Female Sex Steroids Research Articles

The response of cells derived from the supraspinatus tendon to estrogen and calciotropic hormone stimulations: in vitro study

ABSTRACTPurpose: The most frequent complications after rotator cuff repair (RCR) are non-healing and re-tear. Age and gender are both proven risk factors for faulty RCR. This study analyzed the effects of female sex steroids and calciotropic hormones on tendon-derived cell characteristics. Methods: Tendon-derived cells from rat supraspinatus were treated with estradiol-17β (E2); soy isoflavones (daidzein, genistein, biochainin A); raloxifene and estrogen receptors α and β agonists and antagonists; and less-calcemic vitamin-D analog, parathyroid hormone, and vehicle control for 24 h. Cell proliferation and mRNA expression of estrogen receptor α and β, vitamin-D receptor (VDR), scleraxis, and collagen-1 were assessed. Results: E2, Biochainin A, raloxifene, and vitamin-D significantly increased tendon-derived cell proliferation. Estrogen receptor α antagonists neutralized tendon-derived cells response to estradiol 17-β; however, estrogen receptor β antagonists did not have an effect. Scleraxis expression decreased following estradiol 17-β and vitamin-D treatments. Vitamin-D significantly reduced collagen-1 expression, while estradiol 17-β had no effect. Vitamin-D and estradiol 17-β upregulated VDR expression. Conclusions: Significant tendon-derived cell proliferation can be achieved with commonly prescribed female sex and calciotropic hormones. However, collagen-1 expression remained constant or decreased following the administration of these hormones. Female sex steroids and vitamin-D promoted tendon-derived cell proliferation via estrogen receptor α and VDR, not estrogen receptor β. Amplified cell proliferation was not associated with increased scleraxis and collagen-1 expression. These results have important implications to the properties of healing tendon and possible pharmaceutical therapies for patients with torn RC. Further research is warranted to expose the underling mechanisms of these effects.

PP.23.03

Objective: Since renin and aldosterone levels vary during the menstrual cycle, and are critical criteria for interpretation of aldosterone suppression tests to confirm or exclude primary aldosteronism, outcome of testing may vary depending on the menstrual cycle phase. We assessed the effect of timing within the menstrual cycle on levels of renin, aldosterone and female sex steroids during fludrocortisone suppression testing (FST). We are not aware of any study reporting the effect of the phase of the menstrual cycle on FST results, and the current study was therefore designed to examine this important aspect. Design and method: In 22 women undergoing FST who experienced regular menstrual cycles, renin (measured as both plasma renin activity and direct renin concentration), aldosterone (mass spectrometry) and cortisol, progesterone, estradiol, LH and FSH (immunoassay) levels were compared, relative to phase of cycle. Aldosterone levels were compared to those in age-matched males undergoing FST. Results: Progesterone (p < 0.0001) and aldosterone (p = 0.006) levels were higher in nine women (after one of 10 was excluded with anovulatory cycle) studied during the luteal phase than in 12 studied during the follicular phase. All studied during the luteal phase had positive FST and all three with negative FST were studied during the follicular phase. There were no significant differences in other parameters measured except FSH, which was higher (p = 0.02) during the follicular phase. Aldosterone was higher (p = 0.01) in women studied in the luteal (but not follicular) phase compared to men. Conclusions: The menstrual cycle may affect the outcome of FST and other suppression testing used to diagnose primary aldosteronism. Larger patient numbers and preferably restudy of the same patient in both phases should clarify this, and determine the optimum time in the cycle for testing.

