Healthy Women Of Childbearing Age Research Articles

Vitamin D3 induces the expression of membrane progesterone receptors (mPRs) on naive CD4+ T lymphocyte cells in women of reproductive age

ObjectiveVitamin D3 and progesterone (P4) both belong to steroid hormones. These hormones have effects on the function of each other in different ways. The immunomodulatory activity of vitamin D3 and P4 and their role in inducing maternal tolerance for fetus have been shown in various studies. The purpose of this study was to evaluate the effect of vitamin D3 on the expression of membrane progesterone receptors (mPRs) on CD4+ T cells. Materials and methodsNaive CD4+ T cells were isolated from peripheral blood of 38 healthy women of childbearing age. After stimulating by anti-CD3 and anti-CD28 monoclonal antibodies (mAb), these cells were exposed to either various concentrations of vitamin D3 or no exposure at all in a culture medium at 37 °C for 3 days. In the final stage, the mean fluorescence intensity (MFI) of mPRα and mPRβ were evaluated using polyclonal and monoclonal antibodies and several gating strategies on CD4+ T cells. ResultsVitamin D3 significantly increased the expression of mPR α and mPR β on the surface of CD4+ T cells (p ≤ 0.05). ConclusionThe present study demonstrated the potential effect of vitamin D3 on increasing the expression of P4 receptors on CD4+ T cells. This study shows a new aspect of correlation between vitamin D3 and P4 that may influence P4 performance. Therefore, our findings suggest that the appropriate level of this vitamin may affect the optimum P4 immunomodulatory activity during pregnancy.

Elevated serum CCL4/MIP-1β levels in postmenopausal osteoporosis patients are linked with disease severity.

To investigate if the serum CC motif ligand 4 (CCL4) levels are linked to disease severity in patients with postmenopausal osteoporosis (PMOP). We enrolled 66 PMOP females, 68 postmenopausal nonosteoporotic women and 67 healthy women of childbearing age. Bone mineral densities were assessed with dual x-ray absorptiometry scans. The Oswestry disability index and the visual analog scale were employed to quantify functional ability and severity of symptoms. Serum CCL4 levels were examined with a quantitative sandwich enzyme-linked immunosorbent assay. We observed a significant negative correlation of CCL4 serum levels with bone mineral density. Furthermore, serum CCL4 concentrations were significantly related to the visual analog scale and Oswestry Disability Index scores. Serum CCL4 is a potential biomarker to evaluate disease severity in PMOP females.

Polymorphisms of methylenetetrahydrofolate reductase gene among women of childbearing age from Shiyan area

To assess the association of methylenetetrahydrofolate reductase (MTHFR) gene 677C to T polymorphism with blood homocysteine (Hcy) level among women of childbearing age from Shiyan area. PCR-chip hybridization was used to determine the genotype of MTHFR 677C to T, and a biochemical assay was used to determine the total Hcy level among 428 healthy women of childbearing age. Association of MTHFR 677C to T with total Hcy level was assessed. Heterozygous CT mutation was most common form for the MTHFR 677C to T polymorphisms and amounted for 49.77% among the group, while the CC wild type and homozygous TT mutation respectively accounted for 30.61% and 19.63%. These gave a frequency of 44.51% for the 677T allele. The dominant genotype among different age groups were the CT type. Of note, the proportion of MTHFR 677CC is higher in women above 30 years of age. The distribution of MTHFR 677C to T genotypes has differed significantly among different age groups (P<0.05). Compared with those with wild type alleles, carriers of MTHFR mutations had a higher plasma Hcy level. The genotypic frequencies of MTHFR C677T in Shiyan region differed significantly from those of Sichuan, Hebei, Henan and Shandong (P<0.05) but were similar to those of Jiangsu, Guangdong, Ningxia and Xinjiang. The distribution of MTHFR C677T polymorphism among women of childbearing age in Shiyan area is influenced by age and is geographically specific and associated with plasma Hcy level. Nearly 50% of women have carried the high risk alleles, for whom folic acid supplementation is crucial for the reduction of birth defect rate.

Correlation of Serum CCL3/MIP-1α Levels with Disease Severity in Postmenopausal Osteoporotic Females

