Overweight and obesity in long-term breast cancer survivors: how does sexual orientation impact BMI?

In noncancer populations lesbians have greater odds of obesity compared with heterosexual women, suggesting a similar pattern among cancer survivors. Weight of cancer survivors is an important area of study because obesity is associated with an increased risk of recurrence and shorter survival. Sixty-nine lesbian and bisexual and 257 heterosexual survivors of breast cancer were recruited to participate in a one-time telephone survey. Multinomial logit models do not support disparities in obesity due to sexual orientation. Our findings in breast cancer survivors suggest that lesbians are more likely to improve their weight-related behaviors after cancer than heterosexual women.

Effects of ethanol on limited resuscitation in a model of traumatic brain injury and hemorrhagic shock.

OBJECT: Limited resuscitation following uncontrolled hemorrhagic shock (HS) has been associated with improved outcomes in various animal models, although it has not been previously studied in the setting of traumatic brain injury (TBI) and ethanol intoxication. The aim of the present study was to determine the effects of ethanol intoxication in a model of experimental TBI and HS treated with limited resuscitation. METHODS: After induction of anesthesia and the placement of instruments, swine were subjected to a fluid-percussion injury of 3 atm. Simultaneously, hemorrhage was induced from an arterial catheter via a computerized roller pump to a mean arterial blood pressure (MABP) of 50 mm Hg, at which time uncontrolled hemorrhage was induced by the creation of an aortic tear. When the MABP decreased to 30 mm Hg, limited resuscitation to a MABP of 60 mm Hg was begun. After 60 minutes, animals were aggressively resuscitated to baseline MABP levels. Two groups of animals were studied: those receiving tap water by gastrostomy tube and those receiving ethanol (4 g/kg) by gastrostomy tube. Animals were monitored for 180 minutes after TBI. Hemorrhage volumes were significantly greater in ethanol-infused animals (mean +/- standard deviation, 41 +/- 34 mm Hg) compared with tap water-infused animals (17 +/- 18 mm Hg; p = 0.048). Resuscitation requirements were significantly higher and metabolic parameters significantly worse in the ethanol group. Survival time was also significantly decreased in the animals infused with ethanol (81 +/- 60 minutes) compared with those infused with tap water (130 +/- 51 minutes; p = 0.035). CONCLUSIONS: Ethanol intoxication led to increased hemorrhage volume and worsened hemodynamic and metabolic profiles in this model of limited resuscitation after TBI and HS. Ethanol-exposed animals had increased resuscitation requirements and decreased survival times.

Effects of cocaine in an experimental model of traumatic brain injury.

BACKGROUND: Cocaine intoxication is found in a significant subset of emergency department (ED) patients presenting with traumatic brain injury (TBI). OBJECTIVES: To investigate the effects of acute cocaine intoxication on physiologic and metabolic parameters in a model of experimental TBI. METHODS: Under inhalational anesthesia, swine were instrumented and subjected to fluid percussion TBI of 3 atm. Two groups were studied: TBI and cocaine (n = 7) and TBI only (n = 7). Two sequential doses of cocaine hydrochloride were administered intravenously to the animals receiving cocaine: 4 mg/kg 10 minutes prior to injury and 2 mg/kg 1 minute prior to injury. Control animals received normal saline. Cardiorespiratory and cerebral physiologic data were monitored for 180 minutes following injury. Cerebral blood flow (CBF) was measured using dye-labeled microspheres. Serum cocaine levels were measured by gas chromatography/mass spectrometry. RESULTS: Mean (+/- SD) cocaine levels at the time of injury were 1,771 (+/- 403) ng/mL. All animals survived the 180-minute observation period. There was a trend toward higher intracranial pressure (ICP) in the control (15.4 +/- 8.2) vs. cocaine-treated (11.1 +/- 5.8) animals, although this did not reach statistical significance (p = 0.18). Cerebral venous lactate (CVL) levels also trended higher in the control (1.14 +/- 0.22) vs. cocaine-treated (0.91 +/- 0.19) groups (p = 0.06). Cerebral perfusion pressures (CPPs), however, did not differ between groups. The CBF values decreased significantly from baseline in both groups but were not different between groups. CONCLUSIONS: Cocaine-intoxicated animals subjected to TBI showed no significant difference in primary outcome measures of CPP or CBF, although a nonsignificant trend toward lower ICP was noted. Overall, acute cocaine intoxication did not adversely affect the physiologic parameters examined in this TBI model.