Hyperglycemia accelerates apparent diffusion coefficient-defined lesion growth after focal cerebral ischemia in rats with and without features of metabolic syndrome.

Poststroke hyperglycemia is associated with a poor outcome yet clinical management is inadequately informed. We sought to determine whether clinically relevant levels of hyperglycemia exert detrimental effects on the early evolution of focal ischemic brain damage, as determined by magnetic resonance imaging, in normal rats and in those modeling the 'metabolic syndrome'. Wistar Kyoto (WKY) or fructose-fed spontaneously hypertensive stroke-prone (ffSHRSP) rats were randomly allocated to groups for glucose or vehicle administration before permanent middle cerebral artery occlusion. Diffusion-weighted imaging was carried out over the first 4 hours after middle cerebral artery occlusion and lesion volume calculated from apparent diffusion coefficient maps. Infarct volume and immunostaining for markers of oxidative stress were measured in the fixed brain sections at 24 hours. Hyperglycemia rapidly exacerbated early ischemic damage in both WKY and ffSHRSP rats but increased infarct volume only in WKY rats. There was only limited evidence of oxidative stress in hyperglycemic animals. Acute hyperglycemia, at clinically relevant levels, exacerbates early ischemic damage in both normal and metabolic syndrome rats. Management of hyperglycemia may have greatest benefit when performed in the acute phase after stroke in the absence or presence of comorbidities.

Operation restoration: couples reunification retreats for veterans of operations enduring and iraqi freedom.

Couples interventions are promising approaches to help veterans successfully reintegrate into civilian life and recover from combat-related trauma. However, few programs are available to address these needs. This article describes a weekend retreat program we developed called Operation Restoration, which focuses on strengthening the relationships of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans and their partners. We also report results from program evaluations completed by participants of the initial two retreats, aimed at further developing and refining Operation Restoration. The program evaluations explored participants' perceptions of the retreat, including benefits gained, suggestions for improvement, and mental health treatment interests. Information gathered from 43 couples suggests that such retreats may be a useful approach for strengthening the intimate relationships of OEF/OIF veterans and gives direction for future programs.