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Variations in Endometriosis Location and Surgical Outcomes By Race. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Age Does Not Predict Failure to Rescue Following Resuscitative Thoracotomy in Penetrating Trauma. J Emerg Med 2021; 61:12-18. [PMID: 33618932 DOI: 10.1016/j.jemermed.2021.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/07/2021] [Accepted: 01/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The limitations of resuscitative thoracotomy (RT) after penetrating trauma have been well documented, but there is a paucity of data on the effect age has on mortality. This begs the question as to the utility of RT in an aging patient population. We investigate the significance of age as a predictor for failure to rescue after RT in penetrating trauma. OBJECTIVE We sought to identify whether chronologic age has a measurable effect on rates of failure to rescue after RT. METHODS We performed a retrospective cohort analysis using the Trauma Quality Improvement Program from 2011 to 2015 including all pulseless patients undergoing RT after penetrating injury. Our primary outcome was failure to rescue defined as death in the emergency department after RT. Multivariate analyses were performed to identify the relationship between age and morality controlling for injury severity. RESULTS One thousand one hundred twelve RTs were performed during the study period with an overall failure to rescue rate of 61.8% (n = 687) within the emergency department and an in-hospital mortality rate of 96.9%, which is in line with national data. On univariate analysis, there was no significant association between age and mortality (p = 0.44). On multivariate analysis examining the interaction between age and mortality adjusting for injury severity, we found that chronologic age was not an independent predictor of death after RT. CONCLUSIONS Age does not appear to be an independent predictor of failure to rescue after RT in penetrating trauma and should not be a sole determinant in procedural decision making.
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Trends and Perioperative Outcomes across Elective Benign Hysterectomy Procedures from the ACS-NSQIP 2007-2017. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Reliability and Validity of Two Surgical Prioritization Systems for Non-Emergent Gynecologic Surgery during the COVID Pandemic. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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FRI0450 MEASURES OF DISEASE SEVERITY PREDICT DISABILITY AND QUALITY OF LIFE DIFFERENTLY IN RHEUMATOID ARTHRITIS AND CHRONIC CHIKUNGUNYA DISEASE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Chronic rheumatological manifestations similar to those of rheumatoid arthritis (RA) have been described after chikungunya virus infection. However, the clinical significance of the symptoms and disease severity in the two conditions has not been directly compared.Objectives:To compare, using identical measures of disease severity and patient outcomes, the impact of disease severity measures and symptoms on outcomes in RA and chronic chikungunya disease.Methods:Forty patients with chronic chikungunya arthralgia two years post-infection and 40 matched patients with RA were enrolled in Roraima, Brazil. Twenty-eight joints were assessed for tenderness and swelling, a pain intensity visual analogue scale, musculoskeletal stiffness questionnaire, modified Health Assessment Questionnaire and the EuroQol EQ5D-5L quality of life assessment were completed. The importance of the various measures of disease severity were analysed using Spearman’s rank correlation and regression analysis.Results:Tender and swollen joint counts, pain and stiffness were all predictive of the HAQ disability index in RA, but only stiffness was significantly associated with disability in chikungunya patients (Table 1). Tender and swollen joint counts, pain and stiffness were predictive for all EQ5D quality of life domains (except anxiety/depression) in RA patients. In contrast, in chikungunya