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Sample records for brain health multiple

  1. Brain Health

    Science.gov (United States)

    ... Love Your Brain Stay Physically Active Adopt a Healthy Diet Stay Mentally and Socially Active We Can Help ... of any wellness plan. Learn More Adopt a Healthy Diet > Eat a heart-healthy diet that benefits both ...

  2. Brain Diseases - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Brain Diseases URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Brain Diseases - Multiple Languages To use the sharing features on this page, ...

  3. Traumatic Brain Injury - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Traumatic Brain Injury URL of this page: https://medlineplus.gov/ ... W XYZ List of All Topics All Traumatic Brain Injury - Multiple Languages To use the sharing features on this page, ...

  4. Brain Health Fitness: Beyond Retirement

    Science.gov (United States)

    Anand, Raksha; Chapman, Sandra B.; Rackley, Audette; Zientz, Jennifer

    2011-01-01

    The greatest accomplishment of the 20th century--the doubling of the human lifespan--has brought issues related to brain health to the forefront of public health policy. Given that our bodies are outlasting our minds, maximizing brain health is the scientific cause of this millennium. In this paper, we address three major issues related to…

  5. Multiple brain abscesses: A case report

    Directory of Open Access Journals (Sweden)

    Banić-Horvat Sofija

    2004-01-01

    Full Text Available Case Report 10 days before admission a 45-year old female experienced general weakness, and T 38oC. During that period she had no cardio-respiratory nor neurological complaints, and the temperature varied between 37.5oC and 38oC. Her medical history was unremarkable, without immunodeficiency. The day before admission she presented with left arm paresis and during the next day it progressed to paralysis. She had no headache. On admission the following diagnostic procedures were performed: the cranial CT scan showed two lesions (possibly meta lesions. Chest X-ray was normal. WBC=15x109/L, ESR= 90/120. On the second day following admission brain MRI showed multiple abscesses in both hemispheres, mostly in the gray/white junction. High doses of IV metronidasol, cephtriaxon and cipfloxacin were administered without obtaining specimens for micro- biological diagnosis. In next two days she developed coma, respiratory insufficiency and septic temperature. Brain surgery was not performed due to severe involvement of the brain with multiple abscesses. Repeated chest X-ray revealed bilateral pneumonia. A lethal outcome occurred on the third day, regardless of all efforts. Autopsy showed multiple brain abscesses as well as on the lungs and liver. A beta-hemolytic streptococcal infection was established. Conclusions Prevention includes treatment of the infection source. The classic triad of headache, fever and focal deficit occur in less than 50% of patients. Even in such cases brain abscess must be reconsidered. CT appearance of brain abscess is similar to that of neoplastic and other infectious and non infectious deseases - especially in the stage of early cerebritis. If the CT findings are not clear, MRI should be performed.

  6. Building an organic computing device with multiple interconnected brains

    OpenAIRE

    Miguel Pais-Vieira; Gabriela Chiuffa; Mikhail Lebedev; Amol Yadav; Nicolelis, Miguel A.L.

    2015-01-01

    Recently, we proposed that Brainets, i.e. networks formed by multiple animal brains, cooperating and exchanging information in real time through direct brain-to-brain interfaces, could provide the core of a new type of computing device: an organic computer. Here, we describe the first experimental demonstration of such a Brainet, built by interconnecting four adult rat brains. Brainets worked by concurrently recording the extracellular electrical activity generated by populations of cortical ...

  7. No quiet surrender: molecular guardians in multiple sclerosis brain

    OpenAIRE

    Steinman, Lawrence

    2015-01-01

    The brain under immunological attack does not surrender quietly. Investigation of brain lesions in multiple sclerosis (MS) reveals a coordinated molecular response involving various proteins and small molecules ranging from heat shock proteins to small lipids, neurotransmitters, and even gases, which provide protection and foster repair. Reduction of inflammation serves as a necessary prerequisite for effective recovery and regeneration. Remarkably, many lesion-resident molecules activate pat...

  8. A CASE STUDY OF BRAIN VOLUME REDUCTION IN MULTIPLE SCLEROSIS

    Directory of Open Access Journals (Sweden)

    Ivan N. Dimitrov

    2013-07-01

    Full Text Available The development of sophisticated magnetic resonance imaging techniques and software for medical imaging processing and analysis has led to a significant progress in multiple sclerosis research and clinical care. The measurement of brain volumes provides a quantitative representation of damage, thus facilitating the objective follow-up process. The parameters obtained, though not being used routinely in clinical practice, are more and more often applied in clinical studies. The amount of whole brain and regional atrophy, estimated from serial scans, is considered important not only for disease progression, but also for cognitive dysfunction which is common in multiple sclerosis. In this paper we describe a volumetric study of two magnetic resonance scans of a patient with relapsing-remitting multiple sclerosis, performed 16 months one after the other, and analyzed using FSL SIENA software. Analysis demonstrated brain volume reduction of 1.7% between the two scans. We discuss the advantages of the method and its possible clinical applications.

  9. Multiple brain atlas database and atlas-based neuroimaging system.

    Science.gov (United States)

    Nowinski, W L; Fang, A; Nguyen, B T; Raphel, J K; Jagannathan, L; Raghavan, R; Bryan, R N; Miller, G A

    1997-01-01

    For the purpose of developing multiple, complementary, fully labeled electronic brain atlases and an atlas-based neuroimaging system for analysis, quantification, and real-time manipulation of cerebral structures in two and three dimensions, we have digitized, enhanced, segmented, and labeled the following print brain atlases: Co-Planar Stereotaxic Atlas of the Human Brain by Talairach and Tournoux, Atlas for Stereotaxy of the Human Brain by Schaltenbrand and Wahren, Referentially Oriented Cerebral MRI Anatomy by Talairach and Tournoux, and Atlas of the Cerebral Sulci by Ono, Kubik, and Abernathey. Three-dimensional extensions of these atlases have been developed as well. All two- and three-dimensional atlases are mutually preregistered and may be interactively registered with an actual patient's data. An atlas-based neuroimaging system has been developed that provides support for reformatting, registration, visualization, navigation, image processing, and quantification of clinical data. The anatomical index contains about 1,000 structures and over 400 sulcal patterns. Several new applications of the brain atlas database also have been developed, supported by various technologies such as virtual reality, the Internet, and electronic publishing. Fusion of information from multiple atlases assists the user in comprehensively understanding brain structures and identifying and quantifying anatomical regions in clinical data. The multiple brain atlas database and atlas-based neuroimaging system have substantial potential impact in stereotactic neurosurgery and radiotherapy by assisting in visualization and real-time manipulation in three dimensions of anatomical structures, in quantitative neuroradiology by allowing interactive analysis of clinical data, in three-dimensional neuroeducation, and in brain function studies. PMID:9148878

  10. Radiotherapy for multiple brain metastases from hepatocellular carcinomas

    Institute of Scientific and Technical Information of China (English)

    Nobuyuki Toshikuni; Kazuhiko Morii; Michinori Yamamoto

    2007-01-01

    A 78-year-old man with liver cirrhosis was found to have multiple hepatocellular carcinomas (HCCs)and underwent 3 sessions of transcatheter arterial chemoembolization. Fourteen months after diagnosis,the patient presented with left hemiparesis. Contrastenhanced magnetic resonance imaging showed multiple metastases with ring-shaped enhancement in the cerebrum and cerebellum. There were no metastases to other organs. The metastatic lesions almost completely disappeared after whole-brain radiotherapy with a total dose of 50 Gy. Neurologic symptoms decreased,and the patient's quality of life improved. The patient underwent 2 more sessions of transcatheter arterial chemoembolization. Twelve months after the diagnosis of brain metastasis, the patient remains alive. The present case indicates that radiotherapy can improve quality of life and prolong survival in some patients with brain metastases from HCCs.

  11. Premature infants' health at multiple induced pregnancy.

    OpenAIRE

    Chernenkov Yu.V.; Nechaev V.N.; Stasova Yu.V.; Tereshenko V.A.

    2015-01-01

    Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART); to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies), from them 83 premature infants born from multiple induced p...

  12. Clinical Relevance of Brain Volume Measures in Multiple Sclerosis

    DEFF Research Database (Denmark)

    De Stefano, Nicola; Airas, Laura; Grigoriadis, Nikolaos;

    2014-01-01

    Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS and proceed......Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS...... and proceeding throughout the disease course, may be an accurate measure of neurodegeneration and tissue damage. There are a number of magnetic resonance imaging-based methods for determining global or regional brain volume, including cross-sectional (e.g. brain parenchymal fraction) and longitudinal techniques...... (e.g. SIENA [Structural Image Evaluation using Normalization of Atrophy]). Although these methods are sensitive and reproducible, caution must be exercised when interpreting brain volume data, as numerous factors (e.g. pseudoatrophy) may have a confounding effect on measurements, especially...

  13. Coronaviruses in brain tissue from patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Dessau, R B; Lisby, G; Frederiksen, J L

    2001-01-01

    Brain tissue from 25 patients with clinically definite multiple sclerosis (MS) and as controls brain tissue from 36 patients without neurological disease was tested for the presence of human coronaviral RNA. Four PCR assays with primers specific for N-protein of human coronavirus strain 229E...... and three PCR assays with primers specific for the nucleocapsid protein of human coronavirus strain OC43 were performed. Sporadic positive PCR assays were observed in both patients and controls in some of the PCR assays. However, these results were not reproducible and there was no difference...

  14. Resting State Brain Entropy Alterations in Relapsing Remitting Multiple Sclerosis.

    Science.gov (United States)

    Zhou, Fuqing; Zhuang, Ying; Gong, Honghan; Zhan, Jie; Grossman, Murray; Wang, Ze

    2016-01-01

    Brain entropy (BEN) mapping provides a novel approach to characterize brain temporal dynamics, a key feature of human brain. Using resting state functional magnetic resonance imaging (rsfMRI), reliable and spatially distributed BEN patterns have been identified in normal brain, suggesting a potential use in clinical populations since temporal brain dynamics and entropy may be altered in disease conditions. The purpose of this study was to characterize BEN in multiple sclerosis (MS), a neurodegenerative disease that affects millions of people. Since currently there is no cure for MS, developing treatment or medication that can slow down its progression represents a high research priority, for which validating a brain marker sensitive to disease and the related functional impairments is essential. Because MS can start long time before any measurable symptoms and structural deficits, assessing the dynamic brain activity and correspondingly BEN may provide a critical way to study MS and its progression. Because BEN is new to MS, we aimed to assess BEN alterations in the relapsing-remitting MS (RRMS) patients using a patient versus control design, to examine the correlation of BEN to clinical measurements, and to check the correlation of BEN to structural brain measures which have been more often used in MS studies. As compared to controls, RRMS patients showed increased BEN in motor areas, executive control area, spatial coordinating area, and memory system. Increased BEN was related to greater disease severity as measured by the expanded disability status scale (EDSS) and greater tissue damage as indicated by the mean diffusivity. Patients also showed decreased BEN in other places, which was associated with less disability or fatigue, indicating a disease-related BEN re-distribution. Our results suggest BEN as a novel and useful tool for characterizing RRMS. PMID:26727514

  15. Resting State Brain Entropy Alterations in Relapsing Remitting Multiple Sclerosis.

    Directory of Open Access Journals (Sweden)

    Fuqing Zhou

    Full Text Available Brain entropy (BEN mapping provides a novel approach to characterize brain temporal dynamics, a key feature of human brain. Using resting state functional magnetic resonance imaging (rsfMRI, reliable and spatially distributed BEN patterns have been identified in normal brain, suggesting a potential use in clinical populations since temporal brain dynamics and entropy may be altered in disease conditions. The purpose of this study was to characterize BEN in multiple sclerosis (MS, a neurodegenerative disease that affects millions of people. Since currently there is no cure for MS, developing treatment or medication that can slow down its progression represents a high research priority, for which validating a brain marker sensitive to disease and the related functional impairments is essential. Because MS can start long time before any measurable symptoms and structural deficits, assessing the dynamic brain activity and correspondingly BEN may provide a critical way to study MS and its progression. Because BEN is new to MS, we aimed to assess BEN alterations in the relapsing-remitting MS (RRMS patients using a patient versus control design, to examine the correlation of BEN to clinical measurements, and to check the correlation of BEN to structural brain measures which have been more often used in MS studies. As compared to controls, RRMS patients showed increased BEN in motor areas, executive control area, spatial coordinating area, and memory system. Increased BEN was related to greater disease severity as measured by the expanded disability status scale (EDSS and greater tissue damage as indicated by the mean diffusivity. Patients also showed decreased BEN in other places, which was associated with less disability or fatigue, indicating a disease-related BEN re-distribution. Our results suggest BEN as a novel and useful tool for characterizing RRMS.

  16. No quiet surrender: molecular guardians in multiple sclerosis brain.

    Science.gov (United States)

    Steinman, Lawrence

    2015-04-01

    The brain under immunological attack does not surrender quietly. Investigation of brain lesions in multiple sclerosis (MS) reveals a coordinated molecular response involving various proteins and small molecules ranging from heat shock proteins to small lipids, neurotransmitters, and even gases, which provide protection and foster repair. Reduction of inflammation serves as a necessary prerequisite for effective recovery and regeneration. Remarkably, many lesion-resident molecules activate pathways leading to both suppression of inflammation and promotion of repair mechanisms. These guardian molecules and their corresponding physiologic pathways could potentially be exploited to silence inflammation and repair the injured and degenerating brain and spinal cord in both relapsing-remitting and progressive forms of MS and may be beneficial in other neurologic and psychiatric conditions.

  17. Mixture Segmentation of Multispectral MR Brain Images for Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Lihong Li

    2005-04-01

    Full Text Available We present a fully automatic mixture model-based tissue classification of multispectral (T1- and T2-weighted magnetic resonance (MR brain images. Unlike the conventional hard classification with a unique label for each voxel, our method models a mixture to estimate the partial volumes (PV of multiple tissue types within a voxel. A new Markov random field (MRF model is proposed to reflect the spatial information of tissue mixtures. A mixture classification algorithm is performed by the maximum a posterior (MAP criterion, where the expectation maximization (EM algorithm is utilized to estimate model parameters. The algorithm interleaves segmentation with parameter estimation and improves classification in an iterative manner. The presented method is evaluated by clinical MR image datasets for quantification of brain volumes and multiple sclerosis (MS.

  18. Building an organic computing device with multiple interconnected brains.

    Science.gov (United States)

    Pais-Vieira, Miguel; Chiuffa, Gabriela; Lebedev, Mikhail; Yadav, Amol; Nicolelis, Miguel A L

    2015-01-01

    Recently, we proposed that Brainets, i.e. networks formed by multiple animal brains, cooperating and exchanging information in real time through direct brain-to-brain interfaces, could provide the core of a new type of computing device: an organic computer. Here, we describe the first experimental demonstration of such a Brainet, built by interconnecting four adult rat brains. Brainets worked by concurrently recording the extracellular electrical activity generated by populations of cortical neurons distributed across multiple rats chronically implanted with multi-electrode arrays. Cortical neuronal activity was recorded and analyzed in real time, and then delivered to the somatosensory cortices of other animals that participated in the Brainet using intracortical microstimulation (ICMS). Using this approach, different Brainet architectures solved a number of useful computational problems, such as discrete classification, image processing, storage and retrieval of tactile information, and even weather forecasting. Brainets consistently performed at the same or higher levels than single rats in these tasks. Based on these findings, we propose that Brainets could be used to investigate animal social behaviors as well as a test bed for exploring the properties and potential applications of organic computers. PMID:26158615

  19. Brain CT findings of severely multiple handicapped children

    International Nuclear Information System (INIS)

    Brain CT were performed in 63 severely multiple handicapped children (30 males and 33 females) ranging in age from 2 to 21 years. Abnormal findings including ventricular dilatation and cortical atrophy were detected in 56 of the patients (88.9%). There was no specific finding for athetosis type cerebral palsy. There was no constant relationship between underlying diseases and CT findings.(Namekawa, K.)

  20. Brain viscoelasticity alteration in chronic-progressive multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Kaspar-Josche Streitberger

    Full Text Available INTRODUCTION: Viscoelastic properties indicate structural alterations in biological tissues at multiple scales with high sensitivity. Magnetic Resonance Elastography (MRE is a novel technique that directly visualizes and quantitatively measures biomechanical tissue properties in vivo. MRE recently revealed that early relapsing-remitting multiple sclerosis (MS is associated with a global decrease of the cerebral mechanical integrity. This study addresses MRE and MR volumetry in chronic-progressive disease courses of MS. METHODS: We determined viscoelastic parameters of the brain parenchyma in 23 MS patients with primary or secondary chronic progressive disease course in comparison to 38 age- and gender-matched healthy individuals by multifrequency MRE, and correlated the results with clinical data, T2 lesion load and brain volume. Two viscoelastic parameters, the shear elasticity μ and the powerlaw exponent α, were deduced according to the springpot model and compared to literature values of relapsing-remitting MS. RESULTS: In chronic-progressive MS patients, μ and α were reduced by 20.5% and 6.1%, respectively, compared to healthy controls. MR volumetry yielded a weaker correlation: Total brain volume loss in MS patients was in the range of 7.5% and 1.7% considering the brain parenchymal fraction. All findings were significant (P<0.001. CONCLUSIONS: Chronic-progressive MS disease courses show a pronounced reduction of the cerebral shear elasticity compared to early relapsing-remitting disease. The powerlaw exponent α decreased only in the chronic-progressive stage of MS, suggesting an alteration in the geometry of the cerebral mechanical network due to chronic neuroinflammation.

  1. Brain atrophy in multiple sclerosis: therapeutic, cognitive and clinical impact

    Directory of Open Access Journals (Sweden)

    Juan Ignacio Rojas

    2016-03-01

    Full Text Available ABSTRACT Multiple sclerosis (MS was always considered as a white matter inflammatory disease. Today, there is an important body of evidence that supports the hypothesis that gray matter involvement and the neurodegenerative mechanism are at least partially independent from inflammation. Gray matter atrophy develops faster than white matter atrophy, and predominates in the initial stages of the disease. The neurodegenerative mechanism creates permanent damage and correlates with physical and cognitive disability. In this review we describe the current available evidence regarding brain atrophy and its consequence in MS patients.

  2. Whole brain white matter changes revealed by multiple diffusion metrics in multiple sclerosis: A TBSS study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yaou, E-mail: asiaeurope80@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Duan, Yunyun, E-mail: xiaoyun81.love@163.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); He, Yong, E-mail: yong.h.he@gmail.com [State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875 (China); Yu, Chunshui, E-mail: csyuster@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Wang, Jun, E-mail: jun_wang@bnu.edu.cn [State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875 (China); Huang, Jing, E-mail: sainthj@126.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Ye, Jing, E-mail: jingye.2007@yahoo.com.cn [Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Parizel, Paul M., E-mail: paul.parizel@ua.ac.be [Department of Radiology, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, 2650 Edegem, 8 Belgium (Belgium); Li, Kuncheng, E-mail: kunchengli55@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Shu, Ni, E-mail: nshu55@gmail.com [State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875 (China)

    2012-10-15

    Objective: To investigate whole brain white matter changes in multiple sclerosis (MS) by multiple diffusion indices, we examined patients with diffusion tensor imaging and utilized tract-based spatial statistics (TBSS) method to analyze the data. Methods: Forty-one relapsing-remitting multiple sclerosis (RRMS) patients and 41 age- and gender-matched normal controls were included in this study. Diffusion weighted images were acquired by employing a single-shot echo planar imaging sequence on a 1.5 T MR scanner. Voxel-wise analyses of multiple diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were performed with TBSS. Results: The MS patients had significantly decreased FA (9.11%), increased MD (8.26%), AD (3.48%) and RD (13.17%) in their white matter skeletons compared with the controls. Through TBSS analyses, we found abnormal diffusion changes in widespread white matter regions in MS patients. Specifically, decreased FA, increased MD and increased RD were involved in whole-brain white matter, while several regions exhibited increased AD. Furthermore, white matter regions with significant correlations between the diffusion metrics and the clinical variables (the EDSS scores, disease durations and white matter lesion loads) in MS patients were identified. Conclusion: Widespread white matter abnormalities were observed in MS patients revealed by multiple diffusion metrics. The diffusion changes and correlations with clinical variables were mainly attributed to increased RD, implying the predominant role of RD in reflecting the subtle pathological changes in MS.

  3. Whole brain white matter changes revealed by multiple diffusion metrics in multiple sclerosis: A TBSS study

    International Nuclear Information System (INIS)

    Objective: To investigate whole brain white matter changes in multiple sclerosis (MS) by multiple diffusion indices, we examined patients with diffusion tensor imaging and utilized tract-based spatial statistics (TBSS) method to analyze the data. Methods: Forty-one relapsing-remitting multiple sclerosis (RRMS) patients and 41 age- and gender-matched normal controls were included in this study. Diffusion weighted images were acquired by employing a single-shot echo planar imaging sequence on a 1.5 T MR scanner. Voxel-wise analyses of multiple diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were performed with TBSS. Results: The MS patients had significantly decreased FA (9.11%), increased MD (8.26%), AD (3.48%) and RD (13.17%) in their white matter skeletons compared with the controls. Through TBSS analyses, we found abnormal diffusion changes in widespread white matter regions in MS patients. Specifically, decreased FA, increased MD and increased RD were involved in whole-brain white matter, while several regions exhibited increased AD. Furthermore, white matter regions with significant correlations between the diffusion metrics and the clinical variables (the EDSS scores, disease durations and white matter lesion loads) in MS patients were identified. Conclusion: Widespread white matter abnormalities were observed in MS patients revealed by multiple diffusion metrics. The diffusion changes and correlations with clinical variables were mainly attributed to increased RD, implying the predominant role of RD in reflecting the subtle pathological changes in MS

  4. Automated detection of multiple sclerosis lesions in serial brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Valls, Laia [Dr. Josep Trueta University Hospital, Department of Radiology, Girona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain); Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain)

    2012-08-15

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  5. Automated detection of multiple sclerosis lesions in serial brain MRI

    International Nuclear Information System (INIS)

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  6. Brain atrophy at onset and physical disability in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Juan Ignacio Rojas

    2012-10-01

    Full Text Available The aim of this study was to investigate if brain atrophy in multiple sclerosis (MS patients during the disease onset predicts long term disability. METHODS: MS patients with follow-up time of at least 7 years from disease onset and with baseline and second magnetic resonance 12 months later were included to measure brain atrophy. Expanded Disability Status Scale (EDSS was categorized in three groups, EDSS=0, EDSS=1 and 2.5 and EDSS>2.5, and used as disability measure. RESULTS: Twenty-six patients were included. Mean atrophy during the first year in patients that reached an EDSS≥3 was -0.76±0.45 %, in patients with an EDSS between 1 and 2.5 was -0.59±0.56, while in patients with an EDSS of 0 it was -0.38±0.42 (p=0.003. DISCUSSION: Brain atrophy rates during the first year of disease were predictive of disease progression in our population.

  7. Emotional Arousal and Multiple Memory Systems in the Mammalian Brain

    Directory of Open Access Journals (Sweden)

    Mark G. Packard

    2012-03-01

    Full Text Available Emotional arousal induced by stress and/or anxiety can exert complex effects on learning and memory processes in mammals. Recent studies have begun to link study of the influence of emotional arousal on memory with earlier research indicating that memory is organized in multiple systems in the brain that differ in terms of the type of memory they mediate. Specifically, these studies have examined whether emotional arousal may have a differential effect on the cognitive and stimulus-response habit memory processes subserved by the hippocampus and dorsal striatum, respectively. Evidence indicates that stress or the peripheral injection of anxiogenic drugs can bias animals and humans towards the use of striatal-dependent habit memory in dual-solution tasks in which both hippocampal and stritatal-based strategies can provide an adequate solution. A bias towards the use of habit memory can also be produced by intra-basolateral amygdala administration of anxiogenic drugs, consistent with the well documented role of efferent projections of this brain region in mediating the modulatory influence of emotional arousal on memory. In some learning situations, the bias towards the use of habit memory produced by emotional arousal appears to result from an impairing effect on hippocampus-dependent cognitive memory. Further research examining the neural mechanisms linking emotion and the relative use of multiple memory systems should prove useful in view of the potential role for maladaptive habitual behaviors in various human psychopathologies.

  8. Holistic Practice in Traumatic Brain Injury Rehabilitation: Perspectives of Health Practitioners

    OpenAIRE

    Wright, Courtney J.; Zeeman, Heidi; Biezaitis, Valda

    2016-01-01

    Given that the literature suggests there are various (and often contradictory) interpretations of holistic practice in brain injury rehabilitation and multiple complexities in its implementation (including complex setting, discipline, and client-base factors), this study aimed to examine the experiences of practitioners in their conceptualization and delivery of holistic practice in their respective settings. Nineteen health practitioners purposively sampled from an extensive Brain Injury Net...

  9. Focusing and targeting of magnetic brain stimulation using multiple coils.

    Science.gov (United States)

    Ruohonen, J; Ilmoniemi, R J

    1998-05-01

    Neurones can be excited by an externally applied time-varying electromagnetic field. Focused magnetic brain stimulation is attained using multiple small coils instead of one large coil, the resultant induced electric field being a superposition of the fields from each coil. In multichannel magnetic brain stimulation, partial cancellation of fields from individual coils provides a significant improvement in the focusing of the stimulating field, and independent coil channels allow targeting of the stimuli on a given spot without moving the coils. The problem of shaping the stimulating field in multichannel stimulation is analysed, and a method is derived that yields the driving currents required to induce a field with a user-defined shape. The formulation makes use of lead fields and minimum-norm estimation from magneto-encephalography. Using these methods, some properties of multichannel coil arrays are examined. Computer-assisted multichannel stimulation of the cortex will enable several new studies, including quick determination of the cortical regions, the stimulation of which disrupts cortical processing required by a task. PMID:9747568

  10. Premature infants' health at multiple induced pregnancy.

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2015-09-01

    Full Text Available Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART; to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies, from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

  11. Visualizing Iron Deposition in Multiple Sclerosis Cadaver Brains

    International Nuclear Information System (INIS)

    Aim: To visualize and validate iron deposition in two cases of multiple sclerosis using rapid scanning X-Ray Fluorescence (RS-XRF) and Susceptibility Weighted Imaging (SWI). Material and Methods: Two (2) coronal cadaver brain slices from patients clinically diagnosed with multiple sclerosis underwent magnetic resonance imaging (MRI), specifically SWI to image iron content. To confirm the presence of iron deposits and the absence of zinc-rich myelin in lesions, iron and zinc were mapped using RS-XRF. Results: MS lesions were visualized using FLAIR and correlated with the absence of zinc by XRF. XRF and SWI showed that in the first MS case, there were large iron deposits proximal to the draining vein of the caudate nucleus as well as iron deposits associated with blood vessels throughout the globus pallidus. Less iron was seen in association with lesions than in the basal ganglia. The presence of larger amounts of iron correlated reasonably well between RS-XRF and SWI. In the second case, the basal ganglia appeared normal and acute perivascular iron deposition was absent. Conclusion: Perivascular iron deposition is seen in some but not all MS cases, giving credence to the use of SWI to assess iron involvement in MS pathology in vivo.

  12. Visualizing Iron Deposition in Multiple Sclerosis Cadaver Brains

    Energy Technology Data Exchange (ETDEWEB)

    Habib, A.C.; Zheng, W.; Haacke, E.M.; Webb, S.; Nichol, H.; /SLAC

    2012-07-17

    To visualize and validate iron deposition in two cases of multiple sclerosis using rapid scanning X-Ray Fluorescence (RS-XRF) and Susceptibility Weighted Imaging (SWI). Two (2) coronal cadaver brain slices from patients clinically diagnosed with multiple sclerosis underwent magnetic resonance imaging (MRI), specifically SWI to image iron content. To confirm the presence of iron deposits and the absence of zinc-rich myelin in lesions, iron and zinc were mapped using RS-XRF. MS lesions were visualized using FLAIR and correlated with the absence of zinc by XRF. XRF and SWI showed that in the first MS case, there were large iron deposits proximal to the draining vein of the caudate nucleus as well as iron deposits associated with blood vessels throughout the globus pallidus. Less iron was seen in association with lesions than in the basal ganglia. The presence of larger amounts of iron correlated reasonably well between RS-XRF and SWI. In the second case, the basal ganglia appeared normal and acute perivascular iron deposition was absent. Perivascular iron deposition is seen in some but not all MS cases, giving credence to the use of SWI to assess iron involvement in MS pathology in vivo.

  13. How Do Health Care Providers Diagnose Traumatic Brain Injury (TBI)?

    Science.gov (United States)

    ... The pressure can cause additional damage to the brain. A health care provider may insert a probe through the skull to monitor this swelling. 2 In some cases, a shunt or drain is placed into the skull to relieve ICP. [ ...

  14. Advanced Structural and Functional Brain MRI in Multiple Sclerosis.

    Science.gov (United States)

    Giorgio, Antonio; De Stefano, Nicola

    2016-04-01

    Conventional magnetic resonance imaging (MRI) of the central nervous system is crucial for an early and reliable diagnosis and monitoring of patients with multiple sclerosis (MS). Focal white matter (WM) lesions, as detected by MRI, are the pathological hallmark of the disease and show some relation to clinical disability, especially in the long run. Gray matter (GM) involvement is evident from disease onset and includes focal (i.e., cortical lesions) and diffuse pathology (i.e., atrophy). Both accumulate over time and show close relation to physical disability and cognitive impairment. Using advanced quantitative MRI techniques such as magnetization transfer imaging (MTI), diffusion tensor imaging (DTI), proton MR spectroscopy ((1)H-MRS), and iron imaging, subtle MS pathology has been demonstrated from early stages outside focal WM lesions in the form of widespread abnormalities of the normal appearing WM and GM. In addition, studies using functional MRI have demonstrated that brain plasticity is driven by MS pathology, playing adaptive or maladaptive roles to neurologic and cognitive status and explaining, at least in part, the clinicoradiological paradox of MS. PMID:27116723

  15. Brain-immune communication psychoneuroimmunology of multiple sclerosis.

    Science.gov (United States)

    Kern, S; Ziemssen, T

    2008-01-01

    The central nervous system (CNS) and the immune system are two extremely complex and highly adaptive systems. In the face of a real or anticipated threat, be it physical (eg, infection) or psychological (eg, psychosocial stress) in nature, the two systems act in concert to provide optimal adaptation to the demanding internal or environmental conditions. During instances of well being, the communication between these two systems is well tuned and balanced. However, a disturbed crosstalk between the CNS and the immune system is thought to play a major role in a wide series of disorders characterized by a hyporesponsive or hyperresponsive immune system. In multiple sclerosis (MS), a chronic inflammatory and neurodegenerative disease, an excess of inflammatory processes seems to be a hallmark and there is growing evidence for a disturbed communication between the CNS and the immune system as a crucial pathogenic factor. While the exact mechanisms for these phenomena are still poorly understood, the young discipline of psychoneuroimmunology (PNI), which focuses on the mechanism underlying the brain to immune crosstalk, might offer some insights into the existing pathogenic mechanisms. Findings from the field of PNI might also help to gain a better understanding regarding the origin and course of MS clinical symptoms such as fatigue and depression.

  16. Asian American Health - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Asian American Health URL of this page: https://medlineplus.gov/languages/asianamericanhealth.html Other topics A-Z A B ...

  17. Baby Health Checkup - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Baby Health Checkup URL of this page: https://medlineplus.gov/languages/babyhealthcheckup.html Other topics A-Z A B ...

  18. Global health - multiple definitions, single goal

    Directory of Open Access Journals (Sweden)

    Ana Marušić

    2013-03-01

    Full Text Available Although there is a wealth of research on and attention of both the public and the researchers about global health, there is still some controversy and uncertainty about the real meaning of the term "global health". In a multidisciplinary and intersectorial field such as global health, common definition is important for clear and effective communication among all involved in global health.

  19. Potential Moderators of Physical Activity on Brain Health

    Directory of Open Access Journals (Sweden)

    Regina L. Leckie

    2012-01-01

    Full Text Available Age-related cognitive decline is linked to numerous molecular, structural, and functional changes in the brain. However, physical activity is a promising method of reducing unfavorable age-related changes. Physical activity exerts its effects on the brain through many molecular pathways, some of which are regulated by genetic variants in humans. In this paper, we highlight genes including apolipoprotein E (APOE, brain derived neurotrophic factor (BDNF, and catechol-O-methyltransferase (COMT along with dietary omega-3 fatty acid, docosahexaenoic acid (DHA, as potential moderators of the effect of physical activity on brain health. There are a growing number of studies indicating that physical activity might mitigate the genetic risks for disease and brain dysfunction and that the combination of greater amounts of DHA intake with physical activity might promote better brain function than either treatment alone. Understanding whether genes or other lifestyles moderate the effects of physical activity on neurocognitive health is necessary for delineating the pathways by which brain health can be enhanced and for grasping the individual variation in the effectiveness of physical activity interventions on the brain and cognition. There is a need for future research to continue to assess the factors that moderate the effects of physical activity on neurocognitive function.

  20. Whole Brain Irradiation With Hippocampal Sparing and Dose Escalation on Multiple Brain Metastases: A Planning Study on Treatment Concepts

    International Nuclear Information System (INIS)

    Purpose: To develop a new treatment planning strategy in patients with multiple brain metastases. The goal was to perform whole brain irradiation (WBI) with hippocampal sparing and dose escalation on multiple brain metastases. Two treatment concepts were investigated: simultaneously integrated boost (SIB) and WBI followed by stereotactic fractionated radiation therapy sequential concept (SC). Methods and Materials: Treatment plans for both concepts were calculated for 10 patients with 2-8 brain metastases using volumetric modulated arc therapy. In the SIB concept, the prescribed dose was 30 Gy in 12 fractions to the whole brain and 51 Gy in 12 fractions to individual brain metastases. In the SC concept, the prescription was 30 Gy in 12 fractions to the whole brain followed by 18 Gy in 2 fractions to brain metastases. All plans were optimized for dose coverage of whole brain and lesions, simultaneously minimizing dose to the hippocampus. The treatment plans were evaluated on target coverage, homogeneity, and minimal dose to the hippocampus and organs at risk. Results: The SIB concept enabled more successful sparing of the hippocampus; the mean dose to the hippocampus was 7.55 ± 0.62 Gy and 6.29 ± 0.62 Gy, respectively, when 5-mm and 10-mm avoidance regions around the hippocampus were used, normalized to 2-Gy fractions. In the SC concept, the mean dose to hippocampus was 9.8 ± 1.75 Gy. The mean dose to the whole brain (excluding metastases) was 33.2 ± 0.7 Gy and 32.7 ± 0.96 Gy, respectively, in the SIB concept, for 5-mm and 10-mm hippocampus avoidance regions, and 37.23 ± 1.42 Gy in SC. Conclusions: Both concepts, SIB and SC, were able to achieve adequate whole brain coverage and radiosurgery-equivalent dose distributions to individual brain metastases. The SIB technique achieved better sparing of the hippocampus, especially when a10-mm hippocampal avoidance region was used.

  1. Management of solitary and multiple brain metastases from breast cancer

    Directory of Open Access Journals (Sweden)

    Addison Willett

    2015-01-01

    Full Text Available As local and systemic control of breast cancer improves, metastasis to the brain remains a common event requiring a specialized management approach. Women diagnosed with breast cancer who develop brain metastases have superior overall survival compared to patients with other forms of metastatic carcinoma. This article summarizes some of the unique aspects of care for patients with breast cancer metastases to the brain.

  2. Multiple sites of vasopressin synthesis in the injured brain

    OpenAIRE

    Szmydynger-Chodobska, Joanna; Zink, Brian J.; Chodobski, Adam

    2010-01-01

    Previous studies have indicated that the primary targets for vasopressin actions on the injured brain are the cerebrovascular endothelium and astrocytes, and that vasopressin amplifies the posttraumatic production of proinflammatory mediators. Here, the controlled cortical impact model of traumatic brain injury in rats was used to identify the sources of vasopressin in the injured brain. Injury increased vasopressin synthesis in the hypothalamus and cerebral cortex adjacent to the posttraumat...

  3. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?

    OpenAIRE

    Chomi, EN; Mujinja, PG; Enemark, U; Hansen, K; Kiwara, AD

    2014-01-01

    Background Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple...

  4. A Qualitative Study of Multiple Health Behaviors in Adults with Multiple Sclerosis

    Science.gov (United States)

    Golding, Meghan

    2016-01-01

    Background: Evidence regarding inflammatory pathways, elevated cardiovascular risk, and negative effects of secondary conditions on disability progression provide a strong rationale for promoting multiple health behaviors in adults with multiple sclerosis (MS). However, many unanswered questions remain about the best ways to design multiple behavior change interventions for adults with MS. We sought to identify facilitators and barriers to engaging in multiple health behaviors (physical activity, nutrition, and sleep) and to gain further insights into how to develop multiple health behavior change interventions based on preferences of adults with MS. Methods: Focus groups and one-on-one interviews were conducted with 17 participants with MS. Results: Five qualitative themes were identified as either facilitating or hindering engagement in multiple health behaviors: 1) roles, priorities, and preferences; 2) sense of duty; 3) the fatigue and mobility problem; 4) taking control; and 5) resiliency. Participants identified advantages and disadvantages of delivery formats (eg, face-to-face group vs. telephone), frequency of contacts, and intervention strategies based on their individual circumstances and obligations. Participants felt that discussing the benefits of engaging in multiple health behaviors, developing action plans, accommodating preferences, and addressing health problems would be helpful strategies to include in a multiple behavior change intervention. Conclusions: These findings indicate that there may be common facilitators and barriers that can be targeted to promote multiple behavior changes. Future research should explore the best ways to tailor multiple behavior change interventions to preferences, symptoms, psychological traits, and social cognitions. PMID:27803640

  5. Bone Health in Patients with Multiple Sclerosis

    OpenAIRE

    Vit Zikan

    2011-01-01

    Multiple sclerosis (MS) is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs) treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and reso...

  6. Modeling Disease Severity in Multiple Sclerosis Using Electronic Health Records

    Science.gov (United States)

    Xia, Zongqi; Secor, Elizabeth; Chibnik, Lori B.; Bove, Riley M.; Cheng, Suchun; Chitnis, Tanuja; Cagan, Andrew; Gainer, Vivian S.; Chen, Pei J.; Liao, Katherine P.; Shaw, Stanley Y.; Ananthakrishnan, Ashwin N.; Szolovits, Peter; Weiner, Howard L.; Karlson, Elizabeth W.; Murphy, Shawn N.; Savova, Guergana K.; Cai, Tianxi; Churchill, Susanne E.; Plenge, Robert M.; Kohane, Isaac S.; De Jager, Philip L.

    2013-01-01

    Objective To optimally leverage the scalability and unique features of the electronic health records (EHR) for research that would ultimately improve patient care, we need to accurately identify patients and extract clinically meaningful measures. Using multiple sclerosis (MS) as a proof of principle, we showcased how to leverage routinely collected EHR data to identify patients with a complex neurological disorder and derive an important surrogate measure of disease severity heretofore only available in research settings. Methods In a cross-sectional observational study, 5,495 MS patients were identified from the EHR systems of two major referral hospitals using an algorithm that includes codified and narrative information extracted using natural language processing. In the subset of patients who receive neurological care at a MS Center where disease measures have been collected, we used routinely collected EHR data to extract two aggregate indicators of MS severity of clinical relevance multiple sclerosis severity score (MSSS) and brain parenchymal fraction (BPF, a measure of whole brain volume). Results The EHR algorithm that identifies MS patients has an area under the curve of 0.958, 83% sensitivity, 92% positive predictive value, and 89% negative predictive value when a 95% specificity threshold is used. The correlation between EHR-derived and true MSSS has a mean R2 = 0.38±0.05, and that between EHR-derived and true BPF has a mean R2 = 0.22±0.08. To illustrate its clinical relevance, derived MSSS captures the expected difference in disease severity between relapsing-remitting and progressive MS patients after adjusting for sex, age of symptom onset and disease duration (p = 1.56×10−12). Conclusion Incorporation of sophisticated codified and narrative EHR data accurately identifies MS patients and provides estimation of a well-accepted indicator of MS severity that is widely used in research settings but not part of the routine medical

  7. Modeling disease severity in multiple sclerosis using electronic health records.

    Directory of Open Access Journals (Sweden)

    Zongqi Xia

    Full Text Available OBJECTIVE: To optimally leverage the scalability and unique features of the electronic health records (EHR for research that would ultimately improve patient care, we need to accurately identify patients and extract clinically meaningful measures. Using multiple sclerosis (MS as a proof of principle, we showcased how to leverage routinely collected EHR data to identify patients with a complex neurological disorder and derive an important surrogate measure of disease severity heretofore only available in research settings. METHODS: In a cross-sectional observational study, 5,495 MS patients were identified from the EHR systems of two major referral hospitals using an algorithm that includes codified and narrative information extracted using natural language processing. In the subset of patients who receive neurological care at a MS Center where disease measures have been collected, we used routinely collected EHR data to extract two aggregate indicators of MS severity of clinical relevance multiple sclerosis severity score (MSSS and brain parenchymal fraction (BPF, a measure of whole brain volume. RESULTS: The EHR algorithm that identifies MS patients has an area under the curve of 0.958, 83% sensitivity, 92% positive predictive value, and 89% negative predictive value when a 95% specificity threshold is used. The correlation between EHR-derived and true MSSS has a mean R(2 = 0.38±0.05, and that between EHR-derived and true BPF has a mean R(2 = 0.22±0.08. To illustrate its clinical relevance, derived MSSS captures the expected difference in disease severity between relapsing-remitting and progressive MS patients after adjusting for sex, age of symptom onset and disease duration (p = 1.56×10(-12. CONCLUSION: Incorporation of sophisticated codified and narrative EHR data accurately identifies MS patients and provides estimation of a well-accepted indicator of MS severity that is widely used in research settings but not part of the

  8. Music mnemonics aid Verbal Memory and Induce Learning – Related Brain Plasticity in Multiple Sclerosis

    OpenAIRE

    Michael eThaut; David ePeterson; McIntosh, Gerald C.; Volker eHoemberg

    2014-01-01

    Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions. To further elucidate this question specifically for memory, we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis (MS) and if music-assisted learning will also influence short-term, system-level brain plasticity. We measured systems-level brain activity with oscillatory network synchronization during ...

  9. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis

    OpenAIRE

    Klaren, Rachel E; Hubbard, Elizabeth A.; Motl, Robert W.; Pilutti, Lara A.; Wetter, Nathan C.; Sutton, Bradley P.

    2015-01-01

    Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS). Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI) in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV), normalized WM v...

  10. Multiple brain metastases - current management and perspectives for treatment with electrochemotherapy:

    OpenAIRE

    Linnert, Mette; Iversen, Helle K.; Gehl, Julie

    2012-01-01

    Background Due to the advanced oncological treatments of cancer, an overall increase in cancer incidence, and better diagnostic tools, the incidence of brain metastases is on the rise. This review addresses the current treatment options for patients with multiple brain metastases, presenting electrochemotherapy (ECT) as one of the new experimental treatments for this group of patients. Conclusions Neurosurgery, stereotactic surgery, and whole-brain radiotherapy are the evidence-based treatmen...

  11. Treatment outcomes in patients with multiple brain metastases: A prospective randomized study

    OpenAIRE

    Animesh Saha; Sajal Kumar Ghosh; Chhaya Roy; Priyanjit Kayal

    2014-01-01

    Context: There is controversy regarding the radiotherapeutic dose fractionation in brain metastases (bm). Aims: The aim of this study is to analyze the treatment outcomes in patients with multiple bm. Settings and Design: Prospective, randomized study. Subjects and Methods: Patients with multiple bm with Eastern Cooperative Oncology Group performance status ≤2 were included. In arm-A patient received whole brain radiotherapy (WBRT) 30 GY in 10# over 2 weeks and in arm-B patients received 20 G...

  12. Progress on the paternal brain: theory, animal models, human brain research, and mental health implications.

    Science.gov (United States)

    Swain, J E; Dayton, C J; Kim, P; Tolman, R M; Volling, B L

    2014-01-01

    With a secure foundation in basic research across mammalian species in which fathers participate in the raising of young, novel brain-imaging approaches are outlining a set of consistent brain circuits that regulate paternal thoughts and behaviors in humans. The newest experimental paradigms include increasingly realistic baby-stimuli to provoke paternal cognitions and behaviors with coordinated hormone measures to outline brain networks that regulate motivation, reflexive caring, emotion regulation, and social brain networks with differences and similarities to those found in mothers. In this article, on the father brain, we review all brain-imaging studies on PubMed to date on the human father brain and introduce the topic with a selection of theoretical models and foundational neurohormonal research on animal models in support of the human work. We discuss potentially translatable models for the identification and treatment of paternal mood and father-child relational problems, which could improve infant mental health and developmental trajectories with potentially broad public health importance.

  13. Regulation of brain endothelial barrier function by microRNAs in health and neuroinflammation.

    Science.gov (United States)

    Lopez-Ramirez, Miguel Alejandro; Reijerkerk, Arie; de Vries, Helga E; Romero, Ignacio Andres

    2016-08-01

    Brain endothelial cells constitute the major cellular element of the highly specialized blood-brain barrier (BBB) and thereby contribute to CNS homeostasis by restricting entry of circulating leukocytes and blood-borne molecules into the CNS. Therefore, compromised function of brain endothelial cells has serious consequences for BBB integrity. This has been associated with early events in the pathogenesis of several disorders that affect the CNS, such as multiple sclerosis, HIV-associated neurologic disorder, and stroke. Recent studies demonstrate that brain endothelial microRNAs play critical roles in the regulation of BBB function under normal and neuroinflammatory conditions. This review will focus on emerging evidence that indicates that brain endothelial microRNAs regulate barrier function and orchestrate various phases of the neuroinflammatory response, including endothelial activation in response to cytokines as well as restoration of inflamed endothelium into a quiescent state. In particular, we discuss novel microRNA regulatory mechanisms and their contribution to cellular interactions at the neurovascular unit that influence the overall function of the BBB in health and during neuroinflammation.-Lopez-Ramirez, M. A., Reijerkerk, A., de Vries, H. E., Romero, I. A. Regulation of brain endothelial barrier function by microRNAs in health and neuroinflammation. PMID:27118674

  14. The multiple roles of Fatty Acid Handling Proteins in brain

    Directory of Open Access Journals (Sweden)

    Valentine SF Moullé

    2012-09-01

    Full Text Available Lipids are essential components of a living organism as energy source but also as constituent of the membrane lipid bilayer. In addition fatty acid (FA derivatives interact with many signaling pathways. FAs have amphipathic properties and therefore require being associated to protein for both transport and intracellular trafficking. Here we will focus on several fatty acid handling proteins, among which the fatty acid translocase/CD36 (FAT/CD36, members of fatty acid transport proteins (FATPs, and lipid chaperones fatty acid-binding proteins (FABPs. A decade of extensive studies has helped decipher the mechanism of action of these proteins in peripheral tissue with high lipid metabolism. However, considerably less information is available regarding their role in the brain, despite the high lipid content of this tissue. This review will primarily focus on the recent studies that have highlighted the crucial role of lipid handling proteins in brain FA transport, neuronal differentiation and development, cognitive processes and brain diseases. Finally a special focus will be made on the recent studies that have revealed the role of FAT/CD36 in brain lipid sensing and nervous control of energy balance.

  15. Multiple Pathways Linking Racism to Health Outcomes

    OpenAIRE

    Harrell, Camara Jules P.; Burford, Tanisha I.; Cage, Brandi N.; Nelson, Travette McNair; Shearon, Sheronda; Thompson, Adrian; Green, Steven

    2011-01-01

    This commentary discusses advances in the conceptual understanding of racism and selected research findings in the social neurosciences. The traditional stress and coping model holds that racism constitutes a source of aversive experiences that, when perceived by the individual, eventually lead to poor health outcomes. Current evidence points to additional psychophysiological pathways linking facets of racist environments with physiological reactions that contribute to disease. The alternativ...

  16. Seniors' Health - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... JavaScript. Spanish (español) Vietnamese (Tiếng Việt) Spanish (español) Salud de las personas mayores Vietnamese (Tiếng Việt) Aging, Medicines and Alcohol Tiếng Việt (Vietnamese) Bilingual PDF Substance Abuse and Mental Health Services Administration Characters not displaying correctly on ...

  17. Bone Health in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Vit Zikan

    2011-01-01

    Full Text Available Multiple sclerosis (MS is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and resorption with depressed bone formation and a marked disruption of mechanosensory network of tightly connected osteocytes due to increase of osteocyte apoptosis. Patients with higher level of disability have also higher risk of falls that combined with a bone loss increases the frequency of bone fractures. There are currently no recommendations how to best prevent and treat osteoporosis in patients with MS. However, devastating effect of immobilization on the skeleton in patients with MS underscores the importance of adequate mechanical stimuli for maintaining the bone structure and its mechanical competence. The physical as well as pharmacological interventions which can counteract the bone remodeling imbalance, particularly osteocyte apoptosis, will be promising for prevention and treatment of osteoporosis in patients with MS.

  18. The relation between inflammation and neurodegeneration in multiple sclerosis brains

    DEFF Research Database (Denmark)

    Frischer, J.M.; Bramow, S.; Dal-Bianco, A.;

    2009-01-01

    to lesional activity and clinical course, with a particular focus on progressive multiple sclerosis. The study is based on detailed quantification of different inflammatory cells in relation to axonal injury in 67 multiple sclerosis autopsies from different disease stages and 28 controls without neurological......Some recent studies suggest that in progressive multiple sclerosis, neurodegeneration may occur independently from inflammation. The aim of our study was to analyse the interdependence of inflammation, neurodegeneration and disease progression in various multiple sclerosis stages in relation...... and the extent of axonal injury, too, was comparable with that in age-matched controls. Ongoing neurodegeneration in these patients, which exceeded the extent found in normal controls, could be attributed to confounding pathologies such as Alzheimer's or vascular disease. Our study suggests a close association...

  19. Multiple Sclerosis and Catastrophic Health Expenditure in Iran

    Science.gov (United States)

    Juyani, Yaser; Hamedi, Dorsa; Hosseini Jebeli, Seyede Sedighe; Qasham, Maryam

    2016-01-01

    Background: There are many disabling medical conditions which can result in catastrophic health expenditure. Multiple Sclerosis is one of the most costly medical conditions through the world which encounter families to the catastrophic health expenditures. This study aims to investigate on what extent Multiple sclerosis patients face catastrophic costs. Method: This study was carried out in Ahvaz, Iran (2014). The study population included households that at least one of their members suffers from MS. To analyze data, Logit regression model was employed by using the default software STATA12. Results: 3.37% of families were encountered with catastrophic costs. Important variables including brand of drug, housing, income and health insurance were significantly correlated with catastrophic expenditure. Conclusions: This study suggests that although a small proportion of MS patients met the catastrophic health expenditure, mechanisms that pool risk and cost (e.g. health insurance) are required to protect them and improve financial and access equity in health care.

  20. Brain-drain and health care delivery in developing countries

    Directory of Open Access Journals (Sweden)

    Yusuf Abdu Misau

    2010-09-01

    Full Text Available Migration of health workers ‘Brain drain’ is defined as the movement of health personnel in search of a better standard of living and life quality, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. The debate about migration of health workers from the developing to the developed world has remained pertinent for decades now. Regardless of the push and pull factors, migration of health care workers from developing countries to developed ones, have done more harm than good on the health care deliveries in the developing countries. This article reviews the literature on the effects of cross-border migration of health care professionals.

  1. Implications for environmental health of multiple stressors

    Energy Technology Data Exchange (ETDEWEB)

    Mothersill, Carmel; Seymour, Colin [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, L8S 4K1 (Canada)

    2009-06-01

    Recent insights into the mechanisms underlying the biological effects of low dose effects of ionising radiation have revealed that similar mechanisms can be induced by chemical stressors in the environment. This means that interactions between radiation and chemicals are likely and that the outcomes following mixed exposures to radiation and chemicals may not be predictable for human health, by consideration of single agent effects. Our understanding of the biological effects of low dose exposure has undergone a major paradigm shift. We now possess technologies which can detect very subtle changes in cells due to small exposures to radiation or other pollutants. We also understand much more now about cell communication, systems biology and the need to consider effects of low dose exposure at different hierarchical levels of organisation from molecules up to and including ecosystems. Furthermore we understand, at least in part, some of the mechanisms which drive low dose effects and which perpetuate these not only in the exposed organism but also in its progeny and in certain cases, its kin. This means that previously held views about safe doses or lack of harmful effects cannot be sustained. The International Commission on Radiological Protection (ICRP) and all national radiation and environmental protection organisations have always accepted a theoretical risk and have applied the precautionary principle and the LNT (linear-non-threshold) model which basically says that there is no safe dose of radiation. Therefore even in the absence of visible effects, exposure of people to radiation is strictly limited. This review will consider the historical context and the new discoveries and will focus on evidence for emergent effects after mixed exposures to combined stressors which include ionising radiation. The implications for regulation of low dose exposures to protect human health and environmental security will be discussed.

  2. Implications for environmental health of multiple stressors

    International Nuclear Information System (INIS)

    Recent insights into the mechanisms underlying the biological effects of low dose effects of ionising radiation have revealed that similar mechanisms can be induced by chemical stressors in the environment. This means that interactions between radiation and chemicals are likely and that the outcomes following mixed exposures to radiation and chemicals may not be predictable for human health, by consideration of single agent effects. Our understanding of the biological effects of low dose exposure has undergone a major paradigm shift. We now possess technologies which can detect very subtle changes in cells due to small exposures to radiation or other pollutants. We also understand much more now about cell communication, systems biology and the need to consider effects of low dose exposure at different hierarchical levels of organisation from molecules up to and including ecosystems. Furthermore we understand, at least in part, some of the mechanisms which drive low dose effects and which perpetuate these not only in the exposed organism but also in its progeny and in certain cases, its kin. This means that previously held views about safe doses or lack of harmful effects cannot be sustained. The International Commission on Radiological Protection (ICRP) and all national radiation and environmental protection organisations have always accepted a theoretical risk and have applied the precautionary principle and the LNT (linear-non-threshold) model which basically says that there is no safe dose of radiation. Therefore even in the absence of visible effects, exposure of people to radiation is strictly limited. This review will consider the historical context and the new discoveries and will focus on evidence for emergent effects after mixed exposures to combined stressors which include ionising radiation. The implications for regulation of low dose exposures to protect human health and environmental security will be discussed.

  3. Neuroplasticity and Clinical Practice: Building Brain Power for Health.

    Science.gov (United States)

    Shaffer, Joyce

    2016-01-01

    The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide. PMID:27507957

  4. Neuroplasticity and Clinical Practice: Building Brain Power for Health.

    Science.gov (United States)

    Shaffer, Joyce

    2016-01-01

    The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide.

  5. Neuroplasticity and Clinical Practice: Building Brain Power for Health

    Science.gov (United States)

    Shaffer, Joyce

    2016-01-01

    The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide. PMID:27507957

  6. Multiple opiate receptors in the brain of spontaneously hypertensive rats

    Energy Technology Data Exchange (ETDEWEB)

    Das, S.; Bhargava, H.N.

    1986-03-01

    The characteristics of ..mu.., delta and kappa -opiate receptors in the brain of spontaneously hypertensive (SH) and normotensive Wistar-Kyoto (WKY) rats were determined using the receptor binding assays. The ligands used were /sup 3/H-naltrexone (..mu..), /sup 3/H-ethylketocyclazocine (EKC, kappa) and /sup 3/H-Tyr-D-Ser-Gly-Phe-Leu-Thr (DSTLE, delta). Since EKC binds to ..mu.. and delta receptors in addition to kappa, the binding was done in the presence of 100 nM each of DAGO and DADLE to suppress ..mu.. and delta sites, respectively. All three ligands bound to brain membranes of WKY rats at a single high affinity site with the following B/sub max/ (fmol/mg protein) and K/sub d/ (nM) values: /sup 3/H-naltrexone (130.5; 0.43) /sup 3/H-EKC (19.8, 1.7) and /sup 3/H-DSTLE (139, 2.5). The binding of /sup 3/H-naltrexone and /sup 3/H-DSTLE in the brain of WKY and SH did not differ. A consistent increase (22%) in B/sub max/ of /sup 3/H-EKC was found in SHR compared to WKY rats. However, the K/sub d/ values did not differ. The increase in B/sub max/ was due to increases in hypothalamus and cortex. It is concluded that SH rats have higher density of kappa-opiate receptors, particularly in hypothalamus and cortex, compared to WKY rats, and that kappa-opiate receptors may be involved in the pathophysiology of hypertension.

  7. Clinical correlations of brain lesion distribution in multiple sclerosis

    DEFF Research Database (Denmark)

    Vellinga, M M; Geurts, J J G; Rostrup, E;

    2009-01-01

    status scale (EDSS) and MS functional composite (MSFC) subdomain scores and demographic characteristics of 325 MS patients. To identify statistically significant locations, a cluster-forming threshold of 3.1 was used. RESULTS: In clusters in the periventricular region, lesion probability correlated...... significantly (P correlate with lesion probability in any location, and did...... not influence correlations with disability when included in its analyses. CONCLUSION: Periventricular lesions were related to disability. LL influenced relations between disability and lesion probability throughout the brain, suggesting interplay between lesional burden and its location in determining...

  8. Permeability of the blood-brain barrier predicts conversion from optic neuritis to multiple sclerosis

    DEFF Research Database (Denmark)

    Cramer, Stig P; Modvig, Signe; Simonsen, Helle Juhl;

    2015-01-01

    Optic neuritis is an acute inflammatory condition that is highly associated with multiple sclerosis. Currently, the best predictor of future development of multiple sclerosis is the number of T2 lesions visualized by magnetic resonance imaging. Previous research has found abnormalities...... in the permeability of the blood-brain barrier in normal-appearing white matter of patients with multiple sclerosis and here, for the first time, we present a study on the capability of blood-brain barrier permeability in predicting conversion from optic neuritis to multiple sclerosis and a direct comparison...... as part of the diagnostic work-up at time of diagnosis. Eighteen healthy controls were included for comparison. Patients had magnetic resonance imaging and lumbar puncture performed within 4 weeks of onset of optic neuritis. Information on multiple sclerosis conversion was acquired from hospital records 2...

  9. Multiple Antenatal Dexamethasone Treatment Alters Brain Vessel Differentiation in Newborn Mouse Pups.

    Science.gov (United States)

    Neuhaus, Winfried; Schlundt, Marian; Fehrholz, Markus; Ehrke, Alexander; Kunzmann, Steffen; Liebner, Stefan; Speer, Christian P; Förster, Carola Y

    2015-01-01

    Antenatal steroid treatment decreases morbidity and mortality in premature infants through the maturation of lung tissue, which enables sufficient breathing performance. However, clinical and animal studies have shown that repeated doses of glucocorticoids such as dexamethasone and betamethasone lead to long-term adverse effects on brain development. Therefore, we established a mouse model for antenatal dexamethasone treatment to investigate the effects of dexamethasone on brain vessel differentiation towards the blood-brain barrier (BBB) phenotype, focusing on molecular marker analysis. The major findings were that in total brains on postnatal day (PN) 4 triple antenatal dexamethasone treatment significantly downregulated the tight junction protein claudin-5, the endothelial marker Pecam-1/CD31, the glucocorticoid receptor, the NR1 subunit of the N-methyl-D-aspartate receptor, and Abc transporters (Abcb1a, Abcg2 Abcc4). Less pronounced effects were found after single antenatal dexamethasone treatment and in PN10 samples. Comparisons of total brain samples with isolated brain endothelial cells together with the stainings for Pecam-1/CD31 and claudin-5 led to the assumption that the morphology of brain vessels is affected by antenatal dexamethasone treatment at PN4. On the mRNA level markers for angiogenesis, the sonic hedgehog and the Wnt pathway were downregulated in PN4 samples, suggesting fundamental changes in brain vascularization and/or differentiation. In conclusion, we provided a first comprehensive molecular basis for the adverse effects of multiple antenatal dexamethasone treatment on brain vessel differentiation. PMID:26274818

  10. Multiple Antenatal Dexamethasone Treatment Alters Brain Vessel Differentiation in Newborn Mouse Pups.

    Directory of Open Access Journals (Sweden)

    Winfried Neuhaus

    Full Text Available Antenatal steroid treatment decreases morbidity and mortality in premature infants through the maturation of lung tissue, which enables sufficient breathing performance. However, clinical and animal studies have shown that repeated doses of glucocorticoids such as dexamethasone and betamethasone lead to long-term adverse effects on brain development. Therefore, we established a mouse model for antenatal dexamethasone treatment to investigate the effects of dexamethasone on brain vessel differentiation towards the blood-brain barrier (BBB phenotype, focusing on molecular marker analysis. The major findings were that in total brains on postnatal day (PN 4 triple antenatal dexamethasone treatment significantly downregulated the tight junction protein claudin-5, the endothelial marker Pecam-1/CD31, the glucocorticoid receptor, the NR1 subunit of the N-methyl-D-aspartate receptor, and Abc transporters (Abcb1a, Abcg2 Abcc4. Less pronounced effects were found after single antenatal dexamethasone treatment and in PN10 samples. Comparisons of total brain samples with isolated brain endothelial cells together with the stainings for Pecam-1/CD31 and claudin-5 led to the assumption that the morphology of brain vessels is affected by antenatal dexamethasone treatment at PN4. On the mRNA level markers for angiogenesis, the sonic hedgehog and the Wnt pathway were downregulated in PN4 samples, suggesting fundamental changes in brain vascularization and/or differentiation. In conclusion, we provided a first comprehensive molecular basis for the adverse effects of multiple antenatal dexamethasone treatment on brain vessel differentiation.

  11. Brain Plasticity Effects of Neuromodulation Against Multiple Sclerosis Fatigue

    OpenAIRE

    Tecchio, Franca; Cancelli, Andrea; Cottone, Carlo; Ferrucci, Roberta; Vergari, Maurizio; Zito, Giancarlo; Pasqualetti, Patrizio; Filippi, Maria Maddalena; Ghazaryan, Anna; Lupoi, Domenico; Smits, Fenne M.; Giordani, Alessandro; Migliore, Simone; Porcaro, Camillo; Salustri, Carlo

    2015-01-01

    Rationale We recently reported on the efficacy of a personalized transcranial direct current stimulation (tDCS) treatment in reducing multiple sclerosis (MS) fatigue. The result supports the notion that interventions targeted at modifying abnormal excitability within the sensorimotor network could represent valid non-pharmacological treatments. Objective The present work aimed at assessing whether the mentioned intervention also induces changes in the excitability of sensorimotor c...

  12. The topograpy of demyelination and neurodegeneration in the multiple sclerosis brain.

    Science.gov (United States)

    Haider, Lukas; Zrzavy, Tobias; Hametner, Simon; Höftberger, Romana; Bagnato, Francesca; Grabner, Günther; Trattnig, Siegfried; Pfeifenbring, Sabine; Brück, Wolfgang; Lassmann, Hans

    2016-03-01

    Multiple sclerosis is a chronic inflammatory disease with primary demyelination and neurodegeneration in the central nervous system. In our study we analysed demyelination and neurodegeneration in a large series of multiple sclerosis brains and provide a map that displays the frequency of different brain areas to be affected by these processes. Demyelination in the cerebral cortex was related to inflammatory infiltrates in the meninges, which was pronounced in invaginations of the brain surface (sulci) and possibly promoted by low flow of the cerebrospinal fluid in these areas. Focal demyelinated lesions in the white matter occurred at sites with high venous density and additionally accumulated in watershed areas of low arterial blood supply. Two different patterns of neurodegeneration in the cortex were identified: oxidative injury of cortical neurons and retrograde neurodegeneration due to axonal injury in the white matter. While oxidative injury was related to the inflammatory process in the meninges and pronounced in actively demyelinating cortical lesions, retrograde degeneration was mainly related to demyelinated lesions and axonal loss in the white matter. Our data show that accumulation of lesions and neurodegeneration in the multiple sclerosis brain does not affect all brain regions equally and provides the pathological basis for the selection of brain areas for monitoring regional injury and atrophy development in future magnetic resonance imaging studies.

