No abstract

Traumatic brain injury (TBI) may cause persistent cognitive dysfunction. A pilot clinical study was performed to determine if hyperbaric oxygen (HBO2) treatment improves cognitive performance. It was hypothesized that stem cells, mobilized by HBO2 treatment, are recruited to repair damaged neuronal tissue. This hypothesis was tested by measuring the relative abundance of stem cells in peripheral blood and cognitive performance during this clinical trial. The subject population consisted of 28 subjects with persistent cognitive impairment caused by mild to moderate TBI suffered during military deployment to Iraq or Afghanistan. Fluorescence-activated cell sorting (FACS) analysis was performed for stem cell markers in peripheral blood and correlated with variables resulting from standard tests of cognitive performance and post-traumatic stress disorder: ImPACT, BrainCheckers and PCL-M test results. HBO2 treatment correlated with stem cell mobilization as well as increased cognitive performance. Together these results support the hypothesis that stem cell mobilization may be required for cognitive improvement in this population.

1.Measurements have been made of mixed venous Pco, (PV,co,) by two methods during exercise at 50 and 100 W in five adult male subjects.2. The equilibration (plateau) method and the extrapolation (Defares) method were performed alternately, five times each, during the steady-state exercise.3. The coefficient of variation of PT,co, by the extrapolation method was much higher than that of the plateau method. The PJ,co, can be estimated to within f 1 mmHg by the plateau method, and the derived cardiac output to within f0.5 l/min in most cases. The cardiac output calculated by this method agrees closely with that found by direct methods in other studies, whereas the extrapolation method usually overestimates the cardiac output in adults.4. It is suggested that the degree of variation in the extrapolation method is due to technical factors in construction of the line and to the difficulty of deciding what constitutes the end-tidal Pco,.

Histoplasma infections in Europe are rare, and acute disseminated histoplasmosis has only been observed in immunocompromised persons. We describe a case of acute disseminated histoplasmosis in a young, nonimmunocompromised European woman. The probable source of infection was Sri Lanka or the Maldives. At presentation she was severely ill with fever, lymphadenopathy, anemia, thrombocytopenia, hepatosplenomegaly, and polyserositis. Histologically, myelofibrosis and osteosclerosis were observed with extramedullary hematopoiesis. Histoplasma capsulatum yeasts were detected in bone marrow trephine biopsy by methenamine silver staining. Treatment with conventional and liposomal amphotericin B and subsequent itraconazole led to rapid and complete recovery.

In Io patients with neurocirculatory asthenia the effect of two adrenergic beta-blocking drugs, propranolol and practolol, were studied on the ST-T changes observed in the resting electrocardiogram and on those occurring under orthostatic conditions. The drugs were administered intravenously on different occasions. Propranolol improved the ST-T abnormalities in the resting electrocardiogram in all Io patients and in 6 even restored the tracing to normal. In the same io subjects, practolol improved the abnormalities in 8, restored them to normal in 4, while in 2 patients no change occurred under the influence of this drug. Propranolol resulted in complete disappearance of orthostatic ST-T changes in 6 out of 9 patients and improved the tracing in the others; practolol improved the orthostatic electrocardiogram in 6 subjects, but in none was a complete return to normal observed.