Profile Of Women Research Articles

The Influence of Treated and Untreated Subclinical Hypothyroidism on Metabolic Profile in Women with Polycystic Ovary Syndrome.

Background Polycystic ovary syndrome (PCOS) and hypothyroidism are the most common endocrinological disorders among women of reproductive age. Since hypothyroidism occurs more frequently in PCOS patients, it is vital to explain its clinical impact. Aim To evaluate the impact of subclinical hypothyroidism (SCH) and its treatment on the metabolic profile of patients with PCOS. Methods 190 women with PCOS phenotype A were enrolled in the case-control study. They were divided into three groups: 38 women with PCOS and subclinical hypothyroidism, 76 women with PCOS and SCH under thyroid replacement therapy, and 76 women with PCOS and normal thyroid function (control group). Serum lipids, fasting glucose, and insulin, as well as oral glucose tolerance tests were performed. Results In the analyzed parameters, there were no statistic differences between the groups in relation to thyroid function. BMI turned out to be the main factor dividing the patients in terms of serum lipids, fasting glucose, fasting insulin, and oral glucose tolerance test. TSH was associated with total cholesterol and LDL cholesterol levels, whereas BMI has a dominant impact on HDL cholesterol, triglycerides, glucose, and insulin resistance. Conclusions SCH is associated with mild lipid serum alterations in women with PCOS, but it is BMI to have a dominant impact on glucose and insulin. It seems that treatment of SCH in PCOS does not significantly alter lipid and glucose metabolism.

Carotid Arterial Stiffness and Cardiometabolic Profiles in Women with Fibromyalgia.

Background: The present study aimed to evaluate the association between FM and cardiometabolic risk factors and carotid arterial stiffness in FM patients. Methods: The cardiometabolic risk profile was defined based on the Adult Treatment Panel III panel. Carotid intimal media thickness (cIMT) and arterial stiffness were assessed using high-resolution ultrasonography. Multivariate logistic analysis was performed to estimate the association between FM and cardiometabolic risk factors. We used a general linear regression to compare the cIMT and carotid beta-index between the participants with and without FM. Pearson’s coefficient was calculated to evaluate the potential correlation between cardiometabolic risk profiles, cIMT, and arterial stiffening in FM. Results: FM participants showed a higher risk of central obesity (odds ratio [OR] = 3.21, 95% confidence interval [CI] 1.49, 6.91), high triglyceride (OR = 4.73, 95% CI 2.29, 9.79), and impaired fasting glucose (IFG) (OR = 4.27, 95% CI 2.07, 8.81) compared to the control group. The FM group exhibited higher beta-index values than the control group (p = 0.003). Although IFG and triglyceride glucose index showed a tendency to correlate with the beta-index, statistical significance was not observed. Conclusions: FM was associated with an increased risk of central obesity, high triglyceride levels, and IFG. Furthermore, advanced arterial stiffness of the carotid artery was observed in FM, which might be correlated with insulin resistance.

A Case-Control Study of Follicular Fluid Cytokine Profiles in Women with Diminished Ovarian Reserve.

Ovarian reserve is an important determinant of a woman's reproductive potential, and women with diminished ovarian reserve (DOR) often seek in vitro fertilization (IVF). The underlying etiology of DOR is unknown, but follicular fluid cytokine concentrations likely play a role in follicular development and maturation. The present study seeks to investigate the expression of cytokines in follicular fluid (FF) of women with DOR undergoing IVF and explore correlated functional pathways. One hundred ninety-four women undergoing ovarian stimulation were recruited at the time of oocyte retrieval. Women were classified as having DOR if they met one or more of the following criteria: AMH < 1ng/ml, FSH > 10mIU/ml, and/or AFC < 10. Controls included women undergoing IVF for male factor, tubal factor due to tubal ligation, or planned oocyte cryopreservation (non-oncologic). The concentrations of 480 cytokines and related growth factors in follicular fluid were determined using a multiplex immunoassay. Fifty-nine cytokines had significantly different concentrations (53 higher and 6 lower) in the DOR relative to the control group after adjusting for age and body mass index (BMI) (false discovery rate; FDR < 0.1). Using the most informative 44 biomarkers as indicated by a random forest (RF) model, an area under the curve (AUC) of 0.78 was obtained. Thus, follicular microenvironment differs between women with DOR and normal ovarian reserve. The differentially expressed cytokines belong to diverse processes that are primarily involved in follicular maturation and ovulation. These changes may play an important role in treatment outcomes in women with DOR.

