Adrenergic, Coagulation, and Fibrinolytic Responses to Heat

Abstract

Several explanations have been proposed to explain these divergent results-failure to define the population being studied; differing, possibly incorrect methods of sample collection; failure to obtain truly "normal" subjects for control purposes, etc. To avoid these various criticisms we have studied a group of normal, asymptomatic women who had not been hospitalized and compared the findings with those in three groups of patients, the pattern of whose illness had been carefully defined by long-term follow-up in a specialist urinary infection clinic. To reduce sampling errors and to define the regular carrier state of these women each was studied weekly for five or six weeks. To exclude the possible influence of recent infection (Marsh et al., 1972) or antibiotic treatment or a changing state before subsequent infection (Stamey et al., 1971) all the patients were known to have had no bacteriuria or antibiotics for six weeks before the study and no bacteriuria during or within six weeks of completion of the study.The results show no difference in the introital carriage rate of E. coli between normal subjects and patients referred with a history of previous urinary infection whether they were subsequently shown to be intermittently bacteriuric, symptomatic and abacteriuric, or asymptomatic and abacteriuric. A small difference in periurethral carriage of enterobacteria in general was observed between normal subjects and the patient groups though there was no difference between the patient groups. Thus it does seem that patients with a previous history of urinary infection may have a slight change in the overall periurethral colonization as compared with normal women but that there is no difference in this respect between those who are subsequently intermittently bacteriuric and those who are persistently abacteriuric. Furthermore, though E. coli was the most common cause of bacteriuria in our patients no difference in the periurethral carriage rate was observed between the normal subjects and the three patient groups. There was also no difference in the recovery rate or persistence of particular E. coli serotypes.When these results are compared with other reports it must be noted that slightly differing techniques are used. Thus Stamey et al. (1971) studied clean-catch urethral urine samples (labelled VBJ) and samples from the vaginal vestibule, Bailey et al. (1973) studied swabs from the external urethral meatus (periurethral swabs) and vaginal vestibule, and Cox et al. (Cox, 1966;Cox et al., 1968) obtained urethral specimens using a specially designed instrument. We have previously used the term "introital" swab to define what is more correctly a periurethral swab. We have also previously shown and subsequently confirmed that colony counts of the same organism are obtained in the same proportion of instances from urethral urine (vB,) and periurethral swabs in normal women and patients alike.By dividing patients into "persistent", "intermittent," and "non-") carriers of introital bacteria on the basis of sw...

Thromboelastographic Study of Psychophysiological Stress

“…Our findings for the hemostatic impact of the dual stressors is consistent with previous TEG results, 25,30 thereby validating the use of TEG as a tool for assessing the potential effects of other unknown stress.…”

“…It shows that a variety of stressors, both physiological and psychological, have been studied using various TEG methods. The physiological stressors include acute exercise, 25 –28 extreme temperatures, 29 –36 hyperbaric, 37 and hypobaric conditions. 38,39 The psychological stressors include emotional stress.…”

“…An early thromboelastographic investigation of coagulation and fibrinolytic response to heat was conducted in early 1970s. 30 Citrated whole blood samples, taken from volunteers in a sauna bath, were thromboelastographically analyzed. Compared with the control before sauna, the coagulation profiles indicated by R and K were not significantly altered by the heat exposure for 10 minutes.…”

“…Stress may alter hemostasis through its effects on neuroendocrine responses, such as enhanced sympathetic-mediated catecholamine release, 30,132 activated hypothalamic–pituitary–adrenal axis-induced cortisol release, 133 immunoinflammatory effects on leukocyte activation/mobilization, mechanical or physical stress on hemolysis of red blood cells 28 and endothelial cells, 134 and hemoconcentration. 135 Considerable interindividual differences in the response of the hemostatic system to psychophysiological stress have been observed.…”

The effects of intentional hyperthermia on the Thrombelastograph and the Sonoclot analyser

“…Besides its impact on patient haemodynamics and stress responses (Lees et al 1980, Tonnesen et al 1987, Berry et al 1997, WBH has been suggested to a ect coagulation. During WBH to 41 ë C with carboplastin therapy for metastatic disease, changes included platelet and ® brinolytic activation, decreased platelet count, ® brinogen and plasminogen levels, and increased release of platelet alpha granule contents (Britton et al 1974, Barlogie et al 1979, Strother et al 1986). An in vitro study has also demon-strated decreased PT and aPTT in plasma samples at 39 and 41 ë C (Rohrer and Natale 1992).…”