Healthy Adult Women Research Articles

Delta-9-tetrahydrocannabinol reduces willingness to exert effort in women.

BackgroundThe use of cannabis has been clinically associated with decreased motivation to engage in normally rewarding activities. However, evidence from previous controlled studies is mixed.MethodIn this study, we examined the effects of acute delta-9-tetrahydrocannabinol (THC) versus placebo on a task measuring willingness to exert effort for rewards. This is a secondary analysis of a larger study examining interactions between ovarian hormones and THC. In this within-subjects study, oral THC and placebo were administered under double-blind conditions in counterbalanced order to healthy young adult (M age = 24 years) women with previous cannabis experience who were not regular users. Forty subjects completed three 4-h sessions with PL, 7.5 and 15 mg THC, while an additional 18 completed only PL and 15 mg THC sessions (design abridged due to pandemic). At each session, they completed a task consisting of making repeated choices between a hard and an easy task, which were worth varying amounts of money at varying probabilities.ResultsTHC dose-dependently decreased hard task choices (drug effect, b = − 0.79, SE = 0.29, z = − 2.67, p < 0.01), especially at moderate to high expected values of reward (drug × probability × amount interaction, b = 0.77, SE = 0.38, z = 1.99, p = 0.04). THC also slowed task performance (drug effect, b = 0.01, SE = 0.005, t(5.24) = 2.11, p = 0.04), but the effect of THC on choice was still significant after controlling for this psychomotor slowing.ConclusionsThese findings support the idea that cannabis acutely reduces motivation to earn non-drug rewards. Still to be determined are the neurochemical mechanisms underlying this effect.

Height estimation by evaluating morphometric measurements of hands and fingers

Biological bodily integrity is often lost in deaths due to undesirable situations such as femicides, natural disasters and plane crashes. For forensic scientists, accurate estimation of the person's stature is important for identification. In our study, it was aimed to obtain simple and multiple linear regression formulas required for stature calculation from hand and finger morphometric measurement values of young women. This study was carried out with the voluntary participation of 65 healthy young adult women between the ages of 18-24. Measurements were made on the palmar side of the hand using a digital caliper. In the study participants, the mean values of the measured variables; stature 164.45 cm, hand length 17.40 cm, hand width 7.70 cm, palm length 9.92 cm. Simple and multiple regression equations were obtained for stature estimation. The most reliable one of the regression equations obtained for stature estimation was the equation based on hand length. There was no correlation between thumb length and stature. The correlation value between index finger and stature was greater than the values obtained from other fingers (r=0.344, p&lt;0.01). The correlation value between palm length and stature was higher than the correlation value between fingers and stature (r=385, p&lt;0.01). Moderate and high positive correlation values were found between finger lengths and each other. The highest correlation value was between middle finger length and 4th finger length (r=872, p&lt;0.01). The correlation value between thumb and little finger lengths was the smallest (r=415 p&lt;0.01). The correlation value between hand length and stature is higher than the values obtained from finger lengths. In cases where total hand length cannot be measured, linear regression formula based on palm length should be preferred. Regression analysis results showed that palm length gave a better estimation of stature compared to finger length measurements.

Differences in Muscle Fatigability of Vastus Medialis between Sexes Using Surface Electromyographic Power Spectral Analysis in Healthy Adults.

ABSTRACTObjectives:With a relatively high percentage of type I fibers in the vastus medialis (VM), its fatigability may be more sensitive to the effects of muscle activity in the quadriceps. However, sex-related differences in the muscle fatigability of the VM remain unknown. The purpose of the present study was to assess the differences in fatigability of the VM between healthy adult men and women.Methods:Surface electromyographic (EMG) activities of VM oblique (VMO) and VM long (VML) were recorded during sustained isometric contraction on a leg press machine. The results of EMG power spectral analysis were compared between healthy adult men and women. The decline in the median frequency (MF), defined as MF slope, was calculated using spectrum analysis after fast Fourier transform of the raw EMG signals of VMO and VML.Results:The endurance time and the MF slopes of the VMO and VML were significantly longer and lower, respectively, in women than in men. The present results demonstrated that both VMO and VML are more fatigue-resistant in women than in men.Conclusions:Understanding the sex differences in fatigability could help to design more effective exercise regimens for VMO and VML in healthy individuals. A similar approach should be considered when prescribing practical exercise regimens for patients with muscle atrophy.

