Examining the Associations Between Pornography Use and Relationship Outcomes

There has been a growing interest in understanding whether and how pornography use is associated with relationship quality and sexual satisfaction for individuals in long-tem, committed relationships. Past research examining this question has produced inconsistent findings. Moreover, the methodological limitations of past work make it difficult to draw any definitive conclusions. The current thesis consists of three key studies that focus on the relationship between pornography use and relationship outcomes (i.e., relationship quality and sexual satisfaction). In Study 1, I examined the associations between pornography use (an individual’s own use and estimates of partner’s use) and relationship outcomes for 780 adults in long-term committed relationships, while improving upon three significant methodological flaws that have been present in past research: underpowered studies, recruitment of biased samples, and use of unreliable measures. For women, only one significant association emerged: women who estimated that their partners used pornography more frequently reported lower quality in their relationship. Men who reported using pornography more frequently were less sexually satisfied and reported lower relationship quality, as compared to men who used pornography less frequently. Men who estimated that their partners used pornography more frequently were more sexually satisfied, as compared to men who estimated that their partners used pornography less frequently. In Study 2, I replicated the findings from Study 1 and extended them by examining how contextual factors (i.e., pornography-related communication) relates to relationship outcomes. We were able to replicate the findings from Study 1 in an independent sample of 773 adults in long-term romantic relationships. Furthermore, the quality of overall communication and the quality of pornography-related communication were found to be important predictors of relationship outcomes, and attenuated many of the associations of participants’ own pornography use and participants’ perceptions of their partner’s pornography use with relationship outcomes. The quality of pornography-related communication was also positively associated with relationship quality for women and sexual satisfaction for women and men, over and above quality of overall relationship communication. Because pornography-related communication was shown to be important for relationship outcomes, the goal of Study 3 was to examine the degree to which discussions around pornography use is avoided by partners in a romantic relationship. In a sample of 191 adults in romantic relationships, pornography use was found to be the most avoided topic on average, and was avoided significantly more than several other relationship topics. Overall, results underline the importance of considering contextual factors that may influence the relationship between pornography use and relationship outcomes

Immune Responses Elicited in Tertiary Lymphoid Tissues Display Distinctive Features

During chronic inflammation, immune effectors progressively organize themselves into a functional tertiary lymphoid tissue (TLT) within the targeted organ. TLT has been observed in a wide range of chronic inflammatory conditions but its pathophysiological significance remains unknown. We used the rat aortic interposition model in which a TLT has been evidenced in the adventitia of chronically rejected allografts one month after transplantation. The immune responses elicited in adventitial TLT and those taking place in spleen and draining lymph nodes (LN) were compared in terms of antibody production, T cell activation and repertoire perturbations. The anti-MHC humoral response was more intense and more diverse in TLT. This difference was associated with an increased percentage of activated CD4+ T cells and a symmetric reduction of regulatory T cell subsets. Moreover, TCR repertoire perturbations in TLT were not only increased and different from the common pattern observed in spleen and LN but also “stochastic,” since each recipient displayed a specific pattern. We propose that the abnormal activation of CD4+ T cells promotes the development of an exaggerated pathogenic immune humoral response in TLT. Preliminary findings suggest that this phenomenon i) is due to a defective immune regulation in this non-professional inflammatory-induced lymphoid tissue, and ii) also occurs in human chronically rejected grafts

Favorable Outcome of an Exclusively Posttransplant Prophylactic Strategy After Heart Transplantation in Recipients With High Immunological Risk

International audienceBackground: Management of the increasing number of sensitized heart transplant candidates has become a recurrent issue. Rather than using pretransplant desensitization therapies, we used a posttransplant prophylactic strategy. Our aim was to describe outcomes in transplant recipients with preformed donor-specific anti-HLA antibodies (pfDSA) managed with this strategy.Methods: A posttransplant protocol was applied to patients transplanted with pfDSA, consisting of perioperative management of DSA (polyvalent immunoglobulins +/- perioperative plasmapheresis sessions, according to DSA level, as well as induction therapy) and systematic treatment of subsequent antibody-mediated rejection (AMR), even when subclinical. We performed a retrospective analysis of this prospective protocol. The study included all consecutive first recipients of a noncombined heart transplant performed between 2009 and 2015 at our center. The primary endpoint was all-cause mortality. Secondary endpoints included primary graft dysfunction, early posttransplant bleeding, rejection, and cardiac allograft vasculopathy-free survival.Results: A total of 523 patients were studied, including 88 (17%) and 194 (37%) transplanted with DSA mean fluorescence intensity (MFI) of 500 to 1000 and greater than 1000, respectively. The median follow-up period was 4.06 years. Survival was not significantly different between groups. Rejection-free survival was worse in patients with pfDSA MFI >1000, evidenced by a fourfold increase in the risk of antibody-mediated rejection. The incidence of primary graft dysfunction and cardiac allograft vasculopathy-free survival did not significantly differ between groups. Perioperative plasmapheresis increased the risk for transfusion of packed red blood cells.Conclusions: This exclusively posttransplant prophylactic strategy achieved favorable outcomes in heart transplant recipients with pfDSA

Analysis of Transfusion-Related Acute Lung Injury and Possible Transfusion-Related Acute Lung Injury Reported to the French Hemovigilance Network From 2007 to 2013

International audienceUsing the French Hemovigilance Network database from 2007 to 2013, we provide information on demographics, incidence, and risk factors of reported transfusion-related acute lung injury (TRALI) and possible TRALI, analyze TRALI mitigation efforts for fresh frozen plasma and platelet concentrates, and consider the impact of platelet additive solutions on TRALI incidence. We applied the Toronto consensus conference definitions for TRALI and possible TRALI. Two TRALI subgroups were considered: “antibody positive” when a donor has human leukocyte antigen (class I or II) and/or human neutrophil antigen antibodies and the recipient has cognate antigen, and “antibody negative” when immunological investigation is negative or not done. The analysis targeted 378 cases, divided into antibody-positive TRALI (n=75), antibody-negative TRALI (n=100), and possible TRALI (n=203). TRALI patientswere younger and receivedmore blood components than the general population of transfused patients.Moreover,we identified the following clinical conditionswhere patients seemed to be at higher risk to develop TRALI: postpartum hemorrhage, acute myeloid leukemia, liver transplantation, allogeneic and autologous hematopoietic stem cells transplantation, polytrauma, and thrombotic microangiopathy. Policy measures intended to reduce antibody-positive TRALI were found effective for apheresis platelet concentrates and fresh frozen plasma but not forwhole blood–derived platelet concentrates. The use of platelet additive solutions was associated with a significant reduction in the incidence of TRALI following transfusion of buffy coat–derived platelet concentrates but not following transfusion of apheresis platelets. Our data reinforce the concept that possible TRALI and TRALI, as defined in the Canadian consensus conference, share many characteristics. No specific policy measures are currently directed at mitigation of possible TRALI despite its impact on transfusion safety. Despite TRALI mitigationmeasures, the overall incidence of TRALI cases reported to the French Hemovigilance system was not significantly reduced. Therefore, additional research is needed to reduce, if not eradicate, all TRALI categories