The mean platelet volume is decreased in patients with mild head trauma and brain injury.

We planned a prospective study to assess platelet number and size in patients with or without brain injury after mild head trauma (MHT). Platelet count and mean platelet volume (MPV) were assessed in consecutive patients admitted to the emergency department with isolate MHT, as well as in healthy blood donors who served as controls. The study population consisted in 54 patients with MHT, 13 of whom (24%) with intracranial lesions suggestive for brain injury, and 339 healthy blood donors. The value of platelet count was significantly lower in patients with MHT and positive computerized tomography than in healthy controls (P = 0.014). The vales of MPV progressively decreased from healthy controls (11.1 fl) to patients with MHT and negative computerized tomography (9.8 fl; P < 0.001), and further to patients with MHT and positive computerized tomography (8.6 fl; P < 0.001). The MPV was significantly lower in patients with MHT and positive computerized tomography than in those with negative computerized tomography (P = 0.002). As compared with healthy controls, the frequency of decreased MPV values was 10-fold and 17-fold higher in MTH patients with negative and positive computerized tomography, respectively. The MPV exhibited an area under the curve of 0.74 (95% CI, 0.58 to 0.89; P < 0.001) for differentiating MHT patients with positive computerized tomography from those with negative computerized tomography. MHT patients display a larger prevalence of small and hyporeactive platelets. This observation provides a reliable basis for planning further studies to establish whether MPV may be useful for diagnostic evaluation of MHT in the emergency department.

Serum levels of protein S100B predict intracranial lesions in mild head injury.

OBJECTIVES: This study was aimed to assess whether serum S100B levels at emergency department admission can be used to omit unnecessary computed tomography (CT) in patients with minor head injury (MHI). DESIGN AND METHODS: Sixty consecutive patients with recent MHI were included in this study. Serum S100B measurement and CT scanning were performed in all patients within 3h from head injury. RESULTS: A positive CT scan was present in 20 out of 60 subjects. Significantly higher values of protein S100B were found in CT positive than in CT negative patients (1.35 versus 0.48 µg/L; p<0.001). The area under the ROC curve for protein S100B was highly significant (AUC 0.80; p<0.001) and a S100B cut-off value of 0.38 µg/L displayed 100% sensitivity and 58% specificity. CONCLUSIONS: Serum S100-B levels might allow to omit unnecessary CT in patients with pure MHI, thus reducing radiation exposure and saving healthcare resources.

Personality traits and endocrine response as possible asymmetry factors of agonistic outcome in karate athletes.

Individual variations of plasma levels of hormones testosterone (T) and cortisol (C), before (pre) and after (post) Kumite (real fight) and Kata (ritualized fight) were measured in male karate athletes and analyzed in relation with the agonistic outcome (i.e. winning or losing the fight) and personality trait measures. T and C increased only during Kumite contest and pre- and post-competition C levels were higher in losers than winners. Losers showed higher levels of harm avoidance and anxiety as well as lower level of novelty seeking than winners. Importantly, novelty seeking negatively correlates with pre C and the higher the level of risk assessment, emotionality and insecurity indexes the higher the pre C level. In conclusion, personality traits might be an important factor asymmetry between athletes influencing both the probability of winning or losing an agonistic interaction and the different anticipatory endocrine response to the incipient fight.

Idiopathic hypogonadotropic hypogonadism in selective human gonadotropin deficiency in adult man: a case report.

We report a rare case of idiopathic hypogonadotropic hypogonadism in an adult male (31-year-old), who underwent an endocrinological examination because of erectile dysfunction and suspected infertility. Laboratory data showed isolated gonadotropin deficiency. Magnetic resonance imaging (MRI) of the hypothalamic-pituitary unit showed no tumoral expansions. The patient was tested with gonadotropin releasing hormone (Gn-RH) (100 microg as an i.v. bolus injection). No significant LH and FSH responses were observed. Idiopathic hypogonadotropic hypogonadism is usually caused by hypothalamic lesions, however, since Gn-RH was unable to stimulate LH and FSH secretions, we supposed that our patient was affected by defective gonadotropin secretion at pituitary level.