Return to work among elderly patients with acquired brain injuries

Objectives: Generally, it is difficult for elderly patients with acquired brain injuries (ABI) to return to work (RTW). To assess whether elderly patients with ABI can return to their workplace, like working-age patients, we investigated medical and support records and compared the rates of RTW between the working-age and elderly groups. Methods: A prospective cohort study on RTW among inpatients with ABI was conducted. We collected the clinical data of inpatients who were admitted to the Department of Neurosurgery for acute treatment and participation in a health and employment support program; follow-ups were conducted after discharge. Participants with almost independent activities of daily living (ADL) were enrolled. A χ2 test was used to examine factors influencing RTW and successful RTW by groups stratified by white-collar and blue-collar occupations and hemiplegia. The Kaplan-Meier method was used to calculate the RTW proportion curves. Results: The RTW rates were 74% for the working-age group and 89% for the elderly group (χ2 test, p=0.149); age was not a significant factor. Occupation type was the only significant factor for RTW (χ2 test, p=0.014). The RTW proportion curves of both the working age and elderly groups showed early RTW, and the elderly group had a significantly higher RTW profile than the working-age group (log-rank test, p<0.039). Almost all elderly participants were engaged in white-collar or less physical jobs, to which it is easy to return. Conclusions: In participants with almost independent ADL, the elderly group had a higher RTW rate than the working-age group

Rate of return to work in patients with stroke under the health and employment support program of Rosai hospitals in Japan

Abstract To facilitate return to work (RTW) in patients with stroke, a health and employment support (HES) program was started at Rosai hospitals in Japan. This study aimed to determine the rate of RTW in patients with stroke under this support program. We collected demographic and clinical data of patients with stroke from the implementation reports of the HES program. The program provided coordinated dual support, such as acute medical treatments, and stroke and vocational rehabilitation on the medical side, and management and support on the workplace side. The primary endpoint was RTW. Successful and unsuccessful RTW were examined using the χ2 test. The RTW rate curves were analyzed using the Kaplan–Meier method. We enrolled 483 patients; 355 (73%) and 128 (27%) patients had successful and unsuccessful RTW, respectively. Stroke types, neurological findings, and activities of daily living were significant factors for RTW. The Kaplan–Meier method revealed that left hemiplegia, right hemiplegia, and neuropsychological deficits, except for combined disability (hemiplegia with neuropsychological deficits), had similar RTW curves with an RTW rate of > 70%

Usefulness of novel fusion imaging with zero TE sequence and contrast-enhanced T1WI for cavernous sinus dural arteriovenous fistula

Evaluation of access routes and shunting points plays a crucial role in the treatment of cavernous sinus dural arteriovenous fistulas (CS-dAVF). Generally, these evaluations are performed using three-dimensional rotation angiography. However, assessing access routes becomes challenging in cases lacking anterior or posterior drainage routes. Zero TE magnetic resonance imaging (MRI) is an innovative technique enabling the visualization of cortical bone. By merging fusion images of zero TE and contrast-enhanced T1 weighted imaging (CE-T1WI), enhanced arteries can be visualized, resembling cranial bone-like three-dimensional rotation angiography. To determine the usefulness of fusion images in evaluating access routes and shunting points for dural arteriovenous fistulas, a comparison was made between these fusion images and three-dimensional rotation angiography in the same case. This report describes the application of fusion images in evaluating access routes and shunting points

Multiple Intracranial Nodules Associated With Rheumatoid Arthritis: Case Report

Photograph of the U Drop In Café and Gas Station, off Route 66

In Vivo Study of the Efficacy and Safety of 5-Aminolevulinic Radiodynamic Therapy for Glioblastoma Fractionated Radiotherapy

To treat malignant glioma, standard fractionated radiotherapy (RT; 60 Gy/30 fractions over 6 weeks) was performed post-surgery in combination with temozolomide to improve overall survival. Malignant glioblastoma recurrence rate is extremely high, and most recurrent tumors originate from the excision cavity in the high-dose irradiation region. In our previous study, protoporphyrin IX physicochemically enhanced reactive oxygen species generation by ionizing radiation and combined treatment with 5-aminolevulinic acid (5-ALA) and ionizing radiation, while radiodynamic therapy (RDT) improved tumor growth suppression in vivo in a melanoma mouse model. We examined the effect of 5-ALA RDT on the standard fractionated RT protocol using U251MG- or U87MG-bearing mice. 5-ALA was orally administered at 60 or 120 mg/kg, 4 h prior to irradiation. In both models, combined treatment with 5-ALA slowed tumor progression and promoted regression compared to treatment with ionizing radiation alone. The standard fractionated RT protocol of 60 Gy in 30 fractions with oral administration of 120 and 240 mg/kg 5-ALA, the human equivalent dose of photodynamic diagnosis, revealed no significant increase in toxicity to normal skin or brain tissue compared to ionizing radiation alone. Thus, RDT is expected to enhance RT treatment of glioblastoma without severe toxicity under clinically feasible conditions