Stress plays a role in the association between cognitive constructs and measures of eating disorders in male subjects.

OBJECTIVE: Several theorists have hypothesized that stressful situations may trigger abnormal eating and even eating disorders in predisposed people. The purpose of this study was to assess whether a stressful situation would reveal an association between perfectionism and low self-esteem, and measures of eating disorder symptoms in male high school students. METHOD: A sample of 61 male high school students completed the Eating Disorder Inventory, the Multidimensional Perfectionism Scale, and the Self Liking and Competence Scale three times: on an average school day, on the day of an exam and on the day the subjects received the results of that exam. Linear regression analysis was carried out to verify whether the dimensions of perfectionism were associated with the measures of eating disorders. RESULTS: Interoceptive awareness was associated with 'Bulimia' only during the stressful situation and with 'Drive for thinness' both in stress and non stress situations. Other results were contradictory and difficult to interpret. DISCUSSION: The results suggest that in nonclinical male individuals stress might bring out a previously absent association between some psychological predisposing factors for eating disorders and an actual desire or plan for ED related thoughts and behaviours. Such a finding suggests that stress may stimulate behaviours related to eating disorders in a predisposed personality. A central role may be played by interoceptive awareness in male subjects.

TNF alpha released in the early post-operative period is influenced by anaesthesia.

In this study we tested for TNF alpha concentrations 45 subjects undergoing elective prostatectomy performed under two different anaesthetic regimens. In addition, given the influence of neuroendocrine axis on immunological homeostasis, we also determined post surgery cortisol and norepinephrine levels. The patients were randomly assigned to one of two groups: group 1 (no. = 24) received NLA general anaesthesia, whereas group 2 (no. = 21) received spinal analgesia. Blood samples were drawn the day before surgery (t0), at two (t1), at 24 (t2), at 48 (t3) and 72 (t4) hours from the completion of operation. In the patients assigned to the general anaesthesia group an increase of circulating TNF alpha was detected through t1 to t4. In the spinal group TNFa values did not change in t1 and t2, whereas enhanced levels of the cytokine--overlapping with those of group 1--were observed at 48 and 72 hrs following surgery. Cortisol response increased in both the groups, peaking at t1 but, at this time patients undergoing spinal anaesthesia were found to have significantly lower circulating cortisol. A rise of plasma norepinephrine was observed at t1 in the general anaesthesia group alone. For the early TNF alpha increase, observed in group 1 only, we hypothesize that anaesthetics, such as NLA agents, may trigger a TNF alpha release in vivo. Alternatively TNF alpha production may represent the result of the neuroendocrine response such as cortisol and norepinephrine, to the surgical/anaesthetic trauma which could be blocked by subarachnoid anaesthesia. Conversely, the late TNF alpha increase found in all the patients studied might be explained by postoperative infections as well as by inflammation of the injured tissues and/or normal wound healing.

[Thoracoscopic bilateral sympathectomy in Raynaud's syndrome. Anesthesiology problems]. / Simpaticectomia bilaterale per via toracoscopica nella sindrome di Raynaud. Problemi anestesiologici.

The objective of this paper was to examine the major anaesthetic problems during transthoracic endoscopic sympathectomy without artificial pneumothorax and to present our experience of 16 cases suffering from Raynaud's disease. For the perioperative management we used a double lumen endo-bronchial tube and balanced anaesthesia (intravenous agents plus isoflurane). Arterial pressure, heart rate, ECG, end-tidal carbon dioxide concentration, SatO2, blood gases and peak inspiratory pressures were monitored. The results showed that no significant changes in these parameters occurred during surgery. Since hypoxaemia is the main problem of the thoracoscopic sympathectomy the A.A. emphasize the necessity to ensure a correct ventilation as well as a haemodynamic stability throughout the procedure. The combination of balanced anaesthesia and double lumen endobronchial intubation seems an advisable method when no artificial pnx is instituted. A close monitoring of the circulatory and respiratory systems is imperative.