candidate for current instances of 'soul catching', the paper will then compare these forms of primarily image-based brain research with older regimes, revolving around the deciphering of the brain's electrical activity. How has the move from a decoding paradigm to a representational regime affected the conceptualisation of self, psyche, mind and soul (if there still is such an entity)? And in what ways does modern technoscience provide new tools for animating brains?

  17. Traumatic Brain Injury: A Guidebook for Educators.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office for Special Education Services.

    This guidebook is designed to help New York school staff better understand the specialized needs of students with traumatic brain injury (TBI) and appropriately apply educational interventions to improve special and general education services for these students. It provides information on the following areas: (1) the causes, incidence, and…

  18. Optic Neuritis Incidence is Increased in Spring Months in Patients with Asymptomatic Demyelinating Lesions

    PubMed Central

    Balashov, Konstantin E.; Pal, Gian; Rosenberg, Michael L.

    2010-01-01

    Background Optic neuritis (ON) patients can be divided based on the presence or absence of asymptomatic demyelinating lesions (ADL) on brain MRI. The presence of ADL is associated with an increased risk of progression to clinically-definite multiple sclerosis (CDMS). Methods The clinical data and brain MRI of 110 patients with acute unilateral ON were analyzed. Results Patients with ADL had a significantly higher incidence of ON in spring months as compared to patients with no ADL (p=0.0024). Increased incidence of ON in spring months was seen in patients with ADL whether or not they were diagnosed with CDMS on follow-up. PMID:20142310

  19. Incidents Unsuitable for Moral Education.

    ERIC Educational Resources Information Center

    Thomas, R. Murray; And Others

    Educators from over 30 countries judged the suitability of incidents in moral education in the context of their native environment. Participants were 54 secondary school principals or teachers, most of whom were graduate students or married to graduate students at the University of California, Santa Barbara. They were given descriptions of 23…

  20. Serious Incident Management in Australia

    ERIC Educational Resources Information Center

    Ellis, Ike; Thorley-Smith, Sara

    2007-01-01

    As part of its efforts to ensure school safety, the government of New South Wales, Australia, has developed simulation exercises to better prepare principals to manage serious incidents, in collaboration with police. This article describes two initiatives implemented across NSW. The exercises provide principals in both secondary and primary…

  1. Brain metastasis: new opportunities to tackle therapeutic resistance.

    PubMed

    Seoane, Joan; De Mattos-Arruda, Leticia

    2014-09-12

    Brain metastasis is a devastating complication of cancer with unmet therapeutic needs. The incidence of brain metastasis has been rising in cancer patients and its response to treatment is limited due to the singular characteristics of brain metastasis (i.e., blood-brain-barrier, immune system, stroma). Despite improvements in the treatment and control of extracranial disease, the outcomes of patients with brain metastasis remain dismal. The mechanisms that allow tumor cells to promulgate metastases to the brain remain poorly understood. Further work is required to identify the molecular alterations inherent to brain metastasis in order to identify novel therapeutic targets and explicate the mechanisms of resistance to systemic therapeutics. In this article, we review current knowledge of the unique characteristics of brain metastasis, implications in therapeutic resistance, and the possibility of developing biomarkers to rationally guide the use of targeted agents.

  2. Factors associated with vulvodynia incidence.

    PubMed

    Reed, Barbara D; Legocki, Laurie J; Plegue, Melissa A; Sen, Ananda; Haefner, Hope K; Harlow, Sioban D

    2014-02-01

    To assess incidence rates of and risk factors for vulvodynia. We conducted a longitudinal population-based study of women in southeast Michigan (Woman-to-Woman Health Study) using a validated survey-based screening test for vulvodynia that was repeated at 6-month intervals over 30 months. Unadjusted incidence rates were determined using Poisson models. Demographic and symptom-related risk factors for incidence were assessed using discrete time survival analysis. Women who screened negative for vulvodynia at baseline and were followed through at least one additional survey (n=1,786) were assessed for onset of vulvodynia. The incidence rate was 4.2 cases per 100 person-years, and rates per 100 person-years were greater in women who were younger (7.6 cases per 100 person-years at age 20 years, compared with 3.3 cases per 100 person-years at age 60 years), Hispanic (9.5 cases per 100 person-years), married, or living as married (4.9 cases per 100 person-years); had reported symptoms of vulvar pain but did not meet vulvodynia criteria on the initial survey (11.5 cases per 100 person-years); or had reported past symptoms suggesting a history of vulvodynia (7.5 cases per 100 person-years). Increased risk of new-onset vulvodynia also included baseline sleep disturbance, chronic pain in general, specific comorbid pain disorders, and specific comorbid psychological disorders. The incidence rates of vulvodynia differ by age, ethnicity, and marital status. Onset is more likely among women with previous symptoms of vulvodynia or those with intermediate symptoms not meeting criteria for vulvodynia and among those with pre-existing sleep, psychological, and comorbid pain disorders. This suggests vulvodynia is an episodic condition with a potentially identifiable prodromal phase. II.

  3. Aberrations for Grazing Incidence Optics

    NASA Technical Reports Server (NTRS)

    Saha, Timo T.

    2008-01-01

    Large number of grazing incidence telescope configurations have been designed and studied. Wolte1 telescopes are commonly used in astronomical applications. Wolter telescopes consist of a paraboloidal primary mirror and a hyperboloidal or an ellipsoidal secondary mirror. There are 8 possible combinations of Wolter telescopes. Out of these possible designs only type 1 and type 2 telescopes are widely used. Type 1 telescope is typically used for x-ray applications and type 2 telescopes are used for EUV applications. Wolter-Schwarzshild (WS) telescopes offer improved image quality over a small field of view. The WS designs are stigmatic and free of third order coma and, therefore, the PSF is significantly better over a small field of view. Typically the image is more symmetric about its centroid. As for the Wolter telescopes there are 8 possible combinations of WS telescopes. These designs have not been widely used because the surface equations are complex parametric equations complicating the analysis and typically the resolution requirements are too low to take full advantage of the WS designs. There are several other design options. Most notable are wide field x-ray telescope designs. Polynomial designs were originally suggested by Burrows4 and hyperboloid-hyperboloid designs for solar physics applications were designed by Harvey5. No general aberration theory exists for grazing incidence telescopes that would cover all the design options. Several authors have studied the aberrations of grazing incidence telescopes. A comprehensive theory of Wolter type 1 and 2 telescopes has been developed. Later this theory was expanded to include all possible combinations of grazing incidence and also normal incidence paraboloid-hyperboloid and paraboloid-ellipsoid telescopes. In this article the aberration theory of Wolter type telescopes is briefly reviewed.

  4. INCIDENT REPORTING: LEARNING FROM EXPERIENCE

    SciTech Connect

    Weiner, Steven C.; Kinzey, Bruce R.; Dean, Jesse D.; Davis, Patrick B.; Ruiz, Antonio

    2007-09-12

    Experience makes a superior teacher. Sharing the details surrounding safety events is one of the best ways to help prevent their recurrence elsewhere. This approach requires an open, non-punitive environment to achieve broad benefits. The Hydrogen Incident Reporting Tool (www.h2incidents.org) is intended to facilitate the sharing of lessons learned and other relevant information gained from actual experiences using and working with hydrogen and hydrogen systems. Its intended audience includes those involved in virtually any aspect of hydrogen technology, systems and use, with an emphasis towards energy and transportation applications. The database contains records of safety events both publicly available and/or voluntarily submitted. Typical records contain a general description of the occurrence, contributing factors, equipment involved, and some detailing of consequences and changes that have been subsequently implemented to prevent recurrence of similar events in the future. The voluntary and confidential nature and other characteristics surrounding the database mean that any analysis of apparent trends in its contents cannot be considered statistically valid for a universal population. A large portion of reported incidents have occurred in a laboratory setting due to the typical background of the reporting projects, for example. Yet some interesting trends are becoming apparent even at this early stage of the database’s existence and general lessons can already be taken away from these experiences. This paper discusses the database and a few trends that have already become apparent for the reported incidents. Anticipated future uses of this information are also described. This paper is intended to encourage wider participation and usage of the incidents reporting database and to promote the safety benefits offered by its contents.

  5. Modeling Wildfire Incident Complexity Dynamics

    PubMed Central

    Thompson, Matthew P.

    2013-01-01

    Wildfire management in the United States and elsewhere is challenged by substantial uncertainty regarding the location and timing of fire events, the socioeconomic and ecological consequences of these events, and the costs of suppression. Escalating U.S. Forest Service suppression expenditures is of particular concern at a time of fiscal austerity as swelling fire management budgets lead to decreases for non-fire programs, and as the likelihood of disruptive within-season borrowing potentially increases. Thus there is a strong interest in better understanding factors influencing suppression decisions and in turn their influence on suppression costs. As a step in that direction, this paper presents a probabilistic analysis of geographic and temporal variation in incident management team response to wildfires. The specific focus is incident complexity dynamics through time for fires managed by the U.S. Forest Service. The modeling framework is based on the recognition that large wildfire management entails recurrent decisions across time in response to changing conditions, which can be represented as a stochastic dynamic system. Daily incident complexity dynamics are modeled according to a first-order Markov chain, with containment represented as an absorbing state. A statistically significant difference in complexity dynamics between Forest Service Regions is demonstrated. Incident complexity probability transition matrices and expected times until containment are presented at national and regional levels. Results of this analysis can help improve understanding of geographic variation in incident management and associated cost structures, and can be incorporated into future analyses examining the economic efficiency of wildfire management. PMID:23691014

  6. Unlocking the Brain

    MedlinePlus

    ... bold new project to revolutionize understanding of the human brain. It is called the BRAIN Initiative—short for ... how the brain works? Given that a typical human brain contains 86 billion neurons, each with thousands of ...

  7. Brain Tumors (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Brain Tumors KidsHealth > For Parents > Brain Tumors A A ... radiation therapy or chemotherapy, or both. Types of Brain Tumors There are many different types of brain ...

  8. Understanding Brain Tumors

    MedlinePlus

    ... to Know About Brain Tumors . What is a Brain Tumor? A brain tumor is an abnormal growth
 ... Tumors” from Frankly Speaking Frankly Speaking About Cancer: Brain Tumors Download the full book Questions to ask ...

  9. Brain Tumors (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Brain Tumors KidsHealth > For Parents > Brain Tumors Print A ... radiation therapy or chemotherapy, or both. Types of Brain Tumors There are many different types of brain ...

  10. Brain Tumor Diagnosis

    MedlinePlus

    ... Types of Brain Scans X-rays Laboratory Tests DNA Profiling Biopsy Procedure Malignant and Benign Brain Tumors Tumor ... Types of Brain Scans X-rays Laboratory Tests DNA Profiling Biopsy Procedure Malignant and Benign Brain Tumors Tumor ...

  11. Drug delivery systems for brain tumor therapy.

    PubMed

    Rautioa, Jarkko; Chikhale, Prashant J

    2004-01-01

    Brain tumors are one of the most lethal forms of cancer. They are extremely difficult to treat. Although, the rate of brain tumor incidence is relatively low, the field clearly lacks therapeutic strategies capable of overcoming barriers for effective delivery of drugs to brain tumors. Clinical failure of many potentially effective therapeutics for the treatment of brain tumors is usually not due to a lack of drug potency, but rather can be attributed to shortcomings in the methods by which a drug is delivered to the brain and into brain tumors. In response to the lack of efficacy of conventional drug delivery methods, extensive efforts have been made to develop novel strategies to overcome the obstacles for brain tumor drug delivery. The challenge is to design therapeutic strategies that deliver drugs to brain tumors in a safe and effective manner. This review provides some insight into several potential techniques that have been developed to improve drug delivery to brain tumors, and it should be helpful to clinicians and research scientists as well.

  12. Bridging the Communication Gap (Combler les Lacunes dans le Domaine de la Communication)

    DTIC Science & Technology

    1991-02-01

    principles may perform as well, so as auser; it explains problems and proposes research result this application is in-exercises, depending on the...one deals in ments with Superbook in the past have shown superior a different way with inability of current computer performance for searches aimed at...the user to recognize what that potentially offer greatly improved performance . if he is interested in. In the right circumstances this can we can

  13. Brain-Injured Children; With Special References to Doman-Delacato Methods of Treatment.

    ERIC Educational Resources Information Center

    Thomas, Evan W.; LeWinn, Edward B.

    Contents include a definition of brain injury and cerebral palsy, discussions of the pathology of cerebral palsy, incidence and prevalence of cerebral palsy, mental retardation, epilepsy, behavioral disorders, dyslexia, and a summary and conclusions on the problem of brain injury. Attention is also given to the controversy over brain injury as a…

  14. The Creative Brain.

    ERIC Educational Resources Information Center

    Herrmann, Ned

    1982-01-01

    Outlines the differences between left-brain and right-brain functioning and between left-brain and right-brain dominant individuals, and concludes that creativity uses both halves of the brain. Discusses how both students and curriculum can become more "whole-brained." (Author/JM)

  15. The Creative Brain.

    ERIC Educational Resources Information Center

    Herrmann, Ned

    1982-01-01

    Outlines the differences between left-brain and right-brain functioning and between left-brain and right-brain dominant individuals, and concludes that creativity uses both halves of the brain. Discusses how both students and curriculum can become more "whole-brained." (Author/JM)

  16. Fabry disease and incidence of cancer.

    PubMed

    Bird, Sarah; Hadjimichael, Efthymios; Mehta, Atul; Ramaswami, Uma; Hughes, Derralynn

    2017-09-06

    Fabry disease is an X-linked lysosomal storage disorder caused by deficient activity of α-galactosidase A and the resulting accumulation of the glycosphingolipid globotriaosylceramide (Gb3) and its derivatives, including globotriaosylsphingosine (Lyso-Gb3). Increased cellular and plasma levels of Gb3 and Lyso-Gb3 affect multiple organs, with specific clinical consequences for the kidneys, heart and brain. There is growing evidence that alterations in glycosphingolipids may have an oncogenic role and this prompted a review of cases of cancer and benign lesions in a large single centre cohort of Fabry patients. We also explored whether there is a difference in the risk of cancer in Fabry patients compared to the general population. Our results suggest that Fabry patients may have a marginally reduced rate of all cancer (incidence rate ratio 0.61, 95% confidence interval 0.37 to 0.99) but possibly increased rates of melanoma, urological malignancies and meningiomas. Greater knowledge and awareness of cancer in patients with Fabry disease may help identify at-risk individuals and elucidate cancer mechanisms in this rare inherited disease, which may potentially be relevant to the wider cancer population.

  17. State Methods for a Cyber Incident

    DTIC Science & Technology

    2012-03-01

    Statewide Emergency Response and Response Plan SIPC State Infrastructure Protection Center SIRT Security Incident Response Team SIRT State Incident...by statute and policy to report agency information security incidents to the state Security Incident Response Team ( SIRT ). Those reports are made...through recent state statutes. P-16 Yes, agencies are required by statute and policy to report information security incidents to the SIRT . Q-17

  18. Martian 'Brain'

    NASA Technical Reports Server (NTRS)

    2004-01-01

    5 May 2004 Most middle-latitude craters on Mars have strange landforms on their floors. Often, the floors have pitted and convoluted features that lack simple explanation. In this case, the central part of the crater floor shown in this 2004 Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image bears some resemblance to the folded nature of a brain. Or not. It depends upon the 'eye of the beholder,' perhaps. The light-toned 'ring' around the 'brain' feature is more easily explained--windblown ripples and dunes. The crater occurs near 33.1oS, 91.2oW, and is illuminated from the upper left. The picture covers an area about 3 km (1.9 mi) across.

  19. Martian 'Brain'

    NASA Technical Reports Server (NTRS)

    2004-01-01

    5 May 2004 Most middle-latitude craters on Mars have strange landforms on their floors. Often, the floors have pitted and convoluted features that lack simple explanation. In this case, the central part of the crater floor shown in this 2004 Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image bears some resemblance to the folded nature of a brain. Or not. It depends upon the 'eye of the beholder,' perhaps. The light-toned 'ring' around the 'brain' feature is more easily explained--windblown ripples and dunes. The crater occurs near 33.1oS, 91.2oW, and is illuminated from the upper left. The picture covers an area about 3 km (1.9 mi) across.

  20. Silicon Brains

    NASA Astrophysics Data System (ADS)

    Hoefflinger, Bernd

    Beyond the digital neural networks of Chap. 16, the more radical mapping of brain-like structures and processes into VLSI substrates has been pioneered by Carver Mead more than 30 years ago [1]. The basic idea was to exploit the massive parallelism of such circuits and to create low-power and fault-tolerant information-processing systems. Neuromorphic engineering has recently seen a revival with the availability of deep-submicron CMOS technology, which allows for the construction of very-large-scale mixed-signal systems combining local analog processing in neuronal cells with binary signalling via action potentials. Modern implementations are able to reach the complexity-scale of large functional units of the human brain, and they feature the ability to learn by plasticity mechanisms found in neuroscience. Combined with high-performance programmable logic and elaborate software tools, such systems are currently evolving into user-configurable non-von-Neumann computing systems, which can be used to implement and test novel computational paradigms. The chapter introduces basic properties of biological brains with up to 200 Billion neurons and their 1014 synapses, where action on a synapse takes ˜10 ms and involves an energy of ˜10 fJ. We outline 10x programs on neuromorphic electronic systems in Europe and the USA, which are intended to integrate 108 neurons and 1012 synapses, the level of a cat's brain, in a volume of 1 L and with a power dissipation <1 kW. For a balanced view on intelligence, we references Hawkins' view to first perceive the task and then design an intelligent technical response.

  1. Brain imaging

    SciTech Connect

    Bradshaw, J.R.

    1989-01-01

    This book presents a survey of the various imaging tools with examples of the different diseases shown best with each modality. It includes 100 case presentations covering the gamut of brain diseases. These examples are grouped according to the clinical presentation of the patient: headache, acute headache, sudden unilateral weakness, unilateral weakness of gradual onset, speech disorders, seizures, pituitary and parasellar lesions, sensory disorders, posterior fossa and cranial nerve disorders, dementia, and congenital lesions.

  2. Brain abscess.

    PubMed

    Sáez-Llorens, Xavier; Nieto-Guevara, Javier

    2013-01-01

    Brain abscess is a serious and life-threatening disease among children despite advances in diagnosis and management. Changes in the epidemiology of predisposing conditions for brain abscess are associated with changes in the patient population and causative organisms. Though still a potentially fatal infection, there have been recent improvements in diagnosis, treatment, and outcome. Although mortality appears to be decreasing, a significant percentage of children continue to have residual neurological deficits, including epilepsy, permanent motor or sensory dysfunction, visual field defects, and personality change. Some children also require placement of a ventriculoperitoneal shunt. The most common origin of microbial infection in children remains direct or indirect cranial infection arising from the middle ear, paranasal sinuses, or teeth. No prospective clinical trials have compared the various surgical and medical treatment strategies available to guide the management of cerebral abscesses in children. Most surgical and medical treatment guidelines are based on populations consisting primarily of adult patients. The use of corticosteroids for treatment of brain abscess is controversial. Anticonvulsants are recommended in children who have developed seizures potentially to prevent further episodes. Duration of anticonvulsant therapy should be individualized and guided by electroencephalographic (EEG) study in the follow-up phase of disease. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Animating Brains

    PubMed Central

    Borck, Cornelius

    2016-01-01

    A recent paper famously accused the rising field of social neuroscience of using faulty statistics under the catchy title ‘Voodoo Correlations in Social Neuroscience’. This Special Issue invites us to take this claim as the starting point for a cross-cultural analysis: in which meaningful ways can recent research in the burgeoning field of functional imaging be described as, contrasted with, or simply compared to animistic practices? And what light does such a reading shed on the dynamics and effectiveness of a century of brain research into higher mental functions? Reviewing the heated debate from 2009 around recent trends in neuroimaging as a possible candidate for current instances of ‘soul catching’, the paper will then compare these forms of primarily image-based brain research with older regimes, revolving around the deciphering of the brain’s electrical activity. How has the move from a decoding paradigm to a representational regime affected the conceptualisation of self, psyche, mind and soul (if there still is such an entity)? And in what ways does modern technoscience provide new tools for animating brains? PMID:27292322

  4. Replication of grazing incidence optics

    NASA Technical Reports Server (NTRS)

    Ulmer, Melville P.

    1986-01-01

    The replication of grazing incidence optics is reviewed. Electroform and epoxy replication are described and compared. It is concluded that for light weight and deep nesting, replication has a distinct advantage over direct production. The resolution of optics produced in this manner is however, limited to about 10 arc seconds; a typical value is 40 arc seconds. Epoxy replicated pieces tend to have better optical figures than electroformed optics, but the latter can be made thinner to make more deeply nested systems.

  5. Replication of grazing incidence optics

    NASA Technical Reports Server (NTRS)

    Ulmer, Melville P.

    1986-01-01

    The replication of grazing incidence optics is reviewed. Electroform and epoxy replication are described and compared. It is concluded that for light weight and deep nesting, replication has a distinct advantage over direct production. The resolution of optics produced in this manner is however, limited to about 10 arc seconds; a typical value is 40 arc seconds. Epoxy replicated pieces tend to have better optical figures than electroformed optics, but the latter can be made thinner to make more deeply nested systems.

  6. Remodeling the blood-brain barrier microenvironment by natural products for brain tumor therapy.

    PubMed

    Zhao, Xiao; Chen, Rujing; Liu, Mei; Feng, Jianfang; Chen, Jun; Hu, Kaili

    2017-09-01

    Brain tumor incidence shows an upward trend in recent years; brain tumors account for 5% of adult tumors, while in children, this figure has increased to 70%. Moreover, 20%-30% of malignant tumors will eventually metastasize into the brain. Both benign and malignant tumors can cause an increase in intracranial pressure and brain tissue compression, leading to central nervous system (CNS) damage which endangers the patients' lives. Despite the many approaches to treating brain tumors and the progress that has been made, only modest gains in survival time of brain tumor patients have been achieved. At present, chemotherapy is the treatment of choice for many cancers, but the special structure of the blood-brain barrier (BBB) limits most chemotherapeutic agents from passing through the BBB and penetrating into tumors in the brain. The BBB microenvironment contains numerous cell types, including endothelial cells, astrocytes, peripheral cells and microglia, and extracellular matrix (ECM). Many chemical components of natural products are reported to regulate the BBB microenvironment near brain tumors and assist in their treatment. This review focuses on the composition and function of the BBB microenvironment under both physiological and pathological conditions, and the current research progress in regulating the BBB microenvironment by natural products to promote the treatment of brain tumors.

  7. [Skin cancer incidence in Zacatecas].

    PubMed

    Pinedo-Vega, José Luis; Castañeda-López, Rosalba; Dávila-Rangel, J Ignacio; Mireles-García, Fernando; Ríos-Martínez, Carlos; López-Saucedo, Adrián

    2014-01-01

    Skin cancer is the most frequent cancer related to ultraviolet radiation. The aim was to estimate the incidence of skin cancer type, melanoma and non-melanoma in Zacatecas, Mexico. An epidemiological study was carried out during the period from 2008 to 2012. The data were obtained from the Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Secretaría de Salud de Zacatecas (SSZ) and a private source, the Centro Médico Alameda. The incidence and the global prevalence were estimated. We studied 958 skin cancer cases, histopathologically confirmed. The cases were distributed as: 63.6 % basal cell carcinomas, 25.8 % squamous cell carcinomas, and 10.6 % melanoma. Significantly higher proportions were observed in women in the basal cell carcinomas (60.4 %) and squamous cell carcinomas (53.4 %). However, in the case of melanoma, the major proportion was observed in men (55.9 %). The more frequent skin cancer location was the face and for basal cell carcinoma was the nose (53 %); for squamous cell carcinomas were the lips (36 %), and for melanoma it was also the nose (40 %). The skin cancer incidence was estimated in 20 cases for each 100 000 inhabitants. Linear regression analysis showed that the skin cancer is increasing at an annual rate of 10.5 %. The anatomical location indicates that solar UV radiation is a risk factor, since the face is the zone with major exposure to solar radiation.

  8. Critical incident monitoring in anaesthesia.

    PubMed

    Choy, Y C

    2006-12-01

    Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is

  9. Melanoma incidence and frequency modulation (FM) broadcasting.

    PubMed

    Hallberg, Orjan; Johansson, Olle

    2002-01-01

    The incidence of melanoma has been increasing steadily in many countries since 1960, but the underlying mechanism causing this increase remains elusive. The incidence of melanoma has been linked to the distance to frequency modulation (FM) broadcasting towers. In the current study, the authors sought to determine if there was also a related link on a larger scale for entire countries. Exposure-time-specific incidence was extracted from exposure and incidence data from 4 different countries, and this was compared with reported age-specific incidence of melanoma. Geographic differences in melanoma incidence were compared with the magnitude of this environmental stress. The exposure-time-specific incidence from all 4 countries became almost identical, and they were approximately equal to the reported age-specific incidence of melanoma. A correlation between melanoma incidence and the number of locally receivable FM transmitters was found. The authors concluded that melanoma is associated with exposure to FM broadcasting.

  10. Brain Canada: One Brain One Community.

    PubMed

    Jabalpurwala, Inez

    2016-11-02

    Building on the long history of neuroscience in Canada, Brain Canada is accelerating the funding of transformative brain research across Canada, primarily through an innovative $240-million CAN public-private partnership with the Government of Canada and numerous partners. This article describes Brain Canada's "One Brain One Community" approach and its views on international collaboration and the future of brain research. Copyright © 2016. Published by Elsevier Inc.

  11. Reirradiation Tolerance of the Human Brain

    SciTech Connect

    Mayer, Ramona; Sminia, Peter

    2008-04-01

    Purpose: To give an overview of current available clinical data on reirradiation of glioma with respect to the tolerance dose of normal brain tissue. Methods and Materials: Clinical brain reirradiation studies from January 1996 to December 2006 were considered on radiation-induced late adverse effects-i.e., brain tissue necrosis. The studies were analyzed by using the linear quadratic model to derive information on the cumulative biologic effective tolerance dose and equivalent doses in 2-Gy fractions for the healthy human brain. Results: The cumulative dose in conventional reirradiation series (of 81.6-101.9 Gy) were generally lower than in fractionated stereotactic radiotherapy (FSRT) ( 90-133.9 Gy.) or LINAC-based stereotactic radiosurgery series (of 111.6-137.2 Gy). No correlation between the time interval between the initial and reirradiation course and the incidence of radionecrosis was noted. The analysis showed the prescribed to increase with decreasing treatment volume, which is allowed by modern conformal radiation techniques. Conclusion: Radiation-induced normal brain tissue necrosis is found to occur at >100 Gy. The applied reirradiation dose and increases with a change in irradiation technique from conventional to radiosurgery re-treatment, without increasing the probability of normal brain necrosis. Taken together, modern conformal treatment options, because of their limited volume of normal brain tissue exposure, allow brain reirradiation for palliative treatment of recurrent high grade glioma with an acceptable probability of radionecrosis.