Background:The pro-inflammatory protein chemokine cytokine ligand 3 is well established as a vital regulator of bone resorption and osteoclast stimulation.Aims:To investigate if serum cytokine ligand 3 levels correlated with disease severity in postmenopausal osteoporotic women.Study Design:Cross-sectional study.Methods:Eighty-two postmenopausal osteoporotic women, 76 postmenopausal non-osteoporotic women, and 80 healthy women of childbearing age were recruited. The total hip, femoral neck, and L1-L4 spine bone mineral density were assessed by dual-energy X-ray absorptiometry. Serum cytokine ligand 3 concentrations were examined using a commercial enzyme-linked immunosorbent assay kit. Serum inflammatory cytokine interleukin-6, tumor necrosis factor-alpha, and the bone metabolic markers, carboxy-terminal crosslinked and tartrate-resistant acid phosphatase 5b were also examined. Scores on both the visual analogue scale and the Oswestry Disability Index were utilized to assess clinical severity.Results:Patients in the postmenopausal osteoporotic group had significantly increased serum cytokine ligand 3 levels compared with those in both the postmenopausal non-osteoporotic group (40.9±15.1 pg/mL vs 24.2±8.7 pg/mL, p<0.001) and control group (40.9±15.1 pg/mL vs 23.9±9.1 pg/mL, p<0.001). Serum cytokine ligand 3 levels negatively correlated with bone mineral density at the total hip (r=-0.345, p=0.002), femoral neck (r=-0.329, p=0.003), and L1-L4 lumbar spine (r=-0.354, p=0.001) and positively correlated with visual analogue scale scores (r=0.413, p<0.001) and the Oswestry Disability Index (r=0.360, p<0.001). Moreover, serum cytokine ligand 3 levels were correlated with increased tumor necrosis factor-alpha (r=0.305, p=0.005), interleukin-6 (r=0.288, p=0.008), terminal crosslinked and tartrate-resistant acid phosphatase 5b (r=0.371, p<0.001), and carboxy-terminal crosslinked (r=0.317, p=0.004) levels. All correlations were still significant after adjusting for both body mass index and age.Conclusion:Chemokine cytokine ligand 3 may be a useful biomarker that can be used to predict disease severity of postmenopausal osteoporosis. Therapies targeting cytokine ligand 3 and its related signaling pathways to inhibit and delay the osteoclastogenesis process deserve further investigation.

Efficacy and safety of low-dose levonorgestrel-releasing intrauterine system in Chinese women: a multicenter, single-arm, open labeled interventional trial

Objective: To evaluate the efficacy, bleeding profile and safety of low-dose levonorgestrel-releasing intrauterine system (LNG-IUS 8) in Chinese healthy women of childbearing age. Methods: A multi-center, open-label, single-arm clinical trial conducted at 16 centres in China enrolled 773 healthy women of childbearing age (mean age 31.6 years old, range 18 to 40 years old) , who demanded contraception, from April 2006 to June 2013. All women placed LNG-IUS 8 for 3 years and then been followed up at 3, 6, 9, 12, 18, 24, 30, 36 months. The efficacy variables including pregnancy rate and expulsion rate were analyzed using life table, while observing adverse events (AE) to evaluate the safety. The bleeding profile happened during the study was assessed using 90-day reference intervals (World Health Organization criteria) . Results: Eight pregnancies occurred among 773 women, resulting in a overall Pearl index of 0.42 per 100 women years. The 3-year cumulative pregnancy rate was 0.37 per 100 women years and the 3-year cumulative expulsion rate was 1.99 per 100 women years. The number of women with bleeding/spotting reduced and the bleeding/spotting days declined over time. Totally 219 AE were reported related to LNG-IUS 8 placements. The most common AE were vaginal bleeding (8.2%, 63/773) and the ovarian cyst (6.2%, 52/773) . LNG-IUS 8 had an improving effect on dysmenorrhea that the percentage of women with dysmenorrhea as well as the days of dysmenorrhea decreased over time. The percentage of women satisfied or very satisfied with LNG-IUS 8 was 87.2% (622/713) . Conclusion: LNG-IUS 8 is highly effective and safe for Chinese healthy women of childbearing age.

Expression of MMIF, HIF-1α and VEGF in Serum and Endometrial Tissues of Patients with Endometriosis.

The aim of this study was to investigate the expression of macrophage migration inhibitory factor (MMIF), hypoxia-inducible factor-1 a (HIF-1α) and vascular endothelial growth factor (VEGF) in the serum and endometrial tissues of patients with endometriosis (EM) and the clinical significance. Eighty EM patients [American Reproductive Association stage I (n=20), stage II (n=22), stage III (n=21) and stage IV (n=17)] were enrolled and divided into mild (10-14 points, n=28), moderate (16-24 points, n=27) and severe (26-30 points, n=25) dysmenorrhea groups. The control group included 40 healthy women of childbearing age who underwent routine healthcare examinations in the enrolment period. The expression of MMIF, HIF-1α and VEGF in the serum and endometrial tissues was measured by enzyme-linked immunosorbent assay and Western blotting, respectively. Meanwhile, the sensitivity and specificity of serum MMIF, HIF-1α, and VEGF when separately used as single indexes or jointly used as one index were examined as well. The results showed that serum concentrations of MMIF, HIF-1α, and VEGF were significantly higher in EM patients than in controls (P<0.05). The expression of all three proteins in both serum and endometrial tissues increased significantly with the R-AFS stage (P<0.05) and with dysmenorrheal severity (P<0.05). The sensitivity and specificity of the combined detection of serum MMIF, HIF-1α, and VEGF levels were significantly higher than those of single index detection (P<0.05). In conclusion, the expression of MMIF, HIF-1α, and VEGF in the serum and endometrial tissues may be used to assess the stage of EM and the severity of dysmenorrhea. Combined evaluation of MMIF, HIF-1α, and VEGF significantly improves the diagnostic sensitivity and specificity.

