Symptoms of peritraumatic and acute traumatic stress among victims of an industrial disaster.

Previous studies have examined peritraumatic distress, peritraumatic dissociation, and acute stress disorder as predictors of posttraumatic stress disorder (PTSD). The authors examined whether these three predictors were associated with PTSD symptoms when considered simultaneously. Two-hundred victims of a factory explosion in Toulouse, France, were surveyed two and six months after the event with use of retrospective self-reports of peritraumatic distress, peritraumatic dissociation, and acute stress disorder. A hierarchical multiple regression predicting PTSD symptoms six months posttrauma indicated that all three constructs explained unique variance, accounting for up to 62 percent. Peritraumatic distress and dissociation and acute stress disorder appear conceptually different from one another and show promise in identifying who is at risk of PTSD.

The predictive power of peritraumatic dissociation and acute stress symptoms for posttraumatic stress symptoms: a three-month prospective study.

OBJECTIVE: The authors prospectively examined the power of peritraumatic dissociation and acute stress symptoms in predicting posttraumatic stress disorder (PTSD) symptoms. METHOD: Thirty-five assault victims were assessed with the Peritraumatic Dissociative Experiences Questionnaire within 24 hours of the assault. Participants were reassessed 2 weeks after the trauma with the Stanford Acute Stress Reaction Questionnaire and 3 months after the trauma with the Clinician-Administered PTSD Scale and the Impact of Event Scale. Correlational analyses and a hierarchical multiple regression were conducted. RESULTS: Peritraumatic dissociation and acute stress symptoms were correlated with later PTSD symptoms and diagnosis. Together, peritraumatic dissociation and acute stress symptoms accounted for 33% of the variance in PTSD symptoms. CONCLUSIONS: These results support earlier findings that peritraumatic dissociative experiences and acute stress are robust predictors of PTSD. Such symptoms may be of use for identifying at an early stage individuals at highest risk of remaining symptomatic. Future studies should investigate the predictive power of specific peritraumatic and acute stress disorder symptom clusters.

Histiocytic sarcoma in C57BL/6J female mice is associated with liver hematopoiesis: review of 41 cases.

Forty-one cases of histiocytic sarcoma (HS) in C57BL/6J mice were histopathologically studied with special regard to unexpected associated hematopoietic disorders. These cases were retrieved among C57BL/6J female mice used as control mice in a chronic low-dose irradiation experiment. Hematopoietic characteristics were analysed by comparison to 41 disease-free mice from the same cohort. Tumoral involvement of the liver was observed in all 41 HS-bearing mice, followed by infiltration of the spleen (61.8%), lung (32.4%), bone marrow (14.3%), uterus (12.2%), lymph node (9.8%), and kidney (2.4%). By comparative analysis, we were able to demonstrate a significant association of HS with liver hematopoiesis (89.5% in HS group vs 15% in control mice, p < 0.00001), and with central hematopoietic disorders involving the myelocytic cells (decreased in HS, p = 0.003) and erythrocytic cells (increased in HS, p = 0.001). Microscopic characteristics of these 41 cases and physiopathology of the newly described hematopoietic features in HS are further discussed.

[A pilot study in general practice: pressure to prescribe]. / Pression de prescription: étude pilote en médecine générale.

Among the irrational factors involved in medical prescribing, few studies have investigated the problem of the 'pressure to prescribe'. The aim of the present work was to quantify this 'pressure to prescribe' and to investigate some potential predisposing factors. Each instance of a patient's behaviour suggesting 'pressure to prescribe' was registered for 599 outpatient general-practice clinics. 'Pressure to prescribe' was defined as each clear request by a patient that counteracted the diagnostic and/or therapeutic strategy of physicians. The study included 246 men and 356 women (mean age: 45.4 years). 'Pressure to prescribe' was found in 142 patients, i.e. 23.7% (95% confidence interval [CI]: 20.7-27.4%). Among patients aged >18 years, the percentage increased: 27.0% (CI 95%: 23.0-31.4%), i.e. 122 of 452 patients. 'Pressure to prescribe' was first observed with requests for drugs (17.3%), biological tests (2.5%), sick-leave from work (2.09%), radiological procedures (1.1%), medical certificates (1.0%), physiotherapy (0.8%), and referral to a medical specialist (0.3%). The drugs most often associated with 'pressure to prescribe' were analgesic (27.6%), nonsteroidal plus steroidal anti-inflammatory (17.1%), gastroenterological (16.2%), anti-infectious (14.3%) drugs followed by vitamins plus antiasthenic (11.4%), antiseptic (10.5%), nasal decongestant (9.5%), 'vasodilatory' plus 'veinotonic' (8.6%) drugs. Pressure to prescribe neuropsychiatric drugs involved only 7.5% of requests. Two predisposing factors were identified: age (with an increased 'pressure to prescribe' for older people) and, less importantly, female gender (women tended to exert more 'pressure to prescribe' than men). Analysis of 'pressure to prescribe' is an important topic in the area of Social Pharmacology.