Incidence of abnormal cerebral findings in the MRI of clinically healthy divers: role of a patent foramen ovale.

BACKGROUND: To investigate incidence and number of abnormal cerebral hyperintensities (ACFs) in Magnet Resonance Imaging (MRI) and its relation to a patent foramen ovale (PFO) in divers with no history of decompression illness. METHODS: Cohort study on 50 divers (21-5500 dives). MAIN OUTCOME MEASURES: Incidence and number of ACFs visualized by cranial MRI and presence and size of a PFO as documented by echocardiography and transcranial Doppler ultrasound (TCD) with echocontrast. RESULTS: A total of 137 ACFs was found in the 50 subjects, with a significant correlation between the number of dives and number of ACFs (r = 0.28; p < 0.05); but after correction for age, the remaining correlation (r = 0.15) did not reach significance. In 18 divers, a PFO was present by either the application of echocardiography or TCD; in 12 divers, the PFO was of high hemodynamic relevance. Ten of 18 divers with a PFO had at least one ACF, while in the remaining 32 divers, only 14 had at least one ACF (56% versus 44%, p = NS). Seven of 14 divers (50%) with 4 ACFs had a PFO, compared to 11 of 36 (31%) with less than 4 ACFs (p = NS). CONCLUSION: In this cohort of healthy divers, in contrast to an earlier report, no significant association was found between PFO presence and incidence or number of ACFs.

[Psychophysical stress reactions during a psychoanalytic interview]. / Psychophysische Belastungsreaktionen während eines tiefenpsychologischen Interviews.

In 37 young volunteers analytically oriented interviews were taken and their effects being compared to those of conventional stressors using mental arithmetic. Because of their similarity to day-to-day stressors we expected higher cardiovascular reactions (blood pressure, heart rate and catecholamines) under interview situations than in mental arithmetic. Conforming this hypothesis, we found higher reactions in blood pressure regulation, while heart rates were not higher under interview situations compared to laboratory stressors. Epinephrine showed a qualitative difference: Only in interview situations we found a significant rise of 27%. Plasma cortisol also showed a rise in interview situations, however, smaller. We therefore suggest, that analytically oriented interviews are an adequate method to investigate cardiovascular reagibility in young hypertensive-prone persons.