Seroprevalence, Type-Specific of Herpes Simplex Virus and Associated Risk Factors among Women of Child Bearing Age in Kogi State, Nigeria

Background: Viruses of the Herpes viridae family infect 90% of the Earth’s population. Humans are the hosts of at least nine unique herpes viruses. Aim: This study is aimed at evaluating the seroprevalence of type specific herpes simplex virus infection and the associated risk factors in a cross-section of asymptomatic healthy women of childbearing age in Kogi state, Nigeria. Methodology: A total of 330 females of child bearing age (15 - 49 years) participated in this study. They were recruited from various local government areas of three Senatorial districts of Kogi state. Blood samples were collected from participants and analyzed for HSV-1 and HSV-2 antibodies (IgG) quantitatively with ELISA kit. Results: The overall prevalence of HSV was 76.7%. Data further show that majority (96.4%) of the population studied had HSV-1, while 77% had HSV-2 infections. Results also showed that the young adults indicated prevalence of 95.7% for HSV-1 and 74.7% for HSV-2, while in the middle aged, the prevalence were 98.6% for HSV-1, and 84.9% for HSV-2. 99.2% of the married women were positive for HSV-1, while 86.9% were positive for HSV-2. 94.5% of the unmarried women were positive for HSV-1, while 70.5% were positive for HSV-2. The risk of HVS-1 or VS-2 infections was not associated with age, age of first sexual exposure and number sex partners before marriage. Married women were at greater risk for HSV-1 (p = 0.03) and HSV-2 (p ≤ 0.001) infections compared to the unmarried women. Conclusion: The prevalence of the HSV-1 and HSV-2 infections was high among asymptomatic healthy women of childbearing age in Kogi state, Nigeria. Efforts should be made to increase the awareness of HSV infection among the child bearing populace.

A Phase 2 randomized, observer-blind, placebo-controlled, dose-ranging trial of aluminum-adjuvanted respiratory syncytial virus F particle vaccine formulations in healthy women of childbearing age

ObjectiveRespiratory syncytial virus (RSV) causes significant morbidity and mortality in infants. We are developing an RSV fusion (F) protein nanoparticle vaccine for immunization of third trimester pregnant women to passively protect infants through transfer of RSV-specific maternal antibodies. The present trial was performed to assess the immunogenicity and safety of several formulations of RSV F vaccine in 1-dose or 2-dose schedules. MethodsPlacebo, or vaccine with 60μg or 120μg RSV F protein and 0.2, 0.4, or 0.8mg aluminum, were administered intramuscularly on Days 0 and 28 to healthy women 18–35years old. Immunogenicity was assessed from Days 0 through 91 based on anti-F IgG and palivizumab-competitive antibody (PCA) by ELISA, and RSV A and B neutralizing antibodies by microneutralization (MN) assay. Solicited adverse events were collected through Day 7 and unsolicited adverse events through Day 91. ResultsAll formulations were well-tolerated, with no treatment-related serious adverse events. Anti-F IgG and PCA responses were correlated and increased after both doses, while MN increased significantly only after the first dose, then plateaued. The timeliest and most robust antibody responses followed one dose of 120μg RSV F protein and 0.4mg aluminum, but persistence through 91days was modestly (∼25%) superior following two doses of 60μg RSV F protein and 0.8mg aluminum. Western blot analysis showed RSV infections in active vaccinees were reduced by 52% overall (p=0.009 overall) over the Day 0 through 90 period. ConclusionsRSV F nanoparticle vaccine formulations were well tolerated and immunogenic. The optimal combination of convenience and rapid response for immunization in the third trimester occurred with 120μg RSV F and 0.4mg aluminum, which achieved peak immune responses in 14days and sufficient persistence through 91days to allow for passive transfer of IgG antibodies to the fetus. NCT01960686.

Serum CX3CL1/fractalkine concentrations are positively associated with disease severity in postmenopausal osteoporotic patients