  12. Brain Abnormalities in Neuromyelitis Optica Spectrum Disorder

    PubMed Central

    Kim, Woojun; Kim, Su-Hyun; Huh, So-Young; Kim, Ho Jin

    2012-01-01

    Neuromyelitis optica (NMO) is an idiopathic inflammatory syndrome of the central nervous system that is characterized by severe attacks of optic neuritis (ON) and myelitis. Until recently, NMO was considered a disease without brain involvement. However, since the discovery of NMO-IgG/antiaqaporin-4 antibody, the concept of NMO was broadened to NMO spectrum disorder (NMOSD), and brain lesions are commonly recognized. Furthermore, some patients present with brain symptoms as their first manifestation and develop recurrent brain symptoms without ON or myelitis. Brain lesions with characteristic locations and configurations can be helpful in the diagnosis of NMOSD. Due to the growing recognition of brain abnormalities in NMOSD, these have been included in the NMO and NMOSD diagnostic criteria or guidelines. Recent technical developments such as diffusion tensor imaging, MR spectroscopy, and voxel-based morphometry reveal new findings related to brain abnormalities in NMOSD that were not identified using conventional MRI. This paper focuses on the incidence and characteristics of the brain lesions found in NMOSD and the symptoms that they cause. Recent studies using advanced imaging techniques are also introduced. PMID:23259063

  13. Brain abscess of odontogenic origin.

    PubMed

    Antunes, Antonio Azoubel; de Santana Santos, Thiago; de Carvalho, Ricardo Wathson Feitosa; Avelar, Rafael Linard; Pereira, Carlos Umberto; Pereira, José Carlos

    2011-11-01

    Brain abscess is a rare and threatening infection, which is in a suppuration area, caused either by trauma, neurosurgical complication, or by a secondary infection of dental origin complication. The infectious process spread from the start focus can occur in 2 ways: hematogenous or by contiguity. The treatment should ideally be based on the etiological factor excision, combined with drainage and antibiotics as adjuvant; this philosophy is not observed in the reports described in the 1960s, 1970s, and 1980s. This study's goal was to report a case of brain abscess consequent of an odontogenic outbreak, where an adequate treatment was set up, but it was already in advanced stages and had as a result the lethal outcome. Complications from the odontogenic infections have a low incidence, but should never be disregarded, because they can lead to death, as described in this manuscript.

  14. Brain Imaging

    PubMed Central

    Racine, Eric; Bar-Ilan, Ofek; Illes, Judy

    2007-01-01

    Advances in neuroscience are increasingly intersecting with issues of ethical, legal, and social interest. This study is an analysis of press coverage of an advanced technology for brain imaging, functional magnetic resonance imaging, that has gained significant public visibility over the past ten years. Discussion of issues of scientific validity and interpretation dominated over ethical content in both the popular and specialized press. Coverage of research on higher order cognitive phenomena specifically attributed broad personal and societal meaning to neuroimages. The authors conclude that neuroscience provides an ideal model for exploring science communication and ethics in a multicultural context. PMID:17330151

  15. Intervening in the psychopath's brain.

    PubMed

    Glannon, Walter

    2014-02-01

    Psychopathy is a disorder involving personality and behavioral features associated with a high rate of violent aggression and recidivism. This paper explores potential psychopharmacological therapies to modulate dysfunctional neural pathways in psychopaths and reduce the incidence of their harmful behavior, as well as the ethical and legal implications of offering these therapies as an alternative to incarceration. It also considers whether forced psychopharmacological intervention in adults and children with psychopathic traits manifesting in violent behavior can be justified. More generally, the paper addresses the question of how to weigh the psychopath's presumptive right to non-interference in his brain and mind against the public interest in avoiding harm.

  16. Cancer incidence in British vegetarians.

    PubMed

    Key, T J; Appleby, P N; Spencer, E A; Travis, R C; Allen, N E; Thorogood, M; Mann, J I

    2009-07-07

    Few prospective studies have examined cancer incidence among vegetarians. We studied 61,566 British men and women, comprising 32,403 meat eaters, 8562 non-meat eaters who did eat fish ('fish eaters') and 20,601 vegetarians. After an average follow-up of 12.2 years, there were 3350 incident cancers of which 2204 were among meat eaters, 317 among fish eaters and 829 among vegetarians. Relative risks (RRs) were estimated by Cox regression, stratified by sex and recruitment protocol and adjusted for age, smoking, alcohol, body mass index, physical activity level and, for women only, parity and oral contraceptive use. There was significant heterogeneity in cancer risk between groups for the following four cancer sites: stomach cancer, RRs (compared with meat eaters) of 0.29 (95% CI: 0.07-1.20) in fish eaters and 0.36 (0.16-0.78) in vegetarians, P for heterogeneity=0.007; ovarian cancer, RRs of 0.37 (0.18-0.77) in fish eaters and 0.69 (0.45-1.07) in vegetarians, P for heterogeneity=0.007; bladder cancer, RRs of 0.81 (0.36-1.81) in fish eaters and 0.47 (0.25-0.89) in vegetarians, P for heterogeneity=0.05; and cancers of the lymphatic and haematopoietic tissues, RRs of 0.85 (0.56-1.29) in fish eaters and 0.55 (0.39-0.78) in vegetarians, P for heterogeneity=0.002. The RRs for all malignant neoplasms were 0.82 (0.73-0.93) in fish eaters and 0.88 (0.81-0.96) in vegetarians (P for heterogeneity=0.001). The incidence of some cancers may be lower in fish eaters and vegetarians than in meat eaters.

  17. Antidepressants and the adolescent brain.

    PubMed

    Cousins, Lesley; Goodyer, Ian M

    2015-05-01

    Major unipolar depression is a significant global health problem, with the highest incident risk being during adolescence. A depressive illness during this period is associated with negative long-term consequences including suicide, additional psychiatric comorbidity, interpersonal relationship problems, poor educational performance and poor employment attainment well into adult life. Despite previous safety concerns, selective serotonin reuptake inhibitors (SSRIs) remain a key component of the treatment of moderate to severe depression episodes in adolescents. The impact of SSRIs on the developing adolescent brain, however, remains unclear. In this review we first consider what is currently known about the developing brain during adolescence and how these development processes may be affected by a depressive illness. We then review our understanding of the action of SSRIs, their effects on the brain and how these may differ between adults and adolescents. We conclude that there is currently little evidence to indicate that the human adolescent brain is at developmental risk from SSRIs. Furthermore, there is no clear-cut evidence to support the concerns of marked suicidal adverse side effects accruing in depressed adolescents being treated with SSRIs. Neither, however, is there irrefutable evidence to dismiss all such concerns. This makes SSRI prescribing a matter of medical judgement, ensuring the benefits outweigh the risks for the individual patients, as with so much in therapeutics. Overall, SSRIs show clinical benefits that we judge to outweigh the risks to neurodevelopment and are an important therapeutic choice in the treatment of moderate to severe adolescent depression. © The Author(s) 2015.

  18. Elements of critical incident debriefing.

    PubMed

    Curtis, J M

    1995-08-01

    The present paper lists a number of specific therapeutic steps involved in critical incident debriefing. These therapeutic suggestions, while by no means exhaustive, include (a) identification, (b) labeling, (c) articulation, (d) expression, (e) externalization, (f) ventilation, (g) validation, and (h) acceptance. More careful attention to these specific elements--regardless of debriefers' training and backgrounds--might improve therapeutic consistency for trauma victims afflicted with stress-related symptoms. Further applications of these therapeutic steps were also suggested for other types of behavioral problems.

  19. Fortress brain.

    PubMed

    Royall, Donald R

    2013-02-01

    Neurodegenerative diseases are associated with neuronal inclusions, comprised of protein aggregates. In Alzheimer's Disease (AD) and Lewy Body Disease (LBD) such lesions are distributed in a hierarchical retrograde transynaptic spatial pattern. This implies a retrograde transynaptic temporal propagation as well. There can be few explanations for this other than infectious agents (prions and viruses). This suggests that AD and LBD (at least) may have infectious origins. Transynaptic infiltration of the CNS along cranial nerve or other major projections, by one or more infectious agents has important implications. The clinical syndrome and natural history of each neurodegenerative disorder will reflect its portal of entry. There may be a different neurodegenerative syndrome for each cranial nerve or other portal of entry, and not all may manifest as "dementia". Each syndrome may be associated with more than one pathological lesion. Each pathology may be associated with several clinical syndromes. Host-parasite interactions are species specific. This may explain the rarity of AD-like pathology in most other older mammals. Over evolutionary timescales, the human brain should be adapted to predation by neurotropic agents. Viewed from this perspective, the prion-like pro-inflammatory and pro-apoptotic properties of β-amyloid and other proteins may be adaptive, and anti-microbial. Reductions in synaptic density may slow the progress of invading pathogens, while perineuronal nets and other structures may guard the gates. This suggests a defense in depth of a structure, the brain, that is inherently vulnerable to invasion along its neural networks.

  20. Adolescent Brain Development, Substance Use, and Psychotherapeutic Change

    PubMed Central

    Wetherill, Reagan; Tapert, Susan F.

    2013-01-01

    Adolescence is a unique developmental period characterized by major physiological, psychological, social, and brain changes, as well as an increased incidence of maladaptive, addictive behaviors. With the use of magnetic resonance imaging techniques, researchers have been able to provide a better understanding of adolescent brain maturation and how neurodevelopment affects cognition and behavior. This review discusses adolescent brain development and its potential influence on psychotherapeutic change. We focus on cognitive-behavioral and mindfulness-based approaches for treating substance use and highlight potential brain mechanisms underlying response to psychotherapy. Finally, we discuss integrative neuroimaging and treatment studies and potential opportunities for advancing the treatment of adolescent addictive behaviors. PMID:22732057

  1. Adolescent brain development, substance use, and psychotherapeutic change.

    PubMed

    Wetherill, Reagan; Tapert, Susan F

    2013-06-01

    Adolescence is a unique developmental period characterized by major physiological, psychological, social, and brain changes, as well as an increased incidence of maladaptive, addictive behaviors. With the use of MRI techniques, researchers have been able to provide a better understanding of adolescent brain maturation and how neurodevelopment affects cognition and behavior. This review discusses adolescent brain development and its potential influence on psychotherapeutic change. We focus on cognitive-behavioral and mindfulness-based approaches for treating substance use and highlight potential brain mechanisms underlying response to psychotherapy. Finally, we discuss integrative neuroimaging and treatment studies and potential opportunities for advancing the treatment of adolescent addictive behaviors. 2013 APA, all rights reserved

  2. Anatomy of the Brain

    MedlinePlus

    ... as well as how we function in our environment. The diagrams below show brain anatomy, or the various parts of the brain, from two different angles. Side View of the Brain Cross View of the Brain Learning about the various parts of the brain and ...

  3. [Registration procedure for incidents with implants].

    PubMed

    Siebert, H; Stockheim, M; Kienapfel, H; Blömer, W

    2011-09-01

    Incidents involving implants, whether there is a break in the osteosynthesis plate or a synthetic inlay of an endoprosthesis, are incidents with mostly severe repercussions for the patient with immediate and delayed effects for the clinic involved and the manufacturer.

  4. Application of brain cholinesterase reactivation to differentiate between organophosphorus and carbamate pesticide exposure in wild birds

    USGS Publications Warehouse

    Smith, W.R.; Thomas, N.J.; Hulse, C.

    1995-01-01

    Brain cholinesterase activity was measured to evaluate pesticide exposure in wild birds. Thermal reactivation of brain cholinesterase was used to differentiate between carbamate and organophosphorus pesticide exposure. Brain cholinesterase activity was compared with gas chromatography and mass spectrometry of stomach contents. Pesticides were identified and confirmed in 86 of 102 incidents of mortality from 29 states within the USA from 1986 through 1991. Thermal reactivation of cholinesterase activity was used to correctly predict carbamates in 22 incidents and organophosphates in 59 incidents. Agreement (P < 0.001) between predictions based on cholinesterase activities and GC/MS results was significant.

  5. Application of brain cholinesterase reactivation to differentiate between organophosphorus and carbamate pesticide exposure in wild birds

    USGS Publications Warehouse

    Smith, M.R.; Thomas, N.J.; Hulse, C.

    1995-01-01

    Brain cholinesterase activity was measured to evaluate pesticide exposure in wild birds. Thermal reactivation of brain cholinesterase was used to differentiate between carbamate and organophosphorus pesticide exposure. Brain cholinesterase activity was compared with gas chromatography and mass spectrometry of stomach contents. Pesticides were identified and confirmed in 86 of 102 incidents of mortality from 29 states within the USA from 1986 through 1991. Thermal reactivation of cholinesterase activity was used to correctly predict carbamates in 22 incidents and organophosphates in 59 incidents. Agreement (P < 0.001) between predictions based on cholinesterase activities and GC/MS results was significant.

  6. Intracerebral hemorrhage mortality is not changing despite declining incidence

    PubMed Central

    Lisabeth, Lynda D.; Sánchez, Brisa N.; Smith, Melinda A.; Brown, Devin L.; Garcia, Nelda M.; Skolarus, Lesli E.; Meurer, William J.; Burke, James F.; Adelman, Eric E.; Morgenstern, Lewis B.

    2014-01-01

    Objective: To determine trends in incidence and mortality of intracerebral hemorrhage (ICH) in a rigorous population-based study. Methods: We identified all cases of spontaneous ICH in a South Texas community from 2000 to 2010 using rigorous case ascertainment methods within the Brain Attack Surveillance in Corpus Christi Project. Yearly population counts were determined from the US Census, and deaths were determined from state and national databases. Age-, sex-, and ethnicity-adjusted incidence was estimated for each year with Poisson regression, and a linear trend over time was investigated. Trends in 30-day case fatality and long-term mortality (censored at 3 years) were estimated with log-binomial or Cox proportional hazards models adjusted for demographics, stroke severity, and comorbid disease. Results: A total of 734 cases of ICH were included. The age-, sex-, and ethnicity-adjusted ICH annual incidence rate was 5.21 per 10,000 (95% confidence interval [CI] 4.36, 6.24) in 2000 and 4.30 per 10,000 (95% CI 3.21, 5.76) in 2010. The estimated 10-year change in demographic-adjusted ICH annual incidence rate was −31% (95% CI −47%, −11%). Yearly demographic-adjusted 30-day case fatality ranged from 28.3% (95% CI 19.9%, 40.3%) in 2006 to 46.5% (95% CI 35.5, 60.8) in 2008. There was no change in ICH case fatality or long-term mortality over time. Conclusions: ICH incidence decreased over the past decade, but case fatality and long-term mortality were unchanged. This suggests that primary prevention efforts may be improving over time, but more work is needed to improve ICH treatment and reduce the risk of death. PMID:24838789

  7. Investigation of excess thyroid cancer incidence in Los Alamos County

    SciTech Connect

    Athas, W.F.

    1996-04-01

    Los Alamos County (LAC) is home to the Los Alamos National Laboratory, a U.S. Department of Energy (DOE) nuclear research and design facility. In 1991, the DOE funded the New Mexico Department of Health to conduct a review of cancer incidence rates in LAC in response to citizen concerns over what was perceived as a large excess of brain tumors and a possible relationship to radiological contaminants from the Laboratory. The study found no unusual or alarming pattern in the incidence of brain cancer, however, a fourfold excess of thyroid cancer was observed during the late-1980`s. A rapid review of the medical records for cases diagnosed between 1986 and 1990 failed to demonstrate that the thyroid cancer excess had resulted from enhanced detection. Surveillance activities subsequently undertaken to monitor the trend revealed that the excess persisted into 1993. A feasibility assessment of further studies was made, and ultimately, an investigation was conducted to document the epidemiologic characteristics of the excess in detail and to explore possible causes through a case-series records review. Findings from the investigation are the subject of this report.

  8. Incidence and prevalence of treated epilepsy among poor health and low-income Americans

    PubMed Central

    Bakaki, Paul M.; Lhatoo, Samden D.; Koroukian, Siran

    2013-01-01

    Objectives: To determine the incidence and prevalence of treated epilepsy in an adult Medicaid population. Methods: We performed a retrospective, dynamic cohort analysis using Ohio Medicaid claims data between 1992 and 2006. Individuals aged 18–64 years were identified as prevalent cases if they had ≥2 claims of epilepsy (ICD-9-CM: 345.xx) or ≥3 claims of convulsion (ICD-9-CM: 780.3 or 780.39) and ≥2 claims of antiepileptic drugs. Incident cases were required to have no epilepsy or convulsion claims for ≥5 years before epilepsy diagnosis. Subjects were determined as having preexisting disability and/or comorbid conditions, including brain tumor, depression, developmental disorders, migraine, schizophrenia, stroke, and traumatic brain injury, when at least one of these conditions occurred before epilepsy onset. Results: There were 9,056 prevalent cases of treated epilepsy in 1992–2006 and 1,608 incident cases in 1997–2006. The prevalence was 13.2/1,000 (95% confidence interval, 13.0–13.5/1,000). The incidence was 362/100,000 person-years (95% confidence interval, 344–379/100,000 person-years). The incidence and prevalence were significantly higher in men, in older people, in blacks, and in people with preexisting disability and/or comorbid conditions. The most common preexisting conditions in epilepsy subjects were depression, developmental disorders, and stroke, whereas people with brain tumor, traumatic brain injury, and stroke had the higher risk of developing epilepsy. Conclusions: The Medicaid population has a high incidence and prevalence of epilepsy, in an order of magnitude greater than that reported in the US general population. This indigent population carries a disproportionate amount of the epilepsy burden and deserves more attention for its health care needs and support services. PMID:23616158

  9. Metastatic brain tumor

    MedlinePlus

    Brain tumor - metastatic (secondary); Cancer - brain tumor (metastatic) ... For many people with metastatic brain tumors, the cancer is not curable. It will eventually spread to other areas of the body. Prognosis depends on the type of tumor and ...

  10. Special Report: Brain Chemistry.

    ERIC Educational Resources Information Center

    Krassner, Michael B.

    1983-01-01

    Chemical actions in the brain result in cognitive, emotional, neuroendocrine, neuromuscular, and/or neurocirculatory effects. Developments in understanding brain chemistry are discussed, considering among others, neurotransmitter chemistry, neuropeptides, drugs and the brain, antidepressants, and actions of minor tranquilizers. (JN)

  11. That's Using Your Brain!

    ERIC Educational Resources Information Center

    Visser, Dana R.

    1996-01-01

    Discusses new adult learning theories, including those of Roger Sperry (left brain/right brain), Paul McLean (triune brain), and Howard Gardner (multiple intelligences). Relates adult learning theory to training. (JOW)

  12. Special Report: Brain Chemistry.

    ERIC Educational Resources Information Center

    Krassner, Michael B.

    1983-01-01

    Chemical actions in the brain result in cognitive, emotional, neuroendocrine, neuromuscular, and/or neurocirculatory effects. Developments in understanding brain chemistry are discussed, considering among others, neurotransmitter chemistry, neuropeptides, drugs and the brain, antidepressants, and actions of minor tranquilizers. (JN)

  13. Brain-based Learning.

    ERIC Educational Resources Information Center

    Weiss, Ruth Palombo

    2000-01-01

    Discusses brain research and how new imaging technologies allow scientists to explore how human brains process memory, emotion, attention, patterning, motivation, and context. Explains how brain research is being used to revise learning theories. (JOW)

  14. American Brain Tumor Association

    MedlinePlus

    ... Molecule Read More ABTA News April 6, 2017 Chicago-Based American Brain Tumor Association’s Breakthrough for Brain ... Association 8550 W. Bryn Mawr Ave. Ste 550 Chicago, IL 60631 © 2014 American Brain Tumor Association Phone: ...

  15. That's Using Your Brain!

    ERIC Educational Resources Information Center

    Visser, Dana R.

    1996-01-01

    Discusses new adult learning theories, including those of Roger Sperry (left brain/right brain), Paul McLean (triune brain), and Howard Gardner (multiple intelligences). Relates adult learning theory to training. (JOW)

  16. Pediatric Brain Tumor Foundation

    MedlinePlus

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... Pediatric Brain Tumor Foundation Board Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  17. Baby Brain Map

    MedlinePlus

    ... a Member Home Resources & Services Professional Resource Baby Brain Map Mar 17, 2016 The Brain Map was adapted in 2006 by ZERO TO ... on the age range, different hotspots on the brain will appear. Click on a hotspot to reveal ...

  18. Mild Traumatic Brain Injury

    MedlinePlus

    ... Questions Glossary Contact Us Visitor Feedback mild Traumatic Brain Injury mild Traumatic Brain Injury VIDEO STORIES What is TBI Measuring Severity ... most common deployment injuries is a mild Traumatic Brain Injury (TBI). A mild TBI is an injury ...

  19. Traumatic Brain Injury

    MedlinePlus

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  20. Cancer incidence in British vegetarians

    PubMed Central

    Key, T J; Appleby, P N; Spencer, E A; Travis, R C; Allen, N E; Thorogood, M; Mann, J I

    2009-01-01

    Background: Few prospective studies have examined cancer incidence among vegetarians. Methods: We studied 61 566 British men and women, comprising 32 403 meat eaters, 8562 non-meat eaters who did eat fish (‘fish eaters') and 20 601 vegetarians. After an average follow-up of 12.2 years, there were 3350 incident cancers of which 2204 were among meat eaters, 317 among fish eaters and 829 among vegetarians. Relative risks (RRs) were estimated by Cox regression, stratified by sex and recruitment protocol and adjusted for age, smoking, alcohol, body mass index, physical activity level and, for women only, parity and oral contraceptive use. Results: There was significant heterogeneity in cancer risk between groups for the following four cancer sites: stomach cancer, RRs (compared with meat eaters) of 0.29 (95% CI: 0.07–1.20) in fish eaters and 0.36 (0.16–0.78) in vegetarians, P for heterogeneity=0.007; ovarian cancer, RRs of 0.37 (0.18–0.77) in fish eaters and 0.69 (0.45–1.07) in vegetarians, P for heterogeneity=0.007; bladder cancer, RRs of 0.81 (0.36–1.81) in fish eaters and 0.47 (0.25–0.89) in vegetarians, P for heterogeneity=0.05; and cancers of the lymphatic and haematopoietic tissues, RRs of 0.85 (0.56–1.29) in fish eaters and 0.55 (0.39–0.78) in vegetarians, P for heterogeneity=0.002. The RRs for all malignant neoplasms were 0.82 (0.73–0.93) in fish eaters and 0.88 (0.81–0.96) in vegetarians (P for heterogeneity=0.001). Conclusion: The incidence of some cancers may be lower in fish eaters and vegetarians than in meat eaters. PMID:19536095

  1. The Australian Incident Monitoring Study. Crisis management--validation of an algorithm by analysis of 2000 incident reports.

    PubMed

    Runciman, W B; Webb, R K; Klepper, I D; Lee, R; Williamson, J A; Barker, L

    1993-10-01

    Anaesthetists are called upon to manage complex life-threatening crises at a moment's notice. As there is evidence that this may require cognitive tasking beyond the information-processing capacity of the human brain, it was decided to try and develop a generic crisis management algorithm analogous to the "Phase I" immediate response routine used by airline pilots. Such an algorithm, based on the mnemonic "COVER ABCD, A SWIFT CHECK", was developed and refined over 3 meetings, each attended by 60-100 anaesthetists and aviation psychologists. It was validated against 1301 relevant incidents among the first 2000 incidents reported to the Australian Incident Monitoring Study. It proved sufficiently robust and safe to recommend its general use as an initial response to any incident or crisis which occurs when a patient is breathing gas from an anesthetic machine. It requires a limited knowledge base and is easily learnt and rehearsed during the anaesthetist's working day. It will provide a functional diagnosis in over 99% of cases and will correct 62% of the problems in 40-60 seconds. In the remaining 37% it will allow the anaesthetist to proceed with a "sub-algorithm", confident in the knowledge that some important step has not been missed. In just over 30% of incidents this will be for a problem familiar to all anaesthetists (e.g. laryngospasm, bradycardia); in just over 6% it will be for a less common, more complex, but finite, set of problems (3% cardiac arrest, 1% air embolism, 1% anaphylaxis, 1% for the remaining desaturations); in less than 1% diagnosis and correction will require a more complex checklist (e.g. for malignant hyperthermia, pneumothorax). The next stage, the development of specific sub-algorithms and a structured team approach for ongoing problems, is in progress.

  2. Pediatric Rodent Models of Traumatic Brain Injury.

    PubMed

    Semple, Bridgette D; Carlson, Jaclyn; Noble-Haeusslein, Linda J

    2016-01-01

    Due to a high incidence of traumatic brain injury (TBI) in children and adolescents, age-specific studies are necessary to fully understand the long-term consequences of injuries to the immature brain. Preclinical and translational research can help elucidate the vulnerabilities of the developing brain to insult, and provide model systems to formulate and evaluate potential treatments aimed at minimizing the adverse effects of TBI. Several experimental TBI models have therefore been scaled down from adult rodents for use in juvenile animals. The following chapter discusses these adapted models for pediatric TBI, and the importance of age equivalence across species during model development and interpretation. Many neurodevelopmental processes are ongoing throughout childhood and adolescence, such that neuropathological mechanisms secondary to a brain insult, including oxidative stress, metabolic dysfunction and inflammation, may be influenced by the age at the time of insult. The long-term evaluation of clinically relevant functional outcomes is imperative to better understand the persistence and evolution of behavioral deficits over time after injury to the developing brain. Strategies to modify or protect against the chronic consequences of pediatric TBI, by supporting the trajectory of normal brain development, have the potential to improve quality of life for brain-injured children.

  3. Incidence of clubfoot in Uganda.

    PubMed

    Mathias, Richard G; Lule, Joseph Konde; Waiswa, Gonzaga; Naddumba, Edward K; Pirani, Shafique

    2010-01-01

    While the congenital clubfoot deformity is a common deformity recorded in Uganda, the incidence of the condition had never been accurately determined. The objective of this study was to measure the overall incidence of congenital clubfoot deformity in a representative sample of births. A study of all babies born with foot anomalies took place from March 2006 to October 2007. The study was based at 8 Regional Hospitals with active maternity units and a functioning clubfoot clinic. All babies with foot deformities at birth at any of eight centres as detected by the delivery room staff were referred to the respective centre's clubfoot clinic. The children were examined by clubfoot clinic orthopedic officers who diagnosed the specific deformity. Children referred to the clinic from any source and born at the maternity unit were included in the study. The denominator was all live births at the centre during the study period. The total number of live births during the study period was 110,336. The maternity units of the centres identified 290 infants with a foot deformity. One hundred and thirty infants born during the study period were diagnosed in the clubfoot clinic as having a congenital clubfoot deformity. The proportion of infants with a clubfoot deformity was 1.2 per 1000 births over the 20-month period. The male to female ratio was 2.4:1. The rate of clubfoot deformities in the newborn can be used to estimate the numbers of children who should be treated and to estimate resource needs for the identification and management of this treatable congenital malformation. By comparing the number of those treated with the expected number of cases, the numbers of children with neglected clubfoot can be calculated.

  4. Factors affecting the incidence of hypertension.

    PubMed Central

    Buck, C W; Donner, A P

    1987-01-01

    The incidence of hypertension was determined among 10,173 patients of general practices in southwestern Ontario studied from 1978 to 1982. For both sexes the incidence of hypertension rose with increasing age. The incidence was higher among men than among women until age 50, after which it was similar for the two sexes. Obesity was positively associated with incidence for both sexes. In men this association diminished significantly with increasing age. The similar trend in women fell just short of statistical significance. In men but not women heavy alcohol consumption was positively related to the incidence of hypertension. However, the broad definition of this variable may have obscured a relation in women. Among men the effect of obesity on the incidence of hypertension was less for heavy drinkers than for light drinkers. Smoking was not related to the incidence of hypertension in either sex. PMID:3815197

  5. Left brain, right brain: facts and fantasies.

    PubMed

    Corballis, Michael C

    2014-01-01

    Handedness and brain asymmetry are widely regarded as unique to humans, and associated with complementary functions such as a left-brain specialization for language and logic and a right-brain specialization for creativity and intuition. In fact, asymmetries are widespread among animals, and support the gradual evolution of asymmetrical functions such as language and tool use. Handedness and brain asymmetry are inborn and under partial genetic control, although the gene or genes responsible are not well established. Cognitive and emotional difficulties are sometimes associated with departures from the "norm" of right-handedness and left-brain language dominance, more often with the absence of these asymmetries than their reversal.

  6. [Circulating immune complexes in acute concussion of the brain].