PP.23.02

Objective: Since aldosterone and cortisol levels vary during the menstrual cycle, and are utilised in the interpretation of adrenal venous sampling (AVS) to differentiate unilateral from bilateral primary aldosteronism, outcome of AVS in premenopausal women could possibly be influenced by when the collections are made. We assessed the effect of phase of the menstrual cycle on both adrenal and peripheral venous aldosterone and cortisol levels and on serum female sex steroid levels during AVS. Design and method: In 23 premenopausal women with primary aldosteronism undergoing AVS, levels of aldosterone, cortisol, progesterone, estradiol, LH and FSH levels were compared, depending on whether collected during the follicular or luteal phase Results: Based on results at AVS, 10 women had unilateral over-production of aldosterone, and 13 bilateral. Unilateral aldosterone over-production was observed more frequently in women undergoing AVS during the luteal phase compared with the follicular phase (7/10 = 70% vs 3/13 = 23%; p < 0.05). Simultaneously collected peripheral levels of progesterone (p < 0.0001), estradiol (p < 0.05) and aldosterone (p < 0.05) and bilateral adrenal venous levels of aldosterone (p < 0.01) and cortisol (p < 0.01) were higher in those sampled during the luteal phase. Importantly, higher/lower side adrenal venous aldosterone/cortisol ratios (i.e. lateralization indices) were higher during the luteal phase than follicular [median 11 (range 2.94–96) vs 2 (1.23–35), (p < 0.05)]. Conclusions: The phase of the menstrual cycle during which samples are collected significantly affects the levels of aldosterone and cortisol used to interpret AVS. A risk of false lateralization appears to be present when AVS is performed during the luteal phase, but this requires confirmation with larger patient numbers, ideally with studies in each patient during both phases. Meanwhile, recording of the phase of the cycle during which AVS is performed should be encouraged.

Ovariectomy does not exacerbate the negative effects of sleep deprivation on synaptic plasticity in rats

In our previous work, we found that female rats showed more cognitive impairment than male rats following 72h sleep deprivation (SD). Here, we compared the intact female with ovariectomized (OVX) rats to assess the potential modulatory effects of endogenous female sex hormones against the 48h SD-induced cognitive and synaptic modulations. The multiple platform method was applied for SD induction and spatial performances were determined using Morris water maze (MWM) task. Early longterm potentiation (E-LTP) was evaluated in area CA1 of the hippocampus and PCR and western blotting assays were employed to assess hippocampal BDNF gene and protein expression. To reveal any influence of sleep loss on stress level, we also measured the plasma corticosterone levels of animals. Regardless of reproductive status, SD significantly impaired short-term memory and LTP, but did not significantly change the BDNF expression in the hippocampus. The corticosterone levels were decreased in both intact and OVX female rats following SD. These findings suggest that depletion of female sex steroid hormones does not lead to any heightened responsivity of female animals to the negative effects of SD on cognitive and synaptic functions.

Melanoma risk after ovarian stimulation for in vitro fertilization.

Do women treated with ovarian stimulation for IVF have an increased risk of melanoma? Ovarian stimulation for IVF does not increase risk of melanoma, even after a prolonged follow-up. Although exposure to ultraviolet radiation is the major risk factor for melanoma, associations between female sex steroids and melanoma risk have also been suggested. The results of available studies on fertility drugs and melanoma risk are inconclusive since most studies had several methodological limitations such as short follow-up, a small number of cases and no subfertile comparison group. In 1996, a nationwide historic cohort study (the OMEGA-cohort) was established to examine the risk of cancer after ovarian stimulation for IVF. After a median follow-up of 17 years, cancer incidence was ascertained through linkage with the Netherlands Cancer Registry. Melanoma risk in the cohort was compared with that in the general population and between the IVF group and non-IVF group using multivariable Cox regression analyses. The cohort comprises 19 158 women who received IVF between 1983 and 1995 and a comparison group of 5950 women who underwent subfertility treatments other than IVF. Detailed IVF-treatment data were obtained from the medical records and complete information on parity and age at first birth was obtained through linkage with the Dutch Municipal Personal Records Database. In total, 93 melanoma cases were observed. The risk of melanoma was not elevated among IVF-treated women, neither when compared with the general population (standardized incidence ratio = 0.89; 95% confidence interval (CI): 0.69-1.12), nor when compared with the non-IVF group (adjusted hazard ratio (HR) = 1.27; 95% CI: 0.75-2.15). A higher number of IVF cycles was associated with apparent but statistically non-significant risk increases (5-6 cycles HR = 1.92; ≥7 cycles HR = 1.79). However, no significant trend emerged. In women with more follicle stimulating hormone/human menopausal gonadotrophin ampoules comparable non-significant risk increases were found. A longer follow-up did not increase melanoma risk. Nulliparous women did not have a significantly higher melanoma risk than parous women (HR = 1.22; 95% CI: 0.81-1.84). However, women who were 30 years of age or older at first birth had a significantly higher melanoma risk than women who were younger than 30 years at first birth (age: 30-34 years HR = 4.57; 95% CI: 2.07-10.08, >34 years HR = 2.98; 95% CI: 1.23-7.21). Despite our large cohort, the number of melanoma cases was rather small, especially in our comparison group, which hampered subgroup analyses. Our results are reassuring for women who underwent IVF or are contemplating to start IVF. Since our cohort study is one of the largest published so far, with long-term follow-up, a subfertile comparison group, and detailed IVF-treatment data, our results add important information to the available evidence. This study was supported by grants from the Dutch Cancer Society (NKI 2006-3631), the Health Research and Development Counsel (28-2540) and the Dutch Ministry of Health.