Background: The chemokine (C-X3-C motif) ligand 1 (CX3CL1), also called fractalkine (FKN), has recently been reported to be involved in osteoclastogenic process and pathological bone destruction.Objective: This study aimed to investigate the link between serum CX3CL1/FKN levels with disease progression of postmenopausal osteoporotic patients.Methods: A total of 53 women with postmenopausal osteoporosis (PMOP group), 51 postmenopausal non-osteoporotic female patients (PMNOP group) and 50 premenopausal non-osteoporotic healthy women of childbearing age (control group) were enrolled in the study. The bone mineral density (BMD) for all subjects was determined via dual-energy X-ray absorptiometry of the lumbar spine, femoral neck, internal trochanter, total hip, greater trochanter and Ward’s triangle. The levels of FKN in the serum were examined using the enzyme-linked immunosorbent assay method. The serum bone resorption markers TRACP-5b, NTX levels, inflammation markers IL-1β and IL-6 as well as oestrogen-2(E2) were also detected in all participants. The visual analogue scores (VAS) and Oswestry Disability Index (ODI) for low back pain were recorded in PMOP females for evaluation of osteoporotic pain and function.Results: FKN levels were significantly higher in postmenopausal osteoporotic patients compared with postmenopausal non-osteoporotic females (139.8 ± 44.3 pg/mL VS 116.5 ± 23.1 pg/mL, p < 0.05) and healthy controls (139.8 ± 44.3 pg/mL VS 109.7 ± 19.4 pg/mL, p < 0.05). Serum FKN concentrations were negatively associated with BMD at femoral neck (r = −0.394, p = 0.004), total hip(r = −0.374, p = 0.006), internal trochanter(r = −0.340, p = 0.013), greater trochanter(r = −0.376, p = 0.006), Ward’s triangle(r = −0.343, p = 0.012), L1–L4 lumbar spine(r = −0.339, p = 0.013) and positively associated with VAS (r = 0.321, p = 0.019) and ODI (r = 0.377, p = 0.005) scores, bone turnover makers (TRACP-5b:r = 0.341, p = 0.012; NTX:r = 0.364, p = 0.007)as well as inflammation markers (IL-1β: r = 0.396, p = 0.003; IL-6:r = 0.355, p = 0.009) in postmenopausal osteoporotic patients.Conclusions: Serum FKN may serve as a novel biomarker for assessing disease progression and a new potential therapeutic target for anti-resorptive treatment in osteoporosis patients.

Longitudinal analysis of vaginal microbiota in women with recurrent vulvovaginal candidiasis

To investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC). Vaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age. The dynamic changes, microbiota composition, alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs. Lactobacillus was the predominant species in healthy women with similar proportions of L.iners and L.crispatus; small proportions of Gardnerella, Prevotella and other genus were also detected. In some healthy women, the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella, Prevotella, Atopobium, Sneathia. Compared with the healthy women, patients with RVVC showed a significantly reduced diversity of vaginal flora, where L.iners was the predominant species and the content of L.crispatus decreased significantly. In healthy women, the vaginal flora fluctuated with the menstrual cycle, and the fluctuation was the most prominent during menstruation; the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle. The vaginal flora showed attenuated fluctuation in women with RVVC, were highly conserved within the menstrual cycle, and maintained a similar composition in the episodes and intermittent periods. The vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods. Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.

Elevated CCL2/MCP-1 Levels are Related to Disease Severity in Postmenopausal Osteoporotic Patients.

Chemokine (C-C) ligand-2 (CCL2), also named monocyte chemoattractant protein 1 (MCP-1), is an important chemotactic factor involved in a wide range of diseases. Recent studies have shown that CCL2/MCP-1 plays crucial roles in the osteoclastogenic process. The current study was performed to measure serum CCL2 levels in postmenopausal osteoporotic patients and investigate the relationship between CCL2 concentrations in serum and disease severity in postmenopausal osteoporotic patients. A total of 62 postmenopausal osteoporotic female patients (PMOP group), 68 postmenopausal non-osteoporotic female patients (PMNOP group), and 65 healthy women of childbearing age (Control group) were enrolled in the study. The calcaneal quantitative ultrasound was utilized to conduct bone mineral density (BMD) measurements, confirmed at the left femoral neck, greater trochanter, total hip, and L1 - L4 lumbar spine by dual energy X-ray absorptiometry (DXA). Serum CCL2, TNF-α as well as IL-6 levels were measured with enzyme-linked immunosorbent assay. Estrogen-2 (E2) was measured with radioimmunoassay. The Visual Analogue Scores (VAS) was utilized to assess the extent of pain in PMOP. We demonstrated for the first time that CCL2 levels were increased in postmenopausal women compared with controls. We also found that elevated CCL2 levels were linked with decreased BMD and attenuated E2 concentrations. In addition, CCL2 levels were positively correlated with inflammation markers TNF-α, IL-6, and VAS scores. CCL2 in serum serves as a potential biomarker for reflecting disease severity in postmenopausal osteoporotic patients. Therapeutic interventions that target CCL2 and its related signaling pathways in order to delay osteoporosis development deserve further study.

