Abstract: Alcohol is frequently related to interpersonal aggression, but information regarding the role of alcohol consumption by victims of severe aggression is however lacking. In order to better understand the dynamic of victimization, we investigated contextual, facilitator, and psychological impact variables related to victimization in a French sample composed of 1,033 females aged 18–74 years. The participants were recruited using quota sampling methodology, and responses were measured using Computer-Assisted Self-Interviewer. A logistic regression was conducted using a backward elimination procedure to identify the significant predictors of blows and wounds suffered in the past 24 months. The results indicated that victims, relative to nonvictims, did binge drink significantly more often, had a higher aggression trait, and had experienced more social hardships in the past. The study's limitations are noted.
Read More: http://informahealthcare.com/doi/abs/10.3109/10826084.2011.606867
Abstract: Background & Aims
In chronic hepatitis C (CHC), HCV-specific T-cell responses are often dysfunctionnal. In vitro data point out that regulatory T cells (Treg) are able to suppress HCV-specific lymphocyte proliferation and cytokine secretion but their implication in this pathology is still debated.
Methods
Three complementary approaches were performed to investigate phenotype, frequency or localization of intra-hepatic Treg in treatment naïve CHC patients. Double immunohistochemical analysis was performed in 20 formalin-fixed biopsies with CD8/FoxP3 and CD4/FoxP3 antibodies. Cellular markers and cytokines were investigated by quantitative RT-PCR in 27 additional frozen biopsies. Eight other fresh liver biopsies were selected for complementary analysis of immunophenotyping and frequency of intra-hepatic Treg.
Results
Immunohistochemical analyses showed the presence of intra-hepatic CD4+FoxP3+T cells while CD8+FoxP3+T cells were very scarce. CD4+FoxP3+T cells were located in necro-inflammatory areas in contact with CD8+T cells, suggesting that Treg-mediated inhibition of CD8+T cell proliferation may occur by cell–cell contact. RT-PCR analyses showed strong correlations between CD8, FoxP3 and IL-10 with emergence of four distinct gene clusters, CD8-FoxP3, CD8-IL-10, TGF-β−IL-10 and TNF-α-TGF-β. No correlation was found between serum viral load and any immune markers. Interestingly, the FoxP3+/CD8+ cells ratio significantly decreased in severe fibrosis (F > 3) due to the dramatic decline of FoxP3 cells.
Conclusions
This study provides new insights into the histological localization of Treg within HCV-infected liver, with a special accumulation of CD4+FoxP3+Treg cells in necro-inflammatory areas, in contact with CD8+T cells. Our results suggest a link between Treg, CD8 and IL-10 which altogether could balance immune responses against the virus to avoid immunopathogenesis.
Abstract: Soman, an irreversible organophosphorus cholinesterase inhibitor, induces status epilepticus and, in sensitive brain areas, seizure-related brain damage (e.g., brain edema and neuronal loss). The brain metabolic disturbances associated with these events are ill known. In the present study, we thus evaluated these changes in a murine model of soman-induced status epilepticus up to 7 d after intoxication. Mice, protected by HI-6 and atropine methyl nitrate, were poisoned with soman (172mug/kg) and then sacrificed at set time points, from 1h to 7 d. Brain biopsies from the piriform cortex (Pir) and cerebellum (Cer) were analyzed by (1)H HRMAS NMR spectroscopy. Spectra were then analysed using both a supervised multivariate analysis and the QUEST procedure of jMRUI for the quantification of 17 metabolites. The multivariate analysis clearly showed the metabolic differences between a damaged structure (Pir) and a structure with less prominent changes (cerebellum) and helped to globally assess the time course of metabolic changes. Analysis of the individual metabolites showed that the major changes took place in the piriform cortex but that cerebellum was not change-free. The most prominent changes in the former were an early (1 - 4h) increase in alanine and acetate, a delayed increase in lactate, glycerophosphocholine and glutamine as well as a delayed decrease in myo-inositol and N-acetylaspartate. A week after poisoning, some metabolic disturbances were still present. Further research will be necessary to clarify what could be the involvement of these metabolites in physiological processes and how they might become useful surrogate markers of brain damage and repair.