Effect of iron deficiency on cell-mediated immunity in adults

Background Iron plays a vital role in immune system development, integrity, as well as proper function through its growth-promoting and differentiation-inducing properties in immune cells and its interference with cell-mediated immune effector pathways and cytokine activities. In the past few decades, several studies have found that iron deficiency markedly affects the immune system. However, data on the effect of iron deficiency on immune function are still confusing and contradictory. Aim To assess the effect of iron-deficiency anemia on cell-mediated immunity. Patients and methods The percentage and count of T-lymphocytes (CD3+) and their CD4+ and CD8+ subsets and CD4+/CD8+ ratio were evaluated in 25 iron-deficient and 15 healthy adult women. The effect of iron therapy on the same parameters was also assessed in patients after correction of anemia. Results In our study, there was no statistically significant difference between patient and control groups regarding CD3+, CD4+, and CD8+ cell counts and percentages and CD4+/CD8+ ratio, with no statistically significant difference after iron therapy. However, it was found that serum ferritin level was significantly positively correlated with CD4+/CD8+ ratio and CD4+ cell percentage and absolute count and significantly negatively correlated with CD8+ cell percentage. Conclusion Iron deficiency has no effect on cell-mediated immunity with respect to quantitative changes in T-lymphocyte subsets and CD4/CD8 ratio.

Polikistik Over Sendromlu Adolesanlarda Oksidatif Stres Düzeyinin Biyokimyasal Parametrelerle İncelenmesi

Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders among women. Its prevalence increases up to 15% based on the Rotterdam criteria. It has been extensively studied for over 10 years that, among many factors, oxidative stress (OS) is a potential factor in the etiology of PCOS. This study aims to investigate the role of OS in the pathogenesis of PCOS. An examination was made on 30 patients with PCOS and 30 healthy adolescent and young adult women aged between 15-22 years. The diagnosis of PCOS was established considering the recommendations of the last Amsterdam ESHRE/ASRM conference. Basal hormone levels in the early follicular phase, fasting glucose and insulin values, serum lipid profiles, serum albumin, ischemia-modified albumin (IMA), total thiol, native thiol, and disulfide levels were recorded as the patients' main parameters. Albumin, IMA, thiol, and disulfide levels were compared between the PCOS and control groups. The albumin level was statistically significantly higher in the PCOS group than in the control group. A negative correlation was detected between serum CRP levels and serum albumin, native thiol, and total thiol levels. Total and native thiol values were statistically significantly lower in the BMI overweight group. In conclusion, in the present study in which OS markers in 30 PCOS patients and 30 healthy adolescent and young adult women were examined, the serum albumin level was statistically significantly higher in the PCOS group compared to the control group, and IMA, total and native thiol and disulfide levels did not differ between the groups. For a clear understanding of the place of OS in the diagnosis of PCOS, it should be supported by studies involving larger patient groups and adult women of reproductive age.

Effect of hip external rotator muscle contraction on pelvic floor muscle function and the piriformis.

There is a lack of in-depth understanding of the muscles surrounding the pelvic floor muscle (PFM). The study aimed to investigate the functional relationship between PFM and hip external rotator muscles by observing the piriformis muscle thickness and displacement of the bladder base under different contraction conditions of the hip external rotator and/or PFM. We hypothesized that PFM function would be the strongest when the hip external rotator and PFM contracted simultaneously and that during PFM contraction, the piriformis muscle would act as an auxiliary muscle and show coactivation. The participants included 13 healthy adult women (mean age 23.8 ± 2.8years). The three contraction conditions were PFM contraction, hip external rotator contraction, and simultaneous contraction of the hip external rotator and PFM. During the tasks, the piriformis muscle thickness and bladder base displacement were measured using ultrasonography and compared among the contraction conditions using one-way analysis of variance. Significant differences were noted in bladder base displacement among the three contraction conditions (P < 0.01), with PFM contraction having the highest value. The piriformis muscle thickness showed the greatest increase in simultaneous contraction. In our study, we showed PFM contraction positively influences piriformis contraction, while PFM function operationalized by bladder base displacement was highest during PFM contraction alone.