Analysis of serum lipids levels and the establishment of reference intervals for serum lipids in middle and late pregnancy

To explore the serum lipids levels in healthy pregnant women, and to establish the reference intervals of serum lipids in middle and late pregnancy. Triglyceride (TG), total cholesterol (TCH), high density lipoprotein (HDL), low density lipoprotein (LDL), apo-lipoprotein-A(APO-A) and apo-lipoprotein-B (APO-B) were measured in 3 200 pregnant women and 3 200 healthy women of childbearing age(the control group) from January 2014 to Febuary 2015 in Obstetrics and Gynecology Hospital of Fudan University. In the healthy pregnant women, serum lipids were measured at 14-20, 24-28 and 37-40 gestational weeks, respectively. All the parameters were detected by Hitachi 7180 automatic biochemical analyzer. The test results were calculated and determined by the C28-A3 standard of the National Clinical and Laboratory Standards Institute. And the normal reference intervals of serum lipids in middle and late pregnancy were defined as 2.5%-97.5%. (1) The levels of TG, TCH, HDL, LDL, APO-A and APO-B in the control group were 0.8, 4.2, 1.0, 2.7 mmol/L and 1.1, 0.8 g/L, respectively. The levels of TG, TCH, HDL, LDL, APO-A and APO-B in middle and late pregnancy were significantly higher than those in the control group (P<0.05). (2) The serum lipids levels at 14-20, 24-28 and 37-40 gestational weeks in healthy pregnant women were compared with the control group as following. The TG levels were 1.9, 3.8 and 4.4 folds of the control group; the TCH levels were 1.1, 1.5 and 1.5 folds of the control group; the HDL levels were 1.2, 1.6 and 1.5 folds of the control group; the LDL levels were 1.1, 1.4 and 1.4 folds of the control group; the APO-A levels were 1.3, 1.4 and 1.5 folds of the control group; and the APO-B levels were 1.1, 1.5 and 1.5 fold of the control group respectively. The TG level was the most increased, and it increased gradually with gestational age (P<0.01). (3) The median of LDL to HDL cholesterol ratio in the healthy pregnancy group at 14-20, 24-28 and 37-40 gestational weeks were 2.7, 2.5, 2.6, respectively, which were significantly lower than that of the control group (2.8; P<0.05). (4) Reference intervals of serum lipids at 14-20, 24-28 and 37-40 gestational weeks in healthy pregnant women were as following. The TG levels were 0.7-3.9, 1.7-6.3 and 1.6-8.1 mmol/L, respectively; the TCH were 3.3-6.9, 4.3-8.3, 4.3-8.7 mmol/L, respectively; the HDL were 0.8-1.8, 1.0-2.1 and 1.0-2.1 mmol/L, respectively; the LDL were 2.1-4.5, 2.7-5.1 and 2.6-5.2 mmol/L, respectively; the APO-A were 1.1-1.8, 1.2-1.9 and 1.1-2.4 g/L, respectively; and the APO-B were 0.6-1.4, 0.9-1.8 and 0.8-2.1 g/L, respectively. The LDL/HDL ratios were 2.3-3.1, 2.2-2.9 and 2.1-3.0, respectively. Serum lipids increased physiologically with gestational age in middle and late pregnancy. The establishment of reference intervals for serum lipids in pregnancy will help to distinguish abnormal serum lipid levels in middle and late pregnancy.

High prevalence of vitamin D deficiency among women of child-bearing age in Lahore Pakistan, associating with lack of sun exposure and illiteracy.

BackgroundVitamin D status is a key determinant of maternal and neonatal health. Deficiency has been reported to be common in Pakistani women, but information regarding environmental and genetic determinants of vitamin D status is lacking in this population.MethodsWe conducted a cross-sectional study among three groups of healthy women living in Lahore, Pakistan: university students, students or employees of Medrasas or Islamic Institutes, and employees working in office, hospital or domestic settings. Multivariate analysis was performed to identify environmental and genetic determinants of vitamin D status: polymorphisms in genes encoding the vitamin D receptor, vitamin D 25-hydroxylase enzyme CYP2R1 and vitamin D binding protein [DBP] were investigated. We also conducted analyses to identify determinants of body ache and bone pain in this population, and to determine the sensitivity and specificity of testing for hypocalcaemia and raised serum alkaline phosphatase to screen for vitamin D deficiency.ResultsOf 215 participants, 156 (73 %) were vitamin D deficient (serum 25[OH]D <50 nmol/L). Risk of vitamin D deficiency was independently associated with illiteracy (adjusted OR 4.0, 95 % CI 1.03–15.52, P = 0.04), <30 min sun exposure per day (adjusted OR 2.13, 95 % CI 1.08–4.19, P = 0.02), sampling in January to March (adjusted OR 2.38, 95 % CI 1.20–4.70), P = 0.01) and lack of regular intake of multivitamins (adjusted OR 2.61, 95 % CI 1.32–5.16, p = 0.005). Participants with the GG genotype of the rs4588 polymorphism in the gene encoding vitamin D binding protein tended to have lower 25(OH)D concentrations than those with GT/TT genotypes (95 % CI for difference 22.7 to −0.13 nmol/L, P = 0.053). Vitamin D deficiency was independently associated with increased risk of body ache or bone pain (adjusted OR 4.43, 95 % CI 2.07 to 9.49, P = 0.001). Hypocalcaemia (serum calcium concentration ≤9.5 mg/dL) and raised alkaline phosphatase concentration (≥280 IU/L) had low sensitivity and very low specificity for identification of vitamin D deficiency.ConclusionVitamin D deficiency is common among healthy women of child-bearing age in Lahore, Pakistan: illiteracy, decreased sun exposure and lack of multivitamin intake are risk factors.