  13. Multiple large brain abscesses in a newborn that may have resulted from intrauterine infection.

    Science.gov (United States)

    Celik, Istemi Han; Demirel, Gamze; Erdeve, Omer; Uraş, Nurdan; Dilmen, Uğur

    2011-01-01

    Brain abscess is a focal, intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Here, we report a case with multiple, large brain abscesses diagnosed coincidentally on postnatal day 11. This case is noteworthy because the organized abscesses were present as early as day 11 with no significant neurological signs or symptoms. Brain abscess in newborns is a very rare disease that may not exhibit the expected neurological signs and symptoms. Depending on the radiological organization, an abscess in a neonate in the first weeks may be the result of an intrauterine infection. PMID:22272460

  14. Does distracting pain justify performing brain computed tomography in multiple traumas with mild head injury?

    Science.gov (United States)

    Sadeghian, Homa; Motiei-Langroudi, Rouzbeh

    2016-06-01

    Traumatic brain injury (TBI) is a significant health concern classified as mild, moderate, and severe. Although the indications to perform brain computed tomography (CT) are clear in moderate and severe cases, there still exists controversy in mild TBI (mTBI). We designed the study to evaluate the significance of distracting pain in patients with mTBI. The study population included patients with mild traumatic brain injury (GCS ≥13). Moderate and high risk factors including age cerebral edema in brain CT (p > 0.99). No patients had any neurologic symptoms or signs in follow-up. Our results show that in the absence of any other risk factors, distracting pain from other organs (limbs, pelvis, and non-cervical spine) cannot be regarded as a brain CT indication in patients with mild TBI, as it is never associated with significant intracranial lesions. PMID:26931118

  15. Functional brain imaging predicts public health campaign success.

    Science.gov (United States)

    Falk, Emily B; O'Donnell, Matthew Brook; Tompson, Steven; Gonzalez, Richard; Dal Cin, Sonya; Strecher, Victor; Cummings, Kenneth Michael; An, Lawrence

    2016-02-01

    Mass media can powerfully affect health decision-making. Pre-testing through focus groups or surveys is a standard, though inconsistent, predictor of effectiveness. Converging evidence demonstrates that activity within brain systems associated with self-related processing can predict individual behavior in response to health messages. Preliminary evidence also suggests that neural activity in small groups can forecast population-level campaign outcomes. Less is known about the psychological processes that link neural activity and population-level outcomes, or how these predictions are affected by message content. We exposed 50 smokers to antismoking messages and used their aggregated neural activity within a 'self-localizer' defined region of medial prefrontal cortex to predict the success of the same campaign messages at the population level (n = 400,000 emails). Results demonstrate that: (i) independently localized neural activity during health message exposure complements existing self-report data in predicting population-level campaign responses (model combined R(2) up to 0.65) and (ii) this relationship depends on message content-self-related neural processing predicts outcomes in response to strong negative arguments against smoking and not in response to compositionally similar neutral images. These data advance understanding of the psychological link between brain and large-scale behavior and may aid the construction of more effective media health campaigns.

  16. Functional brain imaging predicts public health campaign success.

    Science.gov (United States)

    Falk, Emily B; O'Donnell, Matthew Brook; Tompson, Steven; Gonzalez, Richard; Dal Cin, Sonya; Strecher, Victor; Cummings, Kenneth Michael; An, Lawrence

    2016-02-01

    Mass media can powerfully affect health decision-making. Pre-testing through focus groups or surveys is a standard, though inconsistent, predictor of effectiveness. Converging evidence demonstrates that activity within brain systems associated with self-related processing can predict individual behavior in response to health messages. Preliminary evidence also suggests that neural activity in small groups can forecast population-level campaign outcomes. Less is known about the psychological processes that link neural activity and population-level outcomes, or how these predictions are affected by message content. We exposed 50 smokers to antismoking messages and used their aggregated neural activity within a 'self-localizer' defined region of medial prefrontal cortex to predict the success of the same campaign messages at the population level (n = 400,000 emails). Results demonstrate that: (i) independently localized neural activity during health message exposure complements existing self-report data in predicting population-level campaign responses (model combined R(2) up to 0.65) and (ii) this relationship depends on message content-self-related neural processing predicts outcomes in response to strong negative arguments against smoking and not in response to compositionally similar neutral images. These data advance understanding of the psychological link between brain and large-scale behavior and may aid the construction of more effective media health campaigns. PMID:26400858

  17. Brain metastasis from pheochromocytoma in a patient with multiple endocrine neoplasia type 2A.

    Science.gov (United States)

    Gentile, S; Rainero, I; Savi, L; Rivoiro, C; Pinessi, L

    2001-12-01

    Neurological involvement in multiple endocrine neoplasia (MEN) syndrome is uncommon. Notalgia paresthetica (pruritus localized in an area between D2 and D6 dermatomes) is the neurological symptom more frequently described in patients with MEN 2A. The authors report the unusual case of a MEN 2A patient with a brain metastasis from a pheochromocytoma. PMID:11677427

  18. Brain drain and health workforce distortions in Mozambique.

    Directory of Open Access Journals (Sweden)

    Kenneth Sherr

    Full Text Available INTRODUCTION: Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle-income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs, and the private sector. METHODS: An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980-2006. Data were collected 26-months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties. RESULTS: Of 723 qualifying physicians between 1980-2006, 95.9% (693 were working full-time, including 71.1% (493 as clinicians, 20.5% (142 as health system managers, and 6.9% (48 as researchers/professors. 25.5% (181 of the sample had left the public sector, of which 62.4% (113 continued working in-country and 37.6% (68 emigrated from Mozambique. Of those cases of internal migration, 66.4% (75 worked for NGOs, 21.2% (24 for donor agencies, and 12.4% (14 in the private sector. Annual incidence of physician migration was estimated to be 3.7%, predominately to work in the growing NGO sector. An estimated 36.3% (41/113 of internal migration cases had previously held senior-level management positions in the public sector. DISCUSSION: Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring

  19. Differential binding of Nocardia asteroides in the murine lung and brain suggests multiple ligands on the nocardial surface.

    OpenAIRE

    Beaman, B L

    1996-01-01

    The adherence of Nocardia asteroides in the murine brain and lungs was determined. Virulent strains had increased adherence in the brain and lungs, whereas less virulent strains bound in either the brain or lungs. Nocardiae that attached apically penetrated host cells. Multiple receptors on the nocardial surface may be involved in this differential attachment and penetration.

  20. Environmental influence in the brain, human welfare and mental health.

    Science.gov (United States)

    Tost, Heike; Champagne, Frances A; Meyer-Lindenberg, Andreas

    2015-10-01

    The developing human brain is shaped by environmental exposures--for better or worse. Many exposures relevant to mental health are genuinely social in nature or believed to have social subcomponents, even those related to more complex societal or area-level influences. The nature of how these social experiences are embedded into the environment may be crucial. Here we review select neuroscience evidence on the neural correlates of adverse and protective social exposures in their environmental context, focusing on human neuroimaging data and supporting cellular and molecular studies in laboratory animals. We also propose the inclusion of innovative methods in social neuroscience research that may provide new and ecologically more valid insight into the social-environmental risk architecture of the human brain. PMID:26404717

  1. The benefit of whole brain reirradiation in patients with multiple brain metastases

    International Nuclear Information System (INIS)

    To assess the outcomes, symptom palliation and survival rates in patients who received repeat whole brain radiotherapy (WBRT). Twenty-eight patients who had progression of brain metastasis received a second course of WBRT. Univariate log-rank testing and multivariate Cox regression analysis were used to determine the factors for death among several variables (cumulative BED [BEDcumulative], primary tumor site, Karnofsky performance scale [KPS], previous SRS, number of metastases and absence of extracranial metastases). Correlations between variables and treatment response were evaluated with the Chi-squared test. The median KPS was 60 (range 50 to 100) at the initiation of reirradiation. The median time interval between the two courses of WBRT was 9.5 months (range 3–27 months). The median doses of the first course and the second course of WBRT were 30 Gy (range 20 to 30 Gy) and 25 Gy (range 20 to 30 Gy), respectively. The mean BEDcumulative was 129.5 Gy (range 110 to 150 Gy). Severe or unexpected toxicity was not observed. Symptomatic response was detected in 39% of the patients. The median overall survival following reirradiation was 3 months (range 1 to 12 months, 95% CI 1.82-4.118). Survival was significantly better in responders (median 10 months, 95% CI 3.56-16.43) compared with non-responders (median 2 months, 95% CI 1.3-2.64) (p = 0.000). In multivariate analysis, patients that had lung cancer (p = 0.01), initial KPS ≥60 (p = 0.03) or longer intervals to reirradiation (p = 0.01) had significantly better survival rates. A careful second course of whole brain irradiation might provide a symptomatic and survival benefit in patients with good performance status and longer cranial progression-free intervals

  2. Optimal Gaussian Mixture Models of Tissue Intensities in Brain MRI of Patients with Multiple-Sclerosis

    Science.gov (United States)

    Xiao, Yiming; Shah, Mohak; Francis, Simon; Arnold, Douglas L.; Arbel, Tal; Collins, D. Louis

    Brain tissue segmentation is important in studying markers in human brain Magnetic Resonance Images (MRI) of patients with diseases such as Multiple Sclerosis (MS). Parametric segmentation approaches typically assume unimodal Gaussian distributions on MRI intensities of individual tissue classes, even in applications on multi-spectral images. However, this assumption has not been rigorously verified especially in the context of MS. In this work, we evaluate the local MRI intensities of both healthy and diseased brain tissues of 21 multi-spectral MRIs (63 volumes in total) of MS patients for adherence to this assumption. We show that the tissue intensities are not uniform across the brain and vary across (anatomical) regions of the brain. Consequently, we show that Gaussian mixtures can better model the multi-spectral intensities. We utilize an Expectation Maximization (EM) based approach to learn the models along with a symmetric Jeffreys divergence criterion to study differences in intensity distributions. The effects of these findings are also empirically verified on automatic segmentation of brains with MS.

  3. Functional Brain Network Changes Associated with Maintenance of Cognitive Function in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Santosh A Helekar

    2010-11-01

    Full Text Available In multiple sclerosis (MS functional changes in connectivity due to cortical reorganization could lead to cognitive impairment (CI, or reflect a re-adjustment to reduce the clinical effects of widespread tissue damage. Such alterations in connectivity could result in changes in neural activation as assayed by executive function tasks. We examined cognitive function in MS patients with mild to moderate cognitive impairment and age-matched controls. We evaluated brain activity using functional magnetic resonance imaging (fMRI during the successful performance of the Wisconsin-card sorting (WCS task by MS patients, showing compensatory maintenance of normal function, as measured by response latency and error rate. To assess changes in functional connectivity throughout the brain, we performed a global functional brain network analysis by computing voxel by voxel correlations on the fMRI time series data and carrying out a hierarchical cluster analysis. We found that during the WCS task there is a significant reduction in the number of smaller size brain functional networks, and a change in the brain areas representing the nodes of these networks in MS patients compared to age-matched controls. There is also a concomitant increase in the strength of functional connections between brain loci separated at intermediate scale distances in these patients. These functional alterations might reflect compensatory neuroplastic reorganization underlying maintenance of relatively normal cognitive function in the face of white matter lesions and cortical atrophy produced by MS.

  4. Gamma knife radiosurgery for multiple brain metastases from non-small cell lung cancer. Comparison with whole brain radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Serizawa, Toru; Ono, Junichi [Chiba Cardiovascular Center (Japan); Iuchi, Toshihiko; Osato, Katsunobu

    2001-04-01

    The purpose of this retrospective study is to compare the effectiveness of gamma knife radiosurgery (GKS) with that of whole-brain radiation therapy (WBRT) for multiple cerebral metastases from non-small cell lung cancer. Among 302 cases with cerebral metastases from non-small cell lung cancer treated at the Chiba Cardiovascular Center and Chiba Cancer Center between 1990 and 1999, 100 consecutive patients filling the following 4 entry criteria were analyzed in this study: Up to 10 multiple brain lesions at initial MRI study; No surgically inaccessible tumors with more than 30 mm in diameter; No carcinomatous meningitis; More than 3 months of life expectancy. The patients were divided into two groups: the GKS group (66 patients) and the WBRT group (34 patients). In the GKS group, large lesions ({>=}30mm) were removed microsurgically and all other small lesions (<30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was administered according to the primary physician's protocol. The two groups did not differ in terms of age, gender, initial Karnofsky Performance Scale (KPS) score, pathology of lung caner, number, and size of brain lesion, systemic control, and chemotherapy. Overall survival (OS), neurological survival (NS) and qualitative survival (QS) of the GKS group were longer than those of the WBRT group according to Kaplan-Meier's method. In a multivariate analysis the WBRT group also had significant poor prognostic factors for OS, NS and QS. GKS without prophylactic WBRT could be a primary choice of treatment method for patients with as many as 10 cerebral metastases from non-small cell lung cancer. (author)

  5. Gamma knife radiosurgery for multiple brain metastases from non-small cell lung cancer. Comparison with whole brain radiation therapy

    International Nuclear Information System (INIS)

    The purpose of this retrospective study is to compare the effectiveness of gamma knife radiosurgery (GKS) with that of whole-brain radiation therapy (WBRT) for multiple cerebral metastases from non-small cell lung cancer. Among 302 cases with cerebral metastases from non-small cell lung cancer treated at the Chiba Cardiovascular Center and Chiba Cancer Center between 1990 and 1999, 100 consecutive patients filling the following 4 entry criteria were analyzed in this study: Up to 10 multiple brain lesions at initial MRI study; No surgically inaccessible tumors with more than 30 mm in diameter; No carcinomatous meningitis; More than 3 months of life expectancy. The patients were divided into two groups: the GKS group (66 patients) and the WBRT group (34 patients). In the GKS group, large lesions (≥30mm) were removed microsurgically and all other small lesions (<30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was administered according to the primary physician's protocol. The two groups did not differ in terms of age, gender, initial Karnofsky Performance Scale (KPS) score, pathology of lung caner, number, and size of brain lesion, systemic control, and chemotherapy. Overall survival (OS), neurological survival (NS) and qualitative survival (QS) of the GKS group were longer than those of the WBRT group according to Kaplan-Meier's method. In a multivariate analysis the WBRT group also had significant poor prognostic factors for OS, NS and QS. GKS without prophylactic WBRT could be a primary choice of treatment method for patients with as many as 10 cerebral metastases from non-small cell lung cancer. (author)

  6. Quantitation of blood-brain barrier defect by magnetic resonance imaging and gadolinium-DTPA in patients with multiple sclerosis and brain tumors

    DEFF Research Database (Denmark)

    Larsson, H B; Stubgaard, M; Frederiksen, J L;

    1990-01-01

    In this study quantitation of the degree of deficiency of the blood-brain barrier (BBB) in patients with multiple sclerosis or brain tumors, by using MRI, is shown to be possible. As a measure of permeability of the BBB to Gadolinium-DTPA (Gd-DTPA) the flux per unit of distribution volume per uni...

  7. Quantitation of blood-brain barrier defect by magnetic resonance imaging and gadolinium-DTPA in patients with multiple sclerosis and brain tumors

    DEFF Research Database (Denmark)

    Larsson, H B; Stubgaard, M; Frederiksen, Jette Lautrup Battistini;

    1990-01-01

    In this study quantitation of the degree of deficiency of the blood-brain barrier (BBB) in patients with multiple sclerosis or brain tumors, by using MRI, is shown to be possible. As a measure of permeability of the BBB to Gadolinium-DTPA (Gd-DTPA) the flux per unit of distribution volume per unit...

  8. musical mnemonics aid verbal memory and induce learning related brain plasticity in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Michael eThaut

    2014-06-01

    Full Text Available Recent research in music and brain function has suggested that the temporal pattern structure in music andrhythm can enhance cognitive functions. To further elucidate this question specifically for memory weinvestigated if a musical template can enhance verbal learning in patients with multiple sclerosis and ifmusic assisted learning will also influence short-term, system-level brain plasticity. We measuredsystems-level brain activity with oscillatory network synchronization during music assisted learning.Specifically, we measured the spectral power of 128-channel electroencephalogram (EEG in alpha andbeta frequency bands in 54 patients with multiple sclerosis (MS. The study sample was randomlydivided into 2 groups, either hearing a spoken or musical (sung presentation of Rey’s Auditory VerbalLearning Test (RAVLT. We defined the learning-related synchronization (LRS as the percent changein EEG spectral power from the first time the word was presented to the average of the subsequent wordencoding trials. LRS differed significantly between the music and spoken conditions in low alpha andupper beta bands. Patients in the music condition showed overall better word memory and better wordorder memory and stronger bilateral frontal alpha LRS than patients in the spoken condition. Theevidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization inprefrontal areas in MS patients during word learning. It is suggested that the temporal structure implicitin musical stimuli enhances ‘deep encoding’ during verbal learning and sharpens the timing of neuraldynamics in brain networks degraded by demyelination in MS

  9. Inflammation induces neuro-lymphatic protein expression in multiple sclerosis brain neurovasculature

    OpenAIRE

    Chaitanya, Ganta Vijay; Omura, Seiichi; Sato, Fumitaka; Martinez, Nicholas E.; Minagar, Alireza; Ramanathan, Murali; Guttman, Bianca Weinstock; Zivadinov, Robert; Tsunoda, Ikuo; Alexander, Jonathan S

    2013-01-01

    Background Multiple sclerosis (MS) is associated with ectopic lymphoid follicle formation. Podoplanin+ (lymphatic marker) T helper17 (Th17) cells and B cell aggregates have been implicated in the formation of tertiary lymphoid organs (TLOs) in MS and experimental autoimmune encephalitis (EAE). Since podoplanin expressed by Th17 cells in MS brains is also expressed by lymphatic endothelium, we investigated whether the pathophysiology of MS involves inductions of lymphatic proteins in the infla...

  10. MULTIPLE INTELLIGENCE THEORY AND FOREIGN LANGUAGE LEARNING:A BRAIN-BASED PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Jane Arnold

    2004-06-01

    Full Text Available Gardner's Multiple Intelligences theory is presented as a cognitive perspective on intelligence which has profound implications for education in general. More specifically, it has led to the application of eight of these frames to language teaching and learning. In this chapter, we will argue in favour of the application of MIT to the EFL classroom, using as support some of the major insights for language teaching from brain science.

  11. Spatial path models with multiple indicators and multiple causes: mental health in US counties.

    Science.gov (United States)

    Congdon, Peter

    2011-06-01

    This paper considers a structural model for the impact on area mental health outcomes (poor mental health, suicide) of spatially structured latent constructs: deprivation, social capital, social fragmentation and rurality. These constructs are measured by multiple observed effect indicators, with the constructs allowed to be correlated both between and within areas. However, in the scheme developed here, particular latent constructs may also be influenced by known variables, or, via path sequences, by other constructs, possibly nonlinearly. For example, area social capital may be measured by effect indicators (e.g. associational density, charitable activity), but influenced as causes by other constructs (e.g. area deprivation), and by observed features of the socio-ethnic structure of areas. A model incorporating these features is applied to suicide mortality and the prevalence of poor mental health in 3141 US counties, which are related to the latent spatial constructs and to observed variables (e.g. county ethnic mix). PMID:22749588

  12. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Rachel E. Klaren

    2015-01-01

    Full Text Available Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS. Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV, normalized WM volume (NWMV, and deep GM structures were calculated from 3D T1-weighted structural brain images. We conducted partial correlations (pr controlling for demographic and clinical variables. Results. Moderate-to-vigorous physical activity (MVPA was significantly associated with NGMV (pr=0.370, p<0.05, NWMV (pr=0.433, p<0.01, hippocampus (pr=0.499, p<0.01, thalamus (pr=0.380, p<0.05, caudate (pr=0.539, p<0.01, putamen (pr=0.369, p<0.05, and pallidum (pr=0.498, p<0.01 volumes, when controlling for sex, age, clinical course of MS, and Expanded Disability Status Scale score. There were no associations between sedentary and light physical activity with MRI outcomes. Conclusion. Our results provide the first evidence that MVPA is associated with volumes of whole brain GM and WM and deep GM structures that are involved in motor and cognitive functions in MS.

  13. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis

    Science.gov (United States)

    Klaren, Rachel E.; Hubbard, Elizabeth A.; Motl, Robert W.; Pilutti, Lara A.; Wetter, Nathan C.; Sutton, Bradley P.

    2015-01-01

    Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS). Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI) in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV), normalized WM volume (NWMV), and deep GM structures were calculated from 3D T1-weighted structural brain images. We conducted partial correlations (pr) controlling for demographic and clinical variables. Results. Moderate-to-vigorous physical activity (MVPA) was significantly associated with NGMV (pr = 0.370, p < 0.05), NWMV (pr = 0.433, p < 0.01), hippocampus (pr = 0.499, p < 0.01), thalamus (pr = 0.380, p < 0.05), caudate (pr = 0.539, p < 0.01), putamen (pr = 0.369, p < 0.05), and pallidum (pr = 0.498, p < 0.01) volumes, when controlling for sex, age, clinical course of MS, and Expanded Disability Status Scale score. There were no associations between sedentary and light physical activity with MRI outcomes. Conclusion. Our results provide the first evidence that MVPA is associated with volumes of whole brain GM and WM and deep GM structures that are involved in motor and cognitive functions in MS. PMID:26146460

  14. Significance of MDR1 and multiple drug resistance in refractory human epileptic brain

    Directory of Open Access Journals (Sweden)

    Dini Gabriele

    2004-10-01

    Full Text Available Abstract Background The multiple drug resistance protein (MDR1/P-glycoprotein is overexpressed in glia and blood-brain barrier (BBB endothelium in drug refractory human epileptic tissue. Since various antiepileptic drugs (AEDs can act as substrates for MDR1, the enhanced expression/function of this protein may increase their active extrusion from the brain, resulting in decreased responsiveness to AEDs. Methods Human drug resistant epileptic brain tissues were collected after surgical resection. Astrocyte cell cultures were established from these tissues, and commercially available normal human astrocytes were used as controls. Uptake of fluorescent doxorubicin and radioactive-labeled Phenytoin was measured in the two cell populations, and the effect of MDR1 blockers was evaluated. Frozen human epileptic brain tissue slices were double immunostained to locate MDR1 in neurons and glia. Other slices were exposed to toxic concentrations of Phenytoin to study cell viability in the presence or absence of a specific MDR1 blocker. Results MDR1 was overexpressed in blood vessels, astrocytes and neurons in human epileptic drug-resistant brain. In addition, MDR1-mediated cellular drug extrusion was increased in human 'epileptic' astrocytes compared to 'normal' ones. Concomitantly, cell viability in the presence of cytotoxic compounds was increased. Conclusions Overexpression of MDR1 in different cell types in drug-resistant epileptic human brain leads to functional alterations, not all of which are linked to drug pharmacokinetics. In particular, the modulation of glioneuronal MDR1 function in epileptic brain in the presence of toxic concentrations of xenobiotics may constitute a novel cytoprotective mechanism.

  15. A putative Alzheimer's disease risk allele in PCK1 influences brain atrophy in multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Zongqi Xia

    Full Text Available BACKGROUND: Brain atrophy and cognitive dysfunction are neurodegenerative features of Multiple Sclerosis (MS. We used a candidate gene approach to address whether genetic variants implicated in susceptibility to late onset Alzheimer's Disease (AD influence brain volume and cognition in MS patients. METHODS/PRINCIPAL FINDINGS: MS subjects were genotyped for five single nucleotide polymorphisms (snps associated with susceptibility to AD: PICALM, CR1, CLU, PCK1, and ZNF224. We assessed brain volume using Brain Parenchymal Fraction (BPF measurements obtained from Magnetic Resonance Imaging (MRI data and cognitive function using the Symbol Digit Modalities Test (SDMT. Genotypes were correlated with cross-sectional BPF and SDMT scores using linear regression after adjusting for sex, age at symptom onset, and disease duration. 722 MS patients with a mean (±SD age at enrollment of 41 (±10 years were followed for 44 (±28 months. The AD risk-associated allele of a non-synonymous SNP in the PCK1 locus (rs8192708G is associated with a smaller average brain volume (P=0.0047 at the baseline MRI, but it does not impact our baseline estimate of cognition. PCK1 is additionally associated with higher baseline T2-hyperintense lesion volume (P=0.0088. Finally, we provide technical validation of our observation in a subset of 641 subjects that have more than one MRI study, demonstrating the same association between PCK1 and smaller average brain volume (P=0.0089 at the last MRI visit. CONCLUSION/SIGNIFICANCE: Our study provides suggestive evidence for greater brain atrophy in MS patients bearing the PCK1 allele associated with AD-susceptibility, yielding new insights into potentially shared neurodegenerative process between MS and late onset AD.

  16. Covariance among multiple health risk behaviors in adolescents.

    Directory of Open Access Journals (Sweden)

    Kayla de la Haye

    Full Text Available PURPOSE: In a diverse group of early adolescents, this study explores the co-occurrence of a broad range of health risk behaviors: alcohol, cigarette, and marijuana use; physical inactivity; sedentary computing/gaming; and the consumption of low-nutrient energy-dense food. We tested differences in the associations of unhealthy behaviors over time, and by gender, race/ethnicity, and socioeconomic status. METHODS: Participants were 8360 students from 16 middle schools in California (50% female; 52% Hispanic, 17% Asian, 16% White, and 15% Black/multiethnic/other. Behaviors were measured with surveys in Spring 2010 and Spring 2011. Confirmatory factor analysis was used to assess if an underlying factor accounted for the covariance of multiple behaviors, and composite reliability methods were used to determine the degree to which behaviors were related. RESULTS: The measured behaviors were explained by two moderately correlated factors: a 'substance use risk factor' and an 'unhealthy eating and sedentary factor'. Physical inactivity did not reflect the latent factors as expected. There were few differences in the associations among these behaviors over time or by demographic characteristics. CONCLUSIONS: Two distinct, yet related groups of health compromising behaviors were identified that could be jointly targeted in multiple health behavior change interventions among early adolescents of diverse backgrounds.

  17. Melatonin Improves Outcomes of Heatstroke in Mice by Reducing Brain Inflammation and Oxidative Damage and Multiple Organ Dysfunction

    Directory of Open Access Journals (Sweden)

    Yu-Feng Tian

    2013-01-01

    Full Text Available We report here that when untreated mice underwent heat stress, they displayed thermoregulatory deficit (e.g., animals display hypothermia during room temperature exposure, brain (or hypothalamic inflammation, ischemia, oxidative damage, hypothalamic-pituitary-adrenal axis impairment (e.g., decreased plasma levels of both adrenocorticotrophic hormone and corticosterone during heat stress, multiple organ dysfunction or failure, and lethality. Melatonin therapy significantly reduced the thermoregulatory deficit, brain inflammation, ischemia, oxidative damage, hypothalamic-pituitary-adrenal axis impairment, multiple organ dysfunction, and lethality caused by heat stroke. Our data indicate that melatonin may improve outcomes of heat stroke by reducing brain inflammation, oxidative damage, and multiple organ dysfunction.

  18. Imaging neuroreceptors in the human brain in health and disease

    International Nuclear Information System (INIS)

    For nearly a century it has been known that chemical activity accompanies mental activity, but only recently has it been possible to begin to examine its exact nature. Positron-emitting radioactive tracers have made it possible to study the chemistry of the human brain in health and disease, using chiefly cyclotron-produced radionuclides, carbon-11, fluorine-18 and oxygen-15. It is now well established that measurable increases in regional cerebral blood flow, and glucose and oxygen metabolism accompany the mental functions of perception, cognition, emotion and motion. On 25 May 1983 the first imaging of a neuroreceptor in the human brain was accomplished with carbon-11 N-methyl spiperone, a ligand that binds preferentially to dopamine-2 receptors, 80% of which are located in the caudate nucleus and putamen. Quantitative imaging of serotonin-2, opiate, benzodiazapine and muscarinic cholinergic receptors has subsequently been accomplished. In studies of normal men and women, it has been found that dopamine and serotonin receptor activity decreases dramatically with age, such a decrease being more pronounced in men than in women and greater in the case of dopamine-2 receptors than in serotonin-2 receptors. Preliminary studies of patients with neuropsychiatric disorders suggest that dopamine-2 receptor activity is diminished in the caudate nucleus of patients with Huntington's disease. Positron tomography permits a quantitative assay of picomolar quantities of neuroreceptors within the living human brain. Studies of patients with Parkinson's disease, Alzheimer's disease, depression, anxiety, schizophrenia, acute and chronic pain states and drug addiction are now in progress. (author)

  19. Brain intra- and extracellular sodium concentration in multiple sclerosis: a 7 T MRI study.

    Science.gov (United States)

    Petracca, Maria; Vancea, Roxana O; Fleysher, Lazar; Jonkman, Laura E; Oesingmann, Niels; Inglese, Matilde

    2016-03-01

    Intra-axonal accumulation of sodium ions is one of the key mechanisms of delayed neuro-axonal degeneration that contributes to disability accrual in multiple sclerosis. In vivo sodium magnetic resonance imaging studies have demonstrated an increase of brain total sodium concentration in patients with multiple sclerosis, especially in patients with greater disability. However, total sodium concentration is a weighted average of intra- and extra-cellular sodium concentration whose changes reflect different tissue pathophysiological processes. The in vivo, non-invasive measurement of intracellular sodium concentration is quite challenging and the few applications in patients with neurological diseases are limited to case reports and qualitative assessments. In the present study we provide first evidence of the feasibility of triple quantum filtered (23)Na magnetic resonance imaging at 7 T, and provide in vivo quantification of global and regional brain intra- and extra-cellular sodium concentration in 19 relapsing-remitting multiple sclerosis patients and 17 heathy controls. Global grey matter and white matter total sodium concentration (respectively P brain regional level, clusters of increased total sodium concentration and intracellular sodium concentration and decreased intracellular sodium volume fraction were found in several cortical, subcortical and white matter regions when patients were compared with healthy controls (P < 0.05 family-wise error corrected for total sodium concentration, P < 0.05 uncorrected for multiple comparisons for intracellular sodium concentration and intracellular sodium volume fraction). Measures of total sodium concentration and intracellular sodium volume fraction, but not measures of intracellular sodium concentration were correlated with T2-weighted and T1-weighted lesion volumes (0.05 < P < 0.01) and with Expanded Disability Status Scale (P < 0.05). Thus, suggesting that while intracellular sodium volume fraction decrease could

  20. SU-E-T-568: Improving Normal Brain Sparing with Increasing Number of Arc Beams for Volume Modulated Arc Beam Radiosurgery of Multiple Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Hossain, S; Hildebrand, K; Ahmad, S [University of Oklahoma Health Science Center, Oklahoma City, OK (United States); Larson, D; Ma, L [University of California San Francisco, San Francisco, CA (United States); Sahgal, A [University of Toronto, Toronto, Ontario (Canada)

    2014-06-01

    Purpose: Intensity modulated arc beams have been newly reported for treating multiple brain metastases. The purpose of this study was to determine the variations in the normal brain doses with increasing number of arc beams for multiple brain metastases treatments via the TrueBeam Rapidarc system (Varian Oncology, Palo Alto, CA). Methods: A patient case with 12 metastatic brain lesions previously treated on the Leksell Gamma Knife Perfexion (GK) was used for the study. All lesions and organs at risk were contoured by a senior radiation oncologist and treatment plans for a subset of 3, 6, 9 and all 12 targets were developed for the TrueBeam Rapidarc system via 3 to 7 intensity modulated arc-beams with each target covered by at least 99% of the prescribed dose of 20 Gy. The peripheral normal brain isodose volumes as well as the total beam-on time were analyzed with increasing number of arc beams for these targets. Results: All intensisty modulated arc-beam plans produced efficient treatment delivery with the beam-on time averaging 0.6–1.5 min per lesion at an output of 1200 MU/min. With increasing number of arc beams, the peripheral normal brain isodose volumes such as the 12-Gy isodose line enclosed normal brain tissue volumes were on average decreased by 6%, 11%, 18%, and 28% for the 3-, 6-, 9-, 12-target treatment plans respectively. The lowest normal brain isodose volumes were consistently found for the 7-arc treatment plans for all the cases. Conclusion: With nearly identical beam-on times, the peripheral normal brain dose was notably decreased when the total number of intensity modulated arc beams was increased when treating multiple brain metastases. Dr Sahgal and Dr Ma are currently serving on the board of international society of stereotactic radiosurgery.

  1. Whole brain irradiation with hippocampal sparing and dose escalation on multiple brain metastases. Local tumour control and survival

    Energy Technology Data Exchange (ETDEWEB)

    Oehlke, Oliver; Wucherpfennig, David; Prokic, Vesna [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); Fels, Franziska [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); St. Josefs Hospital, Department of Radiation Oncology, Offenburg (Germany); Frings, Lars [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); University Hospital Freiburg, Department of Geriatrics and Gerontology, Freiburg (Germany); University Medical Center Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Egger, Karl [University Medical Center Freiburg, Department of Neuroradiology, Freiburg (Germany); Weyerbrock, Astrid [University Medical Center Freiburg, Department of Neurosurgery, Freiburg (Germany); Nieder, Carsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Grosu, Anca-Ligia [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); German Cancer Consortium (DKTK), Freiburg (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany)

    2015-01-16

    Hippocampal-avoidance whole brain radiotherapy (HA-WBRT) for multiple brain metastases may prevent treatment-related cognitive decline, compared to standard WBRT. Additionally, simultaneous integrated boost (SIB) on individual metastases may further improve the outcome. Here, we present initial data concerning local tumour control (LTC), intracranial progression-free survival (PFS), overall survival (OS), toxicity and safety for this new irradiation technique. Twenty patients, enrolled between 2011 and 2013, were treated with HA-WBRT (30 Gy in 12 fractions, D{sub 98} {sub %} to hippocampus ≤ 9 Gy) and a SIB (51 Gy) on multiple (2-13) metastases using a volumetric modulated arc therapy (VMAT) approach based on 2-4 arcs. Metastases were evaluated bidimensionally along the two largest diameters in contrast-enhanced three-dimensional T1-weighed MRI. Median follow-up was 40 weeks. The median time to progression of boosted metastases has not been reached yet, corresponding to a LTC rate of 73 %. Median intracranial PFS was 40 weeks, corresponding to a 1-year PFS of 45.3 %. Median OS was 71.5 weeks, corresponding to a 1-year OS of 60 %. No obvious acute or late toxicities grade > 2 (NCI CTCAE v4.03) were observed. D{sub mean} to the bilateral hippocampi was 6.585 Gy ± 0.847 (α/β = 2 Gy). Two patients developed a new metastasis in the area of hippocampal avoidance. HA-WBRT (simultaneous integrated protection, SIP) with SIB to metastases is a safe and tolerable regime that shows favorable LTC for patients with multiple brain metastases, while it has the potential to minimize the side-effect of cognitive deterioration. (orig.) [German] Die Hippocampus-schonende Ganzhirnbestrahlung (HS-GHB) kann im Vergleich zur Standard-GHB die Verschlechterung der neurokognitiven Funktion verhindern. Zusaetzlich vermag ein simultan integrierter Boost (SIB) auf die Metastasen die Prognose der betroffenen Patienten weiter zu verbessern. In dieser Studie praesentieren wir erste Ergebnisse

  2. Gut Microbiome and Infant Health: Brain-Gut-Microbiota Axis and Host Genetic Factors

    Science.gov (United States)

    Cong, Xiaomei; Xu, Wanli; Romisher, Rachael; Poveda, Samantha; Forte, Shaina; Starkweather, Angela; Henderson, Wendy A.

    2016-01-01

    The development of the neonatal gut microbiome is influenced by multiple factors, such as delivery mode, feeding, medication use, hospital environment, early life stress, and genetics. The dysbiosis of gut microbiota persists during infancy, especially in high-risk preterm infants who experience lengthy stays in the Neonatal intensive care unit (NICU). Infant microbiome evolutionary trajectory is essentially parallel with the host (infant) neurodevelopmental process and growth. The role of the gut microbiome, the brain-gut signaling system, and its interaction with the host genetics have been shown to be related to both short and long term infant health and bio-behavioral development. The investigation of potential dysbiosis patterns in early childhood is still lacking and few studies have addressed this host-microbiome co-developmental process. Further research spanning a variety of fields of study is needed to focus on the mechanisms of brain-gut-microbiota signaling system and the dynamic host-microbial interaction in the regulation of health, stress and development in human newborns.

  3. Walking speed and brain glucose uptake are uncoupled in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    John H. Kindred

    2015-02-01

    Full Text Available Motor impairments of the upper and lower extremities are common symptoms of multiple sclerosis (MS. While some peripheral effects like muscle weakness and loss of balance have been shown to influence these symptoms, central nervous system activity has not been fully elucidated. The purpose of this study was to determine if alterations in glucose uptake were associated with motor impairments in patients with multiple sclerosis. Eight patients with multiple sclerosis (4 men and 8 sex matched healthy controls performed 15 minutes of treadmill walking at a self-selected pace, during which ≈ 322 MBq of the positron emission tomography glucose analogue [18F]-Fluorodeoxyglucose was injected. Immediately after the cessation of walking, participants underwent positron emission tomography imaging. Patients with MS had lower FDG uptake in ≈ 40% of the brain compared to the healthy controls (pFWE-corr -0.75, P < 0.032. Within patients with MS only 3 of the 15 regions showed significant correlations: insula (r = -0.74, P = 0.036, hippocampus (r = -0.72, P = 0.045, and calcarine sulcus (r = -0.77, P = 0.026. This data suggests that walking impairments in patients with MS may be due to network wide alterations in glucose metabolism. Understanding how brain activity and metabolism are altered in patients with MS may allow for better measures of disability and disease status within this clinical population.

  4. The cost of health professionals' brain drain in Kenya

    Directory of Open Access Journals (Sweden)

    Gbary Akpa

    2006-07-01

    Full Text Available Abstract Background Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK and the United States of America (USA; (ii to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA; and (iii to describe other losses from brain drain. Methods The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years and the age of retirement (62 years in recipient countries. Results The total cost of educating a single medical doctor from primary school to university is US$ 65,997; and for every doctor who emigrates, a country loses about US$ 517,931 worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is US$ 43,180; and for every nurse that emigrates, a country loses about US$ 338,868 worth of returns from investment. Conclusion Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious

  5. The effect of inflammation and its reduction on brain plasticity in multiple sclerosis: MRI evidence

    Science.gov (United States)

    d'Ambrosio, Alessandro; Petsas, Nikolaos; Wise, Richard G.; Sbardella, Emilia; Allen, Marek; Tona, Francesca; Fanelli, Fulvia; Foster, Catherine; Carnì, Marco; Gallo, Antonio; Pantano, Patrizia; Pozzilli, Carlo

    2016-01-01

    Abstract Brain plasticity is the basis for systems‐level functional reorganization that promotes recovery in multiple sclerosis (MS). As inflammation interferes with plasticity, its pharmacological modulation may restore plasticity by promoting desired patterns of functional reorganization. Here, we tested the hypothesis that brain plasticity probed by a visuomotor adaptation task is impaired with MS inflammation and that pharmacological reduction of inflammation facilitates its restoration. MS patients were assessed twice before (sessions 1 and 2) and once after (session 3) the beginning of Interferon beta (IFN beta), using behavioural and structural MRI measures. During each session, 2 functional MRI runs of a visuomotor task, separated by 25‐minutes of task practice, were performed. Within‐session between‐run change in task‐related functional signal was our imaging marker of plasticity. During session 1, patients were compared with healthy controls. Comparison of patients' sessions 2 and 3 tested the effect of reduced inflammation on our imaging marker of plasticity. The proportion of patients with gadolinium‐enhancing lesions reduced significantly during IFN beta. In session 1, patients demonstrated a greater between‐run difference in functional MRI activity of secondary visual areas and cerebellum than controls. This abnormally large practice‐induced signal change in visual areas, and in functionally connected posterior parietal and motor cortices, was reduced in patients in session 3 compared with 2. Our results suggest that MS inflammation alters short‐term plasticity underlying motor practice. Reduction of inflammation with IFN beta is associated with a restoration of this plasticity, suggesting that modulation of inflammation may enhance recovery‐oriented strategies that rely on patients' brain plasticity. Hum Brain Mapp 37:2431–2445, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:26991559

  6. Multiple brain abscesses in neonate caused by Edwardsiella tarda: case report.

    Science.gov (United States)

    Takeuchi, Hayato; Fujita, Yuri; Ogawa, Hiroshi; Shiomi, Kozue; Toyokawa, Youichi; Yamamoto, Toru; Furukawa, Taizo; Ebisu, Toshihiko

    2009-02-01

    A neonate presented with multiple brain abscesses caused by very unusual infection with the Gram-negative bacterium, Edwardsiella tarda. Serial changes in magnetic resonance imaging findings including diffusion-weighted imaging demonstrated the development from the late cerebritis to late capsule stages. The patient was successfully treated by external drainage, and has since reached normal development milestones. Early diagnosis with computed tomography, magnetic resonance imaging, and ultrasound tomography, and prompt external drainage were essential to the good outcome of this case. PMID:19246871

  7. The dynamic human brain : Genetic aspects in schizophrenia and health

    NARCIS (Netherlands)

    Brans, R.G.H.

    2009-01-01

    The general aim of this thesis is to explore the possible mechanisms underlying the individual differences in brain structure and brain structure change in healthy adults and schizophrenia patients. For this purpose, Magnetic Resonance Imaging scans of the brain were acquired in schizophrenia patien

  8. Social Determinants, Race, and Brain Health Outcomes: Findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A

    2015-01-01

    The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging. PMID:26239039

  9. Associations between multiple health risk behaviors and mental health among Chinese college students.

    Science.gov (United States)

    Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

    2016-01-01

    Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety. PMID:26222809

  10. Associations between multiple health risk behaviors and mental health among Chinese college students.

    Science.gov (United States)

    Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

    2016-01-01

    Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

  11. A Phase I Study of Short-Course Accelerated Whole Brain Radiation Therapy for Multiple Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Caravatta, Luciana; Deodato, Francesco; Ferro, Marica [Department of Radiation Oncology, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Macchia, Gabriella, E-mail: gmacchia@rm.unicatt.it [Department of Radiation Oncology, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Massaccesi, Mariangela [Department of Radiation Oncology, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Cilla, Savino [Medical Physics Unit, Fondazione di Ricerca e Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Padula, Gilbert D.A. [Department of Radiation Oncology, The Lacks Cancer Center Saint Mary' s Health Care, Grand Rapids, Michigan (United States); Mignogna, Samantha; Tambaro, Rosa [Department of Palliative Therapies, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Carrozza, Francesco [Department of Oncology, A. Cardarelli Hospital, Campobasso (Italy); Flocco, Mariano [Madre Teresa di Calcutta Hospice, Larino (Italy); Cantore, Giampaolo [Department of Neurological Sciences, Istituto Neurologico Mediterraneo Neuromed, Istituto di Ricovero e Cura a Carattere Scientifico, Pozzilli (Italy); Scapati, Andrea [Department of Radiation Oncology, ' San Francesco' Hospital, Nuoro (Italy); Buwenge, Milly [Department of Radiotherapy, Mulago Hospital, Kampala (Uganda); and others

    2012-11-15

    Purpose: To define the maximum tolerated dose (MTD) of a SHort-course Accelerated whole brain RadiatiON therapy (SHARON) in the treatment of patients with multiple brain metastases. Methods and Materials: A phase 1 trial in 4 dose-escalation steps was designed: 12 Gy (3 Gy per fraction), 14 Gy (3.5 Gy per fraction), 16 Gy (4 Gy per fraction), and 18 Gy (4.5 Gy per fraction). Eligibility criteria included patients with unfavorable recursive partitioning analysis (RPA) class > or =2 with at least 3 brain metastases or metastatic disease in more than 3 organ systems, and Eastern Cooperative Oncology Group (ECOG) performance status {<=}3. Treatment was delivered in 2 days with twice-daily fractionation. Patients were treated in cohorts of 6-12 to define the MTD. The dose-limiting toxicity (DLT) was defined as any acute toxicity {>=}grade 3, according to the Radiation Therapy Oncology Group scale. Information on the status of the main neurologic symptoms and quality of life were recorded. Results: Characteristics of the 49 enrolled patients were as follows: male/female, 30/19; median age, 66 years (range, 23-83 years). ECOG performance status was <3 in 46 patients (94%). Fourteen patients (29%) were considered to be in recursive partitioning analysis (RPA) class 3. Grade 1-2 acute neurologic (26.4%) and skin (18.3%) toxicities were recorded. Only 1 patient experienced DLT (neurologic grade 3 acute toxicity). With a median follow-up time of 5 months (range, 1-23 months), no late toxicities have been observed. Three weeks after treatment, 16 of 21 symptomatic patients showed an improvement or resolution of presenting symptoms (overall symptom response rate, 76.2%; confidence interval 0.95: 60.3-95.9%). Conclusions: Short-course accelerated radiation therapy in twice-daily fractions for 2 consecutive days is tolerated up to a total dose of 18 Gy. A phase 2 study has been planned to evaluate the efficacy on overall survival, symptom control, and quality of life indices.

  12. Restructuring brain drain: strengthening governance and financing for health worker migration

    OpenAIRE

    Mackey, Tim K.; Liang, Bryan A.

    2013-01-01

    Background: Health worker migration from resource-poor countries to developed countries, also known as ‘‘brain drain’’, represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses.Methods: Using acceptable methods of policy analysis, we first assess c...

  13. Brain

    Science.gov (United States)

    ... will return after updating. Resources Archived Modules Updates Brain Cerebrum The cerebrum is the part of the ... the outside of the brain and spinal cord. Brain Stem The brain stem is the part of ...

  14. Brain tissue segmentation using q-entropy in multiple sclerosis magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Diniz, P.R.B.; Brum, D.G. [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Dept. de Neurociencias e Ciencias do Comportamento; Santos, A. C. [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Dept. de Clinica Medica; Murta-Junior, L.O.; Araujo, D.B. de, E-mail: murta@usp.b [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. Dept. de Fisica e Matematica

    2010-01-15

    The loss of brain volume has been used as a marker of tissue destruction and can be used as an index of the progression of neurodegenerative diseases, such as multiple sclerosis. In the present study, we tested a new method for tissue segmentation based on pixel intensity threshold using generalized Tsallis entropy to determine a statistical segmentation parameter for each single class of brain tissue. We compared the performance of this method using a range of different q parameters and found a different optimal q parameter for white matter, gray matter, and cerebrospinal fluid. Our results support the conclusion that the differences in structural correlations and scale invariant similarities present in each tissue class can be accessed by generalized Tsallis entropy, obtaining the intensity limits for these tissue class separations. In order to test this method, we used it for analysis of brain magnetic resonance images of 43 patients and 10 healthy controls matched for gender and age. The values found for the entropic q index were 0.2 for cerebrospinal fluid, 0.1 for white matter and 1.5 for gray matter. With this algorithm, we could detect an annual loss of 0.98% for the patients, in agreement with literature data. Thus, we can conclude that the entropy of Tsallis adds advantages to the process of automatic target segmentation of tissue classes, which had not been demonstrated previously. (author)

  15. Brain tissue segmentation using q-entropy in multiple sclerosis magnetic resonance images

    Directory of Open Access Journals (Sweden)

    P.R.B. Diniz

    2010-01-01

    Full Text Available The loss of brain volume has been used as a marker of tissue destruction and can be used as an index of the progression of neurodegenerative diseases, such as multiple sclerosis. In the present study, we tested a new method for tissue segmentation based on pixel intensity threshold using generalized Tsallis entropy to determine a statistical segmentation parameter for each single class of brain tissue. We compared the performance of this method using a range of different q parameters and found a different optimal q parameter for white matter, gray matter, and cerebrospinal fluid. Our results support the conclusion that the differences in structural correlations and scale invariant similarities present in each tissue class can be accessed by generalized Tsallis entropy, obtaining the intensity limits for these tissue class separations. In order to test this method, we used it for analysis of brain magnetic resonance images of 43 patients and 10 healthy controls matched for gender and age. The values found for the entropic q index were 0.2 for cerebrospinal fluid, 0.1 for white matter and 1.5 for gray matter. With this algorithm, we could detect an annual loss of 0.98% for the patients, in agreement with literature data. Thus, we can conclude that the entropy of Tsallis adds advantages to the process of automatic target segmentation of tissue classes, which had not been demonstrated previously.

  16. Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Luca Prosperini

    2015-01-01

    Full Text Available Rehabilitation is recognized to be important in ameliorating motor and cognitive functions, reducing disease burden, and improving quality of life in patients with multiple sclerosis (MS. In this systematic review, we summarize the existing evidences that motor and cognitive rehabilitation may enhance functional and structural brain plasticity in patients with MS, as assessed by means of the most advanced neuroimaging techniques, including diffusion tensor imaging and task-related and resting-state functional magnetic resonance imaging (MRI. In most cases, the rehabilitation program was based on computer-assisted/video game exercises performed in either an outpatient or home setting. Despite their heterogeneity, all the included studies describe changes in white matter microarchitecture, in task-related activation, and/or in functional connectivity following both task-oriented and selective training. When explored, relevant correlation between improved function and MRI-detected brain changes was often found, supporting the hypothesis that training-induced brain plasticity is specifically linked to the trained domain. Small sample sizes, lack of randomization and/or an active control group, as well as missed relationship between MRI-detected changes and clinical performance, are the major drawbacks of the selected studies. Knowledge gaps in this field of research are also discussed to provide a framework for future investigations.

  17. Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis

    Science.gov (United States)

    Prosperini, Luca; Piattella, Maria Cristina

    2015-01-01

    Rehabilitation is recognized to be important in ameliorating motor and cognitive functions, reducing disease burden, and improving quality of life in patients with multiple sclerosis (MS). In this systematic review, we summarize the existing evidences that motor and cognitive rehabilitation may enhance functional and structural brain plasticity in patients with MS, as assessed by means of the most advanced neuroimaging techniques, including diffusion tensor imaging and task-related and resting-state functional magnetic resonance imaging (MRI). In most cases, the rehabilitation program was based on computer-assisted/video game exercises performed in either an outpatient or home setting. Despite their heterogeneity, all the included studies describe changes in white matter microarchitecture, in task-related activation, and/or in functional connectivity following both task-oriented and selective training. When explored, relevant correlation between improved function and MRI-detected brain changes was often found, supporting the hypothesis that training-induced brain plasticity is specifically linked to the trained domain. Small sample sizes, lack of randomization and/or an active control group, as well as missed relationship between MRI-detected changes and clinical performance, are the major drawbacks of the selected studies. Knowledge gaps in this field of research are also discussed to provide a framework for future investigations. PMID:26064692

  18. Anisotropy mapping in rat brains using Intermolecular Multiple Quantum Coherence Effects

    CERN Document Server

    Han, Yi

    2014-01-01

    This document reports an unconventional and rapidly developing approach to magnetic resonance imaging (MRI) using intermolecular multiple-quantum coherences (iMQCs). Rat brain images are acquired using iMQCs. We detect iMQCs between spins that are 10 {\\mu}m to 500 {\\mu}m apart. The interaction between spins is dependent on different directions. We can choose the directions on physical Z, Y and X axis by choosing correlation gradients along those directions. As an important application, iMQCs can be used for anisotropy mapping. In the rat brains, we investigate tissue microstructure. We simulated images expected from rat brains without microstructure. We compare those with experimental results to prove that the dipolar field from the overall shape only has small contributions to the experimental iMQC signal. Because of the underlying low signal to noise ratio (SNR) in iMQCs, this anisotropy mapping method still has comparatively large potentials to grow. The ultimate goal of my project is to develop creative a...

  19. A fatal adverse effect of cefazolin administration: severe brain edema in a patient with multiple meningiomas

    Directory of Open Access Journals (Sweden)

    Tribuddharat S

    2016-02-01

    Full Text Available Sirirat Tribuddharat,1 Thepakorn Sathitkarnmanee,1 Amnat Kitkhuandee,2 Sunchai Theerapongpakdee,1 Kriangsak Ngamsaengsirisup,1 Sarinya Chanthawong,11Department of Anesthesiology, 2Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Abstract: Cefazolin is commonly administered before surgery as a prophylactic antibiotic. Hypersensitivity to cefazolin is not uncommon, and the symptoms mostly include urticaria, skin reaction, diarrhea, vomiting, and transient neutropenia, which are rarely life threatening. We present a rare case of fatal cefazolin hypersensitivity in a female who was diagnosed with multiple meningiomas and scheduled for craniotomy and tumor removal. Immediately after cefazolin IV administration, the patient developed acute hypertensive crisis, which resolved within 10 minutes after the treatment. This was followed by unexplained metabolic acidosis. The patient then developed severe brain edema 100 minutes later. The patient had facial edema when her face was exposed for the next 30 minutes. A computed tomography scan revealed global brain edema with herniation. She was admitted to the intensive care unit for symptomatic treatment and died 10 days after surgery from multiorgan failure. The serum IgE level was very high (734 IU/mL. Single-dose administration of cefazolin for surgical prophylaxis may lead to rare, fatal adverse reaction. The warning signs are sudden, unexplained metabolic acidosis, hypertensive crisis, tachycardia, and facial angioedema predominating with or without cutaneous symptoms like urticaria. Keywords: cefazolin, adverse effect, drug hypersensitivity, brain edema, hypertension

  20. Neurophysiological Evidence of Compensatory Brain Mechanisms in Early-Stage Multiple Sclerosis

    Science.gov (United States)

    López-Góngora, Mariana; Escartín, Antonio; Martínez-Horta, Saul; Fernández-Bobadilla, Ramón; Querol, Luis; Romero, Sergio; Mañanas, Miquel Àngel; Riba, Jordi

    2015-01-01

    Multiple sclerosis (MS) is a chronic central nervous system disorder characterized by white matter inflammation, demyelination and neurodegeneration. Although cognitive dysfunction is a common manifestation, it may go unnoticed in recently-diagnosed patients. Prior studies suggest MS patients develop compensatory mechanisms potentially involving enhanced performance monitoring. Here we assessed the performance monitoring system in early-stage MS patients using the error-related negativity (ERN), an event-related brain potential (ERP) observed following behavioral errors. Twenty-seven early-stage MS patients and 31 controls were neuropsychologically assessed. Electroencephalography recordings were obtained while participants performed: a) a stop task and b) an auditory oddball task. Behavior and ERP measures were assessed. No differences in performance were found between groups in most neuropsychological tests or in behavior or ERP components in the auditory oddball task. However, the amplitude of the ERN associated with stop errors in the stop task was significantly higher in patients. ERN amplitude correlated positively with scores on the Expanded Disability Status Scale and the Multiple Sclerosis Severity Score, and negatively with the time since last relapse. Patients showed higher neuronal recruitment in tasks involving performance monitoring. Results suggest the development of compensatory brain mechanisms in early-stage MS and reflect the sensitivity of the ERN to detect these changes. PMID:26322632

  1. Functional brain imaging of gastrointestinal sensation in health and disease

    Institute of Scientific and Technical Information of China (English)

    Lukas Van Oudenhove; Steven J Coen; Qasim Aziz

    2007-01-01

    It has since long been known, from everyday experience as well as from animal and human studies, that psychological processes-both affective and cognitiveexert an influence on gastrointestinal sensorimotor function. More specifically, a link between psychological factors and visceral hypersensitivity has been suggested,mainly based on research in functional gastrointestinal disorder patients. However, until recently, the exact nature of this putative relationship remained unclear,mainly due to a lack of non-invasive methods to study the (neurobiological) mechanisms underlying this relationship in non-sleeping humans. As functional brain imaging, introduced in visceral sensory neuroscience some 10 years ago, does provide a method for in vivo study of brain-gut interactions, insight into the neurobiological mechanisms underlying visceral sensation in general and the influence of psychological factors more particularly,has rapidly grown. In this article, an overview of brain imaging evidence on gastrointestinal sensation will be given, with special emphasis on the brain mechanisms underlying the interaction between affective & cognitive processes and visceral sensation. First, the reciprocal neural pathways between the brain and the gut (braingut axis) will be briefly outlined, including brain imaging evidence in healthy volunteers. Second, functional brain imaging studies assessing the influence of psychological factors on brain processing of visceral sensation in healthy humans will be discussed in more detail.Finally, brain imaging work investigating differences in brain responses to visceral distension between healthy volunteers and functional gastrointestinal disorder patients will be highlighted.

  2. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  3. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  4. Magnetic resonance imaging of multiple sclerosis brain lesions: A semeiologic study by multiple spin-echo sequences

    International Nuclear Information System (INIS)

    Nuclear magnetic resonance imaging (MRI) if the brain is now known as a very sensitive tool for clearly revealing lesions in white matter, and has thus become important in the study of multiple sclerosis (MS). Since 1981, others have shown the best of MRI: we can see 6 x more lesions than CT. MRI contrast bases mainly on the spatial heterogeneity of the relaxation time of different tissues. The sensitivity depends on the longer T1 and/or T2 of the pathological tissues compared to those of normal tissues. In our series, the authors use mainly T2 weighted MR images and they evaluate their interest for the diagnosis of MS. They study the frequency of the abnormalities and their semeiology in a small number of transversal sections imaged at the level of the lateral ventricles. The authors' aim is to describe the NMR-derived morphological signs of MS and to prospect its interest in the physiopathological studies of this disease

  5. Music mnemonics aid Verbal Memory and Induce Learning - Related Brain Plasticity in Multiple Sclerosis.

    Science.gov (United States)

    Thaut, Michael H; Peterson, David A; McIntosh, Gerald C; Hoemberg, Volker

    2014-01-01

    Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions. To further elucidate this question specifically for memory, we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis (MS) and if music-assisted learning will also influence short-term, system-level brain plasticity. We measured systems-level brain activity with oscillatory network synchronization during music-assisted learning. Specifically, we measured the spectral power of 128-channel electroencephalogram (EEG) in alpha and beta frequency bands in 54 patients with MS. The study sample was randomly divided into two groups, either hearing a spoken or a musical (sung) presentation of Rey's auditory verbal learning test. We defined the "learning-related synchronization" (LRS) as the percent change in EEG spectral power from the first time the word was presented to the average of the subsequent word encoding trials. LRS differed significantly between the music and the spoken conditions in low alpha and upper beta bands. Patients in the music condition showed overall better word memory and better word order memory and stronger bilateral frontal alpha LRS than patients in the spoken condition. The evidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization in prefrontal areas in MS patients during word learning. It is suggested that the temporal structure implicit in musical stimuli enhances "deep encoding" during verbal learning and sharpens the timing of neural dynamics in brain networks degraded by demyelination in MS. PMID:24982626

  6. The effect of inflammation and its reduction on brain plasticity in multiple sclerosis: MRI evidence.

    Science.gov (United States)

    Tomassini, Valentina; d'Ambrosio, Alessandro; Petsas, Nikolaos; Wise, Richard G; Sbardella, Emilia; Allen, Marek; Tona, Francesca; Fanelli, Fulvia; Foster, Catherine; Carnì, Marco; Gallo, Antonio; Pantano, Patrizia; Pozzilli, Carlo

    2016-07-01

    Brain plasticity is the basis for systems-level functional reorganization that promotes recovery in multiple sclerosis (MS). As inflammation interferes with plasticity, its pharmacological modulation may restore plasticity by promoting desired patterns of functional reorganization. Here, we tested the hypothesis that brain plasticity probed by a visuomotor adaptation task is impaired with MS inflammation and that pharmacological reduction of inflammation facilitates its restoration. MS patients were assessed twice before (sessions 1 and 2) and once after (session 3) the beginning of Interferon beta (IFN beta), using behavioural and structural MRI measures. During each session, 2 functional MRI runs of a visuomotor task, separated by 25-minutes of task practice, were performed. Within-session between-run change in task-related functional signal was our imaging marker of plasticity. During session 1, patients were compared with healthy controls. Comparison of patients' sessions 2 and 3 tested the effect of reduced inflammation on our imaging marker of plasticity. The proportion of patients with gadolinium-enhancing lesions reduced significantly during IFN beta. In session 1, patients demonstrated a greater between-run difference in functional MRI activity of secondary visual areas and cerebellum than controls. This abnormally large practice-induced signal change in visual areas, and in functionally connected posterior parietal and motor cortices, was reduced in patients in session 3 compared with 2. Our results suggest that MS inflammation alters short-term plasticity underlying motor practice. Reduction of inflammation with IFN beta is associated with a restoration of this plasticity, suggesting that modulation of inflammation may enhance recovery-oriented strategies that rely on patients' brain plasticity. Hum Brain Mapp 37:2431-2445, 2016. © 2016 Wiley Periodicals, Inc. PMID:26991559

  7. Music mnemonics aid Verbal Memory and Induce Learning – Related Brain Plasticity in Multiple Sclerosis

    Science.gov (United States)

    Thaut, Michael H.; Peterson, David A.; McIntosh, Gerald C.; Hoemberg, Volker

    2014-01-01

    Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions. To further elucidate this question specifically for memory, we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis (MS) and if music-assisted learning will also influence short-term, system-level brain plasticity. We measured systems-level brain activity with oscillatory network synchronization during music-assisted learning. Specifically, we measured the spectral power of 128-channel electroencephalogram (EEG) in alpha and beta frequency bands in 54 patients with MS. The study sample was randomly divided into two groups, either hearing a spoken or a musical (sung) presentation of Rey’s auditory verbal learning test. We defined the “learning-related synchronization” (LRS) as the percent change in EEG spectral power from the first time the word was presented to the average of the subsequent word encoding trials. LRS differed significantly between the music and the spoken conditions in low alpha and upper beta bands. Patients in the music condition showed overall better word memory and better word order memory and stronger bilateral frontal alpha LRS than patients in the spoken condition. The evidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization in prefrontal areas in MS patients during word learning. It is suggested that the temporal structure implicit in musical stimuli enhances “deep encoding” during verbal learning and sharpens the timing of neural dynamics in brain networks degraded by demyelination in MS. PMID:24982626

  8. The dynamic human brain : Genetic aspects in schizophrenia and health

    OpenAIRE

    Brans, R.G.H.

    2009-01-01

    The general aim of this thesis is to explore the possible mechanisms underlying the individual differences in brain structure and brain structure change in healthy adults and schizophrenia patients. For this purpose, Magnetic Resonance Imaging scans of the brain were acquired in schizophrenia patients, their relatives and healthy comparison subjects. Since all studies are conducted in relatives, we were able to disentangle genetic and environmental influences on the studied phenotypes. Taken ...

  9. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents : The TRAILS study

    NARCIS (Netherlands)

    de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

    2016-01-01

    BACKGROUND: Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PURPOSE: To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescent

  10. Brain MRI in patients with multiple sclerosis with oligoclonal cerebrospinal fluid bands

    Directory of Open Access Journals (Sweden)

    Mesaroš Šarlota

    2003-01-01

    Full Text Available Locally produced oligoclonal IgG bands (OCB are present in the cerebrospinal fluid (CSF of 95% patients with multiple sclerosis (MS[2,3]. The most sensitive method for the detection of OCB is isoelectric focusing (IEF [1]. Occasional patients with clinically definite MS lack evidence for intrathecal IgG synthesis [2,9]. This study was designed to compare brain magnetic resonance imagining (MRI findings between CSF OCB positive and negative MS patients. The study comprised 22 OB negative patients with clinically definite MS and 22 OCB positive controls matched for age, disease duration, activity and course of MS. In the both groups clinical assessment was performed by using Expanded Disability Status Scale (EDSS score. T2 weighted MRI of the brain was performed on a Siemens Magnetom (1.0 T. Lesions were countred and sized for 15 anatomically defined locations:7 periventricular (PV and 8 non-periventricular (NPV regions. An arbitrary scoring system weighted for lesions size was used to estimate total and regional lesions loads: a1 point was given for each lesion with a diameter 1-5 mm, b 2 points for one lesion with a diameter 6-10 mm, c 3 points for one over 10 mm, and confluent lesions scored one extra point [16]. Atrophy were scored as follows: 0-normal size, 1-mild atrophy, 2-moderate atrophy and 3-severe atrophy. Mean score of total brain MRI loads was lower in OCB negative than in OCB positive MS patients (44 vs. 50 but the difference was not statistically significant. Mean periventricular (32 vs. 23 non-periventricular (26 vs. 19 and infratentorial (11 vs. 9 scores were higher in OCB positive MS group in comparison with OCB negative patients but non-significant (figure 1. There was no correlation between EDSS score and total MRI lesions load in OCB negative MS patients, while in OCB positive group we detected significant correlation between EDSS score and total MRI lesions load (p=0.026 (figure 2. The results of this study demonstrate that

  11. Educational games for brain health: revealing their unexplored potential through a neurocognitive approach

    Directory of Open Access Journals (Sweden)

    Patrick eFissler

    2015-07-01

    Full Text Available Educational games link the motivational nature of games with learning of knowledge and skills. Here, we go beyond effects on these learning outcomes. We review two lines of evidence which indicate the currently unexplored potential of educational games to promote brain health: First, gaming with specific neurocognitive demands (e.g., executive control, and second, educational learning experiences (e.g., studying foreign languages improve brain health markers. These markers include cognitive ability, brain function, and brain structure. As educational games allow the combination of specific neurocognitive demands with educational learning experiences, they seem to be optimally suited for promoting brain health. We propose a neurocognitive approach to reveal this unexplored potential of educational games in future research.

