Introducing The Dizziness Wheel – A New Approach for Optometrists to Evaluate Dizziness/Imbalance in mTBI/Concussion Patients

2021 ◽  
pp. 166-175
Keyword(s):  
Integrated Management ◽  
Healthcare Providers ◽  
Management Process ◽  
Vestibular Disorder ◽  
New Approach ◽  
Therapeutic Experience ◽  
Control And Prevention ◽  
Vision Therapy ◽  
The Brain ◽  
The U.S

More than 3.8 million Americans sustain a concussion or mild traumatic brain injury each year. Over 70 percent (2.66 million) of these patients suffer consequential vision dysfunctions. Research has shown that optometric vision therapy can provide significant improvement in post-concussion vision problems. However, assessing and managing post-concussion visual dysfunctions can be challenging for the optometrist. This difficulty is primarily due to the complex and diffuse damage the brain incurs from concussion, resulting in a unique clinical profile for each individual patient. When vision-based dizziness or imbalance complaints are included in the post-concussion patient’s presentation, the evaluation and management process becomes more complicated. This challenge is exacerbated by the plethora of comorbid, non-vision-based causes for dizziness/imbalance (D/I) that might also be present. According to the Center of Disease Control and Prevention, more than one-third of adults aged 65 years and older suffer falls each year, many of which are secondary to D/I. At least half of the U.S. population is affected by a balance or vestibular disorder sometime during their lives. The purpose of this article is to introduce The Dizziness Wheel. It is a graphic tool, developed and utilized by this author, to help assess and triage a concussed patient’s D/I. It also aids the identification of links amongst multisystem disruptions. This is especially helpful because D/I almost always represent a complex combination of overlapping symptoms. The Dizziness Wheel is not intended to be used as a formal diagnostic tool. Rather it is a differentiation graphic for use throughout the patient’s therapeutic experience. This author has found it to be helpful during initial exams, follow-ups, and in-office therapy. The Dizziness Wheel also can serve as a helpful guide for referral to other types of healthcare providers. Many D/I patients present to the neuro-rehabilitation optometrist without having been comprehensively assessed and treated for non-visual causes of D/I. The Dizziness Wheel can help the optometrist ensure the patient’s safety and access to effective integrated management of dizziness and imbalance.

Switching on swallowing, switching on the brain: A new approach for the treatment of dysphagia after stroke

2001 ◽  
Vol 120 (5) ◽  
pp. A713-A713
Author(s):  
M POWER ◽  
C FRASER ◽  
S HAMDY ◽  
P TYRELL ◽  
J ROTHWELL ◽  
...  
Keyword(s):  
New Approach ◽  
The Brain

Potential immunotherapy for Alzheimer disease and age-related dementia

2019 ◽  
Vol 21 (1) ◽  
pp. 21-25 ◽  
Keyword(s):  
Immune System ◽  
Alzheimer Disease ◽  
Cross Talk ◽  
Immune Checkpoint ◽  
Short Review ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
New Approach ◽  
Age Related ◽  
The Brain

Emerging results support the concept that Alzheimer disease (AD) and age-related dementia are affected by the ability of the immune system to contain the brain's pathology. Accordingly, well-controlled boosting, rather than suppression of systemic immunity, has been suggested as a new approach to modify disease pathology without directly targeting any of the brain's disease hallmarks. Here, we provide a short review of the mechanisms orchestrating the cross-talk between the brain and the immune system. We then discuss how immune checkpoint blockade directed against the PD-1/PD-L1 pathways could be developed as an immunotherapeutic approach to combat this disease using a regimen that will address the needs to combat AD.