Self-Care by Muslim Women during Ramadan Fasting to Protect Nutritional and Cardiovascular Health.

The practice of Ramadan involves a series of changes in lifestyle, mainly in eating habits. The research aim of this study is to determine the prevalence of overweight-obesity, the degree of compliance with dietary recommendations and the effects of religious fasting on cardiovascular health among a population of Muslim women living in Melilla, a Spanish city in North Africa. A follow-up cohort study was conducted on 62 healthy adult women (33.6 ± 12.7 years). Anthropometric and body composition parameters were obtained using bioimpedance and dietary records. All of the participants were overweight or obese, especially due to the non-compliance with dietary recommendations; however, more than 60% considered their weight was appropriate or even low. By the end of Ramadan, the women’s body mass index and fat component values had fallen significantly (p < 0.001), but this loss was later recovered. Dietary records revealed an excessive consumption of lipids and sodium, and the presence of a high waist-to-hip ratio. All of these factors are related to cardiovascular risk. In conclusion, promoting nutritional health and encouraging year-round self-care among adult Muslim women is necessary in order to ensure healthy fasting during Ramadan.

An Assessment of Balance through Posturography in Healthy about Women: An Observational Study.

The incidence of falls in adults constitutes a public health problem, and the alteration in balance is the most important factor. It is necessary to evaluate this through objective tools in order to quantify alterations and prevent falls. This study aims to determine the existence of alteration of balance and the influence of age in a population of healthy women. Static posturography was performed on 49 healthy adult women with no history of falls in four different situations using the Romberg test with the NedSVE/IBV® platform. The variables studied were the body sway area and the anteroposterior and mediolateral displacements. The situation of maximum instability occurred in RGC (p = 0.001), with a significant increase in anteroposterior oscillations regarding the ML (p < 0.001), with no correlation to age. Age alone does not influence the balance in the sample studied, other factors must come together to alter it. The joint cancellation of visual and somatosensory afferents could facilitate the appearance of falls, given that it is a situation of maximum instability. Proprioceptive training is interesting as a preventive strategy for falls.

The effectiveness of weight loss and health promotion interventions for healthy adult women: A systematic review protocol

Introduction: Overweight and obesity is a global public health concern. In Australia, approximately 60% of women are categorised as being overweight or obese, and this rate has been growing steadily since 1995. Positive lifestyle behaviours such as regular participation in physical activity and healthy, well balanced dietary intake can assist with weight loss and weight management, however, many adult women fail to meet recommended guidelines for these behaviours. Currently many interventions have focussed on improving these weight and lifestyle behaviours amongst specific populations (e.g., pregnant or chronically diseased), however such interventions are not always transferrable to the general healthy adult female population. The aim of this review is to systematically collate and synthesise evidence on weight loss and lifestyle behaviour interventions targeting healthy adult women. Methods: This systematic review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Four electronic databases (CINAHL, Medline, CENTRAL, and SPORTDiscus) will be searched to identify potentially relevant studies. The reference lists of all studies included in this review will also be screened to identify further studies for inclusion. The eligibility criteria for inclusion will be studies that: sample adult women (aged 18-64 years), use a randomised controlled trial study design, have weight loss or other health related behaviours (e.g., physical activity, dietary intake) as primary outcomes, and are published in English. The search strategy will include terms (and synonyms) for: weight loss, physical activity, randomised controlled trials, and lifestyle behaviours. Data on participants, study duration, mode of recruitment, study design, and outcome measures will be extracted from the studies which have been selected for inclusion. If possible, results will also be pooled for meta-analyses. Discussion: This systematic review will provide information on the effectiveness of weight loss and health promotion programs for healthy adult women, along with the components of effective interventions, and strategies for successful recruitment. Consequently, the results will help inform the development and design of future gender-tailored weight loss and health promotion programs for women. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.

