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Craniopharyngioma treatment remains a challenge for clinicians and patients. There are many treatment alternatives; however one of them (intracavitary irradiation) seeks to control this type of benign brain tumor using minimally invasive techniques, with the specific aim of avoiding causing significant damage to important structures surrounding the sellar/suprasellar region. We present the case of a 3-year-old patient with a predominantly cystic craniopharyngioma who underwent intracavitary irradiation by stereotactic placement. Using this approach, the patient showed a successful response with remission of headaches and hydrocephalus. A reduction in the size of the cyst was achieved, without deterioration of visual fields, with no hormonal supplementation being needed, and with no evidence of focal neurological signs. [ABSTRACT FROM AUTHOR]

Background: Physical activity behavioral interventions to change individual-level drivers of activity, like motivation, attitudes, and self-efficacy, are often not sustained beyond the intervention period. Interventions at both environmental and individual levels might facilitate durable change. This community-based study seeks to test a multilevel, multicomponent intervention to increase moderate intensity physical activity among people with low incomes living in U.S. public housing developments, over a 2 year period. Methods: The study design is a prospective, cluster randomized controlled trial, with housing developments (n=12) as the units of randomization. In a four-group, factorial trial, we will compare an environmental intervention (E) alone (3 developments), an individual intervention (I) alone (3 developments), an environmental plus individual (E+I) intervention (3 developments), against an assessment only control group (3 developments). The environmental only intervention consists of community health workers leading walking groups and indoor activities, a walking advocacy program for residents, and provision of walking maps/signage. The individual only intervention consists of a 12-week automated telephone program to increase physical activity motivation and self-efficacy. All residents are invited to participate in the intervention activities being delivered at their development. The primary outcome is change in moderate intensity physical activity measured via an accelerometer-based device among an evaluation cohort (n=50 individuals at each of the 12 developments) from baseline to 24-month follow up. Mediation (e.g., neighborhood walkability, motivation) and moderation (e.g., neighborhood stress) of our interventions will be assessed. Lastly, we will interview key informants to assess factors from the Consolidated Framework for Implementation Research domains to inform future implementation. Discussion: We hypothesize participants living in developments in any of the three intervention groups (E only, I only, and E+I combined) will increase minutes of moderate intensity physical activity more than participants in control group developments. We expect delivery of an intervention package targeting environmental and social factors to become active, combined with the individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. If effective, this trial has the potential for implementation through other federal and state housing authorities. Trial registration: Clinical Trails.gov PRS Protocol Registration and Results System, NCT05147298. Registered 28 November 2021. [ABSTRACT FROM AUTHOR]

Background: Colombia's health system allows workers to claim paid sick leave due to health conditions, some of this conditions are related to metabolic and cardiovascular disease. There has been an association between these diseases and depression. However, the effect of behavioral disorders such as depression on absence from work is unknown in the developing world. The objective of the research is to estimate whether low-wage workers suffering from depression, metabolic disease, and cardiovascular disease request more paid sick days than people with the same medical comorbidities, but without depression. Data and Methods: We conducted a retrospective study using data from an insurer in the southwestern region of Colombia in 2016. Depression was identified using an international algorithm that detects chronic conditions from diagnosis and pharmacy data. Outcome variables were the number of days on sick leave allowed by the insurer in one year, and the amount paid by the insurer. We used multivariate regression to estimate whether depression increases sick leave due to metabolic and cardiovascular disease after pre-processing the data using coarsened exact matching. Results: Individuals diagnosed with depressive disorders and absent from work due to metabolic and cardiovascular disease tend to have more paid sick days throughout the year than individuals with no depression suffering from these diseases. Additional absence days were statistically significant in nutritional and metabolic disease (10.6 days) and circulatory diseases (7.4 days). Conclusions: Depression comorbid with a physical disease increases the number of days and consequently the associated costs to the insurer. The incremental cost due to depression is higher compared to what insurers receive annually from the government to cover health services; consequently, additional research is warranted to identify prevention activities that can treat depression, thus lowering the healthcare system's financial burden. [ABSTRACT FROM AUTHOR]