Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis.

Exposure to psychological trauma (for example, childhood/early life adversity, exposure to violence or assault, combat exposure, accidents or natural disasters) is known to increase one's risk of developing certain chronic medical conditions. Clinical and population studies provide evidence of systemic inflammatory activity in trauma survivors with various psychiatric and nonpsychiatric conditions. This transdiagnostic meta-analysis quantitatively integrates the literature on the relationship of inflammatory biomarkers to trauma exposure and related symptomatology. We conducted random effects meta-analyses relating trauma exposure to log-transformed inflammatory biomarker concentrations, using meta-regression models to test the effects of study quality and psychiatric symptomatology on the inflammatory outcomes. Across k=36 independent samples and n=14,991 participants, trauma exposure was positively associated with C-reactive protein (CRP), interleukin (IL)-1ß, IL-6, and tumor necrosis factor (TNF)-α (mean rs =0.2455, 0.3067, 0.2890, and 0.2998, respectively). No significant relationships were noted with fibrinogen, IL-2, IL-4, IL-8, or IL-10. In meta-regression models, the presence of psychiatric symptoms was a significant predictor of increased effect sizes for IL-1ß and IL-6 (ß=1.0175 and 0.3568, respectively), whereas study quality assessment scores were associated with increased effect sizes for IL-6 (ß=0.3812). Positive correlations between inflammation and trauma exposure across a range of sample types and diagnoses were found. Although reviewed studies spanned an array of populations, research on any one specific psychiatric diagnosis was generally limited to one or two studies. The results suggest that chronic inflammation likely represents one potential mechanism underlying risk of health problems in trauma survivors.

Cognitive and physiological antecedents of threat and challenge appraisal.

Cognitive appraisal theories of stress and emotion propose that cognitive appraisals precede physiological responses, whereas peripheralist theories propose that physiological arousal precedes cognitive processes. Three studies examined this issue regarding threat and challenge responses to potential stress. Study 1 supported cognitive appraisal theory by demonstrating that threat and challenge cognitive appraisals and physiological responses could be elicited experimentally by manipulating instructional set. Studies 2 and 3, in contrast, found that manipulations of physiological response patterns consistent with challenge and threat did not result in corresponding changes in cognitive appraisal. Appraisals in Study 3, however, were related to subjective pain independent of the physiological manipulation. These studies suggest a central role for cognitive appraisal processes in elicitation of threat and challenge responses to potentially stressful situations.

[Evaluation of the results of treatment of cancer of the large intestine based on our clinical data]. / Hodnocení výsledku lécby rakoviny tlustého streva na základe vlastního materiálu.

Results of the treatment of 225 patients operated between 1991-1995 on the colorectal carcinoma in the II Clinic of Surgery, Medical Academy Wroclaw are evaluated. The analysis of the own material covers the tumor site, age of the patients, histologic grade and clinical stage according to Dukes. The type of surgical procedure--curative or palliative and the evaluation of the survival, death and recurrence rate is presented. Curative procedures were possible only in approximately 60% of cases. The Dukes stage C and D was established in 55.5% of the operated patients. Authors believe that such a significant number of advanced cases was the reason of so poor results. In conclusion they suggest to introduce screening tests for early detection of colorectal carcinoma.

Treatment of cerebral embolism in heart surgery.

The results in the treatment of air embolism in open heart surgery are presented. Two cases of gaseous cerebral embolism are described. One of the patients had a period of unconsciousness of 54 hours, the other of 17 days. Therapy included administration of vasoactive drugs (xanthinol nicotinate 1500 mg 2 times daily as an intravenous drip) combined with superficial hypothermia (32 degrees C). In both cases complete recovery was achieved.