Acute effects of oral delta-9-tetrahydrocannabinol (THC) on autonomic cardiac activity and their relation to subjective and anxiogenic effects.

Cannabis is the most commonly used psychotropic drug in the United States, after alcohol. Despite its apparent sedative and calming effects, cannabis and its main psychoactive constituent, ∆9 -tetrahydrocannabinol (THC) can produce serious adverse effects including tachycardia and anxiety. These effects can be especially pronounced in women, who remain underrepresented in clinical cannabinoid research. The present study is one of the first to characterize the effects of single doses of oral THC on autonomic nervous system function in healthy adult women. Occasional female cannabis users participated in three laboratory sessions in which they received oral THC (7.5 and 15mg) and placebo. Autonomic measures included heart rate (HR), blood pressure (BP), pre-ejection period (PEP) a measure of cardiac sympathetic functioning, and high frequency heart rate variability (HF-HRV) a measure of parasympathetic cardiac control. Autonomic responses were examined in relation to subjective drug effects. THC dose-dependently increased HR, decreased HF-HRV, and increased ratings of feeling a drug effect, cannabis-like intoxication, and anxiety. Although the drug did not significantly affect BP or PEP, HR was negatively related to both PEP and HF-HRV. HF-HRV, the measure of parasympathetic activity, was significantly negatively related to subjective measures of cannabis intoxication (but not anxiety) at the 15mg dose only. PEP was not significantly related to any subjective measure. These results extend our knowledge of the autonomic effects of THC in relation to subjective drug experience. This and future studies will help us to understand risk factors related to cannabis use.

Heart rate and cardiac autonomic responses to concomitant deep breathing, hand grip exercise, and circulatory occlusion in healthy young adult men and women

BackgroundDeep breathing (DB) and handgrip (HG) exercise -with and without circulatory occlusion (OC) in muscle-, have been shown to have beneficial effects on cardiovascular function; however, the combination of these maneuvers on heart rate (HR) and cardiac sympathovagal balance have not been previously investigated. Therefore, the aim of the present study was to evaluate the effect of simultaneous DB, HG, and OC maneuvers on the sympathovagal balance in healthy women and men subjects.Methods and resultsElectrocardiogram and ventilation were measured in 20 healthy subjects (Women: n = 10; age = 27 ± 4 years; weight = 67.1 ± 8.4 kg; and height = 1.6 ± 0.1 m. Men: n = 10; age = 27 ± 3 years; weight = 77.5 ± 10.1 kg; and height = 1.7 ± 0.1 m) at baseline and during DB, DB + HG, or DB + HG + OC protocols. Heart rate (HR) and respiratory rate were continuously recorded, and spectral analysis of heart rate variability (HRV) were calculated to indirectly estimate cardiac autonomic function. Men and women showed similar HR responses to DB, DB + HG and DB + HG + OC. Men exhibited a significant HR decrease following DB + HG + OC protocol which was accompanied by an improvement in cardiac autonomic control evidenced by spectral changes in HRV towards parasympathetic predominance (HRV High frequency: 83.95 ± 1.45 vs. 81.87 ± 1.50 n.u., DB + HG + OC vs. baseline; p < 0.05). In women, there was a marked decrease in HR after completion of both DB + HG and DB + HG + OC tests which was accompanied by a significant increase in cardiac vagal tone (HRV High frequency: 85.29 ± 1.19 vs. 77.93 ± 0.92 n.u., DB + HG vs. baseline; p < 0.05). No adverse effects or discomfort were reported by men or women during experimental procedures. Independent of sex, combination of DB, HG, and OC was tolerable and resulted in decreases in resting HR and elevations in cardiac parasympathetic tone.ConclusionsThese data indicate that combined DB, HG and OC are effective in altering cardiac sympathovagal balance and reducing resting HR in healthy men and women.