    PubMed

    Midlenko, A I; Biktimirov, T Z; Garmashov, Iu A; Smirnova, M A; Smol'ianinova, V P

    2000-01-01

    The aim of the study was to study the count of circulating immune complexes (CIC) in the blood of children with acute concussion of the brain. The fact that CIC at high concentrations that can penetrate into the brain through the blood-brain barrier and cause complications as vasculitis, microangiopathy, proliferative processes in the meninges, enlarged ventricles of the brain, and atrophy of its tissue was borne in mind. The studies revealed a significant progressive CIC increase within 3 weeks. For correction of blood CIC levels, laser exposure was applied to the carotid and vertebral arteries and acupuncture points. For comparison, thymaline in age-specific doses was used. Laser radiation showed a significant fall of CIC at days 19-21, particular when applied to the acupuncture points. Thymaline did not affect blood CIC levels. Laser application to the acupuncture points in children with acute brain concussion should reduce the incidence of complications of brain injury disease.

  7. Smoking and incidence of glaucoma

    PubMed Central

    Pérez-de-Arcelus, Mónica; Toledo, Estefanía; Martínez-González, Miguel Á.; Martín-Calvo, Nerea; Fernández-Montero, Alejandro; Moreno-Montañés, Javier

    2017-01-01

    Abstract Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma. In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis. During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26–2.81]; P = 0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88–1.82]; P = 0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose–response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10–2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. (HR 0.67 [95% CI: 0.37–1.21]; P = 0.189). Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers. PMID:28072720

  8. Computer Simulation for Emergency Incident Management

    SciTech Connect

    Brown, D L

    2004-12-03

    This report describes the findings and recommendations resulting from the Department of Homeland Security (DHS) Incident Management Simulation Workshop held by the DHS Advanced Scientific Computing Program in May 2004. This workshop brought senior representatives of the emergency response and incident-management communities together with modeling and simulation technologists from Department of Energy laboratories. The workshop provided an opportunity for incident responders to describe the nature and substance of the primary personnel roles in an incident response, to identify current and anticipated roles of modeling and simulation in support of incident response, and to begin a dialog between the incident response and simulation technology communities that will guide and inform planned modeling and simulation development for incident response. This report provides a summary of the discussions at the workshop as well as a summary of simulation capabilities that are relevant to incident-management training, and recommendations for the use of simulation in both incident management and in incident management training, based on the discussions at the workshop. In addition, the report discusses areas where further research and development will be required to support future needs in this area.

  9. Estimating magnitude and duration of incident delays

    SciTech Connect

    Garib, A.; Radwan, A.E.; Al-Deek, H.

    1997-11-01

    Traffic congestion is a major operational problem on urban freeways. In the case of recurring congestion, travelers can plan their trips according to the expected occurrence and severity of recurring congestion. However, nonrecurring congestion cannot be managed without real-time prediction. Evaluating the efficiency of intelligent transportation systems (ITS) technologies in reducing incident effects requires developing models that can accurately predict incident duration along with the magnitude of nonrecurring congestion. This paper provides two statistical models for estimating incident delay and a model for predicting incident duration. The incident delay models showed that up to 85% of variation in incident delay can be explained by incident duration, number of lanes affected, number of vehicles involved, and traffic demand before the incident. The incident duration prediction model showed that 81% of variation in incident duration can be predicted by number of lanes affected, number of vehicles involved, truck involvement, time of day, police response time, and weather condition. These findings have implications for on-line applications within the context of advanced traveler information systems (ATIS).

  10. Improving incident reporting among junior doctors

    PubMed Central

    Hotton, Emily; Jordan, Lesley; Peden, Carol

    2014-01-01

    To ensure systems in hospitals improve to make patient care safer, learning must occur when things go wrong. Incident reporting is one of the commonest mechanisms used to learn from harm events and near misses. Only a relatively small number of incidents that occur are actually reported and different groups of staff have different rates of reporting. Nationally, junior doctors are low reporters of incidents, a finding supported by our local data. We set out to explore the culture and awareness around incident reporting among our junior doctors, and to improve the incident reporting rate within this important staff group. In order to achieve this we undertook a number of work programmes focused on junior doctors, including: assessment of their knowledge, confidence and understanding of incident reporting, education on how and why to report incidents with a focus on reporting on clinical themes during a specific time period, and evaluation of the experience of those doctors who reported incidents. Junior doctors were asked to focus on incident reporting during a one week period. Before and after this focussed week, they were invited to complete a questionnaire exploring their confidence about what an incident was and how to report. Prior to “Incident Reporting Week”, on average only two reports were submitted a month by junior doctors compared with an average of 15 per month following the education and awareness week. This project highlights the fact that using a focussed reporting period and/or specific clinical themes as an education tool can benefit a hospital by promoting awareness of incidents and by increasing incident reporting rates. This can only assist in improving hospital systems, and ultimately increase patient safety. PMID:26734264

  11. Improving incident reporting among junior doctors.

    PubMed

    Hotton, Emily; Jordan, Lesley; Peden, Carol

    2014-01-01

    To ensure systems in hospitals improve to make patient care safer, learning must occur when things go wrong. Incident reporting is one of the commonest mechanisms used to learn from harm events and near misses. Only a relatively small number of incidents that occur are actually reported and different groups of staff have different rates of reporting. Nationally, junior doctors are low reporters of incidents, a finding supported by our local data. We set out to explore the culture and awareness around incident reporting among our junior doctors, and to improve the incident reporting rate within this important staff group. In order to achieve this we undertook a number of work programmes focused on junior doctors, including: assessment of their knowledge, confidence and understanding of incident reporting, education on how and why to report incidents with a focus on reporting on clinical themes during a specific time period, and evaluation of the experience of those doctors who reported incidents. Junior doctors were asked to focus on incident reporting during a one week period. Before and after this focussed week, they were invited to complete a questionnaire exploring their confidence about what an incident was and how to report. Prior to "Incident Reporting Week", on average only two reports were submitted a month by junior doctors compared with an average of 15 per month following the education and awareness week. This project highlights the fact that using a focussed reporting period and/or specific clinical themes as an education tool can benefit a hospital by promoting awareness of incidents and by increasing incident reporting rates. This can only assist in improving hospital systems, and ultimately increase patient safety.

  12. Multimodal brain monitoring reduces major neurologic complications in cardiac surgery.

    PubMed

    Zanatta, Paolo; Messerotti Benvenuti, Simone; Bosco, Enrico; Baldanzi, Fabrizio; Palomba, Daniela; Valfrè, Carlo

    2011-12-01

    Although adverse neurologic outcomes are common complications of cardiac surgery, intraoperative brain monitoring has not received adequate attention. The aim of the present study was to evaluate the effectiveness of multimodal brain monitoring in the prevention of major brain injury and reducing the duration of mechanical ventilation, intensive care unit, and postoperative hospital stays after cardiac surgery. A retrospective, observational, controlled study. A single-center regional hospital. One thousand seven hundred twenty-one patients who had undergone cardiac surgery with cardiopulmonary bypass from July 2007 to July 2010. One hundred sixty-six patients with multimodal brain monitoring and a control group without brain monitoring (N = 1,555) were compared retrospectively. Multimodal brain monitoring was performed for 166 patients, consisting of intraoperative recordings of somatosensory-evoked potentials, electroencephalography, and transcranial Doppler. The incidence of major neurologic complications and the duration of mechanical ventilation, intensive care unit, and postoperative hospital stays were considered. Patients with brain monitoring had a significantly lower incidence of perioperative major neurologic complications (0%) than those without monitoring (4.06%, p = 0.01) and required significantly shorter periods of mechanical ventilation (p = 0.001) and intensive care unit stays (p = 0.01) than controls. The length of postoperative hospital stays did not differ significantly between the 2 groups (p = 0.57). This preliminary study suggests that multimodal brain monitoring can reduce the incidence of neurologic complications as well as hospital costs associated with post-cardiac surgery patient care. Furthermore, intraoperative brain monitoring provides useful information about brain functioning, blood flow velocity, and metabolism, which may guide the anesthesiologist during surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Imaging brain development: the adolescent brain.

    PubMed

    Blakemore, Sarah-Jayne

    2012-06-01

    The past 15 years have seen a rapid expansion in the number of studies using neuroimaging techniques to investigate maturational changes in the human brain. In this paper, I review MRI studies on structural changes in the developing brain, and fMRI studies on functional changes in the social brain during adolescence. Both MRI and fMRI studies point to adolescence as a period of continued neural development. In the final section, I discuss a number of areas of research that are just beginning and may be the subject of developmental neuroimaging in the next twenty years. Future studies might focus on complex questions including the development of functional connectivity; how gender and puberty influence adolescent brain development; the effects of genes, environment and culture on the adolescent brain; development of the atypical adolescent brain; and implications for policy of the study of the adolescent brain. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Changes in convulsion susceptibility of lidocaine by alteration of brain catecholaminergic functions.

    PubMed

    Yoshimura, Y; Dohi, T; Tanaka, S; Takada, K; Tsujimoto, A

    1991-05-01

    Influences of the manipulation of brain catecholaminergic neuronal activity on the incidence of lidocaine-induced convulsions in mice were studied and compared with those of pentylenetetrazol (PTZ)-induced convulsions. alpha-Methyl-p-tyrosine (alpha-MPT) decreased both brain noradrenaline (NA) and dopamine (DA) levels, and disulfiram decreased the NA level and increased the DA level. The incidence of lidocaine-induced convulsions was decreased by treatments with alpha-MPT and disulfiram, while that of PTZ was increased by either treatment. The incidence of lidocaine-induced convulsions was slightly, but not significantly increased by L-dihydroxyphenylalanine (L-DOPA), although the brain DA level was increased by L-DOPA. Methamphetamine and desipramine increased the incidences of lidocaine-induced convulsions. These results may suggest that brain catecholaminergic neurons, differing from their role in inhibiting control of PTZ-seizure, act to facilitate lidocaine-induced convulsions.

  15. Fuzzy Logic for Incidence Geometry

    PubMed Central

    2016-01-01

    The paper presents a mathematical framework for approximate geometric reasoning with extended objects in the context of Geography, in which all entities and their relationships are described by human language. These entities could be labelled by commonly used names of landmarks, water areas, and so forth. Unlike single points that are given in Cartesian coordinates, these geographic entities are extended in space and often loosely defined, but people easily perform spatial reasoning with extended geographic objects “as if they were points.” Unfortunately, up to date, geographic information systems (GIS) miss the capability of geometric reasoning with extended objects. The aim of the paper is to present a mathematical apparatus for approximate geometric reasoning with extended objects that is usable in GIS. In the paper we discuss the fuzzy logic (Aliev and Tserkovny, 2011) as a reasoning system for geometry of extended objects, as well as a basis for fuzzification of the axioms of incidence geometry. The same fuzzy logic was used for fuzzification of Euclid's first postulate. Fuzzy equivalence relation “extended lines sameness” is introduced. For its approximation we also utilize a fuzzy conditional inference, which is based on proposed fuzzy “degree of indiscernibility” and “discernibility measure” of extended points. PMID:27689133

  16. [Familial incidence of myelodysplastic syndromes].

    PubMed

    Wróbel, Tomasz; Mazur, Grzegorz; Pyszel, Angelika; Biedroń, Monika; Kuliczkowski, Kazimierz

    2006-01-01

    The myelodysplastic syndromes (MDS) are heterogeneous group of clonal disorders of hematopoietic stem cells, which manifestation is cytopenia and hypercellular, dysplastic bone marrow, often with increased amount of blasts. The pathogenesis of majority of MDS remains unexplained. It is regarded that genetic predisposition and exposure to toxic environmental agents contribute to genetic mutations in MDS. Molecular abnormalities have attracted interest over past years because of their presence in most cases of MDS, even without noticeable disorders in kariotype. Familial incidence of myelodysplastic syndromes may be helpful in understanding genetic factors of the disease. We describe two families in which MDS occurred in siblings (3 brothers; sister and brother). Kariotype abnormalities have been noted only in one person of each family. The rest of patients had a normal kariotype. This suggests that molecular abnormalities are the cause of their disease. The occupational exposure to precise mutagens (aluminium, greases, diesels, petrol, metals) was noted in two persons in the first family and correspondingly in one person in the second. There was absence of one mutagen common for every member of two reported families.

  17. Fuzzy Logic for Incidence Geometry.

    PubMed

    Tserkovny, Alex

    The paper presents a mathematical framework for approximate geometric reasoning with extended objects in the context of Geography, in which all entities and their relationships are described by human language. These entities could be labelled by commonly used names of landmarks, water areas, and so forth. Unlike single points that are given in Cartesian coordinates, these geographic entities are extended in space and often loosely defined, but people easily perform spatial reasoning with extended geographic objects "as if they were points." Unfortunately, up to date, geographic information systems (GIS) miss the capability of geometric reasoning with extended objects. The aim of the paper is to present a mathematical apparatus for approximate geometric reasoning with extended objects that is usable in GIS. In the paper we discuss the fuzzy logic (Aliev and Tserkovny, 2011) as a reasoning system for geometry of extended objects, as well as a basis for fuzzification of the axioms of incidence geometry. The same fuzzy logic was used for fuzzification of Euclid's first postulate. Fuzzy equivalence relation "extended lines sameness" is introduced. For its approximation we also utilize a fuzzy conditional inference, which is based on proposed fuzzy "degree of indiscernibility" and "discernibility measure" of extended points.

  18. Brain AVM (Arteriovenous Malformation)

    MedlinePlus

    ... a brain scan for another health issue or after the blood vessels rupture and cause bleeding in the brain (hemorrhage). Once diagnosed, a brain AVM can often be treated successfully to prevent complications, such as brain damage or stroke. Find out why Mayo Clinic is the best ...

  19. Experimental missile wound to the brain.

    PubMed

    Carey, M E; Sarna, G S; Farrell, J B; Happel, L T

    1989-11-01

    Among civilians in the United States, 33,000 gunshot wound deaths occur each year; probably half of these involve the head. In combat, head wounds account for approximately half of the immediate mortality when death can be attributed to a single wound. No significant reduction in the neurosurgical mortality associated with these wounds has occurred between World War II and the Vietnam conflict, and very little research into missile wounds of the brain has been undertaken. An experimental model has been developed in the anesthetized cat whereby a ballistic injury to the brain may be painlessly reproduced in order that the pathophysiological effects of brain wounding may be studied and better treatments may be designed to lower the mortality and morbidity rates associated with gunshot wounds. Prominent among physiological effects observed in this model was respiratory arrest even though the missile did not injure the brain stem directly. The incidence of prolonged respiratory arrest increased with increasing missile energy, but arrest was often reversible provided respiratory support was given. It is possible that humans who receive a brain wound die from missile-induced apnea instead of brain damage per se. The mortality rate in humans with brain wounding might be reduced by prompt respiratory support. Brain wounding was associated with persistently increased intracranial pressure and reduced cerebral perfusion pressure not entirely attributable to intracranial bleeding. The magnitude of these derangements appeared to be missile energy-dependent and approached dangerous levels in higher-energy wounds. All wounded cats exhibited postwounding increases in blood glucose concentrations consistent with a generalized stress reaction. A transient rise in hematocrit also occurred immediately after wounding. Both of these phenomena could prove deleterious to optimal brain function after injury.

  20. Dissection of the Process of Brain Metastasis Reveals Targets and Mechanisms for Molecular-based Intervention.

    PubMed

    Weidle, Ulrich H; Birzele, Fabian; Kollmorgen, Gwendlyn; Rüger, Rüdiger

    2016-01-01

    Brain metastases outnumber the incidence of brain tumors by a factor of ten. Patients with brain metastases have a dismal prognosis and current treatment modalities achieve only a modest clinical benefit. We discuss the process of brain metastasis with respect to mechanisms and involved targets to outline options for therapeutic intervention and focus on breast and lung cancer, as well as melanoma. We describe the process of penetration of the blood-brain-barrier (BBB) by disseminated tumor cells, establishment of a metastatic niche, colonization and outgrowth in the brain parenchyma. Furthermore, the role of angiogenesis in colonization of the brain parenchyma, interactions of extravasated tumor cells with microglia and astrocytes, as well as their propensity for neuromimicry, is discussed. We outline targets suitable for prevention of metastasis and summarize targets suitable for treatment of established brain metastases. Finally, we highlight the implications of findings revealing druggable mutations in brain metastases that cannot be identified in matching primary tumors.

  1. Brain evolution by brain pathway duplication

    PubMed Central

    Chakraborty, Mukta; Jarvis, Erich D.

    2015-01-01

    Understanding the mechanisms of evolution of brain pathways for complex behaviours is still in its infancy. Making further advances requires a deeper understanding of brain homologies, novelties and analogies. It also requires an understanding of how adaptive genetic modifications lead to restructuring of the brain. Recent advances in genomic and molecular biology techniques applied to brain research have provided exciting insights into how complex behaviours are shaped by selection of novel brain pathways and functions of the nervous system. Here, we review and further develop some insights to a new hypothesis on one mechanism that may contribute to nervous system evolution, in particular by brain pathway duplication. Like gene duplication, we propose that whole brain pathways can duplicate and the duplicated pathway diverge to take on new functions. We suggest that one mechanism of brain pathway duplication could be through gene duplication, although other mechanisms are possible. We focus on brain pathways for vocal learning and spoken language in song-learning birds and humans as example systems. This view presents a new framework for future research in our understanding of brain evolution and novel behavioural traits. PMID:26554045

  2. Brain evolution by brain pathway duplication.

    PubMed

    Chakraborty, Mukta; Jarvis, Erich D

    2015-12-19

    Understanding the mechanisms of evolution of brain pathways for complex behaviours is still in its infancy. Making further advances requires a deeper understanding of brain homologies, novelties and analogies. It also requires an understanding of how adaptive genetic modifications lead to restructuring of the brain. Recent advances in genomic and molecular biology techniques applied to brain research have provided exciting insights into how complex behaviours are shaped by selection of novel brain pathways and functions of the nervous system. Here, we review and further develop some insights to a new hypothesis on one mechanism that may contribute to nervous system evolution, in particular by brain pathway duplication. Like gene duplication, we propose that whole brain pathways can duplicate and the duplicated pathway diverge to take on new functions. We suggest that one mechanism of brain pathway duplication could be through gene duplication, although other mechanisms are possible. We focus on brain pathways for vocal learning and spoken language in song-learning birds and humans as example systems. This view presents a new framework for future research in our understanding of brain evolution and novel behavioural traits. © 2015 The Authors.

  3. Neurologic features of chronic minamata disease (organic mercury poisoning) and incidence of complications with aging.

    PubMed

    Uchino, M; Tanaka, Y; Ando, Y; Yonehara, T; Hara, A; Mishima, I; Okajima, T; Ando, M

    1995-09-01

    To elucidate the neurologic features of chronic Minamata disease, and the incidence of complications with aging, we studied 80 patients with documented Minamata disease (organic mercury poisoning) from 1986 to 1994 (mean age: 63 years). Of the cardinal neurologic findings, sensory impairment was seen with highest frequency in 98.8% of patients limited to the extremities in 86.3%. Impairment of lower extremity coordination was observed in 60%, constriction of the visual field in 51.9%, and retrocochlear hearing loss in 41%. To assess age-related complications, patients were separated into three groups by age: Group I (10 to 39 years); Group II (40 to 69 years); Group III (> or = 70 years). The incidences of hypertension and cerebrovascular diseases, organic ophthalmologic disorders (including cataracts), presbyacusis, and cervical spondylosis deformans increased significantly with age. Compared with a preceding survey (1981 to 1985, 171 patients, mean age: 63.5 years), the incidences of complicated hypertension and cataracts had decreased, whereas those of cerebrovascular disease and retinitis pigmentosa remained unchanged. The incidences of abnormal brain computed tomography (CT), presbyacusis, cervical spondylosis deformans, and positive tests for urine sugar also increased. The incidences of these complications other than retinitis pigmentosa were similar to those in the general population. These results accurately reflect the recent epidemiological disease tendencies in Japan toward a decreased incidence of hypertension and an increased incidence of diabetes.

  4. A generative model for predicting terrorist incidents

    NASA Astrophysics Data System (ADS)

    Verma, Dinesh C.; Verma, Archit; Felmlee, Diane; Pearson, Gavin; Whitaker, Roger

    2017-05-01

    A major concern in coalition peace-support operations is the incidence of terrorist activity. In this paper, we propose a generative model for the occurrence of the terrorist incidents, and illustrate that an increase in diversity, as measured by the number of different social groups to which that an individual belongs, is inversely correlated with the likelihood of a terrorist incident in the society. A generative model is one that can predict the likelihood of events in new contexts, as opposed to statistical models which are used to predict the future incidents based on the history of the incidents in an existing context. Generative models can be useful in planning for persistent Information Surveillance and Reconnaissance (ISR) since they allow an estimation of regions in the theater of operation where terrorist incidents may arise, and thus can be used to better allocate the assignment and deployment of ISR assets. In this paper, we present a taxonomy of terrorist incidents, identify factors related to occurrence of terrorist incidents, and provide a mathematical analysis calculating the likelihood of occurrence of terrorist incidents in three common real-life scenarios arising in peace-keeping operations

  5. 42 CFR 73.14 - Incident response.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... procedures for failure of intrusion detection or alarm system; and (2) The incident response plan must... select agent or toxin; inventory discrepancies; security breaches (including information systems); severe...

  6. 42 CFR 73.14 - Incident response.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... procedures for failure of intrusion detection or alarm system; and (2) The incident response plan must... select agent or toxin; inventory discrepancies; security breaches (including information systems); severe...

  7. Is there a gender difference in concussion incidence and outcomes?

    PubMed

    Dick, R W

    2009-05-01

    To determine if there is a gender difference in the incidence and outcomes of sport concussion. Critical literature review of sport concussion by gender. PubMed and major sports medicine journals were reviewed using the keywords concussion and gender. Articles included in this paper were English prospective surveillance that included concussion as an injury option conducted over the past 10 years, involved data collected by qualified medical personnel (athletic trainers/therapists or medical doctors) and used injury rates as opposed to raw counts. Only data from sports (soccer, basketball and ice hockey) where actions, equipment and most rules were similar between genders were reviewed. For the PubMed search, using "concussion" and "gender" as keywords, there were 51 articles. Ten studies (four in football (soccer), four in basketball and two in ice hockey, including high school, college and professional athletes) were included in the incidence portion of the paper. Nine of the studies showed higher absolute injury rates for female concussion compared to their male counterparts with four of them reaching statistical significance. Five of the studies (two football (soccer), two basketball and one ice hockey) examined concussion mechanism and in all cases, males had a higher absolute percent of player contact concussions while females had a higher absolute percentage of surface or ball contact concussion episodes. Two brain injury and four sport concussion outcome papers were reviewed. Traumatic brain injury outcome was shown to be worse in females than in males for a majority of measured variables; females also are shown to have different baseline and post-concussion outcomes on neuropsychological testing. After evaluating multiple years of concussion data in comparable sports, the evidence indicates that female athletes may be at greater risk for concussion than their male counterparts. There also is some evidence that gender differences exist in outcomes of

  8. Cancer incidence among male railway engine-drivers and conductors in Sweden, 1976-90.

    PubMed

    Alfredsson, L; Hammar, N; Karlehagen, S

    1996-05-01

    During recent years, the relationship between exposure to magnetic fields and cancer has attracted increasing interest. In Sweden, train personnel are exposed to comparatively strong magnetic fields in their work. The aim of the present study was to investigate cancer incidence, particularly leukemia and brain tumors, among male railway engine drivers and conductors, respectively, and to compare their cancer incidence with that of the general male population. The study population comprised all male railway engine drivers (n = 7,466) and conductors (n = 2,272) who were ever employed at the Swedish State Railways during the period 1976-90. The study population was observed with regard to cancer incidence by means of the National Cancer Register for the period 1976-90. The total cancer incidence (all tumors included) among railway engine drivers was lower than in the general Swedish population. An increased incidence of lymphocytic leukemia was observed among railway engine drivers and conductors combined (relative risk = 2.3; 95 percent confidence interval = 1.3-3.2), with the same point estimate for both occupational groups. For brain tumor (astrocytoma), the observed relative risk was close to one. The study provides evidence of an excess risk of lymphocytic leukemia in railway engine drivers and conductors, workers with known occupational exposure to magnetic fields.

  9. Glancing incidence vs. multilayer coated normal incidence mirrors for EUV telescopes.

    NASA Astrophysics Data System (ADS)

    Wright, G.; Keski-Kuha, R. A. M.

    1989-07-01

    EUV telescopes are typically Wolter Type II telescopes, made with glancing incidence mirrors. Recent developments in multilayer coatings have opened up the possibility of using normal incidence mirrors in a Cassegrain configuration for EUV telescopes. Each of these approaches has advantages and disadvantages. Glancing incidence mirrors have a higher reflectivity with a broad bandwidth, but the surfaces are difficult to make. Normal incidence mirrors are easier to fabricate to the necessary surface requirements, but require coatings with acceptable reflectivity only in a narrow bandpass. The authors discuss the technical tradeoffs of using glancing incidence and normal incidence mirrors for EUV telescopes.

  10. 33 CFR 146.45 - Pollution incidents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Pollution incidents. 146.45...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.45 Pollution incidents. Oil pollution.... Additional provisions concerning liability and compensation because of oil pollution are contained in...

  11. 33 CFR 146.45 - Pollution incidents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Pollution incidents. 146.45...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.45 Pollution incidents. Oil pollution.... Additional provisions concerning liability and compensation because of oil pollution are contained in...

  12. 33 CFR 146.45 - Pollution incidents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Pollution incidents. 146.45...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.45 Pollution incidents. Oil pollution.... Additional provisions concerning liability and compensation because of oil pollution are contained in...

  13. 33 CFR 146.45 - Pollution incidents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Pollution incidents. 146.45...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.45 Pollution incidents. Oil pollution.... Additional provisions concerning liability and compensation because of oil pollution are contained in...

  14. 33 CFR 146.45 - Pollution incidents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Pollution incidents. 146.45...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.45 Pollution incidents. Oil pollution.... Additional provisions concerning liability and compensation because of oil pollution are contained in...

  15. Critical incident stress debriefing in health care.

    PubMed

    Freehill, K M

    1992-07-01

    Transport team professionals have unique responsibilities and are exposed to powerful demands. They cannot avoid incidents that pose personal threats to their own emotional well being. Contact with dead or severely ill or injured children, for example, can be detrimental to the caregiver. Discussions called debriefings held after these critical incidents can decrease acute and delayed stress reactions.

  16. 49 CFR 1542.307 - Incident management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  17. Critical Incidents in ELT Initial Teacher Training

    ERIC Educational Resources Information Center

    Farrell, Thomas S. C.

    2008-01-01

    A critical incident is any unplanned event that occurs during class. In has been suggested that if trainee teachers formally reflect on these critical incidents, it may be possible for them to uncover new understandings of the teaching and learning process. This paper outlines and discusses how eighteen trainee teachers in an English language…

  18. Linux Incident Response Volatile Data Analysis Framework

    ERIC Educational Resources Information Center

    McFadden, Matthew

    2013-01-01

    Cyber incident response is an emphasized subject area in cybersecurity in information technology with increased need for the protection of data. Due to ongoing threats, cybersecurity imposes many challenges and requires new investigative response techniques. In this study a Linux Incident Response Framework is designed for collecting volatile data…

  19. The Incidence of Ankle Sprains in Orienteering.

    ERIC Educational Resources Information Center

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  20. How effective incident management retains market share.

    PubMed

    Enright, Courtenay

    2012-01-01

    This paper discusses the need for business continuity practitioners to make incident management a focal element of their programme. Particularly during the first few minutes and hours of a business disruption, an established incident management methodology is not only key to achieving a successful, coordinated recovery, but it can play an even more important role in maintaining customer confidence following a disruption or crisis.

  1. 40 CFR 68.60 - Incident investigation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Incident investigation. 68.60 Section 68.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.60 Incident investigation. (a...

  2. 40 CFR 68.60 - Incident investigation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Incident investigation. 68.60 Section 68.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.60 Incident investigation. (a...

