The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort

BackgroundThis study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort.MethodsA total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001.ResultsThe past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs] = 1.56–1.86), pre-9/11 stressors (ORs = 1.30–1.50), family support (ORs = 0.83–0.94), and union membership (ORs = 0.50–0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR = 1.36), performing search and rescue work (OR = 1.29), and work support (OR = 0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs = 3.82–41.74), and somatic symptoms and functional difficulties (ORs = 1.30–1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs = 2.93–7.02; and ORs = 1.18–1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls).ConclusionsThese results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.     

共培养下后交叉韧带成纤维细胞中MMPs的基因表达

目的研究后交叉韧带(posterior cruciate ligament,PCL)成纤维细胞与滑膜细胞共培养下,2种细胞之间的交流对PCL成纤维细胞中基质金属蛋白酶MMP-1、2、3表达及活性的影响。方法分为共培养组和单培养组:①用显微镜观察共培养24 h后细胞的活性和迁移率。②分别培养6 h后,提取总RNA,逆转录PCR;实时荧光定量PCR对人后交叉韧带成纤维细胞MMP-1、2、3基因的表达进行半定量和定量分析。③共培养处理1、2、3 d后收集培养上清液,用明胶酶谱法检测MMP-2的活性。结果共培养使PCL细胞和滑膜细胞较单层细胞培养迁移率分别增高了(43.1±0.1)%和(76.2±0.2)%(P<0.01)。与单培养相比,共培养组明显增加了MMP-2的基因表达,但降低了MMP-1、3的基因表达。酶谱结果表明共培养增加了MMP-2活性(P<0.05)。结论共培养能够促进细胞的迁移以及调节细胞中MMP-1、2、3的表达情况。