Comparing arginine flux, catabolism and availability for NO synthesis in American, Indian, and Jamaican women

We have reported that Indian women do not have increased Arg production during pregnancy like their American or Jamaican counterparts. There has not been a direct comparison of Arg flux, catabolism, and availability for NO synthesis in non‐pregnant American, Indian, and Jamaican women. The objective of this study was to determine whether Indian women are producing less Arg and/or catabolizing more Arg to Orn and therefore have less Arg available for anabolic pathways than their Jamaican and American counterparts. Ten healthy women of childbearing age from each country were given 6h primed, constant intravenous infusions of 15N2‐Arg, 2H2‐Cit, 15N2‐Orn, and 2H5‐Phe in both the fasted and fed states to measure Arg flux, hydrolysis, bioavailability, NO synthesis and Phe flux, an index of protein breakdown. USA India Jamaica P Value μmol/kg FFM/h μmol/kg FFM/h μmol/kg FFM/h Fasted Arg flux 56.1 ± 2.1a 54.2 ± 3.1a 66.1 ± 3.1 b 0.01 Arg hydrolysis 17.6 ± 1.5 a 23.7 ± 1.5 b 23.4 ± 1.6 b 0.01 Arg bioavailability 49.9 ± 1.3 ab 42.0 ± 2.6 a 55.5 ± 3.5 b 0.004 NO Synthesis 0.18 ± 0.01a 0.15 ± 0.01 b 0.21 ± 0.02 a 0.002 Phe flux 39.7 ± 0.9 39.0 ± 2.2 43.8 ± 2.3 0.17 Fed Arg flux 79.1 ± 3.3 a 80.3 ± 4.9 a 95.9 ± 2.9 b 0.008 Arg hydrolysis 27.3 ± 2.5 a 39.6 ± 3.7 b 37.2 ± 2.0 b 0.01 Arg bioavailability 51.8 ± 1.2 a 40.7 ± 3.5 b 57.5 ± 3.2 a &amp;lt;0.001 NO Synthesis 0.20 ± 0.01a 0.21 ± 0.03a 0.34 ± 0.04 b &amp;lt; 0.0001 Phe flux 58.8 ± 1.6 59.4 ± 3.0 63.3 ± 2.7 0.39 Means with different superscript letters are significantly different, P &lt; 0.05 (post‐hoc Tukey's multiple comparison test).In conclusion, Indian women had increased Arg hydrolysis without a compensatory increase in Arg flux resulting in decreased bioavailability of Arg for the synthesis of proteins and other Arg‐derived biomolecules, including NO synthesis. Though American women also had slower Arg flux compared to Jamaican women, they were able to conserve Arg bioavailability because of decreased Arg hydrolysis. The results suggest that Indian women may need a higher dietary Arg intake.Supported by the Bill and Melinda Gates Foundation

Quantitative analysis of ovarian artery blood flow volume during whole pulsation cycle in patients with polycystic ovary syndrome

Objective To quantitatively analyze the changes of ovarian artery blood flow volume during whole pulsation cycle in patients with polycystic ovary syndrome(PCOS)by pulsed Doppler.Methods The ovarian arteries of 80PCOS patients were examined by transvaginal color Doppler flow image(TV-CDFI).After examination of the parameters of pulsed Doppler,the ovarian artery blood flow volume in whole pulsation cycle was calculated with velocity-time integral while considering the internal diameter of the blood vessels.The results were compared with those of 80 healthy women of childbearing age in the control group.Results The typical spectrum of ovarian artery blood flow in PCOS patients was highspeed low-resistance waveform.The changes of blood flow volume and resistance index(RI)value were not significantly different at different times of the menstrual cycle(P0.05).However,the changes of blood flow volume and RI value in the control group were significanly different at different times of the menstrual cycle(P0.05).The blood flow volume of PCOS patients was significantly increased compared with those of the control group at different times of menstrual cycle(P0.05). The RI value of ovarian artery in PCOS patients was significantly lower than those in the control group during menstrual cycle 3-9days and 26-32days(P0.05),but showing no significant difference during menstrual cycle 11-15days and 18-23 days(P0.05).Conclusion Quantitative determination of ovarian blood flow volume using blood flow whole pulsation period method can provide a relatively accurate and reliable quantitative assessment of the ovarian perfusion in PCOS patients.

