Nutrition Risk is Associated With Falls Risk in an Observational Study of Community-Dwelling, Rural, Older Adults.

OBJECTIVES: Poor nutritional status is a risk factor for falls and impedes recovery from falls in older adults. The primary objective of this study was to investigate the relationship between nutrition status and fall risk over time in a cohort of older adults. METHODS: Using an observational analytic study design, we collected demographic, fall risk, nutrition risk, food insecurity, and incident falls data from community-dwelling older Vermonters. RESULTS: Data from 708 participants (70.3 years ± 6.6; 82% female) indicate a significant association between fall risk and nutrition risk (p < 0.001), fall risk and food insecurity (p < 0.001), and food insecurity and nutrition risk (p < 0.001). After adjusting for potential confounders, elevated nutrition risk was significantly associated with an incident fall over the next 6 months (p < 0.05). CONCLUSION: Given the evidence for an association between nutrition status and falls, additional research, in a more diverse population, is needed to understand the nuances of these relationships.

Vertebral artery dissection managed by interventional radiology.

A 21-year-old patient presented with sudden-onset headache, visual disturbance and left hand incoordination. She was diagnosed with a left vertebral artery dissection of the V3 segment resulting in multiple cerebellar and cerebral infarcts. There were no risk factors for dissection other than recent COVID-19 infection. She was treated initially with antiplatelets, followed by anticoagulation, but experienced recurrent ischaemia. Although guidance suggests endovascular repair may be beneficial for patients with cerebral artery dissection (CAD) who experience recurrent strokes on medical therapy, evidence is limited. After multidisciplinary team consideration of the individual patient anatomy and risks and benefits of different endovascular techniques, the patient was treated with endovascular coiling. At 10 months follow-up, she had no further strokes and improving neurological symptoms. The case highlighted COVID-19 as a potential trigger for CAD and the use of endovascular coiling in preventing catastrophic cerebral ischaemia in CAD refractive to medical therapy.

Traumatic Fetal Intracranial Hemorrhage Suggested by Point-of-Care Ultrasound.

While the use of ultrasound to diagnose a fetal intracranial hemorrhage in utero is not a new concept, the emphasis of point-of-care ultrasound (POCUS) at the initial trauma presentation of the mother to evaluate for fetal injury is novel. A review of the literature failed to reveal a single case report wherein POCUS in the workup of a pregnant trauma patient led to the diagnosis of fetal intracranial hemorrhage. This is such a case.

A quantitative study of neurochemically defined populations of inhibitory interneurons in the superficial dorsal horn of the mouse spinal cord.

Around a quarter of neurons in laminae I-II of the dorsal horn are inhibitory interneurons. These play an important role in modulating somatosensory information, including that perceived as pain or itch. Previous studies in rat identified four largely non-overlapping neurochemical populations among these cells, defined by expression of galanin, neuropeptide Y (NPY), neuronal nitric oxide synthase (nNOS) or parvalbumin. The galanin cells were subsequently shown to coexpress dynorphin. Several recent studies have used genetically modified mice to investigate the function of different interneuron populations, and it is therefore important to determine whether the same pattern applies in mouse, and to estimate the relative sizes of these populations. We show that the neurochemical organization of inhibitory interneurons in mouse superficial dorsal horn is similar to that in the rat, although a larger proportion of these neurons (33%) express NPY. Between them, these four populations account for ∼75% of inhibitory cells in laminae I-II. Since ∼25% of inhibitory interneurons in this region belong to a novel calretinin-expressing type, our results suggest that virtually all inhibitory interneurons in superficial dorsal horn can be assigned to one of these five neurochemical populations. Although our main focus was inhibitory neurons, we also identified a population of excitatory dynorphin-expressing cells in laminae I-II that are largely restricted to the medial part of the mid-lumbar dorsal horn, corresponding to glabrous skin territory. These findings are important for interpretation of studies using molecular-genetic techniques to manipulate the functions of interneuron populations to investigate their roles in somatosensory processing.