  3. 40 CFR 68.60 - Incident investigation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Incident investigation. 68.60 Section 68.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.60 Incident investigation. (a...

  4. 40 CFR 68.60 - Incident investigation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Incident investigation. 68.60 Section 68.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.60 Incident investigation. (a...

  5. 40 CFR 68.60 - Incident investigation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Incident investigation. 68.60 Section 68.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.60 Incident investigation. (a...

  6. Decision modeling for fire incident analysis

    Treesearch

    Donald G. MacGregor; Armando González-Cabán

    2009-01-01

    This paper reports on methods for representing and modeling fire incidents based on concepts and models from the decision and risk sciences. A set of modeling techniques are used to characterize key fire management decision processes and provide a basis for incident analysis. The results of these methods can be used to provide insights into the structure of fire...

  7. Noticing Critical Incidents in a Mathematics Classroom

    ERIC Educational Resources Information Center

    Choy, Ban Heng

    2014-01-01

    What teachers attend to, how they make sense of, and respond to critical incidents in the classroom are important for improving teaching. However, seeing and understanding important features of critical incidents can be difficult. In this paper, I propose a notion of productive noticing, which I used to analyse a case study of what teachers…

  8. Problematic heroin use incidence trends in Spain.

    PubMed

    Sánchez-Niubò, Albert; Fortiana, Josep; Barrio, Gregorio; Suelves, Josep Maria; Correa, Juan Francisco; Domingo-Salvany, Antònia

    2009-02-01

    To estimate the annual incidence of heroin use in Spain. Data on individuals' year of first heroin use (from 1971 to 2005), year of first heroin treatment between 1991 and 2005 and most frequent route of heroin administration when presenting to treatment were obtained from the Spanish Drug Observatory Register and used to calculate the delay between onset and treatment. By using a log-linear model approach it was possible to correct for missing observations (heroin users who presented for treatment before 1991 and those who had still not presented by the end of 2005) and to estimate heroin incidence over time. The estimated incidence of problematic heroin use in the population aged 15-44 peaked at 190 per 100,000 in 1980--after rising rapidly from less than 40 per 100,000 in 1971--and fell subsequently to about 8 per 100,000 in 2005. On average, incidence was five times higher in men. Injecting heroin incidence peaked and declined rapidly from 1980; as heroin smoking did not decline as rapidly, from 1985 onwards its estimated incidence has remained above that of heroin injecting. The delay between starting heroin use and entering treatment had a median of 3 years. We demonstrate the utility of a method to estimate heroin incidence from analysis of observed trends in presentations at specialist drug treatment facilities. The estimates suggest that incidence of heroin use, especially injecting, has fallen since 1980 and is now lower than in the early 1970s.

  9. Improving Incident Reporting Among Physician Trainees.

    PubMed

    Krouss, Mona; Alshaikh, Jumana; Croft, Lindsay; Morgan, Daniel J

    2016-09-09

    Preventable medical harm is a leading cause of death in the United States. Incident reporting systems have been identified as the primary method to capture medical error and harm. Incidents are rarely reported, particularly among physician trainees. We conducted a single-center, quasi-experimental study to examine the effect of education on the importance of and how to file an incident report for physician trainees on reporting rates. Trainees were provided laminated plastic instructions, and reporting was reinforced with weekly patient safety rounds. In addition, trainees completed anonymous surveys preintervention and postintervention to determine barriers to reporting. A χ test compared the number of reports preintervention and postintervention. For 6 months, 73 resident physicians participated in the study. Median incident reports entered by trainees increased from 1 report per month during the preintervention period to 10 reports per month after the intervention (P = 0.005). The most common barriers to reporting incidents before intervention were not knowing how to report (72.6%), what to report (56.2%), and lack of time (42.5%). A total of 13.7% reported fear of retaliation. Most incident reports were due to delay in patient care (40.9%) and medical errors (33.3%). Real-time education and regular reinforcement increased incident reporting among resident physicians. This educational approach may increase incidence reporting in other institutions.

  10. Linux Incident Response Volatile Data Analysis Framework

    ERIC Educational Resources Information Center

    McFadden, Matthew

    2013-01-01

    Cyber incident response is an emphasized subject area in cybersecurity in information technology with increased need for the protection of data. Due to ongoing threats, cybersecurity imposes many challenges and requires new investigative response techniques. In this study a Linux Incident Response Framework is designed for collecting volatile data…

  11. Urinary Incontinence, Incident Parkinsonism, and Parkinson's Disease Pathology in Older Adults.

    PubMed

    Buchman, Noa M; Leurgans, Sue E; Shah, Raj J; VanderHorst, Veronique; Wilson, Robert S; Bachner, Yaacov G; Tanne, David; Schneider, Julie A; Bennett, David A; Buchman, Aron S

    2017-09-01

    To test the hypothesis that urinary incontinence (UI) is associated with incident parkinsonism in older adults. We used data from 2,617 older persons without dementia. Assessment included baseline self-report UI and annual structured exam which assessed parkinsonian signs, motor performances, cognitive function, and self-report disabilities. We used a series of Cox proportional hazards models to examine the association of UI with parkinsonism and adverse health outcomes and a mixed-effect model to examine the association of UI with the annual rate of cognitive decline. In decedents, regression models were used to examine if UI proximate to death was related to postmortem indices of neuropathologies. At baseline, more than 45% of participants reported some degree of UI. Over an average of nearly 8 years of follow-up, UI was associated with incident parkinsonism (hazard ratio [HR] = 1.07, 95% CI = 1.02, 1.12), death (HR = 1.07, 95% CI = 1.03, 1.11), incident ADL disability (HR = 1.11, 95% CI = 1.07, 1.16), and incident mobility disability (HR = 1.07, 95% CI = 1.02, 1.13). UI was not related to incident MCI (HR = 1.02, 95% CI = 0.97, 1.07), incident AD dementia (HR = 1.00, 95% CI = 0.95, 1.05) or to the rate of cognitive decline (Estimate = -.002, standard error = .002, p = .167). In 1,024 decedents with brain autopsy, UI proximate to death was related to PD pathology (Lewy body pathology and nigral neuronal loss), but not Alzheimer's disease pathology or other age-related neuropathologies. UI in older adults is associated with incident parkinsonism and may identify older adults at risk for accumulating PD brain pathology.

  12. The Austrian Brain Tumour Registry: a cooperative way to establish a population-based brain tumour registry.

    PubMed

    Wöhrer, Adelheid; Waldhör, Thomas; Heinzl, Harald; Hackl, Monika; Feichtinger, Johann; Gruber-Mösenbacher, Ulrike; Kiefer, Andreas; Maier, Hans; Motz, Reinhard; Reiner-Concin, Angelika; Richling, Bernd; Idriceanu, Carmen; Scarpatetti, Michael; Sedivy, Roland; Bankl, Hans-Christian; Stiglbauer, Wolfgang; Preusser, Matthias; Rössler, Karl; Hainfellner, Johannes Andreas

    2009-12-01

    In Austria, registration of malignant brain tumours is legally mandatory, whereas benign and borderline tumours are not reported. The Austrian Brain Tumour Registry (ABTR) was initiated under the auspices of the Austrian Society of Neuropathology for the registration of malignant and non-malignant brain tumours. All Austrian neuropathology units involved in brain tumour diagnostics contribute data on primary brain tumours. Non-microscopically verified cases are added by the Austrian National Cancer Registry to ensure a population-based dataset. In 2005, we registered a total of 1,688 newly diagnosed primary brain tumours in a population of 8.2 million inhabitants with an overall age-adjusted incidence rate of 18.1/100,000 person-years. Non-malignant cases constituted 866 cases (51.3%). The incidence rate was higher in females (18.6/100,000) as compared to males (17.8/100,000), while 95/1,688 (5.6%) cases were diagnosed in children (<18 years). The most common histology was meningioma (n = 504, 29.9%) followed by glioblastoma (n = 340, 20.1%) and pituitary adenoma (n = 151, 8.9%). Comparison with the Central Brain Tumor Registry of the United States (CBTRUS) database showed high congruency of findings. The ABTR model led by neuropathologists in collaboration with epidemiologists and the Austrian National Cancer Registry presents a cooperative way to establish a population-based brain tumour registry with high quality data. This setting links cancer registration to the mission of medical practice and research as defined by the World Medical Association in the Declaration of Helsinki. The continued operation of ABTR will aid in monitoring changes in incidence and in identifying regional disease clusters or geographic variations in brain tumour morbidity/mortality.

  13. Semantic Theme Analysis of Pilot Incident Reports

    NASA Technical Reports Server (NTRS)

    Thirumalainambi, Rajkumar

    2009-01-01

    Pilots report accidents or incidents during take-off, on flight and landing to airline authorities and Federal aviation authority as well. The description of pilot reports for an incident contains technical terms related to Flight instruments and operations. Normal text mining approaches collect keywords from text documents and relate them among documents that are stored in database. Present approach will extract specific theme analysis of incident reports and semantically relate hierarchy of terms assigning weights of themes. Once the theme extraction has been performed for a given document, a unique key can be assigned to that document to cross linking the documents. Semantic linking will be used to categorize the documents based on specific rules that can help an end-user to analyze certain types of accidents. This presentation outlines the architecture of text mining for pilot incident reports for autonomous categorization of pilot incident reports using semantic theme analysis.

  14. DOE's Computer Incident Advisory Capability (CIAC)

    SciTech Connect

    Schultz, E.

    1990-09-01

    Computer security is essential in maintaining quality in the computing environment. Computer security incidents, however, are becoming more sophisticated. The DOE Computer Incident Advisory Capability (CIAC) team was formed primarily to assist DOE sites in responding to computer security incidents. Among CIAC's other responsibilities are gathering and distributing information to DOE sites, providing training workshops, coordinating with other agencies, response teams, and vendors, creating guidelines for incident handling, and developing software tools. CIAC has already provided considerable assistance to DOE sites faced with virus infections and worm and hacker attacks, has issued over 40 information bulletins, and has developed and presented a workshop on incident handling. CIAC's experience in helping sites has produced several lessons learned, including the need to follow effective procedures to avoid virus infections in small systems and the need for sound password management and system administration in networked systems. CIAC's activity and scope will expand in the future. 4 refs.

  15. Investigation of a “Sharps” Incident

    DOE PAGES

    Cournoyer, Michael Edward; Trujillo, Stanley; Schreiber, Stephen Bruce

    2016-08-03

    Special nuclear material research, process development, technology demonstration, and manufacturing capabilities are provided at the Los Alamos National Laboratory Plutonium Facility. Engineered barriers provide the most effective protection from radioactive and hazardous materials. The Worker Safety Security Team augments these passive safety feature by investigating incidents to identify appropriate prevention and mitigation measures. “Learning Teams” facilitate employee feedback loop and integration toward process improvement. Here, this article reports an investigation of a “Sharps” incident and reviews a case study of a technician that cuts his left thumb while making a gasket. Causal analysis of the sharps incident uncovered contributing factorsmore » that created the environment in which the incident occurred. Finally, latent organizational conditions that created error-likely situations or weakened defenses were identified and controlled. Effective improvements that reduce the probability or consequence of similar sharps incidents were implemented.« less

  16. Incidence of hip fracture in southeastern Norway

    PubMed Central

    Reikerås, O.

    2006-01-01

    The incidence of hip fracture has been studied extensively, but there is still some doubt whether the age-specific incidence is increasing. The proportion of trochanteric fractures has varied and has also been said to be increasing. We studied data on 1,730 prospectively registered cases from 1998–2003 and computed age- and gender-specific incidence rates for intracapsular and trochanteric fractures. The incidence of hip fracture for women over 50 years was 1,263 and for men 452 per 100,000. The proportion of trochanteric fractures was 38% for women and 41% for men. There was no significant difference in the proportion of trochanteric fractures either between or within the genders, and the proportion did not exceed 50% in any age group. These findings confirm the high incidence of hip fracture in Norway but do not indicate any increase. The proportion of trochanteric fractures also seems to be stable. PMID:17033761

  17. Debriefing after critical incidents for anaesthetic trainees.

    PubMed

    Tan, H

    2005-12-01

    This survey investigated the need, and the availability, of debriefing after critical incidents for training anaesthetists. A cross-sectional postal survey of all Australian anaesthetic trainees was conducted in May 2002. Four hundred and nineteen responses were analysed (response rate 64%). Debriefing after a critical incident was perceived by most trainees to be useful, however 36% (n = 149) had never been debriefed. Trainees ranked their preferred content for a debriefing as 'anaesthetic issues' followed by the 'psychological impact of the incident' 'patient issues' and 'surgical issues'. Almost half of respondents reported that they did not feel supported by their anaesthetic department after a negative outcome incident. Trainees who had debriefings were more likely to feel supported by senior colleagues. Debriefing after critical incidents should be an integral part of the supervision of anaesthetic trainees.

  18. [Cancer incidence in the Altai Republic].

    PubMed

    Odintsova, I N; Pisareva, L F; Ananina, O A; Khriapenkov, A V; Cherdyntseva, N V

    2014-01-01

    From all regions of the Siberian Federal District (SFD), the Altai Republic is the least urbanized territory, more than third of its population is Altai. The Altai Republic ranks the 11th for cancer incidence among 12 territories of SFD. Cancer incidence rate is 1.4 times less in females than in males. There is a tendency toward increased cancer incidence in the Republic. The two most common cancer sites in males are digestive and respiratory organs. In females, the most common cancer sites are reproductive and digestive organs. Prostate cancer has the highest incidence rate in males and kidney cancer in females. Increase in the cancer incidence rate was observed among male patients who are younger and older than able-bodied age and in female patients who were younger than able-bodied age. Problems related to the improvement of methods for cancer prevention, early detection and treatment are of great importance.

  19. Investigation of a “Sharps” Incident

    SciTech Connect

    Cournoyer, Michael Edward; Trujillo, Stanley; Schreiber, Stephen Bruce

    2016-08-03

    Special nuclear material research, process development, technology demonstration, and manufacturing capabilities are provided at the Los Alamos National Laboratory Plutonium Facility. Engineered barriers provide the most effective protection from radioactive and hazardous materials. The Worker Safety Security Team augments these passive safety feature by investigating incidents to identify appropriate prevention and mitigation measures. “Learning Teams” facilitate employee feedback loop and integration toward process improvement. Here, this article reports an investigation of a “Sharps” incident and reviews a case study of a technician that cuts his left thumb while making a gasket. Causal analysis of the sharps incident uncovered contributing factors that created the environment in which the incident occurred. Finally, latent organizational conditions that created error-likely situations or weakened defenses were identified and controlled. Effective improvements that reduce the probability or consequence of similar sharps incidents were implemented.

  20. Hazardous materials incidents in military aircraft.

    PubMed

    Voge, V M; Tolan, G

    1993-07-01

    We evaluated 10 years of reported hazardous cargo incident information from the U.S. Air Force and Naval Safety Centers. In this first of two papers describing the hazardous cargo problems reported by the two services, we describe types of aircraft and types of hazardous cargo involved in incidents not causing aircraft mishaps. Normally, hazardous cargo must be manifested as such and no passengers are allowed on such flights. Unauthorized hazardous cargo was found on military aircraft carrying passengers. The most common problem was fuel spills or fumes. The most frequent cause of a hazardous cargo incident was improper manifest of same. Improvements are recommended for the incompatible or inconsistent hazardous cargo incident reporting systems, in order to improve prevention of hazardous cargo incidents.

  1. Incidence of lead shot in canvasbacks

    USGS Publications Warehouse

    Perry, M.C.

    1976-01-01

    During 1975 and 1976, 2,544 canvasbacks (Aythya valisineria) from North Dakota, Wisconsin, Illinois, and Maryland were flouroscoped to determine the incidence of body shot. A significant increase from west to east was detected in the incidence of shot for immatures from the four states. The incidence of shot in immatures after the 1975-76 hunting season was 18 percent in Maryland and 20 percent in Illinois. In Wisconsin no difference in the incidence of shot could be detected between areas trapped or time periods when trapping was conducted. In Maryland a significant decrease in the incidence of body shot was detected in adults, but not immatures, between 1975 and 1976. shot was located throughout the body of canvasbacks. Frequency varied from one to nine shot per bird and averaged 2.0 for adults and 1.5 for immatures.

  2. Investigation of a “Sharps” Incident

    SciTech Connect

    Cournoyer, Michael Edward; Trujillo, Stanley; Schreiber, Stephen Bruce

    2016-08-03

    Special nuclear material research, process development, technology demonstration, and manufacturing capabilities are provided at the Los Alamos National Laboratory Plutonium Facility. Engineered barriers provide the most effective protection from radioactive and hazardous materials. The Worker Safety Security Team augments these passive safety feature by investigating incidents to identify appropriate prevention and mitigation measures. “Learning Teams” facilitate employee feedback loop and integration toward process improvement. Here, this article reports an investigation of a “Sharps” incident and reviews a case study of a technician that cuts his left thumb while making a gasket. Causal analysis of the sharps incident uncovered contributing factors that created the environment in which the incident occurred. Finally, latent organizational conditions that created error-likely situations or weakened defenses were identified and controlled. Effective improvements that reduce the probability or consequence of similar sharps incidents were implemented.

  3. Customer focused incident monitoring in anaesthesia.

    PubMed

    Khan, F A; Khimani, S

    2007-06-01

    The database of incident forms relating to anaesthesia services in an institutional risk management programme were reviewed for 2003-2005, the aim being to identify any recurring patterns. Incidents were prospectively categorised as relating to attitude/behaviour, communication breakdown, delay in service, or were related to care, cost, environment, equipment, security, administrative process, quality of service or miscellaneous. The total number of anaesthesia-related incidents reported during the period was 287, which related to 0.44% of the total number of anaesthetics administered during the time period. In all, 170 incidents were reported by the department, 96 by internal customers and 21 by external customers. Only 30% of the complaints came from the operating room. Thirty-four per cent of all incidents related to communication, behaviour and delay in service. A requirement to teach communication skills and stress handling formally in anaesthesia training programmes, and at the time of induction of staff into the department, has been identified.

  4. Inhibition and Brain Work

    PubMed Central

    Buzsáki, György; Kaila, Kai; Raichle, Marcus

    2008-01-01

    The major part of the brain’s energy budget (~60%–80%) is devoted to its communication activities. While inhibition is critical to brain function, relatively little attention has been paid to its metabolic costs. Understanding how inhibitory interneurons contribute to brain energy consumption (brain work) is not only of interest in understanding a fundamental aspect of brain function but also in understanding functional brain imaging techniques which rely on measurements related to blood flow and metabolism. Herein we examine issues relevant to an assessment of the work performed by inhibitory interneurons in the service of brain function. PMID:18054855

  5. Traumatic Brain Injury. Fact Sheet = Lesion Cerebral Traumatica (TBI). Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet, written in both English and Spanish, offers general information about traumatic brain injury. Information includes a definition, incidence, individual characteristics, and educational implications. The signs of traumatic brain injury are listed and include physical disabilities, difficulties with thinking, and social, behavioral,…

  6. Treatment Efficacy: Cognitive-Communicative Disorders Resulting from Traumatic Brain Injury in Adults.

    ERIC Educational Resources Information Center

    Coelho, Carl A.; And Others

    1996-01-01

    This article discusses adults with brain injuries and resulting cognitive communicative disorders. The incidence of brain injuries, the effects of cognitive-communication disorders, the role of the speech-language pathologist, the benefits of treatment, and the effects of different treatments are discussed. Charts are included that summarize…

  7. Traumatic Brain Injury: A Look at Alcohol and Other Drug Abuse Prevention.

    ERIC Educational Resources Information Center

    VSA Educational Services, Washington, DC. Resource Center on Substance Abuse Prevention and Disability.

    This leaflet examines alcohol and other drug abuse prevention for individuals with traumatic brain injury. The characteristics and incidence of traumatic brain injury (TBI) are noted. The implications of alcohol and other drug use are discussed, emphasizing that TBI is often related to lifestyles where alcohol and other drug abuse and risk taking…

  8. Multiple biomarkers and risk of clinical and subclinical vascular brain injury: the framingham offspring study

    USDA-ARS?s Scientific Manuscript database

    Several biomarkers have been individually associated with vascular brain injury, but no prior study has explored the simultaneous association of a biologically plausible panel of biomarkers with the incidence of stroke/transient ischemic attack and the prevalence of subclinical brain injury. In 3127...

  9. 78 FR 38949 - Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-28

    ... National Institute of Standards and Technology Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response AGENCY: National Institute of Standards and Technology, U.S. Department of... Technology (NIST) is seeking information relating to Computer Security Incident Coordination (CSIC). NIST is...

  10. [Research progress of targeted therapy in non-small cell lung cancer brain metastases].

    PubMed

    Jiang, Tao; Zhou, Caicun

    2014-11-01

    Lung cancer is characterized by the highest incidence of solid tumor-related brain metastases, which are reported the incidence ranged 20% to 65%. This is also one of the reasons why it can cause significant mortality. Molecular targeted therapy plays a major role in the management of brain metastases in lung cancer. Targeted agents have become the novel methods for the treatment of lung cancer with brain metastases beyond the whole brain radiation therapy, stereotactic radiosurgery and chemotherapy. Recently, more and more studies and trials laid emphasis on the targeted agents for non-small cell lung cancer (NSCLC) brain metastases treatment. The key point is the efficacy and safety. In this paper, the targeted treatments of NSCLC brain metastases were summarized.

  11. Trends in Incidence of Common Cancers in Iran.

    PubMed

    Enayatrad, Mostafa; Mirzaei, Maryam; Salehiniya, Hamid; Karimirad, Mohammad Reza; Vaziri, Siavash; Mansouri, Fiezollah; Moudi, Asieh

    2016-01-01

    Cancer is a major public health problem in Iran. The aim of this study was to evaluate trends in incidence of ten common cancers in Iran, based on the national cancer registry reports from 2004 to 2009. This epidemiological study was carried out based on existing age-standardized estimate cancer data from the national report on cancer registry/Ministry of Health in Iran. The obtained data were analyzed by test for linear trend and P ≥ 0.05 was taken as the significant level. Totals of 41,169 and 32,898 cases of cancer were registered in men and females, respectively, during these years. Overall age-standard incidence rates (ASRs) per 100,000 population according to primary site weres 125.6 and 113.4 in males and females, respectively. Between 2004 and 2009, the ten most common cancers (excluding skin cancer) were stomach (16.2), bladder (12.6), prostate (11), colon-rectum (10.14), hematopoeitic system (7.1), lung (6.1), esophagus (6.4), brain (3.2), lymph node (3.8) and larynx (3.4) in males; and in females were breast (27.4), colon-rectum (9.3), stomach (7.6), esophagus (6.4), hematopoeitic system (4.9), thyroid (3.9), ovary (3.6), corpus uteri (2.9), bladder (3.2) and lung (2.6). Moreover, results showed that skin cancer was estimated as the most common cancer in both sexes. The lowest and the highest incidence in females and males were reported respectively in 2004 and 2009. Over this period, the incidence of cancer in both sexes has been significantly increasing (p<0.01). Like other less developed and epidemiologically transitioning countries, the trend of age-standardized incidence rate of cancer in Iran is rising. Due to the increasing trends, the future burden of cancer in the Iran is going to be acute with the expected increases in aging populations. Determining and controlling potential risk factors of cancer should hopefully lead to decrease in its burden.

  12. Understanding brain networks and brain organization

    NASA Astrophysics Data System (ADS)

    Pessoa, Luiz

    2014-09-01

    What is the relationship between brain and behavior? The answer to this question necessitates characterizing the mapping between structure and function. The aim of this paper is to discuss broad issues surrounding the link between structure and function in the brain that will motivate a network perspective to understanding this question. However, as others in the past, I argue that a network perspective should supplant the common strategy of understanding the brain in terms of individual regions. Whereas this perspective is needed for a fuller characterization of the mind-brain, it should not be viewed as panacea. For one, the challenges posed by the many-to-many mapping between regions and functions is not dissolved by the network perspective. Although the problem is ameliorated, one should not anticipate a one-to-one mapping when the network approach is adopted. Furthermore, decomposition of the brain network in terms of meaningful clusters of regions, such as the ones generated by community-finding algorithms, does not by itself reveal "true" subnetworks. Given the hierarchical and multi-relational relationship between regions, multiple decompositions will offer different "slices" of a broader landscape of networks within the brain. Finally, I described how the function of brain regions can be characterized in a multidimensional manner via the idea of diversity profiles. The concept can also be used to describe the way different brain regions participate in networks.

  13. Left Brain Systems and Right Brain Managers.

    ERIC Educational Resources Information Center

    Brown, Jerry W.; Service, Allan L.

    1980-01-01

    Shortcomings of management information systems in managerial functions are often attributed to differences between "left brain" activities performed by machines and "right brain" activities performed in decision making. It is argued that academic management information systems should incorporate and recognize both kinds of activity. (MSE)

  14. Left Brain, Right Brain: Who's on First?

    ERIC Educational Resources Information Center

    Hines, Terence

    1985-01-01

    The author states that none of the left-brain/right brain "mythology" is supported by the actual research on the differences between the left and right human cerebral hemispheres. In fact, he states, the research literature flatly contradicts most of the mythology. (CT)

  15. Understanding brain networks and brain organization

    PubMed Central

    Pessoa, Luiz

    2014-01-01

    What is the relationship between brain and behavior? The answer to this question necessitates characterizing the mapping between structure and function. The aim of this paper is to discuss broad issues surrounding the link between structure and function in the brain that will motivate a network perspective to understanding this question. As others in the past, I argue that a network perspective should supplant the common strategy of understanding the brain in terms of individual regions. Whereas this perspective is needed for a fuller characterization of the mind-brain, it should not be viewed as panacea. For one, the challenges posed by the many-to-many mapping between regions and functions is not dissolved by the network perspective. Although the problem is ameliorated, one should not anticipate a one-to-one mapping when the network approach is adopted. Furthermore, decomposition of the brain network in terms of meaningful clusters of regions, such as the ones generated by community-finding algorithms, does not by itself reveal “true” subnetworks. Given the hierarchical and multi-relational relationship between regions, multiple decompositions will offer different “slices” of a broader landscape of networks within the brain. Finally, I described how the function of brain regions can be characterized in a multidimensional manner via the idea of diversity profiles. The concept can also be used to describe the way different brain regions participate in networks. PMID:24819881

  16. Brain development in preterm infants assessed using advanced MRI techniques.

    PubMed

    Tusor, Nora; Arichi, Tomoki; Counsell, Serena J; Edwards, A David

    2014-03-01

    Infants who are born preterm have a high incidence of neurocognitive and neurobehavioral abnormalities, which may be associated with impaired brain development. Advanced magnetic resonance imaging (MRI) approaches, such as diffusion MRI (d-MRI) and functional MRI (fMRI), provide objective and reproducible measures of brain development. Indices derived from d-MRI can be used to provide quantitative measures of preterm brain injury. Although fMRI of the neonatal brain is currently a research tool, future studies combining d-MRI and fMRI have the potential to assess the structural and functional properties of the developing brain and its response to injury. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. NONINVASIVE BRAIN STIMULATION IN TRAUMATIC BRAIN INJURY

    PubMed Central

    Demirtas-Tatlidede, Asli; Vahabzadeh-Hagh, Andrew M.; Bernabeu, Montserrat; Tormos, Jose M.; Pascual-Leone, Alvaro

    2012-01-01

    Brain stimulation techniques have evolved in the last few decades with more novel methods capable of painless, noninvasive brain stimulation. While the number of clinical trials employing noninvasive brain stimulation continues to increase in a variety of medication-resistant neurological and psychiatric diseases, studies evaluating their diagnostic and therapeutic potential in traumatic brain injury (TBI) are largely lacking. This review introduces different techniques of noninvasive brain stimulation, which may find potential use in TBI. We cover transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), low-level laser therapy (LLLT) and transcranial doppler sonography (TCD) techniques. We provide a brief overview of studies to date, discuss possible mechanisms of action, and raise a number of considerations when thinking about translating these methods to clinical use. PMID:21691215

  18. Modulating Brain Oscillations to Drive Brain Function

    PubMed Central

    Thut, Gregor

    2014-01-01

    Do neuronal oscillations play a causal role in brain function? In a study in this issue of PLOS Biology, Helfrich and colleagues address this long-standing question by attempting to drive brain oscillations using transcranial electrical current stimulation. Remarkably, they were able to manipulate visual perception by forcing brain oscillations of the left and right visual hemispheres into synchrony using oscillatory currents over both hemispheres. Under this condition, human observers more often perceived an inherently ambiguous visual stimulus in one of its perceptual instantiations. These findings shed light on the mechanisms underlying neuronal computation. They show that it is the neuronal oscillations that drive the visual experience, not the experience driving the oscillations. And they indicate that synchronized oscillatory activity groups brain areas into functional networks. This points to new ways for controlled experimental and possibly also clinical interventions for the study and modulation of brain oscillations and associated functions. PMID:25549340

  19. Modulating brain oscillations to drive brain function.

    PubMed

    Thut, Gregor

    2014-12-01

    Do neuronal oscillations play a causal role in brain function? In a study in this issue of PLOS Biology, Helfrich and colleagues address this long-standing question by attempting to drive brain oscillations using transcranial electrical current stimulation. Remarkably, they were able to manipulate visual perception by forcing brain oscillations of the left and right visual hemispheres into synchrony using oscillatory currents over both hemispheres. Under this condition, human observers more often perceived an inherently ambiguous visual stimulus in one of its perceptual instantiations. These findings shed light on the mechanisms underlying neuronal computation. They show that it is the neuronal oscillations that drive the visual experience, not the experience driving the oscillations. And they indicate that synchronized oscillatory activity groups brain areas into functional networks. This points to new ways for controlled experimental and possibly also clinical interventions for the study and modulation of brain oscillations and associated functions.