Should aldosterone suppression tests be conducted during a particular phase of the menstrual cycle, and, if so, which phase? Results of a preliminary study.

As renin and aldosterone levels vary during the menstrual cycle, and are critical criteria for interpretation of aldosterone suppression tests to confirm or exclude primary aldosteronism, outcome of testing may vary depending on the menstrual cycle phase. We assessed the effect of timing within the menstrual cycle on levels of renin, aldosterone and female sex steroids during fludrocortisone suppression testing (FST). In 22 women undergoing FST who experienced regular menstrual cycles, renin (measured as both plasma renin activity and direct renin concentration), aldosterone (mass spectrometry) and cortisol, progesterone, oestradiol, LH and FSH (immunoassay) levels were compared, relative to phase of cycle. Aldosterone levels were compared to those in age-matched males undergoing FST. Progesterone (P < 0·0001) and aldosterone (P = 0·006) levels were higher in nine women (after one of 10 was excluded with anovulatory cycle) studied during the luteal phase than in the 12 studied during the follicular phase. All studied during the luteal phase had positive FST, and all three with negative FST were studied during the follicular phase. There were no significant differences in other parameters measured except FSH, which was higher (P = 0·02) during the follicular phase. Aldosterone was higher (P = 0·01) in women studied in the luteal (but not follicular) phase compared to men. The menstrual cycle may affect the outcome of FST and other suppression testing used to diagnose primary aldosteronism. Larger patient numbers and preferably restudy of the same patient in both phases should clarify this and determine the optimum time in the cycle for testing.

A possible relationship between Takotsubo cardiomyopathy and female sex steroid-related modulation of functional cerebral asymmetry

Takotsubo cardiomyopathy (Tc) is a transient left ventricular apical ballooning syndrome, with symptoms and signs of acute myocardial infarction. Tc syndrome, which occurs predominantly in postmenopausal women, is characterized by increase of sympathetic activity.Studies on the gender-specific differences in sympatho-vagal regulation and functional cerebral asymmetry (FCA) imply that female pattern of dominance is characterized by the left hemisphere, which is believed to have parasympathetic predominance, whereas male pattern indicates dominance of the right hemisphere, which is believed to have sympathetic predominance. Fluctuating levels of female sex steroids are supposed to change FCA, modulating transcallosal inter-hemispheric inhibition across the menstrual cycle. The findings suggest that FCA is enhanced during the low steroid phase (menstrual phase), whereas, during high estrogen and/or progesterone phases (follicular and luteal phase) FCA is reduced. This theory is in line with concept of decreased magnitude of inter-hemispheric cortical lateralization in premenopausal women compared to men and postmenopausal women.Therefore, if postmenopausal women are more lateralized for a variety of cerebral functions, they have less balanced equilibrium between the right-sided sympathetic and left-sided parasympathetic predominance. Decrease of endogenous female sex steroid levels in postmenopausal women leads to reduced influence of estrogens to the left hemisphere, which is believed to have parasympathetic predominance. If both of these mechanisms result in sympatho-vagal imbalance, increasing sympathetic system activity in postmenopausal women, it seems reasonable why postmenopausal women became more susceptible to sympathetically-mediated syndromes such as Takotsubo cardiomyopathy.