  12. Educational games for brain health: revealing their unexplored potential through a neurocognitive approach.

    Science.gov (United States)

    Fissler, Patrick; Kolassa, Iris-Tatjana; Schrader, Claudia

    2015-01-01

    Educational games link the motivational nature of games with learning of knowledge and skills. Here, we go beyond effects on these learning outcomes. We review two lines of evidence which indicate the currently unexplored potential of educational games to promote brain health: First, gaming with specific neurocognitive demands (e.g., executive control), and second, educational learning experiences (e.g., studying foreign languages) improve brain health markers. These markers include cognitive ability, brain function, and brain structure. As educational games allow the combination of specific neurocognitive demands with educational learning experiences, they seem to be optimally suited for promoting brain health. We propose a neurocognitive approach to reveal this unexplored potential of educational games in future research. PMID:26257697

  13. Stemming the impact of health professional brain drain from Africa: a systemic review of policy options

    OpenAIRE

    Edward Zimbudzi

    2013-01-01

    Africa has been losing professionally trained health workers who are the core of the health system of this continent for many years. Faced with an increased burden of disease and coupled by a massive exodus of the health workforce, the health systems of many African nations are risking complete paralysis. Several studies have suggested policy options to reduce brain drain from Africa. The purpose of this paper is to review possible policies, which can stem the impact of health professional br...

  14. Childhood brain tumours : Health and function in adult survivors and parental fears

    OpenAIRE

    Anclair, Malin

    2009-01-01

    The general aim of the present research was to investigate health and functional ability of patients treated for childhood brain tumour and systematically examine parental fears after a child s brain tumour. The aims were realised through two part-studies. Childhood cancer once regarded as an acute fatal illness has become a life threatening disease. Previous studies of the long-term sequelae in survivors of children treated for a brain tumour reflect the fact that most ...

  15. Protect Your Brain (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-03-21

    At least three and a half million people in the U.S. sustained a traumatic brain injury (TBI), either with or without other injuries. This podcast discusses the importance of early diagnosis and treatment of brain injuries.  Created: 3/21/2013 by MMWR.   Date Released: 3/21/2013.

  16. The SAIL databank: linking multiple health and social care datasets

    Directory of Open Access Journals (Sweden)

    Ford David V

    2009-01-01

    Full Text Available Abstract Background Vast amounts of data are collected about patients and service users in the course of health and social care service delivery. Electronic data systems for patient records have the potential to revolutionise service delivery and research. But in order to achieve this, it is essential that the ability to link the data at the individual record level be retained whilst adhering to the principles of information governance. The SAIL (Secure Anonymised Information Linkage databank has been established using disparate datasets, and over 500 million records from multiple health and social care service providers have been loaded to date, with further growth in progress. Methods Having established the infrastructure of the databank, the aim of this work was to develop and implement an accurate matching process to enable the assignment of a unique Anonymous Linking Field (ALF to person-based records to make the databank ready for record-linkage research studies. An SQL-based matching algorithm (MACRAL, Matching Algorithm for Consistent Results in Anonymised Linkage was developed for this purpose. Firstly the suitability of using a valid NHS number as the basis of a unique identifier was assessed using MACRAL. Secondly, MACRAL was applied in turn to match primary care, secondary care and social services datasets to the NHS Administrative Register (NHSAR, to assess the efficacy of this process, and the optimum matching technique. Results The validation of using the NHS number yielded specificity values > 99.8% and sensitivity values > 94.6% using probabilistic record linkage (PRL at the 50% threshold, and error rates were Conclusion With the infrastructure that has been put in place, the reliable matching process that has been developed enables an ALF to be consistently allocated to records in the databank. The SAIL databank represents a research-ready platform for record-linkage studies.

  17. Do multiple micronutrient interventions improve child health, growth, and development?

    Science.gov (United States)

    Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H

    2011-11-01

    Micronutrient deficiencies are common and often co-occur in many developing countries. Several studies have examined the benefits of providing multiple micronutrient (MMN) interventions during pregnancy and childhood, but the implications for programs remain unclear. The key objective of this review is to summarize what is known about the efficacy of MMN interventions during early childhood on functional outcomes, namely, child health, survival, growth, and development, to guide policy and identify gaps for future research. We identified review articles including meta-analyses and intervention studies that evaluated the benefits of MMN interventions (3 or more micronutrients) in children (child morbidity, anemia, and growth. Two studies found no effects on child mortality. The findings for respiratory illness and diarrhea are mixed, although suggestive of benefit when provided as fortified foods. There is evidence from several controlled trials (>25) and 2 meta-analyses that MMN interventions improve hemoglobin concentrations and reduce anemia, but the effects were small compared to providing only iron or iron with folic acid. Two recent meta-analyses and several intervention trials also indicated that MMN interventions improve linear growth compared to providing a placebo or single nutrients. Much less is known about the effects on MMN interventions during early childhood on motor and mental development. In summary, MMN interventions may result in improved outcomes for children in settings where micronutrient deficiencies are widespread.

  18. Brain arteriovenous malformation multiplicity predicts diagnosis of Hereditary Hemorrhagic Telangiectasia: Quantitative assessment

    Science.gov (United States)

    Bharatha, Aditya; Faughnan, Marie E.; Kim, Helen; Pourmohamad, Tony; Krings, Timo; Bayrak-Toydemir, Pinar; Pawlikowska, Ludmila; McCulloch, Charles E.; Lawton, Michael T.; Dowd, Christopher F.; Young, William L.; Terbrugge, Karel G.

    2013-01-01

    Purpose To quantitatively estimate the relationship between multiplicity of brain arteriovenous malformations (bAVMs) and the diagnosis of hereditary hemorrhagic telangiectasia (HHT). Methods We combined databases from two large North American bAVM referral centers, including demographics, clinical presentation and angiographic characteristics, and compared HHT patients with non-HHT patients. Logistic regression analysis was performed to quantify the association between bAVM multiplicity and odds of HHT diagnosis. Sensitivity, specificity, positive and negative predictive value (PPV, NPV), and positive and negative likelihood ratios (LR) were calculated to determine accuracy of bAVM multiplicity for screening HHT. Results Prevalence of HHT was 2.8% in the combined group. bAVM multiplicity was present in 39% of HHT patients and was highly associated with diagnosis of HHT in univariate (OR=83, 95% CI:40–173, P<0.0001) and multivariable (OR=87, 95% CI: 38–195, P<0.001) models, adjusting for age at presentation (P=0.013), non-symptomatic presentation (P=0.029) and cohort site (P=0.021). bAVM multiplicity alone was associated with high specificity (99.2%, 95%CI: 98.7–99.6%) and NPV (98.3%, 95% CI: 97.6–98.8%), and low sensitivity (39.3%, 95% CI: 26.5–53.2%) and PPV (59.5%, 95% CI: 42.1–75.2%). Positive and negative LR was 51 and 0.61, respectively, for diagnosis of HHT. HHT bAVMs were also more often smaller in size (<3 cm), non-eloquent in location and associated with superficial venous drainage, compared to non-HHT bAVMs. Conclusion Multiplicity of bAVMs is highly predictive of the diagnosis of HHT. The presence of multiple bAVMs should alert the clinician to the high probability of HHT and lead to comprehensive investigation for this diagnosis. PMID:22034007

  19. Maintaining Brain Health by Monitoring Inflammatory Processes: a Mechanism to Promote Successful Aging

    OpenAIRE

    Rosano, Caterina; Marsland, Anna L.; Gianaros, Peter J.

    2011-01-01

    Maintaining brain health promotes successful aging. The main determinants of brain health are the preservation of cognitive function and remaining free from structural and metabolic abnormalities, including loss of neuronal synapses, atrophy, small vessel disease and focal amyloid deposits visible by neuroimaging. Promising studies indicate that these determinants are to some extent modifiable, even among adults seventy years and older. Converging animal and human evidence further suggests th...

  20. Educational games for brain health: revealing their unexplored potential through a neurocognitive approach

    OpenAIRE

    Patrick eFissler; Iris-Tatjana eKolassa; Claudia eSchrader

    2015-01-01

    Educational games link the motivational nature of games with learning of knowledge and skills. Here, we go beyond effects on these learning outcomes. We review two lines of evidence which indicate the currently unexplored potential of educational games to promote brain health: First, gaming with specific neurocognitive demands (e.g., executive control), and second, educational learning experiences (e.g., studying foreign languages) improve brain health markers. These markers include cognitive...

  1. A New Method for Segmentation of Multiple Sclerosis (MS Lesions on Brain MR Images

    Directory of Open Access Journals (Sweden)

    Simin Jafari

    2015-07-01

    Full Text Available Automatic segmentation of multiple sclerosis (MS lesions in brain MRI has been widely investigated in recent years with the goal of helping MS diagnosis and patient follow-up. In this study we applied gaussian mixture model (GMM to segment MS lesions in MR images. Usually, GMM is optimized using expectation-maximization (EM algorithm. One of the drawbacks of this optimization method is that, it does not convergence to optimal maximum or minimum. Starting from different initial points and saving best result, is a strategy which is used to reach the near optimal. This approach is time consuming and we used another way to initiate the EM algorithm. Also, FAST- Trimmed Likelihood Estimator (FAST-TLE algorithm was applied to determine which voxels should be rejected. The automatically segmentation outputs were scored by two specialists and the results show that our method has capability to segment the MS lesions with Dice similarity coefficient (DSC score of 0.82.

  2. Blood-Brain Barrier Permeability of Normal Appearing White Matter in Relapsing-Remitting Multiple Sclerosis

    DEFF Research Database (Denmark)

    Lund, Henrik; Krakauer, Martin; Skimminge, Arnold;

    2013-01-01

    Background: Multiple sclerosis (MS) affects the integrity of the blood-brain barrier (BBB). Contrast-enhanced T1 weighted magnetic resonance imaging (MRI) is widely used to characterize location and extent of BBB disruptions in focal MS lesions. We employed quantitative T1 measurements before...... and after the intravenous injection of a paramagnetic contrast agent to assess BBB permeability in the normal appearing white matter (NAWM) in patients with relapsing-remitting MS (RR-MS). Methodology/Principal Findings: Fifty-nine patients (38 females) with RR-MS undergoing immunomodulatory treatment...... and nine healthy controls (4 females) underwent quantitative T1 measurements at 3 tesla before and after injection of a paramagnetic contrast agent (0.2 mmol/kg Gd-DTPA). Mean T1 values were calculated for NAWM in patients and total cerebral white matter in healthy subjects for the T1 measurements before...

  3. a Computational Model for Lesion Dynamics in Multiple Sclerosis of the Brain

    Science.gov (United States)

    Mohan, T. R. Krishna; Sen, Surajit; Ramanathan, Murali

    Multiple sclerosis (MS) is a chronic disabling disease of the central nervous system (CNS) that is characterized by lesions with inflammatory cells, axons with the insulating myelin sheath damaged, and axonal loss. The causes of MS are not known and there is as yet no cure. The purpose of this research was to evaluate a physically motivated network model for lesion formation in the brain. The parsimonious network model contained two elements: (i) a spatially spreading pathological process causing cell damage and death leading to neuro-degeneration and, (ii) generation of alarm signals by the damaged cells that lead to activation of programmed death of cells surrounding the lesions in an attempt to contain the spatial spread of the pathologic process. Simulation results with a range of network geometries indicated that the model was capable of describing lesion progression and arrest. The modeling results also demonstrated dynamical complexity with sensitivity to initial conditions.

  4. Application of nanomedicine for crossing the blood-brain barrier: Theranostic opportunities in multiple sclerosis.

    Science.gov (United States)

    Ghalamfarsa, Ghasem; Hojjat-Farsangi, Mohammad; Mohammadnia-Afrouzi, Mousa; Anvari, Enayat; Farhadi, Shohreh; Yousefi, Mehdi; Jadidi-Niaragh, Farhad

    2016-09-01

    Multiple sclerosis (MS) is an autoimmune neurodegenerative disease characterized with immunopathobiological events, including lymphocytic infiltration into the central nervous system (CNS), microglia activation, demyelination and axonal degeneration. Although several neuroprotective drugs have been designed for the treatment of MS, complete remission is yet matter of debate. Therefore, development of novel therapeutic approaches for MS is of a high priority in immunological research. Nanomedicine is a recently developed novel medical field, which is applicable in both diagnosis and treatment of several cancers and autoimmune diseases. Although there is a marked progress in neuroimaging through using nanoparticles, little is known regarding the therapeutic potential of nanomedicine in neurological disorders, particularly MS. Moreover, the majority of data is limited to the MS related animal models. In this review, we will discuss about the brain targeting potential of different nanoparticles as well as the role of nanomedicine in the diagnosis and treatment of MS and its animal model, experimental autoimmune encephalomyelitis. PMID:27416019

  5. Altered Alpha-Synuclein, Parkin, and Synphilin Isoform Levels in Multiple System Atrophy Brains

    DEFF Research Database (Denmark)

    Brudek, Tomasz; Winge, Kristian; Bredo Rasmussen, Nadja;

    2016-01-01

    Together with Parkinson's disease (PD) and dementia with Lewy bodies (DLB), Multiple System Atrophy (MSA) is a member of a diverse group of neurodegenerative disorders termed α-synucleinopathies. Previously, it has been shown that alpha-synuclein, parkin and synphilin-1 display disease specific...... controls using isoform-specific primers and exon specific antibodies in substantia nigra, striatum, cerebellar cortex, and nucleus dentatus. These regions are severely affected by alpha-synuclein pathology and neurodegeneration. Further, we have also investigated transcript levels for parkin and synphilin...... increased levels of parkin isoforms lacking the N-terminal ubiquitin-like domain and an aggregation-prone synphiln-1A isoform that causes neuronal toxicity in MSA. In PD brains, Parkin transcript variant 3, 7 and 11 were significantly and specifically overexpressed in the striatum and cerebellar cortex...

  6. Fatigue in multiple sclerosis: neural correlates and the role of non-invasive brain stimulation

    Directory of Open Access Journals (Sweden)

    Moussa A. Chalah

    2015-11-01

    Full Text Available Multiple sclerosis (MS is a chronic progressive inflammatory disease of the central nervous system and the major cause of non-traumatic disability in young adults. Fatigue is a frequent symptom reported by the majority of MS patients during their disease course and drastically af-fects their quality of life. Despite its significant prevalence and impact, the underlying patho-physiological mechanisms are not well elucidated. MS fatigue is still considered the result of multifactorial and complex constellations, and is commonly classified into primary fatigue related to the pathological changes of the disease itself, and secondary fatigue attributed to mimicking symptoms, comorbid sleep and mood disorders, and medications side effects. Data from neuroimaging, neurophysiology, neuroendocrine and neuroimmune studies have raised hypotheses regarding the origin of this symptom, some of which have succeeded in identifying an association between MS fatigue and structural or functional abnormalities within various brain networks. Hence, the aim of this work is to reappraise the neural correlates of MS fatigue and to discuss the rationale for the emergent use of noninvasive brain stimulation (NIBS techniques as potential treatments. This will include a presentation of the various NIBS modalities and a proposition of their potential mechanisms of action in this context. Specific issues related to the value of transcranial direct current stimulation will be addressed.

  7. Cerebrospinal fluid B cells correlate with early brain inflammation in multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Bettina Kuenz

    Full Text Available BACKGROUND: There is accumulating evidence from immunological, pathological and therapeutic studies that B cells are key components in the pathophysiology of multiple sclerosis (MS. METHODOLOGY/PRINCIPAL FINDINGS: In this prospective study we have for the first time investigated the differences in the inflammatory response between relapsing and progressive MS by comparing cerebrospinal fluid (CSF cell profiles from patients at the onset of the disease (clinically isolated syndrome, CIS, relapsing-remitting (RR and chronic progressive (CP MS by flow cytometry. As controls we have used patients with other neurological diseases. We have found a statistically significant accumulation of CSF mature B cells (CD19+CD138- and plasma blasts (CD19+CD138+ in CIS and RRMS. Both B cell populations were, however, not significantly increased in CPMS. Further, this accumulation of B cells correlated with acute brain inflammation measured by magnetic resonance imaging and with inflammatory CSF parameters such as the number of CSF leukocytes, intrathecal immunoglobulin M and G synthesis and intrathecal production of matrix metalloproteinase (MMP-9 and the B cell chemokine CxCL-13. CONCLUSIONS: Our data support an important role of CSF B cells in acute brain inflammation in CIS and RRMS.

  8. Multiple opioid receptor binding in dissociated intact guinea pig brain cells

    International Nuclear Information System (INIS)

    Dissociated intact guinea pig brain cells were prepared by the method of Rogers and El-Fakahany. Over 95% of these cells are viable as demonstrated by their exclusion of the dye trypan blue. Opioid receptor binding assays were performed in a modified Kreb-Ringers physiological buffer. The following radiolabeled ligands and conditions were used to selectively labeled multiple opioid receptors: mu binding, 1 nM [3H]naloxone + 20 nM DADLE + 300 nM U50,488H; kappa binding, 4 nM (-)-[3H]-EKC + 100 nM DAGO + 500 nM DADLE; delta binding, 2 nM [3H]-DADLE + 100 nM DAGO + 300 nM U50,488H; sigma binding, 4 nM (+)-[3H]SKF 10,047. The intact brain cells in physiological buffer demonstrated specific binding for mu, kappa, delta, and sigma receptors. The relative binding potency of naloxone for each of the receptor types is arbitrarily set at 1

  9. Fatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation.

    Science.gov (United States)

    Chalah, Moussa A; Riachi, Naji; Ahdab, Rechdi; Créange, Alain; Lefaucheur, Jean-Pascal; Ayache, Samar S

    2015-01-01

    Multiple sclerosis (MS) is a chronic progressive inflammatory disease of the central nervous system (CNS) and the major cause of non-traumatic disability in young adults. Fatigue is a frequent symptom reported by the majority of MS patients during their disease course and drastically affects their quality of life. Despite its significant prevalence and impact, the underlying pathophysiological mechanisms are not well elucidated. MS fatigue is still considered the result of multifactorial and complex constellations, and is commonly classified into "primary" fatigue related to the pathological changes of the disease itself, and "secondary" fatigue attributed to mimicking symptoms, comorbid sleep and mood disorders, and medications side effects. Radiological, physiological, and endocrine data have raised hypotheses regarding the origin of this symptom, some of which have succeeded in identifying an association between MS fatigue and structural or functional abnormalities within various brain networks. Hence, the aim of this work is to reappraise the neural correlates of MS fatigue and to discuss the rationale for the emergent use of noninvasive brain stimulation (NIBS) techniques as potential treatments. This will include a presentation of the various NIBS modalities and a suggestion of their potential mechanisms of action in this context. Specific issues related to the value of transcranial direct current stimulation (tDCS) will be addressed. PMID:26648845

  10. Brain-Gut-Microbe Communication in Health and Disease

    OpenAIRE

    Sue eGrenham; Gerard eClarke; Cryan, John F.; Dinan, Timothy G.

    2011-01-01

    Bidirectional signalling between the gastrointestinal tract and the brain is regulated at neural, hormonal and immunological levels. This construct is known as the brain-gut axis and is vital for maintaining homeostasis. Bacterial colonisation of the intestine plays a major role in the post-natal development and maturation of the immune and endocrine systems. These processes are key factors underpinning central nervous system (CNS) signalling. Recent research advances have seen a tremendous i...

  11. Treatment outcomes in patients with multiple brain metastases: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Animesh Saha

    2014-01-01

    Full Text Available Context: There is controversy regarding the radiotherapeutic dose fractionation in brain metastases (bm. Aims: The aim of this study is to analyze the treatment outcomes in patients with multiple bm. Settings and Design: Prospective, randomized study. Subjects and Methods: Patients with multiple bm with Eastern Cooperative Oncology Group performance status ≤2 were included. In arm-A patient received whole brain radiotherapy (WBRT 30 GY in 10# over 2 weeks and in arm-B patients received 20 GY in 5# over 1 week. Assessment of improvement in clinical symptoms was done using Barthel′s adjusted daily live (ADL score. Assessment of radiological response was done using magnetic resonance imaging scan of brain after 3 months of completion of external beam radiation therapy. Acute radiation toxicity was assessed using Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer acute radiation morbidity scoring. Statistical Analysis Used: Chi-square test was used to compare categorical variables between groups. Overall survival was computed by Kaplan-Meier survival analysis and Log-Rank test used for comparison of survival plots. For change in quality-of-life during treatment and follow-up, repeated measures ANOVA were used. Results: In both arms, there was a significant improvement in ADL score after treatment, but when two arms were compared, no significant difference was found between the two treatment arms. There was no statistically significant difference in response or morbidity between the two treatment arms. Median survival was 29 weeks in arm-A compared to 25.86 weeks in patients arm-B. Kaplan-Meier Survival curve analysis shows no significant difference in survival between the two arms. Conclusions: 20 GY in 5 fractions is equally effective with that of the 30 GY in 10 fractions for WBRT in bm. In the palliative setting short duration of treatment with minimum discomfort to the patient is desirable. Hence, we

  12. Self-reported health promotion and disability progression in multiple sclerosis

    NARCIS (Netherlands)

    D'hooghe, Marie Beatrice; Nagels, Guy; De Keyser, Jacques; Haentjens, Patrick

    2013-01-01

    Background: Health behavior may be associated with disability progression in multiple sclerosis (MS). Objectives: To investigate health-promoting behavior as measured by the Health-Promoting Lifestyle Profile II, which includes the subscales of health responsibility, physical activity, nutrition, sp

  13. Clinical application of RapidArc volumetric modulated arc therapy as a component in whole brain radiation therapy for poor prognostic, four or more multiple brain metastases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Heon; Lee, Kyu Chan; Choi, Jin Ho; Kim, Hye Young; Lee, Seok Ho; Sung, Ki Hoon; Kim, Yun Mi [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2012-06-15

    To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. Nine patients with multiple ({>=}4) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10- 12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. The median biologically effective dose to metastatic tumors was 68.1 Gy10 and 67.2 Gy10 and the median brain volume irradiated more than 100 Gy3 were 1.9% (24 cm3) and 0.8% (13 cm3) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.

  14. An exercise-based randomized controlled trial on brain, cognition, physical health and mental health in overweight/obese children (ActiveBrains project): Rationale, design and methods.

    Science.gov (United States)

    Cadenas-Sánchez, Cristina; Mora-González, José; Migueles, Jairo H; Martín-Matillas, Miguel; Gómez-Vida, José; Escolano-Margarit, María Victoria; Maldonado, José; Enriquez, Gala María; Pastor-Villaescusa, Belén; de Teresa, Carlos; Navarrete, Socorro; Lozano, Rosa María; de Dios Beas-Jiménez, Juan; Estévez-López, Fernando; Mena-Molina, Alejandra; Heras, María José; Chillón, Palma; Campoy, Cristina; Muñoz-Hernández, Victoria; Martínez-Ávila, Wendy Daniela; Merchan, María Elisa; Perales, José C; Gil, Ángel; Verdejo-García, Antonio; Aguilera, Concepción M; Ruiz, Jonatan R; Labayen, Idoia; Catena, Andrés; Ortega, Francisco B

    2016-03-01

    The new and recent advances in neuroelectric and neuroimaging technologies provide a new era for further exploring and understanding how brain and cognition function can be stimulated by environmental factors, such as exercise, and particularly to study whether physical exercise influences brain development in early ages. The present study, namely the ActiveBrains project, aims to examine the effects of a physical exercise programme on brain and cognition, as well as on selected physical and mental health outcomes in overweight/obese children. A total of 100 participants aged 8 to 11 years are randomized into an exercise group (N=50) or a control group (N=50). The intervention lasts 20-weeks, with 3-5 sessions per week of 90 min each, and is mainly focused on high-intensity aerobic exercise yet also includes muscle-strengthening exercises. The extent to what the intervention effect remains 8-months after the exercise programme finishes is also studied in a subsample. Brain structure and function and cognitive performance are assessed using structural and functional magnetic resonance imaging and electroencephalographic recordings. Secondary outcomes include physical health outcomes (e.g. physical fitness, body fatness, bone mass and lipid-metabolic factors) and mental health outcomes (e.g. chronic stress indicators and overall behavioural and personality measurements such as anxiety or depression). This project will substantially contribute to the existing knowledge and will have an impact on societies, since early stimulation of brain development might have long lasting consequences on cognitive performance, academic achievement and in the prevention of behavioural problems and the promotion of psychological adjustment and mental health. Clinical trials. Gov identifier: NCT02295072. PMID:26924671

  15. Association of retinal and macular damage with brain atrophy in multiple sclerosis.

    Science.gov (United States)

    Dörr, Jan; Wernecke, Klaus D; Bock, Markus; Gaede, Gunnar; Wuerfel, Jens T; Pfueller, Caspar F; Bellmann-Strobl, Judith; Freing, Alina; Brandt, Alexander U; Friedemann, Paul

    2011-01-01

    Neuroaxonal degeneration in the central nervous system contributes substantially to the long term disability in multiple sclerosis (MS) patients. However, in vivo determination and monitoring of neurodegeneration remain difficult. As the widely used MRI-based approaches, including the brain parenchymal fraction (BPF) have some limitations, complementary in vivo measures for neurodegeneration are necessary. Optical coherence tomography (OCT) is a potent tool for the detection of MS-related retinal neurodegeneration. However, crucial aspects including the association between OCT- and MRI-based atrophy measures or the impact of MS-related parameters on OCT parameters are still unclear. In this large prospective cross-sectional study on 104 relapsing remitting multiple sclerosis (RRMS) patients we evaluated the associations of retinal nerve fiber layer thickness (RNFLT) and total macular volume (TMV) with BPF and addressed the impact of disease-determining parameters on RNFLT, TMV or BPF. BPF, normalized for subject head size, was estimated with SIENAX. Relations were analyzed primarily by Generalized Estimating Equation (GEE) models considering within-patient inter-eye relations. We found that both RNFLT (p = 0.019, GEE) and TMV (p = 0.004, GEE) associate with BPF. RNFLT was furthermore linked to the disease duration (pdamage longitudinally. Longitudinal studies are necessary for validation of data and to further clarify the relevance of TMV. PMID:21494659

  16. The brain as a complex system: plasticity at multiple scales and criticality

    Science.gov (United States)

    Ng, Tony; Miller, Paul

    2015-03-01

    As a complex system, a successful organism is one that can react effectively to environmental fluctuations. Not only should its response repertoire be commensurate with the number of independent conditions that it encounters, behavioral and environmental variations need to be matched at the appropriate scales. In the cortex, neuronal clusters, not individual cells, operate at the proper scale that is necessary to generate appropriate responses to external states of the world. Single neurons, however, serve on a finer scale to mediate interactions between neuronal assemblies. The distinction of scales is significant, as plasticity mechanisms can operate on various spatial and temporal scales. The brain has apparently evolved complex-system strategies to calibrate its own dynamics at multiple scales. This makes the joint study of local balance and global homeostasis fundamentally important, where criticality emerges as a signature of a computationally powerful system. We show via simulations how plasticity mechanisms at multiple scales are inextricably tied to spike-based neuronal avalanches, which are microscopic in origin and poorly predictive of animal behavior, and cluster-based avalanches, which are manifest macroscopically and are relevant to cognition and behavior.

  17. Stemming the impact of health professional brain drain from Africa: a systemic review of policy options

    Directory of Open Access Journals (Sweden)

    Edward Zimbudzi

    2013-06-01

    Full Text Available Africa has been losing professionally trained health workers who are the core of the health system of this continent for many years. Faced with an increased burden of disease and coupled by a massive exodus of the health workforce, the health systems of many African nations are risking complete paralysis. Several studies have suggested policy options to reduce brain drain from Africa. The purpose of this paper is to review possible policies, which can stem the impact of health professional brain drain from Africa. A systemic literature review was conducted. Cinahl, Science Direct and PubMed databases were searched with the following terms: health professional brain drain from Africa and policies for reducing impact of brain drain from Africa. References were also browsed for relevant articles. A total of 425 articles were available for the study but only 23 articles met the inclusion criteria. The review identified nine policy options, which were being implemented in Africa, but the most common was task shifting which had success in several African countries. This review has demonstrated that there is considerable consensus on task shifting as the most appropriate and sustainable policy option for reducing the impact of health professional brain drain from Africa.

  18. Measuring socioeconomic health inequalities in presence of multiple categorical information.

    Science.gov (United States)

    Makdissi, Paul; Yazbeck, Myra

    2014-03-01

    While many of the measurement approaches in health inequality measurement assume the existence of a ratio-scale variable, most of the health information available in population surveys is given in the form of categorical variables. Therefore, the well-known inequality indices may not always be readily applicable to measure health inequality as it may result in the arbitrariness of the health concentration index's value. In this paper, we address this problem by changing the dimension in which the categorical information is used. We therefore exploit the multi-dimensionality of this information, define a new ratio-scale health status variable and develop positional stochastic dominance conditions that can be implemented in a context of categorical variables. We also propose a parametric class of population health and socioeconomic health inequality indices. Finally we provide a twofold empirical illustration using the Joint Canada/United States Surveys of Health 2004 and the National Health Interview Survey 2010.

  19. The Sun Health Research Institute Brain Donation Program: Description and Eexperience, 1987–2007

    Science.gov (United States)

    Sue, Lucia I.; Walker, Douglas G.; Roher, Alex E.; Lue, LihFen; Vedders, Linda; Connor, Donald J.; Sabbagh, Marwan N.; Rogers, Joseph

    2008-01-01

    The Brain Donation Program at Sun Health Research Institute has been in continual operation since 1987, with over 1000 brains banked. The population studied primarily resides in the retirement communities of northwest metropolitan Phoenix, Arizona. The Institute is affiliated with Sun Health, a nonprofit community-owned and operated health care provider. Subjects are enrolled prospectively to allow standardized clinical assessments during life. Funding comes primarily from competitive grants. The Program has made short postmortem brain retrieval a priority, with a 2.75-h median postmortem interval for the entire collection. This maximizes the utility of the resource for molecular studies; frozen tissue from approximately 82% of all cases is suitable for RNA studies. Studies performed in-house have shown that, even with very short postmortem intervals, increasing delays in brain retrieval adversely affect RNA integrity and that cerebrospinal fluid pH increases with postmortem interval but does not predict tissue viability. PMID:18347928

  20. The Sun Health Research Institute Brain Donation Program: description and experience, 1987-2007.

    Science.gov (United States)

    Beach, Thomas G; Sue, Lucia I; Walker, Douglas G; Roher, Alex E; Lue, LihFen; Vedders, Linda; Connor, Donald J; Sabbagh, Marwan N; Rogers, Joseph

    2008-09-01

    The Brain Donation Program at Sun Health Research Institute has been in continual operation since 1987, with over 1000 brains banked. The population studied primarily resides in the retirement communities of northwest metropolitan Phoenix, Arizona. The Institute is affiliated with Sun Health, a nonprofit community-owned and operated health care provider. Subjects are enrolled prospectively to allow standardized clinical assessments during life. Funding comes primarily from competitive grants. The Program has made short postmortem brain retrieval a priority, with a 2.75-h median postmortem interval for the entire collection. This maximizes the utility of the resource for molecular studies; frozen tissue from approximately 82% of all cases is suitable for RNA studies. Studies performed in-house have shown that, even with very short postmortem intervals, increasing delays in brain retrieval adversely affect RNA integrity and that cerebrospinal fluid pH increases with postmortem interval but does not predict tissue viability.

  1. Multiple frequencies sequential coding for SSVEP-based brain-computer interface.

    Directory of Open Access Journals (Sweden)

    Yangsong Zhang

    Full Text Available BACKGROUND: Steady-state visual evoked potential (SSVEP-based brain-computer interface (BCI has become one of the most promising modalities for a practical noninvasive BCI system. Owing to both the limitation of refresh rate of liquid crystal display (LCD or cathode ray tube (CRT monitor, and the specific physiological response property that only a very small number of stimuli at certain frequencies could evoke strong SSVEPs, the available frequencies for SSVEP stimuli are limited. Therefore, it may not be enough to code multiple targets with the traditional frequencies coding protocols, which poses a big challenge for the design of a practical SSVEP-based BCI. This study aimed to provide an innovative coding method to tackle this problem. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we present a novel protocol termed multiple frequencies sequential coding (MFSC for SSVEP-based BCI. In MFSC, multiple frequencies are sequentially used in each cycle to code the targets. To fulfill the sequential coding, each cycle is divided into several coding epochs, and during each epoch, certain frequency is used. Obviously, different frequencies or the same frequency can be presented in the coding epochs, and the different epoch sequence corresponds to the different targets. To show the feasibility of MFSC, we used two frequencies to realize four targets and carried on an offline experiment. The current study shows that: 1 MFSC is feasible and efficient; 2 the performance of SSVEP-based BCI based on MFSC can be comparable to some existed systems. CONCLUSIONS/SIGNIFICANCE: The proposed protocol could potentially implement much more targets with the limited available frequencies compared with the traditional frequencies coding protocol. The efficiency of the new protocol was confirmed by real data experiment. We propose that the SSVEP-based BCI under MFSC might be a promising choice in the future.

  2. Viscoelastic properties of the ferret brain measured in vivo at multiple frequencies by magnetic resonance elastography

    OpenAIRE

    Feng, Y.; Clayton, E. H.; Chang, Y.; Okamoto, R.J.; Bayly, P.V.

    2013-01-01

    Characterization of the dynamic mechanical behavior of brain tissue is essential for understanding and simulating the mechanisms of traumatic brain injury (TBI). Changes in mechanical properties may also reflect changes in the brain due to aging or disease. In this study, we used magnetic resonance elastography (MRE) to measure the viscoelastic properties of ferret brain tissue in vivo. Three-dimensional (3D) displacement fields were acquired during wave propagation in the brain induced by ha...

  3. Agent based modeling of the effects of potential treatments over the blood-brain barrier in multiple sclerosis.

    Science.gov (United States)

    Pennisi, Marzio; Russo, Giulia; Motta, Santo; Pappalardo, Francesco

    2015-12-01

    Multiple sclerosis is a disease of the central nervous system that involves the destruction of the insulating sheath of axons, causing severe disabilities. Since the etiology of the disease is not yet fully understood, the use of novel techniques that may help to understand the disease, to suggest potential therapies and to test the effects of candidate treatments is highly advisable. To this end we developed an agent based model that demonstrated its ability to reproduce the typical oscillatory behavior observed in the most common form of multiple sclerosis, relapsing-remitting multiple sclerosis. The model has then been used to test the potential beneficial effects of vitamin D over the disease. Many scientific studies underlined the importance of the blood-brain barrier and of the mechanisms that influence its permeability on the development of the disease. In the present paper we further extend our previously developed model with a mechanism that mimics the blood-brain barrier behavior. The goal of our work is to suggest the best strategies to follow for developing new potential treatments that intervene in the blood-brain barrier. Results suggest that the best treatments should potentially prevent the opening of the blood-brain barrier, as treatments that help in recovering the blood-brain barrier functionality could be less effective. PMID:26343337

  4. Protect Your Brain (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-03-21

    Recent high-profile cases among professional athletes have called attention to the serious problem of traumatic brain injuries, or TBI, but the problem isn’t limited to playing fields. In 2009, at least three and a half million people in the U.S. sustained a TBI, either with or without other injuries. In this podcast, Dr. Lisa McGuire discusses the importance of early diagnosis and treatment of brain injuries.  Created: 3/21/2013 by MMWR.   Date Released: 3/21/2013.

  5. Multiple abscesses of the left brain hemisphere due to Listeria monocytogenes in an immunocompromised patient: a case report.

    Science.gov (United States)

    Matera, Giovanni; Puccio, Rossana; Giancotti, Aida; Quirino, Angela; Guadagnino, Vincenzo; Pardatscher, Kurt; Caroleo, Santo; De Rose, Marisa; Amorosi, Andrea; Liberto, Maria Carla; Focà, Alfredo

    2012-12-01

    We describe a case of brain abscesses in a cirrhotic and diabetic 57-year-old woman showing fever, aphasia, right hemiparesis and seizures. Neuroradiological investigation revealed unilateral cerebritis evolving in multiple abscesses. From blood and surgical drainage samples Listeria monocytogenes grew in pure culture. Despite decompressive craniotomy, the patient died two months after hospital admission. PMID:23299068

  6. Brain-based health visiting: How neuroscience is shaping practice

    OpenAIRE

    Lyon, Steve; Adams, Karen

    2014-01-01

    Health visitors have always been faced with change and challenge to their role, partly as a result of health visiting being underpinned by a set of 'soft' skills that are difficult to articulate. This article suggests that the relationship-building skills of health visitors can now be underpinned by evidence from developments in neuroscience. In this paper, the aspects of neuroscience behind many of the core interventions health visitors have always used are discussed and their relationship t...

  7. The Outdoor Air Pollution and Brain Health Workshop

    Science.gov (United States)

    Accumulating evidence suggests that air pollution may have a significant impact on central nervous system (CNS) health and disease. To address this issue, the National Institute of Environmental Health Sciences/National Institute of Health convened a panel of research scientists...

  8. Fingolimod prevents blood-brain barrier disruption induced by the sera from patients with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Hideaki Nishihara

    Full Text Available OBJECTIVE: Effect of fingolimod in multiple sclerosis (MS is thought to involve the prevention of lymphocyte egress from lymphoid tissues, thereby reducing autoaggressive lymphocyte infiltration into the central nervous system across blood-brain barrier (BBB. However, brain microvascular endothelial cells (BMECs represent a possible additional target for fingolimod in MS patients by directly repairing the function of BBB, as S1P receptors are also expressed by BMECs. In this study, we evaluated the effects of fingolimod on BMECs and clarified whether fingolimod-phosphate restores the BBB function after exposure to MS sera. METHODS: Changes in tight junction proteins, adhesion molecules and transendothelial electrical resistance (TEER in BMECs were evaluated following incubation in conditioned medium with or without fingolimod/fingolimod-phosphate. In addition, the effects of sera derived from MS patients, including those in the relapse phase of relapse-remitting (RR MS, stable phase of RRMS and secondary progressive MS (SPMS, on the function of BBB in the presence of fingolimod-phosphate were assessed. RESULTS: Incubation with fingolimod-phosphate increased the claudin-5 protein levels and TEER values in BMECs, although it did not change the amount of occludin, ICAM-1 or MelCAM proteins. Pretreatment with fingolimod-phosphate restored the changes in the claudin-5 and VCAM-1 protein/mRNA levels and TEER values in BMECs after exposure to MS sera. CONCLUSIONS: Pretreatment with fingolimod-phosphate prevents BBB disruption caused by both RRMS and SPMS sera via the upregulation of claudin-5 and downregulation of VCAM-1 in BMECs, suggesting that fingolimod-phosphate is capable of directly modifying the BBB. BMECs represent a possible therapeutic target for fingolimod in MS patients.

  9. Quantifying brain tissue volume in multiple sclerosis with automated lesion segmentation and filling

    Directory of Open Access Journals (Sweden)

    Sergi Valverde

    2015-01-01

    Full Text Available Lesion filling has been successfully applied to reduce the effect of hypo-intense T1-w Multiple Sclerosis (MS lesions on automatic brain tissue segmentation. However, a study of fully automated pipelines incorporating lesion segmentation and lesion filling on tissue volume analysis has not yet been performed. Here, we analyzed the % of error introduced by automating the lesion segmentation and filling processes in the tissue segmentation of 70 clinically isolated syndrome patient images. First of all, images were processed using the LST and SLS toolkits with different pipeline combinations that differed in either automated or manual lesion segmentation, and lesion filling or masking out lesions. Then, images processed following each of the pipelines were segmented into gray matter (GM and white matter (WM using SPM8, and compared with the same images where expert lesion annotations were filled before segmentation. Our results showed that fully automated lesion segmentation and filling pipelines reduced significantly the % of error in GM and WM volume on images of MS patients, and performed similarly to the images where expert lesion annotations were masked before segmentation. In all the pipelines, the amount of misclassified lesion voxels was the main cause in the observed error in GM and WM volume. However, the % of error was significantly lower when automatically estimated lesions were filled and not masked before segmentation. These results are relevant and suggest that LST and SLS toolboxes allow the performance of accurate brain tissue volume measurements without any kind of manual intervention, which can be convenient not only in terms of time and economic costs, but also to avoid the inherent intra/inter variability between manual annotations.

  10. Quantifying brain tissue volume in multiple sclerosis with automated lesion segmentation and filling.

    Science.gov (United States)

    Valverde, Sergi; Oliver, Arnau; Roura, Eloy; Pareto, Deborah; Vilanova, Joan C; Ramió-Torrentà, Lluís; Sastre-Garriga, Jaume; Montalban, Xavier; Rovira, Àlex; Lladó, Xavier

    2015-01-01

    Lesion filling has been successfully applied to reduce the effect of hypo-intense T1-w Multiple Sclerosis (MS) lesions on automatic brain tissue segmentation. However, a study of fully automated pipelines incorporating lesion segmentation and lesion filling on tissue volume analysis has not yet been performed. Here, we analyzed the % of error introduced by automating the lesion segmentation and filling processes in the tissue segmentation of 70 clinically isolated syndrome patient images. First of all, images were processed using the LST and SLS toolkits with different pipeline combinations that differed in either automated or manual lesion segmentation, and lesion filling or masking out lesions. Then, images processed following each of the pipelines were segmented into gray matter (GM) and white matter (WM) using SPM8, and compared with the same images where expert lesion annotations were filled before segmentation. Our results showed that fully automated lesion segmentation and filling pipelines reduced significantly the % of error in GM and WM volume on images of MS patients, and performed similarly to the images where expert lesion annotations were masked before segmentation. In all the pipelines, the amount of misclassified lesion voxels was the main cause in the observed error in GM and WM volume. However, the % of error was significantly lower when automatically estimated lesions were filled and not masked before segmentation. These results are relevant and suggest that LST and SLS toolboxes allow the performance of accurate brain tissue volume measurements without any kind of manual intervention, which can be convenient not only in terms of time and economic costs, but also to avoid the inherent intra/inter variability between manual annotations.

  11. Efficacy and toxicity of whole brain radiotherapy in patients with multiple cerebral metastases from malignant melanoma

    International Nuclear Information System (INIS)

    To retrospectively access outcome and toxicity of whole brain radiotherapy (WBRT) in patients with multiple brain metastases (BM) from malignant melanoma (MM). Results of 87 patients (median age 58 years; 35 female, 52 male) treated by WBRT for BM of MM between 2000 and 2011 were reviewed. Total dose applied was either 30 Gy in 10 fractions (n = 56) or 40 Gy in 20 fractions (n = 31). All but 9 patients suffered from extra-cerebral metastases. Prior surgical resection of BM was performed in 18 patients, salvage stereotactic radiosurgery in 13 patients. Mean follow-up was 8 months (range, 0–57 months), the 6- and 12-months overall-(OS) survival rates were 29.2% and 16.5%, respectively. The median OS was 3.5 months. In cerebral follow-up imaging 6 (11) patients showed a complete (partial) remission, while 11 (17) patients had stable disease (intra-cerebral tumor progression). In comparison of total dose, the group treated with 40 Gy in 20 fractions achieved a significant longer OS (p = 0.003, median 3.1 vs. 5.6 months). Furthermore, DS-GPA score (p < 0.001) as well as RPA class (p < 0.001) influenced significantly on OS and patients had a significantly longer OS after surgical resection (p = 0.001, median 3.0 vs. 5.8 months, multivariate p = 0.007). Having extra-cerebral metastases didn't significantly impact on OS (p = 0.21). Treatment of BM from MM with WBRT is tolerated well and some remissions of BM could be achieved. An advantage for higher treatment total doses was seen. However, outcome is non-satisfying, and further improvements in treatment of BM from MM are warranted

  12. Context, emotion, and the strategic pursuit of goals: interactions among multiple brain systems controlling motivated behavior.

    Science.gov (United States)

    Gruber, Aaron J; McDonald, Robert J

    2012-01-01

    Motivated behavior exhibits properties that change with experience and partially dissociate among a number of brain structures. Here, we review evidence from rodent experiments demonstrating that multiple brain systems acquire information in parallel and either cooperate or compete for behavioral control. We propose a conceptual model of systems interaction wherein a ventral emotional memory network involving ventral striatum (VS), amygdala, ventral hippocampus, and ventromedial prefrontal cortex triages behavioral responding to stimuli according to their associated affective outcomes. This system engages autonomic and postural responding (avoiding, ignoring, approaching) in accordance with associated stimulus valence (negative, neutral, positive), but does not engage particular operant responses. Rather, this emotional system suppresses or invigorates actions that are selected through competition between goal-directed control involving dorsomedial striatum (DMS) and habitual control involving dorsolateral striatum (DLS). The hippocampus provides contextual specificity to the emotional system, and provides an information rich input to the goal-directed system for navigation and discriminations involving ambiguous contexts, complex sensory configurations, or temporal ordering. The rapid acquisition and high capacity for episodic associations in the emotional system may unburden the more complex goal-directed system and reduce interference in the habit system from processing contingencies of neutral stimuli. Interactions among these systems likely involve inhibitory mechanisms and neuromodulation in the striatum to form a dominant response strategy. Innate traits, training methods, and task demands contribute to the nature of these interactions, which can include incidental learning in non-dominant systems. Addition of these features to reinforcement learning models of decision-making may better align theoretical predictions with behavioral and neural correlates in

  13. Context, emotion, and the strategic pursuit of goals: Interactions among multiple brain systems controlling motivated behaviour

    Directory of Open Access Journals (Sweden)

    Aaron J Gruber

    2012-08-01

    Full Text Available Motivated behaviour exhibits properties that change with experience and partially dissociate among a number of brain structures. Here, we review evidence from rodent experiments demonstrating that multiple brain systems acquire information in parallel and either cooperate or compete for behavioural control. We propose a conceptual model of systems interaction wherein a ventral emotional memory network involving ventral striatum, amygdala, ventral hippocampus, and ventromedial prefrontal cortex triages behavioural responding to stimuli according to their associated affective outcomes. This system engages autonomic and postural responding (avoiding, ignoring, approaching in accordance with associated stimulus valence (negative, neutral, positive, but does not engage particular operant responses. Rather, this emotional system suppresses or invigorates actions that are selected through competition between goal-directed control involving dorsomedial striatum and habitual control involving dorsolateral striatum. The hippocampus provides contextual specificity to the emotional system, and provides an information rich input to the goal-directed system for navigation and discriminations involving ambiguous contexts, complex sensory configurations, or temporal ordering. The rapid acquisition and high capacity for episodic associations in the emotional system may unburden the more complex goal-directed system and reduce interference in the habit system from processing contingencies of neutral stimuli. Interactions among these systems likely involve inhibitory mechanisms and neuromodulation in the basal ganglia to form a dominant response strategy. Innate traits, training methods, and task demands contribute to the nature of these interactions, which can include incidental learning in non-dominant systems. Addition of these features to reinforcement learning models of decision making may better align theoretical predictions with behavioural and neural

  14. Context, emotion, and the strategic pursuit of goals: interactions among multiple brain systems controlling motivated behavior.

    Science.gov (United States)

    Gruber, Aaron J; McDonald, Robert J

    2012-01-01

    Motivated behavior exhibits properties that change with experience and partially dissociate among a number of brain structures. Here, we review evidence from rodent experiments demonstrating that multiple brain systems acquire information in parallel and either cooperate or compete for behavioral control. We propose a conceptual model of systems interaction wherein a ventral emotional memory network involving ventral striatum (VS), amygdala, ventral hippocampus, and ventromedial prefrontal cortex triages behavioral responding to stimuli according to their associated affective outcomes. This system engages autonomic and postural responding (avoiding, ignoring, approaching) in accordance with associated stimulus valence (negative, neutral, positive), but does not engage particular operant responses. Rather, this emotional system suppresses or invigorates actions that are selected through competition between goal-directed control involving dorsomedial striatum (DMS) and habitual control involving dorsolateral striatum (DLS). The hippocampus provides contextual specificity to the emotional system, and provides an information rich input to the goal-directed system for navigation and discriminations involving ambiguous contexts, complex sensory configurations, or temporal ordering. The rapid acquisition and high capacity for episodic associations in the emotional system may unburden the more complex goal-directed system and reduce interference in the habit system from processing contingencies of neutral stimuli. Interactions among these systems likely involve inhibitory mechanisms and neuromodulation in the striatum to form a dominant response strategy. Innate traits, training methods, and task demands contribute to the nature of these interactions, which can include incidental learning in non-dominant systems. Addition of these features to reinforcement learning models of decision-making may better align theoretical predictions with behavioral and neural correlates in

  15. Optimization of Treatment Geometry to Reduce Normal Brain Dose in Radiosurgery of Multiple Brain Metastases with Single–Isocenter Volumetric Modulated Arc Therapy

    Science.gov (United States)

    Wu, Qixue; Snyder, Karen Chin; Liu, Chang; Huang, Yimei; Zhao, Bo; Chetty, Indrin J.; Wen, Ning

    2016-01-01

    Treatment of patients with multiple brain metastases using a single-isocenter volumetric modulated arc therapy (VMAT) has been shown to decrease treatment time with the tradeoff of larger low dose to the normal brain tissue. We have developed an efficient Projection Summing Optimization Algorithm to optimize the treatment geometry in order to reduce dose to normal brain tissue for radiosurgery of multiple metastases with single-isocenter VMAT. The algorithm: (a) measures coordinates of outer boundary points of each lesion to be treated using the Eclipse Scripting Application Programming Interface, (b) determines the rotations of couch, collimator, and gantry using three matrices about the cardinal axes, (c) projects the outer boundary points of the lesion on to Beam Eye View projection plane, (d) optimizes couch and collimator angles by selecting the least total unblocked area for each specific treatment arc, and (e) generates a treatment plan with the optimized angles. The results showed significant reduction in the mean dose and low dose volume to normal brain, while maintaining the similar treatment plan qualities on the thirteen patients treated previously. The algorithm has the flexibility with regard to the beam arrangements and can be integrated in the treatment planning system for clinical application directly. PMID:27688047

  16. Association of retinal and macular damage with brain atrophy in multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Jan Dörr

    Full Text Available Neuroaxonal degeneration in the central nervous system contributes substantially to the long term disability in multiple sclerosis (MS patients. However, in vivo determination and monitoring of neurodegeneration remain difficult. As the widely used MRI-based approaches, including the brain parenchymal fraction (BPF have some limitations, complementary in vivo measures for neurodegeneration are necessary. Optical coherence tomography (OCT is a potent tool for the detection of MS-related retinal neurodegeneration. However, crucial aspects including the association between OCT- and MRI-based atrophy measures or the impact of MS-related parameters on OCT parameters are still unclear. In this large prospective cross-sectional study on 104 relapsing remitting multiple sclerosis (RRMS patients we evaluated the associations of retinal nerve fiber layer thickness (RNFLT and total macular volume (TMV with BPF and addressed the impact of disease-determining parameters on RNFLT, TMV or BPF. BPF, normalized for subject head size, was estimated with SIENAX. Relations were analyzed primarily by Generalized Estimating Equation (GEE models considering within-patient inter-eye relations. We found that both RNFLT (p = 0.019, GEE and TMV (p = 0.004, GEE associate with BPF. RNFLT was furthermore linked to the disease duration (p<0.001, GEE but neither to disease severity nor patients' age. Contrarily, BPF was rather associated with severity (p<0.001, GEE than disease duration and was confounded by age (p<0.001, GEE. TMV was not associated with any of these parameters. Thus, we conclude that in RRMS patients with relatively short disease duration and rather mild disability RNFLT and TMV reflect brain atrophy and are thus promising parameters to evaluate neurodegeneration in MS. Furthermore, our data suggest that RNFLT and BPF reflect different aspects of MS. Whereas BPF best reflects disease severity, RNFLT might be the better parameter for monitoring axonal

  17. Living with Multiple Health Problems: What Older Adults Should Know

    Science.gov (United States)

    ... other tip sheets. More than half of all adults 65 and older have three or more chronic (ongoing) medical problems, such as heart disease, diabetes, cancer, or arthritis. Caring for older patients with multiple ...

  18. Radiosurgery of multiple brain metastases with single-isocenter dynamic conformal arcs (SIDCA)

    International Nuclear Information System (INIS)

    Purpose: To propose single-isocenter dynamic conformal arcs (SIDCA), a novel technique for radiosurgery of multiple brain metastases, and to compare SIDCA with volumetric modulated arc therapy (VMAT) and multiple-isocenter dynamic conformal arcs (MIDCA) for plan quality. Methods and materials: SIDCA, MIDCA, and VMAT plans were created on 6 patients with 3–5 metastases. Plans were evaluated using Radiation Therapy Oncology Group conformity index (RCI), Paddick conformity index (PCI), gradient index (GI), volumes that received more than 100% (V100%), 50% (V50%), 25% (V25%) and 10% (V10%) of prescription dose, total monitor units (MUs), and delivery time (DT). Results: SIDCA achieved conformal plans (RCI = 1.38 ± 0.12, PCI = 0.72 ± 0.06) with steep dose fall-off (GI = 3.97 ± 0.51). MIDCA plans had comparable plan quality and MUs as SIDCA, but 52% longer DT. The VMAT plans had better conformity (RCI = 1.15 ± 0.09, p < 0.01 and PCI = 0.86 ± 0.06, p < 0.01) than SIDCA, worse GI (4.34 ± 0.46, p < 0.01), higher V25% (p = 0.05) and V10% (p = 0.02), 49% less MUs and 46% shorter DT. Conclusions: All three techniques achieved conformal plans with steep dose fall-off from targets. SIDCA plans had similar plan quality as MIDCA but more efficient to delivery. SIDCA plans had lower peripheral dose spread than VMAT; VMAT plans had better conformity and faster delivery time than SIDCA

  19. MRI pattern recognition in multiple sclerosis normal-appearing brain areas.

    Directory of Open Access Journals (Sweden)

    Martin Weygandt

    Full Text Available OBJECTIVE: Here, we use pattern-classification to investigate diagnostic information for multiple sclerosis (MS; relapsing-remitting type in lesioned areas, areas of normal-appearing grey matter (NAGM, and normal-appearing white matter (NAWM as measured by standard MR techniques. METHODS: A lesion mapping was carried out by an experienced neurologist for Turbo Inversion Recovery Magnitude (TIRM images of individual subjects. Combining this mapping with templates from a neuroanatomic atlas, the TIRM images were segmented into three areas of homogenous tissue types (Lesions, NAGM, and NAWM after spatial standardization. For each area, a linear Support Vector Machine algorithm was used in multiple local classification analyses to determine the diagnostic accuracy in separating MS patients from healthy controls based on voxel tissue intensity patterns extracted from small spherical subregions of these larger areas. To control for covariates, we also excluded group-specific biases in deformation fields as a potential source of information. RESULTS: Among regions containing lesions a posterior parietal WM area was maximally informative about the clinical status (96% accuracy, p<10(-13. Cerebellar regions were maximally informative among NAGM areas (84% accuracy, p<10(-7. A posterior brain region was maximally informative among NAWM areas (91% accuracy, p<10(-10. INTERPRETATION: We identified regions indicating MS in lesioned, but also NAGM, and NAWM areas. This complements the current perception that standard MR techniques mainly capture macroscopic tissue variations due to focal lesion processes. Compared to current diagnostic guidelines for MS that define areas of diagnostic information with moderate spatial specificity, we identified hotspots of MS associated tissue alterations with high specificity defined on a millimeter scale.

  20. Health workforce imbalances in times of globalization: brain drain or professional mobility?

    Science.gov (United States)

    Marchal, Bruno; Kegels, Guy

    2003-01-01

    The health workforce is of strategic importance to the performance of national health systems as well as of international disease control initiatives. The brain drain from rural to urban areas, and from developing to industrialized countries is a long-standing phenomenon in the health professions but has in recent years taken extreme proportions, particularly in Africa. Adopting the wider perspective of health workforce balances, this paper presents an analysis of the underlying mechanisms of health professional migration and possible strategies to reduce its negative impact on health services. The opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from 'human capital flight' and 'brain drain' to 'professional mobility' or 'brain circulation'. In reality, this mobility is very asymmetrical, to the detriment of less developed countries, which lose not only much-needed human resources, but also considerable investments in education and fiscal income. It is argued that low professional satisfaction and the decreasing social valuation of the health professionals are important determinants of the decreasing attraction of the health professions, which underlies both the push from the exporting countries, as well as the pull from the recipient countries. Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries. PMID:14661944

  1. Brain-gut-microbe communication in health and disease.

    Science.gov (United States)

    Grenham, Sue; Clarke, Gerard; Cryan, John F; Dinan, Timothy G

    2011-01-01

    Bidirectional signalling between the gastrointestinal tract and the brain is regulated at neural, hormonal, and immunological levels. This construct is known as the brain-gut axis and is vital for maintaining homeostasis. Bacterial colonization of the intestine plays a major role in the post-natal development and maturation of the immune and endocrine systems. These processes are key factors underpinning central nervous system (CNS) signaling. Recent research advances have seen a tremendous improvement in our understanding of the scale, diversity, and importance of the gut microbiome. This has been reflected in the form of a revised nomenclature to the more inclusive brain-gut-enteric microbiota axis and a sustained research effort to establish how communication along this axis contributes to both normal and pathological conditions. In this review, we will briefly discuss the critical components of this axis and the methodological challenges that have been presented in attempts to define what constitutes a normal microbiota and chart its temporal development. Emphasis is placed on the new research narrative that confirms the critical influence of the microbiota on mood and behavior. Mechanistic insights are provided with examples of both neural and humoral routes through which these effects can be mediated. The evidence supporting a role for the enteric flora in brain-gut axis disorders is explored with the spotlight on the clinical relevance for irritable bowel syndrome, a stress-related functional gastrointestinal disorder. We also critically evaluate the therapeutic opportunities arising from this research and consider in particular whether targeting the microbiome might represent a valid strategy for the management of CNS disorders and ponder the pitfalls inherent in such an approach. Despite the considerable challenges that lie ahead, this is an exciting area of research and one that is destined to remain the center of focus for some time to come.

  2. Brain-Gut-Microbe Communication in Health and Disease

    Directory of Open Access Journals (Sweden)

    Sue eGrenham

    2011-12-01

    Full Text Available Bidirectional signalling between the gastrointestinal tract and the brain is regulated at neural, hormonal and immunological levels. This construct is known as the brain-gut axis and is vital for maintaining homeostasis. Bacterial colonisation of the intestine plays a major role in the post-natal development and maturation of the immune and endocrine systems. These processes are key factors underpinning central nervous system (CNS signalling. Recent research advances have seen a tremendous improvement in our understanding of the scale, diversity and importance of the gut microbiome. This has been reflected in the form of a revised nomenclature to the more inclusive brain-gut-enteric microbiota axis and a sustained research effort to establish how communication along this axis contributes to both normal and pathological conditions. In this review, we will briefly discuss the critical components of this axis and the methodological challenges that have been presented in attempts to define what constitutes a normal microbiota and chart its temporal development. Emphasis is placed on the new research narrative that confirms the critical influence of the microbiota on mood and behaviour. Mechanistic insights are provided with examples of both neural and humoral routes through which these effects can be mediated. The evidence supporting a role for the enteric flora in brain-gut axis disorders is explored with the spotlight on the clinical relevance for irritable bowel syndrome (IBS, a stress-related functional gastrointestinal disorder. We also critically evaluate the therapeutic opportunities arising from this research and consider in particular whether targeting the microbiome might represent a valid strategy for the management of CNS disorders and ponder the pitfalls inherent in such an approach. Despite the considerable challenges that lie ahead, this is an exciting area of research and one that is destined to remain the centre of focus for some

  3. Brain Health Knowledge in Community-Dwelling Older Adults

    Science.gov (United States)

    Park, Carolyn S.; Troutman-Jordan, Meredith; Nies, Mary A.

    2012-01-01

    Aging and its effects on a person's quality of life are a growing health concern and burden for many Americans. Recently, studies have shown that adopting certain healthy behaviors may help maintain and or prevent age-related health issues such as cognitive decline. However, many people are unaware of these newfound facts. Furthermore, there is…

  4. Plan Quality and Treatment Efficiency for Radiosurgery to Multiple Brain Metastases: Non-Coplanar RapidArc vs Gamma Knife

    OpenAIRE

    Haisong eLiu; Andrews, David W; Evans, James J.; Maria eWerner-wasik; Yan eYu; Adam Paul Dicker; Wenyin eShi

    2016-01-01

    Objectives: This study compares the dosimetry and efficiency of two modern radiosurgery (SRS) modalities for multiple brain metastases (Gamma Knife and LINAC-based RapidArc/volumetric modulated arc therapy), with a special focus on the comparison of low dose spread.Methods: Six patients with three or four small brain metastases were used in this study. The size of targets varied from 0.1 ~ 10.5 cc. SRS doses were prescribed according to size of lesions. SRS plans were made using both Gamma Kn...

  5. Neuroenhancement: enhancing brain and mind in health and in disease.

    Science.gov (United States)

    Clark, Vincent P; Parasuraman, Raja

    2014-01-15

    Humans have long used cognitive enhancement methods to expand the proficiency and range of the various mental activities that they engage in, including writing to store and retrieve information, and computers that allow them to perform myriad activities that are now commonplace in the internet age. Neuroenhancement describes the use of neuroscience-based techniques for enhancing cognitive function by acting directly on the human brain and nervous system, altering its properties to increase performance. Cognitive neuroscience has now reached the point where it may begin to put theory derived from years of experimentation into practice. This special issue includes 16 articles that employ or examine a variety of neuroenhancement methods currently being developed to increase cognition in healthy people and in patients with neurological or psychiatric illness. This includes transcranial electromagnetic stimulation methods, such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), along with deep brain stimulation, neurofeedback, behavioral training techniques, and these and other techniques in conjunction with neuroimaging. These methods can be used to improve attention, perception, memory and other forms of cognition in healthy individuals, leading to better performance in many aspects of everyday life. They may also reduce the cost, duration and overall impact of brain and mental illness in patients with neurological and psychiatric illness. Potential disadvantages of these techniques are also discussed. Given that the benefits of neuroenhancement outweigh the potential costs, these methods could potentially reduce suffering and improve quality of life for everyone, while further increasing our knowledge about the mechanisms of human cognition. PMID:24036352

  6. Multiple trauma and mental health in former Ugandan child soldiers.

    Science.gov (United States)

    Klasen, Fionna; Oettingen, Gabriele; Daniels, Judith; Adam, Hubertus

    2010-10-01

    The present study examines the effect of war and domestic violence on the mental health of child soldiers in a sample consisting of 330 former Ugandan child soldiers (age: 11-17 years, female: 49%). All children had experienced at least 1 war-related event and 78% were additionally exposed to at least 1 incident of domestic violence. Prevalences of posttraumatic stress disorder and major depressive disorder were 33%, and 36%, respectively. Behavioral and emotional problems above clinical cutoff were measured in 61%. No gender differences were found regarding mental health outcomes. War experience and domestic violence were significantly associated with all mental health outcomes. The authors' findings point to the detrimental effects of domestic violence in addition to traumatizing war experiences in child soldiers. PMID:21053376

  7. Evidence of impaired brain activity balance after passive sensorimotor stimulation in multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Nikolaos Petsas

    Full Text Available OBJECTIVES: Examination of sensorimotor activation alone in multiple sclerosis (MS patients may not yield a comprehensive view of cerebral response to task stimulation. Additional information may be obtained by examining the negative BOLD response (deactivation. Aim of this work was to characterize activation and deactivation patterns during passive hand movements in MS patients. METHODS: 13 relapsing remitting-MS patients (RRMS, 18 secondary progressive-MS patients (SPMS and 15 healthy controls (HC underwent an fMRI study during passive right-hand movements. Activation and deactivation contrasts in the three groups were entered into ANOVA, age and gender corrected. Post-hoc analysis was performed with one-sample and two-sample t-tests. For each patient we obtained lesion volume (LV from both T1- and T2-weighted images. RESULTS: Activations showed a progressive extension to the ipsilateral brain hemisphere according to the group and the clinical form (HC

  8. Whole-Brain Atrophy Rate in Idiopathic Parkinson's Disease, Multiple System Atrophy, and Progressive Supranuclear Palsy.