  20. Left Brain, Right Brain: Facts and Fantasies

    PubMed Central

    Corballis, Michael C.

    2014-01-01

    Summary Handedness and brain asymmetry are widely regarded as unique to humans, and associated with complementary functions such as a left-brain specialization for language and logic and a right-brain specialization for creativity and intuition. In fact, asymmetries are widespread among animals, and support the gradual evolution of asymmetrical functions such as language and tool use. Handedness and brain asymmetry are inborn and under partial genetic control, although the gene or genes responsible are not well established. Cognitive and emotional difficulties are sometimes associated with departures from the “norm” of right-handedness and left-brain language dominance, more often with the absence of these asymmetries than their reversal. PMID:24465175

  1. Incidence and diagnosis of anosognosia for hemiparesis revisited

    PubMed Central

    Baier, B; Karnath, H

    2005-01-01

    Background: In previous studies, the incidence of anosognosia for hemiparesis has varied between 17% and 58% in samples of brain damaged patients with hemiparesis. Objective: To determine whether this wide variation might be explained by the different criteria used for diagnosing anosognosia. Methods: 128 acute stroke patients with hemiparesis or hemiplegia were tested for anosognosia for hemiparesis using the anosognosia scale of Bisiach et al. Results: 94% of the patients who were rated as having "mild anosognosia"—that is, they did not acknowledge their hemiparesis spontaneously following a general question about their complaints—suffered from, and mentioned, other neurological deficits such as dysarthria, ptosis, or headache. However, they immediately acknowledged their paresis when they were asked about the strength of their limbs. Their other deficits clearly had a greater impact. These patients had significantly milder paresis than those who denied their disorder even when asked directly about their limbs. Conclusions: Patients who do not mention their paresis spontaneously but do so when questioned about it directly should not be diagnosed having "anosognosia." If this more conservative cut off criterion is applied to the data of the present as well as previous studies, a frequency of between 10% and 18% for anosognosia for hemiparesis is obtained in unselected samples of acute hemiparetic stroke patients. The incidence thus seems smaller than previously assumed. PMID:15716526

  2. Brain Tumor Surgery

    MedlinePlus

    ... Proton Therapy Alternative & Integrative Medicine Clinical Trials GBM AGILE TTFields – Optune™ Brain Tumor Treatment Locations Treatment Side ... Proton Therapy Alternative & Integrative Medicine Clinical Trials GBM AGILE TTFields – Optune™ Brain Tumor Treatment Locations Treatment Side ...

  3. Biophysics: Unfolding the brain

    NASA Astrophysics Data System (ADS)

    Kuhl, Ellen

    2016-06-01

    The folded surface of the human brain, although striking, continues to evade understanding. Experiments with swelling gels now fuel the notion that brain folding is modulated by physical forces, and not by genetic, biological or chemical events alone.

  4. Right Brain Drawing.

    ERIC Educational Resources Information Center

    Whalen, Adryce C.

    1985-01-01

    The author describes activities of a weekly enrichment class providing right-brain tasks to gifted elementary students. Activities, which centered on artistic creativity, were taken from "Drawing On the Right Side of the Brain" by B. Edwards. (CL)

  5. Brain Hemispheres: Panacea 2001?

    ERIC Educational Resources Information Center

    Fagan, Edward R.

    1979-01-01

    As with previous educational fads, each promoted as the answer to all educational ills, brain-theory principles have been used by effective teachers long before the "discovery" of "brain-compatible" teaching methods. (Author/SJL)

  6. Brain cancer spreads.

    PubMed

    Perryman, Lara; Erler, Janine T

    2014-07-30

    The discovery that ~20% of patients with brain cancer have circulating tumor cells breaks the dogma that these cells are confined to the brain and has important clinical implications (Müller et al., this issue).

  7. Brain aneurysm repair

    MedlinePlus

    ... aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm ... Your scalp, skull, and the coverings of the brain are opened. A metal clip is placed at ...

  8. Children's Brain Tumor Foundation

    MedlinePlus

    ... CBTF Justin's Hope Fund Grant Recipients Grants Children’s Brain Tumor Foundation, A non-profit organization, was founded ... and the long term outlook for children with brain and spinal cord tumors through research, support, education, ...

  9. Childhood Brain Tumors

    MedlinePlus

    Brain tumors are abnormal growths inside the skull. They are among the most common types of childhood ... still be serious. Malignant tumors are cancerous. Childhood brain and spinal cord tumors can cause headaches and ...

  10. Genetic Brain Disorders

    MedlinePlus

    A genetic brain disorder is caused by a variation or a mutation in a gene. A variation is a different form ... mutation is a change in a gene. Genetic brain disorders affect the development and function of the ...

  11. Brain Mechanisms of Movement.

    ERIC Educational Resources Information Center

    Evarts, Edward V.

    1979-01-01

    This article focuses on the mechanisms of the human brain which bring about body movements. Included is a discussion of the way in which the brain and spinal cord issue commands and receive signals. (Author/SA)

  12. Cancer incidence pattern in Cordoba, Argentina.

    PubMed

    Díaz, María del Pilar; Osella, Alberto R; Aballay, Laura R; Muñoz, Sonia E; Lantieri, María J; Butinof, Mariana; Paz, Roberto Meyer; Pou, Sonia; Eynard, Aldo R; La Vecchia, Carlo

    2009-08-01

    Cancer is the second cause of death in Argentina; nevertheless the distribution of the cancer incidence rates throughout the country is unknown. This study was conducted to describe cancer incidence patterns in Córdoba Province. Incidence data were supplied by the Government Córdoba Cancer Registry. Demographic information (age, sex, and place of residence) and diagnosis, certified by a pathologist, about all incident cases from June 2003 to May 2005 by type and 5-year age groups were obtained. Comparison of the incidence rate of cancer in various counties was performed by using standardized incidence rates (SIR) per 100,000 inhabitants using the world standard population. Estimated SIRs were used to build up incidence maps. Two indicators were created: sex ratio and site-specific ratio. Mixed Poisson models were fitted. Taken as a whole for all counties, SIR was 121.42 and 141.57 for men and women, respectively. The most common sites in men were prostate (13.62), lung (10.12), colon (7.53), and bladder (7.03); in women were breast (22.51) and colon (3.31). The highest and lowest rates were in urban and rural areas, respectively. Cancer registry has a pivotal role in cancer control. Such information is the primary resource of information not only for epidemiological research on cancer determinants but also for planning and evaluating health services for the policies of prevention, diagnosis and treatment of the disease.

  13. Low cancer incidence rates in Ohio Amish.

    PubMed

    Westman, Judith A; Ferketich, Amy K; Kauffman, Ross M; MacEachern, Steven N; Wilkins, J R; Wilcox, Patricia P; Pilarski, Robert T; Nagy, Rebecca; Lemeshow, Stanley; de la Chapelle, Albert; Bloomfield, Clara D

    2010-01-01

    The Amish have not been previously studied for cancer incidence, yet they have the potential to help in the understanding of its environmental and genetic contributions. The purpose of this study was to estimate the incidence of cancer among the largest Amish population. Adults from randomly selected households were interviewed and a detailed cancer family history was taken. Using both the household interview data and a search of the Ohio cancer registry data, a total of 191 cancer cases were identified between the years 1996 and 2003. The age-adjusted cancer incidence rate for all cancers among the Amish adults was 60% of the age-adjusted adult rate in Ohio (389.5/10(5) vs. 646.9/10(5); p < 0.0001). The incidence rate for tobacco-related cancers in the Amish was 37% of the rate for Ohio adults (p < 0.0001). The incidence rate for non-tobacco-related cancers in the Amish was 72% of the age-adjusted adult rate in Ohio (p = 0.0001). Cancer incidence is low in the Ohio Amish. These data strongly support reduction of cancer incidence by tobacco abstinence but cannot be explained solely on this basis. Understanding these contributions may help to identify additional important factors to target to reduce cancer among the non-Amish.

  14. Low cancer incidence rates in Ohio Amish

    PubMed Central

    Westman, Judith A.; Kauffman, Ross M.; MacEachern, Steven N.; Wilkins, J. R.; Wilcox, Patricia P.; Pilarski, Robert T.; Nagy, Rebecca; Lemeshow, Stanley; de la Chapelle, Albert; Bloomfield, Clara D.

    2015-01-01

    Background The Amish have not been previously studied for cancer incidence, yet they have the potential to help in the understanding of its environmental and genetic contributions. The purpose of this study was to estimate the incidence of cancer among the largest Amish population. Methods Adults from randomly selected households were interviewed and a detailed cancer family history was taken. Using both the household interview data and a search of the Ohio cancer registry data, a total of 191 cancer cases were identified between the years 1996 and 2003. Results The age-adjusted cancer incidence rate for all cancers among the Amish adults was 60% of the age-adjusted adult rate in Ohio (389.5/105 vs. 646.9/105; p < 0.0001). The incidence rate for tobacco-related cancers in the Amish was 37% of the rate for Ohio adults (p < 0.0001). The incidence rate for non-tobacco-related cancers in the Amish was 72% of the age-adjusted adult rate in Ohio (p = 0.0001). Conclusion Cancer incidence is low in the Ohio Amish. These data strongly support reduction of cancer incidence by tobacco abstinence but cannot be explained solely on this basis. Understanding these contributions may help to identify additional important factors to target to reduce cancer among the non-Amish. PMID:19779840

  15. Taxonometric Applications in Radiotherapy Incident Analysis

    SciTech Connect

    Dunscombe, Peter B. Ekaette, Edidiong U.; Lee, Robert C.; Cooke, David L.

    2008-05-01

    Recent publications in both the scientific and the popular press have highlighted the risks to which patients expose themselves when entering a healthcare system. Patient safety issues are forcing us to, not only acknowledge that incidents do occur, but also actively develop the means for assessing and managing the risks of such incidents. To do this, we ideally need to know the probability of an incident's occurrence, the consequences or severity for the patient should it occur, and the basic causes of the incident. A structured approach to the description of failure modes is helpful in terms of communication, avoidance of ambiguity, and, ultimately, decision making for resource allocation. In this report, several classification schemes or taxonomies for use in risk assessment and management are discussed. In particular, a recently developed approach that reflects the activity domains through which the patient passes and that can be used as a basis for quantifying incident severity is described. The estimation of incident severity, which is based on the concept of the equivalent uniform dose, is presented in some detail. We conclude with a brief discussion on the use of a defined basic-causes table and how adding such a table to the reports of incidents can facilitate the allocation of resources.

  16. Value of oncogenes for the prediction of brain metastases at initial diagnosis: a review of published data.

    PubMed

    Huang, Qian; Ouyang, Xuenong

    2014-12-09

    Identifying cancer patients who are at high risk of developing brain metastases at initial diagnosis and applying effective intervention or monitoring strategies is of vital importance. Recent advances in the biology of brain metastases revealed that some oncogenes from primary tumors may be potential markers for identifying cancer patients likely to metastasize to the brain. We here summarize data on the mechanisms of brain metastases supporting the involvement of oncogene changes in the brain metastatic evolution. We also review the available evidence on clinical studies of oncogenes in the prediction of cancer patients with high incidence of brain metastases.

  17. NASA Robot Brain Surgeon

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Mechanical Engineer Michael Guerrero works on the Robot Brain Surgeon testbed in the NeuroEngineering Group at the Ames Research Center, Moffett Field, California. Principal investigator Dr. Robert W. Mah states that potentially the simple robot will be able to feel brain structures better than any human surgeon, making slow, very precise movements during an operation. The brain surgery robot that may give surgeons finer control of surgical instruments during delicate brain operations is still under development.

  18. Brain Death Determination.

    PubMed

    Spinello, Irene M

    2015-09-01

    In the United States, each year 1% to 2% of deaths are brain deaths. Considerable variation in the practice of determining brain death still remains, despite the publication of practice parameters in 1995 and an evidence-based guideline update in 2010. This review is intended to give bedside clinicians an overview of definition, the causes and pitfalls of misdiagnosing brain death, and a focus on the specifics of the brain death determination process.

  19. Hypertensive brain stem encephalopathy.

    PubMed

    Liao, Pen-Yuan; Lee, Chien-Chang; Chen, Cheng-Yu

    2015-01-01

    A 48-year-old man presented with headache and extreme hypertension. Computed tomography showed diffuse brain stem hypodensity. Magnetic resonance imaging revealed diffuse brain stem vasogenic edema. Hypertensive brain stem encephalopathy is an uncommon manifestation of hypertensive encephalopathy, which classically occurs at parietooccipital white matter. Because of its atypical location, the diagnosis can be challenging. Moreover, the coexistence of hypertension and brain stem edema could also direct clinicians toward a diagnosis of ischemic infarction, leading to a completely contradictory treatment goal.

  20. Modelling total duration of traffic incidents including incident detection and recovery time.

    PubMed

    Tavassoli Hojati, Ahmad; Ferreira, Luis; Washington, Simon; Charles, Phil; Shobeirinejad, Ameneh

    2014-10-01

    Traffic incidents are key contributors to non-recurrent congestion, potentially generating significant delay. Factors that influence the duration of incidents are important to understand so that effective mitigation strategies can be implemented. To identify and quantify the effects of influential factors, a methodology for studying total incident duration based on historical data from an 'integrated database' is proposed. Incident duration models are developed using a selected freeway segment in the Southeast Queensland, Australia network. The models include incident detection and recovery time as components of incident duration. A hazard-based duration modelling approach is applied to model incident duration as a function of a variety of factors that influence traffic incident duration. Parametric accelerated failure time survival models are developed to capture heterogeneity as a function of explanatory variables, with both fixed and random parameters specifications. The analysis reveals that factors affecting incident duration include incident characteristics (severity, type, injury, medical requirements, etc.), infrastructure characteristics (roadway shoulder availability), time of day, and traffic characteristics. The results indicate that event type durations are uniquely different, thus requiring different responses to effectively clear them. Furthermore, the results highlight the presence of unobserved incident duration heterogeneity as captured by the random parameter models, suggesting that additional factors need to be considered in future modelling efforts.

  1. Fourth-year nursing student perceptions of incidents and incident reporting.

    PubMed

    Espin, Sherry; Meikle, Diane

    2014-04-01

    This study explored how fourth-year nursing students (n = 10) from one urban baccalaureate nursing program perceived incidents potentially harmful to patients, as well as incident reporting. Individual interviews were conducted. Five scenarios were presented in the interviews, with each scenario portraying a situation that varied in terms of the severity of potential for patient harm and the clinical team members involved. Participants' responses were analyzed using a descriptive thematic approach. Of the 50 events (10 participants × 5 scenarios), participants identified 37 events as incidents. Three themes emerged regarding how participants identified an incident: scope of practice, professional roles, and harm to the patient. Regarding 48 of the 50 events, participants said they would report these incidents either informally or formally. Findings from this study suggest a need for nursing education regarding what constitutes an incident, as well as how and when to report incidents.

  2. Aging-associated changes in human brain.

    PubMed

    Mrak, R E; Griffin, S T; Graham, D I

    1997-12-01

    A wide variety of anatomic and histological alterations are common in brains of aged individuals. However, identification of intrinsic aging changes--as distinct from changes resulting from cumulative environmental insult--is problematic. Some degree of neuronal and volume loss would appear to be inevitable, but recent studies have suggested that the magnitudes of such changes are much less than previously thought, and studies of dendritic complexity in cognitively intact individuals suggest continuing neuronal plasticity into the eighth decade. A number of vascular changes become more frequent with age, many attributable to systemic conditions such as hypertension and atherosclerosis. Age-associated vascular changes not clearly linked to such conditions include hyaline arteriosclerotic changes with formation of arterial tortuosities in small intracranial vessels and the radiographic changes in deep cerebral white matter known as "leukoaraiosis." Aging is accompanied by increases in glial cell activation, in oxidative damage to proteins and lipids, in irreversible protein glycation, and in damage to DNA, and such changes may underlie in part the age-associated increasing incidence of "degenerative" conditions such as Alzheimer disease and Parkinson disease. A small number of histological changes appear to be universal in aged human brains. These include increasing numbers of corpora amylacea within astrocytic processes near blood-brain or cerebrospinal fluid-brain interfaces, accumulation of the "aging" pigment lipofuscin in all brain regions, and appearance of Alzheimer-type neurofibrillary tangles (but not necessarily amyloid plaques) in mesial temporal structures.

  3. Our Amazing Brains

    ERIC Educational Resources Information Center

    Bath, Howard

    2005-01-01

    This article begins a regular series on how brain research can help us understand young people and ourselves as well. The intent is to alert the reader to important information from recent research on the brain. This initial installment explores the concept of the triune brain, a term coined by neuroscientist Paul MacLean. This refers to three…

  4. Brain and Language.

    ERIC Educational Resources Information Center

    Damasio, Antonio R., Damasio, Hanna

    1992-01-01

    Discusses the advances made in understanding the brain structures responsible for language. Presents findings made using magnetic resonance imaging (MRI) and positron emission tomographic (PET) scans to study brain activity. These findings map the structures in the brain that manipulate concepts and those that turn concepts into words. (MCO)

  5. Brain Migration Revisited

    ERIC Educational Resources Information Center

    Vinokur, Annie

    2006-01-01

    The "brain drain/brain gain" debate has been going on for the past 40 years, with irresolvable theoretical disputes and unenforceable policy recommendations that economists commonly ascribe to the lack of reliable empirical data. The recent report of the World Bank, "International migration, remittances and the brain drain", documents the…

  6. Brain Migration Revisited

    ERIC Educational Resources Information Center

    Vinokur, Annie

    2006-01-01

    The "brain drain/brain gain" debate has been going on for the past 40 years, with irresolvable theoretical disputes and unenforceable policy recommendations that economists commonly ascribe to the lack of reliable empirical data. The recent report of the World Bank, "International migration, remittances and the brain drain", documents the…

  7. Australian Brain Alliance.

    PubMed

    2016-11-02

    A proposal for an Australian Brain Initiative (ABI) is under development by members of the Australian Brain Alliance. Here we discuss the goals of the ABI, its areas of research focus, its context in the Australian research setting, and its necessity for ensuring continued success for Australian brain research.

  8. Aligning brains and minds

    PubMed Central

    Tong, Frank

    2012-01-01

    In this issue of Neuron, Haxby and colleagues describe a new method for aligning functional brain activity patterns across participants. Their study demonstrates that objects are similarly represented across different brains, allowing for reliable classification of one person’s brain activity based on another’s. PMID:22017984

  9. Brain and Language.

    ERIC Educational Resources Information Center

    Damasio, Antonio R., Damasio, Hanna

    1992-01-01

    Discusses the advances made in understanding the brain structures responsible for language. Presents findings made using magnetic resonance imaging (MRI) and positron emission tomographic (PET) scans to study brain activity. These findings map the structures in the brain that manipulate concepts and those that turn concepts into words. (MCO)

  10. Our Amazing Brains

    ERIC Educational Resources Information Center

    Bath, Howard

    2005-01-01

    This article begins a regular series on how brain research can help us understand young people and ourselves as well. The intent is to alert the reader to important information from recent research on the brain. This initial installment explores the concept of the triune brain, a term coined by neuroscientist Paul MacLean. This refers to three…

  11. Brain Research and Learning.

    ERIC Educational Resources Information Center

    Claycomb, Mary

    Current research on brain activity has many implications for educators. The triune brain concept and the left and right hemisphere concepts are among the many complex theories evolving from experimentation and observation. The triune brain concept suggests that the human forebrain has expanded while retaining three structurally unique formations…

  12. Slowed Walking, Shrinking Brain?

    MedlinePlus

    ... Brain? Seniors whose pace dropped showed shrinkage in brain region linked to memory, spatial orientation To use the sharing features on ... their right hippocampus, according to the study. That brain region is where memory and "spatial orientation" reside. Spatial orientation is the ...

  13. Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures.

    PubMed

    McClelland, Shearwood; Hall, Walter A

    2007-07-01

    Postoperative central nervous system infection (PCNSI) in patients undergoing neurosurgical procedures represents a serious problem that requires immediate attention. PCNSI most commonly manifests as meningitis, subdural empyema, and/or brain abscess. Recent studies (which have included a minimum of 1000 operations) have reported that the incidence of PCNSI after neurosurgical procedures is 5%-7%, and many physicians believe that the true incidence is even higher. To address this issue, we examined the incidence of PCNSI in a sizeable patient population. The medical records and postoperative courses for patients involved in 2111 neurosurgical procedures at our institution during 1991-2005 were reviewed retrospectively to determine the incidence of PCNSI, the identity of offending organisms, and the factors associated with infection. The median age of patients at the time of surgery was 45 years. Of the 1587 cranial operations, 14 (0.8%) were complicated by PCNSI, whereas none of the 32 peripheral nerve operations resulted in PCNSI. The remaining 492 operative cases involved spinal surgery, of which 2 (0.4%) were complicated by PCNSI. The overall incidence of PCNSI was 0.8% (occurring after 16 of 2111 operations); the incidence of bacterial meningitis was 0.3% (occurring after 4 of 1587 operations), and the incidence of brain abscess was 0.2% (occurring after 3 of 1587 operations). The most common offending organism was Staphylococcus aureus (8 cases; 50% of infections), followed by Propionibacterium acnes (4 cases; 25% of infections). Cerebrospinal fluid leakage, diabetes mellitus, and male sex were not associated with PCNSI (P>.05). In one of the largest neurosurgical studies to have investigated PCNSI, the incidence of infection after neurosurgical procedures was <1%--more than 6 times lower than that reported in recent series of comparable numerical size. Cerebrospinal fluid leak, diabetes mellitus, and male sex were not associated with an increased incidence of

  14. Your Brain and Nervous System

    MedlinePlus

    ... Room? What Happens in the Operating Room? Your Brain & Nervous System KidsHealth > For Kids > Your Brain & Nervous ... The coolest wetsuit? Nope — he needs his cerebellum! Brain Stem Keeps You Breathing — and More Another brain ...

  15. Your Brain and Nervous System

    MedlinePlus

    ... los dientes Video: Getting an X-ray Your Brain & Nervous System KidsHealth > For Kids > Your Brain & Nervous ... The coolest wetsuit? Nope — he needs his cerebellum! Brain Stem Keeps You Breathing — and More Another brain ...

  16. Primary lymphoma of the brain

    MedlinePlus

    Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain ... The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. ...

  17. Symptom Complaints Following Combat-Related Traumatic Brain Injury: Relationship to Traumatic Brain Injury Severity and Posttraumatic Stress Disorder

    DTIC Science & Technology

    2009-08-01

    care, (2) they had ever received special education services for a learning disability and/or treatment for ADHD , and (3) prior to their TBI, they...Fugl-Meyer , A.R. ( 1991 ). Trau- matic brain injury in northern Sweden . Incidence and prevalence of long-standing impairments and disabilities

  18. Survival among women with triple receptor-negative breast cancer and brain metastases

    PubMed Central

    Dawood, S.; Broglio, K.; Esteva, F. J.; Yang, W.; Kau, S.-W.; Islam, R.; Albarracin, C.; Yu, T. K.; Green, M.; Hortobagyi, G. N.; Gonzalez-Angulo, A. M.

    2009-01-01

    Background: The purpose of this study was to determine the incidence of and survival following brain metastases among women with triple receptor-negative breast cancer. Patients and methods: In all, 679 patients with nonmetastatic triple receptor-negative breast cancer diagnosed from 1980 to 2006 were identified. Cumulative incidence of brain metastases was computed. Cox proportional hazards models were fitted to explore factors that predict for development of brain metastases. Survival was computed using the Kaplan–Meier product limit method. Results: Median follow-up was 26.9 months. In all, 42 (6.2%) patients developed brain metastases with a cumulative incidence at 2 and 5 years of 5.6% [95% confidence interval (CI) 3.8% to 7.9%] and 9.6% (95% CI 6.8% to 13%), respectively. A total of 24 (3.5%) patients developed brain metastases as the first site of recurrence with cumulative incidence at 2 and 5 years of 2.0% (95% CI 2.6% to 6.0%) and 4.9% (95% CI 3.2% to 7.0%), respectively. In the multivariable model, no specific factor was observed to be significantly associated with time to brain metastases. Median survival for all patients who developed brain metastases and those who developed brain metastases as the first site of recurrence was 2.9 months (95% CI 2.0–7.6 months) and 5.8 months (95% CI 1.7–11.0 months), respectively. Conclusion: In this single-institutional study, patients with nonmetastatic triple receptor-negative breast tumors have a high early incidence of brain metastases associated with poor survival and maybe an ideal cohort to target brain metastases preventive strategies. PMID:19150943

  19. Occurrence and clinical features of brain metastasis after chemoradiotherapy for esophageal carcinoma.

    PubMed

    Kanemoto, Ayae; Hashimoto, Takayuki; Harada, Hideyuki; Asakura, Hirofumi; Ogawa, Hirofumi; Furutani, Kazuhisa; Boku, Narikazu; Nakasu, Yoko; Nishimura, Tetsuo

    2011-01-01

    Brain metastasis from esophageal carcinoma has been considered rare and survival following esophageal carcinoma with distant metastasis is poor. The purpose of this report was to clarify cumulative incidence and risk factors for brain metastasis after chemoradiotherapy for esophageal carcinoma, and to consider recommended treatments for brain metastasis from esophageal carcinoma. We reviewed 391 patients treated with chemoradiotherapy. Median age was 65 years. Clinical stages were I, II, III, and IV in 32, 47, 150, and 162 patients, respectively. Brain imaging was performed usually when patients revealed neurological symptoms. The 3-year cumulative incidence of brain metastasis after chemoradiotherapy was 6.6%. There were 4 patients with single metastasis and 8 with multiple metastases. Initial clinical stages were II, III, and IV in 1, 2, and 9 patients, respectively. Histology included squamous cell carcinoma in 10 patients and others in 2 patients. Univariate analysis demonstrated M factor, distant lymph node relapse, and recurrent lung and liver metastasis as significant risk factors of brain metastasis (P < 0.05). Median survival time after diagnosis of brain metastasis was 2.1 months. Brain metastasis was not directly related to cause of mortality. The causes were extracranial tumor deterioration in 8 patients and infection in 4 patients. Brain metastasis may increase in the future with improving survival from esophageal carcinoma. However, considering the poor survival after diagnosis of brain metastasis, short-term palliative therapy for brain metastasis appears preferable to vigorous long-term therapy.