Evaluation of the Male and Female Sex Steroid Hormones Residues in Eggs , Milk and Their Productsin Alqassim Region

The residues of the sex steroid hormones were determined in the milk, eggs and their products. Sixty five samples of eggs (Baladi and Pure Breeds), milk (liquid, powder and condensed), cheese (soft, semi-soft and hard), ice cream, chocolates, butter (local and imported) and yoghurt were used in addition to 97 processed samples were used in this study. Five grams of each sample was taken out after homogenizing the sample in an electric blender, mixed with 10 ml hexane in a conical flask (100 ml) and incubated under shaking in a shaking water bath for 2 hours (30oC). The sample was poured off into a clean centrifuge tube and centrifuged (3000 rpm/15 minutes, 5°C). The supernatant was aspirated and poured into a clean labeled glass tube. The steroid extract was then exposed to a weak stream of nitrogen gas while samples were incubated on a warm (25oC) metal block until the whole liquid was evaporated. The precipitate was reconstituted in 5 ml phosphate buffer saline (PBS, pH 7.2). Hormone determinations of progesterone (P4), estradiol17 (E2), testosterone (T) and androstenedione (A2) were conducted by commercial ELISA kits. Results exhibited that the highest residues of the four hormones were detected in fresh eggs followed by milk due to the condensed and powder milk, then cheeses. However, the lowest levels of the four hormones existed in yoghurt. Butter, sweets, ice creams and bakeries contained intermediate levels of the four hormones. Also, baladi eggs contained less residues of the four hormones than in white eggs. Also imported food products (i.e. milk, butter, cheese) contained higher residues of the four hormones than their local counterparts.Despite the detection of some residues of the four sex steroid hormones in the food products studied, these levels still far below the maximum allowable levels approved by WHO guidelines in this respect. In conclusion, the consumers especially the children and adolescents must not exceed consuming more than 3 eggs per day and it is better to consume local fresh milk than the imported condensed milk to avoid the accumulation of such hormone residues in their bodies which might affect their future sex life. Keywords: Testosterone, progesterone, estradiol 17, androstenedione, eggs, milk products

Unravelling the Oral Ascendancy of Female Sex Hormones on Periodontium

Bacterial plaque has been established as the primary etiologic factor for the initiation of periodontal disease. It has also been shown that without a susceptible host the periodontal pathogens are necessary but not sufficient for disease to occur. The notable periodontal changes related specifically to female sex steroid levels, primarily those manifested as pathologic alterations in the gingiva, attest to the dramatic potential these hormones possess to impact the oral tissues beyond normal homeostatic functions. Hormonal changes in women present a unique challenge for decision making in periodontal therauptics.

Retraction: 'Switching of chromatin-remodelling complexes for oestrogen receptor-α'.

The female sex steroid hormone oestrogen stimulates both cell proliferation and cell differentiation in target tissues. These biological actions are mediated primarily through nuclear oestrogen receptors (ERs). The ligand‐dependent transactivation of ERs requires several nuclear co‐regulator complexes; however, the cell‐cycle‐dependent associations of these complexes are poorly understood. By using a synchronization system, we found that the transactivation function of ERα at G2/M was lowered. Biochemical approaches showed that ERα associated with two discrete classes of ATP‐dependent chromatin‐remodelling complex in a cell‐cycle‐dependent manner. The components of the NuRD‐type complex were identified as G2/M‐phase‐specific ERα co‐repressors. Thus, our results indicate that the transactivation function of ERα is cell‐cycle dependent and is coupled with a cell‐cycle‐dependent association of chromatin‐remodelling complexes.

EHMTI-0038. Does hypophysial-gonadal system influence formation of tension-type headache in women of reproductive age?

The obvious difference in pain prevalence related to gender is well known, but the underlying mechanisms are not clearly identified. Female sex steroids may play an important role in this difference.