Abstract: OBJECTIVE: In a department of hepatology and gastroenterology, a significant number of patients are hospitalized for alcohol withdrawal. The aim of this retrospective study was to identify factors predictive of severe or complicated alcohol withdrawal in order to improve patient management. METHODS: Between June 2002 and June 2005, 182 patients admitted for alcohol dependence according to the DSM-IV classification were enrolled in this study. A unique management protocol for alcohol withdrawal was applied for all patients. The Cushman score was recorded on day 1, 2 and 3 to assess the severity of alcohol withdrawal. We searched for correlations between epidemiological, clinical and biological data and the Cushman score. RESULT: The study population included 136 (74.7%) men and 46 (25.3%) women, mean age 47.6+/-10.1 years. One hundred and eighteen patients (64.8%) were referred from a specialized outpatient clinic and 64 (35.2%) patients were referred from the emergency unit. The mean and median Cushman scores on day 1, 2 and 3 were: 5.1 and 5; 3.9 and 4; 2.3 and 2, respectively. Twenty patients (11.0%) and five patients (2.7%) had scores greater than or equal to 8 and greater than 12, respectively. The proportion of patients with Cushman score greater than or equal to 8 on day 1 was significantly greater in patients referred from the emergency unit than in those referred from a specialized outpatient clinic (p=0.002). Mean alanine aminotransferase level on day 1 was significantly higher in patients with a score greater than or equal to 8 than in those who had a score less than 8 (112.1+/-44.4 UI/L versus 78.4+/-11.8 UI/L; p=0.046). Referral via an emergency unit as well as an alanine aminotransferase level greater than 1.5fold the upper limit of the normal range were independent predictive factors for a Cushman score greater than or equal to 8. In conclusion, severe alcohol withdrawal (Cushman score>or=8) is significantly associated with initial management in an emergency unit and serum alanine aminotransferase level greater than 1.5 fold the upper limit of the normal range. These predictors should be monitored in order to appropriately adapt the therapeutic schedule.
Abstract: Despite the importance of military leaders in moderating the impact of deployment stressors on unit members, little attention has focused on the training leaders receive in managing unit stress. As part of a NATO Research Panel (Human Factors and Medicine (HFM)-081/Research and Technology Organization Task Group (RTG)), 16 nations participated in a needs assessment survey of military leaders who had returned from an operation within the previous 2 years. Findings from 172 leaders emphasized the lack of training specifically geared for leaders to address operational stress issues for unit members and their families and the need for integrated mental health support across the deployment cycle. In general, most leaders regarded stress-related mental health problems as normal and were supportive of help-seeking. The information obtained here was used to develop a Human Factors and Medicine -081/RTG Leader's Guide on operational stress.
Abstract: AIMS: Etiological investigations proposed for patients with acute pancreatitis have been evolving considerably these past few years, significantly limiting the number of cases labeled idiopathic. The aim of this study was to determine the incidence of non alcoholic non biliary pancreatitis and identify causes, comparing severity by etiology. PATIENT AND METHODS: This retrospective analysis included 108 patients managed from October 1996 to April 2005. Standar-dized extensive etiological investigations were performed. The following criteria of severity were recorded: peak CRP value, Ranson score, Balthazar score, duration of hospital stay and pseudocyst occurrence. RESULTS: The cause of acute pancreatitis was alcohol (N=45), gallstones (N=50), obstruction (N=10), unknown (N=10), drugs (N=9), auto-immunity (N=4), infections (N=3), post-operative (N=2), post-ERCP (N=2), trauma (N=1), hypertriglyceridemia (N=1), genetic (N=1). The main criteria of severity were significantly different between non alcoholic non biliary pancreatitis and the other causes (CRP>120 mg/L, Ranson score>3 and Balthazar score > or =D) while other criteria (pseudocyst occurrence and duration of hospitalisation) were similar. Mean peak CRP was 79.5 mg/L for the overall population and varied significantly by etiology: peak CRP for drug-induced acute pancreatitis (4.6 mg/L) was significantly lower than for the other causes (P<10(-6)). CONCLUSION: This study shows that non alcoholic non biliary causes account for one third of the cases of acute pancreatitis, usually with a mild to moderate presentation. As the mean peak CRP value is significantly lower in drug-induced acute pancreatitis, careful search for an adverse drug reaction is appropriate in patients with acute pancreatitis of unknown cause and a low peak CRP level.
