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Confounding neurodegenerative effects of manganese for in-vivo MR imaging in rat models of brain insults
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Abstracts Trauma Melbourne 2009 / Injury 41S (2010) S49–S62
Methods: Study subjects were identified from the Queensland Trauma Registry (QTR) between 2005 and 2007, who presented to the emergency department of the15 public QTR registered public hospitals and were diagnosed and admitted for treatment. The Abbreviated Injury Scale (AIS) code was used to identify, classify and categorize SDH patients. Demographic data, detailed information of injury incidence environment, treatment and outcome-related variables including length of stay in hospital/Intensive Care Unit (ICU), and details of SDH were examined. Logistic regression analysis was performed to estimate the odds of in-hospital mortality for patients aged (65 yrs. Results: A total of 1316 trauma patients with SDH were identified, of which 498 cases (37.8% of all SDH patients) were elderly ((65 yrs); a higher incidence compared to those aged 0 to 15 yrs (7.9%) and those aged 15-24 yrs (12.9%). Male patients comprised 54.6% of the elderly group which is significantly lower than those in younger age groups (80% in adults aged 25-64 yrs and 79% in those aged 15-24 yrs). Among the 498 elderly patients with SDH, 163 patients presented large SDH, 250 patients with small SDH, and 50 patients with bilateral SDH. Six patients suffered from multiple SDH lesions. There was no significant difference in the Injury Severity Score (ISS)-adjusted length of stay in hospital between elderly and other young age groups, being approximately 10-11 days. However, data indicated that the period of stay by the elderly group in the ICU was less than that in the younger groups (1.2 days compared to 3-4 days). We found a J-shape increase in in-hospital mortality (ISS adjusted) in which the elderly group presented the highest rate (15.4%). Logistic regression analysis indicated that the elderly group with SDH were 2.5 times more likely to die compared to those aged 25-64 yrs. Conclusions: The results indicate that the highest incidence of traumatic SDH is in the elderly, and they were more at risk of inhospital death. In addition, J-shaped mortality rates indicate that those aged 0-24 yrs are also subject to the relatively higher mortality rates. Further investigation of co-morbidity conditions and their long-term health outcomes in elderly patients is warranted. Acknowledgements: The authors gratefully acknowledge the support and contributions of the Motor Accident Insurance Commission (MAIC), Queensland Health (QH), core QTR staff, and Trauma Registry Nurse Coordinators, and all the clinical, administrative and managerial staff at each of the hospitals where the QTR is located. doi:10.1016/j.injury.2010.01.080 POSTER POSTER-11
Confounding neurodegenerative effects of manganese for invivo MR imaging in rat models of brain insults N.C. Jones 1,∗ , L. Cardamone 1 , V. Bouilleret 1,2 , Y.R. Liu 1 , A. Koe 1 , K. Fang 3 , J.P. Williams 3 , D.E. Myers 1 , T.J. O’Brien 1,4 1
Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia 2 Department of Neurophysiology and Epilepsy, ApHp, CHU Bicêtre, Paris, France 3 Small Animal MRI Facility, Florey Neurosciences Institute, Parkville, Victoria, Australia 4 Department of Neurology (RMH), University of Melbourne, Parkville, Victoria, Australia Objectives: Manganese-enhanced magnetic resonance imaging (MEMRI) is an emerging technique to visualize structural and func-
tional detail of the brain in-vivo in experimental animal models of neurological disease or injury. However, the potential for Mn2+ to result in cellular toxicity which could confound the experimental effect is often not considered in these studies. In this study, we examine long-term consequences of manganese exposure in a model of closed head injury – the fluid-percussion injury (FPI) model. Methods: Two groups of adult male Wistar rats (n = 72 in total) were studied with either Mn2+ -enhanced MRI (MEMRI), whereby rats receive MnCl2 (100 mg/kg i.p.) 24 h prior to scanning, or standard MRI (sMRI) with no contrast agent. Rats from both groups underwent either FPI or sham injury, and were longitudinally assessed for up to 6 months for signs of neurological toxicity using behavioural tests, a stress responsivity assay, EEG recording and MRI scanning. Results: Animals in the MEMRI