Perceived stress during labor and its association with depressive symptomatology, anxiety, and pain catastrophizing

Perceived stress is a dimension of the maternal stress response, however little data is available on perceived stress levels and its associated psychological risk factors during labor. In this secondary data analysis from a prospective study evaluating epidural regimens, we investigated the potential associations between depressive symptomatology, anxiety, and pain catastrophizing with perceived stress during labor. Healthy nulliparous adult women with term singleton pregnancies requesting for epidural analgesia in early labor were included. Assessments were administered after epidural analgesia and adequate pain relief were achieved. Perceived stress (Perceived Stress Scale, PSS, high PSS ≥ 16), depressive symptomatology (Edinburgh Postnatal Depression Scale, EPDS, high EPDS ≥ 10), and pain catastrophizing (Pain Catastrophizing Scale, PCS, high total PCS ≥ 25) were assessed as categorical variables. Additionally, anxiety (State-trait Anxiety Inventory, STAI), PCS total and its subscales (rumination, magnification and helplessness) were analyzed as continuous variables. Univariate and multivariable logistic regression models were used to identify factors associated with high PSS. Of 801 women included, 411 (51.9%) had high PSS. High EPDS (OR 2.16, 95%CI 1.36–3.44), increasing trait anxiety (OR 1.17, 95%CI 1.14–1.20), and increasing pain magnification (OR 1.12, 95%CI 1.05–1.19) were independently associated with high PSS. Depressive symptomatology, trait anxiety, and pain magnification were associated with perceived stress during labor, providing impetus for future research aimed at detecting and alleviating stress and its psychological or pain association factors.

Safety and tolerability of a natural supplement containing glucosinolates, phytosterols and citrus flavonoids in adult women: a randomized phase I, placebo-controlled, multi-arm, double-blinded clinical trial

Objective To evaluate the safety and tolerability of an oral herbal supplement containing glucosinolates, phytosterols, and citrus flavonoids (Warmi®, Lima Perú;) in otherwise healthy adult women. Methods This was a phase-I, randomized parallel three arms, double-blinded, and a placebo-controlled clinical trial. A total of 55 participants aged 18-40 were randomly assigned to one of three groups to receive for three months: (1) an oral herbal supplement of 1650 mg/day; (2) an oral herbal supplement of 3300 mg/day; or (3) an oral placebo 3300 mg/day. The primary endpoints were oral safety and tolerability of the supplement. The secondary endpoint was its effect on vital functions, anthropometrics, and laboratory tests. We used an exploratory approach by covariance analysis (ANCOVA) adjusted for the variables’ baseline value for the secondary outcomes. Results All women completed three months of follow-up, reporting no side effects. Our exploratory analysis revealed that treatment with the herbal supplement of 1650 mg/day was associated with increased glucose and uric acid levels. In comparison, the herbal supplement 3300 mg/day was associated with reduced breathing rate, increased basal temperature, and systolic blood pressure, both compared to the placebo group. However, despite significant differences, none of these was clinically significant. Conclusion The oral herbal supplement had a favorable safety and tolerability profile in studied women. There is a need to study its potential as an option to treat menopausal symptoms.

Investıgatıon of the effect of Pilates Exercıses on the Functıonal Parameters of Middle Age Sedantery Women

This study aimed to investigate the effects of 8-week mat and reformer pilates exercises on functional movement skills, flexibility of adult healthy sedentary women. 58 [reformer exercise group (n: 20), mat exercise group (n: 21) and control group (n: 17)] volunteer women participated in the study. Functional Movement Screen test (FMS), sit and reach test, Trunk lateral flexion test, Quadriceps Femoris and M.Iliopsoas flexibility test were applied to the participants. Two-way repeated measures ANOVA was used in the analysis of the obtained data. Additionally, Bonferroni test, one of the multiple comparison tests, was used to determine the source of the difference between groups. Moreover, the percentage changes of eight-week exercises on FMS scores, flexibility and strength parameters of adult women were determined by using the formula %Δ= [(Post-test - Pre-test) / Pre-test*100]. According to the results of the study, it was determined that there was a statistically significant difference in the total FMS mean scores and flexibility test results of the exercise group and the control group. There was a higher increase in FMS scores and lower extremity flexibility values of the reformer group compared to the mat group, on the other hand, upper extremity flexibility levels of the mat group were found to be higher than the reformer group. As a result, it was determined that 8-week mat and reformer pilates exercises had a positive effects on some functional movement skills and flexibility parameters in adult healthy sedentary women. Keywords: Mat pilates, Reformer pilates, Functional movement screen

