Spontaneous subarachnoid haemorrhage due to coarctation of aorta and intraspinal collaterals : a rare presentation

The occurrence of spontaneous subarachnoid haemorrhage (SAH) in association with coarctation of thoracic aorta and absence of intracranial aneurysm is a rare association. In spontaneous SAH, the predominant cause is intracranial aneurysmal rupture. This report describes a case of a 40 year-old male who presented with SAH and was incidentally diagnosed to have coarctation of aorta (CoA) with intraspinal collaterals on further work up. This case demonstrates the importance of detailed evaluation of patients with spontaneous SAH on whom common aetiologies have been ruled out.peer-reviewe

Optimization of a solar air heater with phase change materials: Experimental and ‎numerical study

In this paper, a solar air heater (SAH) with phase change material (PCM)-based energy storage is ‎investigated. Paraffin was placed underneath the absorber plate as the PCM. A transient two-‎dimensional laminar model was used in the Ansys Fluent 17 software to study the effects of different ‎parameters on the performance of the SAH, such as the air mass flow rate, the amount of paraffin, and ‎the thermal conductivity of the paraffin. The performance of the SAH was optimized by considering ‎two objectives simultaneously: thermal energy efficiency and maximum nocturnal temperature ‎difference between the inlet and the outlet of the SAH. To validate the numerical model, a SAH with ‎a 2-cm paraffin layer and the same dimensions as the numerical model was built and tested. The ‎results of the simulation showed good agreement with the experimental results.

Economic shocks and health resilience: lessons from the Russian Federation

Background: Despite extensive research on determinants of health, there is much less information on factors protecting health among those exposed to economic shocks. Using longitudinal data from the Russian Federation in the post-Soviet period, we examined individual-level factors that enhance resilience of health to economic shocks. Methods: Logistic regression analysed factors associated with good self-assessed health (SAH) and health resilience, using pooled samples from the Russia Longitudinal Monitoring Survey-Higher School of Economics (1994–2012). Results: The general population consistently reported ‘average’ SAH, indicating almost invariant trends over the years. Male gender was the strongest predictor of good SAH and health resilience. Other factors positively associated with good SAH were age, higher education, employment, residing in rural areas, living in a larger and/or non-poor household. Among unemployed and those remaining unemployed, residing in rural areas, living in a larger and/or non-poor household remained the strongest predictors of good SAH and health resilience. These same factors were also important for males with recent job loss. Conclusions: Several factors predicting good SAH in the general population also influence health resilience factors among those remaining unemployed and experiencing a job loss. Such factors help to identify those most vulnerable and aid targeting assistance during economic crises

Subarachnoid Haemorrhage in Malta : Are outcomes adversely affected due to lack of a local neurovascular service?

Objective: This study was performed to assess the incidence, treatment and outcome of non-traumatic Subarachnoid Haemorrhage (SAH) in an island which does not offer a neurovascular service and to determine whether such limitation is associated with a poor outcome. Method: Data of adult patients with a diagnosis of non-traumatic SAH was analysed retrospectively over a two-year period from January 01, 2009 to December 31, 2010. Results: The incidence of SAH in Malta is 3.16 cases per 100 000 population per year. An underlying aneurysm was found in 50% of all cases investigated with angiography. These patients were transported to the United Kingdom for definitve management and the outcome of all these patients at 6 months was excellent. (modified Rankin Scale of 0 or 1). Conclusions: With the incidence of non-traumatic SAH being in the low range, setting up an interventional neuroradiology service in our country to treat aneurysmal SAH would not have the required numbers to maintain expertise and would probably translate into worse clinical outcomes. Despite having geographical and logistic limitations, our standards of care and survival rates are not below those of other international centres. Outcomes for patients with low initial Hunt and Hess scores have not been adversely.peer-reviewe

Minimal long-term neurobehavioral impairments after endovascular perforation subarachnoid hemorrhage in mice