disease, tender joint counts were predictive only of usual daily activities; pain was predictive of impaired mobility, self-care and discomfort, while stiffness was predictive for the mobility and anxiety/depression domains (Figure 1). Swollen joint counts were not associated with any of the patient outcomes in chikungunya disease. Linear regression analysis confirmed (p=0.003) that the effect of swollen joint count on the HAQ disability index depends on the underlying disease.Table 1.Association of disease severity with HAQ disability index in rheumatoid and CHIKV+ arthritisSeverity measureRheumatoid arthritisCHIKV+ arthritisr (p)r (p)Tender joint count0.56 (0.0002)0.24 (0.14)Swollen joint count0.60 (<0.0001)0.002 (0.99)Joint pain (VAS)0.55 (0.0002)0.29 (0.07)Stiffness severity0.57 (0.0001)0.38 (0.02)Figure 1.Association of disease severity with quality of life domains in rheumatoid and CHIKV+ arthritisConclusion:The value of all the disease severity measures tested in RA were confirmed, but tender joint counts may have more limited value in the assessment of chronic chikungunya disease. Joint swelling appears to have little impact for chikungunya patients, while stiffness appears to be an important metric to quantify chikungunya arthritis disease severity.Disclosure of Interests:Hugh Watson Shareholder of: Sanofi, Employee of: Sanofi, Ramão Luciano Nogueira-Hayd: None declared, Maony Rodrigues-Moreno: None declared, Felipe Naveca: None declared, Giulia Calusi: None declared, Richard Amdur: None declared, Karol Suchowiecki: None declared, Gary S. Firestein: None declared, Gary Simon: None declared, Aileen Chang: None declared
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0798 “Uncovering My Feet Alleviates My Restless Legs”: Impact of Different Activities and Conditions on Restless Legs Symptoms. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The restless legs syndrome (RLS) is a resting wake state disorder with inactivity/decreased movement as an aggravating factor and activity/increased movement as an alleviating factor. Other activities and conditions may impact RLS symptoms but have not been systematically studied.
Methods
Fifty-six patients with primary severe RLS (age: 64.1±11.3; 66% women) responded about the effect of 20 activities/conditions on their RLS symptoms. Responses were assigned a numerical value: Aggravation (-1), No effect/Don’t know (0), Alleviation (+1), with calculating a mean effect score for each activity/condition and using a sign test to determine if that score was significantly above or below zero (no effect). Responses were further analyzed based on age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, and Painful/Non-Painful RLS. Association of continuous variables and categorical variables with each activity/condition was examined using Spearman correlation test and Fisher exact test, respectively. Bonferroni p threshold was set at p=0.00036.
Results
Activities/conditions with significant (p<0.0001) positive mean effect scores were: Feet uncovering (0.70); Leg massaging (0.63); Cold showers (0.54); and Manual activities (0.46). Activities with significant negative mean effect scores were: Vehicle passenger (-0.80); Show attendance (-0.70); Bedsheets weight on legs (-0.57); Watching TV (-0.54); High ambient temperature (-0.45); During meals (-0.39) (all p<0.0001); and Bedsheets rubbing on legs (-0.34; p=0.0002). Activities/conditions with no significant (all p>0.00036) mean effect scores were: Driving (0.00); Gambling (0.02); Professional activities (0.13); Hot showers (0.13); Using computer (0.14); Low ambient temperature (0.21); Sexual activities (0.27); Mental activities (0.29); and Sports activities (0.34). There was no significant association between each activity/condition and age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, or Painful/Non-Painful RLS.
Conclusion
There is a wide range of impact of different activities/conditions on RLS symptoms. These could be further considered in the non-pharmacological treatment or prevention of RLS symptoms.
Support
This study was not funded.