Reproductive life characteristics in females affected with Parkinson's disease and in healthy control subjects – a comparative study on Polish population

BackgroundSex and blood level of sex hormones play a key role not only in the susceptibility to develop Parkinson's disease (PD) but also influence the natural course of the disease. The aim of this study was to compare reproductive lifespan events in females affected with PD and in “non-parkinsonian” age matched subjects and to evaluate whether the whole life endogenous oestrogen level is associated with variables describing the course of the disease. Materials and methodsReproductive lifespan, age at menarche, age at menopause, gynaecological interventions and parity were compared in 76 women with idiopathic PD and in the age-adjusted control group of 74 subjects. Affected women underwent neurological and psychological assessment. Data were analysed using Mann–Whitney U Test and Spearman Rank Correlation Test. ResultsWomen affected with PD had a shorter reproductive lifespan and experienced final menstruation earlier than the control group. Early menopause was reported by 24% of the patients and only by 16% of the control subjects. Parkinsonian women reported more commonly the history of surgical menopause. Duration of reproductive lifespan, age at menopause and the type of menopause influenced both motor and cognitive functioning of patients. ConclusionsThere may be a relationship between the lifetime average endogenous oestrogen level and the susceptibility to develop PD. Longer reproductive lifespan resulting in higher “whole life” female sex steroids concentrations may exert a protective effect on central nervous system, resulting in milder course of the disease.

The gametogenic cycle and oestradiol levels in the zebra mussel Dreissena polymorpha: a 1-year study

As a common sessile filter feeder with high bioconcentration rates, Dreissena polymorpha is useful as a bioindicator species. Pollution and environmental factors influence the reproductive effort of these bivalves. Therefore, the evaluation of the gametogenic cycle is important for understanding environmentally-related physiological alterations in this dioecious species. Animals from an unpolluted reference site close to the highly polluted Seine River, France, were monitored monthly over 1 year using qualitative and quantitative measures of gametogenesis. Developmental stages of the gonad were determined by visual inspection of histological slides. Unbiased quantitative stereological analysis was conducted to estimate oocyte development and the gonad index was determined. To investigate a possible role of female sex steroids in bivalve gametogenesis as a possible target for xenoestrogens, free oestradiol levels were assessed and analysed with respect to oocyte development. The basic pattern of the reproductive cycle consisted of early gametogenesis during autumn and winter, followed by rapid vitellogenesis in early spring, and spawning towards the summer months. However, the population was characterized by high inter-individual variability of the gonad stages. Furthermore, the simultaneous occurrence of different developmental stages within the same animal made classification difficult. Stereological determination of oocyte volumes as well as gonadosomatic index provided a more precise evaluation of reproductive effort. Oestradiol levels did vary significantly between months, but did not show any clear relationship with a particular stage of gametogenesis or oocyte volume.

Progesterone, as well as 17β-estradiol, is important for regulating AHR battery homoeostasis in the rat uterus

Several studies indicate that the aryl hydrocarbon receptor (AHR), which plays an important role in mediating the toxicity of many industrial chemicals, plays an important role in the physiology of female reproductive tract organs. This makes it likely that the AHR and additional components of the AHR signalling pathway are under the control of female sex steroids. In a previous study, we could already demonstrate the regulation of many members of the AHR battery by 17β-estradiol (E2) in the uterus of rats. In this study, we addressed the potential role of progesterone (P4) in this context. In a comparative approach using ovariectomized rats which were treated for 3days with either vehicle control, E2, progesterone (P4) or the combination of both hormones in addition to sham-operated animals, we could demonstrate that in addition to E2, P4 is also an important factor in regulating AHR signalling in the rat uterus. P4 has effects similar to E2 on uterine Ahr, Arnt and Arnt2 mRNA levels, resulting in a downregulation of these genes, while the E2-mediated downregulation of key AHR response genes Cyp1a1, Gsta2 and Ugt1 is completely antagonized by P4. As with E2, P4 leads to an increase in uterine AHR levels, especially in the endometrial epithelium despite the decrease in corresponding mRNA levels. This indicates a complex gene-specific regulatory network involving E2, P4 and possibly AHR itself to maintain all components of the AHR signalling cascade at the required levels during all stages of the oestrous cycle and pregnancy.