    Science.gov (United States)

    Guevara, C; Bulatova, K; Barker, G J; Gonzalez, G; Crossley, N; Kempton, M J

    2016-01-01

    In multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), the absence of surrogate endpoints makes clinical trials long and expensive. We aim to determine annualized whole-brain atrophy rates (a-WBAR) in idiopathic Parkinson's disease (IPD), MSA, and PSP. Ten healthy controls, 20 IPD, 12 PSP, and 8 MSA patients were studied using a volumetric MRI technique (SIENA). In controls, the a-WBAR was 0.37% ± 0.28 (CI 95% 0.17-0.57), while in IPD a-WBAR was 0.54% ± 0.38 (CI 95% 0.32-0.68). The IPD patients did not differ from the controls. In PSP, the a-WBAR was 1.26% ± 0.51 (CI 95%: 0.95-1.58). In MSA, a-WBAR was 1.65% ± 1.12 (CI 95%: 0.71-2.59). MSA did not differ from PSP. The a-WBAR in PSP and MSA were significantly higher than in the IPD group (p = 0.004 and p < 0.001, resp.). In PSP, the use of a-WBAR required one-half of the patients needed for clinical scales to detect a 50% reduction in their progression. In MSA, one-quarter of the patients would be needed to detect the same effect. a-WBAR is a reasonable candidate to consider as a surrogate endpoint in short clinical trials using smaller sample sizes. The confidence intervals for a-WBAR may add a potential retrospective application for a-WBAR to improve the diagnostic accuracy of MSA and PSP versus IPD.

  9. Amplitude of Sensorimotor Mu Rhythm Is Correlated with BOLD from Multiple Brain Regions: A Simultaneous EEG-fMRI Study

    Science.gov (United States)

    Yin, Siyang; Liu, Yuelu; Ding, Mingzhou

    2016-01-01

    The mu rhythm is a field oscillation in the ∼10Hz range over the sensorimotor cortex. For decades, the suppression of mu (event-related desynchronization) has been used to index movement planning, execution, and imagery. Recent work reports that non-motor processes, such as spatial attention and movement observation, also desynchronize mu, raising the possibility that the mu rhythm is associated with the activity of multiple brain regions and systems. In this study, we tested this hypothesis by recording simultaneous resting-state EEG-fMRI from healthy subjects. Independent component analysis (ICA) was applied to extract the mu components. The amplitude (power) fluctuations of mu were estimated as a time series using a moving-window approach, which, after convolving with a canonical hemodynamic response function (HRF), was correlated with blood-oxygen-level-dependent (BOLD) signals from the entire brain. Two main results were found. First, mu power was negatively correlated with BOLD from areas of the sensorimotor network, the attention control network, the putative mirror neuron system, and the network thought to support theory of mind. Second, mu power was positively correlated with BOLD from areas of the salience network, including anterior cingulate cortex and anterior insula. These results are consistent with the hypothesis that sensorimotor mu rhythm is associated with multiple brain regions and systems. They also suggest that caution should be exercised when attempting to interpret mu modulation in terms of a single brain network. PMID:27499736

  10. Amplitude of Sensorimotor Mu Rhythm Is Correlated with BOLD from Multiple Brain Regions: A Simultaneous EEG-fMRI Study.

    Science.gov (United States)

    Yin, Siyang; Liu, Yuelu; Ding, Mingzhou

    2016-01-01

    The mu rhythm is a field oscillation in the ∼10Hz range over the sensorimotor cortex. For decades, the suppression of mu (event-related desynchronization) has been used to index movement planning, execution, and imagery. Recent work reports that non-motor processes, such as spatial attention and movement observation, also desynchronize mu, raising the possibility that the mu rhythm is associated with the activity of multiple brain regions and systems. In this study, we tested this hypothesis by recording simultaneous resting-state EEG-fMRI from healthy subjects. Independent component analysis (ICA) was applied to extract the mu components. The amplitude (power) fluctuations of mu were estimated as a time series using a moving-window approach, which, after convolving with a canonical hemodynamic response function (HRF), was correlated with blood-oxygen-level-dependent (BOLD) signals from the entire brain. Two main results were found. First, mu power was negatively correlated with BOLD from areas of the sensorimotor network, the attention control network, the putative mirror neuron system, and the network thought to support theory of mind. Second, mu power was positively correlated with BOLD from areas of the salience network, including anterior cingulate cortex and anterior insula. These results are consistent with the hypothesis that sensorimotor mu rhythm is associated with multiple brain regions and systems. They also suggest that caution should be exercised when attempting to interpret mu modulation in terms of a single brain network. PMID:27499736

  11. Gender-specific impact of personal health parameters on individual brain aging in cognitively unimpaired elderly subjects

    Directory of Open Access Journals (Sweden)

    Katja eFranke

    2014-05-01

    Full Text Available Aging alters brain structure and function. Personal health markers and modifiable lifestyle factors are related to individual brain aging as well as to the risk of developing Alzheimer’s disease (AD. This study uses a novel magnetic resonance imaging (MRI-based biomarker to assess the effects of 17 health markers on individual brain aging in cognitively unimpaired elderly subjects. By employing kernel regression methods, the expression of normal brain-aging patterns forms the basis to estimate the brain age of a given new subject. If the estimated age is higher than the chronological age, a positive brain age gap estimation (BrainAGE score indicates accelerated atrophy and is considered a risk factor for developing AD. Within this cross-sectional, multi-center study 228 cognitively unimpaired elderly subjects (118 males completed an MRI at 1.5T, physiological and blood parameter assessments. The multivariate regression model combining all measured parameters was capable of explaining 39% of BrainAGE variance in males (p < 0.001 and 32% in females (p < 0.01. Furthermore, markers of the metabolic syndrome as well as markers of liver and kidney functions were profoundly related to BrainAGE scores in males (p < 0.05. In females, markers of liver and kidney functions as well as supply of vitamin B12 were significantly related to BrainAGE (p < 0.05. In conclusion, in cognitively unimpaired elderly subjects several clinical markers of poor health were associated with subtle structural changes in the brain that reflect accelerated aging, whereas protective effects on brain aging were observed for markers of good health. Additionally, the relations between individual brain aging and miscellaneous health markers show gender-specific patterns. The BrainAGE approach may thus serve as a clinically relevant biomarker for the detection of subtly abnormal patterns of brain aging probably preceding cognitive decline and development of AD.

  12. Functional role of walnuts and acai fruits on brain health

    Science.gov (United States)

    For survival and perpetuity, all plants, including fruit- or vegetable-bearing plants, synthesize an enormous number of secondary chemical compounds, widely known as phytochemicals. A plethora of research suggests that these phytochemicals extend a multitude of health benefits to humans, mainly thro...

  13. Utilization and Costs of Health Care after Geriatric Traumatic Brain Injury

    OpenAIRE

    Thompson, Hilaire J.; Weir, Sharada; Rivara, Frederick P; Wang, Jin; Sullivan, Sean D.; Salkever, David; MacKenzie, Ellen J.

    2012-01-01

    Despite the growing number of older adults experiencing traumatic brain injury (TBI), little information exists regarding their utilization and cost of health care services. Identifying patterns in the type of care received and determining their costs is an important first step toward understanding the return on investment and potential areas for improvement. We performed a health care utilization and cost analysis using the National Study on the Costs and Outcomes of Trauma (NSCOT) dataset. ...

  14. Controlling a Rehabilitation Robot with Brain-Machine Interface: An approach based on Independent Component Analysis and Multiple Kernel Learning

    Directory of Open Access Journals (Sweden)

    Yi-Hung Liu

    2013-03-01

    Full Text Available Patients suffering from severe motor disabilities usually require assistance from other people when doing rehabilitation exercises, which causes the rehabilitation process to be time-consuming and inconvenient. Therefore, we propose an automatic feature extraction method for a brain-machine interface that allows patients to control a robot using their own brain waves. A brain–machine interface (BMI based on the P300 event-related potential (ERP, called Brain Controlled Rehabilitation System (BCRS, was developed to detect the intentions of patients. Using the BCRS, patients can communicate with the robot through their brain waves. However, deciding how to obtain an automatically extracted, useful EEG signal is a difficult and important problem for BMI research. In this paper, Independent Component Analysis – Multiple Kernel Learning (ICA-MKL is used to directly extract a useful signal and build the classification mode for BCRS. The results reveal that this method is useful for automatically extracting the P300 signal and the accuracy is better than MKL. In additional, the same method can be extended into any motor imaginary area and the accuracy of ICA-MKL for brain imaginary data is also good to removing eye-blink artifacts and the accuracy performance is also good.

  15. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes.

    Science.gov (United States)

    Bischoff-Ferrari, Heike A

    2014-01-01

    Recent evidence suggests that vitamin D deficiency has harmful effects on health and that recent vitamin D intake recommendations may be associated with better health outcomes. In this chapter, evidence is summarized from different studies that evaluate threshold levels for serum 25(OH)D levels in relation to bone mineral density (BMD), lower extremity function, dental health, risk of falls, fractures, cancer prevention, incident hypertension and mortality. For all endpoints, levels in the deficient range (nmol/l; ng/ml) are associated with no benefit or adverse effects, while the most advantageous serum levels for 25(OH)D appeared to be close to 75 nmol/l (30 ng/ml). An intake of 800 IU (20 microg) of vitamin D3 (cholecalciferol) per day for all adults may bring 97% of the population to level of at least 50 nmol/l and about 50% up to 75 nmol/l. Thus, higher doses of vitamin D than currently recommended are needed to bring most individuals to75 nmol/l. While estimates suggest that 1600 to 2000 IU vitamin D3 per day may successfully and safely achieve this goal, the implications of higher doses for the total adult population need to be addressed in future studies. PMID:25207384

  16. Emerging roles for folate and related B-vitamins in brain health across the lifecycle.

    Science.gov (United States)

    McGarel, C; Pentieva, K; Strain, J J; McNulty, H

    2015-02-01

    Nutrition plays a fundamental role in supporting the structural and functional development of the human brain from conception, throughout early infancy and extending into later life. A growing body of evidence suggests that folate and the metabolically related B-vitamins are essential for brain health across all age groups, owing to their specific roles in C1 metabolism and particularly in the production of S-adenosylmethionine, a universal methyl donor essential for the production of neurotransmitters. Emerging, though not entirely consistent, evidence suggests that maternal folate status throughout pregnancy may influence neurodevelopment and behaviour of the offspring. Furthermore optimal B-vitamin status is associated with better cognitive health in ageing. Of note, a recent clinical trial provided evidence that supplementation with folic acid and related B-vitamins over a 2-year-period reduced global and regional brain atrophy, as measured by MRI scan in older adults. In terms of potential mechanisms, the effects of these B-vitamins on cognitive health may be independent or may be mediated by nutrient-nutrient and/or relevant gene-nutrient interactions. Furthermore, a new area of research suggests that the in utero environment influences health in later life. Folate, an important cofactor in C1 metabolism, is indirectly involved in DNA methylation, which in turn is considered to be one of the epigenetic mechanisms that may underlie fetal programming and brain development. The present review will explore the evidence that supports a role for folate and the related B-vitamins in brain health across the lifecycle, and potential mechanisms to explain such effects. PMID:25371067

  17. The Brain Drain Potential of Students in the African Health and Nonhealth Sectors

    Directory of Open Access Journals (Sweden)

    Jonathan Crush

    2012-01-01

    Full Text Available The departure of health professionals to Europe and North America is placing an intolerable burden on public health systems in many African countries. Various retention, recall, and replacement policies to ameliorate the impact of this brain drain have been suggested, none of which have been particularly successful to date. The key question for the future is whether the brain drain of health sector skills is likely to continue and whether the investment of African countries in training health professionals will continue to be lost through emigration. This paper examines the emigration intentions of trainee health professionals in six Southern African countries. The data was collected by the Southern African Migration Program (SAMP in a survey of final-year students across the region which included 651 students training for the health professions. The data also allows for the comparison of health sector with other students. The analysis presented in this paper shows very high emigration potential amongst all final-year students. Health sector students do show a slightly higher inclination to leave than those training to work in other sectors. These findings present a considerable challenge for policy makers seeking to encourage students to stay at home and work after graduation.

  18. Promoting brain health through exercise and diet in older adults: a physiological perspective.

    Science.gov (United States)

    Jackson, Philippa A; Pialoux, Vincent; Corbett, Dale; Drogos, Lauren; Erickson, Kirk I; Eskes, Gail A; Poulin, Marc J

    2016-08-15

    The rise in incidence of age-related cognitive impairment is a global health concern. Ageing is associated with a number of changes in the brain that, collectively, contribute to the declines in cognitive function observed in older adults. Structurally, the ageing brain atrophies as white and grey matter volumes decrease. Oxidative stress and inflammation promote endothelial dysfunction thereby hampering cerebral perfusion and thus delivery of energy substrates and nutrients. Further, the development of amyloid plaques and neurofibrillary tangles contributes to neuronal loss. Of interest, there are substantial inter-individual differences in the degree to which these physical and functional changes impact upon cognitive function as we grow older. This review describes how engaging in physical activity and cognitive activities and adhering to a Mediterranean style diet promote 'brain health'. From a physiological perspective, we discuss the effects of these modifiable lifestyle behaviours on the brain, and how some recent human trials are beginning to show some promise as to the effectiveness of lifestyle behaviours in combating cognitive impairment. Moreover, we propose that these lifestyle behaviours, through numerous mechanisms, serve to increase brain, cerebrovascular and cognitive reserve, thereby preserving and enhancing cognitive function for longer. PMID:27524792

  19. Brain and cord myelin water imaging: a progressive multiple sclerosis biomarker

    Directory of Open Access Journals (Sweden)

    Shannon Kolind

    2015-01-01

    Interpretation: In this study we demonstrated that mcDESPOT can be used to measure myelin and atrophy in the brain and spinal cord. Results correlate well with clinical disability scores in PPMS representing cognitive, fine motor and ambulatory disability.

  20. Lifelong brain health is a lifelong challenge: from evolutionary principles to empirical evidence.

    Science.gov (United States)

    Mattson, Mark P

    2015-03-01

    Although the human brain is exceptional in size and information processing capabilities, it is similar to other mammals with regard to the factors that promote its optimal performance. Three such factors are the challenges of physical exercise, food deprivation/fasting, and social/intellectual engagement. Because it evolved, in part, for success in seeking and acquiring food, the brain functions best when the individual is hungry and physically active, as typified by the hungry lion stalking and chasing its prey. Indeed, studies of animal models and human subjects demonstrate robust beneficial effects of regular exercise and intermittent energy restriction/fasting on cognitive function and mood, particularly in the contexts of aging and associated neurodegenerative disorders. Unfortunately, the agricultural revolution and the invention of effort-sparing technologies have resulted in a dramatic reduction or elimination of vigorous exercise and fasting, leaving only intellectual challenges to bolster brain function. In addition to disengaging beneficial adaptive responses in the brain, sedentary overindulgent lifestyles promote obesity, diabetes and cardiovascular disease, all of which may increase the risk of cognitive impairment and Alzheimer's disease. It is therefore important to embrace the reality of the requirements for exercise, intermittent fasting and critical thinking for optimal brain health throughout life, and to recognize the dire consequences for our aging population of failing to implement such brain-healthy lifestyles. PMID:25576651

  1. Prion Infection of Mouse Brain Reveals Multiple New Upregulated Genes Involved in Neuroinflammation or Signal Transduction

    OpenAIRE

    Carroll, James A.; Striebel, James F.; Race, Brent; Phillips, Katie; Chesebro, Bruce

    2014-01-01

    Gliosis is often a preclinical pathological finding in neurodegenerative diseases, including prion diseases, but the mechanisms facilitating gliosis and neuronal damage in these diseases are not understood. To expand our knowledge of the neuroinflammatory response in prion diseases, we assessed the expression of key genes and proteins involved in the inflammatory response and signal transduction in mouse brain at various times after scrapie infection. In brains of scrapie-infected mice at pre...

  2. Multiple health behavior change: a synopsis and comment on “A review of multiple health behavior change interventions for primary prevention”

    OpenAIRE

    Johnston, Winter; Buscemi, Joanna; Coons, Michael J.

    2013-01-01

    The ninth column on Evidence-Based Behavioral Medicine is a synthesis of a recent systematic meta-review of multiple health behavior change (MHBC) interventions published by Prochaska and Prochaska in the American Journal of Lifestyle Medicine (Am J Life Med 5:208–221, 2011). Health risk behaviors are highly prevalent and increase the risk of developing and exacerbating chronic disease. The purpose of the meta-review was to examine the efficacy of MHBC interventions in a variety of population...

  3. The auditory and non-auditory brain areas involved in tinnitus. An emergent property of multiple parallel overlapping subnetworks.

    Science.gov (United States)

    Vanneste, Sven; De Ridder, Dirk

    2012-01-01

    Tinnitus is the perception of a sound in the absence of an external sound source. It is characterized by sensory components such as the perceived loudness, the lateralization, the tinnitus type (pure tone, noise-like) and associated emotional components, such as distress and mood changes. Source localization of quantitative electroencephalography (qEEG) data demonstrate the involvement of auditory brain areas as well as several non-auditory brain areas such as the anterior cingulate cortex (dorsal and subgenual), auditory cortex (primary and secondary), dorsal lateral prefrontal cortex, insula, supplementary motor area, orbitofrontal cortex (including the inferior frontal gyrus), parahippocampus, posterior cingulate cortex and the precuneus, in different aspects of tinnitus. Explaining these non-auditory brain areas as constituents of separable subnetworks, each reflecting a specific aspect of the tinnitus percept increases the explanatory power of the non-auditory brain areas involvement in tinnitus. Thus, the unified percept of tinnitus can be considered an emergent property of multiple parallel dynamically changing and partially overlapping subnetworks, each with a specific spontaneous oscillatory pattern and functional connectivity signature. PMID:22586375

  4. A comprehensive approach to the segmentation of multichannel three-dimensional MR brain images in multiple sclerosis.

    Science.gov (United States)

    Datta, Sushmita; Narayana, Ponnada A

    2013-01-01

    Accurate classification and quantification of brain tissues is important for monitoring disease progression, measurement of atrophy, and correlating magnetic resonance (MR) measures with clinical disability. Classification of MR brain images in the presence of lesions, such as multiple sclerosis (MS), is particularly challenging. Images obtained with lower resolution often suffer from partial volume averaging leading to false classifications. While partial volume averaging can be reduced by acquiring volumetric images at high resolution, image segmentation and quantification can be technically challenging. In this study, we integrated the brain anatomical knowledge with non-parametric and parametric statistical classifiers for automatically classifying tissues and lesions on high resolution multichannel three-dimensional images acquired on 60 MS brains. The results of automatic lesion segmentation were reviewed by the expert. The agreement between results obtained by the automated analysis and the expert was excellent as assessed by the quantitative metrics, low absolute volume difference percent (36.18 ± 34.90), low average symmetric surface distance (1.64 mm ± 1.30 mm), high true positive rate (84.75 ± 12.69), and low false positive rate (34.10 ± 16.00). The segmented results were also in close agreement with the corrected results as assessed by Bland-Altman and regression analyses. Finally, our lesion segmentation was validated using the MS lesion segmentation grand challenge dataset (MICCAI 2008). PMID:24179773

  5. Enhancing multiple object tracking performance with noninvasive brain stimulation: A causal role for the anterior intraparietal sulcus

    Directory of Open Access Journals (Sweden)

    Eric Joshua Blumberg

    2015-02-01

    Full Text Available Multiple object tracking (MOT is a complex task recruiting a distributed network of brain regions. There are also marked individual differences in MOT performance. A positive causal relationship between the anterior intraparietal sulcus (AIPS, an integral region in the MOT attention network and inter-individual variation in MOT performance has not been previously established. The present study used transcranial direction current stimulation (tDCS, a form of non-invasive brain stimulation, in order to examine such a causal link. Active anodal stimulation was applied to the right AIPS and the left dorsolateral prefrontal cortex (and sham stimulation, an area associated with working memory (but not MOT while participants completed a MOT task. Stimulation to the right AIPS significantly improved MOT accuracy more than the other two conditions. The results confirm a causal role of the AIPS in the MOT task and illustrate that transcranial direct current stimulation has the ability to improve MOT performance.

  6. Serious brain injury coexisting with multiple injuries caused by traffic accidents in 69 cases

    Institute of Scientific and Technical Information of China (English)

    张浚; 张鹤飞; 等

    1999-01-01

    Objective To explore the speciality,diagnosis,cure principle of serious brain injury coexisting with nultiple injuries caused by traffic accidents.Methods To analyze the clinic data of 69 cases of serious rain injury combined by oter parts of injuries caused by traffic accidents received from January 1998 to April 1999.Results This type of injury took up 11.5 percent of brain injuries in the same term and 33.6 percent of serious brain injuries.The specialities of the injury are that most of them were pedestrians crashed by vehicles.Coesisting injuries including chest injury and limb fractures accounted for a large part.The brain injury usally presented profound disturbance of consciousness,being dangerous and complicated,and a high ISS value.After treatment 13 cases died,9 cases was heavily crippled,11 cases lightly crippled,and 36 cases recovered.The death was usually caused by brain injury.Conclusions Road traffic accidents increased substantially every year.Most of them are related with violating drive rules and regulations.It is important to decrease the road traffic accidents by strengthening propaganda on traffic safety and traffic management.The main principles for salvage should emphasize the importance of pre-hospital emergency rescue and the accurate diagnosis rate,especially the distinction between coma and shock.The priority should be put on those injuries threatening to life.

  7. Multiple faces of pain: effects of chronic pain on the brain regulation of facial expression.

    Science.gov (United States)

    Vachon-Presseau, Etienne; Roy, Mathieu; Woo, Choong-Wan; Kunz, Miriam; Martel, Marc-Olivier; Sullivan, Michael J; Jackson, Philip L; Wager, Tor D; Rainville, Pierre

    2016-08-01

    Pain behaviors are shaped by social demands and learning processes, and chronic pain has been previously suggested to affect their meaning. In this study, we combined functional magnetic resonance imaging with in-scanner video recording during thermal pain stimulations and use multilevel mediation analyses to study the brain mediators of pain facial expressions and the perception of pain intensity (self-reports) in healthy individuals and patients with chronic back pain (CBP). Behavioral data showed that the relation between pain expression and pain report was disrupted in CBP. In both patients with CBP and healthy controls, brain activity varying on a trial-by-trial basis with pain facial expressions was mainly located in the primary motor cortex and completely dissociated from the pattern of brain activity varying with pain intensity ratings. Stronger activity was observed in CBP specifically during pain facial expressions in several nonmotor brain regions such as the medial prefrontal cortex, the precuneus, and the medial temporal lobe. In sharp contrast, no moderating effect of chronic pain was observed on brain activity associated with pain intensity ratings. Our results demonstrate that pain facial expressions and pain intensity ratings reflect different aspects of pain processing and support psychosocial models of pain suggesting that distinctive mechanisms are involved in the regulation of pain behaviors in chronic pain. PMID:27411160

  8. Imaging and clinical characteristics of children with multiple foci of microsusceptibility changes in the brain on susceptibility-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Niwa, Tetsu [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, PO Box 85500, Utrecht (Netherlands); Aida, Noriko; Fujita, Kazutoshi; Shishikura, Ayako [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Takahara, Taro; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, PO Box 85500, Utrecht (Netherlands); Miyata, Daiki [Kanagawa Children' s Medical Center, Department of Circulation Medicine, Yokohama (Japan); Inoue, Tomio [Yokohama City University, Graduate School of Medicine, Department of Radiology, Yokohama (Japan)

    2010-10-15

    Microsusceptibility changes in the brain are well known to correspond with microbleeds or micrometal fragments in adults, but this phenomenon has not been explored well in children. To assess imaging and clinical characteristics of children with multiple foci of microsusceptibility changes using susceptibility-weighted imaging (SWI). Between 2006 and 2008, 12 children with multiple foci of microsusceptibility on SWI without corresponding abnormal signal on conventional MRI were identified and were retrospectively assessed. The locations of foci of microsusceptibility included the cerebral white matter, basal ganglia, brainstem and cerebellar white matter, without any clear systematic anatomic distribution. CT (n = 5) showed no calcification at the locations corresponding to the microsusceptibility on SWI. Conventional MR imaging showed white matter volume loss (n = 5), delayed myelination (n = 2), acute infarction (n = 1), chronic infarction (n = 1), meningitis (n = 1), slight signal abnormality in the white matter (n = 1) and no abnormal findings (n = 1). Follow-up SWI (n = 3) showed no change of the microsusceptibility foci. Interestingly, all children had a history of heart surgery under extracorporeal circulation for congenital heart disease. Multiple foci of microsusceptibility can be seen in the brain on SWI in children with congenital heart disease who underwent heart surgery with extracorporeal circulation. (orig.)

  9. Examining relationships between multiple health risk behaviors, well-being, and productivity.

    Science.gov (United States)

    Evers, Kerry E; Castle, Patricia H; Prochaska, James O; Prochaska, Janice M

    2014-06-01

    Traditionally, the concept of health promotion has emphasized the reduction of health risk behaviors to reduce disease and impairment. Well-being research expands this focus to include positive constructs such as thriving, productivity, life-evaluation, and emotional and physical health. The objective of the present study was to examine the relationships between health risk behaviors and specific measures of individual well-being. Participants (N = 790) from 49 states completed a one-time online assessment that included the Life-Evaluation Index, Emotional and Physical Health Ladders, the Health Risk Intervention Assessment, and the Work Productivity and Activity Improvement Questionnaire for General Health. Life Evaluation and physical and emotional health were all inversely related to the number of health risk behaviors, with higher well-being scores associated with lower number of risk behaviors. Across the three Life Evaluation categories (Suffering, Struggling, and Thriving) the number of health risk behaviors decreased, productivity loss decreased, and emotional and physical health increased. The results add to previous research on how reducing multiple health risk behaviors can be combined with well-being, i.e., an emphasis on increasing life-evaluation, emotional and physical health, better functioning, and productivity.

  10. Network science and the human brain: Using graph theory to understand the brain and one of its hubs, the amygdala, in health and disease.

    Science.gov (United States)

    Mears, David; Pollard, Harvey B

    2016-06-01

    Over the past 15 years, the emerging field of network science has revealed the key features of brain networks, which include small-world topology, the presence of highly connected hubs, and hierarchical modularity. The value of network studies of the brain is underscored by the range of network alterations that have been identified in neurological and psychiatric disorders, including epilepsy, depression, Alzheimer's disease, schizophrenia, and many others. Here we briefly summarize the concepts of graph theory that are used to quantify network properties and describe common experimental approaches for analysis of brain networks of structural and functional connectivity. These range from tract tracing to functional magnetic resonance imaging, diffusion tensor imaging, electroencephalography, and magnetoencephalography. We then summarize the major findings from the application of graph theory to nervous systems ranging from Caenorhabditis elegans to more complex primate brains, including man. Focusing, then, on studies involving the amygdala, a brain region that has attracted intense interest as a center for emotional processing, fear, and motivation, we discuss the features of the amygdala in brain networks for fear conditioning and emotional perception. Finally, to highlight the utility of graph theory for studying dysfunction of the amygdala in mental illness, we review data with regard to changes in the hub properties of the amygdala in brain networks of patients with depression. We suggest that network studies of the human brain may serve to focus attention on regions and connections that act as principal drivers and controllers of brain function in health and disease.

  11. A Simple and Efficient Methodology To Improve Geometric Accuracy in Gamma Knife Radiation Surgery: Implementation in Multiple Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Karaiskos, Pantelis, E-mail: pkaraisk@med.uoa.gr [Medical Physics Laboratory, Medical School, University of Athens (Greece); Gamma Knife Department, Hygeia Hospital, Athens (Greece); Moutsatsos, Argyris; Pappas, Eleftherios; Georgiou, Evangelos [Medical Physics Laboratory, Medical School, University of Athens (Greece); Roussakis, Arkadios [CT and MRI Department, Hygeia Hospital, Athens (Greece); Torrens, Michael [Gamma Knife Department, Hygeia Hospital, Athens (Greece); Seimenis, Ioannis [Medical Physics Laboratory, Medical School, Democritus University of Thrace, Alexandroupolis (Greece)

    2014-12-01

    Purpose: To propose, verify, and implement a simple and efficient methodology for the improvement of total geometric accuracy in multiple brain metastases gamma knife (GK) radiation surgery. Methods and Materials: The proposed methodology exploits the directional dependence of magnetic resonance imaging (MRI)-related spatial distortions stemming from background field inhomogeneities, also known as sequence-dependent distortions, with respect to the read-gradient polarity during MRI acquisition. First, an extra MRI pulse sequence is acquired with the same imaging parameters as those used for routine patient imaging, aside from a reversal in the read-gradient polarity. Then, “average” image data are compounded from data acquired from the 2 MRI sequences and are used for treatment planning purposes. The method was applied and verified in a polymer gel phantom irradiated with multiple shots in an extended region of the GK stereotactic space. Its clinical impact in dose delivery accuracy was assessed in 15 patients with a total of 96 relatively small (<2 cm) metastases treated with GK radiation surgery. Results: Phantom study results showed that use of average MR images eliminates the effect of sequence-dependent distortions, leading to a total spatial uncertainty of less than 0.3 mm, attributed mainly to gradient nonlinearities. In brain metastases patients, non-eliminated sequence-dependent distortions lead to target localization uncertainties of up to 1.3 mm (mean: 0.51 ± 0.37 mm) with respect to the corresponding target locations in the “average” MRI series. Due to these uncertainties, a considerable underdosage (5%-32% of the prescription dose) was found in 33% of the studied targets. Conclusions: The proposed methodology is simple and straightforward in its implementation. Regarding multiple brain metastases applications, the suggested approach may substantially improve total GK dose delivery accuracy in smaller, outlying targets.

  12. Health and Pleasure in Consumers' Dietary Food Choices: Individual Differences in the Brain's Value System.

    Science.gov (United States)

    Petit, Olivia; Merunka, Dwight; Anton, Jean-Luc; Nazarian, Bruno; Spence, Charles; Cheok, Adrian David; Raccah, Denis; Oullier, Olivier

    2016-01-01

    Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI) focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula), reward value (orbitofrontal cortex), and self-control (inferior frontal gyrus), and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum). Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched.

  13. Health and Pleasure in Consumers' Dietary Food Choices: Individual Differences in the Brain's Value System.

    Science.gov (United States)

    Petit, Olivia; Merunka, Dwight; Anton, Jean-Luc; Nazarian, Bruno; Spence, Charles; Cheok, Adrian David; Raccah, Denis; Oullier, Olivier

    2016-01-01

    Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI) focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula), reward value (orbitofrontal cortex), and self-control (inferior frontal gyrus), and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum). Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched. PMID:27428267

  14. Health and Pleasure in Consumers' Dietary Food Choices: Individual Differences in the Brain's Value System

    Science.gov (United States)

    Petit, Olivia; Merunka, Dwight; Anton, Jean-Luc; Nazarian, Bruno; Spence, Charles; Cheok, Adrian David; Raccah, Denis; Oullier, Olivier

    2016-01-01

    Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI) focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula), reward value (orbitofrontal cortex), and self-control (inferior frontal gyrus), and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum). Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched. PMID:27428267

  15. Health and Pleasure in Consumers' Dietary Food Choices: Individual Differences in the Brain's Value System.

    Directory of Open Access Journals (Sweden)

    Olivia Petit

    Full Text Available Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula, reward value (orbitofrontal cortex, and self-control (inferior frontal gyrus, and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum. Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched.

  16. Neuro-nutraceuticals: The path to brain health via nourishment is not so distant.

    Science.gov (United States)

    Williams, Robert J; Mohanakumar, Kochupurackal P; Beart, Philip M

    2015-10-01

    In this Special Issue on "Nutraceuticals: Molecular and Functional Insights into how Natural Products Nourish the Brain", the editors bring together contributions from experts in nutraceutical research to provide a contemporary overview of how select chemically identified molecules can beneficially affect brain function at the molecular level. Other contributions address key emergent issues such as bioavailability, formulation, blood brain permeability, neuronal health and inflammation that impact upon how nutraceuticals ultimately leverage the brain to function better. Whilst nutraceutical is used as marketing term, it has no regulatory definition, and there is a continuing need for licensing authorities to ensure that adequate guidelines exist pertinent to the safety to guide consumers internationally. In terms of the benefit of nutraceuticals is it clear that some naturally occurring molecules can be advantageous to both the young and aged brain, and that they have actions that ultimately can be directed to aid either in the improvement of cognition or in the management of debilitating neurodegenerative and neuropsychiatric conditions. PMID:26303091

  17. A tumefactive multiple sclerosis lesion in the brain: An uncommon site with atypical magnetic resonance image findings

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Min Sun; Kim, Hyun Sook; Kim, Jae Hoon; Kim, Eun Kyung; Choi, Yun Sun [Eulji Hospital, Eulji University, Seoul (Korea, Republic of)

    2013-11-15

    Tumefactive multiple sclerosis (MS) is a rare type of demyelinating disease. Typical magnetic resonance (MR) image findings show incomplete ring enhancement with a mild mass effect. This lesion is otherwise indistinguishable from other mass-like lesions in the brain. Knowledge of the MR imaging findings for tumefactive MS is thus helpful for correct diagnosis and appropriate therapy. In this report we describe the MR image findings for pathology-confirmed tumefactive MS in an uncommon location, alongside a discussion of its aggressive features.

  18. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2009-03-01

    Full Text Available Background: Radiotherapy for patients suffering from malignant neoplasms has developed greatly during the past decades. Stereotactic radiosurgery (SRS is one important radiotherapeutic option which is defined by a single and highly focussed application of radiation during a specified time interval. One of its important indications is the treatment of brain metastases. Objectives: The objective of this HTA is to summarise the current literature concerning the treatment of brain metastasis and to compare SRS as a single or additional treatment option to alternative treatment options with regard to their medical effectiveness/efficacy, safety and cost-effectiveness as well as their ethical, social and legal implications. Methods: A structured search and hand search of identified literature are performed from January 2002 through August 2007 to identify relevant publications published in English or German. Studies targeting patients with single or multiple brain metastases are included. The methodological quality of included studies is assessed according to quality criteria, based on the criteria of evidence based medicine. Results: Of 1,495 publications 15 medical studies meet the inclusion criteria. Overall study quality is limited and with the exception of two randomized controlleed trials (RCT and two meta-analyses only historical cohort studies are identified. Reported outcome measures are highly variable between studies. Studies with high methodological quality provide evidence, that whole-brain radiotherapy (WBRT in addition to SRS and SRS in addition to WBRT is associated with improved local tumour control rates and neurological function. However, only in patients with single brain metastasis, RPA-class 1 (RPA = Recursive partitioning analysis and certain primary tumour entities, this combination of SRS and WBRT is associated with superior survival compared to WBRT alone. Studies report no significant differences in adverse events between

  19. Occupational stress and psychopathology in health professionals: an explorative study with the multiple indicators multiple causes (MIMIC) model approach.

    Science.gov (United States)

    Iliceto, Paolo; Pompili, Maurizio; Spencer-Thomas, Sally; Ferracuti, Stefano; Erbuto, Denise; Lester, David; Candilera, Gabriella; Girardi, Paolo

    2013-03-01

    Occupational stress is a multivariate process involving sources of pressure, psycho-physiological distress, locus of control, work dissatisfaction, depression, anxiety, mental health disorders, hopelessness, and suicide ideation. Healthcare professionals are known for higher rates of occupational-related distress (burnout and compassion fatigue) and higher rates of suicide. The purpose of this study was to explain the relationships between occupational stress and some psychopathological dimensions in a sample of health professionals. We investigated 156 nurses and physicians, 62 males and 94 females, who were administered self-report questionnaires to assess occupational stress [occupational stress inventory (OSI)], temperament (temperament evaluation of Memphis, Pisa, Paris, and San Diego autoquestionnaire), and hopelessness (Beck hopelessness scale). The best Multiple Indicators Multiple Causes model with five OSI predictors yielded the following results: χ2(9) = 14.47 (p = 0.11); χ2/df = 1.60; comparative fit index = 0.99; root mean square error of approximation = 0.05. This model provided a good fit to the empirical data, showing a strong direct influence of casual variables such as work dissatisfaction, absence of type A behavior, and especially external locus of control, psychological and physiological distress on latent variable psychopathology. Occupational stress is in a complex relationship with temperament and hopelessness and also common among healthcare professionals. PMID:22632290

  20. Her versus his migraine: multiple sex differences in brain function and structure.

    Science.gov (United States)

    Maleki, Nasim; Linnman, Clas; Brawn, Jennifer; Burstein, Rami; Becerra, Lino; Borsook, David

    2012-08-01

    Migraine is twice as common in females as in males, but the mechanisms behind this difference are still poorly understood. We used high-field magnetic resonance imaging in male and female age-matched interictal (migraine free) migraineurs and matched healthy controls to determine alterations in brain structure. Female migraineurs had thicker posterior insula and precuneus cortices compared with male migraineurs and healthy controls of both sexes. Furthermore, evaluation of functional responses to heat within the migraine groups indicated concurrent functional differences in male and female migraineurs and a sex-specific pattern of functional connectivity of these two regions with the rest of the brain. The results support the notion of a 'sex phenotype' in migraine and indicate that brains are differentially affected by migraine in females compared with males. Furthermore, the results also support the notion that sex differences involve both brain structure as well as functional circuits, in that emotional circuitry compared with sensory processing appears involved to a greater degree in female than male migraineurs. PMID:22843414

  1. Integrating multiple health behavior theories into program planning: the PER worksheet.

    Science.gov (United States)

    Langlois, Marietta A; Hallam, Jeffrey S

    2010-03-01

    The foundation of a logic model or any theory-based planning model is the identification of the behavioral antecedents and the relationship of these variables to the target behavior. Applying theoretical concepts to specific behaviors and populations is often challenging for practitioners and program planning students. The challenge comes from the abstract definition of theoretical constructs, the duplication of similar constructs in multiple theories, and the need to combine multiple theories. To simplify the planning process when utilizing logic models and health behavior theory, we recommend the use of the PER Worksheet. The PER Worksheet is a planning tool that provides layman-term prompts for identifying health behavior antecedents. It encompasses five common health behavior theories-health belief model, theory of planned behavior, social cognitive theory, an ecological perspective, and transtheoretical model. The PER Worksheet is organized into three columns: Predisposing, Enabling, and Reinforcing factors, terms of the PRECEDE/PROCEED model. PMID:18552278

  2. Long-Term Survival in a Patient with Multiple Brain Metastases from Small-Cell Lung Cancer Treated with Gamma Knife Radiosurgery on Four Occasions: A Case Report

    Directory of Open Access Journals (Sweden)

    Ameer L. Elaimy

    2012-01-01

    Full Text Available Brain metastases are the most common cancerous neoplasm in the brain. The treatment of these lesions is challenging and often includes a multimodality management approach with whole-brain radiation therapy, stereotactic radiosurgery, and neurosurgery options. Although advances in biomedical imaging technologies and the treatment of extracranial cancer have led to the overall increase in the survival of brain metastases patients, the finding that select patients survive several years remains puzzling. For this reason, we present the case of a 70-year-old patient who was diagnosed with multiple brain metastases from small-cell lung cancer five years ago and is currently alive following treatment with chemotherapy for the primary cancer and whole-brain radiation therapy and Gamma Knife radiosurgery on four separate occasions for the neurological cancer. Since the diagnosis of brain metastases five years ago, the patient’s primary cancer has remained controlled. Furthermore, multiple repeat GKRS procedures provided this patient with high levels of local tumor control, which in combination with a stable primary cancer led to an extended period of survival and a highly functional life. Further analysis and clinical research will be valuable in assessing the durability of multiple GKRS for brain metastases patients who experience long-term survival.

  3. The Canadian survey of health, lifestyle and ageing with multiple sclerosis: methodology and initial results

    OpenAIRE

    Ploughman, Michelle; Beaulieu, Serge; Harris, Chelsea; Hogan, Stephen; Manning, Olivia J; Alderdice, Penelope W; Fisk, John D.; Sadovnick, A Dessa; O'Connor, Paul; Morrow, Sarah A; Metz, Luanne M.; Smyth, Penelope; Mayo, Nancy; Marrie, Ruth Ann; Knox, Katherine B

    2014-01-01

    Objective People with multiple sclerosis (MS) are living longer so strategies to enhance long-term health are garnering more interest. We aimed to create a profile of ageing with MS in Canada by recruiting 1250 (5% of the Canadian population above 55 years with MS) participants and focusing data collection on health and lifestyle factors, disability, participation and quality of life to determine factors associated with healthy ageing. Design National multicentre postal survey. Setting Recrui...

  4. Clustering and correlates of multiple health behaviours in 9-10 year old children

    OpenAIRE

    Leonie K Elsenburg; Eva Corpeleijn; Esther M F van Sluijs; Atkin, Andrew J

    2014-01-01

    Background: Sleep, physical activity, screen time and dietary behaviours influence health during childhood, but few studies have looked at all of these behaviours simultaneously and previous research has relied predominantly on self- or proxy-reports of physical activity and food frequency questionnaires for the assessment of diet. Purpose: To assess the prevalence and clustering of health behaviours and examine the socio-demographic characteristics of children that fail to meet multiple ...

  5. Associations of multiplicity of comorbid health conditions, serious mental illness, and health care costs.

    Science.gov (United States)

    Lee, Sungkyu; Black, Denise; Held, Mary

    2016-08-01

    Using a nationally representative U.S. sample, this study analyzed the effects of serious mental illness (SMI) and comorbid medical conditions on the cost of health care. The results of path model indicated that SMI and comorbid health conditions each increased total health care costs. Additionally, individuals with SMI were likely to have more comorbid medical conditions, which in turn, increased total health care costs. Findings raise awareness of an increased risk of medical conditions among individuals with SMI and the concern of high expenditures associated with comorbid SMI and medical conditions. PMID:27285200

  6. Formal Derivation of Lotka-Volterra-Haken Amplitude Equations of Task-Related Brain Activity in Multiple, Consecutively Performed Tasks

    Science.gov (United States)

    Frank, T. D.

    The Lotka-Volterra-Haken equations have been frequently used in ecology and pattern formation. Recently, the equations have been proposed by several research groups as amplitude equations for task-related patterns of brain activity. In this theoretical study, the focus is on the circular causality aspect of pattern formation systems as formulated within the framework of synergetics. Accordingly, the stable modes of a pattern formation system inhibit the unstable modes, whereas the unstable modes excite the stable modes. Using this circular causality principle it is shown that under certain conditions the Lotka-Volterra-Haken amplitude equations can be derived from a general model of brain activity akin to the Wilson-Cowan model. The model captures the amplitude dynamics for brain activity patterns in experiments involving several consecutively performed multiple-choice tasks. This is explicitly demonstrated for two-choice tasks involving grasping and walking. A comment on the relevance of the theoretical framework for clinical psychology and schizophrenia is given as well.

  7. SU-E-T-629: Feasibility Study of Treating Multiple Brain Tumors with Large Number of Noncoplanar IMRT Beams

    Energy Technology Data Exchange (ETDEWEB)

    Dong, P; Ma, L [UC San Francisco, San Francisco, CA (United States)

    2014-06-15

    Purpose: To study the feasibility of treating multiple brain tumors withlarge number of noncoplanar IMRT beams. Methods: Thirty beams are selected from 390 deliverable beams separated by six degree in 4pi space. Beam selection optimization is based on a column generation algorithm. MLC leaf size is 2 mm. Dose matrices are calculated with collapsed cone convolution and superposition method in a 2 mm by 2mm by 2 mm grid. Twelve brain tumors of various shapes, sizes and locations are used to generate four plans treating 3, 6, 9 and 12 tumors. The radiation dose was 20 Gy prescribed to the 100% isodose line. Dose Volume Histograms for tumor and brain were compared. Results: All results are based on a 2 mm by 2 mm by 2 mm CT grid. For 3, 6, 9 and 12 tumor plans, minimum tumor doses are all 20 Gy. Mean tumor dose are 20.0, 20.1, 20.1 and 20.1 Gy. Maximum tumor dose are 23.3, 23.6, 25.4 and 25.4 Gy. Mean ventricles dose are 0.7, 1.7, 2.4 and 3.1 Gy.Mean subventricular zone dose are 0.8, 1.3, 2.2 and 3.2 Gy. Average Equivalent uniform dose (gEUD) values for tumor are 20.1, 20.1, 20.2 and 20.2 Gy. The conformity index (CI) values are close to 1 for all 4 plans. The gradient index (GI) values are 2.50, 2.05, 2.09 and 2.19. Conclusion: Compared with published Gamma Knife treatment studies, noncoplanar IMRT treatment plan is superior in terms of dose conformity. Due to maximum limit of beams per plan, Gamma knife has to treat multiple tumors separately in different plans. Noncoplanar IMRT plans theoretically can be delivered in a single plan on any modern linac with an automated couch and image guidance. This warrants further study of using noncoplanar IMRT as a viable treatment solution for multiple brain tumors.

  8. Oligoclonal bands in the cerebrospinal fluid and increased brain atrophy in early stages of relapsing-remitting multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Juan Ignacio Rojas

    2012-08-01

    Full Text Available OBJECTIVE: To determine if the presence of oligoclonal bands (OB at early stages of multiple sclerosis was associated with higher brain atrophy, when compared with patients without OB. METHODS: Relapsing-remitting multiple sclerosis (RRMS patients with less than two years of disease onset and OB detection in cerebrospinal fluid (CSF were included. SIENAX was used for total brain volume (TBV, gray matter volume (GMV, and white matter volume (WMV. RESULTS: Forty patients were included, 29 had positive IgG-OB. No differences were found between positive and negative patients in gender, expanded disability status scale (EDSS, treatment received, and T2/T1 lesion load. TBV in positive IgG-OB patients was 1.5 mm³ x 10(6 compared with 1.64 mm³ x 10(6 in the negative ones (p=0.02. GMV was 0.51 mm³ x 10(6 in positive IgG-OB compared with 0.62 mm³ x 10(6 in negative ones (p=0.002. No differences in WMV (p=0.09 were seen. CONCLUSIONS: IgG-OB in the CSF was related to neurodegeneration magnetic resonance (MR markers in early RRMS.

  9. Derivatization for the simultaneous LC/MS quantification of multiple neurotransmitters in extracellular fluid from rat brain microdialysis.

    Science.gov (United States)

    Zhang, Minli; Fang, Chengwei; Smagin, Gennady

    2014-11-01

    Quantification of amino acid based neurotransmitters in extracellular fluids, such as those in the neuron synapse, presents a challenge to the analytical chemistry because of the absence of UV- or fluorescence-detectable functional groups and the low sensitivity in mass spectrometric detection. This report describes a novel use of the succinimide reagent, N-α-Boc-l-tryptophan hydroxysuccinimide ester (Boc-TRP), for the pre-column derivatization to simultaneously quantify multiple neurotransmitters in the rat brain microdialysis samples. The Boc-TRP derivatization was rapid and quantitative in phosphate the buffer (pH 7.4) at room temperature. The derivatized neurotransmitters were suitable for rapid LC/MS quantification with less than 3-min chromatographic separation. The Boc-group in the derivatized product generated unique fragmentation patterns in the triple quadrupole mass spectrometric analysis under Multiple Reaction Monitoring mode and significantly increased the specificity and sensitivity. The derivatization and rapid LC/MS quantification method developed in this study showed a linear dynamic range from single digit nM to 1000nM with coefficient greater than 0.990. At the LOQ, the accuracy ranged from 95 to 108% and the precision (CV%) was less than 20%. Since there was no concentration and reconstitution in the sample workup process, this derivatization approach simplified the neurotransmitter quantification of the brain microdialysis samples. PMID:25200427

  10. Variable dose interplay effects across radiosurgical apparatus in treating multiple brain metastases

    OpenAIRE

    Ma, Lijun; Nichol, Alan; Hossain, Sabbir; Wang, Brian; Petti, Paula; Vellani, Rosemin; Higby, Chris; Ahmad, Salahuddin; Barani, Igor; Shrieve, Dennis C; Larson, David A.; Sahgal, Arjun

    2014-01-01

    Purpose Normal brain tissue doses have been shown to be strongly apparatus dependent for multi-target stereotactic radiosurgery. In this study, we investigated whether inter-target dose interplay effects across contemporary radiosurgical treatment platforms are responsible for such an observation. Methods For the study, subsets ( \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepack...

  11. Her versus his migraine: multiple sex differences in brain function and structure

    OpenAIRE

    Maleki, Nasim; Linnman, Clas; Brawn, Jennifer; Burstein, Rami; Becerra, Lino; Borsook, David

    2012-01-01

    Migraine is twice as common in females as in males, but the mechanisms behind this difference are still poorly understood. We used high-field magnetic resonance imaging in male and female age-matched interictal (migraine free) migraineurs and matched healthy controls to determine alterations in brain structure. Female migraineurs had thicker posterior insula and precuneus cortices compared with male migraineurs and healthy controls of both sexes. Furthermore, evaluation of functional response...

  12. Long-term music training tunes how the brain temporally binds signals from multiple senses

    OpenAIRE

    Lee, Hweeling; Noppeney, Uta

    2011-01-01

    Practicing a musical instrument is a rich multisensory experience involving the integration of visual, auditory, and tactile inputs with motor responses. This combined psychophysics–fMRI study used the musician's brain to investigate how sensory-motor experience molds temporal binding of auditory and visual signals. Behaviorally, musicians exhibited a narrower temporal integration window than nonmusicians for music but not for speech. At the neural level, musicians showed increased audiovisua...

  13. Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction

    NARCIS (Netherlands)

    Vitkova, Marianna; Rosenberger, Jaroslav; Krokavcova, Martina; Szilasiova, Jarmila; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2014-01-01

    Purpose: Bladder, bowel and sexual dysfunction are often overlooked symptoms in patients with multiple sclerosis (MS) and can be associated with lower health-related quality of life (HRQoL). The aim is to explore the association of bladder, bowel and sexual dysfunction with HRQoL in MS patients stra

  14. Employment Status and Perceived Health Status in Younger and Older People with Multiple Sclerosis

    Science.gov (United States)

    Krokavcova, Martina; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2012-01-01

    This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (less than 45 years) and an older (greater than or equal to 45 years) age…

  15. Health-related quality of life in Iranian patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Pakpour, Amir H.; Yekaninejad, Mir Saeed; Mohammadi, Nastaran Keshavarz;

    2009-01-01

    Background and purpose: This study aimed to evaluate aspects of health-related quality of life (HRQoL) of patients with multiple sclerosis (MS) who live in Tehran and to compare data with evaluations of both the general population and MS patients in other countries Material and methods: One hundr...

  16. Social participation and health-related quality of life in people with multiple sclerosis

    NARCIS (Netherlands)

    Mikula, Pavol; Nagyova, Iveta; Krokavcova, Martina; Vitkova, Marianna; Rosenberger, Jaroslav; Szilasiova, Jarmila; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2015-01-01

    Background: Social participation is an integral part of everyday life in society; however, evidence about its association with health-related quality of life (HRQoL) in people with multiple sclerosis (MS) is lacking. Objective: The aim of this study is to explore whether social participation is asso

  17. Health consequences of racist and antigay discrimination for multiple minority adolescents.

    Science.gov (United States)

    Thoma, Brian C; Huebner, David M

    2013-10-01

    Individuals who belong to a marginalized group and who perceive discrimination based on that group membership suffer from a variety of poor health outcomes. Many people belong to more than one marginalized group, and much less is known about the influence of multiple forms of discrimination on health outcomes. Drawing on literature describing the influence of multiple stressors, three models of combined forms of discrimination are discussed: additive, prominence, and exacerbation. The current study examined the influence of multiple forms of discrimination in a sample of African American lesbian, gay, or bisexual (LGB) adolescents ages 14-19. Each of the three models of combined stressors were tested to determine which best describes how racist and antigay discrimination combine to predict depressive symptoms, suicidal ideation, and substance use. Participants were included in this analysis if they identified their ethnicity as either African American (n = 156) or African American mixed (n = 120). Mean age was 17.45 years (SD = 1.36). Results revealed both forms of mistreatment were associated with depressive symptoms and suicidal ideation among African American LGB adolescents. Racism was more strongly associated with substance use. Future intervention efforts should be targeted toward reducing discrimination and improving the social context of multiple minority adolescents, and future research with multiple minority individuals should be attuned to the multiple forms of discrimination experienced by these individuals within their environments. PMID:23731232

  18. Human brain endothelial cells endeavor to immunoregulate CD8 T cells via PD-1 ligand expression in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Pittet Camille L

    2011-11-01

    Full Text Available Abstract Background Multiple sclerosis (MS, an inflammatory disease of the central nervous system (CNS, is characterized by blood-brain barrier (BBB disruption and massive infiltration of activated immune cells. Engagement of programmed cell death-1 (PD-1 expressed on activated T cells with its ligands (PD-L1 and PD-L2 suppresses T cell responses. We recently demonstrated in MS lesions elevated PD-L1 expression by glial cells and absence of PD-1 on many infiltrating CD8 T cells. We have now investigated whether human brain endothelial cells (HBECs, which maintain the BBB, can express PD-L1 or PD-L2 and thereby modulate T cells. Methods We used primary cultures of HBECs isolated from non-tumoral CNS tissue either under basal or inflamed conditions. We assessed the expression of PD-L1 and PD-L2 using qPCR and flow cytometry. Human CD8 T cells were isolated from peripheral blood of healthy donors and co-cultured with HBECs. Following co-culture with HBECs, proliferation and cytokine production by human CD8 T cells were measured by flow cytometry whereas transmigration was determined using a well established in vitro model of the BBB. The functional impact of PD-L1 and PD-L2 provided by HBECs was determined using blocking antibodies. We performed immunohistochemistry for the detection of PD-L1 or PD-L2 concurrently with caveolin-1 (a cell specific marker for endothelial cells on post-mortem human brain tissues obtained from MS patients and normal controls. Results Under basal culture conditions, PD-L2 is expressed on HBECs, whilst PD-L1 is not detected. Both ligands are up-regulated under inflammatory conditions. Blocking PD-L1 and PD-L2 leads to increased transmigration and enhanced responses by human CD8 T cells in co-culture assays. Similarly, PD-L1 and PD-L2 blockade significantly increases CD4 T cell transmigration. Brain endothelium in normal tissues and MS lesions does not express detectable PD-L1; in contrast, all blood vessels in normal

  19. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

    Directory of Open Access Journals (Sweden)

    Tromp Noor

    2012-12-01

    Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.

  20. The effect of multiple reminders on response patterns in a Danish health survey

    DEFF Research Database (Denmark)

    Christensen, Anne I.; Ekholm, Ola; Kristensen, Peter L.;

    2015-01-01

    mailing respondents compared with only first mailing respondents. CONCLUSIONS: Multiple reminders were an effective way to increase the response rate in a national Danish health survey. However, when differences do exist between respondents and non-respondents, the results suggest that second and third......BACKGROUND: Reminders are routinely applied in surveys to increase response rates and reduce the possibility of bias. This study examines the effect of multiple reminders on the response rate, non-response bias, prevalence estimates and exposure-outcome relations in a national self......-administered health survey. METHODS: Data derive from the Danish National Health Survey 2010, in which 298 550 individuals (16 years of age or older) were invited to participate in a cross-sectional survey using a mixed-mode approach (paper and web questionnaires). At least two reminders were sent to non...

  1. Localized in vivo proton spectroscopy in the brain of patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Larsson, H B; Christiansen, P; Jensen, M;

    1991-01-01

    Localized proton spectroscopy was performed in 15 patients with acute or chronic multiple sclerosis (MS). Some of the patients were investigated serially, being given a total of 22 spectroscopic investigations. Resonances corresponding to free lipids were observed in six plaques. This was distinc......Localized proton spectroscopy was performed in 15 patients with acute or chronic multiple sclerosis (MS). Some of the patients were investigated serially, being given a total of 22 spectroscopic investigations. Resonances corresponding to free lipids were observed in six plaques...

  2. An acute dose of gamma-hydroxybutyric acid alters gene expression in multiple mouse brain regions.

    Science.gov (United States)

    Schnackenberg, B J; Saini, U T; Robinson, B L; Ali, S F; Patterson, T A

    2010-10-13

    Gamma-hydroxybutyric acid (GHB) is normally found in the brain in low concentrations and may function as a neurotransmitter, although the mechanism of action has not been completely elucidated. GHB has been used as a general anesthetic and is currently used to treat narcolepsy and alcoholism. Recreational use of GHB is primarily as a "club drug" and a "date rape drug," due to its amnesic effects. For this study, the hypothesis was that behavioral and neurochemical alterations may parallel gene expression changes in the brain after GHB administration. Adult male C57/B6N mice (n=5/group) were administered a single dose of 500 mg/kg GHB (i.p.) and were sacrificed 1, 2 and 4 h after treatment. Control mice were administered saline. Brains were removed and regionally dissected on ice. Total RNA from the hippocampus, cortex and striatum was extracted, amplified and labeled. Gene expression was evaluated using Agilent whole mouse genome 4x44K oligonucleotide microarrays. Microarray data were analyzed by ArrayTrack and differentially expressed genes (DEGs) were identified using P or = 1.7 as the criteria for significance. Principal component analysis (PCA) and Hierarchical Cluster Analysis (HCA) showed that samples from each time point clustered into distinct treatment groups with respect to sacrifice time. Ingenuity pathways analysis (IPA) was used to identify involved pathways. The results show that GHB induces gene expression alterations in hundreds of genes in the hippocampus, cortex and striatum, and the number of affected genes increases throughout a 4-h time course. Many of these DEGs are involved in neurological disease, apoptosis, and oxidative stress.

  3. Multiple Intelligence Theory and Foreign Language Learning: A Brain-Based Perspective

    Science.gov (United States)

    Arnold, Jane; Fonseca, Mª Carmen

    2004-01-01

    Gardner's Multiple Intelligences theory is presented as a cognitive perspective on intelligence which has profound implications for education in general. More specifically, it has led to the application of eight of these frames to language teaching and learning. In this chapter, we will argue in favour of the application of MIT to the EFL…

  4. Identification of multiple post-translational modifications in the porcine brain specific p25α

    NARCIS (Netherlands)

    Kleinnijenhuis, A.J.; Hedegaard, C.; Lundvig, D.; Sundbye, S.; Issinger, O.G.; Jensen, O.N.; Jensen, P.H.

    2008-01-01

    P25α is a protein normally expressed in oligodendrocytes and subcellular relocalization of p25α occurs in multiple system atrophy, Parkinson's disease and Lewy body dementia along with ectopic expression in neurons. Moreover, it accumulates in Lewy body inclusions with aggregated α-synuclein and is

  5. Xylohypha bantiana Multiple Brain Abscesses in a Patient with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Khalid F AlHabib

    2003-01-01

    Full Text Available Xylohypha bantiana is a rare cause of cerebral fungal infection (phaeohyphomycosis. We report on a 72-year-old man who, while taking several immunosuppressive medications for systemic lupus erythematosus, presented with multiple bilateral cerebral abscesses caused by X bantiana. The lesions were not surgically amenable and the patient died two months after discontinuing antifungal therapy.

  6. Screening of Toll-like receptors expression in multiple system atrophy brains

    DEFF Research Database (Denmark)

    Brudek, Tomasz; Winge, Kristian; Agander, Tina Klitmøller;

    2013-01-01

    their deregulation may play a role in neurodegeneration. Multiple system atrophy (MSA) together with Parkinson's disease belongs to a diverse group of neurodegenerative conditions termed α-synucleinopathies. MSA is a fatal late onset disease characterized by the presence of α-synuclein positive glial cytoplasmic...

  7. Simultaneous imaging of multiple neurotransmitters and neuroactive substances in the brain by desorption electrospray ionization mass spectrometry.

    Science.gov (United States)

    Shariatgorji, Mohammadreza; Strittmatter, Nicole; Nilsson, Anna; Källback, Patrik; Alvarsson, Alexandra; Zhang, Xiaoqun; Vallianatou, Theodosia; Svenningsson, Per; Goodwin, Richard J A; Andren, Per E

    2016-08-01

    With neurological processes involving multiple neurotransmitters and neuromodulators, it is important to have the ability to directly map and quantify multiple signaling molecules simultaneously in a single analysis. By utilizing a molecular-specific approach, namely desorption electrospray ionization mass spectrometry imaging (DESI-MSI), we demonstrated that the technique can be used to image multiple neurotransmitters and their metabolites (dopamine, dihydroxyphenylacetic acid, 3-methoxytyramine, serotonin, glutamate, glutamine, aspartate, γ-aminobutyric acid, adenosine) as well as neuroactive drugs (amphetamine, sibutramine, fluvoxamine) and drug metabolites in situ directly in brain tissue sections. The use of both positive and negative ionization modes increased the number of identified molecular targets. Chemical derivatization by charge-tagging the primary amines of molecules significantly increased the sensitivity, enabling the detection of low abundant neurotransmitters and other neuroactive substances previously undetectable by MSI. The sensitivity of the imaging approach of neurochemicals has a great potential in many diverse applications in fields such as neuroscience, pharmacology, drug discovery, neurochemistry, and medicine. PMID:27155126

  8. Multiple contexts of exposure: Activity spaces, residential neighborhoods, and self-rated health.

    Science.gov (United States)

    Sharp, Gregory; Denney, Justin T; Kimbro, Rachel T

    2015-12-01

    Although health researchers have made progress in detecting place effects on health, existing work has largely focused on the local residential neighborhood and has lacked a temporal dimension. Little research has integrated both time and space to understand how exposure to multiple contexts - where adults live, work, shop, worship, and seek healthcare - influence and shape health and well-being. This study uses novel longitudinal data from the Los Angeles Family and Neighborhood Survey to delve deeper into the relationship between context and health by considering residential and activity space neighborhoods weighted by the amount of time spent in these contexts. Results from multilevel cross-classified logistic models indicate that contextual exposure to disadvantage, residential or non-residential, is independently associated with a higher likelihood of reporting poor or fair health. We also find support for a contextual incongruence hypothesis. For example, adults living in the most disadvantaged neighborhoods are more likely to report poor or fair health when they spend time in more advantaged neighborhoods than in more disadvantaged ones, while residents of more advantaged neighborhoods report worse health when they spend time in more disadvantaged areas. Our results suggest that certain types of place-based cumulative exposures are associated with a sense of relative neighborhood deprivation that potentially manifests in worse health ratings.

  9. Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Currie, Candace; Boyce, Will;

    2009-01-01

    ' absolute wealth and economic inequality explained part of the individual level socio-economic variation in health complaints. METHODS: The Health Behaviour in School-aged Children (HBSC) international study from 2005/06 provided data on 204,534 11-, 13- and 15-year old students from nationally random......OBJECTIVES: To use comparable data from many countries to examine 1) socio-economic inequality in multiple health complaints among adolescents, 2) whether the countries' absolute wealth and economic inequality was associated with symptom load among adolescents, and 3) whether the countries...... samples of schools in 37 countries in Europe and North America. The outcome measure was prevalence of at least two daily health complaints, measured by the HBSC Symptom Check List. We included three independent variables at the individual level (sex, age group, family affluence measured by the Family...

