Helmets in surgical history

Presented as the Herbert Moran Lecture 11 May 1995.The relevance of historical experience is evident in a consideration of helmets designed for head protection in war, industry, sport and road transport. Modern helmets are designed to minimize the risk of brain damage by penetration and by blunt impact; where facial or ocular injury is likely, facial protection may be provided by visors, goggles or full-face helmets. The effectiveness of helmets should be monitored by studies of actual injuries; historically, surgeons have done this, in war and peace, for centuries.Donald Simpso

Surgical and postmortem pathology studies: contribution for the investigation of temporal lobe epilepsy

Pathology studies in epilepsy patients bring useful information for comprehending the physiopathology of various forms of epilepsy, as well as aspects related to response to treatment and long-term prognosis. These studies are usually restricted to surgical specimens obtained from patients with refractory focal epilepsies. Therefore, most of them pertain to temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) and malformations of cortical development (MCD), thus providing information of a selected group of patients and restricted regions of the brain. Postmortem whole brain studies are rarely performed in epilepsy patients, however they may provide extensive information on brain pathology, allowing the analysis of areas beyond the putative epileptogenic zone. In this article, we reviewed pathology studies performed in epilepsy patients with emphasis on neuropathological findings in TLE with MTS and MCD. Furthermore, we reviewed data from postmortem studies and discussed the importance of performing these studies in epilepsy populations

Sleep and chronic pain

Chronic pain can be unrelenting. Unlike acute pain for which therapies could provide relief, chronic pain can seldom be cured. Persistent pain often impairs functioning. It may be surprising but chronic pain patients’ quality of life has been found to be lower than those of patients with chronic illnesses (e.g., chronic obstructive pulmonary disease) or life-threatening diseases (e.g., HIV/AIDS). While some individuals manage to live fulfilling lives despite pain, others suffer both physically and mentally and go on to develop anxiety, depression, and even increased suicidal ideation and behavior. One plausible reason is that, to many chronic pain patients, pain is not the only source of distress and disability. Among the many other concomitant health and emotional problems, sleep (or the lack of it) is a particular area with which most chronic pain patients want help