  20. Cancer Incidence Among Police Officers in a U.S. Northeast Region: 1976–2006

    PubMed Central

    Charles, Luenda E.; Burchfiel, Cecil M.; Andrew, Michael E.; Violanti, John M

    2015-01-01

    Police officers are exposed to occupational hazards which may put them at increased risk of cancer. We examined the incidence of cancer in a cohort of 2,234 white-male police officers in Buffalo, New York. The study population was followed for 31 years (1976–2006). The incidence of cancer, ascertained using a population-based tumor registry, was compared with 9 US regions using the Surveillance Epidemiology and End Results (SEER) program data. Four hundred and six officers (18.2%) developed cancer between 1976 and 2006. The risk of overall cancer among police officers was found to be similar to the general white-male population (Standardized Incidence Ratio [SIR] = 0.94, 95%, Confidence Interval [CI] = 0.85–1.03). An elevated risk of Hodgkin ‘s lymphoma was observed relative to the general population (SIR = 3.34, 95%, CI= 1.22–7.26). The risk of brain cancer, although only slightly elevated relative to the general population (SIR = 1.61, 95%, CI = 0.73–3.05), was significantly increased with 30 years or more of service (SIR = 2.92, 95%, CI = 1.07–6.36). Incidence ratios were significantly lower than expected for skin and bladder cancer. Police officers were at increased risk of Hodgkin’s lymphoma overall and of brain cancer after 30 years of service. PMID:22900461

  1. 78 FR 38878 - Critical Incident Stress Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-28

    ... accident scene, must often tend to the injured and secure the scene, compounding the extent and the... accident/incident, such as craft and supervisory employees who are called out to the scene. In this way, a...

  2. Using Incidence Sampling to Estimate Covariances.

    ERIC Educational Resources Information Center

    Knapp, Thomas R.

    1979-01-01

    This paper presents the generalized symmetric means approach to the estimation of population covariances, complete with derivations and examples. Particular attention is paid to the problem of missing data, which is handled very naturally in the incidence sampling framework. (CTM)

  3. Risk-based Classification of Incidents

    NASA Technical Reports Server (NTRS)

    Greenwell, William S.; Knight, John C.; Strunk, Elisabeth A.

    2003-01-01

    As the penetration of software into safety-critical systems progresses, accidents and incidents involving software will inevitably become more frequent. Identifying lessons from these occurrences and applying them to existing and future systems is essential if recurrences are to be prevented. Unfortunately, investigative agencies do not have the resources to fully investigate every incident under their jurisdictions and domains of expertise and thus must prioritize certain occurrences when allocating investigative resources. In the aviation community, most investigative agencies prioritize occurrences based on the severity of their associated losses, allocating more resources to accidents resulting in injury to passengers or extensive aircraft damage. We argue that this scheme is inappropriate because it undervalues incidents whose recurrence could have a high potential for loss while overvaluing fairly straightforward accidents involving accepted risks. We then suggest a new strategy for prioritizing occurrences based on the risk arising from incident recurrence.

  4. CANCER INCIDENCE IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    Despite low mortality and cancer incidence rates overall, farmers may experience excess risk of several cancers. These excesses have been observed in some, but not all, retrospective epidemiological studies of agricultural workers in several countries. Excess risk has been ob...

  5. Prevention of future incidents and investigational lines

    PubMed Central

    Martín, Miguel J.; Zapatero, José; López, Mario

    2011-01-01

    All radiation devices in use nowadays are subject to cause serious incidents and accidents, with potential risks in exposed population groups. These risks may have immediate or long term health implications. The detection of radioactive incidents is a procedure that should be systematized in economically developed societies. International organizations may provide support to other states in the event of a radioactive incident. Prevention, mitigation and treatment of the radiation effects are done by anticipating the moment of exposure and by establishing new efforts for investigation of radioprotective products. In this article we will analyze the causes of radiological incidents, the means to detect them, and the current preventive and therapeutic procedures available, with special emphasis on new biodosimetry methods for triage and investigational radioprotective drugs. Finally, we will explore the most efficient measures, for future prevention. PMID:24376973

  6. CANCER INCIDENCE IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    Despite low mortality and cancer incidence rates overall, farmers may experience excess risk of several cancers. These excesses have been observed in some, but not all, retrospective epidemiological studies of agricultural workers in several countries. Excess risk has been ob...

  7. Major incident in Kent: a case report.

    PubMed

    Hardy, Sophie Elizabeth Jap

    2015-09-22

    A major incident was declared after a road traffic accident involving 150 cars and 200 people in Kent, England. The emergency services oversaw coordination of the scene, recovery and triage of casualties and transfer of patients to hospital. The crash was one of the worst seen on British roads and it has been hailed as a miracle that there were no deaths and very few serious injuries.This case report is a retrospective analysis of the regional health system's response to the crash. The structure is based on the content of a report submitted using an online open access template for major incident reporting (Scand J Trauma Resusc Emerg Med 22: 5, 2014; http://www.majorincidentreporting.org ). A more comprehensive analysis of the incident has also been the theme of a Masters thesis (Hardy S. Reporting Major Incidents in England: Putting Theory into Practice. England: Queen Mary's University of London; 2014).

  8. [Features of brain stem tumors in children].

    PubMed

    Ciobanu, Antonela; Miron, Ingrith; Tansanu, I

    2012-01-01

    Brain stem tumors account for about 10-20% of childhood brain tumors. Peak incidence for these tumors occurs around age 6 to 7 years. Despite their severity and poor prognosis, brain stem tumors remain an area of intense research with regard to their diagnosis and management. In the interval 2003-2010, 8 children (4 girls and 4 boys) aged 2-13 years (mean age 6.82), diagnosed with brain stem tumors were followed up. Disease history, onset symptoms, complete physical, laboratory and imaging investigations, and individualized therapeutic approach have been reviewed. Family history was considered to be of particular clinical importance. Monitoring the disease progression was possible until the time of death (when it occurred in hospital) or by information provided by the family and family physician in cases where death occurred at patient's home. Clinical signs and symptoms depend on tumor location, its aggressiveness, and patient's age. Progressive neurological deficits, signs and symptoms caused by increased intracranial pressure, visual disturbances, behavioral disorders, seizures, endocrine disruption, failure to thrive may occur in various combinations. In only 50% of our cases the tumor could be removed. Imaging proved highly suggestive for a brain stem tumor. Histopathological examination diagnosed one pilocytic astrocytoma (grade I), one fibrillary astrocytoma (grade II), one anaplastic astrocytoma (grade III), and one glioblastoma multiforme (grade IV). In the remaining 4 cases imaging was suggestive for glial tumors. Multimodal therapy was used in 2 patients, 7 received adjuvant chemotherapy, and in 1 case no therapy was administered because the tumor rapidly progressed to death. Seven of our patients died on an average of 6.28 months after the diagnosis (range 2 to 9 months). A family history of brain tumors in 2 of our cases supports the hypothesis of genetic factors involvement. Brain stem tumors are still difficult to investigate, and the results on

  9. The neuropathology of traumatic brain injury.

    PubMed

    Mckee, Ann C; Daneshvar, Daniel H

    2015-01-01

    Traumatic brain injury, a leading cause of mortality and morbidity, is divided into three grades of severity: mild, moderate, and severe, based on the Glasgow Coma Scale, the loss of consciousness, and the development of post-traumatic amnesia. Although mild traumatic brain injury, including concussion and subconcussion, is by far the most common, it is also the most difficult to diagnose and the least well understood. Proper recognition, management, and treatment of acute concussion and mild traumatic brain injury are the fundamentals of an emerging clinical discipline. It is also becoming increasingly clear that some mild traumatic brain injuries have persistent, and sometimes progressive, long-term debilitating effects. Evidence indicates that a single traumatic brain injury can precipitate or accelerate multiple age-related neurodegenerations, increase the risk of developing Alzheimer's disease, Parkinson's disease, and motor neuron disease, and that repetitive mild traumatic brain injuries can provoke the development of a tauopathy, chronic traumatic encephalopathy. Clinically, chronic traumatic encephalopathy is associated with behavioral changes, executive dysfunction, memory loss, and cognitive impairments that begin insidiously and progress slowly over decades. Pathologically, chronic traumatic encephalopathy produces atrophy of the frontal and temporal lobes, thalamus, and hypothalamus, septal abnormalities, and abnormal deposits of hyperphosphorylated tau (τ) as neurofibrillary tangles and disordered neurites throughout the brain. The incidence and prevalence of chronic traumatic encephalopathy and the genetic risk factors critical to its development are currently unknown. Chronic traumatic encephalopathy frequently occurs as a sole diagnosis, but may be associated with other neurodegenerative disorders, including Alzheimer's disease, Lewy body disease, and motor neuron disease. Currently, chronic traumatic encephalopathy can be diagnosed only at

  10. Nanoparticle-mediated brain drug delivery: Overcoming blood-brain barrier to treat neurodegenerative diseases.

    PubMed

    Saraiva, Cláudia; Praça, Catarina; Ferreira, Raquel; Santos, Tiago; Ferreira, Lino; Bernardino, Liliana

    2016-08-10

    The blood-brain barrier (BBB) is a vital boundary between neural tissue and circulating blood. The BBB's unique and protective features control brain homeostasis as well as ion and molecule movement. Failure in maintaining any of these components results in the breakdown of this specialized multicellular structure and consequently promotes neuroinflammation and neurodegeneration. In several high incidence pathologies such as stroke, Alzheimer's (AD) and Parkinson's disease (PD) the BBB is impaired. However, even a damaged and more permeable BBB can pose serious challenges to drug delivery into the brain. The use of nanoparticle (NP) formulations able to encapsulate molecules with therapeutic value, while targeting specific transport processes in the brain vasculature, may enhance drug transport through the BBB in neurodegenerative/ischemic disorders and target relevant regions in the brain for regenerative processes. In this review, we will discuss BBB composition and characteristics and how these features are altered in pathology, namely in stroke, AD and PD. Additionally, factors influencing an efficient intravenous delivery of polymeric and inorganic NPs into the brain as well as NP-related delivery systems with the most promising functional outcomes will also be discussed.

  11. Pediatric brain death: updated guidelines.

    PubMed

    Mullen, Jodi E

    2013-01-01

    Logan, a 5-year-old boy, was riding his bike with his 7-year-old brother when he was struck from behind by a car traveling at approximately 40 mph. The driver indicated that she did not see the riders until she hit Logan, who was not wearing a helmet at the time of the accident. Logan was thrown from his bike and was found at the side of the road, unresponsive and posturing. Although he was uninjured, Logan's brother witnessed the incident.Emergency medical services arrived and placed Logan on a backboard with a c-collar. Because he was not protecting his airway, he was intubated and then given sodium chloride fluids and brought to the pediatric emergency department. Upon arrival, his Glasgow Coma Scale score was 5, and his right pupil was 6 mm and not reactive.Logan's initial head computed tomographic scan showed diffuse brain edema, with early downward transtentorial brain herniation. The pediatric neurosurgeon determined that no operative management was appropriate for Logan. Besides a small laceration on his forehead, Logan had no other injuries. At this time, he was taking a few spontaneous respirations and had occasional posturing of his extremities.

  12. Solar Cell Angle of Incidence Corrections

    NASA Technical Reports Server (NTRS)

    Burger, Dale R.; Mueller, Robert L.

    1995-01-01

    The Mars Pathfinder mission has three different solar arrays each of which sees changes in incidence angle during normal operation. When solar array angle of incidence effects was researched little published data was found. The small amount of-published data created a need to obtain and evaluate such data. The donation of the needed data, which was taken in the fall of 1994, was a major factor in the preparation of this paper.

  13. Assessment of Headache Incidence During SURVIVEX 2004

    DTIC Science & Technology

    2009-08-12

    Assessment of Headache Incidence during SURVIVEX 2004 Gerard DeMers, DO, MPH Wayne G. Horn, M.D. Linda M. Hughes, M.S. Approved and...7(/(3+21(180%(5 ,QFOXGHDUHDFRGH 12/08/2009 Memorandum Report 10/1/2002-04/13/2009 Assessment of Headache Incidence during SURVIVEX...release, distribution unlimited The extent to which headaches occur among submariners and impact their performance is unknown. The objective of this

  14. Estimating Insolation Incident on Tilted Surfaces

    NASA Technical Reports Server (NTRS)

    Elkin, R. E.; Toelle, R. G.

    1983-01-01

    ASHMET computer program estimates amount of solar insolation incident on surfaces of several types of solar collectors, including fixed-position flat-plate, monthly-tilt-adjusted flat-plat, beam-tracting, and fixed-azimuthtracker. Basic methodology employed in ASHMET is to use ASHRAE relationships to obtain clear-day total daily insolation incident on collector surface of representative day of each month of year. ASHMET is interactive program and prompts user for all required data.

  15. The Mayaguez Incident: An Organizational Theory Analysis

    DTIC Science & Technology

    2006-09-01

    Mayaguez crew. To the military, the operation was an embarrassment, all because of failures that occurred within the organizational structure and poor...Applying selected concepts of organizational theory to the Mayaguez incident of 1975 leads to a more comprehensive understanding of events and more...accurate lessons learned. Application of organizational theory to the incident demonstrates that the decision processes at the executive level left the

  16. Properties And Performance Of Grazing Incidence Reflectors

    NASA Astrophysics Data System (ADS)

    Aspnes, D. E.; Kelso, S. M.

    We numerically analyze at near-grazing incidence various configurations containing elliptical, toroidal, and the recently proposed common-axis rotationally symmetric anamorphic (CARSA) elements to determine the type and importance of aberrations inherent in each. CARS pairs of elliptical mirrors are shown to have negligible focusing errors for typical synchrotron source dimensions, and therefore comprise useful building blocks from which to construct grazing-incidence optical systems. To minimize aberrations, cylindrical, spherical, or toroidal elements should be avoided.

  17. Properties and performance of grazing incidence reflectors

    NASA Astrophysics Data System (ADS)

    Aspnes, D. E.; Kelso, S. M.

    1982-05-01

    Various configurations containing elliptical, toroidal, and the recently proposed common-axis rotationally symmetric anamorphic (CARSA) elements are numerically analyzed at near-grazing incidence, to determine the type and importance of aberrations inherent in each. CARS pairs of elliptical mirrors are shown to have negligible focusing errors for typical synchrotron source dimensions, and therefore comprise useful building blocks from which to construct grazing-incidence optical systems. To minimize aberrations, cylindrical, spherical, or toroidal elements should be avoided.

  18. Incidence of hip fracture in Shiraz, Iran.

    PubMed

    Soveid, Mahmood; Serati, Ali Reza; Masoompoor, Masoomeh

    2005-11-01

    Hip fracture, the most serious complication of osteoporosis, puts the burden of a lot of costs for treatment on any health system. Previous reports on rates of hip fracture in Asian countries differ a lot. The aim of this study was to estimate the incidence rate of hip fracture in Shiraz, Iran. In Shiraz, Iran, all operating-room logs with diagnosis of hip fracture were reviewed for hip fractures caused by a simple fall in patients over 50 years, during March 21, 2000, to March 21, 2003. According to patients' medical records, age, sex, type of fracture (intertrochanteric, neck, subtrochanteric) and patients' regions according to Shiraz municipality divisions were obtained. The age-adjusted incidence rates of hip fracture standardized to the 1985 US white population (325.74/100,000 for men and 519.05/100,000 for women) and to the 1989 US white population (384.61/100,000 for men and 548.17/100,000 for women) were the highest in Asia. The intertrochanteric fractures were significantly higher among females ( p =0.003). The incidence of intertrochanteric and neck fractures were increased with age. In all age groups, females had higher incidence rates, except for ages over 80 years, in which males had higher incidence rates than females. In wealthier regions of the city, the incidence rates were higher than in other regions. High incidence of hip fracture in our population, especially in males over 80 years, shows that preventive strategies for hip fracture and osteoporosis should be considered in males as well as females. Further studies are needed to find incidence rates in other cities, especially in the very urbanized city of Tehran.

  19. Establishing and operating an incident response team

    SciTech Connect

    Padgett, K.M.

    1992-01-01

    Occurrences of improprieties dealing with computer usage are on the increase. They range all the way from misuse by employees to international computer telecommunications hacking. In addition, natural disasters and other disasters such as catastrophic fires may also fall into the same category. These incidents, like any other breach of acceptable behavior, may or may not involve actual law breaking. A computer incident response team should be created as a first priority. This report discusses the establishment and operation of a response team.

  20. Establishing and operating an incident response team

    SciTech Connect

    Padgett, K.M.

    1992-09-01

    Occurrences of improprieties dealing with computer usage are on the increase. They range all the way from misuse by employees to international computer telecommunications hacking. In addition, natural disasters and other disasters such as catastrophic fires may also fall into the same category. These incidents, like any other breach of acceptable behavior, may or may not involve actual law breaking. A computer incident response team should be created as a first priority. This report discusses the establishment and operation of a response team.

  1. Estimating Insolation Incident on Tilted Surfaces

    NASA Technical Reports Server (NTRS)

    Elkin, R. E.; Toelle, R. G.

    1983-01-01

    ASHMET computer program estimates amount of solar insolation incident on surfaces of several types of solar collectors, including fixed-position flat-plate, monthly-tilt-adjusted flat-plat, beam-tracting, and fixed-azimuthtracker. Basic methodology employed in ASHMET is to use ASHRAE relationships to obtain clear-day total daily insolation incident on collector surface of representative day of each month of year. ASHMET is interactive program and prompts user for all required data.

  2. Cancer-specific incidence rates of tuberculosis

    PubMed Central

    Seo, Gi Hyeon; Kim, Min Jae; Seo, Soyoung; Hwang, Boram; Lee, Eugene; Yun, Yujin; Choi, Minsun; Kim, Moonsuk; Kim, Jin Won; Kim, Eu Suk; Kim, Hong Bin; Song, Kyoung-Ho

    2016-01-01

    Abstract Population-based studies of the incidence of tuberculosis in cancer patients according to the type of cancer are limited. We investigated the cancer-specific incidence of tuberculosis in a nationwide population-based cohort in a country with an intermediate burden of tuberculosis. We used mandatory National Health Insurance claims data to construct a cancer cohort of adults (aged 20–99 years) with newly diagnosed malignancies other than lung cancer, from January 2008 to December 2012. Patients who developed tuberculosis in this period were identified in the cancer cohort and the general population. Standardized incidence ratios (SIRs) of tuberculosis in the cancer cohort according to type of cancer and time after cancer diagnosis were calculated by comparing the observed incidence rates with those inferred from the age- and gender-specific incidence rates in the general population. A total of 855,382 cancer patients and 1589,876 person-years (py) were observed. A total of 5745 patients developed tuberculosis; the mean incidence rate was 361.3 per 100,000 py, and the SIR was 2.22 (95% confidence interval [CI], 2.17–2.27). The incidence rate was highest for hematologic malignancy and lowest for thyroid cancer. It was also highest as 650.1 per 100,000 py, with SIR of 3.70 (CI, 3.57–3.83) for the first 6 months after diagnosis of malignancy and then declined. However, it still remained higher than that of the general population after 24 months (SIR = 1.43, CI, 1.36–1.51). The incidence of tuberculosis increases after diagnosis in patients with malignancies. The risk of tuberculosis differs according to the type of cancer and remains elevated even 24 months after cancer diagnosis. Tuberculosis should be considered an important comorbidity in patients with malignancies. PMID:27661041

  3. Silent embolic infarcts on computed tomography brain scans and risk of ipsilateral hemispheric events in patients with asymptomatic internal carotid artery stenosis.

    PubMed

    Kakkos, Stavros K; Sabetai, Michael; Tegos, Thomas; Stevens, John; Thomas, Dafydd; Griffin, Maura; Geroulakos, George; Nicolaides, Andrew N

    2009-04-01

    This study tested the hypothesis that silent embolic infarcts on computed tomography (CT) brain scans can predict ipsilateral neurologic hemispheric events and stroke in patients with asymptomatic internal carotid artery stenosis. In a prospective multicenter natural history study, 821 patients with asymptomatic carotid stenosis graded with duplex scanning who had CT brain scans were monitored every 6 months for a maximum of 8 years. Duplex scans were reported centrally, and stenosis was expressed as a percentage in relation to the normal distal internal carotid criteria used by the North American Symptomatic Carotid Endarterectomy Trialists. CT brain scans were reported centrally by a neuroradiologist. In 146 patients (17.8%), 8 large cortical, 15 small cortical, 72 discrete subcortical, and 51 basal ganglia ipsilateral infarcts were present; these were considered likely to be embolic and were classified as such. Other infarct types, lacunes (n = 15), watershed (n = 9), and the presence of diffuse white matter changes (n = 95) were not considered to be embolic. During a mean follow-up of 44.6 months (range, 6 months-8 years), 102 ipsilateral hemispheric neurologic events (amaurosis fugax in 16, 38 transient ischemic attacks [TIAs], and 47 strokes) occurred, 138 patients died, and 24 were lost to follow-up. In 462 patients with 60% to 99% stenosis, the cumulative event-free rate at 8 years was 0.81 (2.4% annual event rate) when embolic infarcts were absent and 0.63 (4.6% annual event rate) when present (log-rank P = .032). In 359 patients with <60% stenosis, embolic infarcts were not associated with increased risk (log-rank P = .65). In patients with 60% to 99% stenosis, the cumulative stroke-free rate was 0.92 (1.0% annual stroke rate) when embolic infarcts were absent and 0.71 (3.6% annual stroke rate) when present (log-rank P = .002). In the subgroup of 216 with moderate 60% to 79% stenosis, the cumulative TIA or stroke-free rate in the absence and presence of

  4. Exploring Health Care Professionals' Perceptions of Incidents and Incident Reporting in Rehabilitation Settings.

    PubMed

    Espin, Sherry; Carter, Celina; Janes, Nadine; McAllister, Mary

    2015-06-12

    Research exploring patient safety in rehabilitation settings is limited. This study's aim was to describe team members' perceptions of incidents and incident reporting in rehabilitation settings. Semistructured interviews were conducted with 18 health care professionals from multiple rehabilitation units (medical, neurological, and orthopedic) at 2 inner-city rehabilitation centers. Five hypothetical scenarios were presented to participants during the interviews. Participants were asked to classify the scenarios and whether they would report any identified incidents. Data were analyzed using a descriptive thematic approach. Participants classified events based on 2 parameters: the nature of the outcome and deviation from professional practice. Factors influencing participants' decisions to file incident reports included their classification of the events in the scenarios (i.e., events classified as critical incidents were more often reported than those classified as incident or near miss); the severity of the impact on the client; and their profession's perceived role in reporting specific incidents. When participants said they would report incidents, all agreed that they would report only objective facts. The study findings demonstrate gaps between incident-reporting policy and practice, and opportunities to address these gaps. Organizational leaders can work with all health care professions to support their roles in reporting. Interprofessional team building, focused on valuing all team members, may improve interprofessional communication and reporting. Setting standards for classifying events could increase consistency in reporting. Ultimately, encouraging reporting of near misses and incidents can create a culture of learning focused on problem solving and improved patient safety.

  5. Safety incident reporting in emergency radiology: analysis of 1717 safety incident reports.

    PubMed

    Mansouri, Mohammad; Shaqdan, Khalid W; Aran, Shima; Raja, Ali S; Lev, Michael H; Abujudeh, Hani H

    2015-12-01

    The aim of this article is to describe the incidence and types of safety reports logged in the radiology safety incident reporting system in our emergency radiology section over an 8-year period. Electronic incident reporting system of our institute was searched for the variables in emergency radiology. All reports from April 2006 to June 2014 were included and deindentified. The following event classifications were investigated in radiography, CT, and MRI modalities: diagnostic test orders, ID/documentation/consent, safety/security/conduct, service coordination, surgery/procedure, line/tube, fall, medication/IV safety, employee general incident, environment/equipment, adverse drug reaction, skin/tissue, and diagnosis/treatment. A total of 881,194 emergency radiology examinations were performed during the study period, 1717 (1717/881,194 = 0.19 %) of which resulted in safety reports. Reports were classified into 14 different categories, the most frequent of which were "diagnostic test orders" (481/1717 = 28 % total incident reports), "medication/IV safety" (302/1717 = 18 % total incident reports), and "service coordination" (204/1717 = 12 % total incident reports). X-ray had the highest report rate (873/1717 = 50 % total incident reports), followed by CT (604/1717 = 35 % total incident reports) and MRI (240/1717 = 14 % total incident reports). Forty-six percent of safety incidents (789/1717) caused no harm and did not reach the patient, 36 % (617/1717) caused no harm but reached the patient, 18 % (308/1717) caused temporary or minor harm/ damage, and less than 1 % caused permanent or major harm/ damage or death. Our study shows an overall safety incident report rate of 0.19 % in emergency radiology including radiography, CT, and MRI modalities. The most common safety incidents were diagnostic test orders, medication/IV safety, and service coordination.

  6. Whither brain death?

    PubMed

    Bernat, James L

    2014-01-01

    The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public.

  7. Cancer incidence among adolescents and young adults in urban Shanghai, 1973-2005.

    PubMed

    Wu, Qi-Jun; Vogtmann, Emily; Zhang, Wei; Xie, Li; Yang, Wan-Shui; Tan, Yu-Ting; Gao, Jing; Xiang, Yong-Bing

    2012-01-01

    Lack of cancer incidence information for adolescents and young adults led us to describe incidence trends within the young population of 15 to 49 year-olds in urban Shanghai between 1973 and 2005. During 1973 to 2005, data on 43,009 (45.8%) male and 50,828 (54.2%) female cancer cases aged 15-49 years from the Shanghai Cancer Registry were analyzed. Five-year age-specific rates, world age-standardized rates, percent change (PC), and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. During the 33-year study period, overall cancer incidence of adolescents and young adults among males marginally decreased by 0.5% per year (P<0.05). However, overall cancer incidence for females slightly increased by 0.8% per year (P<0.05). The leading cancer for males in rank were liver, stomach, lung, colorectal, and nasopharyngeal cancers and for females were breast, stomach, colorectal, thyroid, and ovarian cancers. Among specific sites, incidence rates significantly decreased for cancers of the esophagus, stomach, and liver in both sexes. In contrast, incidence rates significantly increased for kidney cancers, non-Hodgkin lymphoma, and brain and nervous system tumors in both sexes and increased for breast and ovarian cancers among females. Overall cancer incidence rates of adolescents and young adults decreased in males whereas they increased in females. Our findings suggest the importance of further epidemiology and etiologic studies to further elucidate factors contributing to the cancer incidence trends of adolescents and young adults in China.