  10. Abscessos cerebrais múltiplos após apendicectomia: relato de caso Multiple brain abscesses following appendicectomy: case report

    Directory of Open Access Journals (Sweden)

    Michele Schops

    1996-06-01

    Full Text Available Paciente masculino de 39 anos, com quadro de abdomen agudo de evolução de 72 horas, foi submetido a apendicectomia. Desenvolveu 14 dias após, quadro de cefaléia, vômitos, afasia, torpor, hemiplegia à direita e rigidez de nuca. A tomografia computadorizada craniana mostrou múltiplos abscessos cerebrais supra tentoriais bilateralmente. Após punção aspirativa do maior deles foi instituída antibióticoterapia resultando em cura do paciente.A 39 years old male patient with a 72 hours evolution of acute abdominal syndrome was submitted to appendicectomy. Fourteen days later he developed headache, vomiting, aphasia, torpor, nuchal stiffness and right hemiplegia. A CT-scan showed multiple brain abscesses on both hemispheres. After aspirative puncture of the largest one, antibiotic treatment was established with total recovery of the patient.

  11. Lateral ventricular cerebrospinal fluid diffusivity as a potential neuroimaging marker of brain temperature in multiple sclerosis: a hypothesis and implications.

    Science.gov (United States)

    Hasan, Khader M; Lincoln, John A; Nelson, Flavia M; Wolinsky, Jerry S; Narayana, Ponnada A

    2015-04-01

    In this retrospective study we tested the hypothesis that the net effect of impaired electrical conduction and therefore increased heat dissipation in multiple sclerosis (MS) results in elevated lateral ventricular (LV) cerebrospinal fluid (CSF) diffusivity as a measure of brain temperature estimated in vivo using diffusion tensor imaging (DTI). We used validated DTI-based segmentation methods to obtain normalized LV-CSF volume and its corresponding CSF diffusivity in 108 MS patients and 103 healthy controls in the age range of 21-63 years. The LV CSF diffusivity was ~2% higher in MS compared to controls that correspond to a temperature rise of ~1°C that could not be explained by changes in the CSF viscosity due to altered CSF protein content in MS. The LV diffusivity decreased with age in healthy controls (r=-0.29; p=0.003), but not in MS (r=0.15; p=0.11), possibly related to MS pathology. Age-adjusted LV diffusivity increased with lesion load (r=0.518; p=1×10(-8)). Our data suggest that the total brain lesion load is the primary contributor to the increase in LV CSF diffusivity in MS. These findings suggest that LV diffusivity is a potential in vivo biomarker of the mismatch between heat generation and dissipation in MS. We also discuss limitations and possible confounders. PMID:25485790

  12. A system architecture for sharing de-identified, research-ready brain scans and health information across clinical imaging centers.

    Science.gov (United States)

    Chervenak, Ann L; van Erp, Theo G M; Kesselman, Carl; D'Arcy, Mike; Sobell, Janet; Keator, David; Dahm, Lisa; Murry, Jim; Law, Meng; Hasso, Anton; Ames, Joseph; Macciardi, Fabio; Potkin, Steven G

    2012-01-01

    Progress in our understanding of brain disorders increasingly relies on the costly collection of large standardized brain magnetic resonance imaging (MRI) data sets. Moreover, the clinical interpretation of brain scans benefits from compare and contrast analyses of scans from patients with similar, and sometimes rare, demographic, diagnostic, and treatment status. A solution to both needs is to acquire standardized, research-ready clinical brain scans and to build the information technology infrastructure to share such scans, along with other pertinent information, across hospitals. This paper describes the design, deployment, and operation of a federated imaging system that captures and shares standardized, de-identified clinical brain images in a federation across multiple institutions. In addition to describing innovative aspects of the system architecture and our initial testing of the deployed infrastructure, we also describe the Standardized Imaging Protocol (SIP) developed for the project and our interactions with the Institutional Review Board (IRB) regarding handling patient data in the federated environment. PMID:22941984

  13. Comprehensive oral-health assessment of individuals with acquired brain-injury in neuro-rehabilitation setting

    DEFF Research Database (Denmark)

    Kothari, Mohit; Spin-Neto, Rubens; Nielsen, Jørgen Feldbæk

    2016-01-01

    PRIMARY OBJECTIVE: To perform a detailed clinical oral health assessment and oral-health-related social and behavioural aspect assessment in individuals with acquired brain injury (ABI). RESEARCH DESIGN: Prospective observational study. METHODS AND PROCEDURES: Thirteen individuals with ABI were r...

  14. Concurrent multiple health risk behaviors among adolescents in Luangnamtha province, Lao PDR

    Directory of Open Access Journals (Sweden)

    Thomsen Sarah

    2011-01-01

    Full Text Available Abstract Background Multiple health risk behaviors (HRBs among adolescents pose a threat to their health, including HIV/AIDS. Health risk behaviors such as alcohol use, smoking, substance use, and sexual risk behaviors among youth have been shown to co-occur with each others. The objectives of this study was to estimate the prevalence of single and concurrent health risk behaviors and to explore how health risk behavior is associated with socio-demographic factors and peers' behaviors. Methods A cross sectional design was used to examine health risk behaviors of adolescents between the age 14 and 19 years living in the Luangnamtha province, Lao PDR. The study was conducted between June and August, 2008. An ordinal logistic regression model that simultaneously explored demographic factors and the influence of the behavior of peers on three categories of multiple HRBs (no risk, one risk, and two or more health risk behaviors was performed. Results A total of 1360 respondents, 669 (49.1% boys with mean age 16.7 ± 1.6 and 699 (50.9% girls aged 16.1 ± 1.5 were recruited into the study. The majority reported two or fewer risk behaviors. However, multiple risk behaviors increased with age for both sexes. About 46.8% (n = 637 reported no risk, 39.3 percent (n = 535 reported one risk, 8.1 percent (n = 110 reported two risks, and 5.8 percent reported more than two health risk behaviors. The protective factors among boys were school attendance (OR = .53, CI = .33-.86, being Hmong and Yao ethnicity (OR = .48, CI-.26-.90, while being above the age of 15 (OR = 2.20, 95% CI = 1.33-3.60, Akha ethnicity (OR = 2.20, 95% CI = 1.04-4.61, peer's smoking (OR = 3.11, 95% CI = 2.1-4.6, and peer's drinking alcohol (OR = 1.88, 95% CI = 1.1-3.21 were significantly associated with the presence of multiple risk behaviors among boys. Having some education (OR = 0.17, 95% CI = 0.06-0.45, and being of Hmong and Yao ethnicity (OR = 0.38, 95% CI = 0.18-0.80 were factors that

  15. Surveying Multiple Health Professional Team Members within Institutional Settings: An Example from the Nursing Home Industry

    OpenAIRE

    Clark, Melissa A.; Roman, Anthony; Rogers, Michelle L.; Tyler, Denise A; Mor, Vincent

    2014-01-01

    Quality improvement and cost containment initiatives in health care increasingly involve interdisciplinary teams of providers. To understand organizational functioning, information is often needed from multiple members of a leadership team since no one person may have sufficient knowledge of all aspects of the organization. To minimize survey burden, it is ideal to ask unique questions of each member of the leadership team in areas of their expertise. However, this risks substantial missing d...

  16. Multiple Health Behavior Changes in a Cancer Prevention Intervention for Construction Workers, 2001-2003

    OpenAIRE

    Harley, Amy E.; Devine, Carol M.; Beard, Binta; Stoddard, Anne M.; Hunt, Mary K.; Sorensen, Glorian

    2010-01-01

    Introduction: Few multiple behavior change interventions have addressed tobacco use in conjunction with fruit and vegetable consumption, particularly among high-risk blue-collar workers. Tools for Health, a cancer prevention intervention for construction laborers, was effective in achieving behavior change for smoking cessation and fruit and vegetable consumption separately. This study examines whether addressing smoking and fruit and vegetable consumption was successful in achieving positive...

  17. Prevalence of Multiple Chronic Conditions Among US Adults: Estimates From the National Health Interview Survey, 2010

    OpenAIRE

    Ward, Brian W.; Schiller, Jeannine S.

    2013-01-01

    Preventing and ameliorating chronic conditions has long been a priority in the United States; however, the increasing recognition that people often have multiple chronic conditions (MCC) has added a layer of complexity with which to contend. The objective of this study was to present the prevalence of MCC and the most common MCC dyads/triads by selected demographic characteristics. We used respondent-reported data from the 2010 National Health Interview Survey (NHIS) to study the US adult civ...

  18. Identifying and Measuring Multilevel Influences on College-Aged Athletes’ Multiple Health Behavior: A Pilot Study

    OpenAIRE

    Geller, Karly S.; Madeline A. Herbert

    2014-01-01

    The current study gathered preliminary data relative to the influences on intercollegiate athletes’ multiple health behavior. A secondary objective was to inform future measurement of identified factors. A sample of 20 intercollegiate athletes participated in an open-ended survey, followed by a corresponding focus groups (≈90-minute). Qualitative data were gathered relative to the factors impacting athletes’ excessive alcohol intake, fruit and vegetable consumption (FVC), and maintenance of p...

  19. Private health insurance and quality of life: perspectives of older Australians with multiple chronic conditions.

    Science.gov (United States)

    Jeon, Yun-Hee; Black, Annie; Govett, Janelle; Yen, Laurann; McRae, Ian

    2012-01-01

    A qualitative study was conducted to explore in-depth issues relating to the health costs of chronic illness as identified in a previous study. A key theme that emerged from interviews carried out was the benefits and challenges of private health insurance (PHI) membership, and choices older Australians with multimorbidity make in accessing health services, with and without PHI. This is the focus of this paper. Semistructured interviews were conducted with 40 older people with multiple chronic conditions. Data were analysed using content analysis. Key motivators for maintaining PHI included: fear of an inability to access timely health care; the opportunity to exercise choice in service provider; a belief of being 'better off' both medically and financially, which was often ill-founded; and the core values of self reliance and independence. Most described financial pressure caused by rising PHI premiums as well as other out-of-pocket health related expenses. Many older people who can ill afford PHI still struggle to maintain it, potentially at the cost of their quality of life, based on beliefs about costs of health care that they have never properly assessed. The findings highlight the degree to which people whose resources are constrained are prepared to go to maintain access to private hospital care. Attention should be given to assisting older people to make informed and valid choices of health insurance derived from the facts, rather than being based on fear and assumptions.

  20. Brain-derived neurotrophic factor as a regulator of systemic and brain energy metabolism and cardiovascular health

    OpenAIRE

    Rothman, Sarah M.; Kathleen J Griffioen; Wan, Ruiqian; Mattson, Mark P.

    2012-01-01

    Overweight sedentary individuals are at increased risk for cardiovascular disease, diabetes, and some neurological disorders. Beneficial effects of dietary energy restriction (DER) and exercise on brain structural plasticity and behaviors have been demonstrated in animal models of aging and acute (stroke and trauma) and chronic (Alzheimer's and Parkinson's diseases) neurological disorders. The findings described later, and evolutionary considerations, suggest brain-derived neurotrophic factor...

  1. Plan Quality and Treatment Efficiency for Radiosurgery to Multiple Brain Metastases: Non-Coplanar RapidArc vs Gamma Knife

    Directory of Open Access Journals (Sweden)

    Haisong eLiu

    2016-02-01

    Full Text Available Objectives: This study compares the dosimetry and efficiency of two modern radiosurgery (SRS modalities for multiple brain metastases (Gamma Knife and LINAC-based RapidArc/volumetric modulated arc therapy, with a special focus on the comparison of low dose spread.Methods: Six patients with three or four small brain metastases were used in this study. The size of targets varied from 0.1 ~ 10.5 cc. SRS doses were prescribed according to size of lesions. SRS plans were made using both Gamma Knife® Perfexion and a single-isocenter, multiple non-coplanar RapidArc®. Dosimetric parameters analyzed included RTOG conformity index (CI, gradient index (GI, 12 Gy isodose volume (V12Gy for each target, and the dose spread (Dspread for each plan. Dspread reflects SRS plan’s capability of confining radiation to within the local vicinity of the lesion and to not spread out to the surrounding normal brain tissues. Each plan has a dose (Dspread, such that once dose decreases below Dspread (on total tissue DVH, isodose volume starts increasing dramatically. Dspread is defined as that dose when volume increase first exceeds 20 cc per 0.1 Gy dose decrease. Results: RapidArc SRS has smaller CI (1.19 ±0.14 vs. 1.50 ± 0.16, p<0.001 and larger GI (4.77 ± 1.49 vs. 3.65 ± 0.98, p <0.01. V12Gy results were comparable (2.73 ± 1.38 cc vs. 3.06 ± 2.20 cc, p = 0.58. Moderate to lower dose spread, V6, V4.5, and V3, were also equivalent. Gamma Knife plans achieved better very low dose spread (≤3 Gy and also had slightly smaller Dspread, 1.9 Gy vs 2.5 Gy. Total treatment time for Gamma Knife is estimated between 60~100 min. Gamma Knife treatments are between 3~5 times longer compared to RapidArc treatment techniques.Conclusion: Dosimetric parameters reflecting prescription dose conformality (CI, dose fall off (GI, radiation necrosis indicator (V12Gy, and dose spread (Dspread were compared between Gamma Knife SRS and RapidArc SRS for multi-mets. RapidArc plans have

  2. Clustering and correlates of multiple health behaviours in 9-10 year old children.

    Directory of Open Access Journals (Sweden)

    Leonie K Elsenburg

    Full Text Available Sleep, physical activity, screen time and dietary behaviours influence health during childhood, but few studies have looked at all of these behaviours simultaneously and previous research has relied predominantly on self- or proxy-reports of physical activity and food frequency questionnaires for the assessment of diet.To assess the prevalence and clustering of health behaviours and examine the socio-demographic characteristics of children that fail to meet multiple health behaviour guidelines.Data are from the Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people (SPEEDY study. Participants (n = 1472, 42.9% male were dichotomized based on whether or not they met public health guidelines for accelerometer-assessed physical activity, diet-diary assessed fruit/vegetable intake and fat/non-milk extrinsic sugar (NMES intake, and self-reported screen time and sleep duration. Behavioural clustering was assessed using an observed over expected ratio (O/E. Socio-demographic characteristics of participants that failed to meet multiple health behaviour guidelines were examined using ordinal logistic regression. Data were analysed in 2013.83.3% of children failed to meet guidelines for two or more health behaviours. The O/E ratio for two behavioural combinations significantly exceeded 1, both of which featured high screen time, insufficient fruit/vegetable consumption and excessive fat/NMES intake. Children who were older (Proportional odds ratio (95% confidence interval: 1.69 (1.21,2.37 and those that attended a school with a physical activity or diet-related policy (1.28 (1.01,1.62 were more likely to have a poor health behaviour profile. Girls (0.80 (0.64,0.99, participants with siblings (0.76 (0.61,0.94 and those with more highly educated parents (0.73 (0.56,0.94 were less likely to have a poor health behaviour profile.A substantial proportion of children failed to meet guidelines for multiple health behaviours

  3. Hybrid EEG-fNIRS Asynchronous Brain-Computer Interface for Multiple Motor Tasks.

    Directory of Open Access Journals (Sweden)

    Alessio Paolo Buccino

    Full Text Available Non-invasive Brain-Computer Interfaces (BCI have demonstrated great promise for neuroprosthetics and assistive devices. Here we aim to investigate methods to combine Electroencephalography (EEG and functional Near-Infrared Spectroscopy (fNIRS in an asynchronous Sensory Motor rhythm (SMR-based BCI. We attempted to classify 4 different executed movements, namely, Right-Arm-Left-Arm-Right-Hand-Left-Hand tasks. Previous studies demonstrated the benefit of EEG-fNIRS combination. However, since normally fNIRS hemodynamic response shows a long delay, we investigated new features, involving slope indicators, in order to immediately detect changes in the signals. Moreover, Common Spatial Patterns (CSPs have been applied to both EEG and fNIRS signals. 15 healthy subjects took part in the experiments and since 25 trials per class were available, CSPs have been regularized with information from the entire population of participants and optimized using genetic algorithms. The different features have been compared in terms of performance and the dynamic accuracy over trials shows that the introduced methods diminish the fNIRS delay in the detection of changes.

  4. Long-term music training tunes how the brain temporally binds signals from multiple senses.

    Science.gov (United States)

    Lee, Hweeling; Noppeney, Uta

    2011-12-20

    Practicing a musical instrument is a rich multisensory experience involving the integration of visual, auditory, and tactile inputs with motor responses. This combined psychophysics-fMRI study used the musician's brain to investigate how sensory-motor experience molds temporal binding of auditory and visual signals. Behaviorally, musicians exhibited a narrower temporal integration window than nonmusicians for music but not for speech. At the neural level, musicians showed increased audiovisual asynchrony responses and effective connectivity selectively for music in a superior temporal sulcus-premotor-cerebellar circuitry. Critically, the premotor asynchrony effects predicted musicians' perceptual sensitivity to audiovisual asynchrony. Our results suggest that piano practicing fine tunes an internal forward model mapping from action plans of piano playing onto visible finger movements and sounds. This internal forward model furnishes more precise estimates of the relative audiovisual timings and hence, stronger prediction error signals specifically for asynchronous music in a premotor-cerebellar circuitry. Our findings show intimate links between action production and audiovisual temporal binding in perception. PMID:22114191

  5. Meningoencephalitis and new onset of seizures in an patient with normal brain CT and multiple lesions on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Vidal, Jose E.; Spichler, Anne; Oliveira, Augusto C.P. de; Lomar, Andre Villela [Instituto de Infectologia Emilio Ribas, Sao Paulo, SP (Brazil)

    2004-02-01

    Toxoplasmic encephalitis is the most common cerebral mass lesion in patients with AIDS. The definitive diagnosis requires direct demonstration of the tachyzoite form of Toxoplasma gondii in cerebral tissue. The presumptive diagnosis is based on serology, clinical and radiological features, and on response to anti-Toxoplasma therapy. Typically, patients have a subacute presentation of focal neurological signs, with multiple lesions in computed tomography (CT) or magnetic resonance imaging (MRI). However, the neurological and CT scan spectrum is broad. We report a case of toxoplasmic encephalitis in a heterosexual man without prior history of HIV infection. He was admitted with four days of headache, confusion, and new onset of seizures. His brain CT disclosed no alterations and MRI revealed multiple lesions. Empirical specific anti-Toxoplasma therapy was initiated and the patient experienced excellent clinical and radiological improvement. His HIV tests were positive and the CD{sub 4}{sup +} cell count was 74 cells/ml (8.5 %). On follow up, three months later, the general state of the patient was good, without neurological sequelae and with a normal MRI. We concluded that toxoplasmic encephalitis should be considered in the differential diagnosis of meningoencephalitis in sexually active individuals, including cases without prior history or suspicion of HIV infection, and no abnormalities on CT scan. (author)

  6. Sleep Disorders Reduce Health-Related Quality of Life in Multiple Sclerosis (Nottingham Health Profile Data in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Christian Veauthier

    2015-07-01

    Full Text Available Quality of Life (QoL is decreased in multiple sclerosis (MS, but studies about the impact of sleep disorders (SD on health-related quality of Life (HRQoL are lacking. From our original cohort, a cross-sectional polysomnographic (PSG study in consecutive MS patients, we retrospectively analysed the previously unpublished data of the Nottingham Health Profile (NHP. Those MS patients suffering from sleep disorders (n = 49 showed significantly lower HRQoL compared to MS patients without sleep disorders (n = 17. Subsequently, we classified the patients into four subgroups: insomnia (n = 17, restless-legs syndrome, periodic limb movement disorder and SD due to leg pain (n = 24, obstructive sleep apnea (n = 8 and patients without sleep disorder (n = 17. OSA and insomnia patients showed significantly higher NHP values and decreased HRQoL not only for the sleep subscale but also for the “energy” and “emotional” area of the NHP. In addition, OSA patients also showed increased NHP values in the “physical abilities” area. Interestingly, we did not find a correlation between the objective PSG parameters and the subjective sleep items of the NHP. However, this study demonstrates that sleep disorders can reduce HRQoL in MS patients and should be considered as an important confounder in all studies investigating HRQoL in MS.

  7. Metabolic stress responses in Drosophila are modulated by brain neurosecretory cells that produce multiple neuropeptides.

    Directory of Open Access Journals (Sweden)

    Lily Kahsai

    Full Text Available In Drosophila, neurosecretory cells that release peptide hormones play a prominent role in the regulation of development, growth, metabolism, and reproduction. Several types of peptidergic neurosecretory cells have been identified in the brain of Drosophila with release sites in the corpora cardiaca and anterior aorta. We show here that in adult flies the products of three neuropeptide precursors are colocalized in five pairs of large protocerebral neurosecretory cells in two clusters (designated ipc-1 and ipc-2a: Drosophila tachykinin (DTK, short neuropeptide F (sNPF and ion transport peptide (ITP. These peptides were detected by immunocytochemistry in combination with GFP expression driven by the enhancer trap Gal4 lines c929 and Kurs-6, both of which are expressed in ipc-1 and 2a cells. This mix of colocalized peptides with seemingly unrelated functions is intriguing and prompted us to initiate analysis of the function of the ten neurosecretory cells. We investigated the role of peptide signaling from large ipc-1 and 2a cells in stress responses by monitoring the effect of starvation and desiccation in flies with levels of DTK or sNPF diminished by RNA interference. Using the Gal4-UAS system we targeted the peptide knockdown specifically to ipc-1 and 2a cells with the c929 and Kurs-6 drivers. Flies with reduced DTK or sNPF levels in these cells displayed decreased survival time at desiccation and starvation, as well as increased water loss at desiccation. Our data suggest that homeostasis during metabolic stress requires intact peptide signaling by ipc-1 and 2a neurosecretory cells.

  8. Health, disability, and life insurance experiences of working-age persons with multiple sclerosis.

    Science.gov (United States)

    Iezzoni, L I; Ngo, L

    2007-05-01

    Working-age Americans with multiple sclerosis (MS) may face considerable financial insecurities when they become unable to work and lack the health, disability, and life insurance typically offered through employers. In order to estimate the rates of having these insurance policies, as well as how insurance status affects reports of financial stress, we conducted half-hour telephone interviews with 983 working-age persons across the US, who reported being diagnosed with MS. The interviews occurred from May through November 2005, and among the sampled individuals contacted and confirmed eligible, 93.2% completed the interview. The study population was largely female (78.9%), Caucasian (86.4%), married (68.6%), with at least some college education (71.5%), and unemployed (60.2%). Overall, 96.3% had some health insurance (40.3% with public health insurance, primarily Medicare), 56.7% had long-term disability insurance (36.4% with public programs), and 68.3% had life insurance. Notably, 27.4% indicated that, since being diagnosed with MS, health insurance concerns had significantly affected employment decisions. In addition, 16.4% reported considerable difficulty paying for health care, 27.4% put off or postponed seeking needed health care because of costs, and 22.3% delayed filling prescriptions, skipped medication doses, or split pills because of costs. Overall, 26.6% reported considerable worries about affording even basic necessities, such as food, utilities, and housing.

  9. A latent process model for forecasting multiple time series in environmental public health surveillance.

    Science.gov (United States)

    Morrison, Kathryn T; Shaddick, Gavin; Henderson, Sarah B; Buckeridge, David L

    2016-08-15

    This paper outlines a latent process model for forecasting multiple health outcomes arising from a common environmental exposure. Traditionally, surveillance models in environmental health do not link health outcome measures, such as morbidity or mortality counts, to measures of exposure, such as air pollution. Moreover, different measures of health outcomes are treated as independent, while it is known that they are correlated with one another over time as they arise in part from a common underlying exposure. We propose modelling an environmental exposure as a latent process, and we describe the implementation of such a model within a hierarchical Bayesian framework and its efficient computation using integrated nested Laplace approximations. Through a simulation study, we compare distinct univariate models for each health outcome with a bivariate approach. The bivariate model outperforms the univariate models in bias and coverage of parameter estimation, in forecast accuracy and in computational efficiency. The methods are illustrated with a case study using healthcare utilization and air pollution data from British Columbia, Canada, 2003-2011, where seasonal wildfires produce high levels of air pollution, significantly impacting population health. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26887823

  10. Syndromes associated with children exposure to mycotoxins and health risk assessment to multiple mycotoxins in infant foods

    OpenAIRE

    Alvito, Paula; Carla MARTINS; Assunção, Ricardo; Pires, M.J.; Calhau, Maria Antónia

    2015-01-01

    1. Children health and mycotoxins; 2. Routes of exposure; 3. Syndromes Syndromes associated associated with children children exposure exposure to mycotoxins: to mycotoxins: ingestion and inhalation; 4. Health risk assessment to multiple mycotoxins in infant foods -MYCOMIX project (PTDC/DTP-FTO/0417/2012); 5. Critical role of health professionals

  11. Brain Basics

    Medline Plus

    Full Text Available ... Trials — Participants Statistics Help for Mental Illnesses Outreach Research Priorities Funding Labs at NIMH News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The ...

  12. Induced Brain Plasticity after a Facilitation Programme for Autobiographical Memory in Multiple Sclerosis: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Alexandra Ernst

    2012-01-01

    Full Text Available This preliminary study tackles the assessment and treatment of autobiographical memory (AbM in relapsing-remitting multiple sclerosis (RR-MS patients. Our aim was to investigate cerebral activation changes, following clinical improvement of AbM due to a cognitive training based on mental visual imagery (MVI. We assessed AbM using the Autobiographical Interview (AI in eight patients and 15 controls. The latter subjects established normative data. The eight patients showed selective defective performance on the AI. Four patients were trained cognitively and underwent pre- and post-AI and fMRI. The remaining four patients took a second AI, at the same interval, but with no intervention in between. Results showed a significant improvement of AbM performance after the facilitation programme that could not be explained by learning effects since the AI scores remained stable between the two assessments in the second group of patients. As expected, AbM improvement was accompanied by an increased cerebral activity in posterior cerebral regions in post-facilitation fMRI examination. We interpret this activation changes in terms of reflecting the emphasis made on the role of MVI in memory retrieval through the facilitation programme. These preliminary significant clinical and neuroimaging changes suggest the beneficial effects of this technique to alleviate AbM retrieval deficit in MS patients.

  13. Induced Brain Plasticity after a Facilitation Programme for Autobiographical Memory in Multiple Sclerosis: A Preliminary Study

    Science.gov (United States)

    Ernst, Alexandra; Botzung, Anne; Gounot, Daniel; Sellal, François; Blanc, Frédéric; de Seze, Jerome; Manning, Liliann

    2012-01-01

    This preliminary study tackles the assessment and treatment of autobiographical memory (AbM) in relapsing-remitting multiple sclerosis (RR-MS) patients. Our aim was to investigate cerebral activation changes, following clinical improvement of AbM due to a cognitive training based on mental visual imagery (MVI). We assessed AbM using the Autobiographical Interview (AI) in eight patients and 15 controls. The latter subjects established normative data. The eight patients showed selective defective performance on the AI. Four patients were trained cognitively and underwent pre- and post-AI and fMRI. The remaining four patients took a second AI, at the same interval, but with no intervention in between. Results showed a significant improvement of AbM performance after the facilitation programme that could not be explained by learning effects since the AI scores remained stable between the two assessments in the second group of patients. As expected, AbM improvement was accompanied by an increased cerebral activity in posterior cerebral regions in post-facilitation fMRI examination. We interpret this activation changes in terms of reflecting the emphasis made on the role of MVI in memory retrieval through the facilitation programme. These preliminary significant clinical and neuroimaging changes suggest the beneficial effects of this technique to alleviate AbM retrieval deficit in MS patients. PMID:23125932

  14. Involvement of Subcortical Brain Structures During Olfactory Stimulation in Multiple Chemical Sensitivity.

    Science.gov (United States)

    Alessandrini, Marco; Micarelli, Alessandro; Chiaravalloti, Agostino; Bruno, Ernesto; Danieli, Roberta; Pierantozzi, Mariangela; Genovesi, Giuseppe; Öberg, Johanna; Pagani, Marco; Schillaci, Orazio

    2016-03-01

    Multiple chemical sensitivity (MCS) patients usually react to odour compounds and the majority of neuroimaging studies assessed, especially at the cortical level, many olfactory-related correlates. The purpose of the present study was to depict sub-cortical metabolic changes during a neutral (NC) and pure (OC) olfactory stimulation by using a recently validated (18)F-2-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computer tomography procedure in 26 MCS and 11 healthy (HC) resting subjects undergoing a battery of clinical tests. Twelve subcortical volumes of interest were identified by the automated anatomical labeling library and normalized to thalamus FDG uptake. In both groups, when comparing OC to NC, the within-subjects ANOVA demonstrated a relative decreased metabolism in bilateral putamen and hippocampus and a relative increased metabolism in bilateral amygdala, olfactory cortex (OLF), caudate and pallidum. The between-groups ANOVA demonstrated in MCS a significant higher metabolism in bilateral OLF during NC. As in HC subjects negative correlations were found in OC between FDG uptake in bilateral amygdala and hippocampus and odor pleasantness scale, the latter positively correlated with MCS subjects' bilateral putamen FDG uptake in OC. Besides FDG uptake resemblances in both groups were found, for the first time a relative higher metabolism increase in OLF in MCS subjects at rest with respect to HC was found. When merging this aspect to the different subcortical FDG uptake correlations patterns in the two groups, the present study demonstrated to describe a peculiar metabolic index of behavioral and neurological aspects of MCS complaints. PMID:26438099

  15. [Multiplicity and prevention for patients with hydrocephalus secondary to severe traumatic brain injury after surgery].

    Science.gov (United States)

    Cao, Ke; Meng, Guangran; Li, Zongzheng; Wang, Faxuan; Ma, Hui

    2015-09-01

    目的:探讨重型颅脑伤(severe traumatic brain injury,STBI)患者术后发生继发性脑积水的相关因素,为临床上如何早期防治继发性脑积水提供指导方案及理论依据。方法:对按同一标准纳入的107例于2010年6月至2013年6月入住宁夏医科大学附属总医院神经外科STBI患者进行前瞻性研究,对年龄、性别、手术前/后格拉斯哥昏迷评分(Glasgow coma scale,GCS)、术后是否继发脑室系统出血、手术前/后颅脑CT中脑导水管及环池结构情况、腰椎穿刺术与继发性脑积水形成之间的关系进行logistic多因素回归分析,探讨术后继发性脑积水的危险因素与保护因素,并着重对保护因素进行分析。结果:多因素回归分析显示:患者术前(OR=0.099,95% CI:0.028~0.350)/术后(OR=0.088,95% CI:0.012~0.649)GCS评分低、术后脑室系统出血(OR=0.168,95% CI:0.029~0.979)、术前(OR=0.134,95% CI:0.038~0.473)/术后(OR=0.221,95% CI:0.055~0.882)颅脑CT中脑导水管及环池结构不清均为STBI术后患者继发性脑积水的危险因素;腰椎穿刺术(OR=75.885,95% CI:9.612~599.122)为STBI术后患者继发性脑积水的保护性因素。且术后脑积水主要发生于术后2周内和2周~3个月,对照组脑积水发生率均明显高于腰椎穿刺组(P0.05)。 结论:对于STBI术后患者,在生命体征稳定的情况下,早期辅以行腰椎穿刺术可显著降低术后急性期、亚急性期继发性脑积水的发生率,改善患者预后。.

  16. Brain Tumors (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy 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 ...

  17. [Indoor air and human health--sick house syndrome and multiple chemical sensitivity].

    Science.gov (United States)

    Ando, Masanori

    2002-01-01

    The number of complaints about the quality of indoor air has increased during the past two decades. These complaints have been frequent enough that the term "Sick House Syndrome or Sick Building Syndrome" and "Multiple Chemical Sensitivity" has been coined. Complaints are likely related to the increased use of synthetic organic materials in house, furnishing, and consumer products; and the buildings, furnishings, and consumer products; and the decreased ventilation for energy conservation in homes. Approximately thousand volatile chemicals have been identified in indoor air. The main sources of these chemicals are house materials, combustion fumes, cleaning compounds, and paints or stains. Exposure to high levels of these emissions and to others, coupled with the fact that most people spend more time indoors than outdoors, raises the possibility that the risk to human health from indoor air pollution may be potentially greater than the risk posed from outdoor pollutants. The complaints most frequently voiced with respect to Sick House Syndrome are irritations of the eye, nose, and throat; cough and hoarseness of voice; headache and mental fatigue. The syndrome of multiple chemical sensitivities is controversial subject with increasing impact on the field of indoor air quality. The controversy surrounding Multiple Chemical Sensitivity includes its definition, theories of etiology and pathogenesis, diagnostic, and life style. Multiple Chemical Sensitivity is considered the hypothesis that is a disease caused by exposure to many chemically distinct environmental substances at very low.

  18. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity

    Directory of Open Access Journals (Sweden)

    Alexander Tallner

    2015-07-01

    Full Text Available Multiple sclerosis (MS patients, in general, show reduced physical function, physical activity, and quality of life. Positive associations between physical activity and quality of life have been reported. In particular, we were interested in the relation between physical activity and mental health in MS patients without limitation of physical function, since limitations of physical function may influence both physical activity and quality of life. Assessment comprised the Baecke questionnaire on physical activity, the Short Form 36 Health Survey (SF-36, and Beck Depression Inventory (BDI. We ranked our sample according to physical activity into four groups and performed an ANOVA to analyze the relationship between levels of physical activity and health-related quality of life (HRQoL. Then we performed a subgroup analysis and included patients with unlimited walking distance and a score of less than 18 in the BDI. Most active vs. inactive patients were compared for the mental subscales of the SF-36 and depression scores. From 632 patients, 265 met inclusion criteria and hence quartiles were filled with 67 patients each. Active and inactive patients did not differ considerably in physical function. In contrast, mental subscales of the SF-36 were higher in active patients. Remarkable and significant differences were found regarding vitality, general health perception, social functioning and mental health, all in favor of physically active patients. Our study showed that higher physical activity is still associated with higher mental health scores even if limitations of physical function are accounted for. Therefore, we believe that physical activity and exercise have considerable health benefits for MS patients.

  19. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity.

    Science.gov (United States)

    Tallner, Alexander; Waschbisch, Anne; Hentschke, Christian; Pfeifer, Klaus; Mäurer, Mathias

    2015-07-02

    Multiple sclerosis (MS) patients, in general, show reduced physical function, physical activity, and quality of life. Positive associations between physical activity and quality of life have been reported. In particular, we were interested in the relation between physical activity and mental health in MS patients without limitation of physical function, since limitations of physical function may influence both physical activity and quality of life. Assessment comprised the Baecke questionnaire on physical activity, the Short Form 36 Health Survey (SF-36), and Beck Depression Inventory (BDI). We ranked our sample according to physical activity into four groups and performed an ANOVA to analyze the relationship between levels of physical activity and health-related quality of life (HRQoL). Then we performed a subgroup analysis and included patients with unlimited walking distance and a score of less than 18 in the BDI. Most active vs. inactive patients were compared for the mental subscales of the SF-36 and depression scores. From 632 patients, 265 met inclusion criteria and hence quartiles were filled with 67 patients each. Active and inactive patients did not differ considerably in physical function. In contrast, mental subscales of the SF-36 were higher in active patients. Remarkable and significant differences were found regarding vitality, general health perception, social functioning and mental health, all in favor of physically active patients. Our study showed that higher physical activity is still associated with higher mental health scores even if limitations of physical function are accounted for. Therefore, we believe that physical activity and exercise have considerable health benefits for MS patients.

  20. Multiplicity of cerebrospinal fluid functions: New challenges in health and disease

    Directory of Open Access Journals (Sweden)

    Stopa Edward G

    2008-05-01

    and excretory benefits. Finally, CSF reabsorption via multiple pathways (olfactory and spinal arachnoidal bulk flow is likely complemented by fluid clearance across capillary walls (aquaporin 4 and arachnoid villi when CSFP and fluid retention are markedly elevated. A model is presented that links CSF and ISF homeostasis to coordinated fluxes of water and solutes at both the blood-CSF and blood-brain transport interfaces. Outline 1 Overview 2 CSF formation 2.1 Transcription factors 2.2 Ion transporters 2.3 Enzymes that modulate transport 2.4 Aquaporins or water channels 2.5 Receptors for neuropeptides 3 CSF pressure 3.1 Servomechanism regulatory hypothesis 3.2 Ontogeny of CSF pressure generation 3.3 Congenital hydrocephalus and periventricular regions 3.4 Brain response to elevated CSF pressure 3.5 Advances in measuring CSF waveforms 4 CSF flow 4.1 CSF flow and brain metabolism 4.2 Flow effects on fetal germinal matrix 4.3 Decreasing CSF flow in aging CNS 4.4 Refinement of non-invasive flow measurements 5 CSF volume 5.1 Hemodynamic factors 5.2 Hydrodynamic factors 5.3 Neuroendocrine factors 6 CSF turnover rate 6.1 Adverse effect of ventriculomegaly 6.2 Attenuated CSF sink action 7 CSF composition 7.1 Kidney-like action of CP-CSF system 7.2 Altered CSF biochemistry in aging and disease 7.3 Importance of clearance transport 7.4 Therapeutic manipulation of composition 8 CSF recycling in relation to ISF dynamics 8.1 CSF exchange with brain interstitium 8.2 Components of ISF movement in brain 8.3 Compromised ISF/CSF dynamics and amyloid retention 9 CSF reabsorption 9.1 Arachnoidal outflow resistance 9.2 Arachnoid villi vs. olfactory drainage routes 9.3 Fluid reabsorption along spinal nerves 9.4 Reabsorption across capillary aquaporin channels 10 Developing translationally effective models for restoring CSF balance 11 Conclusion

  1. Relationships between brain water content and diffusion tensor imaging parameters (apparent diffusion coefficient and fractional anisotropy) in multiple sclerosis

    International Nuclear Information System (INIS)

    Fifteen multiple sclerosis patients were examined by diffusion tensor imaging (DTI) to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in a superventricular volume of interest of 8 x 8 x 2 cm3 containing gray matter (GM) and white matter (WM) tissue. Point resolved spectroscopy 2D-chemical shift imaging of the same volume was performed without water suppression. The water contents and DTI parameters in 64 voxels of 2 cm3 were compared. The water content was increased in patients compared with controls (GM: 244±21 vs. 194±10 a.u.; WM: 245±32 vs. 190±11 a.u.), FA decreased (GM: 0.226±0.038 vs. 0.270±0.020; WM: 0.337±0.044 vs. 0.402±0.011) and ADC increased [GM: 1134±203 vs. 899±28 (x 10-6 mm2/s); WM: 901±138 vs. 751±17 (x 10-6 mm2/s)]. Correlations of water content with FA and ADC in WM were strong (r=-0.68, P<0.02; r=0.75; P<0.01, respectively); those in GM were weaker (r=-0.50, P<0.05; r=0.45, P<0.1, respectively). Likewise, FA and ADC were more strongly correlated in WM (r=-0.88; P<0.00001) than in GM (r=-0.69, P<0.01). The demonstrated relationship between DTI parameters and water content in multiple sclerosis patients suggests a potential for therapy monitoring in normal-appearing brain tissue. (orig.)

  2. Relationships between brain water content and diffusion tensor imaging parameters (apparent diffusion coefficient and fractional anisotropy) in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Sijens, Paul E.; Irwan, Roy; Potze, Jan Hendrik; Oudkerk, Matthijs [University Medical Center Groningen and University of Groningen, Department of Radiology, Groningen (Netherlands); Mostert, Jop P.; Keyser, Jacques de [University Medical Center Groningen and University of Groningen, Department of Neurology, Groningen (Netherlands)

    2006-04-15

    Fifteen multiple sclerosis patients were examined by diffusion tensor imaging (DTI) to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in a superventricular volume of interest of 8 x 8 x 2 cm{sup 3} containing gray matter (GM) and white matter (WM) tissue. Point resolved spectroscopy 2D-chemical shift imaging of the same volume was performed without water suppression. The water contents and DTI parameters in 64 voxels of 2 cm{sup 3} were compared. The water content was increased in patients compared with controls (GM: 244{+-}21 vs. 194{+-}10 a.u.; WM: 245{+-}32 vs. 190{+-}11 a.u.), FA decreased (GM: 0.226{+-}0.038 vs. 0.270{+-}0.020; WM: 0.337{+-}0.044 vs. 0.402{+-}0.011) and ADC increased [GM: 1134{+-}203 vs. 899{+-}28 (x 10{sup -6} mm{sup 2}/s); WM: 901{+-}138 vs. 751{+-}17 (x 10{sup -6} mm{sup 2}/s)]. Correlations of water content with FA and ADC in WM were strong (r=-0.68, P<0.02; r=0.75; P<0.01, respectively); those in GM were weaker (r=-0.50, P<0.05; r=0.45, P<0.1, respectively). Likewise, FA and ADC were more strongly correlated in WM (r=-0.88; P<0.00001) than in GM (r=-0.69, P<0.01). The demonstrated relationship between DTI parameters and water content in multiple sclerosis patients suggests a potential for therapy monitoring in normal-appearing brain tissue. (orig.)

  3. Relationships between brain water content and diffusion tensor imaging parameters (apparent diffusion coefficient and fractional anisotropy) in multiple sclerosis.

    Science.gov (United States)

    Sijens, Paul E; Irwan, Roy; Potze, Jan Hendrik; Mostert, Jop P; De Keyser, Jacques; Oudkerk, Matthijs

    2006-04-01

    Fifteen multiple sclerosis patients were examined by diffusion tensor imaging (DTI) to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in a superventricular volume of interest of 8 x 8 x 2 cm(3) containing gray matter (GM) and white matter (WM) tissue. Point resolved spectroscopy 2D-chemical shift imaging of the same volume was performed without water suppression. The water contents and DTI parameters in 64 voxels of 2 cm(3) were compared. The water content was increased in patients compared with controls (GM: 244+/-21 vs. 194+/-10 a.u.; WM: 245+/-32 vs. 190+/-11 a.u.), FA decreased (GM: 0.226+/-0.038 vs. 0.270+/-0.020; WM: 0.337+/-0.044 vs. 0.402+/-0.011) and ADC increased [GM: 1134+/-203 vs. 899+/-28 (x10(-6) mm(2)/s); WM: 901+/-138 vs. 751+/-17 (x10(-6) mm(2)/s)]. Correlations of water content with FA and ADC in WM were strong (r=-0.68, P<0.02; r=0.75; P<0.01, respectively); those in GM were weaker (r=-0.50, P<0.05; r=0.45, P<0.1, respectively). Likewise, FA and ADC were more strongly correlated in WM (r=-0.88; P<0.00001) than in GM (r=-0.69, P<0.01). The demonstrated relationship between DTI parameters and water content in multiple sclerosis patients suggests a potential for therapy monitoring in normal-appearing brain tissue.

  4. Chronic arsenic poisoning: a global health issue -- a report of multiple primary cancers.

    Science.gov (United States)

    Walvekar, R R; Kane, S V; Nadkarni, M S; Bagwan, I N; Chaukar, D A; D'Cruz, A K

    2007-02-01

    Chronic arsenic (As) poisoning is a worldwide public health problem. Effects of prolonged exposure to high levels of As in drinking water have been observed and documented in various epidemiological studies from all over the world. The non-malignant cutaneous effects of chronic exposure to inorganic As are well known. A case presenting with multiple cutaneous cancers as well as an internal lung primary in a patient exposed to toxic levels of As in the drinking water is discussed along with a review of literature.

  5. Self-rated health in women prior to clinical onset of multiple sclerosis

    DEFF Research Database (Denmark)

    Nielsen, Nete Munk; Harpsøe, Maria C; Simonsen, Jacob;

    2016-01-01

    BACKGROUND: It has been suggested that onset of multiple sclerosis (MS) is preceded by a clinically silent period of up to 10 years. OBJECTIVES: Examine whether such a period should be associated with poor self-rated health (SRH). METHODS: Information on SRH before pregnancy was ascertained among...... 80,848 women participating in the Danish National Birth Cohort (DNBC) 1996-2002. Women were followed for MS from enrolment in DNBC in the 16th week of pregnancy until 31 December 2011. Associations between SRH and MS were evaluated by means of hazard ratios (HR) with 95% confidence intervals (CIs...

  6. Mindfulness facets, trait emotional intelligence, emotional distress, and multiple health behaviors: A serial two-mediator model.

    Science.gov (United States)

    Jacobs, Ingo; Wollny, Anna; Sim, Chu-Won; Horsch, Antje

    2016-06-01

    In the present study, we tested a serial mindfulness facets-trait emotional intelligence (TEI)-emotional distress-multiple health behaviors mediation model in a sample of N = 427 German-speaking occupational therapists. The mindfulness facets-TEI-emotional distress section of the mediation model revealed partial mediation for the mindfulness facets Act with awareness (Act/Aware) and Accept without judgment (Accept); inconsistent mediation was found for the Describe facet. The serial two-mediator model included three mediational pathways that may link each of the four mindfulness facets with multiple health behaviors. Eight out of 12 indirect effects reached significance and fully mediated the links between Act/Aware and Describe to multiple health behaviors; partial mediation was found for Accept. The mindfulness facet Observe was most relevant for multiple health behaviors, but its relation was not amenable to mediation. Implications of the findings will be discussed. PMID:27062306

  7. Mindfulness facets, trait emotional intelligence, emotional distress, and multiple health behaviors: A serial two-mediator model.

    Science.gov (United States)

    Jacobs, Ingo; Wollny, Anna; Sim, Chu-Won; Horsch, Antje

    2016-06-01

    In the present study, we tested a serial mindfulness facets-trait emotional intelligence (TEI)-emotional distress-multiple health behaviors mediation model in a sample of N = 427 German-speaking occupational therapists. The mindfulness facets-TEI-emotional distress section of the mediation model revealed partial mediation for the mindfulness facets Act with awareness (Act/Aware) and Accept without judgment (Accept); inconsistent mediation was found for the Describe facet. The serial two-mediator model included three mediational pathways that may link each of the four mindfulness facets with multiple health behaviors. Eight out of 12 indirect effects reached significance and fully mediated the links between Act/Aware and Describe to multiple health behaviors; partial mediation was found for Accept. The mindfulness facet Observe was most relevant for multiple health behaviors, but its relation was not amenable to mediation. Implications of the findings will be discussed.

  8. Serum levels of brain-derived neurotrophicfactor correlate with the number of T2 MRI lesions in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    E.R. Comini-Frota

    2012-01-01

    Full Text Available The objective of the present study was to determine if there is a relationship between serum levels of brain-derived neurotrophic factor (BDNF and the number of T2/fluid-attenuated inversion recovery (T2/FLAIR lesions in multiple sclerosis (MS. The use of magnetic resonance imaging (MRI has revolutionized the study of MS. However, MRI has limitations and the use of other biomarkers such as BDNF may be useful for the clinical assessment and the study of the disease. Serum was obtained from 28 MS patients, 18-50 years old (median 38, 21 women, 0.5-10 years (median 5 of disease duration, EDSS 1-4 (median 1.5 and 28 healthy controls, 19-49 years old (median 33, 19 women. BDNF levels were measured by ELISA. T1, T2/FLAIR and gadolinium-enhanced lesions were measured by a trained radiologist. BDNF was reduced in MS patients (median [range] pg/mL; 1160 [352.6-2640] compared to healthy controls (1640 [632.4-4268]; P = 0.03, Mann-Whitney test and was negatively correlated (Spearman correlation test, r = -0.41; P = 0.02 with T2/FLAIR (11-81 lesions, median 42. We found that serum BDNF levels were inversely correlated with the number of T2/FLAIR lesions in patients with MS. BDNF may be a promising biomarker of MS.

  9. The issue of multiple univariate comparisons in the context of neuroelectric brain mapping: an application in a neuromarketing experiment.

    Science.gov (United States)

    Vecchiato, G; De Vico Fallani, F; Astolfi, L; Toppi, J; Cincotti, F; Mattia, D; Salinari, S; Babiloni, F

    2010-08-30

    This paper presents some considerations about the use of adequate statistical techniques in the framework of the neuroelectromagnetic brain mapping. With the use of advanced EEG/MEG recording setup involving hundred of sensors, the issue of the protection against the type I errors that could occur during the execution of hundred of univariate statistical tests, has gained interest. In the present experiment, we investigated the EEG signals from a mannequin acting as an experimental subject. Data have been collected while performing a neuromarketing experiment and analyzed with state of the art computational tools adopted in specialized literature. Results showed that electric data from the mannequin's head presents statistical significant differences in power spectra during the visualization of a commercial advertising when compared to the power spectra gathered during a documentary, when no adjustments were made on the alpha level of the multiple univariate tests performed. The use of the Bonferroni or Bonferroni-Holm adjustments returned correctly no differences between the signals gathered from the mannequin in the two experimental conditions. An partial sample of recently published literature on different neuroscience journals suggested that at least the 30% of the papers do not use statistical protection for the type I errors. While the occurrence of type I errors could be easily managed with appropriate statistical techniques, the use of such techniques is still not so largely adopted in the literature.

  10. The issue of multiple univariate comparisons in the context of neuroelectric brain mapping: an application in a neuromarketing experiment.

    Science.gov (United States)

    Vecchiato, G; De Vico Fallani, F; Astolfi, L; Toppi, J; Cincotti, F; Mattia, D; Salinari, S; Babiloni, F

    2010-08-30

    This paper presents some considerations about the use of adequate statistical techniques in the framework of the neuroelectromagnetic brain mapping. With the use of advanced EEG/MEG recording setup involving hundred of sensors, the issue of the protection against the type I errors that could occur during the execution of hundred of univariate statistical tests, has gained interest. In the present experiment, we investigated the EEG signals from a mannequin acting as an experimental subject. Data have been collected while performing a neuromarketing experiment and analyzed with state of the art computational tools adopted in specialized literature. Results showed that electric data from the mannequin's head presents statistical significant differences in power spectra during the visualization of a commercial advertising when compared to the power spectra gathered during a documentary, when no adjustments were made on the alpha level of the multiple univariate tests performed. The use of the Bonferroni or Bonferroni-Holm adjustments returned correctly no differences between the signals gathered from the mannequin in the two experimental conditions. An partial sample of recently published literature on different neuroscience journals suggested that at least the 30% of the papers do not use statistical protection for the type I errors. While the occurrence of type I errors could be easily managed with appropriate statistical techniques, the use of such techniques is still not so largely adopted in the literature. PMID:20637802

  11. Serum levels of brain-derived neurotrophic factor correlate with the number of T2 MRI lesions in multiple sclerosis

    International Nuclear Information System (INIS)

    The objective of the present study was to determine if there is a relationship between serum levels of brain-derived neurotrophic factor (BDNF) and the number of T2/fluid-attenuated inversion recovery (T2/FLAIR) lesions in multiple sclerosis (MS). The use of magnetic resonance imaging (MRI) has revolutionized the study of MS. However, MRI has limitations and the use of other biomarkers such as BDNF may be useful for the clinical assessment and the study of the disease. Serum was obtained from 28 MS patients, 18-50 years old (median 38), 21 women, 0.5-10 years (median 5) of disease duration, EDSS 1-4 (median 1.5) and 28 healthy controls, 19-49 years old (median 33), 19 women. BDNF levels were measured by ELISA. T1, T2/FLAIR and gadolinium-enhanced lesions were measured by a trained radiologist. BDNF was reduced in MS patients (median [range] pg/mL; 1160 [352.6-2640]) compared to healthy controls (1640 [632.4-4268]; P = 0.03, Mann-Whitney test) and was negatively correlated (Spearman correlation test, r = -0.41; P = 0.02) with T2/FLAIR (11-81 lesions, median 42). We found that serum BDNF levels were inversely correlated with the number of T2/FLAIR lesions in patients with MS. BDNF may be a promising biomarker of MS

  12. Serum levels of brain-derived neurotrophic factor correlate with the number of T2 MRI lesions in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Comini-Frota, E.R. [Unidade de Neurologia, Hospital Universitário, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Rodrigues, D.H. [Laboratório de Imunofarmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Miranda, E.C. [Ecoar Diagnostic Center, Belo Horizonte, MG (Brazil); Brum, D.G. [Hospital das Clínicas,Faculdade de Medicina de Ribeirão Preto,Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Kaimen-Maciel, D.R. [Unidade de Neurologia, Hospital Universitário, Universidade Estadual de Londrina, Londrina, PR (Brazil); Donadi, E.A. [Hospital das Clínicas,Faculdade de Medicina de Ribeirão Preto,Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Teixeira, A.L. [Unidade de Neurologia, Hospital Universitário, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Laboratório de Imunofarmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil)

    2011-11-23

    The objective of the present study was to determine if there is a relationship between serum levels of brain-derived neurotrophic factor (BDNF) and the number of T2/fluid-attenuated inversion recovery (T2/FLAIR) lesions in multiple sclerosis (MS). The use of magnetic resonance imaging (MRI) has revolutionized the study of MS. However, MRI has limitations and the use of other biomarkers such as BDNF may be useful for the clinical assessment and the study of the disease. Serum was obtained from 28 MS patients, 18-50 years old (median 38), 21 women, 0.5-10 years (median 5) of disease duration, EDSS 1-4 (median 1.5) and 28 healthy controls, 19-49 years old (median 33), 19 women. BDNF levels were measured by ELISA. T1, T2/FLAIR and gadolinium-enhanced lesions were measured by a trained radiologist. BDNF was reduced in MS patients (median [range] pg/mL; 1160 [352.6-2640]) compared to healthy controls (1640 [632.4-4268]; P = 0.03, Mann-Whitney test) and was negatively correlated (Spearman correlation test, r = -0.41; P = 0.02) with T2/FLAIR (11-81 lesions, median 42). We found that serum BDNF levels were inversely correlated with the number of T2/FLAIR lesions in patients with MS. BDNF may be a promising biomarker of MS.

  13. Researching the mental health needs of hard-to-reach groups: managing multiple sources of evidence

    Directory of Open Access Journals (Sweden)

    Lamb Jonathan

    2009-12-01

    Full Text Available Abstract Background Common mental health problems impose substantial challenges to patients, carers, and health care systems. A range of interventions have demonstrable efficacy in improving the lives of people experiencing such problems. However many people are disadvantaged, either because they are unable to access primary care, or because access does not lead to adequate help. New methods are needed to understand the problems of access and generate solutions. In this paper we describe our methodological approach to managing multiple and diverse sources of evidence, within a research programme to increase equity of access to high quality mental health services in primary care. Methods We began with a scoping review to identify the range and extent of relevant published material, and establish key concepts related to access. We then devised a strategy to collect - in parallel - evidence from six separate sources: a systematic review of published quantitative data on access-related studies; a meta-synthesis of published qualitative data on patient perspectives; dialogues with local stakeholders; a review of grey literature from statutory and voluntary service providers; secondary analysis of patient transcripts from previous qualitative studies; and primary data from interviews with service users and carers. We synthesised the findings from these diverse sources, made judgements on key emerging issues in relation to needs and services, and proposed a range of potential interventions. These proposals were debated and refined using iterative electronic and focus group consultation procedures involving international experts, local stakeholders and service users. Conclusions Our methods break new ground by generating and synthesising multiple sources of evidence, connecting scientific understanding with the perspectives of users, in order to develop innovative ways to meet the mental health needs of under-served groups.

  14. Association between Smoking and Health Outcomes in Postmenopausal Women Living with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Rachel Jawahar

    2014-01-01

    Full Text Available Background. In multiple sclerosis (MS, symptom management and improved health-related quality of life (HrQOL may be modified by smoking. Objective. To evaluate the extent to which smoking is associated with worsened health outcomes and HrQOL for postmenopausal women with MS. Methods. We identified 251 Women’s Health Initiative Observational Study participants with a self-reported MS diagnosis. Using a linear model, we estimated changes from baseline to 3 years for activities of daily living, total metabolic equivalent tasks (MET hours per week, mental and physical component scales (MCS, PCS of the SF-36, and menopausal symptoms adjusting for years since menopause and other confounders. Results. Nine percent were current and 50% past smokers. Age at smoking initiation was associated with significant changes in MCS during menopause. PCS scores were unchanged. While women who had ever smoked experienced an increase in physical activity during menopause, the physical activity levels of women who never smoked declined. Residual confounding may explain this finding. Smoking was not associated with change in menopausal symptoms during the 3-year follow-up. Conclusion. Smoking was not associated with health outcomes among post-menopausal women with MS.

  15. Reduced expression of NO-sensitive guanylyl cyclase in reactive astrocytes of Alzheimer disease, Creutzfeldt-Jakob disease, and multiple sclerosis brains.

    Science.gov (United States)

    Baltrons, María Antonia; Pifarré, Paula; Ferrer, Isidre; Carot, José Miguel; García, Agustina

    2004-12-01

    In Alzheimer's disease (AD) brains increased NO synthase (NOS) expression is found in reactive astrocytes surrounding amyloid plaques. We have recently shown that treatment with beta-amyloid peptides or IL-1beta down-regulates NO-sensitive soluble guanylyl cyclase (sGC) in cultured astrocytes and in adult rat brain. In this work, we have examined sGC activity and expression in postmortem brain tissue of AD patients and matched controls. No significant alteration was observed in basal or NO-stimulated sGC activity, nor in sGC beta1 and alpha1 subunit levels in cortical extracts of AD brains. Immunohistochemistry showed intense and widespread labeling of sGC beta1 in cortical and hippocampal neurons and white matter fibrillar astrocytes, while grey matter astrocytes were faintly stained. In AD, expression of sGC in neurons and fibrillar astrocytes is not altered but is markedly reduced in reactive astrocytes surrounding amyloid plaques. Immunostaining for sGC beta1 was also lacking in reactive astrocytes in cortex and subcortical white matter in Creutzfeldt-Jakob disease brains and in subacute and chronic plaques in multiple sclerosis (MS) brains. Thus, induction of astrocyte reactivity is associated with decreased capacity to generate cGMP in response to NO both in vitro and in vivo. This effect may be related to the development of the astroglial inflammatory response. PMID:15571982

  16. Healthy Brain Development: Precursor to Learning. National Health/Education Consortium (1st, Baltimore, Maryland, December 6, 1990).

    Science.gov (United States)

    Institute for Educational Leadership, Washington, DC.

    This report presents the proceedings of a consortium at which leading developmental neuroscientists from across the United States and Canada met at Johns Hopkins University to explore the relationship between children's health and learning and to propose policy changes. Early brain development and its relationship to intelligence, learning, and…

  17. MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo

    Energy Technology Data Exchange (ETDEWEB)

    Dupuy, Sheena L.; Tauhid, Shahamat; Kim, Gloria; Chu, Renxin; Tummala, Subhash [Departments of Neurology, Brigham and Women' s Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA (United States); Hurwitz, Shelley [Departments of Medicine, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Bakshi, Rohit, E-mail: rbakshi@bwh.harvard.edu [Departments of Neurology, Brigham and Women' s Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA (United States); Departments of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States)

    2015-08-15

    Highlights: • Compared T1SE and T1GE in detecting hypointense brain lesions in MS patients. • T1GE detected a higher cerebral lesion volume and number than T1SE. • T1SE correlated significantly with disability, while T1GE did not. • Hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. - Abstract: Objective: Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS). Background: Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified. Design/methods: In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean ± SD) 3.5 ± 2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5 T MRI scanner. Images were re-sampled to axial 5 mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations. Results: Considering the entire cohort, T1GE detected a higher lesion volume (5.90 ± 6.21 vs. 4.17 ± 4.84 ml, p < 0.0001) and higher lesion number (27.82 ± 20.66 vs. 25.20 ± 20.43, p < 0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p < 0.01). A higher lesion number by T1GE was seen only in the RR group (p < 0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r = 0.29, p < 0.05) while T1GE (r = 0.23, p = 0.13) and FLAIR (r = 0.24, p = 0.12) did not. Conclusion: Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE

  18. MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo

    International Nuclear Information System (INIS)

    Highlights: • Compared T1SE and T1GE in detecting hypointense brain lesions in MS patients. • T1GE detected a higher cerebral lesion volume and number than T1SE. • T1SE correlated significantly with disability, while T1GE did not. • Hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. - Abstract: Objective: Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS). Background: Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified. Design/methods: In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean ± SD) 3.5 ± 2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5 T MRI scanner. Images were re-sampled to axial 5 mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations. Results: Considering the entire cohort, T1GE detected a higher lesion volume (5.90 ± 6.21 vs. 4.17 ± 4.84 ml, p < 0.0001) and higher lesion number (27.82 ± 20.66 vs. 25.20 ± 20.43, p < 0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p < 0.01). A higher lesion number by T1GE was seen only in the RR group (p < 0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r = 0.29, p < 0.05) while T1GE (r = 0.23, p = 0.13) and FLAIR (r = 0.24, p = 0.12) did not. Conclusion: Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE

  19. The effect of disease modifying therapies on brain atrophy in patients with relapsing-remitting multiple sclerosis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Georgios Tsivgoulis

    Full Text Available The aim of the present meta-analysis was to evaluate the effect of disease-modifying drugs (DMD on brain atrophy in patients with relapsing-remitting multiple sclerosis (RRMS using available randomized-controlled trial (RCT data.We conducted a systematic review and meta-analysis according to PRISMA guidelines of all available RCTs of patients with RRMS that reported data on brain volume measurements during the study period.We identified 4 eligible studies, including a total of 1819 RRMS patients (71% women, mean age 36.5 years, mean baseline EDSS-score: 2.4. The mean percentage change in brain volume was found to be significantly lower in DMD versus placebo subgroup (standardized mean difference: -0.19; 95%CI: -0.27--0.11; p<0.001. We detected no evidence of heterogeneity between estimates (I2 = 30%, p = 0.19 nor publication bias in the Funnel plots. Sensitivity analyses stratifying studies according to brain atrophy neuroimaging protocol disclosed no evidence of heterogeneity (p = 0.16. In meta-regression analyses, the percentage change in brain volume was found to be inversely related with duration of observation period in both DMD (meta-regression slope = -0.03; 95% CI: -0.04--0.02; p<0.001 and placebo subgroups (meta-regression slope = -0.05; 95% CI: -0.06--0.04; p<0.001. However, the rate of percentage brain volume loss over time was greater in placebo than in DMD subgroup (p = 0.017, ANCOVA.DMD appear to be effective in attenuating brain atrophy in comparison to placebo and their benefit in delaying the rate of brain volume loss increases linearly with longer treatment duration.

  20. A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers

    OpenAIRE

    Perrin, Paul B.; Ivan Panyavin; Alejandra Morlett Paredes; Adriana Aguayo; Miguel Angel Macias; Brenda Rabago; Sandra J. Fulton Picot; Juan Carlos Arango-Lasprilla

    2015-01-01

    Background. Multiple sclerosis (MS) rates in Latin America are increasing, and caregivers there experience reduced mental and physical health. Based on rigid gender roles in Latin America, women more often assume caregiving duties, yet the differential impact on women of these duties is unknown. Methods. This study examined gender differences in mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Zarit Bu...

  1. How Do Patients and Providers React to Different Incentives in the Chinese Multiple Health Security Systems?

    Institute of Scientific and Technical Information of China (English)

    Chun-Yu Zhang; Hideki Hashimoto

    2015-01-01

    Background:China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes.Methods:The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing.We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives.Results:Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates.Under plans with an annual ceiling for insurance coverage,patients spent significantly more in the second half of the year than in the first half of the year.The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider.Conclusions:Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers.Reformation is necessary to reduce those incentives,and improve equity and efficiency in healthcare use.

  2. Statistical strategies for constructing health risk models with multiple pollutants and their interactions: possible choices and comparisons

    OpenAIRE

    Sun, Zhichao; Tao, Yebin; Li, Shi; Ferguson, Kelly K; Meeker, John D.; Park, Sung Kyun; Batterman, Stuart A.; Mukherjee, Bhramar

    2013-01-01

    Background As public awareness of consequences of environmental exposures has grown, estimating the adverse health effects due to simultaneous exposure to multiple pollutants is an important topic to explore. The challenges of evaluating the health impacts of environmental factors in a multipollutant model include, but are not limited to: identification of the most critical components of the pollutant mixture, examination of potential interaction effects, and attribution of health effects to ...