40 Hz auditory steady-state response in females: When is it better to entrain?

Auditory steady-state responses (ASSRs) are widely applied to test brain's ability to follow external stimulation in neuropsychiatric disorders. It is known that ASSRs are related to GABAergic transmission. Female sex steroid homones - both estrogens and progesterone - affect functioning of GABAergic system. However, it is not known how these hormones affect brain's ability to entrain. This study was designed to test the ability to synchronize to 40 Hz stimulation during different phases of the menstrual cycle. Twenty-eight healthy females participated in the research during one of the menstrual cycle phases: (1) early follicular; (2) late follicular; (3) and mid-luteal. Auditory 40 Hz trains of 500 ms were delivered binaurally and EEG was recorded. Time-frequency analysis of the data was performed and phase-locking index, evoked amplitude and total intensity measures were extracted and decomposed by non-negative multi-way factorization. Additionally, alpha power of the baseline period was calculated. Parameters of ASSR were increasing in a linear manner with increasing levels of 17β-estradiol and largest estimates of ASSR parameters were obtained in the late follicular phase, smallest - in the mid-luteal phase. Alpha power values were highest in the late follicular phase and lowest in the mid-luteal phase, pointing to lower arousal level in the late follicular phase. We speculate that increased 40 Hz ASSRs during mid-cycle might be related to the level of general arousal and specific GABA-mediated changes during the menstrual cycle. The results suggest that the ability to entrain to 40 Hz stimulation depends on the phase of menstrual cycle. This should be taken into account, particularly when ASSRs are used in clinical practice, comparing patients and healthy subjects.

Estimating volumes of the pituitary gland from T1-weighted magnetic-resonance images: Effects of age, puberty, testosterone, and estradiol

The pituitary gland is a key structure in the hypothalamic–pituitary–gonadal (HPG) axis — it plays an important role in sexual maturation during puberty. Despite its small size, its volume can be quantified using magnetic resonance imaging (MRI). Here, we study a cohort of 962 typically developing adolescents from the Saguenay Youth Study and estimate pituitary volumes using a newly developed multi-atlas segmentation method known as the MAGeT Brain algorithm. We found that age and puberty stage (controlled for age) each predicts adjusted pituitary volumes (controlled for total brain volume) in both males and females. Controlling for the effects of age and puberty stage, total testosterone and estradiol levels also predict adjusted pituitary volumes in males and pre-menarche females, respectively. These findings demonstrate that the pituitary gland grows during adolescence, and its volume relates to circulating plasma-levels of sex steroids in both males and females.

Sex differences in the pulmonary circulation: implications for pulmonary hypertension

Pulmonary arterial hypertension (PAH), a form of pulmonary hypertension, is a complex disease of multifactorial origin. While new developments regarding pathophysiological features and therapeutic options in PAH are being reported, one important fact has emerged over the years: there is a sex difference in the incidence of this disease such that while there is a higher incidence in females, disease outcomes are much worse in males. Accordingly, recent attention has been focused on understanding the features of sex differences in the pulmonary circulation and the contributory mechanisms, particularly sex hormones and their role in the pathological and pathophysiological features of PAH. However, to date, there is no clear consensus whether sex hormones (particularly female sex steroids) are beneficial or detrimental in PAH. In this review, we highlight some of the most recent evidence regarding the influence of sex hormones (estrogen, testosterone, progesterone, dehydroepiandrosterone) and estrogen metabolites on key pathophysiological features of PAH such as proliferation, vascular remodeling, vasodilation/constriction, and inflammation, thus setting the stage for research avenues to identify novel therapeutic target for PAH as well as potentially other forms of pulmonary hypertension.

Sex-steroid regulation of relaxin receptor isoforms (RXFP1 & RXFP2) expression in the patellar tendon and lateral collateral ligament of female WKY rats.

