Immunoreactive leptin and leptin mRNA expression are increased in rat hypo- but not hyperthyroidism.

In this study, plasma leptin concentrations were measured in rats artificially rendered hyper- or hypothyroid by administration of thyroxine or TRH, by administration of methimazole, or by thyroidectomy. Compared with those in untreated controls, leptin immunoreactivity was not affected in the hyperthyroid state, but was significantly increased in hypothyroid animals. Methimazole administration for longer time periods caused a stepwise increase in plasma leptin immunoreactivity. Greatest leptin concentrations were seen after 28 days of methimazole. Seven days after withdrawal of the methimazole, leptin concentrations no longer differed from those observed in control animals. In hypothyroid animals, expression of leptin mRNA was increased in both retroperitoneal and epididymal adipose tissue, whereas no difference was seen for subcutaneous or mesenteric fat. Incubation of rat leptin with plasma of eu- or hypothyroid rats and subsequent HPLC analysis of leptin plasma peaks gave no indication of an altered hormone stability. We conclude that, in hypothyroid rats, leptin concentrations may be increased as a result of stimulated leptin synthesis in retroperitoneal and epididymal adipose tissue.

Warming intravenous fluids reduces perioperative hypothermia in women undergoing ambulatory gynecological surgery.

UNLABELLED: We evaluated whether warming i.v. fluids resulted in less hypothermia (core temperature < 35.5 degrees C) compared with room-temperature fluids. Thirty-eight adult outpatients undergoing elective gynecological surgery of > 30 min were randomized to two groups: fluid warming at 42 degrees C or control (room temperature fluids at approximately 21 degrees C). All patients received general anesthesia with isoflurane, tracheal intubation, standard operating room blankets and surgical drapes, and passive humidification of inspired gases. Tympanic membrane (core) temperatures were measured at baseline and at 15-min intervals after induction. The incidence of shivering and postoperative requirement for meperidine and/or radiant heat were evaluated. Core temperatures were lower in the control compared with the warm fluid group at the end of surgery (35.6 +/- 0.1 degrees C vs 36.2 +/- 0.1 degrees C; P < 0.05). More patients had final core temperature < 35.5 degrees C in the control compared with the warm fluid group (35% vs 0%; P < 0.05). There were no differences in time to discharge from the postanesthesia care unit or the incidence of shivering between the groups. We conclude that fluid warming, in conjunction with standard heat conservation measures, was effective in maintaining normothermia during outpatient gynecological surgery; however, there was no improvement in patient outcome. IMPLICATIONS: Women who received i.v. fluid at body temperature had significantly higher core temperatures during and after outpatient gynecological surgery compared with women who received i.v. fluids at the temperature of the operating room.

Coping differences between college women and men in China and the United States.

We examined and compared the direct and moderating effects of problem-focused and emotion-focused coping in male and female college students in the United States and the People's Republic of China. American students reported more interference with academic activities as a result of stress; Chinese students reported more interference with personal development. American students reported a greater occurrence of stressful life events and higher stressfulness of these events. American students also reported less problem-focused coping than Chinese students. We found little evidence for an additive effect of coping; moderating effects, both buffering and maladaptive, differed by gender and culture. Particularly for American students, interference was more directly related to stress levels in men, whereas coping exhibited more moderating effects in women. Contrary to predictions, only American women exhibited a buffering effect for problem-focused coping, and no maladaptive effects of emotion-focused coping were found for any group. Chinese women, and to a lesser extent, Chinese men, exhibited a pattern of buffering effects for emotion-focused coping and maladaptive moderating effects for problem-focused coping.

Anxiety in patients awaiting primary medical care.

Adult patients in a family medicine clinic were surveyed to identify variables related to situational anxiety in a relatively unthreatening medical setting. Anxiety scores ranged from extremely calm to extremely anxious, with the average near the midpoint. Scores on other variables were reliably related to degree of reported anxiety. Multiple regression and discriminant analyses revealed the following to be the strongest predictors of higher anxiety: a passive orientation toward the visit; uncertainty about the state of one's health; expectations of physical discomfort, embarrassment, and invasion of privacy; a shorter time waiting; and few previous exposures to the clinic, physician, and procedure. Results are discussed in terms of implications for practice and for future research.

Autonomic arousal as a cognitive cue in stressful situations.

The need for further investigation and integration in a real world situation is demonstrated in a critical review of the literature on autonomic feedback and attribution of arousal in stressful situations. In the present study, actual autonomic arousal, arbitrary feedback of arousal, and attributions for arousal were manipulated in a dental clinic where the subjects were awaiting oral surgery. The main prediction was that cognized arousal (due either to perception of actual arousal or to arbitrary feedback about arousal level) in the absence of a nonemotional attribution for that cognized arousal would lead to higher subjective report of anxiety and to greater avoidance than would be found with either of these conditions unmet. The results on the subjective report measure generally supported this hypothesis. In addition, arbitrary feedback about arousal level did not interact with the actual arousal manipulation; nor did it produce changes in pulse rate or blood pressure, further supporting a cognitive interpretation of the effects of autonomic arousal on subjective report. However, the study illustrates difficulties in inducing beneficial beliefs in the real world. And the manipulations generally did not affect the behavioral measure, probably due to the expected consequences of that behavior.