  3. What is important, what needs treating? How GPs perceive older patients’ multiple health problems: a mixed method research study

    OpenAIRE

    Junius-Walker Ulrike; Wrede Jennifer; Schleef Tanja; Diederichs-Egidi Heike; Wiese Birgitt; Hummers-Pradier Eva; Dierks Marie-Luise

    2012-01-01

    Abstract Background GPs increasingly deal with multiple health problems of their older patients. They have to apply a hierarchical management approach that considers priorities to balance competing needs for treatment. Yet, the practice of setting individual priorities in older patients is largely unexplored. This paper analyses the GPs’ perceptions on important and unimportant health problems and how these affect their treatment. Methods GPs appraised the importance of health problems for a ...

  4. Using Personality Traits to Construct Linear Growth Models of Mental Health in Family Members of Individuals With Severe Brain Injury

    DEFF Research Database (Denmark)

    Trujillo, Michael; Perrin, Paul B; Doser, Karoline;

    2016-01-01

    Objective: No studies have examined the impact of personality traits on mental health among caregivers of individuals with severe brain injury. Therefore, the purpose of the current study was to construct linear growth models to examine whether the personality traits of family members of individu......Objective: No studies have examined the impact of personality traits on mental health among caregivers of individuals with severe brain injury. Therefore, the purpose of the current study was to construct linear growth models to examine whether the personality traits of family members...... the Short Form-36 assessing mental HRQoL (vitality, social functioning, role limitations-emotional, mental health), anxiety, and depression across 5 time points during the 1st year after injury. The measure of personality was administered 3 months after the patients' discharge. Results: All mental HRQo...

  5. Measuring multiple neurochemicals and related metabolites in blood and brain of the rhesus monkey by using dual microdialysis sampling and capillary hydrophilic interaction chromatography–mass spectrometry

    OpenAIRE

    Li, Juan; Pföstl, Veronika von; Zaldivar, Daniel; Zhang, Xiaozhe; Logothetis, Nikos; Rauch, Alexander

    2012-01-01

    In vivo measurement of multiple functionally related neurochemicals and metabolites (NMs) is highly interesting but remains challenging in the field of basic neuroscience and clinical research. We present here an analytical method for determining five functionally and metabolically related polar substances, including acetylcholine (quaternary ammonium), lactate and pyruvate (organic acids), as well as glutamine and glutamate (amino acids). These NMs are acquired from samples of the brain and ...

  6. Oral health-related risk behaviours and attitudes among Croatian adolescents--multiple logistic regression analysis.

    Science.gov (United States)

    Spalj, Stjepan; Spalj, Vedrana Tudor; Ivanković, Luida; Plancak, Darije

    2014-03-01

    The aim of this study was to explore the patterns of oral health-related risk behaviours in relation to dental status, attitudes, motivation and knowledge among Croatian adolescents. The assessment was conducted in the sample of 750 male subjects - military recruits aged 18-28 in Croatia using the questionnaire and clinical examination. Mean number of decayed, missing and filled teeth (DMFT) and Significant Caries Index (SIC) were calculated. Multiple logistic regression models were crated for analysis. Although models of risk behaviours were statistically significant their explanatory values were quite low. Five of them--rarely toothbrushing, not using hygiene auxiliaries, rarely visiting dentist, toothache as a primary reason to visit dentist, and demand for tooth extraction due to toothache--had the highest explanatory values ranging from 21-29% and correctly classified 73-89% of subjects. Toothache as a primary reason to visit dentist, extraction as preferable therapy when toothache occurs, not having brushing education in school and frequent gingival bleeding were significantly related to population with high caries experience (DMFT > or = 14 according to SiC) producing Odds ratios of 1.6 (95% CI 1.07-2.46), 2.1 (95% CI 1.29-3.25), 1.8 (95% CI 1.21-2.74) and 2.4 (95% CI 1.21-2.74) respectively. DMFT> or = 14 model had low explanatory value of 6.5% and correctly classified 83% of subjects. It can be concluded that oral health-related risk behaviours are interrelated. Poor association was seen between attitudes concerning oral health and oral health-related risk behaviours, indicating insufficient motivation to change lifestyle and habits. Self-reported oral hygiene habits were not strongly related to dental status.

  7. Adapting portfolio theory for the evaluation of multiple investments in health with a multiplicative extension for treatment synergies.

    Science.gov (United States)

    Bridges, J F P; Stewart, M; King, M T; van Gool, K

    2002-01-01

    Portfolio theory is central to the analysis of risk in many areas of economics but is seldom used appropriately in health economics. This contribution examines the use of portfolio theory in the context of cost-effectiveness analysis (CEA). A number of modifications are needed to apply portfolio analysis to the economic evaluation of health care interventions. First, the method of reporting the results of a CEA, and consequently some of the underlying assumptions, needs to be modified. Second, portfolio theory needs to be expressed in terms of effects on individuals aggregated to a population. Finally, one needs to allow for the possibility of synergy between the various health interventions. This paper derives a general formula for a portfolio of health care interventions that allows for synergies between interventions where the population effects are aggregated from individual effects. A number of special cases are also derived to highlight the nature of the formulation of the modified portfolio theory. We conclude that, while modified portfolio theory adds a theoretical foundation to health care evaluations, it may not be operational until estimates of the correlation between interventions are available, and the question of uncertainty is resolved in health care evaluation. Also, while a synergy may be present at the individual level, when aggregated over a large population it may not be significant given the standard assumption of constant returns to scale.

  8. Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms

    DEFF Research Database (Denmark)

    Momsen, A. H.; Nielsen, C. V.; Nielsen, M. B. D.;

    2016-01-01

    . Methods: In 2011-2012, 736 (34%) of 2172 sick-listed individuals completed a posted questionnaire and were included. Main outcome was self-reported employment status. The Symptom Check List (SCL-SOM)'s sum score (0-48) was categorized in high (>18) and low (≤18) levels. Previous employment, sick-listing......Objectives: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work. Study design: A cross-sectional study nested in a clinical trial...... unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally. Conclusions: Sick-listed individuals reporting high levels of symptoms were more...

  9. Evaluating and improving multiple choice papers: true-false questions in public health medicine.

    Science.gov (United States)

    Dixon, R A

    1994-09-01

    The quality of a multiple true-false (MTF) examination paper in public health medicine for 149 clinical medical students was evaluated using predefined performance criteria to offer guidelines for improvement of such a paper. There were 35 questions, each with five true-false branches, and the performance of the overall best 25% of candidates was compared for individual items with that of the overall worst 25%. To improve discrimination between best and worst candidates, 60% of items needed changes, and several indicators were used to identify how, usually because the branch was too easy (26%), unpopular (16%) or too hard (10%). A number of guidelines for writing good MTF questions and for improving them are suggested. The inequity is illustrated of marking systems which do not allocate a negative mark for incorrect answers equal in size to the positive mark for correct ones, with zero for unanswered questions or 'don't know' answers. PMID:7845259

  10. A quantitative approach for integrating multiple lines of evidence for the evaluation of environmental health risks

    Directory of Open Access Journals (Sweden)

    Jerome J. Schleier III

    2015-01-01

    Full Text Available Decision analysis often considers multiple lines of evidence during the decision making process. Researchers and government agencies have advocated for quantitative weight-of-evidence approaches in which multiple lines of evidence can be considered when estimating risk. Therefore, we utilized Bayesian Markov Chain Monte Carlo to integrate several human-health risk assessment, biomonitoring, and epidemiology studies that have been conducted for two common insecticides (malathion and permethrin used for adult mosquito management to generate an overall estimate of risk quotient (RQ. The utility of the Bayesian inference for risk management is that the estimated risk represents a probability distribution from which the probability of exceeding a threshold can be estimated. The mean RQs after all studies were incorporated were 0.4386, with a variance of 0.0163 for malathion and 0.3281 with a variance of 0.0083 for permethrin. After taking into account all of the evidence available on the risks of ULV insecticides, the probability that malathion or permethrin would exceed a level of concern was less than 0.0001. Bayesian estimates can substantially improve decisions by allowing decision makers to estimate the probability that a risk will exceed a level of concern by considering seemingly disparate lines of evidence.

  11. Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Amy A. Herrold, PhD

    2015-02-01

    Full Text Available Mental health disorders (MHDs, mild traumatic brain injury (mTBI, and alcohol use disorder (AUD are endemic among recent Veterans, resulting in a population with heterogeneous, co-occurring conditions. While alcohol craving negatively affects rehabilitation and leads to relapse, no studies have examined alcohol craving among Veterans with co-occurring MHDs and mTBI. The purpose of this preliminary cohort study is to describe alcohol craving in a convenience sample of Iraq and Afghanistan Veterans (n = 48, including those exposed to traumatic events and experiencing active symptoms. Veterans completed weekly telephone interviews that included the Alcohol Use Disorder Identification Test, consumption questions (AUDIT-C (week 1 and the Penn Alcohol Craving Scale (PACS (weeks 1–6. Sixty percent of the sample screened positive on the AUDIT-C for probable AUD. Using Rasch analysis, the person separation reliability of the PACS was strong (0.87 among AUDIT-C positive Veterans. Higher PACS scores were reported among AUDIT-C positive versus AUDIT-C negative Veterans (mixed effects analysis, p < 0.001. PACS scores were higher among AUDIT-C positive Veterans with MHDs with and without mTBI versus AUDIT-C positive combat comparison Veterans (pairwise comparison, p < 0.001. Rates of hazardous alcohol use are high among Iraq and Afghanistan conflict Veterans and suggest that alcohol craving is elevated among those with MHDs with and without mTBI.

  12. Parasites and health affect multiple sexual signals in male common wall lizards, Podarcis muralis

    NARCIS (Netherlands)

    Martín, J.; Amo de Paz, L.; López, P.

    2008-01-01

    Multiple advertising sexual traits may either advertise different characteristics of male condition or be redundant to reinforce reliability of signals. Research has focused on multiple visual traits. However, in animals that use different multiple additional sensory systems, such as chemoreception,

  13. Longitudinal Trajectories of Health Related Quality of Life in Danish Family Members of Individuals with Severe Brain Injury

    DEFF Research Database (Denmark)

    Norup, Anne; Snipes, Daniel J.; Siert, Lars;

    2013-01-01

    Scant research has examined health-related quality of life (HRQoL) in family members of patients with severe brain injury, even less has been done in Scandinavian countries, and none has examined this construct longitudinally. The current study therefore used multilevel modelling to investigate...... the trajectories of HRQoL in 94 Danish family members of patients with severe brain injury at five time points, beginning at the patient's stay in a neuro intensive care unit through one year after injury. The family members’ HRQoL scores significantly and strongly increased over time, and Role Limitations...... – Emotional scores were higher when patients had high Rancho Los Amigos Scale scores at admission to early intensive rehabilitation in hospital. These results suggest that the acute and sub-acute periods after brain injury are an extremely difficult time psychologically for many families, and family...

  14. Graded perturbations of metabolism in multiple regions of human brain in Alzheimer's disease: Snapshot of a pervasive metabolic disorder.

    Science.gov (United States)

    Xu, Jingshu; Begley, Paul; Church, Stephanie J; Patassini, Stefano; Hollywood, Katherine A; Jüllig, Mia; Curtis, Maurice A; Waldvogel, Henry J; Faull, Richard L M; Unwin, Richard D; Cooper, Garth J S

    2016-06-01

    Alzheimer's disease (AD) is an age-related neurodegenerative disorder that displays pathological characteristics including senile plaques and neurofibrillary tangles. Metabolic defects are also present in AD-brain: for example, signs of deficient cerebral glucose uptake may occur decades before onset of cognitive dysfunction and tissue damage. There have been few systematic studies of the metabolite content of AD human brain, possibly due to scarcity of high-quality brain tissue and/or lack of reliable experimental methodologies. Here we sought to: 1) elucidate the molecular basis of metabolic defects in human AD-brain; and 2) identify endogenous metabolites that might guide new approaches for therapeutic intervention, diagnosis or monitoring of AD. Brains were obtained from nine cases with confirmed clinical/neuropathological AD and nine controls matched for age, sex and post-mortem delay. Metabolite levels were measured in post-mortem tissue from seven regions: three that undergo severe neuronal damage (hippocampus, entorhinal cortex and middle-temporal gyrus); three less severely affected (cingulate gyrus, sensory cortex and motor cortex); and one (cerebellum) that is relatively spared. We report a total of 55 metabolites that were altered in at least one AD-brain region, with different regions showing alterations in between 16 and 33 metabolites. Overall, we detected prominent global alterations in metabolites from several pathways involved in glucose clearance/utilization, the urea cycle, and amino-acid metabolism. The finding that potentially toxigenic molecular perturbations are widespread throughout all brain regions including the cerebellum is consistent with a global brain disease process rather than a localized effect of AD on regional brain metabolism. PMID:26957286

  15. Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents.

    Directory of Open Access Journals (Sweden)

    Gabriela Ilie

    Full Text Available OBJECTIVE: Our knowledge on the adverse correlates of traumatic brain injuries (TBI, including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. METHOD AND FINDINGS: Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS. Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9 of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52, attempting suicide (AOR = 3.39, seeking counselling through a crisis help-line (AOR = 2.10, and being prescribed medication for anxiety, depression, or both (AOR = 2.45. Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70, being cyber-bullied (AOR = 2.05, and being threatened with a weapon at school (AOR = 2.90, compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. CONCLUSIONS: Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during

  16. BrainModes: the role of neuronal oscillations in health and disease.

    Science.gov (United States)

    Terry, John R; Ritter, Petra; Daffertshofer, Andreas

    2011-03-01

    The core idea of complexity science--namely how macroscopic phenomena emerge from the interactions between microscopic quantities--is particularly relevant to the study of the human brain. It is in this context that the term "BrainModes" was adopted to explore how cooperative phenomena (or 'modes' of activity) occurring at one spatial or temporal scale give rise to coherent structures at other scales. This Special Issue reports the 2009 BrainModes Workshop, held in Bristol (December 2009) which focussed on the fusion of theoretical, computational, experimental and clinical methods for enhancing our understanding of the role played by neuronal oscillations in healthy and diseased brain states. PMID:21145909

  17. Distinct representations of configural and part information across multiple face-selective regions of the human brain

    OpenAIRE

    Golarai, Golijeh; Ghahremani, Dara G.; Eberhardt, Jennifer L.; John D E Gabrieli

    2015-01-01

    Several regions of the human brain respond more strongly to faces than to other visual stimuli, such as regions in the amygdala (AMG), superior temporal sulcus (STS), and the fusiform face area (FFA). It is unclear if these brain regions are similar in representing the configuration or natural appearance of face parts. We used functional magnetic resonance imaging of healthy adults who viewed natural or schematic faces with internal parts that were either normally configured or randomly rearr...

  18. Abnormal blood-brain barrier permeability in normal appearing white matter in multiple sclerosis investigated by MRI

    DEFF Research Database (Denmark)

    Cramer, Stig Præstekær; Simonsen, Helle Juhl; Frederiksen, Jette Lautrup Battistini;

    2013-01-01

    To investigate whether blood-brain barrier (BBB) permeability is disrupted in normal appearing white matter in MS patients, when compared to healthy controls and whether it is correlated with MS clinical characteristics.......To investigate whether blood-brain barrier (BBB) permeability is disrupted in normal appearing white matter in MS patients, when compared to healthy controls and whether it is correlated with MS clinical characteristics....

  19. Minimizing inter-subject variability in fNIRS based Brain Computer Interfaces via multiple-kernel support vector learning

    OpenAIRE

    Abibullaev, Berdakh; An, Jinung; Lee, Seung-Hyun; Jin, Sang-Hyeon; Moon, Jeon-Il

    2012-01-01

    Brain signal variability in the measurements obtained from different subjects during different sessions significantly deteriorates the accuracy of most brain-computer interface (BCI) systems. Moreover these variabilities, also known as inter-subject or inter-session variabilities, require lengthy calibration sessions before the BCI system can be used. Furthermore, the calibration session has to be repeated for each subject independently and before use of the BCI due to the inter-session varia...

  20. The low levels of eicosapentaenoic acid in rat brain phospholipids are maintained via multiple redundant mechanisms[S

    OpenAIRE

    Chen, Chuck T; Domenichiello, Anthony F.; Trépanier, Marc-Olivier; Liu, Zhen; Masoodi, Mojgan; Bazinet, Richard P.

    2013-01-01

    Brain eicosapentaenoic acid (EPA) levels are 250- to 300-fold lower than docosahexaenoic acid (DHA), at least partly, because EPA is rapidly β-oxidized and lost from brain phospholipids. Therefore, we examined if β-oxidation was necessary for maintaining low EPA levels by inhibiting β-oxidation with methyl palmoxirate (MEP). Furthermore, because other metabolic differences between DHA and EPA may also contribute to their vastly different levels, this study aimed to quantify the incorporation ...

  1. Physical Activity, Cognitive Function, and Brain Health: What Is the Role of Exercise Training in the Prevention of Dementia?

    OpenAIRE

    Thompson, Paul D.; Beth Parker; Gregory, Sara M.

    2012-01-01

    The population of elderly adults in the US is growing, and the prevalence of age-related cognitive decline and dementia is expected to increase in turn. Effective and inexpensive interventions or preventive measures are necessary to attenuate the increased economic and social burden of dementia. This review will focus on the potential for physical activity and exercise training to promote brain health and improve cognitive function via neurophysiological changes. We will review pertinent anim...

  2. The effect of saponification on the mucopolysaccharides of the ground substance of the human brain: the relation to focal edema and multiple sclerosis.

    Science.gov (United States)

    Feigin, I

    1981-03-01

    The acid mucopolysaccharides of brain tissues are disclosed by their metachromatic staining with toluidine blue following saponification with potassium hydroxide, presumably as a result of the liberation of acid groups previously esterified. Earlier histochemical studies had disclosed the presence of neutral mucopolysaccharides by staining with the periodic acid-Schiff technique, and such staining is intensified by prior saponification. Many biochemical studies have reported the presence of both acid and neutral mucopolysaccharides in brain tissues. Within the white matter following brain edema, the quantity of stained mucopolysaccharides is decreased in the plaques of multiple sclerosis and pontine myelinolysis, and in the lesions of diffuse sclerosis. All of these are characterized by myelin loss with relative preservation of axons. The known physiological effects of the mucopolysaccharides on the water content of normal tissues, and on the properties and diffusability of the increments of fluid that constitute edema, lead to the suggestion that edema may play a major role in the pathogenesis of the demyelinating diseases, including multiple sclerosis.

  3. Circulating brain-derived neurotrophic factor and indices of metabolic and cardiovascular health: data from the Baltimore Longitudinal Study of Aging.

    Directory of Open Access Journals (Sweden)

    Erin Golden

    Full Text Available BACKGROUND: Besides its well-established role in nerve cell survival and adaptive plasticity, brain-derived neurotrophic factor (BDNF is also involved in energy homeostasis and cardiovascular regulation. Although BDNF is present in the systemic circulation, it is unknown whether plasma BDNF correlates with circulating markers of dysregulated metabolism and an adverse cardiovascular profile. METHODOLOGY/PRINCIPAL FINDINGS: To determine whether circulating BDNF correlates with indices of metabolic and cardiovascular health, we measured plasma BDNF levels in 496 middle-age and elderly subjects (mean age approximately 70, in the Baltimore Longitudinal Study of Aging. Linear regression analysis revealed that plasma BDNF is associated with risk factors for cardiovascular disease and metabolic syndrome, regardless of age. In females, BDNF was positively correlated with BMI, fat mass, diastolic blood pressure, total cholesterol, and LDL-cholesterol, and inversely correlated with folate. In males, BDNF was positively correlated with diastolic blood pressure, triglycerides, free thiiodo-thyronine (FT3, and bioavailable testosterone, and inversely correlated with sex-hormone binding globulin, and adiponectin. CONCLUSION/SIGNIFICANCE: Plasma BDNF significantly correlates with multiple risk factors for metabolic syndrome and cardiovascular dysfunction. Whether BDNF contributes to the pathogenesis of these disorders or functions in adaptive responses to cellular stress (as occurs in the brain remains to be determined.

  4. Assessment of human health impact from exposure to multiple air pollutants in China based on satellite observations

    Science.gov (United States)

    Yu, Tao; Wang, Wen; Ciren, Pubu; Zhu, Yan

    2016-10-01

    Assessment of human health impact caused by air pollution is crucial for evaluating environmental hazards. In this paper, concentrations of six air pollutants (PM10, PM2.5, NO2, SO2, O3, and CO) were first derived from satellite observations, and then the overall human health risks in China caused by multiple air pollutants were assessed using an aggregated health risks index. Unlike traditional approach for human health risks assessment, which relied on the in-situ air pollution measurements, the spatial distribution of aggregated human health risks in China were obtained using satellite observations in this research. It was indicated that the remote sensing data have advantages over in-situ data in accessing human health impact caused by air pollution.

  5. Sensitivity and reproducibility of a new fast 3D segmentation technique for clinical MR-based brain volumetry in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Lukas, Carsten; Bellenberg, Barbara; Schimrigk, Sebastian K.; Przuntek, Horst [Ruhr University, Department of Neurology, St. Josef Hospital, Bochum (Germany); Hahn, Horst K.; Rexilius, Jan; Peitgen, Heinz-Otto [MeVis, Center for Medical Diagnostic Systems and Visualization, Bremen (Germany); Schmid, Gebhard; Koester, Odo [Ruhr University, Department of Radiology and Nuclear Medicine, St. Josef Hospital, Bochum (Germany)

    2004-11-01

    Fast, reliable and easy-to-use methods to quantify brain atrophy are of increasing importance in clinical studies on neuro-degenerative diseases. Here, ILAB 4, a new volumetry software that uses a fast semi-automated 3D segmentation of thin-slice T1-weighted 3D MR images based on a modified watershed transform and an automatic histogram analysis was evaluated. It provides the cerebral volumes: whole brain, white matter, gray matter and intracranial cavity. Inter- and intra-rater reliability and scan-rescan reproducibility were excellent in measuring whole brain volumes (coefficients of variation below 0.5%) of volunteers and patients. However, gray and white matter volumes were more susceptible to image quality. High accuracy of the absolute volume results ({+-}5 ml) were shown by phantom and preparation measurements. Analysis times were 6 min for processing of 128 slices. The proposed technique is reliable and highly suitable for quantitative studies of brain atrophy, e.g., in multiple sclerosis. (orig.)

  6. Sensitivity and reproducibility of a new fast 3D segmentation technique for clinical MR-based brain volumetry in multiple sclerosis.

    Science.gov (United States)

    Lukas, Carsten; Hahn, Horst K; Bellenberg, Barbara; Rexilius, Jan; Schmid, Gebhard; Schimrigk, Sebastian K; Przuntek, Horst; Köster, Odo; Peitgen, Heinz-Otto

    2004-11-01

    Fast, reliable and easy-to-use methods to quantify brain atrophy are of increasing importance in clinical studies on neuro-degenerative diseases. Here, ILAB 4, a new volumetry software that uses a fast semi-automated 3D segmentation of thin-slice T1-weighted 3D MR images based on a modified watershed transform and an automatic histogram analysis was evaluated. It provides the cerebral volumes: whole brain, white matter, gray matter and intracranial cavity. Inter- and intra-rater reliability and scan-rescan reproducibility were excellent in measuring whole brain volumes (coefficients of variation below 0.5%) of volunteers and patients. However, gray and white matter volumes were more susceptible to image quality. High accuracy of the absolute volume results (+/-5 ml) were shown by phantom and preparation measurements. Analysis times were 6 min for processing of 128 slices. The proposed technique is reliable and highly suitable for quantitative studies of brain atrophy, e.g., in multiple sclerosis. PMID:15536555

  7. The Correlation between the Virus- and Brain Antigen-Specific B Cell Response in the Blood of Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Marie Wunsch

    2016-04-01

    Full Text Available There is a largely divergent body of literature regarding the relationship between Epstein-Barr virus (EBV infection and brain inflammation in multiple sclerosis (MS. Here, we tested MS patients during relapse (n = 11 and in remission (n = 19 in addition to n = 22 healthy controls to study the correlation between the EBV- and brain-specific B cell response in the blood by enzyme-linked immunospot (ELISPOT and enzyme-linked immunosorbent assay (ELISA. Cytomegalovirus (CMV was used as a control antigen tested in n = 16 MS patients during relapse and in n = 35 patients in remission. Over the course of the study, n = 16 patients were untreated, while n = 33 patients received immunomodulatory therapy. The data show that there was a moderate correlation between the frequencies of EBV- and brain-reactive B cells in MS patients in remission. In addition we could detect a correlation between the B cell response to EBV and disease activity. There was no evidence of an EBV reactivation. Interestingly, there was also a correlation between the frequencies of CMV- and brain-specific B cells in MS patients experiencing an acute relapse and an elevated B cell response to CMV was associated with higher disease activity. The trend remained when excluding seronegative subjects but was non-significant. These data underline that viral infections might impact the immunopathology of MS, but the exact link between the two entities remains subject of controversy.

  8. Brain and Nervous System

    Science.gov (United States)

    ... to Know About Zika & Pregnancy Brain and Nervous System KidsHealth > For Parents > Brain and Nervous System Print ... is quite the juggler. Anatomy of the Nervous System If you think of the brain as a ...

  9. Professional competencies in health sciences education: from multiple intelligences to the clinic floor.

    Science.gov (United States)

    Lane, India F

    2010-03-01

    Nontechnical competencies identified as essential to the health professional's success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding "professional success" is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and "bedside" or "cageside" manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made.

  10. Professional competencies in health sciences education: from multiple intelligences to the clinic floor.

    Science.gov (United States)

    Lane, India F

    2010-03-01

    Nontechnical competencies identified as essential to the health professional's success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding "professional success" is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and "bedside" or "cageside" manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made. PMID:19585247

  11. Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease.

    Science.gov (United States)

    Levitt, David G; Levitt, Michael D

    2014-01-01

    Serum bilirubin measurements are commonly obtained for the evaluation of ill patients and to screen for liver disease in routine physical exams. An enormous research effort has identified the multiple mechanisms involved in the production and metabolism of conjugated (CB) and unconjugated bilirubin (UB). While the qualitative effects of these mechanisms are well understood, their expected quantitative influence on serum bilirubin homeostasis has received less attention. In this review, each of the steps involved in bilirubin production, metabolism, hepatic cell uptake, and excretion is quantitatively examined. We then attempt to predict the expected effect of normal and defective function on serum UB and CB levels in health and disease states including hemolysis, extra- and intrahepatic cholestasis, hepatocellular diseases (eg, cirrhosis, hepatitis), and various congenital defects in bilirubin conjugation and secretion (eg, Gilbert's, Dubin-Johnson, Crigler-Najjar, Rotor syndromes). Novel aspects of this review include: 1) quantitative estimates of the free and total UB and CB in the plasma, hepatocyte, and bile; 2) detailed discussion of the important implications of the recently recognized role of the hepatic OATP transporters in the maintenance of CB homeostasis; 3) discussion of the differences between the standard diazo assay versus chromatographic measurement of CB and UB; 4) pharmacokinetic implications of the extremely high-affinity albumin binding of UB; 5) role of the enterohepatic circulation in physiologic jaundice of newborn and fasting hyperbilirubinemia; and 6) insights concerning the clinical interpretation of bilirubin measurements. PMID:25214800

  12. Integrated health messaging for multiple neglected zoonoses: Approaches, challenges and opportunities in Morocco.

    Science.gov (United States)

    Ducrotoy, M J; Yahyaoui Azami, H; El Berbri, I; Bouslikhane, M; Fassi Fihri, O; Boué, F; Petavy, A F; Dakkak, A; Welburn, S; Bardosh, K L

    2015-12-01

    Integrating the control of multiple neglected zoonoses at the community-level holds great potential, but critical data is missing to inform the design and implementation of different interventions. In this paper we present an evaluation of an integrated health messaging intervention, using powerpoint presentations, for five bacterial (brucellosis and bovine tuberculosis) and dog-associated (rabies, cystic echinococcosis and leishmaniasis) zoonotic diseases in Sidi Kacem Province, northwest Morocco. Conducted by veterinary and epidemiology students between 2013 and 2014, this followed a process-based approach that encouraged sequential adaptation of images, key messages, and delivery strategies using auto-evaluation and end-user feedback. We describe the challenges and opportunities of this approach, reflecting on who was targeted, how education was conducted, and what tools and approaches were used. Our results showed that: (1) replacing words with local pictures and using "hands-on" activities improved receptivity; (2) information "overload" easily occurred when disease transmission pathways did not overlap; (3) access and receptivity at schools was greater than at the community-level; and (4) piggy-backing on high-priority diseases like rabies offered an important avenue to increase knowledge of other zoonoses. We conclude by discussing the merits of incorporating our validated education approach into the school curriculum in order to influence long-term behaviour change. PMID:26299194

  13. Health related quality of life in people with multiple sclerosis : the role of coping, social participation and self-esteem

    NARCIS (Netherlands)

    Mikula, Pavol

    2014-01-01

    Multiple sclerosis (MS) is the most common neurological disease with disabling consequences that occurs in young adults. Symptoms of MS are responsible for high levels of stress and low levels of overall health-related quality of life (HRQoL). In this dissertation we aimed at gaining insight into th

  14. Review of health-related quality of life data in multiple myeloma patients treated with novel agents

    NARCIS (Netherlands)

    P. Sonneveld (Pieter); S.G.R. Verelst (Silvia G.R.); P. Lewis (P.); V. Gray-Schopfer (V.); K. Hutchings (Kim); R. Nixon; M. Petrucci (Maria)

    2013-01-01

    textabstractIn multiple myeloma (MM), health-related quality of life (HRQoL) data is becoming increasingly important, owing to improved survival outcomes and the impact of treatment-related toxicity on HRQoL. Researchers are more frequently including HRQoL assessments in clinical trials, but analysi

  15. Health-related quality of life in Iranian patients with multiple sclerosis: a cross-cultural study

    DEFF Research Database (Denmark)

    Pakpour, Amir H; Yekaninejad, Mir S; Mohammadi, Nastaran K;

    2009-01-01

    BACKGROUND AND PURPOSE: This study aimed to evaluate aspects of health-related quality of life (HRQoL) of patients with multiple sclerosis (MS) who live in Tehran and to compare data with evaluations of both the general population and MS patients in other countries. MATERIAL AND METHODS: One hund...

  16. Exercise, Diet, and Stress Management as Mediators between Functional Disability and Health-Related Quality of Life in Multiple Sclerosis

    Science.gov (United States)

    Sung, Connie; Chiu, Chung-Yi; Lee, Eun-Jeong; Bezyak, Jill; Chan, Fong; Muller, Veronica

    2013-01-01

    The main objective of this study was to examine the mediational and moderational effect of exercise, diet, and stress management on the relationship between functional disability and health-related quality of life. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 215…

  17. Multiple "buy buttons" in the brain: Forecasting chocolate sales at point-of-sale based on functional brain activation using fMRI.

    Science.gov (United States)

    Kühn, Simone; Strelow, Enrique; Gallinat, Jürgen

    2016-08-01

    We set out to forecast consumer behaviour in a supermarket based on functional magnetic resonance imaging (fMRI). Data was collected while participants viewed six chocolate bar communications and product pictures before and after each communication. Then self-reports liking judgement were collected. fMRI data was extracted from a priori selected brain regions: nucleus accumbens, medial orbitofrontal cortex, amygdala, hippocampus, inferior frontal gyrus, dorsomedial prefrontal cortex assumed to contribute positively and dorsolateral prefrontal cortex and insula were hypothesized to contribute negatively to sales. The resulting values were rank ordered. After our fMRI-based forecast an instore test was conducted in a supermarket on n=63.617 shoppers. Changes in sales were best forecasted by fMRI signal during communication viewing, second best by a comparison of brain signal during product viewing before and after communication and least by explicit liking judgements. The results demonstrate the feasibility of applying neuroimaging methods in a relatively small sample to correctly forecast sales changes at point-of-sale.

  18. Multiple "buy buttons" in the brain: Forecasting chocolate sales at point-of-sale based on functional brain activation using fMRI.

    Science.gov (United States)

    Kühn, Simone; Strelow, Enrique; Gallinat, Jürgen

    2016-08-01

    We set out to forecast consumer behaviour in a supermarket based on functional magnetic resonance imaging (fMRI). Data was collected while participants viewed six chocolate bar communications and product pictures before and after each communication. Then self-reports liking judgement were collected. fMRI data was extracted from a priori selected brain regions: nucleus accumbens, medial orbitofrontal cortex, amygdala, hippocampus, inferior frontal gyrus, dorsomedial prefrontal cortex assumed to contribute positively and dorsolateral prefrontal cortex and insula were hypothesized to contribute negatively to sales. The resulting values were rank ordered. After our fMRI-based forecast an instore test was conducted in a supermarket on n=63.617 shoppers. Changes in sales were best forecasted by fMRI signal during communication viewing, second best by a comparison of brain signal during product viewing before and after communication and least by explicit liking judgements. The results demonstrate the feasibility of applying neuroimaging methods in a relatively small sample to correctly forecast sales changes at point-of-sale. PMID:27173762

  19. Racial Disparities in Children's Health: A Longitudinal Analysis of Mothers Based on the Multiple Disadvantage Model.

    Science.gov (United States)

    Cheng, Tyrone C; Lo, Celia C

    2016-08-01

    This secondary data analysis of 4373 mothers and their children investigated racial disparities in children's health and its associations with social structural factors, social relationships/support, health/mental health, substance use, and access to health/mental health services. The study drew on longitudinal records for mother-child pairs created from data in the Fragile Families and Child Wellbeing Study. Generalized estimating equations yielded results showing children's good health to be associated positively with mother's health (current health and health during pregnancy), across three ethnic groups. For African-American children, good health was associated with mothers' education level, receipt of informal child care, receipt of public health insurance, uninsured status, and absence of depression. For Hispanic children, health was positively associated with mothers' education level, receipt of substance-use treatment, and non-receipt of public assistance. Implications for policy and intervention are discussed. PMID:26754044

  20. Health service use in adults 20-64 years with traumatic brain injury, spinal cord injury or pelvic fracture. A cohort study with 9-year follow-up

    DEFF Research Database (Denmark)

    Laursen, Bjarne; Helweg-Larsen, Karin

    2012-01-01

    To estimate the health service use over 9 years after the injury year for patients with traumatic brain injury (TBI), spinal cord injury (SCI) and pelvic fracture (PF), and compare with non-injured.......To estimate the health service use over 9 years after the injury year for patients with traumatic brain injury (TBI), spinal cord injury (SCI) and pelvic fracture (PF), and compare with non-injured....

  1. A secure web-based approach for accessing transitional health information for people with traumatic brain injury.

    Science.gov (United States)

    Lemaire, E D; Deforge, D; Marshall, S; Curran, D

    2006-03-01

    A web-based transitional health record was created to provide regional healthcare professionals with ubiquitous access to information on people with brain injuries as they move through the healthcare system. Participants included public, private, and community healthcare organizations/providers in Eastern Ontario (Canada). One hundred and nineteen service providers and 39 brain injury survivors registered over 6 months. Fifty-eight percent received English and 42% received bilingual services (English-French). Public health providers contacted the regional service coordinator more than private providers (52% urban centres, 26% rural service providers, and 22% both areas). Thirty-five percent of contacts were for technical difficulties, 32% registration inquiries, 21% forms and processes, 6% resources, and 6% education. Seventeen technical enquiries required action by technical support personnel: 41% digital certificates, 29% web forms, and 12% log-in. This web-based approach to clinical information sharing provided access to relevant data as clients moved through or re-entered the health system. Improvements include automated digital certificate management, institutional health records system integration, and more referral tracking tools. More sensitive test data could be accessed on-line with increasing consumer/clinician confidence. In addition to a strong technical infrastructure, human resource issues are a major information security component and require continuing attention to ensure a viable on-line information environment. PMID:16469409

  2. Zimbabwe's Medical Brain Drain: Impact Assessment on Health Service Delivery and Examination of Policy Responses: A Literature Review

    Directory of Open Access Journals (Sweden)

    Conrad Chibango

    2013-06-01

    Full Text Available The migration of health professionals to greener pastures negatively impacts on the healthservice delivery of the source countries. The trend is that doctors and nurses migrate fromrural areas to urban areas or from developing countries to developed countries in search ofbetter economic welfare and working conditions. In search of the same conditions, healthprofessionals also migrate from the public sector to the private sector. The causes for thismigration, which are largely viewed to be of economic nature, constitute the ‘push’ and‘pull’ factors. It is these factors that policy-makers should carefully study in order to arrestthe medical brain drain. Zimbabwe has not been spared of this phenomenon. In theprocess, the poor, and especially in rural areas, have been the worst victims. ZimbabweanGovernment policies, though well-intended, have not been adequate enough to arrest thesituation. This paper argues that an integrated policy approach is best positioned toaddress the brain drain problem, which has negatively impacted on the health servicedelivery system. The integrated policy approach takes cognizance of the various factorsthat constitute the complex nature of the brain drain. Such factors include global, regional,national, international market labour, development theory and practice, and human rightsand justice issues, which, unfortunately, are not usually given much consideration duringthe policy formulation process.

  3. Lifelong Brain Health is a Lifelong Challenge: From Evolutionary Principles to Empirical Evidence

    OpenAIRE

    Mattson, Mark P.

    2015-01-01

    Although the human brain is exceptional in size and information processing capabilities, it is similar to other mammals with regards to the factors that promote its optimal performance. Three such factors are the challenges of physical exercise, food deprivation/fasting, and social/intellectual engagement. Because it evolved, in part, for success in seeking and acquiring food, the brain functions best when the individual is hungry and physically active, as typified by the hungry lion stalking...

  4. Acute and chronic glucocorticoid treatments regulate astrocyte-enriched mRNAs in multiple brain regions in vivo

    Directory of Open Access Journals (Sweden)

    Bradley S. Carter

    2013-08-01

    Full Text Available Previous studies have primarily interpreted gene expression regulation by glucocorticoids in the brain in terms of impact on neurons; however, less is known about the corresponding impact of glucocorticoids on glia and specifically astrocytes in vivo. Recent microarray experiments have identified glucocorticoid-sensitive mRNAs in primary astrocyte cell culture, including a number of mRNAs that have reported astrocyte-enriched expression patterns relative to other brain cell types. Here, we have tested whether elevations of glucocorticoids regulate a subset of these mRNAs in vivo following acute and chronic corticosterone exposure in adult mice. Acute corticosterone exposure was achieved by a single injection of 10 mg/kg corticosterone, and tissue samples were harvested two hours post-injection. Chronic corticosterone exposure was achieved by administering 10 mg/mL corticosterone via drinking water for two weeks. Gene expression was then assessed in two brain regions associated with glucocorticoid action (prefrontal cortex and hippocampus by qPCR and by in situ hybridization. The majority of measured mRNAs regulated by glucocorticoids in astrocytes in vitro were similarly regulated by acute and/or chronic glucocorticoid exposure in vivo. In addition, the expression levels for mRNAs regulated in at least one corticosterone exposure condition (acute/chronic demonstrated moderate positive correlation between the two conditions by brain region. In situ hybridization analyses suggest that select mRNAs are regulated by chronic corticosterone exposure specifically in astroctyes based on (1 similar general expression patterns between corticosterone-treated and vehicle-treated animals and (2 similar expression patterns to the pan-astrocyte marker Aldh1l1. Our findings demonstrate that glucocorticoids regulate astrocyte-enriched mRNAs in vivo and suggest that glucocorticoids regulate gene expression in the brain in a cell type-dependent fashion.

  5. SU-E-T-587: Optimal Volumetric Modulated Arc Radiotherapy Treatment Planning Technique for Multiple Brain Metastases with Increasing Number of Arcs

    International Nuclear Information System (INIS)

    Purpose: To show improvements in dose conformity and normal brain tissue sparing using an optimal planning technique (OPT) against clinically acceptable planning technique (CAP) in the treatment of multiple brain metastases. Methods: A standardized international benchmark case with12 intracranial tumors was planned using two different VMAT optimization methods. Plans were split into four groups with 3, 6, 9, and 12 targets each planned with 3, 5, and 7 arcs using Eclipse TPS. The beam geometries were 1 full coplanar and half non-coplanar arcs. A prescription dose of 20Gy was used for all targets. The following optimization criteria was used (OPT vs. CAP): (No upper limit vs.108% upper limit for target volume), (priority 140–150 vs. 75–85 for normal-brain-tissue), and (selection of automatic sparing Normal-Tissue-Objective (NTO) vs. Manual NTO). Both had priority 50 to critical structures such as brainstem and optic-chiasm, and both had an NTO priority 150. Normal-brain-tissue doses along with Paddick Conformity Index (PCI) were evaluated. Results: In all cases PCI was higher for OPT plans. The average PCI (OPT,CAP) for all targets was (0.81,0.64), (0.81,0.63), (0.79,0.57), and (0.72,0.55) for 3, 6, 9, and 12 target plans respectively. The percent decrease in normal brain tissue volume (OPT/CAP*100) achieved by OPT plans was (reported as follows: V4, V8, V12, V16, V20) (184, 343, 350, 294, 371%), (192, 417, 380, 299, 360%), and (235, 390, 299, 281, 502%) for the 3, 5, 7 arc 12 target plans, respectively. The maximum brainstem dose decreased for the OPT plan by 4.93, 4.89, and 5.30 Gy for 3, 5, 7 arc 12 target plans, respectively. Conclusion: Substantial increases in PCI, critical structure sparing, and decreases in normal brain tissue dose were achieved by eliminating upper limits from optimization, using automatic sparing of normal tissue function with high priority, and a high priority to normal brain tissue

  6. SU-E-T-587: Optimal Volumetric Modulated Arc Radiotherapy Treatment Planning Technique for Multiple Brain Metastases with Increasing Number of Arcs

    Energy Technology Data Exchange (ETDEWEB)

    Keeling, V; Hossain, S; Hildebrand, K; Ahmad, S [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Larson, D; Ma, L [University of California San Francisco, San Francisco, CA (United States); Sahgal, A [University of Toronto, Toronto, ON (Canada)

    2015-06-15

    Purpose: To show improvements in dose conformity and normal brain tissue sparing using an optimal planning technique (OPT) against clinically acceptable planning technique (CAP) in the treatment of multiple brain metastases. Methods: A standardized international benchmark case with12 intracranial tumors was planned using two different VMAT optimization methods. Plans were split into four groups with 3, 6, 9, and 12 targets each planned with 3, 5, and 7 arcs using Eclipse TPS. The beam geometries were 1 full coplanar and half non-coplanar arcs. A prescription dose of 20Gy was used for all targets. The following optimization criteria was used (OPT vs. CAP): (No upper limit vs.108% upper limit for target volume), (priority 140–150 vs. 75–85 for normal-brain-tissue), and (selection of automatic sparing Normal-Tissue-Objective (NTO) vs. Manual NTO). Both had priority 50 to critical structures such as brainstem and optic-chiasm, and both had an NTO priority 150. Normal-brain-tissue doses along with Paddick Conformity Index (PCI) were evaluated. Results: In all cases PCI was higher for OPT plans. The average PCI (OPT,CAP) for all targets was (0.81,0.64), (0.81,0.63), (0.79,0.57), and (0.72,0.55) for 3, 6, 9, and 12 target plans respectively. The percent decrease in normal brain tissue volume (OPT/CAP*100) achieved by OPT plans was (reported as follows: V4, V8, V12, V16, V20) (184, 343, 350, 294, 371%), (192, 417, 380, 299, 360%), and (235, 390, 299, 281, 502%) for the 3, 5, 7 arc 12 target plans, respectively. The maximum brainstem dose decreased for the OPT plan by 4.93, 4.89, and 5.30 Gy for 3, 5, 7 arc 12 target plans, respectively. Conclusion: Substantial increases in PCI, critical structure sparing, and decreases in normal brain tissue dose were achieved by eliminating upper limits from optimization, using automatic sparing of normal tissue function with high priority, and a high priority to normal brain tissue.

  7. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

    OpenAIRE

    Tromp Noor; Baltussen Rob

    2012-01-01

    Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frame...

  8. [Self-esteem Saves Brain and Health: Evidence from a Follow-up Investigation after the Great East Japan Earthquake].

    Science.gov (United States)

    Sekiguchi, Atsushi

    2015-10-01

    Self-esteem plays a crucial role in mental health status. Past studies have revealed higher self-esteem as one of the most important traits of resilience in the context of stressful life events. In fact, our recent studies demonstrated that high self-esteem is a predicting factor for the recovery from brain volume reduction due to the post-earthquake distress. In this article, we introduce structural brain magnetic resonance imaging research with respect to self-esteem as well as past investigations about psychological and physiological backgrounds of tolerance to psycho-social stressors in individuals with high self-esteem. Finally, we discuss effective methods for improving self-esteem to manage unusual events like natural disaster.

  9. [Self-esteem Saves Brain and Health: Evidence from a Follow-up Investigation after the Great East Japan Earthquake].

    Science.gov (United States)

    Sekiguchi, Atsushi

    2015-10-01

    Self-esteem plays a crucial role in mental health status. Past studies have revealed higher self-esteem as one of the most important traits of resilience in the context of stressful life events. In fact, our recent studies demonstrated that high self-esteem is a predicting factor for the recovery from brain volume reduction due to the post-earthquake distress. In this article, we introduce structural brain magnetic resonance imaging research with respect to self-esteem as well as past investigations about psychological and physiological backgrounds of tolerance to psycho-social stressors in individuals with high self-esteem. Finally, we discuss effective methods for improving self-esteem to manage unusual events like natural disaster. PMID:26450072

  10. Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease

    Directory of Open Access Journals (Sweden)

    Levitt DG

    2014-09-01

    Full Text Available David G Levitt,1 Michael D Levitt2 1Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA; 2Research Service, Veterans Affairs Medical Center, Minneapolis, MN, USAAbstract: Serum bilirubin measurements are commonly obtained for the evaluation of ill patients and to screen for liver disease in routine physical exams. An enormous research effort has identified the multiple mechanisms involved in the production and metabolism of conjugated (CB and unconjugated bilirubin (UB. While the qualitative effects of these mechanisms are well understood, their expected quantitative influence on serum bilirubin homeostasis has received less attention. In this review, each of the steps involved in bilirubin production, metabolism, hepatic cell uptake, and excretion is quantitatively examined. We then attempt to predict the expected effect of normal and defective function on serum UB and CB levels in health and disease states including hemolysis, extra- and intrahepatic cholestasis, hepatocellular diseases (eg, cirrhosis, hepatitis, and various congenital defects in bilirubin conjugation and secretion (eg, Gilbert's, Dubin–Johnson, Crigler–Najjar, Rotor syndromes. Novel aspects of this review include: 1 quantitative estimates of the free and total UB and CB in the plasma, hepatocyte, and bile; 2 detailed discussion of the important implications of the recently recognized role of the hepatic OATP transporters in the maintenance of CB homeostasis; 3 discussion of the differences between the standard diazo assay versus chromatographic measurement of CB and UB; 4 pharmacokinetic implications of the extremely high-affinity albumin binding of UB; 5 role of the enterohepatic circulation in physiologic jaundice of newborn and fasting hyperbilirubinemia; and 6 insights concerning the clinical interpretation of bilirubin measurements.Keywords: liver, conjugation, diazo, albumin, Rotor

  11. Reverse the 'real brain drain' for our children, urges Director of Public Health

    OpenAIRE

    Public Health Agency

    2011-01-01

    The second annual report of the Director of Public Health (DPH) for Northern Ireland was published today. This significant report highlights the many public health challenges that affect people in Northern Ireland. Dr Carolyn Harper, Director of Public Health, leads the public health team that tackles this complex agenda, working with many statutory, community and voluntary partner organisations across health, local government, education, housing and other sectors.

  12. Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis

    Science.gov (United States)

    Ulrichsen, Kristine M.; Kaufmann, Tobias; Dørum, Erlend S.; Kolskår, Knut K.; Richard, Geneviève; Alnæs, Dag; Arneberg, Tone J.; Westlye, Lars T.; Nordvik, Jan E.

    2016-01-01

    Background: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief. Objective: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries. Materials and Methods: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke. Results: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17). Conclusion: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions. PMID:27445888

  13. Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Hojnacki David

    2011-10-01

    Full Text Available Abstract Background The potential pathogenesis between the presence and severity of chronic cerebrospinal venous insufficiency (CCSVI and its relation to clinical and imaging outcomes in brain parenchyma of multiple sclerosis (MS patients has not yet been elucidated. The aim of the study was to investigate the relationship between CCSVI, and altered brain parenchyma venous vasculature visibility (VVV on susceptibility-weighted imaging (SWI in patients with MS and in sex- and age-matched healthy controls (HC. Methods 59 MS patients, 41 relapsing-remitting and 18 secondary-progressive, and 33 HC were imaged on a 3T GE scanner using pre- and post-contrast SWI venography. The presence and severity of CCSVI was determined using extra-cranial and trans-cranial Doppler criteria. Apparent total venous volume (ATVV, venous intracranial fraction (VIF and average distance-from-vein (DFV were calculated for various vein mean diameter categories: .9 mm. Results CCSVI criteria were fulfilled in 79.7% of MS patients and 18.2% of HC (p Conclusions MS patients with higher number of venous stenoses, indicative of CCSVI severity, showed significantly decreased venous vasculature in the brain parenchyma. The pathogenesis of these findings has to be further investigated, but they suggest that reduced metabolism and morphological changes of venous vasculature may be taking place in patients with MS.

  14. Impact of fluoxetine on the human brain in multiple sclerosis as quantified by proton magnetic resonance spectroscopy and diffusion tensor imaging.

    Science.gov (United States)

    Sijens, Paul E; Mostert, Jop P; Irwan, Roy; Potze, Jan Hendrik; Oudkerk, Matthijs; De Keyser, Jacques

    2008-12-30

    The antidepressant fluoxetine stimulates astrocytic glycogenolysis, which serves as an energy source for axons. In multiple sclerosis patients fluoxetine administration may improve energy supply in neuron cells and thus inhibit axonal degeneration. In a preliminary pilot study, 15 patients with multiple sclerosis (MS) were examined by diffusion tensor imaging (DTI) and (1)H magnetic resonance spectroscopy (MRS) in order to quantify the brain tissue diffusion properties (fractional anisotropy, apparent diffusion coefficient) and metabolite levels (choline, creatine and N-acetylaspartate) in cortical gray matter brain tissue, in normal appearing white matter and in white matter lesions. After oral administration of fluoxetine (20 mg/day) for 1 week, the DTI and MRS measurements were repeated and after treatment with a higher dose (40 mg/day) during the next week, a third series of DTI/MRS examinations was performed in order to assess any changes in diffusion properties and metabolism. One trend was observed in gray matter tissue, a decrease of choline measured at weeks 1 and 2 (significant in a subgroup of 11 relapsing remitting/secondary progressive MS patients). In white matter lesions, the apparent diffusion coefficient was increased at week 1 and N-acetylaspartate was increased at week 2 (both significant). These preliminary results provide evidence of a neuroprotective effect of fluoxetine in MS by the observed partial normalization of the structure-related MRS parameter N-acetylaspartate in white matter lesions.

  15. Brain Basics

    Medline Plus

    Full Text Available ... the understanding of how the brain grows and works and the effects of genes and environment on mental health. This knowledge is allowing scientists to make important discoveries that ...

  16. Brain Basics

    Medline Plus

    Full Text Available ... related to changes in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot ... NIMH Strategic Plan in 2016 August 31, 2016, 2:00-3:00 PM ET General Health Information ...

  17. Development of an MRI rating scale for multiple brain regions: comparison with volumetrics and with voxel-based morphometry

    Energy Technology Data Exchange (ETDEWEB)

    Davies, R.R.; Williams, Guy B. [University of Cambridge, Department of Clinical Neurosciences, Cambridge (United Kingdom); Scahill, Victoria L.; Graham, Kim S. [Cardiff University, MRC Cognition and Brain Sciences Unit, Cambridge and Wales Institute of Cognitive Neuroscience, School of Psychology, Cardiff (United Kingdom); Graham, Andrew [University of Cambridge, Department of Clinical Neurosciences, Cambridge (United Kingdom); Cardiff University, MRC Cognition and Brain Sciences Unit, Cambridge and Wales Institute of Cognitive Neuroscience, School of Psychology, Cardiff (United Kingdom); Hodges, John R. [University of Cambridge, Department of Clinical Neurosciences, Cambridge (United Kingdom); Cardiff University, MRC Cognition and Brain Sciences Unit, Cambridge and Wales Institute of Cognitive Neuroscience, School of Psychology, Cardiff (United Kingdom); Prince of Wales Medical Research Institute, Cognitive Neurology, Sydney, NSW (Australia)

    2009-08-15

    We aimed to devise a rating method for key frontal and temporal brain regions validated against quantitative volumetric methods and applicable to a range of dementia syndromes. Four standardised coronal MR images from 36 subjects encompassing controls and cases with Alzheimer's disease (AD) and frontotemporal dementia (FTD) were used. After initial pilot studies, 15 regions produced good intra- and inter-rater reliability. We then validated the ratings against manual volumetry and voxel-based morphometry (VBM) and compared ratings across the subject groups. Validation against both manual volumetry (for both frontal and temporal lobes), and against whole brain VBM, showed good correlation with visual ratings for the majority of the brain regions. Comparison of rating scores across disease groups showed involvement of the anterior fusiform gyrus, anterior hippocampus and temporal pole in semantic dementia, while anterior cingulate and orbitofrontal regions were involved in behavioural variant FTD. This simple visual rating can be used as an alternative to highly technical methods of quantification, and may be superior when dealing with single cases or small groups. (orig.)

  18. Development of an MRI rating scale for multiple brain regions: comparison with volumetrics and with voxel-based morphometry

    International Nuclear Information System (INIS)

    We aimed to devise a rating method for key frontal and temporal brain regions validated against quantitative volumetric methods and applicable to a range of dementia syndromes. Four standardised coronal MR images from 36 subjects encompassing controls and cases with Alzheimer's disease (AD) and frontotemporal dementia (FTD) were used. After initial pilot studies, 15 regions produced good intra- and inter-rater reliability. We then validated the ratings against manual volumetry and voxel-based morphometry (VBM) and compared ratings across the subject groups. Validation against both manual volumetry (for both frontal and temporal lobes), and against whole brain VBM, showed good correlation with visual ratings for the majority of the brain regions. Comparison of rating scores across disease groups showed involvement of the anterior fusiform gyrus, anterior hippocampus and temporal pole in semantic dementia, while anterior cingulate and orbitofrontal regions were involved in behavioural variant FTD. This simple visual rating can be used as an alternative to highly technical methods of quantification, and may be superior when dealing with single cases or small groups. (orig.)

  19. Mapping of multiple parameter m-health scenarios to mobile WiMAX QoS variables.

    Science.gov (United States)

    Alinejad, Ali; Philip, N; Istepanian, R S H

    2011-01-01

    Multiparameter m-health scenarios with bandwidth demanding requirements will be one of key applications in future 4 G mobile communication systems. These applications will potentially require specific spectrum allocations with higher quality of service requirements. Furthermore, one of the key 4 G technologies targeting m-health will be medical applications based on WiMAX systems. Hence, it is timely to evaluate such multiple parametric m-health scenarios over mobile WiMAX networks. In this paper, we address the preliminary performance analysis of mobile WiMAX network for multiparametric telemedical scenarios. In particular, we map the medical QoS to typical WiMAX QoS parameters to optimise the performance of these parameters in typical m-health scenario. Preliminary performance analyses of the proposed multiparametric scenarios are evaluated to provide essential information for future medical QoS requirements and constraints in these telemedical network environments. PMID:22254612

  20. Mapping of multiple parameter m-health scenarios to mobile WiMAX QoS variables.

    Science.gov (United States)

    Alinejad, Ali; Philip, N; Istepanian, R S H

    2011-01-01

    Multiparameter m-health scenarios with bandwidth demanding requirements will be one of key applications in future 4 G mobile communication systems. These applications will potentially require specific spectrum allocations with higher quality of service requirements. Furthermore, one of the key 4 G technologies targeting m-health will be medical applications based on WiMAX systems. Hence, it is timely to evaluate such multiple parametric m-health scenarios over mobile WiMAX networks. In this paper, we address the preliminary performance analysis of mobile WiMAX network for multiparametric telemedical scenarios. In particular, we map the medical QoS to typical WiMAX QoS parameters to optimise the performance of these parameters in typical m-health scenario. Preliminary performance analyses of the proposed multiparametric scenarios are evaluated to provide essential information for future medical QoS requirements and constraints in these telemedical network environments.

  1. Functional and structural cerebral changes in key brain regions after a facilitation programme for episodic future thought in relapsing-remitting multiple sclerosis patients.

    Science.gov (United States)

    Ernst, Alexandra; Sourty, Marion; Roquet, Daniel; Noblet, Vincent; Gounot, Daniel; Blanc, Frédéric; De Seze, Jérôme; Manning, Liliann

    2016-06-01

    Increasingly studied, episodic future thought (EFT) impairment negatively affects patients' daily life. Along these lines, working with relapsing-remitting multiple sclerosis (RR-MS) patients, we documented the clinical effectiveness of a mental visual imagery (MVI)-based facilitation programme on EFT impairment related to executive function difficulties. We aimed at improving the characterisation of the cognitive and neural underpinnings of RR-MS patients' EFT amelioration, by exploring the structural and functional brain changes following the MVI programme. Seventeen non-depressed RR-MS patients were recruited and randomly assigned in the (i) experimental group (n=10), who followed the MVI programme or in the control group (n=7), who followed a verbal control programme. Using an adapted version of the Autobiographical Interview to assess EFT, after facilitation, significant improvement was observed in the experimental group only. This was accompanied by increased activation in the prefrontal region during the generation of future events and was positively correlated with grey matter volume increase in this same brain area. Increased activations in the parahippocampal and the middle temporal gyri were also observed in the experimental group in post-facilitation. Likewise, functional connectivity changes were observed in the posterior brain regions after facilitation. Only minor cerebral changes were observed in the control group, likely reflecting practice effects. Our study showed that EFT improvement following the MVI programme led to functional and structural changes in brain regions sustaining contextual processing, visual imagery, the integration and maintenance of multimodal information. Taken together, these findings suggest that a cognitive intervention focusing on scene construction can be efficient to alleviate EFT impairment related to executive dysfunction. As such, this study opens the way to the development of tailor-made rehabilitation programmes

  2. Multiple Balances in Workplace Dialogue: Experiences of an Intervention in Health Care

    Science.gov (United States)

    Grill, Christina; Ahlborg, Gunnar, Jr.; Wikström, Ewa; Lindgren, Eva-Carin

    2015-01-01

    Purpose: This paper aims to illuminate and analyse the participants' experiences of the influences of a dialogue intervention. Cooperation and coordination in health care require planning of dialogically oriented communication to prevent stress and ill health and to promote health, well-being, learning, and efficiency in the organisation.…

  3. Ethnic discrimination and health: the relationship between experienced ethnic discrimination and multiple health domains in Norway's rural Sami population

    Directory of Open Access Journals (Sweden)

    Ketil Lenert Hansen

    2015-02-01

    Full Text Available Objective: Self-reported ethnic discrimination has been associated with a range of health outcomes. This study builds on previous efforts to investigate the prevalence of self-reported ethnic discrimination in the indigenous (Sami population, and how such discrimination may be associated with key health indicators. Study design: The study relies on data from the 2003/2004 (n=4,389 population-based study of adults (aged 36–79 years in 24 rural municipalities of Central and North Norway (the SAMINOR study. Self-reported ethnic discrimination was measured using the question: “Have you ever experienced discrimination due to your ethnic background?” Health indicators included questions regarding cardiovascular disease, diabetes, chronic muscle pain, metabolic syndrome and obesity. Logistic regression was applied to examine the relationship between self-reported ethnic discrimination and health outcomes. Results: The study finds that for Sami people living in minority areas, self-reported ethnic discrimination is associated with all the negative health indicators included in the study. Conclusion: We conclude that ethnic discrimination affects a wide range of health outcomes. Our findings highlight the importance of ensuring freedom from discrimination for the Sami people of Norway.

  4. Exposure to multiple metals from groundwater-a global crisis: geology, climate change, health effects, testing, and mitigation.

    Science.gov (United States)

    Mitchell, Erika; Frisbie, Seth; Sarkar, Bibudhendra

    2011-09-01

    This paper presents an overview of the global extent of naturally occurring toxic metals in groundwater. Adverse health effects attributed to the toxic metals most commonly found in groundwater are reviewed, as well as chemical, biochemical, and physiological interactions between these metals. Synergistic and antagonistic effects that have been reported between the toxic metals found in groundwater and the dietary trace elements are highlighted, and common behavioural, cultural, and dietary practices that are likely to significantly modify health risks due to use of metal-contaminated groundwater are reviewed. Methods for analytical testing of samples containing multiple metals are discussed, with special attention to analytical interferences between metals and reagents. An overview is presented of approaches to providing safe water when groundwater contains multiple metallic toxins.

  5. Multiple early victimization experiences as a pathway to explain physical health disparities among sexual minority and heterosexual individuals.

    Science.gov (United States)

    Andersen, Judith P; Zou, Christopher; Blosnich, John

    2015-05-01

    Prior research shows that health disparities exist between sexual minority and heterosexual individuals. We extend the literature by testing if the higher prevalence of childhood victimization experienced by sexual minority individuals accounts for lifetime health disparities. Heterosexual (n = 422) and sexual minority (n = 681) participants were recruited on-line in North America. Respondents completed surveys about their childhood victimization experiences (i.e., maltreatment by adults and peer victimization) and lifetime physician-diagnosed physical health conditions. Results showed that sexual minority individuals experienced higher prevalence of childhood victimization and lifetime physical health problems than heterosexuals. Mediation analyses indicated that maltreatment by adults and peer bullying explained the health disparities between sexual minority individuals and heterosexuals. This study is the first to show that multiple childhood victimization experiences may be one pathway to explain lifetime physical health disparities. Intervention programs reducing the perpetration of violence against sexual minority individuals are critical to reduce health care needs related to victimization experiences. PMID:25864147

  6. Multiple organ procurement

    Directory of Open Access Journals (Sweden)

    Vuković Milivoje

    2007-01-01

    Full Text Available Introduction. Liver transplantation is the most demanding of all solid organ transplantations. It requires perfect organization and motivation of health care professionals, patients and their families. This article deals with the procedure for multiple organ procurement, reviews criteria for organ donation and describes the surgical technique for multiple organ procurement. Discussion. Adequate selection and evaluation of cadaveric donors and of organs for transplantation should include early identification of potential donors, and early diagnosis of brain death. The procurement of the highest number of viable organs for transplantation requires excellence in each of the phases. Early and aggressive physiologic support in the maintenance of potential donors can reduce organ donor loss due to irreversible asystole or multiorgan failure (it is almost always possible to maintain organ perfusion pressure and increase the number of organs without increasing post-transplant morbidity or mortality. The ideal donor is a young, previously healthy, brain dead, victim of an accident. Conclusion. The surgical procedure for multiple organ procurement from brain death donors must be performed without intraopertive organ damage. .

  7. In vivo determination of T1 and T2 in the brain of patients with severe but stable multiple sclerosis

    DEFF Research Database (Denmark)

    Larsson, H B; Frederiksen, J; Kjaer, L;

    1988-01-01

    In vivo measurements of relaxation processes in multiple sclerosis (MS) lesions by magnetic resonance imaging (MRI) may be important for evaluation of the disease activity in individual MS plaques. To obtain information of presumably chronic plaques, 10 patients with severe, but stable MS were in...

  8. Obesity and dementia: Adipokines interact with the brain

    NARCIS (Netherlands)

    Arnoldussen, I.A.C.; Kiliaan, A.J.; Gustafson, D.R.