The incidence of non-contact knee injury was found higher in female than in male and is related to the phases of the menstrual cycle. This raised the possibility that female sex-steroids are involved in the mechanism underlying this injury via affecting the expression of the receptors for relaxin, a peptide hormone known to modulate ligament laxity. Therefore, this study aims to investigate the effect of sex-steroids on relaxin receptor isoforms (RXFP1 & RXFP2) expression in the ligaments and tendons of the knee. Methods: Ovariectomized adult female WKY rats were treated with different doses of estrogen (0.2, 2, 20 μg/kg), progesterone (4mg) and testosterone (125 & 250μg/kg) for three consecutive days. At the end of the treatment, the animals were sacrificed and the patellar tendon and lateral collateral ligament were harvested for mRNA and protein expression analyses by Real Time PCR and Western blotting respectively. Results: RXFP1, the main isoform expressed in these knee structures and RXFP2 showed a dose-dependent increase in expression with estrogen. Progesterone treatment resulted in an increase while testosterone caused a dose-dependent decrease in the mRNA and protein expression of both relaxin receptor isoforms. Discussion: Progesterone and high dose estrogen up-regulate while testosterone down-regulates RXFP1 and RXFP2 expression in the patellar tendon and lateral collateral ligament of rat's knee. Conclusion: Relaxin receptor isoforms up-regulation by progesterone and high dose estrogen could provide the basis for the reported increase in knee laxity while down-regulation of these receptor isoforms by testosterone could explain low incidence of non-contact knee injury in male.

Http://www.omicsgroup.org/journals/pulmonary-agenesis-with-dextrocardia-and-hypertrophic-cardiomyopathy-first-case-report-2167-0897.1000141.php?aid=26283

Background: Last two decades have witnessed a steady improvement in the quality of perinatal care in India. Better understanding of the pathophysiology and newer treatment strategies like antenatal steroid, surfactant use, newer modes of ventilation and stringent aseptic measures have contributed to the improved survival of very low birth weight babies. Methods: In a prospective cohort study conducted in a tertiary care center over two years period (October 2011- September 2013), 744 VLBW babies (birth weight <1500 g) were assessed for gestational age, maturity, maternal risk factors and administration of antenatal steroids. Morbidities like birth asphyxia, sepsis, jaundice, respiratory distress syndrome, intraventricular haemorrhage, necrotisingenterocolitis, apnoea, pulmonary haemorrhage and patent ductusarteriosus were noted. Screening for retinopathy of prematurity and hearing impairment was done. Outcome in terms of survival till discharge was recorded. Results: Out of 744 VLBW babies, 496 (66.67%) survived till discharge. Maternal risk factors associated with birth of VLBW babies were primiparity (58.06%), poor socio economic status (40.86%), multiple gestations (36.83%), PROM (26.34%), hypertension (13.44%) and under nutrition (12.36%). Jaundice (43.31%), apnoea (26.34%), birth asphyxia (20.43%), RDS (19.89%) and sepsis (18.82%) were found to be significant morbidities. Mortality was higher among males (20.43%) than females (12.9%). None below 27 weeks of gestation and birth weight of 800 g survived. RDS was the main cause of death (46.15%) followed by birth asphyxia (23%), sepsis (19.2%) and IVH (11.5%). Antenatal steroid improved the survival (72.9%) and reduced the incidence of RDS, NEC and IVH. ROP was detected in 30.49% VLBW babies. 33.3 % of the survivors failed in the initial hearing screening. Conclusions: Higher birth weight, gestational age, female sex and antenatal steroids improved survival amongst VLBW babies. Antenatal steroids reduced incidence of RDS, NEC and IVH when preterm delivery was inevitable. Judicial use of supplemental oxygen and blood products prevent development of ROP.

Sexual dimorphism of functional brain asymmetry

The brain structural and functional asymmetries are thought to be a result of interplay between different factors, beginning with the genes and continuing with many non-genetic pre- and postnatal factors, including hormones. Observations obtained from human studies indicate that females show decreased magnitude of inter-hemispheric cortical lateralization compared to males, while males exhibit a greater degree of cortical asymmetry than females for components of cognitive and perceptual processing. It has also been recognized that men and women differ in hemispheric recruitment. The findings suggest that functional cortical asymmetry is enhanced during the low steroid phase (menstrual phase), whereas, during high estrogen and/or progesterone phases (follicular and luteal phase) functional cortical asymmetry is reduced. Fluctuating levels of female sex steroids are supposed to change functional cerebral asymmetry, modulating transcallosal interhemispheric inhibition across the menstrual cycle. The further investigations are necessary to understand sexually-dimorphic patterns of cortical asymmetry, as well as to reveal evolutional and biological aspects of this phenomenon.