Female veterans of the OEF/OIF conflict: Concordance of PTSD symptoms and substance misuse

This study examined the post-deployment rates of comorbid PTSD and substance abuse in a cohort of female veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Female OEF/ OIF veterans and reservists (N=36) completed a battery of assessments as part of a larger study. Of the 36 participants, 11 (31%) screened positive for posttraumatic stress disorder (PTSD), 17 (47%) screened positive for high-risk drinking and 2 (6%) screened positive for drug abuse. Higher scores on measures of alcohol and drug use predicted positive PTSD status (p≤0.01) and alcohol misuse was significant in explaining unique variance of PTSD status (p≤0.05). Our findings suggest a trend toward increased problematic drinking among female OEF/OIF veterans and reservists and a relationship between substance misuse and PTSD. Future research should investigate needs for gender-specific PTSD and substance-abuse treatment needs

Diminished vagal activity and blunted circadian heart rate dynamics in posttraumatic stress disorder assessed through 24-h linear and unifractal analysis

Background : Affected autonomic heart regulation is implicated in the pathophysiology of cardiovascular diseases and is also associated with posttraumatic stress disorder (PTSD). However, although sympathetic hyperactivation has been repeatedly shown in PTSD, research has neglected the parasympathetic branch. The objective of this study is the long-term assessment of heart rate (HR) dynamics and its circadian changes as an index of autonomic imbalance in PTSD. Since tonic parasympathetic activity underlies long-range correlation of heartbeat interval fluctuations in healthy state, we included nonlinear (unifractal) analysis as an important and sensitive readout to assess functional alterations. Methods : Electrocardiogram recordings over a 24-h period were conducted in 15 deployed male subjects with moderate to high levels of combat exposure (PTSD: n=7; combat controls: n=8). Analysis of HR dynamics included time domain, frequency domain and non-linear analysis based on detrended fluctuation analysis. Psychiatric symptoms were assessed using structured interviews, including the Clinician Administered PTSD Scale. Results : Subjects with PTSD showed significantly higher baseline HR, higher LF/HF ratio in frequency domain analysis, blunted differences between daytime and nighttime measures, as well as higher scaling coefficient αfast during the day, indicating diminished tonic parasympathetic activity. Conclusions : This study appears to be the first combining linear and non-linear methods to assess long-period autonomic and circadian differences in HR dynamics between combatants with and without PTSD. Diminished circadian differences and blunted tonic parasympathetic activity altering HR dynamics suggest central neuro-autonomic dysregulation that could represent a possible link to increased cardiovascular mortality in PTSD

The association of posttraumatic stress disorder and metabolic syndrome: a study of increased health risk in veterans

<p>Abstract</p> <p>Background</p> <p>There is accumulating evidence for a link between trauma exposure, posttraumatic stress disorder (PTSD) and diminished health status. To assess PTSD-related biological burden, we measured biological factors that comprise metabolic syndrome, an important established predictor of morbidity and mortality, as a correlate of long-term health risk in PTSD.</p> <p>Methods</p> <p>We analyzed clinical data from 253 male and female veterans, corresponding to five factors linked to metabolic syndrome (systolic and diastolic blood pressure, waist-to-hip ratio and fasting measures of high-density lipoprotein (HDL) cholesterol, serum triglycerides and plasma glucose concentration). Clinical cut-offs were defined for each biological parameter based on recommendations from the World Health Organization and the National Cholesterol Education Program. Controlling for relevant variables including sociodemographic variables, alcohol/substance/nicotine use and depression, we examined the impact of PTSD on metabolic syndrome using a logistic regression model.</p> <p>Results</p> <p>Two-fifths (40%) of the sample met criteria for metabolic syndrome. Of those with PTSD (<it>n </it>= 139), 43% met criteria for metabolic syndrome. The model predicted metabolic syndrome well (-2 log likelihood = 316.650, chi-squared = 23.731, <it>p </it>= 0.005). Veterans with higher severity of PTSD were more likely to meet diagnostic criteria for metabolic syndrome (Wald = 4.76, <it>p </it>= 0.03).</p> <p>Conclusion</p> <p>These findings provide preliminary evidence linking higher severity of PTSD with risk factors for diminished health and increased morbidity, as represented by metabolic syndrome.</p

Hemorragia intracerebral traumática tardia: registro de cinco casos

São relatados os casos de cinco pacientes que apresentaram hemorragia intracerebral tardia como consequência de traumatismo crânio-encefálico. O diagnóstico e o acompanhamento evolutivo dos pacientes foi efetuado com o auxilio da tomografia axial computorizada (CT-scan). Os possíveis mecanismos responsáveis por essa ocorrência são analisados