    2014-01-01

    Obesity is a pandemic and a serious global health concern. Obesity is a risk factor for multiple conditions and contributes to multi-morbidities, resulting in increased health costs and millions of deaths each year. Obesity has been associated with changes in brain structure, cognitive deficits, dem

  9. Effect of Yoga Exercise on General Health Status (GHS and Sense of Life in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    SH Najafi doulatabad

    2011-08-01

    Full Text Available Introduction & Objective: Multiple sclerosis (MS is a type of progressing and degenerating disease of myelin membrane of nervous cells in the Central Nervous System (CNS which could cause the incidence of many signs and complications in patients. The disease could affect different aspects of an individual’s life and disturb his/her normal life. This study was carried out in order to survey the effect of yoga exercise on general health status (GHS and sense of life in patients with multiple sclerosis. Materials & Methods: This research was a clinical trial study carried out at Yasouj University of Medical Sciences on 60 female patients with multiple sclerosis from Kohgiloyeh and Boyerahmad province in 2009.The data collecting tool consisted was MSQoL-54 questionnaire contained demographic information of patients. Patients were randomly divided into two control and case groups (30 persons in each group. Then, the general health status (GHS and sense of life of the subjects were evaluated. Yoga therapy was done in the case group for three months and each month included eight sessions of 1-1.5 hours while no intervention was carried out on the control group. One month after Yoga therapy, the general health status (GHS and sense of life for both groups were evaluated and compared with each other. Collected data were analyzed using descriptive tests, statistical independent t-test and paired t-test by the SPSS software. Results: The mean age of samples was 31.6±8.0 with the range of 18-45 years. Forty two (70% of the subjects were married and 18 (30% were single. Forty four (73.3% had high school education and 16 (26.6% had a university degree. Regarding occupation, most of them (63.3% were housewives. Results of the study showed that after Yoga therapy, the mean rate of general health status (GHS and sense of life as a whole had significant statistical difference between two groups (P<0.05. Conclusion: Yoga has improved the general health status

  10. Health Workforce Brain Drain: From Denouncing the Challenge to Solving the Problem

    OpenAIRE

    Akhenaten Benjamin Siankam Tankwanchi; Cağlar Ozden; Vermund, Sten H.

    2013-01-01

    Editors' Summary Background Population growth and aging and increasingly complex health care interventions, as well as existing policies and market forces, mean that many countries are facing a shortage of health care professionals. High-income countries are addressing this problem in part by encouraging the immigration of foreign health care professionals from low- and middle-income countries. In the US, for example, international medical graduates (IMGs) can secure visas and permanent resid...

  11. A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties.

    Science.gov (United States)

    McKay, Mary McKernan; Gopalan, Geetha; Franco, Lydia; Assael, Kara Dean; Chacko, Anil; Jackson, Jerrold; Fuss, Ashley

    2011-11-01

    This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.

  12. Rural-Urban Analyses of Health-Related Quality of Life among People with Multiple Sclerosis

    Science.gov (United States)

    Buchanan, Robert J.; Zhu, Li; Schiffer, Randolph; Radin, Dagmar; James, Wesley

    2008-01-01

    Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. Purpose: To…

  13. Health-Promoting Changes with Children as Agents: Findings from a Multiple Case Study Research

    Science.gov (United States)

    Simovska, Venka; Carlsson, Monica

    2012-01-01

    Purpose: With the aim of contributing to the evidence base on school-based health promotion, the authors discuss the outcomes and processes of a European intervention project aiming to prevent obesity among children (4-16 years) and promote their health and well-being, titled "Shape Up: a school-community approach to influencing determinants of…

  14. Understanding the End User Perspective: A Multiple-Case Study of Successful Health Information Technology Implementation

    Science.gov (United States)

    Behravesh, Bardia

    2010-01-01

    The United States continues to lag behind other countries in its adoption of health information technology. A failure to increase adoption will jeopardize the nation's ability to reduce medical errors, address the rapid growth of healthcare costs, and enact effective healthcare reform. Health information technology (HIT) implementation success…

  15. Resource atlases for multi-atlas brain segmentations with multiple ontology levels based on T1-weighted MRI.

    Science.gov (United States)

    Wu, Dan; Ma, Ting; Ceritoglu, Can; Li, Yue; Chotiyanonta, Jill; Hou, Zhipeng; Hsu, John; Xu, Xin; Brown, Timothy; Miller, Michael I; Mori, Susumu

    2016-01-15

    Technologies for multi-atlas brain segmentation of T1-weighted MRI images have rapidly progressed in recent years, with highly promising results. This approach, however, relies on a large number of atlases with accurate and consistent structural identifications. Here, we introduce our atlas inventories (n=90), which cover ages 4-82years with unique hierarchical structural definitions (286 structures at the finest level). This multi-atlas library resource provides the flexibility to choose appropriate atlases for various studies with different age ranges and structure-definition criteria. In this paper, we describe the details of the atlas resources and demonstrate the improved accuracy achievable with a dynamic age-matching approach, in which atlases that most closely match the subject's age are dynamically selected. The advanced atlas creation strategy, together with atlas pre-selection principles, is expected to support the further development of multi-atlas image segmentation. PMID:26499813

  16. Resource atlases for multi-atlas brain segmentations with multiple ontology levels based on T1-weighted MRI.

    Science.gov (United States)

    Wu, Dan; Ma, Ting; Ceritoglu, Can; Li, Yue; Chotiyanonta, Jill; Hou, Zhipeng; Hsu, John; Xu, Xin; Brown, Timothy; Miller, Michael I; Mori, Susumu

    2016-01-15

    Technologies for multi-atlas brain segmentation of T1-weighted MRI images have rapidly progressed in recent years, with highly promising results. This approach, however, relies on a large number of atlases with accurate and consistent structural identifications. Here, we introduce our atlas inventories (n=90), which cover ages 4-82years with unique hierarchical structural definitions (286 structures at the finest level). This multi-atlas library resource provides the flexibility to choose appropriate atlases for various studies with different age ranges and structure-definition criteria. In this paper, we describe the details of the atlas resources and demonstrate the improved accuracy achievable with a dynamic age-matching approach, in which atlases that most closely match the subject's age are dynamically selected. The advanced atlas creation strategy, together with atlas pre-selection principles, is expected to support the further development of multi-atlas image segmentation.

  17. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    OpenAIRE

    von der Schulenburg, Johann-Matthias; Willich, Stefan N.; Vauth, Christoph; Ernst, Iris; Schwarzbach, Christoph; Bockelbrink, Angelina; Müller-Riemenschneider, Falk

    2009-01-01

    Background Radiotherapy for patients suffering from malignant neoplasms has developed greatly during the past decades. Stereotactic radiosurgery (SRS) is one important radiotherapeutic option which is defined by a single and highly focussed application of radiation during a specified time interval. One of its important indications is the treatment of brain metastases . Objectives The objective of this HTA is to summarise the current literature concerning the treatment of b...

  18. In vivo astrocytic Ca2+ signaling in health and brain disorders

    OpenAIRE

    Ding, Shinghua

    2013-01-01

    Astrocytes are the predominant glial cell type in the CNS. Although astrocytes are electrically nonexcitable, their excitability is manifested by their Ca2+ signaling, which serves as a mediator of neuron–glia bidirectional interactions via tripartite synapses. Studies from in vivo two-photon imaging indicate that in healthy animals, the properties of spontaneous astrocytic Ca2+ signaling are affected by animal species, age, wakefulness and the location of astrocytes in the brain. Intercellul...

  19. Managing health worker migration: a qualitative study of the Philippine response to nurse brain drain

    Directory of Open Access Journals (Sweden)

    Dimaya Roland M

    2012-12-01

    Full Text Available Abstract Background The emigration of skilled nurses from the Philippines is an ongoing phenomenon that has impacted the quality and quantity of the nursing workforce, while strengthening the domestic economy through remittances. This study examines how the development of brain drain-responsive policies is driven by the effects of nurse migration and how such efforts aim to achieve mind-shifts among nurses, governing and regulatory bodies, and public and private institutions in the Philippines and worldwide. Methods Interviews and focus group discussions were conducted to elicit exploratory perspectives on the policy response to nurse brain drain. Interviews with key informants from the nursing, labour and immigration sectors explored key themes behind the development of policies and programmes that respond to nurse migration. Focus group discussions were held with practising nurses to understand policy recipients’ perspectives on nurse migration and policy. Results Using the qualitative data, a thematic framework was created to conceptualize participants’ perceptions of how nurse migration has driven the policy development process. The framework demonstrates that policymakers have recognised the complexity of the brain drain phenomenon and are crafting dynamic policies and programmes that work to shift domestic and global mindsets on nurse training, employment and recruitment. Conclusions Development of responsive policy to Filipino nurse brain drain offers a glimpse into a domestic response to an increasingly prominent global issue. As a major source of professionals migrating abroad for employment, the Philippines has formalised efforts to manage nurse migration. Accordingly, the Philippine paradigm, summarised by the thematic framework presented in this paper, may act as an example for other countries that are experiencing similar shifts in healthcare worker employment due to migration.

  20. Clinical and MRI diagnosis of brain multiple sclerosis%颅脑多发性硬化的临床及MRI诊断

    Institute of Scientific and Technical Information of China (English)

    吴华旺; 成官迅; 张静; 梁丽宁

    2008-01-01

    目的 探讨多发性硬化(MS)的临床及MRJ特征,提高对多发性硬化的认识及诊断水平.方法 对20例颅脑MS患者临床资料、病灶部位、形态、MR信号及强化特点、胼胝体改变进行回顾性分析评价.结果 MS以青、中年女性稍多见,急性、亚急性起病,多以视觉障碍或肢体感觉、运动障碍为首发症状.视觉诱发电位大多数异常.MRJ检查18例发现病灶,敏感性90%(18/20).病灶以双侧侧脑室旁、额叶皮层及皮层下、半卵圆中心多发.病灶大、小不等,多数为圆形、卵圆形."直角脱髓鞘征"及"白质变脏征"是两个较为典型的征象.T1WI上表现为等、低信号,T2WI及Flair序列上表现为高信号,Flair序列显示病灶更清晰.增强扫描病灶可呈结节状强化、环状强化、弧形强化或无强化.结论 MS的临床及MRI表现具有一定特征.MRI有助于脑部MS的诊断及鉴别诊断,是诊断MS最敏感的成像方法.%Objective To study the clinical and MRI features of multiple sclerosis and to get a better understanding and diagnosing level of brain multiple sclerosis. Methods Twenty patients of brain multiple sclerosis were evaluated retrospectively with regard to clinical data, lesion location,shapes, MR signal and enhancement patterns, as well as the changes of corpus callosum. Results Multiple sclerosis often occurred in young and middle-aged women with acute and subacute onset. The initial symptoms included visual disturbance, acrognosis or motor disturbance. The vision-evoked potential was abnormal in most patients. Lesions were found in 18 patients by MRI scanning, the sensitivity of MKI being 90% (18/20). The distribution of lesions were observed most frequently at the two sides of periventricle, cortical and juxtacortical of frontal lobe and centrum semiovale. The shape of lesions were mostly round or ovate with different sizes. Two typical manifestations of multiple sclerosis were "right-angle demyelination sign" and

  1. Brain-Specific Cytoskeletal Damage Markers in Cerebrospinal Fluid: Is There a Common Pattern between Amyotrophic Lateral Sclerosis and Primary Progressive Multiple Sclerosis?

    Science.gov (United States)

    Abdelhak, Ahmed; Junker, Andreas; Brettschneider, Johannes; Kassubek, Jan; Ludolph, Albert C; Otto, Markus; Tumani, Hayrettin

    2015-01-01

    Many neurodegenerative disorders share a common pathophysiological pathway involving axonal degeneration despite different etiological triggers. Analysis of cytoskeletal markers such as neurofilaments, protein tau and tubulin in cerebrospinal fluid (CSF) may be a useful approach to detect the process of axonal damage and its severity during disease course. In this article, we review the published literature regarding brain-specific CSF markers for cytoskeletal damage in primary progressive multiple sclerosis and amyotrophic lateral sclerosis in order to evaluate their utility as a biomarker for disease progression in conjunction with imaging and histological markers which might also be useful in other neurodegenerative diseases associated with affection of the upper motor neurons. A long-term benefit of such an approach could be facilitating early diagnostic and prognostic tools and assessment of treatment efficacy of disease modifying drugs.

  2. Brain-Specific Cytoskeletal Damage Markers in Cerebrospinal Fluid: Is There a Common Pattern between Amyotrophic Lateral Sclerosis and Primary Progressive Multiple Sclerosis?

    Directory of Open Access Journals (Sweden)

    Ahmed Abdelhak

    2015-07-01

    Full Text Available Many neurodegenerative disorders share a common pathophysiological pathway involving axonal degeneration despite different etiological triggers. Analysis of cytoskeletal markers such as neurofilaments, protein tau and tubulin in cerebrospinal fluid (CSF may be a useful approach to detect the process of axonal damage and its severity during disease course. In this article, we review the published literature regarding brain-specific CSF markers for cytoskeletal damage in primary progressive multiple sclerosis and amyotrophic lateral sclerosis in order to evaluate their utility as a biomarker for disease progression in conjunction with imaging and histological markers which might also be useful in other neurodegenerative diseases associated with affection of the upper motor neurons. A long-term benefit of such an approach could be facilitating early diagnostic and prognostic tools and assessment of treatment efficacy of disease modifying drugs.

  3. Hypoperfusion of brain parenchyma is associated with the severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis: a cross-sectional preliminary report

    Directory of Open Access Journals (Sweden)

    Bergsland Niels

    2011-03-01

    Full Text Available Abstract Background Several studies have reported hypoperfusion of the brain parenchyma in multiple sclerosis (MS patients. We hypothesized a possible relationship between abnormal perfusion in MS and hampered venous outflow at the extracranial level, a condition possibly associated with MS and known as chronic cerebrospinal venous insufficiency (CCSVI. Methods We investigated the relationship between CCSVI and cerebral perfusion in 16 CCSVI MS patients and 8 age- and sex-matched healthy controls. Subjects were scanned in a 3-T scanner using dynamic susceptibility, contrast-enhanced, perfusion-weighted imaging. Cerebral blood flow (CBF, cerebral blood volume (CBV and mean transit time (MTT were measured in the gray matter (GM, white matter (WM and the subcortical GM (SGM. The severity of CCSVI was assessed according to the venous hemodynamic insufficiency severity score (VHISS on the basis of the number of venous segments exhibiting flow abnormalities. Results There was a significant association between increased VHISS and decreased CBF in the majority of examined regions of the brain parenchyma in MS patients. The most robust correlations were observed for GM and WM (r = -0.70 to -0.71, P P corrected = 0.022, and for the putamen, thalamus, pulvinar nucleus of thalamus, globus pallidus and hippocampus (r = -0.59 to -0.71, P P corrected Conclusions This pilot study is the first to report a significant relationship between the severity of CCSVI and hypoperfusion in the brain parenchyma. These preliminary findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole. Reduced perfusion could contribute to the known mechanisms of virtual hypoxia in degenerated axons.

  4. Interleukin-17- and interleukin-22-secreting myelin-specific CD4(+) T cells resistant to corticoids are related with active brain lesions in multiple sclerosis patients.

    Science.gov (United States)

    Wing, Ana Cristina; Hygino, Joana; Ferreira, Thais B; Kasahara, Taissa M; Barros, Priscila O; Sacramento, Priscila M; Andrade, Regis M; Camargo, Solange; Rueda, Fernanda; Alves-Leon, Soniza V; Vasconcelos, Claudia Cristina; Alvarenga, Regina; Bento, Cleonice A M

    2016-02-01

    Multiple sclerosis (MS) is thought to be an autoimmune disorder. It is believed that immunological events in the early stages have great impact on the disease course. Therefore, we aimed to evaluate the cytokine profile of myelin basic protein (MBP)-specific T cells from MS patients in the early phase of the disease and correlate it to clinical parameters, as well as to the effect of in vitro corticoid treatment. Peripheral T cells from MS patients were stimulated with MBP with our without hydrocortisone for 5 days. The cytokines level were determined by ELISA. The number of active brain lesions was determined by MRI scans, and the neurological disabilities were assessed by Expanded Disability Status Scale scores. Our results demonstrated that MS-derived T cells responded to MBP by producing high levels of T helper type 1 (Th1) and Th17 cytokines. Although the production of interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor, IL-17 and IL-22 was less sensitive to hydrocortisone inhibition, only IL-17 and IL-22 levels correlated with active brain lesions. The ability of hydrocortisone to inhibit IL-17 and IL-22 production by MBP-specific CD4(+) T cells was inversely related to the number of active brain lesions. Finally, the production of both cytokines was significantly higher in cell cultures from Afrodescendant patients and it was less sensitive to hydrocortisone inhibition. In summary, our data suggest that IL-17- and IL-22-secreting CD4(+) T cells resistant to corticoids are associated with radiological activity of the MS in early stages of the disease, mainly among Afrodescendant patients who, normally, have worse prognosis.

  5. Sodium MRI in Multiple Sclerosis is Compatible with Intracellular Sodium Accumulation and Inflammation-Induced Hyper-Cellularity of Acute Brain Lesions

    Science.gov (United States)

    Biller, Armin; Pflugmann, Isabella; Badde, Stephanie; Diem, Ricarda; Wildemann, Brigitte; Nagel, Armin M.; Jordan, J.; Benkhedah, Nadia; Kleesiek, Jens

    2016-01-01

    The cascade of inflammatory pathogenetic mechanisms in multiple sclerosis (MS) has no specific conventional MRI correlates. Clinicians therefore stipulate improved imaging specificity to define the pathological substrates of MS in vivo including mapping of intracellular sodium accumulation. Based upon preclinical findings and results of previous sodium MRI studies in MS patients we hypothesized that the fluid-attenuated sodium signal differs between acute and chronic lesions. We acquired brain sodium and proton MRI data of N = 29 MS patients; lesion type was defined by the presence or absence of contrast enhancement. N = 302 MS brain lesions were detected, and generalized linear mixed models were applied to predict lesion type based on sodium signals; thereby controlling for varying numbers of lesions among patients and confounding variables such as age and medication. Hierarchical model comparisons revealed that both sodium signals average tissue (χ2(1) = 27.89, p < 0.001) and fluid-attenuated (χ2(1) = 5.76, p = 0.016) improved lesion type classification. Sodium MRI signals were significantly elevated in acute compared to chronic lesions compatible with intracellular sodium accumulation in acute MS lesions. If confirmed in further studies, sodium MRI could serve as biomarker for diagnostic assessment of MS, and as readout parameter in clinical trials promoting attenuation of chronic inflammation. PMID:27507776

  6. Sodium MRI in Multiple Sclerosis is Compatible with Intracellular Sodium Accumulation and Inflammation-Induced Hyper-Cellularity of Acute Brain Lesions.

    Science.gov (United States)

    Biller, Armin; Pflugmann, Isabella; Badde, Stephanie; Diem, Ricarda; Wildemann, Brigitte; Nagel, Armin M; Jordan, J; Benkhedah, Nadia; Kleesiek, Jens

    2016-01-01

    The cascade of inflammatory pathogenetic mechanisms in multiple sclerosis (MS) has no specific conventional MRI correlates. Clinicians therefore stipulate improved imaging specificity to define the pathological substrates of MS in vivo including mapping of intracellular sodium accumulation. Based upon preclinical findings and results of previous sodium MRI studies in MS patients we hypothesized that the fluid-attenuated sodium signal differs between acute and chronic lesions. We acquired brain sodium and proton MRI data of N = 29 MS patients; lesion type was defined by the presence or absence of contrast enhancement. N = 302 MS brain lesions were detected, and generalized linear mixed models were applied to predict lesion type based on sodium signals; thereby controlling for varying numbers of lesions among patients and confounding variables such as age and medication. Hierarchical model comparisons revealed that both sodium signals average tissue (χ(2)(1) = 27.89, p < 0.001) and fluid-attenuated (χ(2)(1) = 5.76, p = 0.016) improved lesion type classification. Sodium MRI signals were significantly elevated in acute compared to chronic lesions compatible with intracellular sodium accumulation in acute MS lesions. If confirmed in further studies, sodium MRI could serve as biomarker for diagnostic assessment of MS, and as readout parameter in clinical trials promoting attenuation of chronic inflammation. PMID:27507776

  7. Sensory neuron-specific sodium channel SNS is abnormally expressed in the brains of mice with experimental allergic encephalomyelitis and humans with multiple sclerosis

    Science.gov (United States)

    Black, Joel A.; Dib-Hajj, Sulayman; Baker, David; Newcombe, Jia; Cuzner, M. Louise; Waxman, Stephen G.

    2000-10-01

    Clinical abnormalities in multiple sclerosis (MS) have classically been considered to be caused by demyelination and/or axonal degeneration; the possibility of molecular changes in neurons, such as the deployment of abnormal repertoires of ion channels that would alter neuronal electrogenic properties, has not been considered. Sensory Neuron-Specific sodium channel SNS displays a depolarized voltage dependence, slower activation and inactivation kinetics, and more rapid recovery from inactivation than classical "fast" sodium channels. SNS is selectively expressed in spinal sensory and trigeminal ganglion neurons within the peripheral nervous system and is not expressed within the normal brain. Here we show that sodium channel SNS mRNA and protein, which are not present within the cerebellum of control mice, are expressed within cerebellar Purkinje cells in a mouse model of MS, chronic relapsing experimental allergic encephalomyelitis. We also demonstrate SNS mRNA and protein expression within Purkinje cells from tissue obtained postmortem from patients with MS, but not in control subjects with no neurological disease. These results demonstrate a change in sodium channel expression in neurons within the brain in an animal model of MS and in humans with MS and suggest that abnormal patterns of neuronal ion channel expression may contribute to clinical abnormalities such as ataxia in these disorders.

  8. Brain Potentials Highlight Stronger Implicit Food Memory for Taste than Health and Context Associations

    NARCIS (Netherlands)

    Hoogeveen, Heleen R; Jolij, Jacob; Ter Horst, Gert J; Lorist, Monicque M

    2016-01-01

    Increasingly consumption of healthy foods is advised to improve population health. Reasons people give for choosing one food over another suggest that non-sensory features like health aspects are appreciated as of lower importance than taste. However, many food choices are made in the absence of the

  9. Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wong Les G

    2007-10-01

    Full Text Available Abstract Background Dietary supplement use in the United States is prevalent and represents an important source of nutrition. However, little is known about individuals who routinely consume multiple dietary supplements. This study describes the dietary supplement usage patterns, health, and nutritional status of long-term multiple dietary supplement users, and where possible makes comparisons to non-users and multivitamin/mineral supplement users. Methods Using a cross-sectional study design, information was obtained by online questionnaires and physical examination (fasting blood, blood pressure, body weight from a convenience sample of long-term users of multiple dietary supplements manufactured by Shaklee Corporation (Multiple Supp users, n = 278. Data for non-users (No Supp users, n = 602 and multivitamin/mineral supplement users (Single Supp users, n = 176 were obtained from the National Health and Nutrition Examination Survey (NHANES 2001–2002 and NHANES III 1988–1994. Logistic regression methods were used to estimate odds ratios with 95% confidence intervals. Results Dietary supplements consumed on a daily basis by more than 50% of Multiple Supp users included a multivitamin/mineral, B-complex, vitamin C, carotenoids, vitamin E, calcium with vitamin D, omega-3 fatty acids, flavonoids, lecithin, alfalfa, coenzyme Q10 with resveratrol, glucosamine, and a herbal immune supplement. The majority of women also consumed gamma linolenic acid and a probiotic supplement, whereas men also consumed zinc, garlic, saw palmetto, and a soy protein supplement. Serum nutrient concentrations generally increased with increasing dietary supplement use. After adjustment for age, gender, income, education and body mass index, greater degree of supplement use was associated with more favorable concentrations of serum homocysteine, C-reactive protein, high-density lipoprotein cholesterol, and triglycerides, as well as lower risk of prevalent elevated blood

  10. A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers

    Directory of Open Access Journals (Sweden)

    Paul B. Perrin

    2015-01-01

    Full Text Available Background. Multiple sclerosis (MS rates in Latin America are increasing, and caregivers there experience reduced mental and physical health. Based on rigid gender roles in Latin America, women more often assume caregiving duties, yet the differential impact on women of these duties is unknown. Methods. This study examined gender differences in mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Zarit Burden Inventory, health-related quality of life (HRQOL; Short Form-36, and social support (Interpersonal Support Evaluation List-12 in 81 (66.7% women Mexican MS caregivers. Results. As compared to men caregivers, women had lower mental health (p=0.006, HRQOL (p<0.001, and social support (p<0.001. This was partially explained by women caregivers providing care for nearly twice as many hours/week as men (79.28 versus 48.48, p=0.018 and for nearly three times as many months (66.31 versus 24.30, p=0.002. Conclusions. Because gender roles in Latin America influence women to assume more substantial caregiving duties, MS caregiver interventions in Latin America—particularly for women caregivers—should address the influence of gender-role conformity on care and psychosocial functioning.

  11. Influence of type 2 diabetes on brain volumes and changes in brain volumes: Results from the Women's Health Initiative Magnetic Resonance Imaging Studies

    OpenAIRE

    Espeland, MA; Bryan, RN; Goveas, JS; Robinson, JG; Siddiqui, MS; Liu, S.; Hogan, PE; Casanova, R; Coker, LH; Yaffe, K.; Masaki, K.; Rossom, R; Resnick, SM

    2012-01-01

    OBJECTIVE - To study how type 2 diabetes adversely affects brain volumes, changes in volume, and cognitive function. RESEARCH DESIGN AND METHODS - Regional brain volumes and ischemic lesion volumes in 1,366 women, aged 72-89 years, were measured with structural brain magnetic resonance imaging (MRI). Repeat scans were collected an average of 4.7 years later in 698 women. Cross-sectional differences and changes with time between women with and without diabetes were compared. Relationships that...

  12. A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands: the Dutch Multiple Sclerosis Study protocol

    NARCIS (Netherlands)

    Jongen, P.J.; Heerings, M.; Lemmens, W.A.; Donders, R.; Zande, A. van der; Noort, E.; Kool, A.

    2015-01-01

    BACKGROUND: In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about t

  13. A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands : the Dutch Multiple Sclerosis Study protocol

    NARCIS (Netherlands)

    Jongen, Peter Joseph; Heerings, Marco; Lemmens, Wim A.; Donders, Rogier; van der Zande, Anneke; van Noort, Esther; Kool, Anton

    2015-01-01

    Background: In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about t

  14. Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

    Directory of Open Access Journals (Sweden)

    Edvardsson Kristina

    2012-10-01

    Full Text Available Abstract Background To improve health in the population, public health interventions must be successfully implemented within organisations, requiring behaviour change in health service providers as well as in the target population group. Such behavioural change is seldom easily achieved. The purpose of this study was to examine the outcomes of a child health promotion programme (The Salut Programme on professionals’ self-reported health promotion practices, and to investigate perceived facilitators and barriers for programme implementation. Methods A before-and-after design was used to measure programme outcomes, and qualitative data on implementation facilitators and barriers were collected on two occasions during the implementation process. The sample included professionals in antenatal care, child health care, dental services and open pre-schools (n=144 pre-implementation in 13 out of 15 municipalities in a Swedish county. Response rates ranged between 81% and 96% at the four measurement points. Results Self-reported health promotion practices and collaboration were improved in all sectors at follow up. Significant changes included: 1 an increase in the extent to which midwives in antenatal care raised issues related to men’s violence against women, 2 an increase in the extent to which several lifestyle topics were raised with parents/clients in child health care and dental services, 3 an increased use of motivational interviewing (MI and separate ‘fathers visits’ in child health care 4 improvements in the supply of healthy snacks and beverages in open pre-schools and 5 increased collaboration between sectors. Main facilitators for programme implementation included cross-sectoral collaboration and sector-specific work manuals/questionnaires for use as support in everyday practice. Main barriers included high workload, and shortage of time and staff. Conclusion This multisectoral programme for health promotion, based on sector

  15. Developing the Mental Health Workforce: Review and Application of Training Approaches from Multiple Disciplines

    OpenAIRE

    Lyon, Aaron R.; Stirman, Shannon Wiltsey; Kerns, Suzanne E. U.; Bruns, Eric J.

    2011-01-01

    Strategies specifically designed to facilitate the training of mental health practitioners in evidence-based practices (EBPs) have lagged behind the development of the interventions themselves. The current paper draws from an interdisciplinary literature (including medical training, adult education, and teacher training) to identify useful training and support approaches as well as important conceptual frameworks that may be applied to training in mental health. Theory and research findings a...

  16. Multiple Imputation based Clustering Validation (MIV) for Big Longitudinal Trial Data with Missing Values in eHealth.

    Science.gov (United States)

    Zhang, Zhaoyang; Fang, Hua; Wang, Honggang

    2016-06-01

    Web-delivered trials are an important component in eHealth services. These trials, mostly behavior-based, generate big heterogeneous data that are longitudinal, high dimensional with missing values. Unsupervised learning methods have been widely applied in this area, however, validating the optimal number of clusters has been challenging. Built upon our multiple imputation (MI) based fuzzy clustering, MIfuzzy, we proposed a new multiple imputation based validation (MIV) framework and corresponding MIV algorithms for clustering big longitudinal eHealth data with missing values, more generally for fuzzy-logic based clustering methods. Specifically, we detect the optimal number of clusters by auto-searching and -synthesizing a suite of MI-based validation methods and indices, including conventional (bootstrap or cross-validation based) and emerging (modularity-based) validation indices for general clustering methods as well as the specific one (Xie and Beni) for fuzzy clustering. The MIV performance was demonstrated on a big longitudinal dataset from a real web-delivered trial and using simulation. The results indicate MI-based Xie and Beni index for fuzzy-clustering are more appropriate for detecting the optimal number of clusters for such complex data. The MIV concept and algorithms could be easily adapted to different types of clustering that could process big incomplete longitudinal trial data in eHealth services. PMID:27126063

  17. Multiple Imputation based Clustering Validation (MIV) for Big Longitudinal Trial Data with Missing Values in eHealth.

    Science.gov (United States)

    Zhang, Zhaoyang; Fang, Hua; Wang, Honggang

    2016-06-01

    Web-delivered trials are an important component in eHealth services. These trials, mostly behavior-based, generate big heterogeneous data that are longitudinal, high dimensional with missing values. Unsupervised learning methods have been widely applied in this area, however, validating the optimal number of clusters has been challenging. Built upon our multiple imputation (MI) based fuzzy clustering, MIfuzzy, we proposed a new multiple imputation based validation (MIV) framework and corresponding MIV algorithms for clustering big longitudinal eHealth data with missing values, more generally for fuzzy-logic based clustering methods. Specifically, we detect the optimal number of clusters by auto-searching and -synthesizing a suite of MI-based validation methods and indices, including conventional (bootstrap or cross-validation based) and emerging (modularity-based) validation indices for general clustering methods as well as the specific one (Xie and Beni) for fuzzy clustering. The MIV performance was demonstrated on a big longitudinal dataset from a real web-delivered trial and using simulation. The results indicate MI-based Xie and Beni index for fuzzy-clustering are more appropriate for detecting the optimal number of clusters for such complex data. The MIV concept and algorithms could be easily adapted to different types of clustering that could process big incomplete longitudinal trial data in eHealth services.

  18. 60 years of advances in neuropsychopharmacology for improving brain health, renewed hope for progress.

    Science.gov (United States)

    Millan, Mark J; Goodwin, Guy M; Meyer-Lindenberg, Andreas; Ögren, Sven Ove

    2015-05-01

    Pharmacotherapy is effective in helping many patients suffering from psychiatric and neurological disorders, and both psychotherapeutic and stimulation-based techniques likewise have important roles to play in their treatment. However, therapeutic progress has recently been slow. Future success for improving the control and prevention of brain disorders will depend upon deeper insights into their causes and pathophysiological substrates. It will also necessitate new and more rigorous methods for identifying, validating, developing and clinically deploying new treatments. A field of Research and Development (R and D) that remains critical to this endeavour is Neuropsychopharmacology which transformed the lives of patients by introducing pharmacological treatments for psychiatric disorder some 60 years ago. For about half of this time, the European College of Neuropsychopharmacology (ECNP) has fostered efforts to enhance our understanding of the brain, and to improve the management of psychiatric disorders. Further, together with partners in academia and industry, and in discussions with regulators and patients, the ECNP is implicated in new initiatives to achieve this goal. This is then an opportune moment to survey the field, to analyse what we have learned from the achievements and failures of the past, and to identify major challenges for the future. It is also important to highlight strategies that are being put in place in the quest for more effective treatment of brain disorders: from experimental research and drug discovery to clinical development and collaborative ventures for reinforcing "R and D". The present article sets the scene, then introduces and interlinks the eight articles that comprise this Special Volume of European Neuropsychopharmacology. A broad-based suite of themes is covered embracing: the past, present and future of "R and D" for psychiatric disorders; complementary contributions of genetics and epigenetics; efforts to improve the

  19. The microbiota-gut-brain axis: neurobehavioral correlates, health and sociality

    Directory of Open Access Journals (Sweden)

    Augusto Jacobo Montiel-Castro

    2013-10-01

    Full Text Available Recent data suggest that the human body is not such a neatly self-sufficient island after all. It is more like a super-complex ecosystem containing trillions of bacteria and other microorganisms that inhabit all our surfaces; skin, mouth, sexual organs, and specially intestines. It has recently become evident that such microbiota, specifically within the gut, can greatly influence many physiological parameters, including cognitive functions, such as learning, memory and decision making processes. Human microbiota is a diverse and dynamic ecosystem, which has evolved in a mutualistic relationship with its host. Ontogenetically, it is vertically inoculated from the mother during birth, established during the first year of life and during lifespan, horizontally transferred among relatives, mates or close community members. This micro-ecosystem serves the host by protecting against pathogens, metabolizing complex lipids and polysaccharides that otherwise would be inaccessible nutrients, neutralizing drugs and carcinogens, modulating intestinal motility, and making visceral perception possible. It is now evident that the bidirectional signaling between the gastrointestinal tract and the brain, mainly through the vagus nerve, the so called ´microbiota-gut-vagus-brain axis,´ is vital for maintaining homeostasis and it may be also involved in the etiology of several metabolic and mental dysfunctions/disorders. Here we review evidence on the ability of the gut microbiota to communicate with the brain and thus modulate behavior, and also elaborate on the ethological and cultural strategies of human and non-human primates to select, transfer and eliminate microorganisms for selecting the commensal profile.

  20. Adult Relationships in Multiple Contexts and Associations with Adolescent Mental Health

    Science.gov (United States)

    Capp, Gordon; Berkowitz, Ruth; Sullivan, Kathrine; Astor, Ron Avi; De Pedro, Kris; Gilreath, Tamika D.; Benbenishty, Rami; Rice, Eric

    2016-01-01

    Purpose: Adult relationships provide critical support for adolescents because of their potential to foster positive development and provide protective influences. Few studies examine multiple ecological layers of adult relationships in connection with well-being and depression. This study examines the influence of relationships from multiple…

  1. Brain source localization: A new method based on MUltiple SIgnal Classification algorithm and spatial sparsity of the field signal for electroencephalogram measurements

    Science.gov (United States)

    Vergallo, P.; Lay-Ekuakille, A.

    2013-08-01

    Brain activity can be recorded by means of EEG (Electroencephalogram) electrodes placed on the scalp of the patient. The EEG reflects the activity of groups of neurons located in the head, and the fundamental problem in neurophysiology is the identification of the sources responsible of brain activity, especially if a seizure occurs and in this case it is important to identify it. The studies conducted in order to formalize the relationship between the electromagnetic activity in the head and the recording of the generated external field allow to know pattern of brain activity. The inverse problem, that is given the sampling field at different electrodes the underlying asset must be determined, is more difficult because the problem may not have a unique solution, or the search for the solution is made difficult by a low spatial resolution which may not allow to distinguish between activities involving sources close to each other. Thus, sources of interest may be obscured or not detected and known method in source localization problem as MUSIC (MUltiple SIgnal Classification) could fail. Many advanced source localization techniques achieve a best resolution by exploiting sparsity: if the number of sources is small as a result, the neural power vs. location is sparse. In this work a solution based on the spatial sparsity of the field signal is presented and analyzed to improve MUSIC method. For this purpose, it is necessary to set a priori information of the sparsity in the signal. The problem is formulated and solved using a regularization method as Tikhonov, which calculates a solution that is the better compromise between two cost functions to minimize, one related to the fitting of the data, and another concerning the maintenance of the sparsity of the signal. At the first, the method is tested on simulated EEG signals obtained by the solution of the forward problem. Relatively to the model considered for the head and brain sources, the result obtained allows to

  2. Research on prevention of bilirubin-induced brain injury and kernicterus: National Institute of Child Health and Human Development conference executive summary. 2003.

    Science.gov (United States)

    Blackmon, Lillian R; Fanaroff, Avroy A; Raju, Tonse N K

    2004-07-01

    In July 2003, the National Institute of Child Health and Human Development convened a conference, "Research on Prevention of Bilirubin-Induced Brain Injury and Kernicterus: Bench-to-Bedside." This article will provide a summary of presentations and discussions from this conference. The summary will focus on the identified knowledge gaps in 5 areas related to bilirubin-induced brain injury and kernicterus: 1) neurobiology and neuroimaging; 2) epidemiology and issues of clinical management; 3) methodologies for assessing clinical jaundice and direct and noninvasive measurement of serum bilirubin and hemolysis; 4) therapies for management of neonatal hyperbilirubinemia; and 5) public health surveillance and systems-based approaches to prevention. PMID:15231933

  3. Brain and face: communicating signals of health in the left and right sides of the face.

    Science.gov (United States)

    Reis, V A; Zaidel, D W

    2001-01-01

    In human communication and mate selection the appearance of health sends signals regarding biological fitness. We compared the appearance of health in the sides of the face to previous results on left-right facial asymmetry in the appearance of beauty (1). The stimuli were created by aligning the left and right sides of the face each with its own mirror image. Here, participants viewed 38 pairs of left-left and right-right faces and judged which member of the pair looked healthier. No significant interaction emerged between decision (health vs attractiveness) and face side. Rather, in women's faces right-right was significantly more healthy and attractive than left-left, while in men's faces there was no significant left-right difference. In biology and evolution, health and beauty are closely linked and the findings here confirm this relationship in human faces.

  4. Brain Potentials Highlight Stronger Implicit Food Memory for Taste than Health and Context Associations

    OpenAIRE

    Heleen R Hoogeveen; Jacob Jolij; Gert J Ter Horst; Lorist, Monicque M.

    2016-01-01

    Increasingly consumption of healthy foods is advised to improve population health. Reasons people give for choosing one food over another suggest that non-sensory features like health aspects are appreciated as of lower importance than taste. However, many food choices are made in the absence of the actual perception of a food's sensory properties, and therefore highly rely on previous experiences of similar consumptions stored in memory. In this study we assessed the differential strength of...

  5. Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol

    Directory of Open Access Journals (Sweden)

    Hill Sophie

    2012-03-01

    Full Text Available Abstract Background Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. Methods This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1, we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2, before being uploaded to the Internet and evaluated (Stages 3 and 4. Discussion This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader

  6. Human brain mapping: Experimental and computational approaches

    Energy Technology Data Exchange (ETDEWEB)

    Wood, C.C.; George, J.S.; Schmidt, D.M.; Aine, C.J. [Los Alamos National Lab., NM (US); Sanders, J. [Albuquerque VA Medical Center, NM (US); Belliveau, J. [Massachusetts General Hospital, Boston, MA (US)

    1998-11-01

    This is the final report of a three-year, Laboratory-Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). This program developed project combined Los Alamos' and collaborators' strengths in noninvasive brain imaging and high performance computing to develop potential contributions to the multi-agency Human Brain Project led by the National Institute of Mental Health. The experimental component of the project emphasized the optimization of spatial and temporal resolution of functional brain imaging by combining: (a) structural MRI measurements of brain anatomy; (b) functional MRI measurements of blood flow and oxygenation; and (c) MEG measurements of time-resolved neuronal population currents. The computational component of the project emphasized development of a high-resolution 3-D volumetric model of the brain based on anatomical MRI, in which structural and functional information from multiple imaging modalities can be integrated into a single computational framework for modeling, visualization, and database representation.

  7. Diagnostic values of Brain CT-Scan in Tuberculous Meningitis; A Major Health Problem in Afghanistan

    Directory of Open Access Journals (Sweden)

    N. Rasouly

    2009-01-01

    Full Text Available   "nTuberculous meningitis (TBM is the most serious complication of tuberculosis (TB in children. Afghanistan is one of the highest burden TB countries; the incidence rate is estimated at 161/100,000 of the population per year. "nEarly diagnosis of TBM is a challenge because of non-specific initial clinical features. "nDelay of diagnosis is associated with higher morbidity and mortality rate. "nRadiological evaluation has a major rule in the early diagnosis of the disease which includes chest X-Ray in case of association with pulmonary TB, cranial CT scan and MRI. "nCT scan findings in TBM are quite interesting and important and have great impact on the management of the patients. "nGenerally CT findings differ according to the presentation of patients and are usually divided into two groups of non-complicated cases and complicated cases. "nCT finding in case of non-complicated TBM can be entirely normal and sometimes we may find diffuse brain edema and lepto-meningeal inflammation with increased uptake of contrast material in CECT. The meningeal enhancement is more pronounced in the basal cisterns. "nCT finding of complicated cases are more catastrophic including communicating hydrocephalus, ventriculitis, venous or dural thrombosis with presence of delta sign (finding in sagittal sinus thrombosis, parenchymal spread (infarction, cerebritis and abscess, hygroma or empyema (epidural, subdural, and appearance of tuberculomas in the brain.  

  8. Efficient block processing of long duration biotelemetric brain data for health care monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Soumya, I. [Department of E.I.E, GITAM University, Visakhapatnam (India); Zia Ur Rahman, M., E-mail: mdzr-5@ieee.org [Department of E.C.E, K.L. University, Vaddeswaram, Green Fields, Guntur, Andhra Pradesh (India); Rama Koti Reddy, D. V. [Department of Instrumentation Engineering, College of Engineering, Andhra University, Visakhapatnam (India); Lay-Ekuakille, A. [Department of Innovation Engineering, University of Salento, Lecce (Italy)

    2015-03-15

    In real time clinical environment, the brain signals which doctor need to analyze are usually very long. Such a scenario can be made simple by partitioning the input signal into several blocks and applying signal conditioning. This paper presents various block based adaptive filter structures for obtaining high resolution electroencephalogram (EEG) signals, which estimate the deterministic components of the EEG signal by removing noise. To process these long duration signals, we propose Time domain Block Least Mean Square (TDBLMS) algorithm for brain signal enhancement. In order to improve filtering capability, we introduce normalization in the weight update recursion of TDBLMS, which results TD-B-normalized-least mean square (LMS). To increase accuracy and resolution in the proposed noise cancelers, we implement the time domain cancelers in frequency domain which results frequency domain TDBLMS and FD-B-Normalized-LMS. Finally, we have applied these algorithms on real EEG signals obtained from human using Emotive Epoc EEG recorder and compared their performance with the conventional LMS algorithm. The results show that the performance of the block based algorithms is superior to the LMS counter-parts in terms of signal to noise ratio, convergence rate, excess mean square error, misadjustment, and coherence.

  9. Efficient block processing of long duration biotelemetric brain data for health care monitoring

    International Nuclear Information System (INIS)

    In real time clinical environment, the brain signals which doctor need to analyze are usually very long. Such a scenario can be made simple by partitioning the input signal into several blocks and applying signal conditioning. This paper presents various block based adaptive filter structures for obtaining high resolution electroencephalogram (EEG) signals, which estimate the deterministic components of the EEG signal by removing noise. To process these long duration signals, we propose Time domain Block Least Mean Square (TDBLMS) algorithm for brain signal enhancement. In order to improve filtering capability, we introduce normalization in the weight update recursion of TDBLMS, which results TD-B-normalized-least mean square (LMS). To increase accuracy and resolution in the proposed noise cancelers, we implement the time domain cancelers in frequency domain which results frequency domain TDBLMS and FD-B-Normalized-LMS. Finally, we have applied these algorithms on real EEG signals obtained from human using Emotive Epoc EEG recorder and compared their performance with the conventional LMS algorithm. The results show that the performance of the block based algorithms is superior to the LMS counter-parts in terms of signal to noise ratio, convergence rate, excess mean square error, misadjustment, and coherence

  10. Imaging dopamine and opiate receptors in the human brain in health and disease

    International Nuclear Information System (INIS)

    Chemical activity accompanies mental activity, but only recently has it been possible to begin to examine its nature. In 1983 the first imaging of a neuroreceptor in the human brain was accomplished with carbon-11 methyl spipeone, a ligand that binds preferentially to dopamine-2 receptors, 80% of which are located in the caudate nucleus and putamen. Quantitative imaging of serotonin-2, opiate, benzodiazapine and muscarinic cholinergic receptors has subsequently been accomplished. In studies of normal men and women, it has been found that dopamine and serotonin receptor activity decreases dramatically with age, such a decrease being more pronounced in men than in women and greater in the case of dopamine receptors than serotonin-2 receptors. Preliminary studies in patients with neuropsychiatric disorders suggests that dopamine-2 receptor activity is diminished in the caudate nucleus of patients with Huntington's disease. Positron tomography permits quantitative assay of picomolar quantities of neuroreceptors within the living human brain. Studies of patients with Parkinson's disease, Alzheimer's disease, depression, anxiety, schizophrenia, acute and chronic pain states and drug addiction are now in progress

  11. Health, Happiness and Human Enhancement-Dealing with Unexpected Effects of Deep Brain Stimulation.

    Science.gov (United States)

    Schermer, Maartje

    2013-01-01

    Deep Brain Stimulation (DBS) is a treatment involving the implantation of electrodes into the brain. Presently, it is used for neurological disorders like Parkinson's disease, but indications are expanding to psychiatric disorders such as depression, addiction and Obsessive Compulsive Disorder (OCD). Theoretically, it may be possible to use DBS for the enhancement of various mental functions. This article discusses a case of an OCD patient who felt very happy with the DBS treatment, even though her symptoms were not reduced. First, it is explored if the argument that 'doctors are not in the business of trading happiness', as used by her psychiatrist to justify his discontinuation of the DBS treatment, holds. The relationship between enhancement and the goals of medicine is discussed and it is concluded that even though the goals of medicine do not set strict limits and may even include certain types of enhancement, there are some good reasons for limiting the kind of things doctors are required or allowed to do. Next, the case is discussed from the perspective of beneficence and autonomy. It is argued that making people feel good is not the same as enhancing their well-being and that it is unlikely-though not absolutely impossible-that the well-being of the happy OCD patient is really improved. Finally, some concerns regarding the autonomy of a request made under the influence of DBS treatment are considered. PMID:24273618

  12. Self-other relations in social development and autism: multiple roles for mirror neurons and other brain bases.

    Science.gov (United States)

    Williams, Justin H G

    2008-04-01

    Mirror neuron system dysfunction may underlie a self-other matching impairment, which has previously been suggested to account for autism. Embodied Cognition Theory, which proposes that action provides a foundation for cognition has lent further credence to these ideas. The hypotheses of a self-other matching deficit and impaired mirror neuron function in autism have now been well supported by studies employing a range of methodologies. However, underlying mechanisms require further exploration to explain how mirror neurons may be involved in attentional and mentalizing processes. Impairments in self-other matching and mirror neuron function are not necessarily inextricably linked and it seems possible that different sub-populations of mirror neurons, located in several regions, contribute differentially to social cognitive functions. It is hypothesized that mirror neuron coding for action-direction may be required for developing attentional sensitivity to self-directed actions, and consequently for person-oriented, stimulus-driven attention. Mirror neuron networks may vary for different types of social learning such as "automatic" imitation and imitation learning. Imitation learning may be more reliant on self-other comparison processes (based on mirror neurons) that identify differences as well as similarities between actions. Differential connectivity with the amygdala-orbitofrontal system may also be important. This could have implications for developing "theory of mind," with intentional self-other comparison being relevant to meta-representational abilities, and "automatic" imitation being more relevant to empathy. While it seems clear that autism is associated with impaired development of embodied aspects of cognition, the ways that mirror neurons contribute to these brain-behavior links are likely to be complex.

  13. Multiple Beneficial Health Effects of Natural Alkylglycerols from Shark Liver Oil

    Directory of Open Access Journals (Sweden)

    Alain B. Legrand

    2010-07-01

    Full Text Available Alkylglycerols (alkyl-Gro are ether lipids abundant in the liver of some elasmobranch fish species such as ratfishes and some sharks. Shark liver oil from Centrophorus squamosus (SLO, or alkyl-Gro mix from this source, have several in vivo biological activities including stimulation of hematopoiesis and immunological defences, sperm quality improvement, or anti-tumor and anti-metastasis activities. Several mechanisms are suggested for these multiple activities, resulting from incorporation of alkyl-Gro into membrane phospholipids, and lipid signaling interactions. Natural alkyl-Gro mix from SLO contains several alkyl-Gro, varying by chain length and unsaturation. Six prominent constituents of natural alkyl-Gro mix, namely 12:0, 14:0, 16:0, 18:0, 16:1 n-7, and 18:1 n-9 alkyl-Gro, were synthesized and tested for anti-tumor and anti-metastatic activities on a model of grafted tumor in mice (3LL cells. 16:1 and 18:1 alkyl-Gro showed strong activity in reducing lung metastasis number, while saturated alkyl-Gro had weaker (16:0 or no (12:0, 14:0, 18:0 effect. Multiple compounds and mechanisms are probably involved in the multiple activities of natural alkyl-Gro.

  14. Teen Brain: Still Under Construction

    Science.gov (United States)

    ... Teen Brain Reprints For more information Share The Teen Brain: Still Under Construction Download PDF Download ePub ... emotional health. The Changing Brain and Behavior in Teens One interpretation of all these findings is that ...

  15. One health, multiple challenges : The inter-species transmission of influenza A virus

    NARCIS (Netherlands)

    Short, Kirsty R; Richard, Mathilde; Verhagen, Josanne H; van Riel, Debby; Schrauwen, Eefje J A; van den Brand, Judith M A; Mänz, Benjamin; Bodewes, Rogier; Herfst, Sander

    2015-01-01

    Influenza A viruses are amongst the most challenging viruses that threaten both human and animal health. Influenza A viruses are unique in many ways. Firstly, they are unique in the diversity of host species that they infect. This includes waterfowl (the original reservoir), terrestrial and aquatic

  16. One health, multiple challenges: The inter-species transmission of influenza A virus

    NARCIS (Netherlands)

    K.R. Short (Kirsty); M. Richard (Mathilde); J.H. Verhagen (Josanne); D.A.J. van Riel (Debby); E.J.A. Schrauwen (Eefje); J.M.A. van den Brand (Judith); B. Mänz (Benjamin); R. Bodewes (Rogier); S. Herfst (Sander)

    2015-01-01

    textabstractInfluenza A viruses are amongst the most challenging viruses that threaten both human and animal health. Influenza A viruses are unique in many ways. Firstly, they are unique in the diversity of host species that they infect. This includes waterfowl (the original reservoir), terrestrial

  17. Native Hawaiian and Pacific Islander Health - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... with Your Baby's Crying Wawin am bukot Kilin ilo an Jan Ninnin eo nejom - kajin Majöl (Marshallese) ... Information Translations Diabetes during Pregnancy Nañinmij in Tôñal ilo am Bôroro - kajin Majöl (Marshallese) Bilingual PDF Health ...

  18. Professional Competencies in Health Sciences Education: From Multiple Intelligences to the Clinic Floor

    Science.gov (United States)

    Lane, India F.

    2010-01-01

    Nontechnical competencies identified as essential to the health professionals success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding "professional success" is extensive and wide-ranging, crossing educational,…

  19. A probabilistic framework for the spatio-temporal segmentation of multiple sclerosis lesions in MR images of the brain

    Science.gov (United States)

    Greenspan, Hayit; Mayer, Arnaldo; Shahar, Allon

    2003-05-01

    In this paper we describe the application of a novel statistical image-sequence (video) modeling scheme to sequences of multiple sclerosis (MS) images taken over time. A unique key feature of the proposed framework is the analysis of the image-sequence input as a single entity as opposed to a sequence of separate frames. The extracted space-time regions allow for the detection and identification of disease events and processes, such as the appearance and progression of lesions. According to the proposed methodology, coherent space-time regions in the feature space, and corresponding coherent segments in the video content are extracted by unsupervised clustering via Gaussian mixture modeling (GMM). The parameters of the GMM are determined via the maximum likelihood principle and the Expectation-Maximization (EM) algorithm. The clustering of the image sequence yields a collection of regions (blobs) in a four-dimensional feature space (including intensity, position (x,y), and time). Regions corresponding to MS lesions are automatically identified based on criteria regarding the mean intensity and the size variability over time. The proposed methodology was applied to a registered sequence of 24 T2-weighted MR images acquired from an MS patient over a period of approximately a year. Examples of preliminary qualitative results are shown.

  20. Multiple Criteria Decision Analysis for Health Care Decision Making—Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading mult

  1. Multiple Criteria Decision Analysis for Health Care Decision Making—An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; IJzerman, Maarten

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading

  2. Oral health status in patients with brain injury: a systematic review

    DEFF Research Database (Denmark)

    Kothari, Mohit; Pillai, Rajath; Futarmal Kothari, Simple;

    2016-01-01

    Med, Embase, and Scopus electronic databases until January 2016 to identify studies presenting the assessment of the oral health status of patients afflicted with any kind of ABI. The search strategy was restricted to English-language publications, enrolling patients above 18 years. Studies on the association...

  3. Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study.

    Science.gov (United States)

    Bonavita, S; Sacco, R; Della Corte, M; Esposito, S; Sparaco, M; d'Ambrosio, A; Docimo, R; Bisecco, A; Lavorgna, L; Corbo, D; Cirillo, S; Gallo, A; Esposito, F; Tedeschi, G

    2015-01-01

    To better understand the effects of short-term computer-based cognitive rehabilitation (cCR) on cognitive performances and default mode network (DMN) intrinsic functional connectivity (FC) in cognitively impaired relapsing remitting (RR) multiple sclerosis (MS) patients. Eighteen cognitively impaired RRMS patients underwent neuropsychological evaluation by the Rao's brief repeatable battery and resting-state functional magnetic resonance imaging to evaluate FC of the DMN before and after a short-term (8 weeks, twice a week) cCR. A control group of 14 cognitively impaired RRMS patients was assigned to an aspecific cognitive training (aCT), and underwent the same study protocol. Correlations between DMN and cognitive performances were also tested. After cCR, there was a significant improvement of the following tests: SDMT (p Stroop Color-Word Interference Test and FC in the PCC emerged. After aCT, the control group did not show any significant effect either on FC or neuropsychological tests. No significant differences were found in brain volumes and lesion load in both groups when comparing data acquired at baseline and after cCR or aCT. In cognitively impaired RRMS patients, cCR improves cognitive performances (i.e., processing speed and visual and verbal sustained memory), and increases FC in the PCC and IPC of the DMN. This exploratory study suggests that cCR may induce adaptive cortical reorganization favoring better cognitive performances, thus strengthening the value of cognitive exercise in the general perspective of building either cognitive or brain reserve. PMID:25308631

  4. Multiple Paths to Just Ends: Using Narrative Interviews and Timelines to Explore Health Equity and Homelessness

    Directory of Open Access Journals (Sweden)

    Michelle L Patterson PhD, RPsych

    2012-04-01

    Full Text Available Underlying the daily lives of people with experiences of homelessness and mental illness is a complex interplay of individual and structural factors that perpetuate cycles of inequity. The introduction of novel methodological combinations within qualitative research has the potential to advance knowledge regarding the experience of health equity by such individuals and to clarify the relationship between these experiences and broader structural inequities. To explore the lived experience of inequity, we present a thematic analysis of narrative interviews in conjunction with timelines from 31 adults experiencing homelessness and mental illness. Use of these methods together enabled a novel and expanded appreciation for the varied ways in which differential access to the social determinants of health influences the trajectories and experiences of inequity for people who are homeless and mentally ill. The further utility of these methods for better understanding the experience of inequity is explored and implications for research, policy, and practice are discussed.

  5. The Effect Of Supplemental Insurance On Health Care Demand With Multiple Information: A Latent Class Analysis

    OpenAIRE

    Dardanoni V; Li Donni P

    2009-01-01

    The Medicare program, which provides insurance coverage to the elderly in the United States, does not protect them fully against high out-of-pocket costs. For this reason private supplementary insurance, named Medigap, has been available to cover Medicare gaps. This paper studies how Medigap affects the utilization of health care services. The decision to take out supplemental insurance is likely to be infuenced by unobservable attributes such as actual risk type and insurance preferences. Em...

  6. Autonomy and integrity : Drivers of health care professionals dealing with multiple obligations

    OpenAIRE

    Bergin, Elsmari

    2009-01-01

    The medical services have undergone substantial changes over the past decades, and the design and content of health care have been determined by economic programmes, streamlining, and rationalization. The calls to cut costs and implement reorganizations have come largely from politicians and have been handled by middle and high-level managers. Advances in medicine and technology have led to heavier burdens on staff, and another challenge concerns having to deal with patients...

  7. Building a high quality medical data architecture for multiple uses in an integrated health care environment

    OpenAIRE

    Boterenbrood, Frank; Krediet, Irene; Goossen, William

    2014-01-01

    Objective: The aim was to create a reliable information provisioning system in healthcare for both care and research processes, based on existing data standards and standardized electronic messages. The research question is: How can a Clinical Data Ware House (CDWH) be developed for standardized basic patient data, generic nursing data and data about oncology nursing, allowing management of Electronic Health Record data, electronic data exchange and data analytics? Materials and methods: The ...

  8. Brain hypoperfusion in adolescents dependent of multiple drugs Hipoperfusão cerebral em adolescentes dependentes de múltiplas drogas

    Directory of Open Access Journals (Sweden)

    Elba Cristina Sá de Camargo Etchebehere

    2010-04-01

    Full Text Available Brain SPECT imaging (BSI with statistical parametric mapping (SPM offers a clear and accurate vision of perfusion changes. OBJECTIVE: To study brain perfusion abnormalities in adolescents' dependent of multiple drugs. METHOD: Sixteen male patients (15.1±2.1 years were submitted to 99mTc-HMPAO BSI with SPM. RESULTS: Cortical hypoperfusion occurred in 7/16 patients (44%. There was a significant inverse correlation between the number of hypoperfused regions and the patient's age (p= -0.6737; p=0.004 and with the age when the drug dependence began (p= -0.5616; p=0.023. There was also a tendency towards an inverse correlation between regions of hypoperfusion and the duration of the drug dependence. CONCLUSION: BSI with SPM can help detect hypoperfusion in adolescents dependent on multiple drugs. The younger the patients, the more regions of hypoperfusion are noted. Probably, the neuronal plasticity has an important role in this phenomenon because the highest neural activity occurs in childhood.SPECT cerebral (SC com statistical parametric mapping (SPM oferece uma visão clara e acurada de alterações perfusionais. OBJETIVO: Avaliar anormalidades perfusionais cerebrais em adolescentes usuários de múltiplas drogas. MÉTODO: Dezesseis pacientes masculinos (15,1±2,1 anos foram submetidos a SC com SPM utilizando-se HMPAO-99mTc. RESULTADOS: Hipoperfusão cortical ocorreu em 7/16 pacientes (44%. Houve uma significativa correlação inversa entre o número de áreas hipoperfundidas e a idade dos pacientes (p= -0,6737; p=0,004 e com a idade quando iniciaram o abuso das drogas (p= -0,5616; p=0,023. Também houve uma tendência para uma correlação inversa entre as áreas de hipoperfusão e a duração do abuso de drogas. CONCLUSÃO: SC com SPM pode auxiliar na detecção de hipoperfusão cortical em adolescentes dependentes de múltiplas drogas. Quanto menor a idade, mais áreas de hipoperfusão são identificadas. Provavelmente a plasticidade neuronal

  9. Increased concentrations of glutamate and glutamine in normal-appearing white matter of patients with multiple sclerosis and normal MR imaging brain scans.

    Directory of Open Access Journals (Sweden)

    Anders Tisell

    Full Text Available In Multiple Sclerosis (MS the relationship between disease process in normal-appearing white matter (NAWM and the development of white matter lesions is not well understood. In this study we used single voxel proton 'Quantitative Magnetic Resonance Spectroscopy' (qMRS to characterize the NAWM and thalamus both in atypical 'Clinically Definite MS' (CDMS patients, MRI(neg (N = 15 with very few lesions (two or fewer lesions, and in typical CDMS patients, MRI(pos (N = 20 with lesions, in comparison with healthy control subjects (N = 20. In addition, the metabolite concentrations were also correlated with extent of brain atrophy measured using Brain Parenchymal Fraction (BPF and severity of the disease measured using 'Multiple Sclerosis Severity Score' (MSSS. Elevated concentrations of glutamate and glutamine (Glx were observed in both MS groups (MRI(neg 8.12 mM, p<0.001 and MRI(pos 7.96 mM p<0.001 compared to controls, 6.76 mM. Linear regressions of Glx and total creatine (tCr with MSSS were 0.16 ± 0.06 mM/MSSS (p = 0.02 for Glx and 0.06 ± 0.03 mM/MSSS (p = 0.04 for tCr, respectively. Moreover, linear regressions of tCr and myo-Inositol (mIns with BPF were -6.22 ± 1.63 mM/BPF (p<0.001 for tCr and -7.71 ± 2.43 mM/BPF (p = 0.003 for mIns. Furthermore, the MRI(pos patients had lower N-acetylaspartate and N-acetylaspartate-glutamate (tNA and elevated mIns concentrations in NAWM compared to both controls (tNA: p = 0.04 mIns p<0.001 and MRI(neg (tNA: p = 0.03 , mIns: p = 0.002. The results suggest that Glx may be an important marker for pathology in non-lesional white matter in MS. Moreover, Glx is related to the severity of MS independent of number of lesions in the patient. In contrast, increased glial density indicated by increased mIns and decreased neuronal density indicated by the decreased tNA, were only observed in NAWM of typical CDMS patients with white matter lesions.

  10. Matrix metalloproteinases in the brain and blood-brain barrier: Versatile breakers and makers.

    Science.gov (United States)

    Rempe, Ralf G; Hartz, Anika Ms; Bauer, Björn

    2016-09-01

    Matrix metalloproteinases are versatile endopeptidases with many different functions in the body in health and disease. In the brain, matrix metalloproteinases are critical for tissue formation, neuronal network remodeling, and blood-brain barrier integrity. Many reviews have been published on matrix metalloproteinases before, most of which focus on the two best studied matrix metalloproteinases, the gelatinases MMP-2 and MMP-9, and their role in one or two diseases. In this review, we provide a broad overview of the role various matrix metalloproteinases play in brain disorders. We summarize and review current knowledge and understanding of matrix metalloproteinases in the brain and at the blood-brain barrier in neuroinflammation, multiple sclerosis, cerebral aneurysms, stroke, epilepsy, Alzheimer's disease, Parkinson's disease, and brain cancer. We discuss the detrimental effects matrix metalloproteinases can have in these conditions, contributing to blood-brain barrier leakage, neuroinflammation, neurotoxicity, demyelination, tumor angiogenesis, and cancer metastasis. We also discuss the beneficial role matrix metalloproteinases can play in neuroprotection and anti-inflammation. Finally, we address matrix metalloproteinases as potential therapeutic targets. Together, in this comprehensive review, we summarize current understanding and knowledge of matrix metalloproteinases in the brain and at the blood-brain barrier in brain disorders.

  11. What is important, what needs treating? How GPs perceive older patients’ multiple health problems: a mixed method research study

    Directory of Open Access Journals (Sweden)

    Junius-Walker Ulrike

    2012-08-01

    Full Text Available Abstract Background GPs increasingly deal with multiple health problems of their older patients. They have to apply a hierarchical management approach that considers priorities to balance competing needs for treatment. Yet, the practice of setting individual priorities in older patients is largely unexplored. This paper analyses the GPs’ perceptions on important and unimportant health problems and how these affect their treatment. Methods GPs appraised the importance of health problems for a purposive sample of their older patients in semi-structured interviews. Prior to the interviews, the GPs had received a list of their patients’ health problems resulting from a geriatric assessment and were asked to rate the importance of each identified problem. In the interviews the GPs subsequently explained why they considered certain health problems important or not and how this affected treatment. Data was analysed using qualitative content analysis and quantitative methods. Results The problems GPs perceive as important are those that are medical and require active treatment or monitoring, or that induce empathy or awareness but cannot be assisted further. Unimportant problems are those that are well managed problems and need no further attention as well as age-related conditions or functional disabilities that provoke fatalism, or those considered outside the GPs’ responsibility. Statements of professional actions are closely linked to explanations of important problems and relate to physical problems rather than functional and social patient issues. Conclusions GPs tend to prioritise treatable clinical conditions. Treatment approaches are, however, vague or missing for complex chronic illnesses and disabilities. Here, patient empowerment strategies are of value and need to be developed and implemented. The professional concepts of ageing and disability should not impede but rather foster treatment and care. To this end, GPs need to be able to

  12. The Impact of Multiple Master Patient Index Records on the Business Performance of Health Care Organizations: A Qualitative Grounded Theory Study

    Science.gov (United States)

    Banton, Cynthia L.