Potential immunotherapy for Alzheimer disease and age-related dementia

2019 ◽  
Vol 21 (1) ◽  
pp. 21-25 ◽  
Keyword(s):  
Immune System ◽  
Alzheimer Disease ◽  
Cross Talk ◽  
Immune Checkpoint ◽  
Short Review ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
New Approach ◽  
Age Related ◽  
The Brain

Emerging results support the concept that Alzheimer disease (AD) and age-related dementia are affected by the ability of the immune system to contain the brain’s pathology. Accordingly, well-controlled boosting, rather than suppression of systemic immunity, has been suggested as a new approach to modify disease pathology without directly targeting any of the brain’s disease hallmarks. Here, we provide a short review of the mechanisms orchestrating the cross-talk between the brain and the immune system. We then discuss how immune checkpoint blockade directed against the PD-1/PD-L1 pathways could be developed as an immunotherapeutic approach to combat this disease using a regimen that will address the needs to combat AD.

scholarly journals Stethoscope hygiene: A call to action. Recommendations to update the CDC guidelines

2021 ◽  
pp. 1-3
Author(s):  
Sarathi Kalra ◽  
Alpesh Amin ◽  
Nancy Albert ◽  
Cindy Cadwell ◽  
Cole Edmonson ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Acoustic Properties ◽  
Patient Encounter ◽  
Call To Action ◽  
The Us ◽  
Cdc Guidelines ◽  
Control And Prevention ◽  
Healthcare Acquired Infections ◽  
Current Guidance ◽  
Tremendous Challenge

Abstract Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.

scholarly journals Tracking U.S. Pertussis Incidence: Correlation of Public Health Surveillance and Google Search Data Varies by State

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Christopher H. Arehart ◽  
Michael Z. David ◽  
Vanja Dukic
Keyword(s):  
Public Health ◽  
Linear Models ◽  
State Level ◽  
Individual State ◽  
Control And Prevention ◽  
Search Data ◽  
State Models ◽  
Uniform Manner ◽  
Google Search ◽  
The U.S

AbstractThe Morbidity and Mortality Weekly Reports of the U.S. Centers for Disease Control and Prevention document a raw proxy for counts of pertussis cases in the U.S., and the Project Tycho (PT) database provides an improved source of these weekly data. These data are limited because of reporting delays, variation in state-level surveillance practices, and changes over time in diagnosis methods. We aim to assess whether Google Trends (GT) search data track pertussis incidence relative to PT data and if sociodemographic characteristics explain some variation in the accuracy of state-level models. GT and PT data were used to construct auto-correlation corrected linear models for pertussis incidence in 2004–2011 for the entire U.S. and each individual state. The national model resulted in a moderate correlation (adjusted R2 = 0.2369, p < 0.05), and state models tracked PT data for some but not all states. Sociodemographic variables explained approximately 30% of the variation in performance of individual state-level models. The significant correlation between GT models and public health data suggests that GT is a potentially useful pertussis surveillance tool. However, the variable accuracy of this tool by state suggests GT surveillance cannot be applied in a uniform manner across geographic sub-regions.

A new approach to the molecular basis of neoplastic transformation in the brain

1992 ◽  
Vol 18 (5) ◽  
pp. 443-453 ◽  
Author(s):  
O. D. WIESTLER ◽  
O. BRÜSTLE ◽  
R. H. EIBL ◽  
H. RADNER ◽  
A. VON DEIMLING ◽  
...  
Keyword(s):  
Molecular Basis ◽  
Neoplastic Transformation ◽  
New Approach ◽  
The Brain

Strength of cold-formed steel shear diaphragms

1979 ◽  
Vol 6 (1) ◽  
pp. 5-17 ◽  
Author(s):  
Paul Fazio ◽  
Kinh Ha ◽  
S. Chockalingam
Keyword(s):  
Air Force ◽  
Test Data ◽  
Seismic Design ◽  
Shear Capacity ◽  
Rational Method ◽  
New Approach ◽  
Iron And Steel ◽  
Cold Formed Steel ◽  
The U.S ◽  
Steel Institute

The design of light-gage steel corrugated shear diaphragms is not yet covered by the structural codes of many countries, including Canada. The shear capacity of steel diaphragms may be predicted by various approaches currently available, namely, those proposed by: (1) the American Iron and Steel Institute; (2) the Manual of seismic design of buildings, published by the U.S. Departments of the Army, Navy, and Air Force; and (3) the recommendations outlined in the current British code. In this paper, a rational method is proposed and the application of all the above methods is illustrated with reference to a specific example. Finally, the shear strengths of many diaphragms are predicted by the new approach developed by the authors and the results are compared to test data.