Exercise intensity of Zumba compared to walking in healthy adult women

Zumba is an alternative type of dance-exercise for improving fitness and cardiovascular risk in women. However, the aerobic training intensity of Zumba for healthy adult women is unclear. To describe heart rate (HR), lactate and energy-expenditure during a Zumba class, relating them to participants’ second ventilatory threshold (VT2). Comparisons were performed with a low-to-moderate intensity aerobic exercise session (walking/running). Ten healthy women (28 ± 3.2 yrs, BMI 25.3 ± 2.7) were examined on three occasions, in a randomized cross-over study: preliminary tests (body composition/aerobic fitness), session 1 (Zumba), and session 2 (aerobic exercise, 65% HRreserve). Fingertip blood samples were taken pre, at 25 min, and post exercise sessions. HR was continuously measured. VT2 was determined from the HR deflection point obtained during a maximum effort test. Zumba presented higher HR percentage of VT2 (95.3%) than walking (86%). Lactate concentration (mmol.L −1 ) of Zumba (10.9 ± 3.4) was superior to aerobic exercise (6.9 ± 3.6) at 25 min, also post-exercise. Both Zumba and aerobic exercise increased lactate responses at 25 min and post-exercise, when compared to rest. Energy-expenditure of Zumba (573.9 ± 100.3) was superior to aerobic exercise (260.4 ± 63.8). Exercise intensity of Zumba was superior to low-intensity aerobic exercise, with HR and lactate responses corresponding to participants’ VT2. This suggests that Zumba may be used as a promising way of increasing levels of physical activity at moderate-vigorous intensity, enhancing cardiovascular fitness and reducing CVR in health adult women. La zumba est une modalité d’entraînement aérobie à type de danse utilisée pour améliorer la condition physique et le risque cardiovasculaire des femmes. Cependant, le niveau dintensité d’exercice que représente la Zumba chez des femmes adultes en bonne santé reste mal précisée. Situer la fréquence cardiaque (FC), le lactate et la dépense énergétique lors d’un cours de Zumba, par rapport au deuxième seuil ventilatoire (SV2) des participantes. Des comparaisons ont été effectuées avec une séance d’exercices aérobies d’intensité faible à modérée (marche/course). Dix femmes en bonne santé (28 ± 3,2 ans, IMC 25,3 ± 2,7) ont été examinées à trois reprises, dans une étude croisée randomisée: tests préliminaires (composition corporelle/aptitude aérobie), session 1 (Zumba) et session 2 (exercice aérobie, 65% HR de réserve). Des échantillons de sang du bout des doigts ont été prélevés avant, à 25 minutes et après les séances d’exercice. Le rythme cardiaque (FC) a été mesurée en continu. Le SV2 a été déterminé à partir du point de déflexion du rythme cardiaque obtenu lors d’un exercice maximal. La Zumba correspond à un pourcentage plus élevé (95,3 %) de la FC au SV2 que la marche (86 %). La concentration de lactate (mmol.L-1) lors de la Zumba (10,9 ± 3,4) était supérieure à celle de l’exercice aérobie (6,9 ± 3,6) à 25 min et après l’exercice. Le Zumba et l’exercice aérobie ont tous deux augmenté les réponses lactatémiques à 25 minutes et après l’exercice, en comparaison avec le repos. La dépense énergétique lors de la Zumba (573,9 ± 100,3) était supérieure à celle d’un l’exercice aérobie (260,4 ± 63,8) L’intensité de l’exercice correspondant à la Zumba était supérieure à celle d’un exercice aérobie de faible intensité, avec des réponses FC et lactate correspondant au SV2 des participants. Cela suggère que la Zumba peut être utilisée afin d’augmenter les niveaux d’activité physique, d’améliorer la condition cardio-vasculaire et de réduire le risque cardiovasculaire chez des femmes adultes en bonne santé.

Factors Associated With Postoperative Opioid Prescribing After Primary Elective Cesarean Section.

