Exposure Hypothermia and the Winter Sports SCI Participant

Abstract

Sensation is impaired in the individual with a complete spinal cord injury and it can be compromised in those with incomplete lesions. Quadriplegics and high paraplegics are, therefore, susceptible to environmental temperature changes (partially poikilothermics). Physicians have assumed that SCI persons engaged in winter sports activities are sensitive to exposure hypothermia. To test this premise, participants were examined within five minutes following their arrival from the ski slopes. Sublingual temperature, pulse and respirations were obtained from nine participants. Exposure hypothermia was found in one-third of the selected individuals. We concluded that exposure hypothermia is one of the complications to look for in the winter sports SCI participant, and that cases could be misdiagnosed if physiological knowledge of the SCI person is lacking.     

The Preoperative Sexual Functioning and Quality of Sexual Life in Colorectal Cancer: A Study among Patients and Their Partners

IntroductionEven though the body of literature on sexual functioning is growing, information on the preoperative sexual functioning and the quality of sexual life after colorectal cancer is lacking. Research focusing on female patients and on partners is also rather scarce.AimThis cross‐sectional study aimed to describe the preoperative sexual functioning, quality of sexual life, and relationship functioning for male and female colorectal cancer patients and their partners. In addition, the mean scores of the patients and partners were compared with mean norm scores.MethodsPatients diagnosed with colorectal cancer (N = 136) and their partners (N = 106) were recruited before surgical treatment in six Dutch hospitals.Main Outcome MeasuresMen completed the International Index of Erectile Functioning, while women completed the Female Sexual Function Index. All partnered participants completed the Golombok‐Rust Inventory of Sexual Satisfaction and the Maudsley Marital Questionnaire. The mean scores were compared with mean norm scores derived from the manuals of the questionnaires.ResultsAll participants were in a heterosexual relationship. Female patients reported a lower quality of sexual life compared with male patients. Male partners reported a lower sexual functioning and a lower quality of sexual life compared with male patients. Colorectal cancer patients and partners (both sexes) reported a lower sexual functioning and a lower quality of sexual life compared with norm populations but scored similar on relationship functioning.ConclusionA lower sexual functioning and a lower quality of sexual life are already reported preoperatively; however, relationship functioning was comparable with a norm population. Therefore, all the impairment seen after treatment should not be solely attributed to the effects of treatment. Traa MJ, De Vries J, Roukema JA, and Den Oudsten BL. The preoperative sexual functioning and quality of sexual life in colorectal cancer: A study among patients and their partners. J Sex Med 2012;9:3247–3254.     

Thrombin generation reveals high procoagulant potential in the plasma of sickle cell disease children

Changes in several components of the clotting system are well documented in sickle cell disease (SCD) patients. However, whether the global hemostatic potential of these patients is altered is still unclear. Calibrated automated thrombogram® method of thrombin generation (TG) was used to characterize the hemostatic potential of 83 SCD children (75 SS, 6 SC, and 2 Sβ ^thal) at steady‐state as compared with 50 controls of the same range of age. TG was triggered using 1 pM tissue factor and 4 μM phospholipids with and without thrombomodulin. Thirteen SCD children were also evaluated during vaso‐occlusive crisis. Protein C activity, free protein S and D‐dimers levels were measured in parallel. SCD patients showed higher rates of thrombin formation, higher thrombin peak height (with and without thrombomodulin), and higher endogenous thrombin potential (ETP) than controls in the presence of thrombomodulin. Reduction of ETP (RETP) in the presence of thrombomodulin was lower in SCD group compared with controls and correlated both with protein C and protein S levels. ETP, RETP, peak height, and velocity index of TG correlated with D‐dimers. Compound heterozygous patients showed an intermediate hemostatic phenotype at steady‐state. No significant difference was observed when comparing TG parameters during vaso‐occlusive crisis to those obtained at steady‐state in the same patients. The global hemostatic potential is increased and reflects the hypercoagulable state of SCD patients even at steady‐state. The relevance of this finding with respect to the risk of thrombotic complications of the disease needs further investigation. Am. J. Hematol. 2011. © 2011 Wiley‐Liss, Inc.     

A large-scale genome-wide gene expression analysis in peripheral blood identifies very few differentially expressed genes related to antidepressant treatment and response in patients with major depressive disorder

A better understanding of the biological factors underlying antidepressant treatment in patients with major depressive disorder (MDD) is needed. We perform gene expression analyses and explore sources of variability in peripheral blood related to antidepressant treatment and treatment response in patients suffering from recurrent MDD at baseline and after 8 weeks of treatment. The study includes 281 patients, which were randomized to 8 weeks of treatment with vortioxetine (N = 184) or placebo (N = 97). To our knowledge, this is the largest dataset including both gene expression in blood and placebo-controlled treatment response measured by a clinical scale in a randomized clinical trial. We identified three novel genes whose RNA expression levels at baseline and week 8 are significantly (FDR < 0.05) associated with treatment response after 8 weeks of treatment. Among these genes were SOCS3 (FDR = 0.0039) and PROK2 (FDR = 0.0028), which have previously both been linked to depression. Downregulation of these genes was associated with poorer treatment response. We did not identify any genes that were differentially expressed between placebo and vortioxetine groups at week 8 or between baseline and week 8 of treatment. Nor did we replicate any genes identified in previous peripheral blood gene expression studies examining treatment response. Analysis of genome-wide expression variability showed that type of treatment and treatment response explains very little of the variance, a median of <0.0001% and 0.05% in gene expression across all genes, respectively. Given the relatively large size of the study, the limited findings suggest that peripheral blood gene expression might not be the best approach to explore the biological factors underlying antidepressant treatment.Subject terms: Predictive markers, Depression     

Moderate alcohol consumption is associated with lower chronic disease burden expressed in disability-adjusted life years: a prospective cohort study

The relation of alcohol consumption with disease burden remains debated partly due to opposite associations with cardiovascular disease (CVD) and cancer. The relation of alcohol consumption with disease burden expressed in disability-adjusted life years (DALYs) summarizes opposing associations of alcohol consumption on chronic diseases. This study aimed to investigate the association of alcohol consumption with chronic disease burden expressed in DALYs based on individual-participant data. The study was a prospective study among 33,066 men and women from the EPIC-NL cohort. At baseline, alcohol consumption was assessed with a validated food-frequency questionnaire. Participants were followed for occurrence of and mortality from chronic diseases and DALYs were calculated. After 12.4 years follow-up, 6647 disease incidences and 1482 deaths were documented, resulting in 68,225 healthy years of life lost (6225 DALYs). Moderate drinkers (women 5–14.9 g/day, men 5–29.9 g/day) had a lower chronic disease burden (mean DALYs ?0.27; 95% CI ?0.43; ?0.11) than light drinkers (0–4.9 g/day), driven by a lower disease burden due to CVD (?0.18: ?0.29; ?0.06) but not cancer (?0.05: ?0.16; 0.06). The associations were most pronounced among older participants (≥50 years; ?0.32; ?0.53; ?0.10) and not observed among younger women (?0.08; ?0.43; 0.35), albeit non-significant (p_interaction > 0.14). Substantial drinking (women 15–29.9 g/day, men 30–59.9 g/day) compared to light drinking was not associated with chronic disease burden. Our results show that moderate compared to light alcohol consumption was associated with living approximately 3 months longer in good health. These results were mainly observed among older participants and not seen among younger women.     

Multi-Center Analysis of Liver Transplantation for Combined Hepatocellular Carcinoma-Cholangiocarcinoma Liver Tumors

1. Download : Download high-res image (269KB)
2. Download : Download full-size image