scholarly journals Food Worker Experiences with and Beliefs about Working While Ill†

2013 ◽  
Vol 76 (12) ◽  
pp. 2146-2154 ◽  
Author(s):  
L. RAND CARPENTER ◽  
ALICE L. GREEN ◽  
DAWN M. NORTON ◽  
ROBERTA FRICK ◽  
MELISSA TOBIN-D'ANGELO ◽  
...  
Keyword(s):  
Disease Control ◽  
Environmental Health ◽  
Foodborne Pathogens ◽  
Work Experience ◽  
Job Loss ◽  
Foodborne Illness ◽  
Job Responsibilities ◽  
Control And Prevention ◽  
Food Workers ◽  
The U.S

Transmission of foodborne pathogens from ill food workers to diners in restaurants is an important cause of foodborne illness outbreaks. The U.S. Food and Drug Administration recommends that food workers with vomiting or diarrhea (symptoms of foodborne illness) be excluded from work. To understand the experiences and characteristics of workers who work while ill, workplace interviews were conducted with 491 food workers from 391 randomly selected restaurants in nine states that participated in the Environmental Health Specialists Network of the Centers for Disease Control and Prevention. Almost 60% of workers recalled working while ill at some time. Twenty percent of workers said that they had worked while ill with vomiting or diarrhea for at least one shift in the previous year. Factors significantly related to workers having said that they had worked while ill with vomiting or diarrhea were worker sex, job responsibilities, years of work experience, concerns about leaving coworkers short staffed, and concerns about job loss. These findings suggest that the decision to work while ill with vomiting or diarrhea is complex and multifactorial.

Redirecting adult mesenchymal stromal cells to the brain: a new approach for treating CNS autoimmunity and neuroinflammation?

2018 ◽  
Vol 96 (4) ◽  
pp. 347-357
Author(s):  
Jasmine J Wilson ◽  
Kerrie L Foyle ◽  
Jade Foeng ◽  
Todd Norton ◽  
Duncan R McKenzie ◽  
...  
Keyword(s):  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
New Approach ◽  
Cns Autoimmunity ◽  
The Brain

Where Is the Beat? The Neural Correlates of Lexical Stress and Rhythmical Well-formedness in Auditory Story Comprehension

2017 ◽  
Vol 29 (7) ◽  
pp. 1119-1131 ◽  
Author(s):  
Katerina D. Kandylaki ◽  
Karen Henrich ◽  
Arne Nagels ◽  
Tilo Kircher ◽  
Ulrike Domahs ◽  
...  
Keyword(s):  
Stress Pattern ◽  
Lexical Stress ◽  
Story Comprehension ◽  
Speech Comprehension ◽  
New Approach ◽  
Sensorimotor Network ◽  
Electrophysiological Studies ◽  
Stress Patterns ◽  
Domain Independent ◽  
The Brain

While listening to continuous speech, humans process beat information to correctly identify word boundaries. The beats of language are stress patterns that are created by combining lexical (word-specific) stress patterns and the rhythm of a specific language. Sometimes, the lexical stress pattern needs to be altered to obey the rhythm of the language. This study investigated the interplay of lexical stress patterns and rhythmical well-formedness in natural speech with fMRI. Previous electrophysiological studies on cases in which a regular lexical stress pattern may be altered to obtain rhythmical well-formedness showed that even subtle rhythmic deviations are detected by the brain if attention is directed toward prosody. Here, we present a new approach to this phenomenon by having participants listen to contextually rich stories in the absence of a task targeting the manipulation. For the interaction of lexical stress and rhythmical well-formedness, we found one suprathreshold cluster localized between the cerebellum and the brain stem. For the main effect of lexical stress, we found higher BOLD responses to the retained lexical stress pattern in the bilateral SMA, bilateral postcentral gyrus, bilateral middle fontal gyrus, bilateral inferior and right superior parietal lobule, and right precuneus. These results support the view that lexical stress is processed as part of a sensorimotor network of speech comprehension. Moreover, our results connect beat processing in language to domain-independent timing perception.

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