AbstractCognitive deficits are among the most severe and pervasive consequences of aneurysmal subarachnoid hemorrhage (SAH). A critical step in developing therapies targeting such outcomes is the characterization of experimentally-tractable pre-clinical models that exhibit multi-domain neurobehavioral deficits similar to those afflicting humans. We therefore searched for neurobehavioral abnormalities following endovascular perforation induction of SAH in mice, a heavily-utilized model. We instituted a functional screen to manage variability in injury severity, then assessed acute functional deficits, as well as activity, anxiety-related behavior, learning and memory, socialization, and depressive-like behavior at sub-acute and chronic time points (up to 1 month post-injury). Animals in which SAH was induced exhibited reduced acute functional capacity and reduced general activity to 1 month post-injury. Tests of anxiety-related behavior including central area time in the elevated plus maze and thigmotaxis in the open field test revealed increased anxiety-like behavior at subacute and chronic time-points, respectively. Effect sizes for subacute and chronic neurobehavioral endpoints in other domains, however, were small. In combination with persistent variability, this led to non-significant effects of injury on all remaining neurobehavioral outcomes. These results suggest that, with the exception of anxiety-related behavior, alternate mouse models are required to effectively analyze cognitive outcomes after SAH.</jats:p

Corruption Across Countries and Regions: Some Consequences of Local Osmosis

Large and persistent differences in corruption across comparable countries often are loosely attributed to unarticulated “cultural factors.” Such attributions may indicate a lack of firmer perspectives from social sciences. An even more challenging research issue is the presence of such differences across regions within the same country, because, in comparison to different countries, such regions generally share more socioeconomic and governance characteristics. A principal theme of this paper is that an individual’s perceptions of his or her environment are influenced by the realities that this individual and others have faced in the past, and that these perceptions affect current and future actions of individuals, which in turn exert influences on the current and future realities. A dynamic analysis of this theme yields a number of observations concerning individuals’ behavior and societal outcomes.

Contribution of Matrix Metalloproteinase-9 to Cerebral Edema and Functional Outcome following Experimental Subarachnoid Hemorrhage

Background: Cerebral edema is an important risk factor for death and poor outcome following subarachnoid hemorrhage (SAH). However, underlying mechanisms are still poorly understood. Matrix metalloproteinase (MMP)-9 is held responsible for the degradation of microvascular basal lamina proteins leading to blood-brain barrier dysfunction and, thus, formation of vasogenic cerebral edema. The current study was conducted to clarify the role of MMP-9 for the development of cerebral edema and for functional outcome after SAH. Methods: SAH was induced in FVB/N wild-type (WT) or MMP-9 knockout (MMP-9(-/-)) mice by endovascular puncture. Intracranial pressure (ICP), regional cerebral blood flow (rCBF), and mean arterial blood pressure (MABP) were continuously monitored up to 30 min after SAH. Mortality was quantified for 7 days after SAH. In an additional series neurological function and body weight were assessed for 3 days after SAH. Subsequently, ICP and brain water content were quantified. Results: Acute ICP, rCBF, and MABP did not differ between WT and MMP-9(-/-) mice, while 7 days' mortality was lower in MMP-9(-/-) mice (p = 0.03; 20 vs. 60%). MMP-9(-/-) mice also exhibited better neurological recovery, less brain edema formation, and lower chronic ICP. Conclusions: The results of the current study suggest that MMP-9 contributes to the development of early brain damage after SAH by promoting cerebral edema formation. Hence, MMP-9 may represent a novel molecular target for the treatment of SAH. Copyright (C) 2011 S. Karger AG, Base

Ill-Health as a Household Norm: Evidence from Other People's Health Problems

This paper presents evidence that an individual's self-assessed health (SAH) does not only suffer from systematic reporting bias and adaptation bias but is also biased owing to confounding social norm effects. Using 13 waves of the British Household Panel Survey, I am able to show that, while there is a negative and statistically significant correlation between SAH and individuals' own health problem index, this negative effect varies significantly with the average number of health problems per (other) family member. Consistent with Akerlof's (1980) social norm theory, the gap in SAH between individuals with and without health problems reduces as the average number of health problems for other household members increases. Under the assumption that SAH is endogenous, this finding suggests that the objective health of other household members could be a good instrument for self-assessed levels of health.Self-assessed health; subjective health; relative; norm; comparison effects; chronic illness; BHPS