Guidelines indicate the need to balance the risks of opioid prescribing with the need to adequately manage pain after cesarean section (CS). Although guidelines suggest the need for tailored opioid prescribing, it is unclear whether providers currently tailor opioid prescribing practices given patient-related factors. Thus, research is needed to first understand post-CS pain management and opioid prescribing. The objective of the present study was to identify factors related to CS discharge opioid prescriptions. This retrospective cohort study was approved by the Brooke Army Medical Center Institutional Review Board (San Antonio, Texas; #C.2020.094e) on June 23, 2020. Electronic health record data of healthy adult women undergoing primary elective CS, performed under regional neuraxial anesthesia at a single, academic, tertiary medical center from 2018 to 2019, were included. Multivariable regression examined patient and medical factors associated with post-CS opioid prescriptions. In the present sample (N = 169), 23% (n = 39) of patients did not use opioids postoperatively, while inpatient and almost all of those patients (n = 36) received a discharge prescription for opioids with a median amount of 225 morphine milligram equivalent doses. There was a lack of evidence indicating that patient and medical factors were associated with discharge opioid dose. Patient and medical factors were not associated with post-CS opioid prescribing. Larger studies are needed to better elucidate optimal post-CS pain management in the days and months that follow CS. Such findings are needed to better tailor opioid prescribing, consistent with clinical practice guidelines.

Safety and immunogenicity of a prototype recombinant alpha-like protein subunit vaccine (GBS-NN) against Group B Streptococcus in a randomised placebo-controlled double-blind phase 1 trial in healthy adult women

BackgroundGroup B Streptococcus (GBS) is the leading cause of life-threatening infections in new-borns and may cause invasive disease, stillbirth and preterm delivery during pregnancy. While no licensed vaccine exists, maternal immunization might protect against neonatal disease and adverse pregnancy outcomes. We assessed the safety and immunogenicity of a prototype vaccine consisting of the fused N-terminal domains of the AlphaC and Rib surface proteins of GBS (GBS-NN). MethodsGBS-NN was tested in a randomised, double-blind, placebo-controlled, parallel group, phase I study, in healthy non-pregnant women. A dose-escalation phase, with two doses, four weeks apart, of 10, 50 or 250 µg, administered with or without aluminium hydroxide, was initially assessed (n = 60). This was followed by a dose-confirmation study, where one dose of 100 µg adjuvanted GBS-NN was compared with two doses of either 50 or 100 µg adjuvanted GBS-NN, again administered with four weeks interval between the doses (n = 180). Safety and immunogenicity were monitored for one year. ResultsGBS-NN was well tolerated with some, mostly mild, injection site reactions observed. Adjuvant significantly increased antibody concentrations and the response was boosted by a second dose. The IgG GMCs remained strongly elevated during the whole one-year duration of the study. Maximal responses occurred after two 50 µg doses, resulting in IgG GMC of 16.9 µg/ml at the primary immunological endpoint, twelve weeks after the first dose. For this regimen, 100% and 89% of the subjects achieved antibody levels above the arbitrary thresholds of 1 and 4 µg/ml, respectively. The added beneficial effect of a second dose was most pronounced for subjects with pre-existing IgG levels below the median of the entire cohort. ConclusionThe prototype GBS-NN vaccine was found to be well tolerated and highly immunogenic with an optimal regimen of two doses of 50 µg in the presence of adjuvant. Further development of a maternal vaccine based on the N-terminal domains of the alpha-like protein family of GBS is warranted (NCT02459262).

Is There an Association Between Bone Microarchitecture and Fracture in Patients who were Treated for High-grade Osteosarcoma? A Controlled Study at Long-term Follow-up Using High-resolution Peripheral Quantitative CT.