  8. Cancer incidence and mortality in Shandong province, 2012

    PubMed Central

    Fu, Zhentao; Lu, Zilong; Li, Yingmei; Zhang, Jiyu; Zhang, Gaohui; Chen, Xianxian; Chu, Jie; Ren, Jie; Liu, Haiyan

    2016-01-01

    rural areas, respectively. The cancer mortality was 164.47/100,000 (207.42/100,000 in males, 120.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 117.54/100,000 and 116.90/100,000, and the cumulative mortality rate (0.74 years old) was 13.53%. The cancer mortality, ASMRC and ASMRW were 141.59/100,000, 101.17/100,000 and 100.33/100,000 in urban areas, and 173.79/100,000, 124.20/100,000 and 123.64/100,000 in rural areas, respectively. Cancers of the lung, stomach, liver, esophagus, colorectum, female breast, brain, leukemia, bladder and pancreas were the most common cancers, accounting for about 82.12% of all cancer new cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 89.01% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates. Conclusions Cancer surveillance information in Shandong province is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in Shandong province, and so cancer prevention and control in Shandong province should be enhanced including health education, health promotion, cancer screening and cancer care services. PMID:27478312

  9. Comparative Incidence of Conformational, Neurodegenerative Disorders

    PubMed Central

    de Pedro-Cuesta, Jesús; Rábano, Alberto; Martínez-Martín, Pablo; Ruiz-Tovar, María; Alcalde-Cabero, Enrique; Almazán-Isla, Javier; Avellanal, Fuencisla; Calero, Miguel

    2015-01-01

    Background The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs). Methods We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD). We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD) forms, amyotrophic lateral sclerosis (ALS), and sporadic rapidly progressing neurodegenerative dementia (sRPNDd). For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined. Findings Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD), to 1589 and 2589 for AMD and Alzheimer's disease (AD) respectively. Age-specific profiles varied from (a) symmetrical, inverted V-shaped curves for low incidences to (b) those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c) a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20–24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration. Interpretation These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to

  10. Brain plasticity in the developing brain.

    PubMed

    Kolb, Bryan; Mychasiuk, Richelle; Muhammad, Arif; Gibb, Robbin

    2013-01-01

    The developing normal brain shows a remarkable capacity for plastic change in response to a wide range of experiences including sensory and motor experience, psychoactive drugs, parent-child relationships, peer relationships, stress, gonadal hormones, intestinal flora, diet, and injury. The effects of injury vary with the precise age-at-injury, with the general result being that injury during cell migration and neuronal maturation has a poor functional outcome, whereas similar injury during synaptogenesis has a far better outcome. A variety of factors influence functional outcome including the nature of the behavior in question and the age at behavioral assessment as well as pre- and postinjury experiences. Here, we review the phases of brain development, how factors influence brain, and behavioral development in both the normal and perturbed brain, and propose mechanisms that may underlie these effects.

  11. Brain size, sex, and the aging brain.

    PubMed

    Jäncke, Lutz; Mérillat, Susan; Liem, Franziskus; Hänggi, Jürgen

    2015-01-01

    This study was conducted to examine the statistical influence of brain size on cortical, subcortical, and cerebellar compartmental volumes. This brain size influence was especially studied to delineate interactions with Sex and Age. Here, we studied 856 healthy subjects of which 533 are classified as young and 323 as old. Using an automated segmentation procedure cortical (gray and white matter [GM and WM] including the corpus callosum), cerebellar (GM and WM), and subcortical (thalamus, putamen, pallidum, caudatus, hippocampus, amygdala, and accumbens) volumes were measured and subjected to statistical analyses. These analyses revealed that brain size and age exert substantial statistical influences on nearly all compartmental volumes. Analyzing the raw compartmental volumes replicated the frequently reported Sex differences in compartmental volumes with men showing larger volumes. However, when statistically controlling for brain size Sex differences and Sex × Age interactions practically disappear. Thus, brain size is more important than Sex in explaining interindividual differences in compartmental volumes. The influence of brain size is discussed in the context of an allometric scaling of the compartmental volumes. © 2014 Wiley Periodicals, Inc.

  12. Tuberculosis incidence in prisons: a systematic review.

    PubMed

    Baussano, Iacopo; Williams, Brian G; Nunn, Paul; Beggiato, Marta; Fedeli, Ugo; Scano, Fabio

    2010-12-21

    Transmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively. The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

  13. Invasive cancer incidence - United States, 2010.

    PubMed

    Henley, S Jane; Singh, Simple; King, Jessica; Wilson, Reda; Ryerson, Blythe

    2014-03-28

    Cancer has many causes, some of which can, at least in part, be avoided through interventions known to reduce cancer risk. Healthy People 2020 objectives call for reducing colorectal cancer incidence to 38.6 per 100,000 persons, reducing late-stage breast cancer incidence to 41.0 per 100,000 women, and reducing cervical cancer incidence to 7.1 per 100,000 women. To assess progress toward reaching these Healthy People 2020 targets, CDC analyzed data from U.S. Cancer Statistics (USCS) for 2010. USCS includes incidence data from CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and mortality data from the National Vital Statistics System. In 2010, a total of 1,456,496 invasive cancers were reported to cancer registries in the United States (excluding Arkansas and Minnesota), an annual incidence rate of 446 cases per 100,000 persons, compared with 459 in 2009. Cancer incidence rates were higher among men (503) than women (405), highest among blacks (455), and ranged by state from 380 to 511 per 100,000 persons. Many factors, including tobacco use, obesity, insufficient physical activity, and human papilloma virus (HPV) infection, contribute to the risk for developing cancer, and differences in cancer incidence indicate differences in the prevalence of these risk factors. These differences can be reduced through policy approaches such as the Affordable Care Act, which could increase access for millions of persons to appropriate and timely cancer preventive services, including help with smoking cessation, cancer screening, and vaccination against HPV.

  14. Cancer incidence estimation method: an Apulian experience.

    PubMed

    Nannavecchia, Anna M; Rashid, Ivan; Cuccaro, Francesco; Chieti, Antonio; Bruno, Danila; Burgio Lo Monaco, Maria G; Tanzarella, Cinzia; Bisceglia, Lucia

    2017-09-01

    The Cancer Registry of Puglia (RTP) was instituted in 2008 as a regional population-based cancer registry. It consists of six sections (Foggia, Barletta-Andria-Tran, Bari, Brindisi, Lecce, and Taranto) and covers more than 4 000 000 inhabitants. At present, four of six sections have received accreditation by AIRTUM (53% of regional population). To point out possible regional geographic variability in cancer incidence and also to support health services planning, we developed an original estimation method to ensure a complete territorial coverage. Incidence data of the four accredited RTP sections for the shared incidence period 2006-2008, the 2001-2009 hospitalization regional data, and 2006-2009 mortality data were considered. To take into account specific health features of different provinces, we performed an estimate of cancer incidence rates of nonaccredited sections using a combination of accredited sections rates and a factor that combines mortality and hospitalization ratios available for all the sections. Finally, we validated the method and we applied it to estimate regional cancer rates as the population-weighted average of accredited sections and nonaccredited sections adjusted rates. The validation process shows that estimated rates are close to real incidence data. The most frequent neoplasms in Apulia are breast (direct standardized rates 96.8 per 100 000 inhabitants), colon-rectum (36.6), and thyroid cancer (25.3) in women and prostate (70.2), lung (68.4), and colon-rectum cancer (52.2) in men. This method could be useful to assess the cancer incidence when complete cancer registration data are not available, but hospitalization, mortality, and neighbouring incidence data are available.

  15. The incidence of IDDM in Singapore children.

    PubMed

    Lee, W W; Ooi, B C; Thai, A C; Loke, K Y; Tan, Y T; Rajan, U; Tan, C L

    1998-08-01

    To determine the incidence of insulin dependent diabetes mellitus (IDDM) in children 0-12 years of age in Singapore, which has a population of 2.9 million. The primary source was a 2-year phone and mail survey of doctors in the government and government restructured hospitals and the private sector. The secondary source was the membership records of the Diabetes Society of Singapore. Using the capture-recapture method, ascertainment was assessed to be 92.2% complete. The age standardised incidence rate was 2.46 per 100,000 children 0-12 years old, for the period 1992-1994 (95% confidence interval: 2.16-2.75). The data seemed to indicate a rising incidence of IDDM in this population, being 1.4/100,000 in 1992, 2.4/100,000 in 1993 and 3.8/100,000 in 1994. The male: female ratio is 1:1.85. There was seasonal variation with fewer cases from July to October and more from November to May. Five percent of patients had a first degree relative with IDDM. Malays appeared to have a lower incidence (1.23/100,000) compared to the Chinese (2.25/100,000) and the Indians (5.78/100,000). The incidence of IDDM in Singapore children is similar to that reported for Hong Kong and Japan, but higher than that for Shanghai. The female preponderance is similar to that seen in other Asian population. The data suggests a rising incidence of IDDM in Singapore and differences in incidence between the Malays, Chinese and Indians, but further observations are needed.

  16. Clinical incidents involving students on placement: an analysis of incident reports to identify potential risk factors.

    PubMed

    Gaida, J E; Maloney, S; Lo, K; Morgan, P

    2015-06-01

    Students are sometimes involved in incidents during clinical training. To the authors' knowledge, no quantitative studies of incidents specifically involving physiotherapy students on clinical placement are available in the literature. A retrospective audit (2008 to 2011) of incident reports involving physiotherapy students was conducted to identify the nature and features of incidents. The study aimed to determine if injuries to a student or patient were more or less likely when the supervisor was in close proximity, and whether students with lower academic performance in their preclinical semester were more likely to be involved in an incident. There were 19 care-delivery-related and three equipment-related incidents. There were no incidents of violent, aggressive or demeaning behaviour towards students. The incident rate was 9.0/100,000 student-hours for third-year students and 6.8/100,000 student-hours for fourth-year students. The majority of incidents (55%) occurred from 11 am to 12-noon and from 3 pm to 3.30 pm. Incidents more often resulted in patient or student injury when the supervisor was not in close proximity (approximately 50% vs approximately 20%), although the difference was not significant (P=0.336). The academic results of students involved in incidents were equivalent to the whole cohort in their preclinical semester {mean 75 [standard deviation (SD) 6] vs 76 (SD 7); P=0.488}. The unexpected temporal clustering of incidents warrants further investigation. Student fatigue may warrant attention as a potential contributor; however, contextual factors, such as staff workload, along with organisational systems, structures and procedures may be more relevant. The potential relationship between supervisor proximity and injury also warrants further exploration. The findings of the present study should be integrated into clinical education curricula and communicated to clinical educators. Copyright © 2014 Chartered Society of Physiotherapy. Published by

  17. Incidence of intraoperative seizures during motor evoked potential monitoring in a large cohort of patients undergoing different surgical procedures.

    PubMed

    Ulkatan, Sedat; Jaramillo, Ana Maria; Téllez, Maria J; Kim, Jinu; Deletis, Vedran; Seidel, Kathleen

    2017-04-01

    OBJECTIVE The purpose of this study was to investigate the incidence of seizures during the intraoperative monitoring of motor evoked potentials (MEPs) elicited by electrical brain stimulation in a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. METHODS The authors retrospectively analyzed data from 4179 consecutive patients who underwent surgery or an interventional radiology procedure with MEP monitoring. RESULTS Of 4179 patients, only 32 (0.8%) had 1 or more intraoperative seizures. The incidence of seizures in cranial procedures, including craniotomies and interventional neuroradiology, was 1.8%. In craniotomies in which transcranial electrical stimulation (TES) was applied to elicit MEPs, the incidence of seizures was 0.7% (6/850). When direct cortical stimulation was additionally applied, the incidence of seizures increased to 5.4% (23/422). Patients undergoing craniotomies for the excision of extraaxial brain tumors, particularly meningiomas (15 patients), exhibited the highest risk of developing an intraoperative seizure (16 patients). The incidence of seizures in orthopedic spine surgeries was 0.2% (3/1664). None of the patients who underwent surgery for conditions of the spinal cord, neck, or peripheral nerves or who underwent cranial or noncranial interventional radiology procedures had intraoperative seizures elicited by TES during MEP monitoring. CONCLUSIONS In this largest such study to date, the authors report the incidence of intraoperative seizures in patients who underwent MEP monitoring during a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. The low incidence of seizures induced by electrical brain stimulation

  18. [Chemical incidents and gathering information on toxicity].

    PubMed

    Yamamoto, Miyako; Morikawa, Kaoru

    2006-12-01

    Major cases of chemical incidents and information on chemical agents and chemical terrorist attacks are outlined. Since the late 1990s, major incidents occurred consecutively, such as two cases of sarin attack in 1994 and 1995, an oil spill from a Russian oil tanker in the Japan Sea in 1997, arsenic poisoning in Wakayama in 1998, the criticality incident at Tokai-Mura in 1999 in Japan, and terrorist attacks on September 11, 2001, in New York. The importance of crisis management and cooperation among relevant organizations has been emphasized. To provide information for an appropriate and quick response in emergencies, we prepared a Web portal site for information on chemicals including chemical agents, a chemical incident database, and links to relevant Web sites. In intentional cases of poisoning caused by toxic chemicals in Japan, 111 cases were collected mainly from a newspaper database (1984-1999). Many copy-cat poisonings occurred, especially in 1984-1985 and in 1998 just after an arsenic poisoning incident in Wakayama. Many cases occurred in the laboratories of institutes, universities, and hospitals where various types of chemicals are used.

  19. Delphi technique used in laser incident surveillance

    NASA Astrophysics Data System (ADS)

    Clark, Krystyn R.; Johnson, Thomas E.; Neal, Thomas A.

    2004-07-01

    There are several data sources for collecting laser incidents. All reviewed sources collect information differently for varying purposes. An effort was undertaken to combine laser exposure reporting data into a single database so that trends in laser incidents could be identified. A review of available datasets revealed significant disparities in laser exposure reporting. As a result, utilizing the existing database to predict personnel at increased risk for laser exposure and injury is challenging if not impossible. For example, many of the data sources do not contain information about physical examinations, diagnosis, or medical follow-up, which are important for studying laser injury outcomes. This study proposes using the Delphi Technique to identify relevant fields that should be collected for a laser incident database based on the experiences of three groups of United States Air Force (USAF) professionals: (1) Engineers (Bioenvironmental Engineers), (2) Health Physicists, and (3) Physicians (Ophthalmologists and Flight Surgeons). In broad terms, these three professional groups coordinate laser incident analyses and investigations. Knowing what information is most important for studying laser incidents is the first step in establishing an effective database that will assist in identifying occupations that are at high-risk for laser injury. Robust data sets obtained for analysis by these healthcare professionals can be an effective tool for laser injury prevention and management.

  20. Incidence and overall survival of malignant ameloblastoma.

    PubMed

    Rizzitelli, Alexandra; Smoll, Nicolas R; Chae, Michael P; Rozen, Warren M; Hunter-Smith, David J

    2015-01-01

    Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER) database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma. Using the International Classification of Diseases for Oncology (ICD-O) codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma. The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival. To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.

  1. Incidence and Overall Survival of Malignant Ameloblastoma

    PubMed Central

    Rizzitelli, Alexandra; Smoll, Nicolas R.; Chae, Michael P.; Rozen, Warren M.; Hunter-Smith, David J.

    2015-01-01

    Background Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6–2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER) database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma. Method Using the International Classification of Diseases for Oncology (ICD-O) codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma. Results The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival. Conclusions To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years. PMID:25692490

  2. Comparing center-specific cumulative incidence functions.

    PubMed

    Fan, Ludi; Schaubel, Douglas E

    2016-01-01

    The competing risks data structure arises frequently in clinical and epidemiologic studies. In such settings, the cumulative incidence function is often used to describe the ultimate occurrence of a particular cause of interest. If the objective of the analysis is to compare subgroups of patients with respect to cumulative incidence, imbalance with respect to group-specific covariate distributions must generally be factored out, particularly in observational studies. This report proposes a measure to contrast center- (or, more generally group-) specific cumulative incidence functions (CIF). One such application involves evaluating organ procurement organizations with respect to the cumulative incidence of kidney transplantation. In this case, the competing risks include (i) death on the wait-list and (ii) removal from the wait-list. The proposed method assumes proportional cause-specific hazards, which are estimated through Cox models stratified by center. The proposed center effect measure compares the average CIF for a given center to the average CIF that would have resulted if that particular center had covariate pattern-specific cumulative incidence equal to that of the national average. We apply the proposed methods to data obtained from a national organ transplant registry.

  3. Deconstructing Incidents of Female Perpetrated Sex Crimes.

    PubMed

    Budd, Kristen M; Bierie, David M; Williams, Katria

    2017-04-01

    Very little is known about co-offending by female sexual offenders (FSOs), especially in terms of diverse forms of offender groupings. To address this gap in the literature, this study uses 21 years (1992-2012) of National Incident-Based Reporting System data to analyze incidents of sexual offending committed by four female groupings: solo FSOs ( n = 29,238), coed pairs consisting of one male and one FSO ( n = 11,112), all-female groups ( n = 2,669), and multiple perpetrator groups that consist of a combination of three or more FSOs and male sexual offenders (MSOs; n = 4,268). Using a multinomial logistic regression model, the data show significant differences in offender, victim, and crime context incident characteristics. The data also indicate that incidents with solo FSOs and all-female groups have similar characteristics, coed pairs and multiple perpetrator incidents have similar characteristics, and these two categorizations are fairly distinct from one another. Implications of this research are discussed in addition to directions for future research on female sexual offending.

  4. Timing of increased autistic disorder cumulative incidence.

    PubMed

    McDonald, Michael E; Paul, John F

    2010-03-15

    Autistic disorder (AD) is a severe neurodevelopmental disorder typically identified in early childhood. Both genetic and environmental factors are implicated in its etiology. The number of individuals identified as having autism has increased dramatically in recent years, but whether some proportion of this increase is real is unknown. If real, susceptible populations may have exposure to controllable exogenous stressors. Using literature AD data from long-term (approximately 10-year) studies, we determined cumulative incidence of AD for each cohort within each study. These data for each study were examined for a changepoint year in which the AD cumulative incidence first increased. We used data sets from Denmark, California, Japan, and a worldwide composite of studies. In the Danish, California, and worldwide data sets, we found that an increase in AD cumulative incidence began about 1988-1989. The Japanese study (1988-1996) had AD cumulative incidence increasing continuously, and no changepoint year could be calculated. Although the debate about the nature of increasing autism continues, the potential for this increase to be real and involve exogenous environmental stressors exists. The timing of an increase in autism incidence may help in screening for potential candidate environmental stressors.

  5. [Incidence some congenital defects in Monterrey, Mexico].

    PubMed

    Hernández-Herrera, Ricardo J; Cerda-Flores, Ricardo M; Dávila-Rodríguez, Martha I; Cortés-Gutiérrez, Elva I

    2002-12-01

    In Mexico, the congenital defects (CD) in newborns represent the third cause of infant morbi-mortality. Incidence rates/1000 reported for our country vary from 8.15 (Puebla) to 32.90 (Distrito Federal). The aim of this study was to estimate the incidence of some CD in Monterrey, Mexico. A transversal, prospective, descriptive, and observational study was carried out at the Hospital de Ginecologia y Obstetricia No. 23, IMSS during January 1995 to December 1999. The external CD were analyzed according to World Health Organization (WHO) and classified according to their topography distribution. A total incidence of 9.89 [(1309/132,369)* 1000)] was detected. The more frequent CD were: the nervous system (2.33), the chromosomal (1.67), osteomuscular (1.67) of face and neck (1.18), and reproductive system (0.81). The less frequent CD were: the digestive system (0.43), diverse syndromes (0.38), and skin (0.29). Even though the global incidence of DC observed in this study is into the rank informed in the national and international literature. Because of this incidence has a great variability, we considered important to homogenize diagnosis criteria for each DC. With this results it will be possible to carry out comparative cross-sectional studies to determine if they are similar or different and then, by association studies to establish its possible etiological factors.

  6. Comorbidities Among Persons With Incident Psychiatric Condition

    PubMed Central

    Fluegge, Kyle R.

    2016-01-01

    Objective: I sought to determine how medical comorbidities co-exist with incident psychiatric condition. Method: I used data from all 11 available waves (1992-2012) of the Health and Retirement Study (HRS). I identified 4,358 index participants with self-reported incident psychiatric condition. I collected comorbidity data from participants preceding, including, and succeeding that incident wave. Comorbidities assessed included high blood pressure (HBP), diabetes mellitus, cancer, lung disease, heart disease, stroke, and arthritis. Modified Poisson regression combined with log-linked binomial regression was used to estimate relative risks (RRs) of reporting a comorbidity preceding and following the incident wave. Multiple comparison testing dictated significance of RRs with p < .007. Results: For the waves preceding the index wave, the RRs of reporting all comorbidities except HBP and cancer were significantly (p < .007) increased. For the waves following incident psychiatric condition, the risks of reporting heart disease, diabetes, and lung disease were significantly (p < .007) increased. These results were adjusted for participant age, race, gender, other comorbidities listed, and the wave in which a comorbidity was reported. Conclusion: The bidirectional association between a psychiatric condition and medical illnesses could only be statistically confirmed for lung disease, diabetes, and heart disease. It is of interest to determine how reporting a psychiatric condition may affect the sequelae of health care use and treatment outcomes for patients with either of these comorbidities or a combination of them. PMID:28008416

  7. Breast Cancer Brain Metastases: Clonal Evolution in Clinical Context

    PubMed Central

    Saunus, Jodi M.; McCart Reed, Amy E.; Lim, Zhun Leong; Lakhani, Sunil R.

    2017-01-01

    Brain metastases are highly-evolved manifestations of breast cancer arising in a unique microenvironment, giving them exceptional adaptability in the face of new extrinsic pressures. The incidence is rising in line with population ageing, and use of newer therapies that stabilise metastatic disease burden with variable efficacy throughout the body. Historically, there has been a widely-held view that brain metastases do not respond to circulating therapeutics because the blood-brain-barrier (BBB) restricts their uptake. However, emerging data are beginning to paint a more complex picture where the brain acts as a sanctuary for dormant, subclinical proliferations that are initially protected by the BBB, but then exposed to dynamic selection pressures as tumours mature and vascular permeability increases. Here, we review key experimental approaches and landmark studies that have charted the genomic landscape of breast cancer brain metastases. These findings are contextualised with the factors impacting on clonal outgrowth in the brain: intrinsic breast tumour cell capabilities required for brain metastatic fitness, and the neural niche, which is initially hostile to invading cells but then engineered into a tumour-support vehicle by the successful minority. We also discuss how late detection, abnormal vascular perfusion and interstitial fluid dynamics underpin the recalcitrant clinical behaviour of brain metastases, and outline active clinical trials in the context of precision management. PMID:28098771

  8. Pathological correlations between traumatic brain injury and chronic neurodegenerative diseases.

    PubMed

    Cruz-Haces, Marcela; Tang, Jonathan; Acosta, Glen; Fernandez, Joseph; Shi, Riyi

    2017-01-01

    Traumatic brain injury is among the most common causes of death and disability in youth and young adults. In addition to the acute risk of morbidity with moderate to severe injuries, traumatic brain injury is associated with a number of chronic neurological and neuropsychiatric sequelae including neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. However, despite the high incidence of traumatic brain injuries and the established clinical correlation with neurodegeneration, the causative factors linking these processes have not yet been fully elucidated. Apart from removal from activity, few, if any prophylactic treatments against post-traumatic brain injury neurodegeneration exist. Therefore, it is imperative to understand the pathophysiological mechanisms of traumatic brain injury and neurodegeneration in order to identify potential factors that initiate neurodegenerative processes. Oxidative stress, neuroinflammation, and glutamatergic excitotoxicity have previously been implicated in both secondary brain injury and neurodegeneration. In particular, reactive oxygen species appear to be key in mediating molecular insult in neuroinflammation and excitotoxicity. As such, it is likely that post injury oxidative stress is a key mechanism which links traumatic brain injury to increased risk of neurodegeneration. Consequently, reactive oxygen species and their subsequent byproducts may serve as novel fluid markers for identification and monitoring of cellular damage. Furthermore, these reactive species may further serve as a suitable therapeutic target to reduce the risk of post-injury neurodegeneration and provide long term quality of life improvements for those suffering from traumatic brain injury.

  9. Non-coding RNAs in cancer brain metastasis.

    PubMed

    Wu, Kerui; Sharma, Sambad; Venkat, Suresh; Liu, Keqin; Zhou, Xiaobo; Watabe, Kounosuke

    2016-01-01

    More than 90% of cancer death is attributed to metastatic disease, and the brain is one of the major metastatic sites of melanoma, colon, renal, lung and breast cancers. Despite the recent advancement of targeted therapy for cancer, the incidence of brain metastasis is increasing. One reason is that most therapeutic drugs can't penetrate blood-brain-barrier and tumor cells find the brain as sanctuary site. In this review, we describe the pathophysiology of brain metastases to introduce the latest understandings of metastatic brain malignancies. This review also particularly focuses on non-coding RNAs and their roles in cancer brain metastasis. Furthermore, we discuss the roles of the extracellular vesicles as they are known to transport information between cells to initiate cancer cell-microenvironment communication. The potential clinical translation of non-coding RNAs as a tool for diagnosis and for treatment is also discussed in this review. At the end, the computational aspects of non-coding RNA detection, the sequence and structure calculation and epigenetic regulation of non-coding RNA in brain metastasis are discussed.

  10. 49 CFR 171.16 - Detailed hazardous materials incident reports.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Materials Incident Report to the Information Systems Manager, PHH-63, Pipeline and Hazardous Materials... Hazardous Material Incident Report to the Information System Manager, DHM-63, Research and Special Programs... INFORMATION, REGULATIONS, AND DEFINITIONS Incident Reporting, Notification, BOE Approvals and Authorization...

  11. How to Report a Pesticide Incident Involving Exposures to People

    EPA Pesticide Factsheets

    Pesticides incidents must be reported by pesticide registrants. Others, such as members of the public and environmental professionals, would like to report pesticide incidents. This website will facilitate such incident reporting.

  12. Brain iron homeostasis.

    PubMed

    Moos, Torben

    2002-11-01

    Iron is essential for virtually all types of cells and organisms. The significance of the iron for brain function is reflected by the presence of receptors for transferrin on brain capillary endothelial cells. The transport of iron into the brain from the circulation is regulated so that the extraction of iron by brain capillary endothelial cells is low in iron-replete conditions and the reverse when the iron need of the brain is high as in conditions with iron deficiency and during development of the brain. Whereas there is good agreement that iron is taken up by means of receptor-mediated uptake of iron-transferrin at the brain barriers, there are contradictory views on how iron is transported further on from the brain barriers and into the brain extracellular space. The prevailing hypothesis for transport of iron across the BBB suggests a mechanism that involves detachment of iron from transferrin within barrier cells followed by recycling of apo-transferrin to blood plasma and release of iron as non-transferrin-bound iron into the brain interstitium from where the iron is taken up by neurons and glial cells. Another hypothesis claims that iron-transferrin is transported into the brain by means of transcytosis through the BBB. This thesis deals with the topic "brain iron homeostasis" defined as the attempts to maintain constant concentrations of iron in the brain internal environment via regulation of iron transport through brain barriers, cellular iron uptake by neurons and glia, and export of iron from brain to blood. The first part deals with transport of iron-transferrin complexes from blood to brain either by transport across the brain barriers or by uptake and retrograde axonal transport in motor neurons projecting beyond the blood-brain barrier. The transport of iron and transport into the brain was examined using radiolabeled iron-transferrin. Intravenous injection of [59Fe-125]transferrin led to an almost two-fold higher accumulation of 59Fe than of

  13. Experimental traumatic brain injury

    PubMed Central

    2010-01-01

    Traumatic brain injury, a leading cause of death and disability, is a result of an outside force causing mechanical disruption of brain tissue and delayed pathogenic events which collectively exacerbate the injury. These pathogenic injury processes are poorly understood and accordingly no effective neuroprotective treatment is available so far. Experimental models are essential for further clarification of the highly complex pathology of traumatic brain injury towards the development of novel treatments. Among the rodent models of traumatic brain injury the most commonly used are the weight-drop, the fluid percussion, and the cortical contusion injury models. As the entire spectrum of events that might occur in traumatic brain injury cannot be covered by one single rodent model, the design and choice of a specific model represents a major challenge for neuroscientists. This review summarizes and evaluates the strengths and weaknesses of the currently available rodent models for traumatic brain injury. PMID:20707892

  14. Brain retractor systems.

    PubMed

    Dujovny, Manuel; Ibe, Onyekachi; Perlin, Alfred; Ryder, Travis

    2010-09-01

    Reviews of the brain retractor evolution are described. Instrument characteristics as well as the physiopathological and histopathological damage of the brain are induced by brain retraction. The literature related to the brain retractor was reviewed. Journals, books, personal testimony, government patents, and electronic media databases were analysed. The brain retractor started as a hand-held flat ribbon manufactured on copper and stainless steel. This shape evolved into a shovel. Several shapes acquired from the early period were from a tappered, spoon shape covered by silicone. The posterior evolution was the development of the articulate arm, fixed to the skull or to the self-retaining subcutaneous retractor, or attached to a frame or to a stereotactic instrument. The pressure monitor was the most important safety addition. In conclusion, a better monitor system needs to be developed to avoid brain injury.