High negativity of IgG antibodies against human papillomavirus type 6, 11, 16 and 18 virus-like particles in healthy women of childbearing age

Objective: Few studies on human papillomavirus (HPV) seroprevalence have focused on low-resource areas where highest HPV DNA prevalence in the world occurs. This study aimed to assess the level of susceptibility to the most common low- and high-risk HPVs of sexually active women of childbearing age attending Wesley Guild Hospital, Ilesa, Osun State, Nigeria. Methods: A total of 91 such women (range 16-40, mean age 29.35 years) were consecutively recruited, after they had given consents to participate in the study. With interviewer-administered questionnaire, we collected pertinent demographic/behavioral data, and about 5 ml blood samples (aseptically) from each woman. Serum of each sample was assayed for HPV-6, -11, -16 and -18 virus-like particles using a HPV IgG ELISA kit. The results obtained were statistically analyzed using binary logistic regression. Results: We observed a high overall anti-HPV seronegativity of 93.4% among the women. Group-specific seronegativity was also high ranging from 86-100%. Though the mean age of the 3 age-groups (16-18, 19-30 and 31-40 years) significantly differed, none of their variables showed statistical association with the seronegativity. Conclusions: With our observations of low evidence (6.6% seropositivity) of natural exposure of the women to the studied HPVs and their low level of enlightenment regarding HPV infection and its attendant consequences, we recommend a statewide enlightenment campaign and adequate vaccination with quadrivalent HPV vaccine of sexually active females.

Tear secretion and tear stability of women on hormonal contraceptives

PurposeTo investigate the effects of injectable hormonal contraceptives on tear secretion and tear stability of females within child bearing age in Nigeria. MethodsThe experimental group consisted of 32 healthy females (mean age was 34.72±5.44) on injectable hormonal contraceptives; and the control group comprised 32 females (mean age was 34.66±5.24) who were not on hormonal contraceptives. The tear stability and tear secretion were measured using the non-invasive tear break up time (NITBUT) technique and Schirmer's strips, respectively. All the females were at follicular phase of menstrual cycle. The plasma levels of progesterone and estradiol of all subjects were determined. ResultsThere were no remarkable effects of injectable hormonal contraceptives on tear secretion (P=0.929) and tear stability (P=0.814). There were weak correlations between the plasma levels of progesterone and tear secretion (r=−0.232, P>0.05), as well as with tear stability (r=−0.322, P>0.05). Also, there were weak positive correlation between plasma levels of estradiol and tear secretion (r=0.304, P>0.05), as well as with tear stability (r=0.262, P>0.05). There were no significant differences in tear stability between the experimental and control groups (P>0.05). ConclusionsInjectable hormonal contraceptives had no significant effects on tear secretion and tear stability of healthy women of childbearing age. Further studies may be required to determine the effects of hormonal contraceptives on tear volume and stability of women with dry eyes.

Methotrexate-Induced Pseudotumor Cerebri and Psychosis in a Case of Rheumatoid Arthritis

Back to table of contents Previous article Next article LettersFull AccessMethotrexate-Induced Pseudotumor Cerebri and Psychosis in a Case of Rheumatoid ArthritisShravani Sur, M.B.B.S., DPM, D.N.B., and Amit Chauhan, M.B.B.S., M.SShravani SurSenior ResidentDept. of PsychiatryInstitute of Mental Health & HospitalMathura Road, BilochpuraAgra-282002IndiaSearch for more papers by this author, M.B.B.S., DPM, D.N.B., and Amit ChauhanSenior ResidentBone and Joint InstituteMedanta- The MedicityGurgaon, HaryanaIndiaSearch for more papers by this author, M.B.B.S., M.SPublished Online:1 Oct 2012https://doi.org/10.1176/appi.neuropsych.11100237AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: The syndrome of increased intracranial pressure without hydrocephalus, or mass lesion with normal cerebral spinal fluid (CSF) composition, previously known as pseudotumor cerebri, is now termed idiopathic intracranial hypertension (IIH).1 Typically, it occurs in obese but otherwise healthy women of childbearing age. We describe a case of IIH in a young man suffering from rheumatoid arthritis presenting with psychiatric symptoms.Case ReportA 30-year-old male patient was diagnosed with early-onset, seronegative rheumatoid arthritis and started on subcutaneous methotrexate (7.5 mg) once weekly, along with folic acid supplement (5 mg weekly). After 8 months of regular therapy, he began complaining of recurrent headaches, vomiting, and blurring of vision. CT scan and MRI revealed normal study. Fundoscopy revealed bilateral papilledema, and lumbar puncture showed increased CSF pressure. He was diagnosed as having pseudotumor cerebri, or IIH. Methotrexate was suspected to be causing the IIH and was thus discontinued. However, recurrent projectile vomiting and headache continued for about 15 days. About 1 month later, there was abrupt onset of frightening auditory and visual hallucinations along with irrelevant speech and disturbed sleep. Patient was referred to the psychiatry department on the 3rd day after onset of psychosis. He was conscious, oriented to place and person, but not to time, sitting with a vacant look on his face, and speaking irrelevantly at times. There were no perceptual abnormalities at time of presentation. The vomiting and headache symptoms had become less frequent, but had not resolved. Family history revealed schizophrenia in his father. Patient was treated with low-dose antipsychotic (olanzapine 5 mg/day in two divided doses) and sedatives. Acetazolamide was given at a dosage of 250 mg/day for 14 days. After 2 weeks, he showed complete resolution of psychotic symptoms as well as symptoms due to increased intracranial pressure.DiscussionCorticosteroids used for treatment of rheumatoid arthritis are well known to cause IIH and psychosis after prolonged use. However, methotrexate is not commonly implicated. In the above patient, the contingency of the symptoms with methotrexate use and improvement on withdrawal of the drug and treatment of IIH implicate a direct causal relationship. A family history of schizophrenia in the above patient may have increased the risk of precipitating psychosis.One study on women with IIH showed higher rates of depression and anxiety.2 Only one report describes psychosis in a patient developing pseudotumor cerebri, due to hypervitaminosis A, in which the patient initially had depression alternating with bouts of elation and later developed paranoid ideation. The patient recovered after withdrawal of Vitamin A. Other reports mention lethargy, loss of interest, irritability, and insomnia as some of the psychiatric symptoms of increased intracranial tension.3Senior ResidentDept. of PsychiatryInstitute of Mental Health & HospitalMathura Road, BilochpuraAgra-282002IndiaSenior ResidentBone and Joint InstituteMedanta- The MedicityGurgaon, HaryanaIndiaCorrespondence: Dr. Sur: e-mail: [email protected]comReferences1 Friedman DI, Jacobson DM: Diagnostic criteria for idiopathic intracranial hypertension. Neurology 2002; 59:1492–1495Crossref, Medline, Google Scholar2 Kleinschmidt JJ, Digre KB, Hanover R: Idiopathic intracranial hypertension: relationship to depression, anxiety, and quality of life. Neurology 2000; 54:319–324Crossref, Medline, Google Scholar3 Restak RM: Pseudotumor cerebri, psychosis and hypervitaminosis A. J Nerv Ment Dis 1972; 155:72–75Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByDiagnosis of idiopathic intracranial hypertension - the importance of excluding secondary causes: A systematic review25 November 2021 | Cephalalgia, Vol. 42, No. 6Acta Neurologica Belgica, Vol. 119, No. 1Neurología, Vol. 34, No. 4Neurología (English Edition), Vol. 34, No. 4Journal of Psychopharmacology, Vol. 33, No. 10Pediatric Neurology, Vol. 77Neurological and Neuropsychiatric Adverse Effects of Dermatologic Medications10 November 2016 | CNS Drugs, Vol. 30, No. 12Australasian Journal of Dermatology, Vol. 56, No. 2Methotrexate2 March 2013 | Reactions Weekly, Vol. 1441, No. 1 Volume 24Issue 4 Fall 2012Pages E18-E18 Metrics PDF download History Published online 1 October 2012 Published in print 1 October 2012

