OBJECTIVE: Excessive central fat puts one at greater risk of disease. In animal studies, stress-induced cortisol secretion has been shown to increase central fat. The objective of this study was to assess whether women with central fat distribution (as indicated by a high waist-to-hip ratio [WHR]), across a range of body mass indexes, display consistently heightened cortisol reactivity to repeated laboratory stressors. METHODS: Fifty-nine healthy premenopausal women, 30 with a high WHR and 29 with a low WHR, were exposed to consecutive laboratory sessions over 4 days (three stress sessions and one rest session). During these sessions, cortisol and psychological responses were assessed. RESULTS: Women with a high WHR evaluated the laboratory challenges as more threatening, performed more poorly on them, and reported more chronic stress. These women secreted significantly more cortisol during the first stress session than women with a low WHR. Furthermore, lean women with a high WHR lacked habituation to stress in that they continued to secrete significantly more cortisol in response to now familiar challenges (days 2 and 3) than lean women with a low WHR. CONCLUSIONS: Central fat distribution is related to greater psychological vulnerability to stress and cortisol reactivity. This may be especially true among lean women, who did not habituate to repeated stress. The current cross-sectional findings support the hypothesis that stress-induced cortisol secretion may contribute to central fat and demonstrate a link between psychological stress and risk for disease.

Adaptation, Psychological↗

PubMedDate not supplied

Comparison between sterile saline and tap water for the cleaning of acute traumatic soft tissue wounds.

OBJECTIVE: To find out if there were any differences in infection rates if acute traumatic soft tissue wounds were cleaned with tap water instead of sterile saline. DESIGN: Randomised study. SETTING: Emergency department at one city hospital. SUBJECTS: 705 consecutive patient with soft tissue wounds less than six hours old that did not penetrate a viscus, cavity, or joint and could be treated by primary suture. INTERVENTIONS: Randomly allocated to have the wound cleaned with either sterile saline or tap water in addition to debridement. MAIN OUTCOME MEASURE: Rate of wound infection, the presence of which was indicated by pus in the wound and prolonged healing. RESULTS: The infection rate in wounds cleaned with sterile saline was 10.3% compared with 5.4% in wounds cleaned with tap water (p less than 0.05). Infected wounds were significantly larger than uninfected ones (p less than 0.05) and more likely to be located on a lower extremity (p less than 0.05). There were no microbiological differences between the two groups, and no bacterial species grown from tap water was subsequently grown from an infected wound. CONCLUSION: Sterile saline should be replaced by tap water for the cleaning of acute traumatic superficial soft tissue wounds.

Acute Disease↗

PubMedDate not supplied

Beneficial effect of treatment with a prostacyclin analogue in severe peripheral atherosclerosis. A case report.

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Arteriosclerosis↗

PubMedDate not supplied

False popliteal aneurysm caused by exostosis of the femur.

A 45-year-old woman with a false aneurysm of the left popliteal artery caused by an exostosis of the femur is described. The patient had a tender swelling in the distal part of the thigh and a soft-tissue tumor was initially suspected. Diagnosis was made by ultrasonography, plain X-ray and angiography. The aneurysm and exostosis were resected. The literature regarding this condition is reviewed. Surgical treatment of popliteal aneurysm is recommended mainly because of the risk of occlusion of distal vessels by peripheral embolism.

Aneurysm↗