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1439 Feasibility and Surgical Outcomes Associated with Reduced Port Robotic-Assisted Hysterectomy. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perioperative Narcotic Trends in Women Undergoing Minimally Invasive Hysterectomy for Benign Indications. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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03: Effect of perioperative transfusion on postoperative morbidity following minimally invasive hysterectomy. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Early Outcomes After Carotid Endarterectomy and Carotid Artery Stenting for Carotid Stenosis in the ACS-NSQIP Database. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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OC-0273: Phase II Trial of De-intensified Chemoradiotherapy for HPV-associated Oropharyngeal Cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30583-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Surgical Outcomes of Minimally Invasive and Abdominal Procedures for Endometriosis. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28: Rates of hiv, malaria and tb affecting pregnancies in the unites states, 1998-2011. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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New Case-Complexity Score for Benign Laparoscopic Hysterectomy. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The Effect of Operative Time on Outcomes in Minimally Invasive and Abdominal Myomectomy: An Analysis of the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP). J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Complexicity Scoring System for Minimally Invasive Hysterectomy: A Validity Study. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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SU-D-204-05: Fitting Four NTCP Models to Treatment Outcome Data of Salivary Glands Recorded Six Months After Radiation Therapy for Head and Neck Tumors. Med Phys 2016. [DOI: 10.1118/1.4955610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-F-T-104: Determining the NTCP Parameters of Pharyngeal Constrictors and Proximal Esophagus for Radiation Induced Swallowing Problems Recorded Six Months After Radiation Therapy for Head and Neck Tumors. Med Phys 2016. [DOI: 10.1118/1.4956240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-D-204-04: Correlations Between Dosimetric Indices and Follow-Up Data for Salivary Glands Six Months After Radiation Therapy for Head and Neck Cancer. Med Phys 2016. [DOI: 10.1118/1.4955609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-F-T-107: Correlations Between Dosimetric Indices of Pharyngeal Constrictors and Proximal Esophagus with Associated Patient-Reported Outcomes Six Months After Radiation Therapy for Head and Neck Cancer. Med Phys 2016. [DOI: 10.1118/1.4956243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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OC-0453: Phase II trial of de-intensified chemoradiotherapy for HPV-associated oropharyngeal cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31702-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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CKD PATHOPHYSIOLOGY AND CLINICAL STUDIES. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Convergent functional genomics of schizophrenia: from comprehensive understanding to genetic risk prediction. Mol Psychiatry 2012; 17:887-905. [PMID: 22584867 PMCID: PMC3427857 DOI: 10.1038/mp.2012.37] [Citation(s) in RCA: 322] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 02/28/2012] [Accepted: 03/05/2012] [Indexed: 02/07/2023]
Abstract
We have used a translational convergent functional genomics (CFG) approach to identify and prioritize genes involved in schizophrenia, by gene-level integration of genome-wide association study data with other genetic and gene expression studies in humans and animal models. Using this polyevidence scoring and pathway analyses, we identify top genes (DISC1, TCF4, MBP, MOBP, NCAM1, NRCAM, NDUFV2, RAB18, as well as ADCYAP1, BDNF, CNR1, COMT, DRD2, DTNBP1, GAD1, GRIA1, GRIN2B, HTR2A, NRG1, RELN, SNAP-25, TNIK), brain development, myelination, cell adhesion, glutamate receptor signaling, G-protein-coupled receptor signaling and cAMP-mediated signaling as key to pathophysiology and as targets for therapeutic intervention. Overall, the data are consistent with a model of disrupted connectivity in schizophrenia, resulting from the effects of neurodevelopmental environmental stress on a background of genetic vulnerability. In addition, we show how the top candidate genes identified by CFG can be used to generate a genetic risk prediction score (GRPS) to aid schizophrenia diagnostics, with predictive ability in independent cohorts. The GRPS also differentiates classic age of onset schizophrenia from early onset and late-onset disease. We also show, in three independent cohorts, two European American and one African American, increasing overlap, reproducibility and consistency of findings from single-nucleotide polymorphisms to genes, then genes prioritized by CFG, and ultimately at the level of biological pathways and mechanisms. Finally, we compared our top candidate genes for schizophrenia from this analysis with top candidate genes for bipolar disorder and anxiety disorders from previous CFG analyses conducted by us, as well as findings from the fields of autism and Alzheimer. Overall, our work maps the genomic and biological landscape for schizophrenia, providing leads towards a better understanding of illness, diagnostics and therapeutics. It also reveals the significant genetic overlap with other major psychiatric disorder domains, suggesting the need for improved nosology.