Abstract: AIM: To study the specificity of hospitalized adolescent suicide attempters. METHOD: Among a national sample of students (n = 11,718, mean age = 16.6 years) studied in 1999, 9.2% (n = 1078) made at least one suicide attempt during their life (SA); 21.9% (n = 234) of them were hospitalized (HSA). We identified the risk factors (family, school, behavioral and psychological) of SA and HSA by comparing (by gender) a) suicide attempters to non-suicide attempters and b) hospitalized suicide attempters to non-hospitalized suicide attempters. RESULTS: Both for girls and boys, the risk factors for SA varied. However, certain risk factors, particularly depressive mood, low self-esteem and poor parent-child relationships, were not associated with hospitalization. Hospitalized suicide attempters had more personal and social problems. But there is an important difference according to gender: in boys, hospitalization is related to physical fighting (OR = 2.2) and offences (OR = 3.4), in girls to running away (OR = 1.7), consumption of illegal drugs other than cannabis (OR = 2.0), having a living standard outside average (OR = 2.0) and going to a private school (OR = 1.7). CONCLUSION: Suicide attempters with problem behavior are more at risk of being hospitalized than others. However, the difference between hospitalized and non-hospitalized subjects was smaller than expected.
Abstract: To date, there has been little research into the relationship between violent behavior and the practice of sport in young adolescents (both girls and boys) in the general population. Indeed, sport is often recommended as a means of prevention and an alternative to violence in adolescence. For this reason, we studied this issue in a representative sample of 14-16 year-olds (ESPAD 99). Among this sample, boys practised some form of extra-curricular sport more than girls (75% vs. 57%), this practice being more intensive (13% boys vs. 4% girls practising sport more than 8 hours per week outside of school) and more "competitive" (14% vs. 4% taking part in national and/or international events). Boys also exhibited more violent behavior than girls, including stealing (mean 0.91 for boys vs. 0.49 in girls), fighting (mean 1.71 in boys vs. 0.49 in girls) or serious offences (mean 0.66 in boys vs. 0.34 in girls). Taking part in competitions was found to be highly associated with violent behavior. In particular, competition at a national or international level was associated (in decreasing order of significance) with fighting (OR=2.35), serious offences (OR=1.78) and stealing (OR=1.58), after adjustment for age, gender, father's educational level and type of school attended. The practical implications of this study are that it is important to moderate one's judgment about the positive effects of sport in reducing youth violence, to be attentive to violent acts perpetrated in stadiums and to better analyze the eventual beneficial effects of sports clubs.
Abstract: Early February 1999, the French Ministère de la Jeunesse et des Sports (Youth and Sports Ministry) sponsored three different studies, aiming to prevent harmful behavior in the area of sport practices among youth. Two years earlier, our health care team working with drug users published reports on the meaningfulness of intensive sports activities in the history of our patients. The present work was performed to highlight the midterm results of one of these studies, to better understand and quantify the importance of physical training in the history of a group of outpatients seen for addictive disorders and comorbid pathologies. For 20 consecutive weeks, 3,040 self-administered questionnaires were available for persons consulting 20 health centers, 2 self-help groups and a general practitioner network working in the field of alcohol or heroine abuse. One thousand one hundred and eleven questionnaires were filled out (36.1%) and returned by mail for complete analysis: 86% of the answering persons had practiced at least one sports activity or participated in physical training, 10.5% had participated in a national or international level competition, and 10.6% reported stress fractures. In the intensive sports group, 36% had used illicit drugs intravenously and 16.4% said they had already used doping substances. Only 28.4% said they experienced dependence during their period of intensive sports activities compared with 15.2% before this time, and a majority (56.4%) thereafter. Intensive sports or physical training should not be seen as a protective factor nor as a way of improving addictive behaviors. More studies are needed to evaluate individual vulnerability factors and specific harm of overtraining and to determine the exact periods when men and women participating in sports activities are likely to abuse drugs, especially at the end of their career.
Abstract: Over the past decade, we have observed a disparity between alcohol consumption and related mortality, especially in its regional distribution. Two epidemiological surveys carried out by CRSSA and INSERM (unit 472) focused on drinking behaviour patterns among young conscripts and secondary school students. Regular drinkers in particular were studied. Geographical distribution of regular alcohol use differs from that of alcohol-related deaths. Alcohol consumption is higher in the south of France than in the north, while mortality from alcohol abuse remains higher in the north.
Abstract: We have developed a method for the assessment of auditive loss using a sample of 1794 Bekesy audiograms recorded in young military students. A rectangular digital filter was used to smooth rough audiogram signals so as to detect pathological patterns such as scotoms and recruitments. Three factors were extracted from principal component analysis. They were correlated with the usual auditory indices and explained 70% of the total observed variance. The first factor is a general indicator of deafness, while the second and third describe the shapes of the hearing threshold level (asymmetry and convexity). This method can be used for rapid identification of suspect audiograms and is thus of value for epidemiological surveillance of populations exposed to impulsive noise.