    2014-01-01

    The purpose of this qualitative grounded theory study was to explore and examine the factors that led to the creation of multiple record entries, and present a theory on the impact the problem has on the business performance of health care organizations. A sample of 59 health care professionals across the United States participated in an online…

  13. Public Health Risks of Multiple-Drug-Resistant Enterococcus spp. in Southeast Asia.

    Science.gov (United States)

    Daniel, Diane Sunira; Lee, Sui Mae; Dykes, Gary A; Rahman, Sadequr

    2015-09-01

    Enterococci rank as one of the leading causes of nosocomial infections, such as urinary tract infections, surgical wound infections, and endocarditis, in humans. These infections can be hard to treat because of the rising incidence of antibiotic resistance. Enterococci inhabiting nonhuman reservoirs appear to play a critical role in the acquisition and dissemination of antibiotic resistance determinants. The spread of antibiotic resistance has become a major concern in both human and veterinary medicine, especially in Southeast Asia, where many developing countries have poor legislation and regulations to control the supply and excessive use of antimicrobials. This review addresses the occurrence of antibiotic-resistant enterococci in Association of Southeast Asian Nations countries and proposes infection control measures that should be applied to limit the spread of multiple-drug-resistant enterococci.

  14. Incidence of fractures in patients with multiple sclerosis: the Danish National Health Registers

    DEFF Research Database (Denmark)

    Bazelier, Marloes T; de Vries, Frank; Bentzen, Joan;

    2012-01-01

    (controls). Incidence rates of fracture were estimated as the number of fractures per 1000 person-years. Incidence rate ratios (IRRs) were calculated by dividing fracture rates in MS patients by fracture rates in controls. Results: Among patients with MS, the incidence rate of any fracture yielded 22.8 per......Background: Patients with multiple sclerosis (MS) are potentially at high risk of fracture due to falls and osteoporosis. Objective: To estimate incidence rates of fractures in MS patients, stratified by fracture type, sex and age, and to compare these rates with controls. Methods: The case...... population consisted of all patients with an accepted diagnosis of MS in the Danish MS Registry (1949-2007). Data were linked to the National Hospital Discharge Register (1977-2007). Patients with MS (n = 11,157) were 1: 6 matched by year of birth, gender, calendar time and region to persons without MS...

  15. Semen collection requirement from multiple-organs brain-dead donors: report of two cases and analysis of the available Brazilian legislation.

    Science.gov (United States)

    Sardinha, L A C; Dantas Filho, V P; Montone, E B B; Athayde, M V O; Rodrigues, S L L; Panunto, M R; Araújo, S; Zambelli, H J L

    2013-04-01

    Along with developments in transplantation there have been major breakthroughs in the techniques of assisted reproduction. The areas of common interest include requesting semen collection from organ donors with a diagnosis of brain death. After the recent report of two cases in the Search Service of Organs and Tissues, we analyzed legislation in our country, which still lacks specific guidance in such situations. Organ transplantation progressively established itself as an effective therapeutic option in our country since the 1960s. It represents viable alternative to improve both the quality and length of life as well as to decrease long-term costs of patients with severe end-stage organ failure. These programs have specific rules and laws that are necessary to guide all stages of transplantation: donor identification, authorization and execution as well as recipients selection of implantation techniques. Assisted reproduction also needs legislation specific for human infertility, a public health problem that affects medical, psychological, and legitimate desires of people. The World Health Organization estimates that infertility reaches 20% of the population demanding the development and use of techniques for its treatment. Brazilian legislation includes regulations for transplantation of organs and tissues in law no. 9434 of February 04, 1997; it provides for the removal of organs, tissues, and human body parts for transplantation and other treatments. This law is regulated by Decree no. 2268 of June 30, 1997, establishing the National Transplant System, which standardizes these processes. The postmortem organ and tissue provision must be preceded by a diagnosis of via the Brain Death Protocol (Federal Council of Medicine-Brazil). The sole paragraph of Article 1 makes clear that its provisions do not apply to blood, sperm, or ovules as confirmed by the sole paragraph of Article 1 in the Decree 2.268/97 regulation. Since there is no specific legislation, assisted

  16. Semen collection requirement from multiple-organs brain-dead donors: report of two cases and analysis of the available Brazilian legislation.

    Science.gov (United States)

    Sardinha, L A C; Dantas Filho, V P; Montone, E B B; Athayde, M V O; Rodrigues, S L L; Panunto, M R; Araújo, S; Zambelli, H J L

    2013-04-01

    Along with developments in transplantation there have been major breakthroughs in the techniques of assisted reproduction. The areas of common interest include requesting semen collection from organ donors with a diagnosis of brain death. After the recent report of two cases in the Search Service of Organs and Tissues, we analyzed legislation in our country, which still lacks specific guidance in such situations. Organ transplantation progressively established itself as an effective therapeutic option in our country since the 1960s. It represents viable alternative to improve both the quality and length of life as well as to decrease long-term costs of patients with severe end-stage organ failure. These programs have specific rules and laws that are necessary to guide all stages of transplantation: donor identification, authorization and execution as well as recipients selection of implantation techniques. Assisted reproduction also needs legislation specific for human infertility, a public health problem that affects medical, psychological, and legitimate desires of people. The World Health Organization estimates that infertility reaches 20% of the population demanding the development and use of techniques for its treatment. Brazilian legislation includes regulations for transplantation of organs and tissues in law no. 9434 of February 04, 1997; it provides for the removal of organs, tissues, and human body parts for transplantation and other treatments. This law is regulated by Decree no. 2268 of June 30, 1997, establishing the National Transplant System, which standardizes these processes. The postmortem organ and tissue provision must be preceded by a diagnosis of via the Brain Death Protocol (Federal Council of Medicine-Brazil). The sole paragraph of Article 1 makes clear that its provisions do not apply to blood, sperm, or ovules as confirmed by the sole paragraph of Article 1 in the Decree 2.268/97 regulation. Since there is no specific legislation, assisted

  17. Support vector data description for fusion of multiple health indicators for enhancing gearbox fault diagnosis and prognosis

    International Nuclear Information System (INIS)

    A novel method for enhancing gearbox fault diagnosis and prognosis is developed by fusion of multiple health indicators through support vector data description. First, the Comblet transform is used to identify gear residual error signals from the raw signal. Second, based on the observation of gear residual error signals, a total of 11 gear health indicators are identified, and are categorized into two types of indicators. The first and second types of indicators are for fault diagnosis and prognosis, respectively. The first type has six indicators, which are sensitive to impulsive signals triggered by anomalous impacts. The second type has five indicators, which are suitable for tracking degradation of faults. Third, through the support vector data description, the first six health indicators are fused into type one indicators for fault diagnosis. The remaining five indicators are fused into type two indicators for fault prognosis. Finally, a Gaussian kernel is designed to enhance the performance of type one and two indicators by optimal range of width size. The effectiveness of the proposed method is validated through experiments. The new method has been proven to be superior to methods that use unfused indicators individually

  18. Schoolchildren, maternal nutrition and generating healthy brains: the importance of lifecycle education for fertility, health and peace.

    Science.gov (United States)

    House, Simon H

    2009-01-01

    In order to generate healthy brains, the earlier in life that children develop a healthy lifestyle the better. At home and at school, with a good diet and physical activity, children need to experience and to understand the value of healthy metabolism. Continuous education is needed in lifecycle health, with awareness that the most vulnerable phase relates to reproduction. This is the way that most people can become parents of healthy children. Nutrient deficits, toxins, or uro-genital disease, often unnoticed, affect quality of sperm or ovum, and subsequent development. Early errors can have the most pronounced effect. Gene-switches are being set early in life. Any early flaw can be magnified by growth. Moreover children's habits become set and young couples are too busy to learn and adapt. Many are liable to unintended pregnancy. Adoption of a healthy lifestyle at a young age is the most reliable route to producing healthy babies. The mother's state throughout pregnancy, emotions/hormones included, naturally continues to powerfully affect her child's development, therefore future physical and mental health, behaviour and ability. There has recently been a serious increase in babies conceived by schoolchildren, as well as a shift by working women towards childbearing in their late thirties or more. A return towards childbearing in the twenties and early thirties can reduce risks for the child. The mother needs to build her appropriate body-stores--vitamins and minerals, proteins, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and other essential polyunsaturated fatty acids (PUFA)--to ensure optimal development of her child. Replenishment of reserves is important for maternal health and before bearing another child. A restorative time of three years is desirable. Governments and school teachers need to guide and encourage parents in this health education and practice, and to use their authority to achieve it in schools. Empowerment with knowledge is the

  19. Brain Potentials Highlight Stronger Implicit Food Memory for Taste than Health and Context Associations.

    Science.gov (United States)

    Hoogeveen, Heleen R; Jolij, Jacob; Ter Horst, Gert J; Lorist, Monicque M

    2016-01-01

    Increasingly consumption of healthy foods is advised to improve population health. Reasons people give for choosing one food over another suggest that non-sensory features like health aspects are appreciated as of lower importance than taste. However, many food choices are made in the absence of the actual perception of a food's sensory properties, and therefore highly rely on previous experiences of similar consumptions stored in memory. In this study we assessed the differential strength of food associations implicitly stored in memory, using an associative priming paradigm. Participants (N = 30) were exposed to a forced-choice picture-categorization task, in which the food or non-food target images were primed with either non-sensory or sensory related words. We observed a smaller N400 amplitude at the parietal electrodes when categorizing food as compared to non-food images. While this effect was enhanced by the presentation of a food-related word prime during food trials, the primes had no effect in the non-food trials. More specifically, we found that sensory associations are stronger implicitly represented in memory as compared to non-sensory associations. Thus, this study highlights the neuronal mechanisms underlying previous observations that sensory associations are important features of food memory, and therefore a primary motive in food choice. PMID:27213567

  20. Brain Potentials Highlight Stronger Implicit Food Memory for Taste than Health and Context Associations.

    Directory of Open Access Journals (Sweden)

    Heleen R Hoogeveen

    Full Text Available Increasingly consumption of healthy foods is advised to improve population health. Reasons people give for choosing one food over another suggest that non-sensory features like health aspects are appreciated as of lower importance than taste. However, many food choices are made in the absence of the actual perception of a food's sensory properties, and therefore highly rely on previous experiences of similar consumptions stored in memory. In this study we assessed the differential strength of food associations implicitly stored in memory, using an associative priming paradigm. Participants (N = 30 were exposed to a forced-choice picture-categorization task, in which the food or non-food target images were primed with either non-sensory or sensory related words. We observed a smaller N400 amplitude at the parietal electrodes when categorizing food as compared to non-food images. While this effect was enhanced by the presentation of a food-related word prime during food trials, the primes had no effect in the non-food trials. More specifically, we found that sensory associations are stronger implicitly represented in memory as compared to non-sensory associations. Thus, this study highlights the neuronal mechanisms underlying previous observations that sensory associations are important features of food memory, and therefore a primary motive in food choice.

  1. Brain Potentials Highlight Stronger Implicit Food Memory for Taste than Health and Context Associations.

    Science.gov (United States)

    Hoogeveen, Heleen R; Jolij, Jacob; Ter Horst, Gert J; Lorist, Monicque M

    2016-01-01

    Increasingly consumption of healthy foods is advised to improve population health. Reasons people give for choosing one food over another suggest that non-sensory features like health aspects are appreciated as of lower importance than taste. However, many food choices are made in the absence of the actual perception of a food's sensory properties, and therefore highly rely on previous experiences of similar consumptions stored in memory. In this study we assessed the differential strength of food associations implicitly stored in memory, using an associative priming paradigm. Participants (N = 30) were exposed to a forced-choice picture-categorization task, in which the food or non-food target images were primed with either non-sensory or sensory related words. We observed a smaller N400 amplitude at the parietal electrodes when categorizing food as compared to non-food images. While this effect was enhanced by the presentation of a food-related word prime during food trials, the primes had no effect in the non-food trials. More specifically, we found that sensory associations are stronger implicitly represented in memory as compared to non-sensory associations. Thus, this study highlights the neuronal mechanisms underlying previous observations that sensory associations are important features of food memory, and therefore a primary motive in food choice.

  2. Information retrieval pathways for health information exchange in multiple care settings

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.

    2014-01-01

    Objectives To determine which health information exchange (HIE) technologies and information retrieval pathways healthcare professionals relied on to meet their information needs in the context of laboratory test results, radiological images and reports, and medication histories. Study Design...... The study reveals that healthcare professionals used a complex combination of information retrieval pathways for HIE to obtain clinical information from external organizations. The choice for each approach was setting- and information-specific, but was also highly dynamic across users and their information...... needs. Conclusions Our findings about the complex nature of information sharing in healthcare provide insights for informatics professionals about the usage of information; indicate the need for managerial support within each organization; and suggest approaches to improve systems for organizations...

  3. Multiple Sclerosis Patients Valuing Their Own Health Status: Valuation and Psychometric Properties of the 15D

    Science.gov (United States)

    Dagklis, Ioannis E.; Aletras, Vasilis H.; Tsantaki, Efthymia; Orologas, Anastasios; Niakas, Dimitrios

    2016-01-01

    An ongoing debate on decision and cost-utility analyses is whether to use preferences of general public or patients. The aim of this study was to replicate the valuation procedure of the multi-attribute utility generic measure, 15D, using a sample of multiple sclerosis (MS) patients and to assess its psychometric properties. Consecutive outpatient MS patients were recruited from two MS centers in Greece. The three-stage valuation procedure was applied and, with the use of elicited preference weights, an MS patients’ algorithm was developed. The original Finnish value set derived from healthy individuals was also used to calculate scores and a comparison between the two algorithms was made. A total of 64 MS patients were evaluated. The 15D scores obtained with the MS patients’ valuation algorithm were higher than the original one. The derived utilities differed significantly with respect to age, depressive symptoms, Expanded Disability Status Scale score and clinical form. MS patients indicated as most important domains mobility, mental functioning and vitality. Cronbach’s alpha was estimated 0.876 and correlations between relevant dimensions of the instruments were moderate to high. The 15D was generally feasible and reliable in patients with MS and the valuation system yielded acceptable psychometric properties.

  4. QL-11HEALTH-RELATED QUALITY OF LIFE, COGNITIVE FUNCTIONING AND SURVIVAL IN PATIENTS TREATED WITH STEREOTACTIC RADIOTHERAPY FOR BRAIN METASTASES: A PROSPECTIVE STUDY

    OpenAIRE

    Habets, Esther; Dirven, Linda; Wiggenraad, Ruud; Zwinkels, Hanneke; Nijeholt, Geert Lycklama á; Taphoorn, Martin

    2014-01-01

    BACKGROUND: Although stereotactic radiotherapy (SRT) for brain metastases is expected to have a less detrimental effect on cognition and health-related quality of life (HRQoL) than whole-brain radiotherapy (WBRT), the precise effect is largely unknown. METHODS: Cognition and HRQoL were measured prior to SRT, 3 and 6 months follow-up. Four cognitive domains and seven preselected scales of the EORTC-QLQC30 and BN20 were analysed. Survival analysis was performed and effect of total volume of bra...

  5. Cross-behavior associations and multiple health behavior change: A longitudinal study on physical activity and fruit and vegetable intake.

    Science.gov (United States)

    Fleig, Lena; Küper, Carina; Lippke, Sonia; Schwarzer, Ralf; Wiedemann, Amelie U

    2015-05-01

    This study aimed to examine the interrelation of physical activity and fruit and vegetable intake. The influence of stage congruence between physical activity and fruit and vegetable intake on multiple behavior change was also investigated. Health behaviors, social-cognitions, and stages of change were assessed in 2693 adults at two points in time. Physical activity and fruit and vegetable intake were assessed 4 weeks after the baseline. Social-cognitions, stages as well as stage transitions across behavior domains were positively interrelated. Stage congruence was not related to changes in physical activity and fruit and vegetable intake. Physical activity and nutrition appear to facilitate rather than hinder each other. Having intentions to change both behaviors simultaneously does not seem to overburden individuals.

  6. The expected and actual communication of health care workers during the management of intrapartum: An interpretive multiple case study

    Directory of Open Access Journals (Sweden)

    Doreen K.M. M'Rithaa

    2015-02-01

    Full Text Available Background: Daily activities within a health care organisation are mediated by information communication processes (ICP involving multiple health care professionals at different levels of care. Effective perinatal management requires critical information to be accurately communicated. If there is a breakdown in this communication patient safety is at risk for various reasons such as: inadequate critical information, misconception of information and uninformed decisions being made. The purpose of this study was to interpret the complexities around ICP in order to contribute to the effective management of the intrapartum period.Methods: Multi method, multiple case study approach was used to understand the ICP during the management of the intrapartum period. During the study, the expected ICP, the actual ICP, the challenges involved and the desired ICP were analysed. Twenty-four in-depth interviews with skilled birth attendants (SBAs employing observer-as-participant roles, field notes, and document review methods were utilised to gather the data. Thematic analysis was utilised to analyse the data using Atlas TI software.Results: The study revealed three subthemes which emerged from the expected ICP, whilst three others that emerged formed the theme actual ICP. The subthemes from the expected ICP included: accessibility of obstetric services, expected referral, recommended tools, expected communication and expected documentation. The theme actual ICP held threee merging subthemes: the handover processes, collaborative information seeking, information communicated and referral processes.Conclusion: This study showed that what was expected was not what was actually happening. The requirements of the policies and protocols need to be effectively implemented to improve practice building these into current biomedical guidelines.

  7. Multiple endoscopic biopsies in research subjects: safety results from a National Institutes of Health series

    Science.gov (United States)

    Yao, Michael D.; von Rosenvinge, Erik C.; Groden, Catherine; Mannon, Peter J.

    2016-01-01

    Background Routine endoscopic mucosal biopsies are generally considered safe. However, the outcomes of performing large numbers of biopsies in subjects enrolled in research protocols have not been reported. Objective Our purpose was to assess the safety of taking numerous mucosal biopsy specimens during endoscopic procedures (eg, >20/endoscopic procedure) in research subjects. Design Single-center retrospective chart review. Setting Research hospital: National Institutes of Health (NIH) Clinical Center. Patients Volunteers who underwent research protocol endoscopies with large numbers of biopsies during 2001 to 2008 at the NIH. Main Outcome Measurements Charts were reviewed for the occurrence of procedure-related major/minor complications. Results A total of 253 research endoscopies were performed on 133 patients: 169 colonoscopies, 64 sigmoidoscopies, and 20 upper endoscopies. A total of 9,661 biopsy specimens were obtained for research and histopathologic examination (mean 38.2 ± 15.6 per procedure). No major complications were identified. Minor complications occurred with 13 (5.1%) lower endoscopic procedures and included self-limited bleeding (4), pain (5), or both (4). There was no statistically significant association between the number of biopsies, type of procedure, location of research biopsies, operator, polypectomy, or the use of nonsteroidal anti-inflammatory drugs and the risk of complications. Limitations Retrospective design, modest sample size. Conclusions This is the first report on the safety of performing large numbers of endoscopic biopsies in research subjects. This practice is well tolerated and appears to have no more than minimal risk without appreciably increasing the risk of otherwise routine endoscopy. PMID:19136110

  8. Public health implications of Acanthamoeba and multiple potential opportunistic pathogens in roof-harvested rainwater tanks.

    Science.gov (United States)

    Hamilton, K A; Ahmed, W; Palmer, A; Sidhu, J P S; Hodgers, L; Toze, S; Haas, C N

    2016-10-01

    A study of six potential opportunistic pathogens (Acanthamoeba spp., Legionella spp., Legionella longbeachae, Pseudomonas aeruginosa, Mycobacterium avium and Mycobacterium intracellulare) and an accidental human pathogen (Legionella pneumophila) in 134 roof-harvested rainwater (RHRW) tank samples was conducted using quantitative PCR (qPCR). All five opportunistic pathogens and accidental pathogen L. pneumophila were detected in rainwater tanks except Legionella longbeachae. Concentrations ranged up to 3.1×10(6) gene copies per L rainwater for Legionella spp., 9.6×10(5) gene copies per L for P. aeruginosa, 6.8×10(5) gene copies per L for M. intracellulare, 6.6×10(5) gene copies per L for Acanthamoeba spp., 1.1×10(5) gene copies per L for M. avium, and 9.8×10(3) gene copies per L for L. pneumophila. Among the organisms tested, Legionella spp. (99% tanks) were the most prevalent followed by M. intracellulare (78%). A survey of tank-owners provided data on rainwater end-uses. Fecal indicator bacteria (FIB) Escherichia coli and Enterococcus spp. were enumerated using culture-based methods, and assessed for correlations with opportunistic pathogens and L. pneumophila tested in this study. Opportunistic pathogens did not correlate well with FIB except E. coli vs. Legionella spp. (tau=0.151, P=0.009) and E. coli vs. M. intracellulare (tau=0.14, P=0.015). However, M. avium weakly correlated with both L. pneumophila (Kendall's tau=0.017, P=0.006) and M. intracellulare (tau=0.088, P=0.027), and Legionella spp. also weakly correlated with M. intracellulare (tau=0.128, P=0.028). The presence of these potential opportunistic pathogens in tank water may present health risks from both the potable and non-potable uses documented from the current survey data. PMID:27336236

  9. Catalysts for better health care. Medical tissue banks bring multiple benefits to countries

    International Nuclear Information System (INIS)

    For millions of injured and disabled people around the world, the treatment brings a new quality of life. Called tissue grafting or transplantation, it relies on the use of sterilized bone, skin, and other tissues to heal serious injuries, wounds, and sickness. Prime beneficiaries include severe burn victims, and men, women, and children suffering from crippling diseases, birth defects, and blindness. Long applied in plastic and orthopaedic surgery, tissue grafting once relied only on using a patient's own tissues, known as an autograft. But now tissues from human or animal donors (allograft) are used for transplantation. This new form of tissue grafting has made big strides over the past decade. An expanding number of facilities today prepare the valuable tissues to the high-quality standards demanded in medical care. Dozens of such new tissue banks have opened in Asia, Latin America, Europe, and North America. A productive channel of progress has been an IAEA-supported technical cooperation programme. Through it, experts have worked together behind the scenes to help national health authorities establish tissue banks, train associated staff, and develop standards and regulatory guides. The IAEA accordingly has gained more experience and success than any other international organization in supporting the establishment of tissue banks for medical use in developing countries. Increasingly for quality and cost reasons, the technology of irradiation is used to sterilize tissues for medical care. The IAEA, through its technical cooperation channels, assists national atomic energy authorities to safely and productively employ radiation technology. An interregional programme on radiation and tissue banking, initiated over a decade ago, today extends to 30 countries

  10. Public health implications of Acanthamoeba and multiple potential opportunistic pathogens in roof-harvested rainwater tanks.

    Science.gov (United States)

    Hamilton, K A; Ahmed, W; Palmer, A; Sidhu, J P S; Hodgers, L; Toze, S; Haas, C N

    2016-10-01

    A study of six potential opportunistic pathogens (Acanthamoeba spp., Legionella spp., Legionella longbeachae, Pseudomonas aeruginosa, Mycobacterium avium and Mycobacterium intracellulare) and an accidental human pathogen (Legionella pneumophila) in 134 roof-harvested rainwater (RHRW) tank samples was conducted using quantitative PCR (qPCR). All five opportunistic pathogens and accidental pathogen L. pneumophila were detected in rainwater tanks except Legionella longbeachae. Concentrations ranged up to 3.1×10(6) gene copies per L rainwater for Legionella spp., 9.6×10(5) gene copies per L for P. aeruginosa, 6.8×10(5) gene copies per L for M. intracellulare, 6.6×10(5) gene copies per L for Acanthamoeba spp., 1.1×10(5) gene copies per L for M. avium, and 9.8×10(3) gene copies per L for L. pneumophila. Among the organisms tested, Legionella spp. (99% tanks) were the most prevalent followed by M. intracellulare (78%). A survey of tank-owners provided data on rainwater end-uses. Fecal indicator bacteria (FIB) Escherichia coli and Enterococcus spp. were enumerated using culture-based methods, and assessed for correlations with opportunistic pathogens and L. pneumophila tested in this study. Opportunistic pathogens did not correlate well with FIB except E. coli vs. Legionella spp. (tau=0.151, P=0.009) and E. coli vs. M. intracellulare (tau=0.14, P=0.015). However, M. avium weakly correlated with both L. pneumophila (Kendall's tau=0.017, P=0.006) and M. intracellulare (tau=0.088, P=0.027), and Legionella spp. also weakly correlated with M. intracellulare (tau=0.128, P=0.028). The presence of these potential opportunistic pathogens in tank water may present health risks from both the potable and non-potable uses documented from the current survey data.

  11. Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review.

    Science.gov (United States)

    Fineblit, Samuel; Selci, Erin; Loewen, Hal; Ellis, Michael; Russell, Kelly

    2016-09-01

    Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE(®), PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. PMID:26916876

  12. Multiple Presentations of Brain TB

    Directory of Open Access Journals (Sweden)

    H. Kharazi

    2008-01-01

    Full Text Available Tuberculosis of the central nervous system is an im-portant cause of mortality and morbidity."nPrompt diagnosis and early treatment are extremely important to reduce its morbidity and mortality. The main forms of central nervous system tuberculosis are represented by tuberculosis meningitis, meningeal or parenchymal tuberculomas, and tuberculosis abscess formation. Sequels consist of hydrocephalus, calcifi-cations, and areas of encephalomalacia."nCT is the diagnostic imaging modality in many clini-cal settings to demonstrate the various aspects of cra-nial tuberculosis on initial presentation and to moni-tor the evolution of the disease and response to ther-apy. In this review we illustrate CT scan findings of intracranial lesions of tuberculosis in our patients.

  13. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors

    Directory of Open Access Journals (Sweden)

    Severens Johan L

    2008-06-01

    Full Text Available Abstract Background A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45–70. This paper describes the design of the Vitalum study. Methods/Design Dutch general medical practices (N = 23 were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881 received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions

  14. OSU-03012 and Viagra Treatment Inhibits the Activity of Multiple Chaperone Proteins and Disrupts the Blood-Brain Barrier: Implications for Anti-Cancer Therapies.

    Science.gov (United States)

    Booth, Laurence; Roberts, Jane L; Tavallai, Mehrad; Nourbakhsh, Aida; Chuckalovcak, John; Carter, Jori; Poklepovic, Andrew; Dent, Paul

    2015-08-01

    We examined the interaction between OSU-03012 (also called AR-12) with phosphodiesterase 5 (PDE5) inhibitors to determine the role of the chaperone glucose-regulated protein (GRP78)/BiP/HSPA5 in the cellular response. Sildenafil (Viagra) interacted in a greater than additive fashion with OSU-03012 to kill stem-like GBM cells. Treatment of cells with OSU-03012/sildenafil: abolished the expression of multiple oncogenic growth factor receptors and plasma membrane drug efflux pumps and caused a rapid degradation of GRP78 and other HSP70 and HSP90 family chaperone proteins. Decreased expression of plasma membrane receptors and drug efflux pumps was dependent upon enhanced PERK-eIF2α-ATF4-CHOP signaling and was blocked by GRP78 over-expression. In vivo OSU-03012/sildenafil was more efficacious than treatment with celecoxib and sildenafil at killing tumor cells without damaging normal tissues and in parallel reduced expression of ABCB1 and ABCG2 in the normal brain. The combination of OSU-03012/sildenafil synergized with low concentrations of sorafenib to kill tumor cells, and with lapatinib to kill ERBB1 over-expressing tumor cells. In multiplex assays on plasma and human tumor tissue from an OSU-03012/sildenafil treated mouse, we noted a profound reduction in uPA signaling and identified FGF and JAK1/2 as response biomarkers for potentially suppressing the killing response. Inhibition of FGFR signaling and to a lesser extent JAK1/2 signaling profoundly enhanced OSU-03012/sildenafil lethality. PMID:25736380

  15. OSU‐03012 and Viagra Treatment Inhibits the Activity of Multiple Chaperone Proteins and Disrupts the Blood–Brain Barrier: Implications for Anti‐Cancer Therapies

    Science.gov (United States)

    Booth, Laurence; Roberts, Jane L.; Tavallai, Mehrad; Nourbakhsh, Aida; Chuckalovcak, John; Carter, Jori; Poklepovic, Andrew

    2015-01-01

    We examined the interaction between OSU‐03012 (also called AR‐12) with phosphodiesterase 5 (PDE5) inhibitors to determine the role of the chaperone glucose‐regulated protein (GRP78)/BiP/HSPA5 in the cellular response. Sildenafil (Viagra) interacted in a greater than additive fashion with OSU‐03012 to kill stem‐like GBM cells. Treatment of cells with OSU‐03012/sildenafil: abolished the expression of multiple oncogenic growth factor receptors and plasma membrane drug efflux pumps and caused a rapid degradation of GRP78 and other HSP70 and HSP90 family chaperone proteins. Decreased expression of plasma membrane receptors and drug efflux pumps was dependent upon enhanced PERK‐eIF2α‐ATF4‐CHOP signaling and was blocked by GRP78 over‐expression. In vivo OSU‐03012/sildenafil was more efficacious than treatment with celecoxib and sildenafil at killing tumor cells without damaging normal tissues and in parallel reduced expression of ABCB1 and ABCG2 in the normal brain. The combination of OSU‐03012/sildenafil synergized with low concentrations of sorafenib to kill tumor cells, and with lapatinib to kill ERBB1 over‐expressing tumor cells. In multiplex assays on plasma and human tumor tissue from an OSU‐03012/sildenafil treated mouse, we noted a profound reduction in uPA signaling and identified FGF and JAK1/2 as response biomarkers for potentially suppressing the killing response. Inhibition of FGFR signaling and to a lesser extent JAK1/2 signaling profoundly enhanced OSU‐03012/sildenafil lethality. J. Cell. Physiol. 230: 1982–1998, 2015. © 2015 The Authors. Journal of Cellular Physiology Published by Wiley Periodicals, Inc. PMID:25736380

  16. Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

    Science.gov (United States)

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making.

  17. Anti-Integrin Therapy for Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Eiji Kawamoto

    2012-01-01

    Full Text Available Integrins are the foremost family of cell adhesion molecules that regulate immune cell trafficking in health and diseases. Integrin alpha4 mediates organ-specific migration of immune cells to the inflamed brain, thereby playing the critical role in the pathogenesis of multiple sclerosis. Anti-alpha4 integrin therapy aiming to block infiltration of autoreactive lymphocytes to the inflamed brain has been validated in several clinical trials for the treatment of multiple sclerosis. This paper provides readers with an overview of the molecular and structural bases of integrin activation as well as rationale for using anti-alpha4 integrin therapy for multiple sclerosis and then chronicles the rise and fall of this treatment strategy using natalizumab, a humanized anti-alpha4 integrin.

  18. Scientific Opinion on the substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    an opinion on the scientific substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function. The scope of the applications was proposed to fall under health claims based on newly developed scientific evidence. The Panel considers that the food constituent......, glycaemic carbohydrates, which is the subject of the health claims, is sufficiently characterised in relation to the claimed effect. Maintenance of normal brain function is a beneficial physiological effect. A claim on glycaemic carbohydrates and maintenance of normal brain function has already been...

  19. Feasibility of single-isocenter, multi-arc non-coplanar volumetric modulated arc therapy for multiple brain tumors using a linear accelerator with a 160-leaf multileaf collimator: a phantom study

    OpenAIRE

    Iwai, Yoshio; Ozawa, Shuichi; Ageishi, Tatsuya; Pellegrini, Roberto; Yoda, Kiyoshi

    2014-01-01

    The feasibility of single isocenter, multi-arc non-coplanar volumetric modulated arc therapy (VMAT) for multiple brain tumors was studied using an Elekta Synergy linear accelerator with an Agility multileaf collimator and a Monaco treatment planning system. Two VMAT radiosurgery plans consisting of a full arc and three half arcs were created with a prescribed dose of 20 Gy in a single fraction. After dose delivery to a phantom, ionization chambers and radiochromic films were used for dose mea...

  20. Treatment patterns and health care resource utilization associated with dalfampridine extended release in multiple sclerosis: a retrospective claims database analysis

    Directory of Open Access Journals (Sweden)

    Guo A

    2016-05-01

    Full Text Available Amy Guo,1 Michael Grabner,2 Swetha Rao Palli,2 Jessica Elder,1 Matthew Sidovar,1 Peter Aupperle,1 Stephen Krieger3 1Acorda Therapeutics Inc., Ardsley, New York, NY, USA; 2HealthCore Inc., Wilmington, DE, USA; 3Corinne Goldsmith Dickinson Center for MS, Icahn School of Medicine at Mount Sinai, New York, NY, USA Background: Although previous studies have demonstrated the clinical benefits of dalfampridine extended release (D-ER tablets in patients with multiple sclerosis (MS, there are limited real-world data on D-ER utilization and associated outcomes in patients with MS. Purpose: The objective of this study was to evaluate treatment patterns, budget impact, and health care resource utilization (HRU associated with D-ER use in a real-world setting. Methods: A retrospective claims database analysis was conducted using the HealthCore Integrated Research DatabaseSM. Adherence (measured by medication possession ratio, or [MPR] and persistence (measured by days between initial D-ER claim and discontinuation or end of follow-up were evaluated over 1-year follow-up. Budget impact was calculated as cost per member per month (PMPM over the available follow-up period. D-ER and control cohorts were propensity-score matched on baseline demographics, comorbidities, and MS-related resource utilization to compare walking-impairment-related HRU over follow-up. Results: Of the 2,138 MS patients identified, 1,200 were not treated with D-ER (control and 938 were treated with D-ER. Patients were aged 51 years on average and 74% female. Approximately 82.6% of D-ER patients were adherent (MPR >80%. The estimated budget impact range of D-ER was $0.014–$0.026 PMPM. Propensity-score-matched D-ER and controls yielded 479 patients in each cohort. Postmatching comparison showed that the D-ER cohort was associated with fewer physician (21.5% vs 62.4%, P<0.0001 and other outpatient visits (22.8% vs 51.4%, P<0.0001 over the 12-month follow-up. Changes in HRU from follow

  1. Increasing incidence of multiple sclerosis among women in Buenos Aires: a 22 year health maintenance organization based study.

    Science.gov (United States)

    Cristiano, E; Patrucco, L; Miguez, J; Giunta, D; Peroni, J; Rojas, J I

    2016-10-01

    Studies in multiple sclerosis (MS) suggest a trend of increasing disease prevalence and incidence, and especially, a disproportional increase in the incidence of multiple sclerosis in women. The objective of this study was to evaluate the incidence of MS over 22 years and to determine the ratio in incidence of men to women in a health maintenance organization from Buenos Aires, Argentina. The population was made up of all members of a hospital-based HMO affiliated between January 1992 and December 2013. Each person was followed contributing time at risk. Cases with definite diagnosis of MS were included. Incidence density was calculated with 95 % confidence intervals and compared between women and men. 165,456 subjects were followed for a total of 1,488,575 person-years, of whom 42 developed MS. Incidence density was 3/100,000 person-years (95 % CI 2.1-3.5/100,000 person-years). During this period (1992-2013), the incidence rate in women increased from 1/100,000 (95 % CI 0.8-1.6) to 4.9/100,000 (95 % CI 4.1-5.4) (p incidence ranged from 1.4/100,000 (95 % CI 1-1.7) to 1.8 (1.3-2.1) (p = 0.16). Incidence density during the study period increased significantly in women but not in men. This is the first report of this phenomenon in Latin America region.

  2. P08.11SURGICAL MANAGEMENT OF BRAIN METASTASES FROM LUNG ADENOCARCINOMA: A SINGLE CENTER EXPERIENCE AND REFLECTIONS ON MULTIPLE LESIONS

    Science.gov (United States)

    Fornaro, R.; Agnoletti, A.; Specchia, F.M. Calamo; Garbossa, D.; Lanotte, M.; Ducati, A.

    2014-01-01

    INTRODUCTION: Metastases are the most common intracerebral tumors, and they're expected to increase in the next years. Prognosis is linked to the progression of systemic and cerebral disease. Among patients in good conditions, removal of the cerebral metastasis represents the first treatment to apply. To evaluate the ideal conditions for surgery and its results we performed this single-center study on patients with solitary and multiple cerebral metastases. MATERIALS AND METHODS: We analyzed patients treated for cerebral metastasis between January 2004 and 2011. We considered only cases with non-small cell lung carcinoma (NSCLC) as primary tumor. We collected mortality and complication rates and analyzed the early outcomes before adjuvant therapy. Finally we used a χ2 test (p = 0.05) to assess if better early outcomes (improved or stable KPS) were significantly related to the presence of solitary VS multiple lesions. RESULTS: Our series included 199 patients; mean survival was 11.08 months. 95 patients harbored a single brain metastasis (Group 1) and 104 had more than one localization (Group 2). 67 patients underwent surgical operation. The mean pre-operative KPS was 75/100 in Group 1 and 65/100 in Group 2. After surgery in Group 1 the score improved in 69% of patients, was unchanged in 20% and worsened in 11%. In Group 2 the post-operative KPS was increased in 66% of cases, unchanged in 17% and worsened in 17% of cases. Statistical analysis did not show significant differences in the rates of good (KPS improved or stable) and poor outcomes in the two groups of operated patients. Patients with lesions in the posterior fossa improved after surgery more than those with supratentorial metastases. DISCUSSION: Observation of an high mortality for not-neurological causes confirms that modern treatments allow a significant control of the disease within the nervous system. Surgery entails the additional advantage of large tissue-samples availability for histological

  3. Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age.

    Science.gov (United States)

    Brown, Tyson H; Richardson, Liana J; Hargrove, Taylor W; Thomas, Courtney S

    2016-06-01

    This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses.

  4. Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age.

    Science.gov (United States)

    Brown, Tyson H; Richardson, Liana J; Hargrove, Taylor W; Thomas, Courtney S

    2016-06-01

    This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses. PMID:27284076

  5. Fractality of sensations and the brain health: the theory linking neurodegenerative disorder with distortion of spatial and temporal scale-invariance and fractal complexity of the visible world

    Directory of Open Access Journals (Sweden)

    Marina Vladimirovna Zueva

    2015-07-01

    Full Text Available The theory that ties normal functioning and pathology of the brain and visual system with the spatial-temporal structure of the visual and other sensory stimuli is described for the first time in the present study. The deficit of fractal complexity of environmental influences can lead to the distortion of fractal complexity in the visual pathways of the brain and abnormalities of development or aging. The use of fractal light stimuli and fractal stimuli of other modalities can help to restore the functions of the brain, particularly in the elderly and in patients with neurodegenerative disorders or amblyopia. Nonlinear dynamics of these physiological processes have a strong base of evidence, which is seen in the impaired fractal regulation of rhythmic activity in aged and diseased brains. From birth to old age, we live in a nonlinear world, in which objects and processes with the properties of fractality and non-linearity surround us. Against this background, the evolution of man took place and all periods of life unfolded. Works of art created by man may also have fractal properties. The positive influence of music on cognitive functions is well-known. Insufficiency of sensory experience is believed to play a crucial role in the pathogenesis of amblyopia and age-dependent diseases. The brain is very plastic in its early development, and the plasticity decreases throughout life. However, several studies showed the possibility to reactivate the adult's neuroplasticity in a variety of ways. We propose that a non-linear structure of sensory information on many spatial and temporal scales is crucial to the brain health and fractal regulation of physiological rhythms. Theoretical substantiation of the author's theory is presented. Possible applications and the future research that can experimentally confirm or refute the theoretical concept are considered.

  6. Multiple Stressors in a Top Predator Seabird: Potential Ecological Consequences of Environmental Contaminants, Population Health and Breeding Conditions.

    Science.gov (United States)

    Bustnes, Jan O; Bourgeon, Sophie; Leat, Eliza H K; Magnusdóttir, Ellen; Strøm, Hallvard; Hanssen, Sveinn A; Petersen, Aevar; Olafsdóttir, Kristin; Borgå, Katrine; Gabrielsen, Geir W; Furness, Robert W

    2015-01-01

    Environmental contaminants may have impacts on reproduction and survival in wildlife populations suffering from multiple stressors. This study examined whether adverse effects of persistent organic pollutants (POPs) increased with poor population health and breeding conditions in three colonies (60-74°N) of great skua (Stercorarius skua) in the north-eastern Atlantic (Shetland, Iceland and Bjørnøya [Bear Island]). POPs (organochlorines [OCs] and polybrominated diphenyl ethers [BDEs]) were measured in plasma of incubating birds (n = 222), concentrations differing nearly tenfold among colonies: Bjørnøya (2009) > Bjørnøya (2010) > Iceland (2009) > Shetland (2009). Reproductive success (hatching success and chick survival) showed that breeding conditions were favourable in Shetland and at Bjørnøya (2010), but were very poor in Iceland and at Bjørnøya (2009). Biomarkers indicated that health was poor in the Shetland population compared to the other populations. Females whose chicks hatched late had high POP concentrations in all colonies except at Bjørnøya (2010), and females losing their eggs at Bjørnøya (2009) tended to have higher concentrations than those hatching. Moreover, there was a negative relationship between female POP concentrations and chick body condition at hatching in Iceland and at Bjørnøya (2010). Supplementary feeding experiments were conducted, and in Iceland where feeding conditions were poor, significant negative relationships were found between female POP concentrations and daily growth-rate in first-hatched chicks of control nests, but not in food supplemented nests. This suggests that negative impacts of POPs were mitigated by improved feeding conditions. For second-chicks, there was a strong negative relationship between the female POP concentrations and growth-rate, but no effects of supplementary feeding. Lowered adult return-rate between breeding seasons with increasing POP loads were found both at Bjørnøya (2009) and in

  7. Correlates of Adherence to a Telephone-Based Multiple Health Behavior Change Cancer Preventive Intervention for Teens: The Healthy for Life Program (HELP)

    Science.gov (United States)

    Mays, Darren; Peshkin, Beth N.; Sharff, McKane E.; Walker, Leslie R.; Abraham, Anisha A.; Hawkins, Kirsten B.; Tercyak, Kenneth P.

    2012-01-01

    This study examined factors associated with teens' adherence to a multiple health behavior cancer preventive intervention. Analyses identified predictors of trial enrollment, run-in completion, and adherence (intervention initiation, number of sessions completed). Of 104 teens screened, 73% (n = 76) were trial eligible. White teens were more…

  8. The impact of farmers’ participation in field trials in creating awareness and stimulating compliance with the World Health Organization’s farm-based multiple-barrier approach

    DEFF Research Database (Denmark)

    Amponsah, Owusu; Vigre, Håkan; Schou, Torben Wilde;

    2016-01-01

    The results of a study aimed as assessing the extent to which urban vegetable farmers’ participation in field trials can impact on their awareness and engender compliance with the World Health Organization’s farm-based multiple-barrier approach are presented in this paper. Both qualitative...

  9. Anatomically standardised 99mTc-ECD brain perfusion SPET allows accurate differentiation between healthy volunteers, multiple system atrophy and idiopathic Parkinson's disease

    International Nuclear Information System (INIS)

    The clinical differentiation between typical idiopathic Parkinson's disease (IPD) and atypical parkinsonian disorders such as multiple system atrophy (MSA) is complicated by the presence of signs and symptoms common to both forms. The goal of this study was to re-evaluate the contribution of brain perfusion single-photon emission tomography (SPET) with anatomical standardisation and automated analysis in the differentiation of IPD and MSA. This was achieved by discriminant analysis in comparison with a large set of age- and gender-matched healthy volunteers. Technetium-99m ethyl cysteinate dimer SPET was performed on 140 subjects: 81 IPD patients (age 62.6±10.2 years; disease duration 11.0±6.4 years; 50 males/31 females), 15 MSA patients (61.5±9.2 years; disease duration 3.0±2.2 years; 9 males/6 females) and 44 age- and gender-matched healthy volunteers (age 59.2±11.9 years; 27 males/17 females). Patients were matched for severity (Hoehn and Yahr stage). Automated predefined volume of interest (VOI) analysis was carried out after anatomical standardisation. Stepwise discriminant analysis with cross-validation using the leave-one-out method was used to determine the subgroup of variables giving the highest accuracy for this differential diagnosis. Between MSA and IPD, the only regions with highly significant differences in uptake after Bonferroni correction were the putamen VOIs. Comparing MSA versus normals and IPD, with putamen VOI values as discriminating variables, cross-validated performance showed correct classification of MSA patients with a sensitivity of 73.3%, a specificity of 84% and an accuracy of 83.6%. Additional input from the right caudate head and the left prefrontal and left mesial temporal cortex allowed 100% discrimination even after cross-validation. Discrimination between the IPD group alone and healthy volunteers was accurate in 94% of the cases after cross-validation, with a sensitivity of 91.4% and a specificity of 100%. The three

  10. Brain Basics

    Medline Plus

    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... learning more about how the brain grows and works in healthy people, and how normal brain development ...

  11. Feasibility of single-isocenter, multi-arc non-coplanar volumetric modulated arc therapy for multiple brain tumors using a linear accelerator with a 160-leaf multileaf collimator: a phantom study.

    Science.gov (United States)

    Iwai, Yoshio; Ozawa, Shuichi; Ageishi, Tatsuya; Pellegrini, Roberto; Yoda, Kiyoshi

    2014-09-01

    The feasibility of single isocenter, multi-arc non-coplanar volumetric modulated arc therapy (VMAT) for multiple brain tumors was studied using an Elekta Synergy linear accelerator with an Agility multileaf collimator and a Monaco treatment planning system. Two VMAT radiosurgery plans consisting of a full arc and three half arcs were created with a prescribed dose of 20 Gy in a single fraction. After dose delivery to a phantom, ionization chambers and radiochromic films were used for dose measurement. The first VMAT radiosurgery plan had nine targets inside the phantom, and the doses were measured by the chambers at two different points and by the films on three sagittal and three coronal planes. The differences between the calculated dose and the dose measured by a Farmer ionization chamber and a pinpoint ionization chamber were radiosurgery plan was based on a clinical 14 brain metastases. Differences between calculated and film-measured doses were evaluated on two sagittal planes. The average pass rates of the gamma indices on the planes under each of 3%/3 mm and 2%/2 mm criteria were 97.8% and 88.8%, respectively. It was confirmed that single-isocenter, non-coplanar multi-arc VMAT radiosurgery for multiple brain metastases was feasible using Elekta Synergy with Agility and Monaco treatment planning systems. It was further shown that film dosimetry was accurately performed for a dose of up to nearly 25 Gy. PMID:24944266

  12. Progressive increase of T1 signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images in the pediatric brain exposed to multiple doses of gadolinium contrast.

    Science.gov (United States)

    Roberts, Donna R; Holden, Kenton R

    2016-03-01

    Recently, there have been reports of gadolinium accumulation in the brain and bone of adult patients with normal renal function who have undergone multiple gadolinium contrast administrations. This case report gives the first description of a pediatric patient who, following multiple contrasted MRI exams, demonstrated abnormal signal on unenhanced T1-weighted imaging involving the dentate nucleus and globus pallidus, a finding which has previously been shown to represent gadolinium deposition in adults. The patient presented here had no history of intracranial pathology which would alter the blood brain barrier or abnormal renal function. The clinical significance of gadolinium accumulation in the human body is currently unknown but is of concern, particularly in pediatric patients who have a lifetime to manifest any potential adverse consequences. Therefore, research is needed to address the clinical significance, if any, of gadolinium deposition in the developing pediatric brain. Given these current uncertainties, clinicians should continue to use prudence in selecting pediatric patients to undergo contrasted MRI and in selecting the appropriate contrast agents to use.

  13. Multimodal Brain Visualization

    OpenAIRE

    Nadeem, Saad; Kaufman, Arie

    2016-01-01

    Current connectivity diagrams of human brain image data are either overly complex or overly simplistic. In this work we introduce simple yet accurate interactive visual representations of multiple brain image structures and the connectivity among them. We map cortical surfaces extracted from human brain magnetic resonance imaging (MRI) data onto 2D surfaces that preserve shape (angle), extent (area), and spatial (neighborhood) information for 2D (circular disk) and 3D (spherical) mapping, spl...

  14. The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients

    Directory of Open Access Journals (Sweden)

    Sina Waibel

    2015-07-01

    Full Text Available Background: Integrated health care networks (IHN are promoted in numerous countries as a response to fragmented care delivery by providing a coordinated continuum of services to a defined population. However, evidence on their effectiveness and outcome is scarce, particularly considering continuity across levels of care; that is the patient's experience of connected and coherent care received from professionals of the different care levels over time. The objective was to analyse the chronic obstructive pulmonary disease (COPD patients’ perceptions of continuity of clinical management and information across care levels and continuity of relation in IHN of the public health care system of Catalonia.Methods: A qualitative multiple case study was conducted, where the cases are COPD patients. A theoretical sample was selected in two stages: (1 study contexts: IHN and (2 study cases consisting of COPD patients. Data were collected by means of individual, semi-structured interviews to the patients, their general practitioners and pulmonologists and review of records. A thematic content analysis segmented by IHN and cases with a triangulation of sources and analysists was carried out.Results: COPD patients of all networks perceived that continuity of clinical management was existent due to clear distribution of roles for COPD care across levels, rapid access to care during exacerbations and referrals to secondary care when needed; nevertheless, patients of some networks highlighted too long waiting times to non-urgent secondary care. Physicians generally agreed with patients, however, also indicated unclear distribution of roles, some inadequate referrals and long waiting times to primary care in some networks. Concerning continuity of information, patients across networks considered that their clinical information was transferred across levels via computer and that physicians also used informal communication mechanisms (e-mail, telephone; whereas

  15. Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: Why we should measure them all

    OpenAIRE

    Asada, Yukiko; Whipp, Alyce; Kindig, David; Billard, Beverly; Rudolph, Barbara

    2014-01-01

    Introduction Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and compar...

  16. Development of the Young Brain

    Medline Plus

    Full Text Available ... development of the adolescent brain has been the life work of National Institute of Mental Health researcher ... Jay Giedd. Dr. Giedd: At different ages of life certain parts of the brain have much more ...

  17. Development of the Young Brain

    Medline Plus

    Full Text Available ... development of the adolescent brain. Decades of imaging work have led to remarkable insight and a more ... of the adolescent brain has been the life work of National Institute of Mental Health researcher Dr. ...

  18. Development of the Young Brain

    Medline Plus

    Full Text Available ... development of the adolescent brain has been the life work of National Institute of Mental Health researcher Dr. Jay Giedd. Dr. Giedd: At different ages of life certain parts of the brain have much more ...

  19. Development of the Young Brain

    Medline Plus

    Full Text Available ... items) Suicide Prevention (8 items) Treatments (11 items) Development of the Young Brain May 2, 2011 For ... Health neuroscientist Dr. Jay Giedd has studied the development of the adolescent brain. Decades of imaging work ...

  20. Development of the Young Brain

    Medline Plus

    Full Text Available ... with Traumatic Events (3 items) NIMH (24 items) Development of the Young Brain May 2, 2011 For ... Health neuroscientist Dr. Jay Giedd has studied the development of the adolescent brain. Decades of imaging work ...

  1. Development of the Young Brain

    Science.gov (United States)

    ... with Traumatic Events (3 items) NIMH (24 items) Development of the Young Brain May 2, 2011 For ... Health neuroscientist Dr. Jay Giedd has studied the development of the adolescent brain. Decades of imaging work ...

  2. Development of the Young Brain

    Medline Plus

    Full Text Available ... Institute of Mental Health neuroscientist Dr. Jay Giedd has studied the development of the adolescent brain. Decades ... growth. Studying the development of the adolescent brain has been the life work of National Institute of ...

  3. Brain Sciences – An Open Access Journal

    Directory of Open Access Journals (Sweden)

    Germán Barrionuevo

    2010-07-01

    Full Text Available During the first ten years that followed “The Decade of the Brain”, the quest of neuroscience for understanding brain function in health and disease has greatly expanded to include molecular, developmental, cognitive and evolutionary aspects of the nervous system. This increased multidisciplinary effort has been complemented by the spectacular development of highly sophisticated experimental methods. Neuroscientists can now perform studies ranging from molecular and imaging analysis of single pre- and postsynaptic neuronal processes to imaging of neural activity in the whole brain during perceptual and motor behavioral tasks. At the same time, theoretical advances in neuroscience have been aided by the rapid development of mathematical and computational simulations of biologically and functionally realistic single cells and complex neural networks across multiple spatiotemporal scales. Therefore, neuroscientists are more than ever in a position to deliver answers to basic, medical and biotechnological questions related to brain function and dysfunction. [...

  4. Brain herniation

    Science.gov (United States)

    ... 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 ...

  5. Correlates of Adherence to a Telephone-Based Multiple Health Behavior Change Cancer Preventive Intervention for Teens: The Healthy for Life Program (HELP)

    OpenAIRE

    Mays, Darren; Peshkin, Beth N.; Sharff, McKane E.; Walker, Leslie R.; Abraham, Anisha A.; Hawkins, Kirsten; Tercyak, Kenneth P.

    2011-01-01

    This study examined factors associated with teens’ adherence to a multiple health behavior cancer preventive intervention. Analyses identified predictors of trial enrollment, run-in completion, and adherence (intervention initiation, number of sessions completed). Of 104 teens screened, 73% (n = 76) were trial-eligible. White teens were more likely to enroll than non-whites (χ2 [1] df = 4.49, p = 0.04). Among enrolled teens, 76% (n = 50) completed the run-in; there were no differences between...

  6. Multiple Criteria Decision Analysis for Health Care Decision Making--Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force.

    Science.gov (United States)

    Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kaló, Zoltán; Lönngren, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading, multiple criteria decision analysis (MCDA), are useful for this purpose. In 2014, ISPOR established an Emerging Good Practices Task Force. The task force's first report defined MCDA, provided examples of its use in health care, described the key steps, and provided an overview of the principal methods of MCDA. This second task force report provides emerging good-practice guidance on the implementation of MCDA to support health care decisions. The report includes: a checklist to support the design, implementation and review of an MCDA; guidance to support the implementation of the checklist; the order in which the steps should be implemented; illustrates how to incorporate budget constraints into an MCDA; provides an overview of the skills and resources, including available software, required to implement MCDA; and future research directions.

  7. Multiple Criteria Decision Analysis for Health Care Decision Making--Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force.

    Science.gov (United States)

    Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kaló, Zoltán; Lönngren, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading, multiple criteria decision analysis (MCDA), are useful for this purpose. In 2014, ISPOR established an Emerging Good Practices Task Force. The task force's first report defined MCDA, provided examples of its use in health care, described the key steps, and provided an overview of the principal methods of MCDA. This second task force report provides emerging good-practice guidance on the implementation of MCDA to support health care decisions. The report includes: a checklist to support the design, implementation and review of an MCDA; guidance to support the implementation of the checklist; the order in which the steps should be implemented; illustrates how to incorporate budget constraints into an MCDA; provides an overview of the skills and resources, including available software, required to implement MCDA; and future research directions. PMID:27021745

  8. Caring for Multiples

    Science.gov (United States)

    ... labor & premature birth The newborn intensive care unit (NICU) Birth defects & other health conditions Loss & grief Tools & ... Home > Complications & Loss > The newborn intensive care unit (NICU) > Caring for multiples Caring for multiples E-mail ...

  9. Postnatal Development of Brain-Derived Neurotrophic Factor (BDNF) and Tyrosine Protein Kinase B (TrkB) Receptor Immunoreactivity in Multiple Brain Stem Respiratory-Related Nuclei of the Rat

    OpenAIRE

    LIU, QIULI; Wong-Riley, Margaret T.T.

    2013-01-01

    Previously, we found a transient imbalance between suppressed excitation and enhanced inhibition in the respiratory network of the rat around postnatal days (P) 12–13, a critical period when the hypoxic ventilatory response is at its weakest. The mechanism underlying the imbalance is poorly understood. Brain-derived neurotrophic factor (BDNF) and its tyrosine protein kinase B (TrkB) receptors are known to potentiate glutamatergic and attenuate gamma-aminobutyric acid (GABA)ergic neurotransmis...

  10. Willingness to pay for improved respiratory and cardiovascular health: a multiple-format, stated-preference approach.

    Science.gov (United States)

    Johnson, F R; Banzhaf, M R; Desvousges, W H

    2000-06-01

    This study uses stated-preference (SP) analysis to measure willingness to pay (WTP) to reduce acute episodes of respiratory and cardiovascular ill health. The SP survey employs a modified version of the health state descriptions used in the Quality of Well Being (QWB) Index. The four health state attributes are symptom, episode duration, activity restrictions and cost. Preferences are elicited using two different SP formats: graded-pair and discrete-choice. The different formats cause subjects to focus on different evaluation strategies. Combining two elicitation formats yields more valid and robust estimates than using only one approach. Estimates of indirect utility function parameters are obtained using advanced panel econometrics for each format separately and jointly. Socio-economic differences in health preferences are modelled by allowing the marginal utility of money relative to health attributes to vary across respondents. Because the joint model captures the combined preference information provided by both elicitation formats, these model estimates are used to calculate WTP. The results demonstrate the feasibility of estimating meaningful WTP values for policy-relevant respiratory and cardiac symptoms, even from subjects who never have personally experienced these conditions. Furthermore, because WTP estimates are for individual components of health improvements, estimates can be aggregated in various ways depending upon policy needs. Thus, using generic health attributes facilitates transferring WTP estimates for benefit-cost analysis of a variety of potential health interventions.

  11. Child Sexual Abuse and Women's Sexual Health: The Contribution of CSA Severity and Exposure to Multiple Forms of Childhood Victimization

    Science.gov (United States)

    Lacelle, Celine; Hebert, Martine; Lavoie, Francine; Vitaro, Frank; Tremblay, Richard E.

    2012-01-01

    Research studies have provided increasing evidence for the potential adverse impact of child sexual abuse on women's sexual health. The present study examined the association between child sexual abuse and sexual health while controlling for various forms of childhood victimization. Self-report questionnaires were administered to 889 young women…

  12. Associations between poor sleep quality and stages of change of multiple health behaviors among participants of employee wellness program

    Directory of Open Access Journals (Sweden)

    Siu-kuen Azor Hui

    2015-01-01

    Conclusions: The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population.

  13. Human health risk assessment of multiple contaminants due to consumption of animal-based foods available in the markets of Shanghai, China.

    Science.gov (United States)

    Lei, Bingli; Zhang, Kaiqiong; An, Jing; Zhang, Xinyu; Yu, Yingxin

    2015-03-01

    To assess the health risks due to food consumption, the human daily intake and uptake of organochlorine pesticides, polychlorinated biphenyls, polybrominated diphenyl ethers, polycyclic aromatic hydrocarbons, and toxic trace elements (mercury, chromium, cadmium, lead, and arsenic) were estimated based on the animal-based foods collected from markets in Shanghai, China. The estimated daily intake and uptake considering the contaminant bioaccessibility via single food consumption were 9.4-399 and 4.2-282 ng/kg body weight/day for adults, and 10.8-458 and 4.8-323 ng/kg body weight/day for children, respectively. These values were 0.2-104 and 0.05-58.1, and 0.2-119 and 0.06-66.6 ng/kg body weight/day via multiple food consumption for adults and children, respectively. According to the United States Environmental Protection Agency risk assessment method, the non-cancer and cancer health risks posed by the contaminants were estimated using the hazard quotient and the lifetime cancer risk method, respectively. The results showed that the combined hazard quotient values for multiple contaminants via single or multiple food consumption were below 1, suggesting that the residents in Shanghai would not experience a significant non-cancer health risk. Among the contaminants investigated, the potential non-cancer risk of methylmercury was highest. However, the combined cancer risk posed by multiple contaminants in most foods exceeded the accepted risk level of 10(-6), and inorganic arsenic was the main contributor. The risks caused by polybrominated diphenyl ethers for cancer and non-cancer effects were negligible. The cancer risk of inorganic arsenic is a matter of concern in animal-based foods from Shanghai markets. PMID:25315930

  14. Understanding brain networks and brain organization

    Science.gov (United States)

    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.

  15. The Predictive Syndemic Effect of Multiple Psychosocial Problems on Health Care Costs and Utilization among Sexual Minority Women.

    Science.gov (United States)

    Valentine, Sarah E; Elsesser, Steven; Grasso, Chris; Safren, Steven A; Bradford, Judith B; Mereish, Ethan; O'Cleirigh, Conall

    2015-12-01

    Previous studies documenting sexual minority women's disproportionate risk for a range of medical, mental health, and substance use disorders have not provided a predictive framework for understanding their interrelations and outcomes. The present study aimed to address this gap by testing the syndemic effect of co-occurring psychosocial problems on 7-year health care costs and utilization among sexual minority women. The sample was comprised of sexual minority women (N = 341) who were seen at an urban LGBT-affirmative community health center. Medical and mental health care utilization and cost data were extracted from electronic medical records. Demographically adjusted regression models revealed that co-occurring psychosocial problems (i.e., childhood sexual abuse, partner violence, substance use, and mental health distress [history of suicide attempt]) were all strongly interrelated. The presence of these indicators had a syndemic (additive) effect on medical costs and utilization and mental health utilization over 7-year follow-up, but no effect on 7-year mental health costs. These results suggest that the presence and additive effect of these syndemic conditions may, in part, explain increased medical costs and utilization (and higher medical morbidity) among sexual minority women. PMID:26438415

  16. Multiple sclerosis

    International Nuclear Information System (INIS)

    Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

  17. A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

    Science.gov (United States)

    McKay, Mary M.; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Chacko, Anil; Jackson, Jerrold M.; Fuss, Ashley

    2011-01-01

    This article presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within 13 urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this article focuses on parent…

  18. Impact of fluoxetine on the human brain in multiple sclerosis as quantified by proton magnetic resonance spectroscopy and diffusion tensor imaging

    NARCIS (Netherlands)

    Sijens, Paul E.; Mostert, Jop P.; Irwan, Roy; Potze, Jan Hendrik; Oudkerk, Matthijs; De Keyser, Jacques

    2008-01-01

    The antidepressant fluoxetine stimulates astrocytic glycogenolysis, which serves as an energy source for axons. In multiple sclerosis patients fluoxetine administration may improve energy supply in neuron cells and thus inhibit axonal degeneration. In a preliminary pilot study, 15 patients with mult

  19. Neuroimaging of language processes: fMRI of silent and overt lexical processing and the promise of multiple process imaging in single brain studies

    International Nuclear Information System (INIS)

    To implement and evaluate a multiple-process functional magnetic resonance imaging (fMRI) paradigm designed to effectively and efficiently activate several language-related regions for use with neurosurgical patients. Both overt and covert response conditions were examined. The fMRI experiments compared the traditional silent word-generation condition versus an overt one as they engage frontal language regions (Experiment 1) and silent versus overt semantic association conditions as they engage multiple language processing regions (Experiment 2). In Experiment 1 the overt condition yielded greater magnitude of activation, but not volume of activation, in the left inferior frontal and insular cortices than did the silent condition for most, but not all, participants. Experiment 2 demonstrated that the activation of multiple established language processing regions (ie, orthographic, phonological and semantic) can be achieved in a significant number of participants, particularly under overt semantic association conditions and that such activation varies in predictable ways. The traditional silent response condition cannot be considered as equivalent to the overt response condition during word generation or semantic association. The multiple-process imaging method introduced here was sensitive to processing robust orthographic, phonological, and semantic regions, particularly under the overt response condition. (author)

  20. Assessment of demyelination, edema, and gliosis by in vivo determination of T1 and T2 in the brain of patients with acute attack of multiple sclerosis

    DEFF Research Database (Denmark)

    Larsson, H B; Frederiksen, J; Petersen, J;

    1989-01-01

    This study intended to investigate the possibility of magnetic resonance (MR) to characterize the acute plaque due to multiple sclerosis (MS). To obtain information, in vivo measurements of relaxation processes were performed in 10 patients with known acute MS plaques, using a whole-body supercon...