Neoadjuvant chemotherapy in patients with primary osteosarcoma improves survival rates, but it also causes side effects in various organs including bone. Low bone mineral density (BMD) can occur owing partly to chemotherapy or limited mobility. This can cause a higher risk of fractures compared with those who do not receive such treatment. Changes in BMD alone cannot explain the propensity of fractures. Studying microarchitectural changes of bone might help to understand the effect. (1) Do patients who were treated for osteosarcoma (more than 20 years previously) have low BMD? (2) Do these patients experience more fractures than controls who do not have osteosarcoma? (3) What differences in bone microarchitecture are present between patients treated for high-grade osteosarcoma and individuals who have never had osteosarcoma? We contacted 48 patients who were treated for osteosarcoma and who participated in an earlier study. These patients underwent multimodal treatment including chemotherapy more than 20 years ago. Of the original patient group, 60% (29 of 48) were missing, leaving 40% (19 of 48) available for inclusion in this study; all 19 agreed to participate. There were nine men and 10 women with a mean age of 46 ± 4 years and a mean time from surgery to examination of 28 ± 3 years. BMD was measured by dual-energy x-ray absorptiometry, and any fracture history was assessed using a questionnaire. Additionally, high-resolution peripheral quantitative CT was performed to compare the groups in terms of microarchitectural changes, such as cortical and trabecular area, cortical and trabecular thickness, cortical porosity, and endocortical perimeter. Participants in the control group were selected from a cohort consisting of a population-based random sample of 499 healthy adult women and men. Osteoporosis or low BMD was not an exclusion criterion for entering this study; however, the patients in the control group were selected based on a normal BMD (that is, T score > -1.0 at both the spine and hip). Also, the participants were matched based on age and sex. Differences between patients and controls were assessed using the Wilcoxon rank sum test for continuous variables and a chi-square test for categorical variables. A multiple regression analysis was performed. Model assumptions were checked using histograms and quantile-quantile plots of residuals. Twelve of 19 patients who were treated for osteosarcoma had either osteopenia (eight patients) or osteoporosis (four patients). More patients with osteosarcoma reported sustaining fractures (11 of 19 patients) than did control patients (2 of 19 controls; p < 0.001). Among all microarchitectural parameters, only the endocortical perimeter was increased in patients compared with the control group (75 ± 15 mm versus 62 ± 18 mm; p = 0.04); we found no differences between the groups in terms of cortical and trabecular area, cortical and trabecular thickness, or cortical porosity. Although patients who were treated for osteosarcoma had osteopenic or osteoporotic BMD and a higher proportion of patients experienced fractures than did patients in the control group, we could not confirm differences in microarchitectural parameters using high-resolution peripheral quantitative CT. Therefore, it seems that bone geometry and microstructural parameters are not likely the cause of the increased proportion of fractures observed in our patients who were treated for osteosarcoma. Until we learn more about the bone changes associated with chemotherapy in patients with osteosarcoma, we recommend that patients undergo regular BMD testing, and we recommend that physicians consider osteoporosis treatment in patients with low BMD. These data might provide the impetus for future multicenter prospective studies examining the association between chemotherapy and bone microarchitecture. Level III, therapeutic study.

Interval Training and Endurance Training to Increase VO2max: Article Review

This study aims to determine better between Interval Training and Endurance Training to increase VO2max capacity in healthy adult men and women. The method used is a literature review, looking for articles from Electronic DataBased in PubMed, ScienceDirect, Eric. Journal, Google Scholar, and ProQuest that have been published and accredited. A total of 8 papers were selected for in-depth review. The results show that Interval Training is better than Endurance Training, even though both can increase VO2max.

Women’s self-estimates of body size are more accurate and precise when made with three-quarter view than front-view stimuli

Recently, Cornelissen, Cornelissen, Groves, McCarty and Tovée (2018) asked which image orientations (e.g. front-, side-, or three-quarter view) are most appropriate for tasks which are used for self-estimates of body size and shape. Based on psychophysical measurements, they showed that front view stimuli showed substantially poorer content validity compared to side- and three-quarter view stimuli. Here, we tested the real-world consequences of Cornelissen et al.’s (2018) findings. We carried out a body size self-estimation task in a sample of healthy adult women, once with front view stimuli, and once with three-quarter view stimuli. The order in which front- and three-quarter view tasks were carried out was randomized across participants. Compared to three-quarter view stimuli, we found that: a) the precision of participants’ judgements was worse with front view stimuli, and b) that front view stimuli led to over-estimation of body size by ∼1.7 BMI units. While these results need to be replicated, they do suggest that careful consideration needs to be given to stimulus orientation in future studies.