group, regardless of whether they received FPI, showed dramatic and progressive signs of cerebral toxicity, as evidenced by significantly reduced weight gain; progressive brain volume decrease; significantly increased anxiety levels and depressive-like behaviours; and significantly enhanced stress responsivity, compared with rats in the sMRI group. These outcomes were compounded by the effect of neurotrauma. Conclusions: These results demonstrate the long-term structural and functional consequences of the use of manganese as a contrast agent for in-vivo MRI in rats. These consequences can confound experimental outcomes and must be taken into account when designing longitudinal imaging studies using manganeseenhanced MRI. Acknowledgements: We wish to acknowledge the assistance of Mary Joy Gleeson and staff of the Small Animal MRI Facility of the Howard Florey Institute for assistance with the MRI scanning. doi:10.1016/j.injury.2010.01.081 POSTER POSTER-12
Provision of allied health services following the Black Saturday bushfires A. Kolmus 1,∗ , A. Holland 1,3 , J. Salway 1 , H. Cleland 1,2 1
Physiotherapy Department, The Alfred, Prahran, Victoria, Australia Department of Plastic and Maxillofacial Surgery, The Royal Children’s Hospital, Parkville, Victoria, Australia 3 School of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia 2
The Black Saturday bushfires resulted in a large number of admissions to the burns unit. To cope with increased demand for clinical services, extra resources were allocated including more allied health staff. Objectives: To describe the characteristics and clinical requirements of the bushfire cohort and document allied health service provision following this catastrophic event. Method: Demographic data from admissions during the previous 12 months (n = 273) was compared to those from the bushfires (n = 19). Allied health service provision was compared in a cohort matched for age, gender and burn area. Results: Compared to the previous year’s admissions, bushfire patients were older (median age 55 years vs. 39 years, p = 0.001), more likely to require ICU admission (p < 0.001), had more fullthickness burns (p < 0.001), stayed longer (21 days vs. 8 days, p < 0.001) and were more likely to be discharged to the residence of friends or family and less likely to go home (p = 0.002). In
Abstracts Trauma Melbourne 2009 / Injury 41S (2010) S49–S62
Methods: Study subjects were identified from the Queensland Trauma Registry (QTR) between 2005 and 2007, who presented to the emergency department of the15 public QTR registered public hospitals and were diagnosed and admitted for treatment. The Abbreviated Injury Scale (AIS) code was used to identify, classify and categorize SDH patients. Demographic data, detailed information of injury incidence environment, treatment and outcome-related variables including length of stay in hospital/Intensive Care Unit (ICU), and details of SDH were examined. Logistic regression analysis was performed to estimate the odds of in-hospital mortality for patients aged (65 yrs. Results: A total of 1316 trauma patients with SDH were identified, of which 498 cases (37.8% of all SDH patients) were elderly ((65 yrs); a higher incidence compared to those aged 0 to 15 yrs (7.9%) and those aged 15-24 yrs (12.9%). Male patients comprised 54.6% of the elderly group which is significantly lower than those in younger age groups (80% in adults aged 25-64 yrs and 79% in those aged 15-24 yrs). Among the 498 elderly patients with SDH, 163 patients presented large SDH, 250 patients with small SDH, and 50 patients with bilateral SDH. Six patients suffered from multiple SDH lesions. There was no significant difference in the Injury Severity Score (ISS)-adjusted length of stay in hospital between elderly and other young age groups, being approximately 10-11 days. However, data indicated that the period of stay by the elderly group in the ICU was less than that in the younger groups (1.2 days compared to 3-4 days). We found a J-shape increase in in-hospital mortality (ISS adjusted) in which the elderly group presented the highest rate (15.4%). Logistic regression analysis indicated that the elderly group with SDH were 2.5 times more likely to die compared to those aged 25-64 yrs. Conclusions: The results indicate that the highest incidence of traumatic SDH is in the elderly, and they were more at risk of inhospital death. In addition, J-shaped mortality rates indicate that those aged 0-24 yrs are also subject to the relatively higher mortality rates. Further investigation of co-morbidity conditions and their long-term health outcomes in elderly patients is warranted. Acknowledgements: The authors gratefully acknowledge the support and contributions of the Motor Accident Insurance Commission (MAIC), Queensland Health (QH), core QTR staff, and Trauma Registry Nurse Coordinators, and all the clinical, administrative and managerial staff at each of the hospitals where the QTR is located. doi:10.1016/j.injury.2010.01.080 POSTER POSTER-11