  15. Patient safety incidents are common in primary care: A national prospective active incident reporting survey

    PubMed Central

    Brami, Jean; Chanelière, Marc; Kret, Marion; Mosnier, Anne; Dupie, Isabelle; Haeringer-Cholet, Anouk; Keriel-Gascou, Maud; Maradan, Claire; Villebrun, Frédéric; Makeham, Meredith; Quenon, Jean-Luc

    2017-01-01

    Background The study objectives were to describe the incidence and the nature of patient safety incidents (PSIs) in primary care general practice settings, and to explore the association between these incidents and practice or organizational characteristics. Methods GPs, randomly selected from a national influenza surveillance network (n = 800) across France, prospectively reported any incidents observed each day over a one-week period between May and July 2013. An incident was an event or circumstance that could have resulted, or did result, in harm to a patient, which the GP would not wish to recur. Primary outcome was the incidence of PSIs which was determined by counting reports per total number of patient encounters. Reports were categorized using existing taxonomies. The association with practice and organizational characteristics was calculated using a negative binomial regression model. Results 127 GPs (participation rate 79%) reported 317 incidents of which 270 were deemed to be a posteriori judged preventable, among 12,348 encounters. 77% had no consequences for the patient. The incidence of reported PSIs was 26 per 1000 patient encounters per week (95% CI [23‰ -28‰]). Incidents were three times more frequently related to the organization of healthcare than to knowledge and skills of health professionals, and especially to the workflow in the GPs’ offices and to the communication between providers and with patients. Among GP characteristics, three were related with an increased incidence in the final multivariable model: length of consultation higher than 15 minutes, method of receiving radiological results (by fax compared to paper or email), and being in a multidisciplinary clinic compared with sole practitioners. Conclusions Patient safety incidents (PSIs) occurred in mean once every two days in the sampled GPs and 2% of them were associated with a definite possibility for harm. Studying the association between organizational features of general

  16. Cervical venous reflux in dynamic brain scintigraphy.

    PubMed

    Hayt, D B; Perez, L A

    1976-01-01

    Cervical venous reflux, shown by dynamic brain scintigraphy, was investigated through three avenues of approach: (A) by reviewing 371 randomly chosen routine dynamic intracerebral bloodflow studies to estimate its incidence; (B) by correlative positive-contrast superior venacavography in patients with characteristic cervical venous reflux; and (C) by performing dynamic brain scintigraphy while utilizing various positional and physiologic maneuvers to attempt to produce cervical venous reflux in patients who did not exhibit this phenomenon on earlier examination. Although any obstruction of the superior vena cava or a properly timed Valsalva maneuver in selected patients can produce the scintigraphic picture of cervical venous reflux, in most cases it is a normal phenomenon due to incompetent or absent cervical venous valves.

  17. Neurologic sequelae of brain tumors in children.

    PubMed

    Ullrich, Nicole J

    2009-11-01

    Neurologic signs and symptoms are often the initial presenting features of a primary brain tumor and may also emerge during the course of therapy or as late effects of the tumor and its treatment. Variables that influence the development of such neurologic complications include the type, size, and location of the tumor, the patient's age at diagnosis, and the treatment modalities used. Heightened surveillance and improved neuroimaging modalities have been instrumental in detecting and addressing such complications, which are often not appreciated until many years after completion of therapy. As current brain tumor therapies are continually refined and newer targeted therapies are developed, it will be important for future cooperative group studies to include systematic assessments to determine the incidence of neurologic complications and to provide a framework for the development of novel strategies for prevention and intervention.

  18. [Diagnosis and treatment of traumatic brain injury].

    PubMed

    Rickels, E

    2009-02-01

    Traumatic brain injury (TBI) is still the major cause of death under 45 years of age and an important one for children under 15. Its incidence is 332/100,000 inhabitants. It results from an impact with the skull with/without lesion of the brain but at least a short-term neurological disorder. All other injuries to the skull should be called concussion. The duration of unconsciousness defines the severity of TBI. Patients with TBI should be admitted to a surgical ward. Those retaining consciousness and with GCS scores of 15 might be allowed to go home if under surveillance. With GCS of <15 or with risk factors, TBI requires a CT scan and in-hospital surveillance. Acutely life-threatening, i.e. space-occupying, bleeding must be operated on immediately. Epidural or subdural bleeding, especially in comatose patients, is still a vital risk and thus requires immediate surgery.

  19. The incidence and prevalence of thyroid autoimmunity.

    PubMed

    McLeod, Donald S A; Cooper, David S

    2012-10-01

    The thyroid gland is the most common organ affected by autoimmune disease. Other autoimmune diseases, most notably type 1 diabetes mellitus, are increasing in incidence. It is unknown whether autoimmune thyroid diseases are following the same pattern. This review summarizes studies of autoimmune thyroid disease incidence and prevalence since 1950, not only for these measures of occurrences, but also for commenting on identified risk factors for thyroid autoimmunity. We find that incidence of autoimmune thyroid disease is currently higher than in historic series although the studies are so variable in design, patient population, disease definition, and laboratory methods that it is impossible to tell whether this difference is real. Further research is required to assess the possibility of changing disease patterns of autoimmune thyroid disease as opposed to simple changes in diagnostic thresholds.

  20. Incidence of bruxism in TMD population.

    PubMed

    Chandwani, Briesh; Ceneviz, Caroline; Mehta, Noshir; Scrivani, Steven

    2011-01-01

    The objective of the study presented here was to examine the incidence of bruxism in patients suffering from temporomandibular disorders. Two cohorts of patients suffering from temporomandibular disorders were evaluated. One group, composed of 163 patients, was asked specifically about the occurrence of bruxism, while the other group, composed of 200 patients, was not specifically asked about bruxism (self-reporting). The incidence of bruxism was only 20.5% for the group that only self-reported bruxism, while the incidence was 65% when asked specifically about bruxism. It is critical to ask specifically about bruxism. Patients are more likely to report bruxism when asked specifically about it. It is important to incorporate this as part of a TMD evaluation.

  1. Methods of responding to healthcare security incidents.

    PubMed

    Furnell, S; Gritzalis, D; Katsikas, S; Mavroudakis, K; Sanders, P; Warren, M

    1998-01-01

    This paper considers the increasing requirement for security in healthcare IT systems and, in particular, identifies the need for appropriate means by which healthcare establishments (HCEs) may respond to incidents. The main discussion focuses upon two significant initiatives that have been established in order to improve understanding and awareness of healthcare security issues. The first is the establishment of a dedicated Incident Reporting Scheme (IRS) for HCEs, enabling the level and types of security incidents faced within the healthcare community to be monitored and advice appropriately targeted. The second aspect presents a description of healthcare security World Wide Web service, which provides a comprehensive source of advice and guidance for establishments when trying to address and prevent IT security breaches. The discussion is based upon work that is currently being undertaken with the ISHTAR (Implementing Secure Healthcare Telematics Applications in Europe) project, as part of the Telematics Applications for Health programme of the European Commission.

  2. Determinants of occupational disease incidence in Mexico.

    PubMed

    Idrovo, Alvaro J; Pérez-Núñez, Ricardo

    2005-01-01

    Most occupational health researchers have studied individual determinants, tending to forget those causes that are universally present. To explore some determinants of occupational disease incidence in Mexico, the authors carried out an ecological study with data from 32 Mexican states. Using ordinary least squares regression, they explored associations between occupational disease incidence and the Gini coefficient, the percentage of small and median enterprises, and migration. Income inequality and the combined percentage of small and median enterprises were negatively associated with the incidence of occupational disease. In Mexico, the "population strategy" of the prevention of occupational disease suggests that big enterprises' contexts are related to a higher occurrence of occupational diseases. Further studies using multilevel approaches are needed to establish whether these occupational diseases are related to exposures present in big or in small and median enterprises.

  3. Social Activities, Incident Cardiovascular Disease, and Mortality.

    PubMed

    Han, Sae Hwang; Tavares, Jane L; Evans, Molly; Saczynski, Jane; Burr, Jeffrey A

    2017-03-01

    This study examined the relationships between social activities, incident cardiovascular disease (CVD), and non-CVD mortality among older adults in the United States. Data from the Health and Retirement Study (2006-2010) were employed. Two measures of social engagement, volunteering and informal helping, along with two measures of social participation, attendance at religious services and social group meetings, were included. Mediation models for health behaviors were estimated. Multinomial logistic regression models demonstrated that volunteering provided the most consistent results in terms of a lower risk of incident CVD and mortality. Furthermore, volunteering at higher time commitments is related to lower CVD incidence and death; informally helping others at a modest time commitment is related to lower risk of death only. Health behaviors mediated the relationships. Social participation was not related to either CVD or mortality. Social activity is a modifiable behavior that may be considered a potential health intervention.

  4. Plasmonics metalens independent from the incident polarizations.

    PubMed

    Wang, Wei; Guo, Zhongyi; Li, Rongzhen; Zhang, Jingran; Li, Yan; Liu, Yi; Wang, Xinshun; Qu, Shiliang

    2015-06-29

    An ultra-thin, planar, broadband metalens composed of L-shaped gap antennas on a thin gold film has been designed, which is suitable for both circular and X/Y linear polarizations focusing simultaneously. The phase discontinuity of the cross-polarized transmisson light can be manipulated by the length and width of the L-shaped gap antenna accurately. The designed planar metalens posses a strong focusing ability over a large wavelength range, and the size of the focus spot is in sub-wavelength scale. The focal lengths change from 13 to 7 um with incident wavelength from 750 to 1300 nm, and the cause of dispersion is explained and analyzed in detail. The designed metalens can work very well at a wide incident angles of 0~45°. Most importantly, its unique focusing ability that is independent of the incident polarizations will greatly promotes the practical applications and developments of the metasurfaces.

  5. Cancer incidence among Finnish nuclear reactor workers.

    PubMed

    Auvinen, Anssi; Pukkala, Eero; Hyvönen, Hannu; Hakama, Matti; Rytömaa, Tapio

    2002-07-01

    Because of their well-documented exposures to repeated low doses of ionizing radiation, nuclear reactor workers offer an opportunity to assess cancer risk from low-dose radiation. A cohort of all 15,619 Finnish nuclear reactor workers was established through dose-monitoring records. A questionnaire survey revealed no substantial differences in consumption of tobacco or alcohol between different exposure groups nor between nuclear power company employees and contract workers. In the follow-up for cancer incidence, no clear excess in cancer incidence was observed overall, nor was any observed in any of the specific cancer types studied. There was little evidence for an association between cancer incidence and cumulative radiation dose, but the statistical power was limited. More precise estimates will be available from an international collaborative study of nuclear industry workers, including our cohort.

  6. Incident position detector for radiation beam

    SciTech Connect

    Koumura, N.; Niwa, Y.; Ogino, Y.; Ohwada, M.; Tanaka, K.

    1983-05-17

    Disclosed is a device for detecting an incident position of radiation beam, particularly, its center or center of gravity. The detecting device is provided with a scanning type radiation beam sensing device having a plurality of radiation sensing elements in a linear arrangement, and the sensing device is disposed in such a manner that its radiation receiving surface may be substantially coincided with an incident surface of the radiation beam to be detected. When reading an output from the sensing device, the time sequential output signals from the sensing device are split into predetermined sections, and the signal quantities among the sections are compared. In this way, the position of the center or the center of gravity of the radiation beam on the incident surface is detected with the position corresponding to a split point of the signals as the reference.

  7. The incidence of severe physical child abuse in Wales.

    PubMed

    Sibert, J R; Payne, E H; Kemp, A M; Barber, M; Rolfe, K; Morgan, R J H; Lyons, R A; Butler, I

    2002-03-01

    The purposes of this study were: (1) to ascertain the incidence and nature of severe physical child abuse in Wales; (2) to ascertain the incidence of all physical abuse in babies under 1 year of age; and (3) to determine whether child protection registers (CPR) accurately reflect the numbers of children who are physically abused. This is a population-based incidence study based in Wales, UK, for 2 years from April 1996 through March 1998. Children studied were under the age of 14 with severe physical abuse consistent with the criminal law level of Grievous Bodily Harm. This included seven categories of injury (death; head injury including subdural hemorrhage; internal abdominal injury; physical injury in Munchausen Syndrome by Proxy including suffocation; fracture; burn or scald; adult bite). Cases were ascertained by a pediatrician surveillance reporting system (WPSU). A criterion for inclusion was multidisciplinary agreement that physical abuse had occurred (at case conference, strategy meeting, or Part 8 Review). The incidence of all babies under 1 year of age with physical abuse was also studied. Ascertainment of babies under the age of 1 year was undertaken from CPR as well as the WPSU. Severe abuse is six times more common in babies [54/100,000/year (95% CI +/- 17.2)] than in children from 1 year to 4 years of age [9.2/100,000 (95% CI +/- 3.6)]. It is 120 times more common than in 5- to 13-year-olds [0.47/100,000 (95% CI +/- 0.47)]. This is mainly because two types of serious abuse (brain injury including subdural hemorrhage and fractures) are more common in babies under the age of 1 year than older children. Using data from two sources (the WPSU and CPRs), the incidence of physical abuse in babies is 114/100,000 (CI 114 +/- 11.8) per year. This equates to 1 baby in 880 being abused in the first year of life. The largely rural Health Authority area in Wales had incidence figures for abuse in babies that were 50% of the three other predominantly urban Health

  8. Left Brain, Right Brain, Super Brain: The Holistic Model.

    ERIC Educational Resources Information Center

    Yellin, David

    Recent discoveries about the whole brain seem to call for a holistic approach to learning, one in which educators would teach the whole person, including physical and emotional states as well as cognitive abilities. Three holistic techniques are particularly relevant to education: (1) biofeedback; (2) yoga; and (3) the Lozanov method. Biofeedback…

  9. Malignant testicular tumour incidence and mortality trends

    PubMed Central

    Wojtyła-Buciora, Paulina; Więckowska, Barbara; Krzywinska-Wiewiorowska, Małgorzata; Gromadecka-Sutkiewicz, Małgorzata

    2016-01-01

    Aim of the study In Poland testicular tumours are the most frequent cancer among men aged 20–44 years. Testicular tumour incidence since the 1980s and 1990s has been diversified geographically, with an increased risk of mortality in Wielkopolska Province, which was highlighted at the turn of the 1980s and 1990s. The aim of the study was the comparative analysis of the tendencies in incidence and death rates due to malignant testicular tumours observed among men in Poland and in Wielkopolska Province. Material and methods Data from the National Cancer Registry were used for calculations. The incidence/mortality rates among men due to malignant testicular cancer as well as the tendencies in incidence/death ratio observed in Poland and Wielkopolska were established based on regression equation. The analysis was deepened by adopting the multiple linear regression model. A p-value < 0.05 was arbitrarily adopted as the criterion of statistical significance, and for multiple comparisons it was modified according to the Bonferroni adjustment to a value of p < 0.0028. Calculations were performed with the use of PQStat v1.4.8 package. Results The incidence of malignant testicular neoplasms observed among men in Poland and in Wielkopolska Province indicated a significant rising tendency. The multiple linear regression model confirmed that the year variable is a strong incidence forecast factor only within the territory of Poland. A corresponding analysis of mortality rates among men in Poland and in Wielkopolska Province did not show any statistically significant correlations. Conclusions Late diagnosis of Polish patients calls for undertaking appropriate educational activities that would facilitate earlier reporting of the patients, thus increasing their chances for recovery. Introducing preventive examinations in the regions of increased risk of testicular tumour may allow earlier diagnosis. PMID:27095941

  10. Cancer incidence among Nordic airline cabin crew.

    PubMed

    Pukkala, Eero; Helminen, Mika; Haldorsen, Tor; Hammar, Niklas; Kojo, Katja; Linnersjö, Anette; Rafnsson, Vilhjálmur; Tulinius, Hrafn; Tveten, Ulf; Auvinen, Anssi

    2012-12-15

    Airline cabin crew are occupationally exposed to cosmic radiation and jet lag with potential disruption of circadian rhythms. This study assesses the influence of work-related factors in cancer incidence of cabin crew members. A cohort of 8,507 female and 1,559 male airline cabin attendants from Finland, Iceland, Norway and Sweden was followed for cancer incidence for a mean follow-up time of 23.6 years through the national cancer registries. Standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. A case-control study nested in the cohort (excluding Norway) was conducted to assess the relation between the estimated cumulative cosmic radiation dose and cumulative number of flights crossing six time zones (indicator of circadian disruption) and cancer risk. Analysis of breast cancer was adjusted for parity and age at first live birth. Among female cabin crew, a significantly increased incidence was observed for breast cancer [SIR 1.50, 95% confidence interval (95% CI) 1.32-1.69], leukemia (1.89, 95% CI 1.03-3.17) and skin melanoma (1.85, 95% CI 1.41-2.38). Among men, significant excesses in skin melanoma (3.00, 95% CI 1.78-4.74), nonmelanoma skin cancer (2.47, 95% CI 1.18-4.53), Kaposi sarcoma (86.0, 95% CI 41.2-158) and alcohol-related cancers (combined SIR 3.12, 95% CI 1.95-4.72) were found. This large study with complete follow-up and comprehensive cancer incidence data shows an increased incidence of several cancers, but according to the case-control analysis, excesses appear not to be related to the cosmic radiation or circadian disruptions from crossing multiple time zones. Copyright © 2012 UICC.

  11. Incidence and characteristics of chemical burns.

    PubMed

    Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

    2017-05-01

    Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. Atherosclerosis and incident depression in late life.

    PubMed

    Newson, Rachel S; Hek, Karin; Luijendijk, Hendrika J; Hofman, Albert; Witteman, Jacqueline C M; Tiemeier, Henning

    2010-11-01

    Depression is a prominent concern for older adults; therefore, it is important to identify causal mechanisms so that prevention and treatment strategies can be developed. The vascular depression hypothesis proposes that vascular factors precede the onset of depression in older adults. However, although cross-sectional associations have been established, owing to a lack of objective assessments and longitudinal data, the validity and temporal nature of this relationship is unclear. To examine whether atherosclerosis, an asymptomatic subclinical indicator of vascular burden, increases the risk of developing depression in older adults. Prospective, population-based study. Set within the Rotterdam study, participants were assessed on objective measures of generalized atherosclerosis at baseline (1997-1999) and followed up for an average of 6 years for incident depression. The baseline sample consisted of 3564 participants (56% female) with a mean age of 72 years who initially did not have depression or dementia. Depression was categorized into symptoms or syndromes and assessed in a multidimensional manner from physician and mental health specialist reports, pharmacy records (antidepressant usage), a clinical interview, and self-report. During 21 083 person-years, 429 incidents of depressive symptoms and 197 incidents of depressive syndromes occurred. Individual atherosclerotic measures and a composite measure were not predictive of incident depressive symptoms (composite measure hazard ratio, 0.93; 95% confidence interval, 0.83-1.05) or incident depressive syndromes (composite measure hazard ratio, 0.97; 95% confidence interval, 0.81-1.16). An a priori power analysis indicated a sufficient sample size (α = .05; 0.95 power). Atherosclerosis does not appear to increase the risk of incident depression in older adults. These findings do not support the vascular depression hypothesis and, alternatively, taking findings from prior studies into account, suggest either that

  13. Consciousness, brain, neuroplasticity

    PubMed Central

    Askenasy, Jean; Lehmann, Joseph

    2013-01-01

    Subjectivity, intentionality, self-awareness and will are major components of consciousness in human beings. Changes in consciousness and its content following different brain processes and malfunction have long been studied. Cognitive sciences assume that brain activities have an infrastructure, but there is also evidence that consciousness itself may change this infrastructure. The two-way influence between brain and consciousness has been at the center of philosophy and less so, of science. This so-called bottom-up and top-down interrelationship is controversial and is the subject of our article. We would like to ask: how does it happen that consciousness may provoke structural changes in the brain? The living brain means continuous changes at the synaptic level with every new experience, with every new process of learning, memorizing or mastering new and existing skills. Synapses are generated and dissolved, while others are preserved, in an ever-changing process of so-called neuroplasticity. Ongoing processes of synaptic reinforcements and decay occur during wakefulness when consciousness is present, but also during sleep when it is mostly absent. We suggest that consciousness influences brain neuroplasticity both during wakefulness as well as sleep in a top-down way. This means that consciousness really activates synaptic flow and changes brain structures and functional organization. The dynamic impact of consciousness on brain never stops despite the relative stationary structure of the brain. Such a process can be a target for medical intervention, e.g., by cognitive training. PMID:23847580

  14. Brain Stimulation in Addiction.

    PubMed

    Salling, Michael C; Martinez, Diana

    2016-11-01

    Localized stimulation of the human brain to treat neuropsychiatric disorders has been in place for over 20 years. Although these methods have been used to a greater extent for mood and movement disorders, recent work has explored brain stimulation methods as potential treatments for addiction. The rationale behind stimulation therapy in addiction involves reestablishing normal brain function in target regions in an effort to dampen addictive behaviors. In this review, we present the rationale and studies investigating brain stimulation in addiction, including transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation. Overall, these studies indicate that brain stimulation has an acute effect on craving for drugs and alcohol, but few studies have investigated the effect of brain stimulation on actual drug and alcohol use or relapse. Stimulation therapies may achieve their effect through direct or indirect modulation of brain regions involved in addiction, either acutely or through plastic changes in neuronal transmission. Although these mechanisms are not well understood, further identification of the underlying neurobiology of addiction and rigorous evaluation of brain stimulation methods has the potential for unlocking an effective, long-term treatment of addiction.

  15. Consciousness, brain, neuroplasticity.

    PubMed

    Askenasy, Jean; Lehmann, Joseph

    2013-01-01

    Subjectivity, intentionality, self-awareness and will are major components of consciousness in human beings. Changes in consciousness and its content following different brain processes and malfunction have long been studied. Cognitive sciences assume that brain activities have an infrastructure, but there is also evidence that consciousness itself may change this infrastructure. The two-way influence between brain and consciousness has been at the center of philosophy and less so, of science. This so-called bottom-up and top-down interrelationship is controversial and is the subject of our article. We would like to ask: how does it happen that consciousness may provoke structural changes in the brain? The living brain means continuous changes at the synaptic level with every new experience, with every new process of learning, memorizing or mastering new and existing skills. Synapses are generated and dissolved, while others are preserved, in an ever-changing process of so-called neuroplasticity. Ongoing processes of synaptic reinforcements and decay occur during wakefulness when consciousness is present, but also during sleep when it is mostly absent. We suggest that consciousness influences brain neuroplasticity both during wakefulness as well as sleep in a top-down way. This means that consciousness really activates synaptic flow and changes brain structures and functional organization. The dynamic impact of consciousness on brain never stops despite the relative stationary structure of the brain. Such a process can be a target for medical intervention, e.g., by cognitive training.

  16. Recording pressure ulcer risk assessment and incidence.

    PubMed

    Plaskitt, Anne; Heywood, Nicola; Arrowsmith, Michaela

    2015-07-15

    This article reports on the introduction of an innovative computer-based system developed to record and report pressure ulcer risk and incidence at an acute NHS trust. The system was introduced to ensure that all patients have an early pressure ulcer risk assessment, which prompts staff to initiate appropriate management if a pressure ulcer is detected, thereby preventing further patient harm. Initial findings suggest that this electronic process has helped to improve the timeliness and accuracy of data on pressure ulcer risk and incidence. In addition, it has resulted in a reduced number of reported hospital-acquired pressure ulcers.

  17. Cancer incidence before and after kidney transplantation.

    PubMed

    Vajdic, Claire M; McDonald, Stephen P; McCredie, Margaret R E; van Leeuwen, Marina T; Stewart, John H; Law, Matthew; Chapman, Jeremy R; Webster, Angela C; Kaldor, John M; Grulich, Andrew E

    2006-12-20

    Immune suppression after organ transplantation is associated with a markedly increased risk of nonmelanoma skin cancer and a few virus-associated cancers. Although it is generally accepted that other cancers do not occur at increased rates, there have been few long-term population-based cohort studies performed. To compare the incidence of cancer in patients receiving immune suppression after kidney transplantation with incidence in the same population in 2 periods before receipt of immune suppression: during dialysis and during end-stage kidney disease before renal replacement therapy (RRT). A population-based cohort study of 28,855 patients with end-stage kidney disease who received RRT, with 273,407 person-years of follow-up. Incident cancers (1982-2003) were ascertained by record linkage between the Australia and New Zealand Dialysis and Transplant Registry and the Australian National Cancer Statistics Clearing House. Standardized incidence ratios (SIRs) of cancer, using age-specific, sex-specific, calendar year-specific, and state/territory-specific population cancer incidence rates. The overall incidence of cancer, excluding nonmelanoma skin cancer and those cancers known to frequently cause end-stage kidney disease, was markedly increased after transplantation (n = 1236; SIR, 3.27; 95% confidence interval [CI], 3.09-3.46). In contrast, cancer incidence was only slightly increased during dialysis (n = 870; SIR, 1.35; 95% CI, 1.27-1.45) and before RRT (n = 689; SIR, 1.16; 95% CI, 1.08-1.25). After transplantation, cancer occurred at significantly increased incidence at 25 sites, and risk exceeded 3-fold at 18 of these sites. Most of these cancers were of known or suspected viral etiology. Kidney transplantation is associated with a marked increase in cancer risk at a wide variety of sites. Because SIRs for most types of cancer were not increased before transplantation, immune suppression may be responsible for the increased risk. These data suggest a broader

  18. Infrared microanalysis of contaminants at grazing incidence

    NASA Astrophysics Data System (ADS)

    Reffner, John A.

    1991-04-01

    A new objective lens for grazing angle FT-IR microscopy provides a means for the infrared analysis of monomolecular films in small (25 X 25 micrometers ) areas. Conventional grazing incidence reflection spectroscopy is an established technology for detecting and analyzing thin surface films on metals or highly reflecting materials. The grazing incidence objective extends these techniques to microscopic areas. Applications of grazing angle FT-IR microscopy (GAM) are illustrated by exemplar analyses. The analyses of thin film lubricants and contaminants are specially important.

  19. The incidence of congenitally absent foot pulses.

    PubMed Central

    Robertson, G. S.; Ristic, C. D.; Bullen, B. R.

    1990-01-01

    The pedal pulses of 547 young healthy subjects were examined using digital palpation and a Doppler probe to determine the incidence of congenitally absent foot pulses. The posterior tibial (PT) pulse was absent in only one subject (0.18%), while the dorsalis pedis (DP) pulse was bilaterally absent in nine subjects (1.8%) and unilaterally absent in a further six subjects. The low incidence of congenital absence makes the clinical finding of an absent pedal pulse in later life a more significant marker of peripheral vascular disease than current surgical texts would have us believe. PMID:2185683

  20. The incidence of urea cycle disorders

    PubMed Central

    Summar, Marshall L.; Koelker, Stefan; Freedenberg, Debra; Le Mons, Cynthia; Haberle, Johannes; Lee, Hye-Seung; Kirmse, Brian

    2014-01-01

    A key question for urea cycle disorders is their incidence. In the United States two UCDs, argininosuccinic synthetase and lyase deficiency, are currently detected by newborn screening. We used newborn screening data on over 6 million births and data from the large US and European longitudinal registries to determine how common these conditions are. The incidence for the United States is predicted to be 1 urea cycle disorder patient for every 35,000 births presenting about 113 new patients per year across all age groups. PMID:23972786