Vaginal Impact of the Oral Administration of Total Freeze-Dried Culture of LCR 35 in Healthy Women

The use of probiotics in the prevention or treatment of some vaginal infections has been the subject of numerous studies. To assess the presence of Lactobacillus casei rhamnosus (LCR35) in the vagina after an oral administration, an open randomised pilot study was conducted on 20 healthy women of child-bearing age. Materials and Methods. 2 groups of 10 women were given a 28-day oral course, that is, at least 108 CFU/day (group 1) or 2 × 108 CFU/day (group 2) of LCR35. Nugent score and vaginal screening for LCR35 were undertaken before and after 28 days of treatment. Results. The mean Nugent score decreased in group 1 (−0,2) as well as in group 2 (−0,3). 10% of women in group 1 versus 40% of women in group 2 were carrying LCR35 at the end of the trial. Conclusion. LCR35, at the minimal dose of 2 × 108 CFU/day, can return the Nugent score to normal in healthy women of child-bearing age, by means of a well-tolerated vaginal temporary presence. Phase III clinical trials will specify the preventive or curative impact of this orally administered strain on a range of vaginal disorders such as bacterial vaginosis or vulvovaginal candidiasis.

Asymptomatic bacteriuria in users of low-dose combined oral contraceptives

ABSTRACTObjectives To investigate the association between oral contraceptive use and the prevalence of asymptomatic bacteriuria in women.Methods The study was conducted on healthy women of childbearing age who either used low-dose combined oral contraceptives (COCs; cases) or applied the withdrawal method (controls). A positive urine culture with a colony count of more than 105/ml, with the same bacteria on two consecutive specimens, was defined as asymptomatic bacteriuria. Pyuria was defined as the presence of ≥10 leukocytes per mm3 of urine.Results Overall, 369 women in the COC group and 364 in the control group were evaluated. The mean ages of women in the COC group and of controls were 29.9 ± 5.4 years and 30.4 ± 6.0 years, respectively (p = 0.280). Asymptomatic bacteriuria was detected in 2.4% of COC users and 1.9% of the controls (p = 0.633). Pyuria was found in 16% of the cases and 18.1% of the controls (p = 0.441). None of these differences was statistically significant. There was no significant association between duration of COC usage (< 1 year vs. ≥ 1 year) and asymptomatic bacteriuria.Conclusion Use of low-dose COCs (even long-term) does not increase the risk of asymptomatic bacteriuria.