Confounding neurodegenerative effects of manganese for invivo MR imaging in rat models of brain insults N.C. Jones 1,∗ , L. Cardamone 1 , V. Bouilleret 1,2 , Y.R. Liu 1 , A. Koe 1 , K. Fang 3 , J.P. Williams 3 , D.E. Myers 1 , T.J. O’Brien 1,4 1
Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia 2 Department of Neurophysiology and Epilepsy, ApHp, CHU Bicêtre, Paris, France 3 Small Animal MRI Facility, Florey Neurosciences Institute, Parkville, Victoria, Australia 4 Department of Neurology (RMH), University of Melbourne, Parkville, Victoria, Australia Objectives: Manganese-enhanced magnetic resonance imaging (MEMRI) is an emerging technique to visualize structural and func-
tional detail of the brain in-vivo in experimental animal models of neurological disease or injury. However, the potential for Mn2+ to result in cellular toxicity which could confound the experimental effect is often not considered in these studies. In this study, we examine long-term consequences of manganese exposure in a model of closed head injury – the fluid-percussion injury (FPI) model. Methods: Two groups of adult male Wistar rats (n = 72 in total) were studied with either Mn2+ -enhanced MRI (MEMRI), whereby rats receive MnCl2 (100 mg/kg i.p.) 24 h prior to scanning, or standard MRI (sMRI) with no contrast agent. Rats from both groups underwent either FPI or sham injury, and were longitudinally assessed for up to 6 months for signs of neurological toxicity using behavioural tests, a stress responsivity assay, EEG recording and MRI scanning. Results: Animals in the MEMRI group, regardless of whether they received FPI, showed dramatic and progressive signs of cerebral toxicity, as evidenced by significantly reduced weight gain; progressive brain volume decrease; significantly increased anxiety levels and depressive-like behaviours; and significantly enhanced stress responsivity, compared with rats in the sMRI group. These outcomes were compounded by the effect of neurotrauma. Conclusions: These results demonstrate the long-term structural and functional consequences of the use of manganese as a contrast agent for in-vivo MRI in rats. These consequences can confound experimental outcomes and must be taken into account when designing longitudinal imaging studies using manganeseenhanced MRI. Acknowledgements: We wish to acknowledge the assistance of Mary Joy Gleeson and staff of the Small Animal MRI Facility of the Howard Florey Institute for assistance with the MRI scanning. doi:10.1016/j.injury.2010.01.081 POSTER POSTER-12
Provision of allied health services following the Black Saturday bushfires A. Kolmus 1,∗ , A. Holland 1,3 , J. Salway 1 , H. Cleland 1,2 1
Physiotherapy Department, The Alfred, Prahran, Victoria, Australia Department of Plastic and Maxillofacial Surgery, The Royal Children’s Hospital, Parkville, Victoria, Australia 3 School of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia 2
The Black Saturday bushfires resulted in a large number of admissions to the burns unit. To cope with increased demand for clinical services, extra resources were allocated including more allied health staff. Objectives: To describe the characteristics and clinical requirements of the bushfire cohort and document allied health service provision following this catastrophic event. Method: Demographic data from admissions during the previous 12 months (n = 273) was compared to those from the bushfires (n = 19). Allied health service provision was compared in a cohort matched for age, gender and burn area. Results: Compared to the previous year’s admissions, bushfire patients were older (median age 55 years vs. 39 years, p = 0.001), more likely to require ICU admission (p < 0.001), had more fullthickness burns (p < 0.001), stayed longer (21 days vs. 8 days, p < 0.001) and were more likely to be discharged to the residence of friends or family and less likely to go home (p = 0.002). In