Even mild head injuries can cause significant abnormalities in brain function that last for several days, which may explain the neurological symptoms experienced by some individuals who have experienced a head injury associated with sports, accidents or combat, according to a study by Virginia Commonwealth University School of Medicine researchers.
These findings advance research in the field of traumatic brain injury (TBI), enabling researchers to better understand what brain structural or functional changes underlie posttraumatic disorders – a question that until now has remained unclear.
Previous research has shown that even a mild case of TBI can result in long-lasting neurological issues that include slowing of cognitive processes, confusion, chronic headache, posttraumatic stress disorder and depression.
The VCU team, led by Kimberle M. Jacobs, Ph.D., associate professor in the Department of Anatomy and Neurobiology, demonstrated for the first time, using sophisticated bioimaging and electrophysiological approaches, that mild injury can cause structural disruption of axons in the brain while also changing the way the neurons fire in areas where they have not been structurally altered. Axons are nerve fibers in the brain responsible for conducting electrical impulses. The team used models of mild traumatic brain injury and followed morphologically identified neurons in live cortical slices.
‘These findings should help move the field forward by providing a unique bioimaging and electrophysiological approach to assess the evolving changes evoked by mild TBI and their potential therapeutic modulation,’ said co-investigator, John T. Povlishock, Ph.D., professor and chair of the VCU School of Medicine’s Department of Anatomy and Neurobiology and director of the Commonwealth Center for the Study of Brain Injury.
According to Povlishock, additional benefit may also derive from the use of this model system with repetitive injuries to determine if repeated insults exacerbate the observed abnormalities. Virginia Commonwealth University

Big gaps in basic knowledge about the numbers and causes of apparently inexplicable heart attacks among young sportsmen and women are seriously hampering our ability to prevent them, says a sport and exercise medicine specialist in the British Journal of Sports Medicine.
At the very least, we need to start building reliable databases of all such events across sport, in a bid to start plugging these knowledge gaps, say Dr Richard Weiler and colleagues.
His comments come in the wake of the recent high profile case of premier league footballer, Fabrice Muamba, who collapsed on pitch, in front of a stadium packed with spectators, after sustaining a sudden heart attack.
Fortunately, Mr Muamba recovered, but cases like these, although rare, are still likely to occur despite screening programmes, and they are poorly understood, emphasises Dr Weiler.
These cases have prompted improvements in pitch-side and acute sports medicine, including emergency life support, defibrillation and the development of practical education courses and emergency care guidelines, says Dr Weiler.
None the less, he says: ‘We still lack many answers to basic questions about these afflictions. We do not know the exact numbers and trends in prevalence or incidence, and do not understand the [multiple causes] that trigger sudden cardiac death in previously healthy athletes.’
Issues that still need further investigation are the roles of gender and ethnicity, geography and genes, he says.
For example, Sub-Saharan Africa may be a ‘cardiac hotspot,’ with recent research linking sudden heart attacks to sickle cell trait.
Other research suggests that African Americans are three times more prone to sudden cardiac death/arrest than white athletes, although the rates vary considerably depending on the type of sport played.
And another study found that heart (ECG) tracing patterns differ between white and black athletes, although whether this is normal or indicates a higher risk for sudden cardiac death is not known, says Dr Weiler.
Screening programmes throw up a considerable number of false positive results, and it is still far from clear whether screening actually cuts the number of deaths, whether it is cost effective, and how to manage any abnormal findings, he says.
‘It is vital that we start to answer these questions based on reliable science and evidence,’ he insists. ‘To achieve this, we propose the collection and recording of reliable data across sport of every sudden cardiac death/arrest,’ he writes.
But for this to happen, co-operation and collaboration will be needed among sporting organisations, federations, and clubs, in addition to the establishment of sport specific and national registries for these incidents, he suggests.
Dr Weiler cites a FIFA (International Football Federation) initiative. This requires a medical assessment before a match for all FIFA competitions, and includes a recently established database for all its 208 member associations in a bid to build up an evidence base and better understand the condition.
‘This is one of many efforts needed to fill knowledge gaps and enable us to mitigate the risks of sudden cardiac arrest/death,’ concludes Dr Weiler, adding that minimum standards of pitch-side medical care across all sports are essential. EurekAlert

