The effects of normal human variability and hand activity on sensory testing with the full Semmes-Weinstein monofilaments kit.

The first part of this study aimed to determine the effect of human variability on assessment using Semmes-Weinstein monofilaments. Fifteen healthy subjects were tested using a full monofilament kit of known calibration. When the subjects were retested, they responded to a different filament 48% of the time. The second part of the study aimed to determine the effects of vigorous hand activity on sensation, as measured with Semmes-Weinstein monofilaments. Forty randomly selected healthy subjects were assessed before and after they performed a brief, standardized gripping activity. After hand activity, the subjects responded to a different filament 53% of the time. In both parts of this study, the changes in monofilament results were random in direction and magnitude. The number of changes did vary between test sites, the radial nerve sites being most variable and the ulnar nerve sites least variable. It is concluded that the results of testing with the five smallest monofilaments in the full Semmes-Weinstein kit were not reliable in normal subjects and that they did not detect change in sensory function in normal subjects.     

Increased factor VIII coagulant activity levels in male carriers of the factor V R2 polymorphism.

A common factor V gene haplotype, the FVR2 haplotype (FVHR2), has been associated with a reduced cofactor activity in activated protein C-mediated activated factor VIII inactivation. Our aim was to investigate the role of FVHR2 as a possible determinant of factor VIII levels in a population study. A total of 516 individuals (401 men, 115 women; mean age 58.4 +/- 10.8 years) were enrolled within the frame of a regional cardiovascular survey, characterized for factor VIII coagulant activity (FVIII:c) and factor V coagulant activity (FV:c) levels, and genotyped for factor V polymorphisms. In men without signs of overt inflammation, FVHR2 carriers had higher levels of FVIII:c than noncarriers (154 IU/dl, 95% confidence interval = 143-166 versus 142 IU/dl, 95% confidence interval = 138-147; P = 0.045) and were more represented in individuals with high (> or = 150 IU/dl) FVIII:c levels (21.2 versus 10.8%; odds ratio = 2.27, 95% confidence interval = 1.17-4.39 after adjustment for age, blood group and high-sensitivity C-reactive protein levels). In conclusion, this clinical report suggests the common FVHR2 as a possible independent determinant of FVIII:c levels. The report concomitantly addresses the relationship between factor V and factor VIII levels and supports the hypothesis of a mild prothrombotic role of FVHR2 by means of increased factor VIII levels.     

Outcome of frozen embryo replacement cycles following elective cryopreservation of all embryos in women at risk of developing ovarian hyperstimulation syndrome

Aim: Our aim was to compare the outcome in subsequent frozen embryo replacement cycles in four groups of patients who had elective cryopreservation of all their embryos because they were considered to be at increased risk of developing severe ovarian hyperstimulation syndrome. Design: Sixty-two (91%) of 68 IVF cycles (68 patients) in which elective cryopreservation of all embryos was performed were analyzed. All patients continued on the GnRH agonist, buserelin, after oocyte recovery until the onset of vaginal bleeding. Frozen embryo replacement occurred in a hormone replacement cycle that started either on day 3 of the withdrawal bleed (group I;N=15) or after serum estradiol levels had fallen to <100 pmol/L (group II;N=16). The other patients commenced a frozen embryo replacement cycle several months later in either a hormone replacement (group III;N=15) or a natural (group IV;N=16) cycle. Results: Two patients developed severe ovarian hyperstimulation syndrome. There were no significant differences among the four groups regarding demographic variables, the dose of hMG used, and the clinical outcome. There was a higher but not significantly different clinical pregnancy rate in group I (26.7%), compared to group II (12.5%), group III (13.3%), and group IV (18.8%). Conclusions: Several options exist for the timing and protocol used for frozen embryo replacement in patients who had elective cryopreservation for the prevention of ovarian hyperstimulation syndrome, none of which was found to be clearly superior in this observational report.Presented at the 1994 Annual Conference of the American Fertility Society.     

Addiction.: By David Marteau. Quay Books Division, Mark Allen Publishing, Ltd, London. 2001, 168pp., {pound}14.99. ISBN: 1-85642-189-9.

Addiction was written by David Marteau, a nurse and former headof treatment at Clouds House. It is a short book offering comprehensivecoverage of the causes, nature and treatment of     

Convergent evidence for construct validity of a 7-point likert scale of lower limb muscle soreness.

OBJECTIVES: The aim of this study was to examine the construct validity of the 7-point Likert scale of muscle soreness, assessing its relationship with Visual Analogue Scale (VAS). An additional aim was to examine its sensitivity as measure of symptom of eccentric-contraction muscle damage. DESIGN: Correlational study. SETTING: Self-administered questionnaires collected in field setting. PARTICIPANTS: Twenty-six soccer players. INTERVENTIONS: 4-week preseason training camp, which included high-intensity plyometric training sessions. MAIN OUTCOME MEASUREMENTS: Players self-reported the perceived muscle soreness of the lower limbs using the VAS (criterion measure) and the 7-point Likert scale of muscle soreness. RESULTS: Significant individual correlations were found between the 2 muscle soreness scales (mean r=0.80+/-0.07; range, 0.65 to 0.94). The correlation using the pooled data was 0.81. No significant muscle soreness scale x time interaction was found for standardized measures of muscle soreness (P=0.98). The main factor for time (24, 48, 72, and 96 hours after the first plyometric training session) was significant (P=0.0001). Effect sizes for the changes in the Likert and VAS absolute scores during the first 96 hours were similar (partial eta=0.13). CONCLUSIONS: The results of this study provide further convergent evidence for the construct validity of the 7-point Likert scale of muscle soreness. The 2 scales showed similar sensitivity to muscle soreness caused by eccentric contractions during the first 96 hours after plyometric exercises.     

LUST FOR LIFE: PLEASURE UNDER THE REALITY PRINCIPLE AND GROWTH IN EROS

ABSTRACT Drawing on ideas from the psychoanalytic thought of Bion and the philosophy of Whitehead the paper explores the difference between'prehended lust'and perverse sexuality. Prehended lust is regarded as life-enhancing whereas in perverse sexuality excitement is generated to disencumber the individual of anxiety. This view is illustrated by clinical material and by a more lengthy discussion of the recent British film The Principles of Lust , directed by Penny Woolcock.