Stainable hepatic iron in 341 African American adults at coroner/medical examiner autopsy

BACKGROUND: Results of previous autopsy studies indicate that increased hepatic iron stores or hepatic iron overload is common in African Americans dying in hospitals, but there are no reports of hepatic iron content in other cohorts of African Americans. METHODS: We investigated the prevalence of heavy liver iron deposition in African American adults. Using established histochemical criteria, we graded Perls' acid ferrocyanide-reactive iron in the hepatocytes and Kupffer cells of 341 consecutive African American adults who were autopsied in the coroner/medical examiner office. Heavy staining was defined as grade 3 or 4 hepatocyte iron or grade 3 Kupffer cell iron. RESULTS: There were 254 men and 85 women (mean age ± 1 SD: 44 ± 13 y vs. 48 ± 14 y, respectively; p = 0.0255); gender was unstated or unknown in two subjects. Approximately one-third of subjects died of natural causes. Heavy staining was observed in 10.2% of men and 4.7% of women. 23 subjects had heavy hepatocyte staining only, six had heavy Kupffer cell staining only, and one had a mixed pattern of heavy staining. 15 subjects had histories of chronic alcoholism; three had heavy staining confined to hepatocytes. We analyzed the relationships of three continuous variables (age at death in years, hepatocyte iron grade, Kupffer cell iron grade) and two categorical variables (sex, cause of death (natural and non-natural causes)) in all 341 subjects using a correlation matrix with Bonferroni correction. This revealed two positive correlations: hepatocyte with Kupffer cell iron grades (p < 0.01), and male sex with hepatocyte iron grade (p < 0.05). We also analyzed the relationship of steatosis, inflammation, and fibrosis/cirrhosis in 30 subjects with heavy iron staining using a correlation matrix with Bonferroni correction. There were significant positive correlations of steatosis with inflammation (r = 0.5641; p < 0.01), and of inflammation with fibrosis/cirrhosis (r = 0.6124; p < 0.01). CONCLUSIONS: The present results confirm and extend previous observations that heavy liver iron staining is relatively common in African Americans. The pertinence of these observations to genetic and acquired causes of iron overload in African Americans is discussed

Linking psychological need experiences to daily and recurring dreams

The satisfaction of individuals’ psychological needs for autonomy, competence, and relatedness, as conceived from a self-determination theory perspective, is said to be conducive to personal growth and well-being. What has been unexamined is whether psychological need-based experiences, either their satisfaction or frustration, manifests in people’s self-reported dream themes as well as their emotional interpretation of their dreams. A cross-sectional study (N = 200; M age = 21.09) focusing on individuals’ recurrent dreams and a three-day diary study (N = 110; M age = 25.09) focusing on daily dreams indicated that individuals experiencing psychological need frustration, either more enduringly or on a day-to-day basis, reported more negative dream themes and interpreted their dreams more negatively. The contribution of psychological need satisfaction was more modest, although it related to more positive interpretation of dreams. The discussion focuses on the role of dreams in the processing and integration of psychological need-frustrating experiences

Gestalt Therapy and Its Contribution to the Understanding of the Link Between Health and the Environment

International audienceResolutely inscribed into a sensitive and dynamic approach that emphasizes feelings and the perception of the body, Gestalt therapy focuses on the processes of contact between the organism and the environment, during which the forms (gestalten) are shaped and reshaped. This approach departs from the usual description of a subject in his/her environment to shed light the processes of interrelation between the subject and his/her environment. It abandons the classical and static pattern of separation between the inside and the outside, between the self and the other to focus on the modalities of contact, to its dysfunctions, to the mechanisms of regulation that arise, and to the permanent adjustment between one person and his/her environment. This premise that organism and environment are inseparable is innovative because it challenges the individualist and solipsistic view of the self. The Gestaltist innovation lies less in the libertarian minds of its founding fathers, who favored the expression of the body and of the emotions in normative societies than in its invitation to convert our usual way of thinking. The perspective of an “organism-environment” field invites us to escape from dualism by taking into account, in one situation, all the different elements that assemble to coexist, to leave the binary dynamic (“either you, or me”) to consider the dynamic of a co-construction (“and you, and me”). Therefore, this innovative paradigm has effects on the conception of health and/or care: health is an unstable equilibrium, and disease is not reduced to organic deterioration but defines a way of living, an integral part of the human existence