Substance use and misuse in burn patients: testing the classical hypotheses of the interaction between posttraumatic symptomatology and substance use

Background: We aimed to test whether the three classical hypotheses of the interaction between posttraumatic symptomatology and substance use (high risk of trauma exposure, susceptibility for posttraumatic symptomatology, and self-medication of symptoms), may be useful in the understanding of substance use among burn patients. Methods: We analysed substance use data (nicotine, alcohol, cannabis, amphetamines, cocaine, opiates, and tranquilizers) and psychopathology measures among burn patients admitted to a Burns Unit and enrolled in a longitudinal observational study. Lifetime substance use information (n = 246) was incorporated to analyses aiming to test the high risk hypothesis. Only patients assessed for psychopathology in a six months follow-up (n = 183) were included in prospective analyses testing the susceptibility and self-medication hypotheses. Results: Regarding the high risk hypothesis, results show a higher proportion of heroin and tranquilizer users compared to the general population. Furthermore, in line with the susceptibility hypothesis, higher levels of symptomatology were found in lifetime alcohol, tobacco and drug users during recovery. The self-medication hypothesis could be tested partially due to the hospital stay “cleaning” effect, but severity of symptoms was linked to caffeine, nicotine, alcohol and cannabis use after discharge. Conclusions: We found that the three classical hypotheses could be used to understand the link between traumatic experiences and substance use explaining different patterns of burn patient’s risk for trauma exposure and emergence of symptomatology.

The effect of carbohydrate mouth rinsing on fencing performance and cognitive function following fatigue-inducing fencing

This study investigated the impact that mouth rinsing carbohydrate solution has on skill-specific performance and reaction time following a fatigue inducing bout of fencing in epee fencers. Nine healthy, national level epee fencers visited a laboratory on 2 occasions, separated by a minimum of 5 days, to complete a 1-minute lunge test and Stroop test pre and post fatigue. Heart rate and ratings of perceived exertion (RPE) were recorded during completion of the fatiguing protocol. Between fights the participants mouth rinsed for 10 seconds, either 25ml of 6.7% maltodextrin solution (MALT) or water (PLAC). Blood lactate and glucose were recorded at baseline, pre- and post-testing. Results showed an increase in heart rate and overall RPE over time in both conditions. There were no differences in blood glucose (F(1,8)=.63, P=.4, ηp=.07) or blood lactate levels (F(1,8)=.12, P=.70, ηp=.01) between conditions as a function of time. There was a significant improvement in lunge test accuracy during the MALT trial (F(1,8)=5.21, P=.05, ηp=.40) with an increase from pre (81.2 ±8.3%) to post (87.6 ±9.4%), whereas there was no significant change during the placebo (pre 82.1 ±8.8%, post 78.8 ±6.4%). There were no recorded differences between conditions in response time to congruent (F(1,8)=.33, P=.58, ηp=.04) or incongruent stimuli (F(1,8)=.19, P=.68, ηp=.02). The study indicates that when fatigued mouth rinsing MALT significantly improves accuracy of skill-specific fencing performance but no corresponding influence on reaction time was observed.