Tufts Medical Center researchers have shown that presence of a gene strongly linked to appetite regulation is highly predictive of a premature infant’s readiness to feed orally. An analysis of just a drop of an infant’s saliva could be the key to preventing many feeding problems and the expensive medical complications that can occur when infants are fed by mouth too early.
In a study Maron and colleagues have identified a biomarker in saliva that predicts a baby is not yet ready to feed 95 percent of the time. The biomarker, a gene for the neuropeptide Y2 receptor, NPY2R, is a known regulator of feeding behaviour. In their study, the researchers demonstrated that levels of NPY2R in saliva decline as a newborn matures enough to feed orally.
‘There’s a really important need for a better understanding and a more accurate assessment of infants’ feeding skills, ” said Jill L. Maron, MD, MPH, a researcher at the Mother Infant Research Institute at Tufts Medical Center. ‘Nearly every baby born early is at risk for feeding associated morbidities, which often lead to prolonged hospitalisations, short and long term health complications, and significant parental anxiety. This is a way of monitoring the most vulnerable babies very non-invasively. We can help guide clinical care without ever hurting them.”
Currently, caregivers use a variety of subjective measurements, such as evaluating a baby’s sucking and swallowing skills, to determine when it’s safe to feed a baby by mouth. But these methods are imprecise and often lead to feeding a baby too early, which can cause the child to choke, accidentally inhale breast milk or formula into their lungs leading to pneumonia, or other problems. Babies who suffer these early feeding difficulties can also go on to develop long-term feeding problems and are at risk of developmental delays. Research indicates that more than 40 percent of children in feeding disorder clinics were premature babies.
The NPY2R gene has been studied extensively because it helps regulate appetite and plays a role in both obesity and eating disorders. But no one had examined its role in prompting premature babies to eat, because most researchers were not focusing on appetite’s role in newborn feeding problems. Tufts Medical Center

Children born with cleft lip, cleft palate and other craniofacial disorders face numerous medical challenges beyond appearance.
Patients can face serious airway, feeding, speech and hearing problems, as well as social and psychological challenges, Laura Swibel Rosenthal, MD, of Loyola University Medical Center and colleagues write.
‘The management of patients with craniofacial syndromes is complex,’ Rosenthal and colleagues write. ‘Otolaryngologic [ear-nose-throat] evaluation is of paramount importance in providing adequate care for this patient population.’
About 1 in 600 babies in the United States is born with a cleft lip and/or cleft palate, according to the Cleft Palate Foundation. The defect can range from a small notch in the lip to a grove that runs into the roof of the mouth. It can occur in isolation or in combination with other craniofacial birth defects. (A craniofacial disorder refers to an abnormality of the face and/or head.)
The first step in managing craniofacial patients is ensuring a safe airway. There’s also a great potential for nasal obstruction and sleep apnoea. And patients are at increased risk of developing upper airway problems such as sinusitis, laryngitis and rhinitis.
Hearing loss is common and often progressive. Thus, in addition to receiving standard newborn hearing screening, craniofacial patients should continue to receive periodic hearing tests, Rosenthal and colleagues write.
Craniofacial patients typically require several corrective surgeries, performed in staged fashion. Surgeons and anaesthesiologists should be aware of the potential challenges these patients may have with general anaesthesia.
The authors recommend a multidisciplinary approach, beginning with genetic counselling to determine the cause of the malformation, to inform parents about what to expect and to learn about the implications for other family members.
In addition to otolaryngologists, other specialists who typically care for craniofacial patients include pulmonologists, gastroenterologists, dentists and orthodontists. Depending on the congenital condition, a patient also may see pediatric specialists, such as cardiologists, ophthalmologists, neurosurgeons, endocrinologists, urologists, nephrologists and orthopaedic surgeons.
Most patients also need additional support services, including case management (social work), psychology or psychiatry, speech pathology, physical therapy, occupational therapy and other educational services. Loyola University Health System

A new study led by University of Kentucky researchers shows a new way to precisely detect a single chemical at extremely low concentrations and high contamination.
The study was carried out in the laboratory of Peixuan Guo, the William S. Farish Endowed Chair in Nanobiotechnology at the University of Kentucky Markey Cancer Center. The study shows that the phi29 DNA packaging nanomotor connector can be used to sense chemicals with reactive thioesters or maleimide using single channel conduction assays based on three observable fingerprints. This channel system could be further developed into very sensitive sensing devices.
The ability to detect a chemical at a low concentration and high contamination is especially important for environmental surveillance, homeland security, athlete drug monitoring, toxin/drug screening, and earlier disease diagnosis.
In the case of disease diagnosis, the production of an unusual metabolic product is a feature of disease, but in early stages, the concentration of this product is very low. Single molecule detection will facilitate the early detection of disease such as cancer, so as to facilitate earlier treatment.
‘Sensitivity of detection is a major challenge in the diagnosis of many diseases,’ said Guo. ‘Our next step is to find one metabolic product of one disease and determine the reality in earlier disease diagnosis.’
‘The proof-of-principle studies described in this study will be extended in the future to engineer multiple probes within a single pore for concurrent detection of multiple targets at the single molecule level in real time,’ said Farzin Haque, research assistant professor at the UK College of Pharmacy, and first author on the paper. EurekAlert