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Phase II Multicenter Trial of Caphosol for the Reduction of Mucositis in Patients Receiving Radiation Therapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Interim Report of a Phase II Study of Lapatinib and Concurrent Radiotherapy in Patients With Locally Advanced Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Clinical Experiences of Frameless Intracranial Stereotactic Radiotherapy using Three Image-guided Positioning Systems. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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LEFT VENTRICULAR MASS INDEX PREDICTS RENAL OUTCOMES IN HIGH VASCULAR RISK MEN: A 3-YEAR FOLLOW-UP STUDY. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cutaneous Squamous Cell Carcinoma Metastatic to Parotid Area Lymph Nodes. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Craniospinal Irradiation in the Management of Adult Medulloblastoma. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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WE-C-AUD B-02: Tumor Volume Simulation in Radiotherapy Using Four-Level Cell Population Model. Med Phys 2008. [DOI: 10.1118/1.2962689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in african-americans (AA), compared to caucasians (Cauc): A retrospective analysis. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.17558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pattern of Failure and Toxicity of Intensity-Modulated Radiation Therapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Impact of Radiographic Findings on Prognosis for Skin Carcinoma with Clinical Perineural Invasion. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The IRB is not a data and safety monitoring board. IRB 2000; 22:9-11. [PMID: 11883486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Selecting a surrogate to consent to medical research. IRB 2000; 22:7-11. [PMID: 11883475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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IRB triage of projects that involve medical record review. IRB 2000; 22:4-7. [PMID: 12546009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Abstract
BACKGROUND Repetitive recall of traumatic memories and chronic intermittent hyperarousal are characteristic of posttraumatic stress disorder (PTSD). Hyperarousal and memory dysfunction implicates "limbic" brain regions, including the amygdaloid complex, hippocampal formation, and limbic cortex, such as the orbitofrontal and anterior cingulate areas. To investigate the neurobiologic role of these brain regions in PTSD, we measured regional cerebral blood flow in PTSD with single photon emission computerized tomography (SPECT) during a symptom provocation paradigm. METHODS Fourteen Vietnam veterans with PTSD, 11 combat control subjects, and 14 normal control subjects were studied with [99mTc]HMPAO in two sessions 48 hours apart: one session after exposure to white noise and the other following exposure to combat sounds. Skin conductance, heart rate, and subjective experience were recorded at the time of the studies. RESULTS Activation for all three groups occurred in the anterior cingulate/middle prefrontal gyrus. Activation in the region of the left amygdala/nucleus accumbens was found in PTSD patients only. Deactivation was found in all three groups in the left retrosplenial region. CONCLUSIONS These findings implicate regions of the "limbic" brain, which may mediate the response to aversive stimuli in healthy individuals and in patients suffering from PTSD.
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Psychophysiologic responsivity in posttraumatic stress disorder: generalized hyperresponsiveness versus trauma specificity. Biol Psychiatry 1998; 44:1037-44. [PMID: 9821568 DOI: 10.1016/s0006-3223(98)00182-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Clinically, subjects with posttraumatic stress disorder (PTSD) are viewed as hyperresponsive to a variety of stimuli. Psychophysiologic studies, however, have demonstrated hyperresponsiveness only to stimuli that are closely related to the original trauma. METHODS This set of experiments uses a variety of stimuli that vary in trauma-relatedness, arousal level, sensory modality stimulated, and degree of cognitive processing demanded to assess the extent of generalization of physiologic responses. Heart rate (HR), frontal electromyogram (EMG), and skin conductance (EDG) responses were measured during presentation of each stimulus. RESULTS PTSD subjects (n = 15) had an elevated baseline EDG and increased HR and EMG responses to the trauma-related stimulus (combat sounds) compared to normal control subjects (n = 11) and combat control subjects (n = 10). No significant differences were noted between PTSD and control groups in response to non-trauma-related arousing stimuli. CONCLUSIONS These results suggest that the physiologic hyperresponsivity of PTSD subjects is limited to stimuli closely associated with the inciting trauma.
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