Surgery for Obesity and Weight-Related Diseases Changes the Inflammatory Profile in Women with Severe Obesity: a Randomized Controlled Clinical Trial.

Obesity increases significantly every year worldwide. Since 1980, the prevalence of individuals with obesity has practically doubled. Obesity plays an important role in the pathophysiology of diseases that arise from a complex interaction of nutritional, genetic, and metabolic factors, characterizing a chronic inflammatory state. This study aimed to verify the systemic inflammatory response through the analysis of IGF-1, IL-23, and resistin levels and the lipid profile in severely obese women undergoing surgery for obesity and weight-related diseases. This randomized controlled clinical trial includes female patients clinically diagnosed with severe obesity with an indication for bariatric surgery. In the initial evaluation, no significant difference was observed between the control (CG) and bariatric surgery (BSG) groups. The weight, BMI, systolic and diastolic blood pressures, total cholesterol, LDL, HDL, total non-HDL cholesterol, and glucose in BSG patients showed a significant change after surgery. Pre- and post-surgery levels of resistin, IGF-1, and IL-23 showed a significant difference in the BSG group, but only IL-23 was changed after 6months in the CG. The results of this study confirmed that weight loss induced by surgery for obesity and weight-related diseases improved the lipid profile and reduced the chronic inflammatory status in women with severe obesity.

Effects of Sodium Selenite Injection on Serum Metabolic Profiles in Women Diagnosed with Breast Cancer-Related Lymphedema-Secondary Analysis of a Randomized Placebo-Controlled Trial Using Global Metabolomics.

In our previous study, intravenous (IV) injection of selenium alleviated breast cancer-related lymphedema (BCRL). This secondary analysis aimed to explore the metabolic effects of selenium on patients with BCRL. Serum samples of the selenium-treated (SE, n = 15) or the placebo-controlled (CTRL, n = 14) groups were analyzed by ultra-high-performance liquid chromatography with Q-Exactive Orbitrap tandem mass spectrometry (UHPLC-Q-Exactive Orbitrap/MS). The SE group showed a lower ratio of extracellular water to segmental water (ECW/SW) in the affected arm to ECW/SW in the unaffected arm (arm ECW/SW ratio) than the CTRL group. Metabolomics analysis showed a valid classification at 2-weeks and 107 differential metabolites were identified. Among them, the levels of corticosterone, LTB4-DMA, and PGE3—which are known anti-inflammatory compounds—were elevated in the SE group. Pathway analysis demonstrated that lipid metabolism (glycerophospholipid metabolism, steroid hormone biosynthesis, or arachidonic acid metabolism), nucleotide metabolism (pyrimidine or purine metabolism), and vitamin metabolism (pantothenate and CoA biosynthesis, vitamin B6 metabolism, ascorbate and aldarate metabolism) were altered in the SE group compared to the CTRL group. In addition, xanthurenic acid levels were negatively associated with whole blood selenium level (WBSe) and positively associated with the arm ECW/SW. In conclusion, selenium IV injection improved the arm ECW/SW ratio and altered the serum metabolic profiles in patients with BCRL, and improved the anti-inflammatory process in lipid, nucleotide and vitamin pathways, which might alleviate the symptoms of BCRL.

Cardiometabolic Profiles in Women with a History of Hypertensive and Normotensive Fetal Growth Restriction.

Background: The majority of evidence on associations between pregnancy complications and future maternal disease focuses on hypertensive (Ht) complications. We hypothesize that impaired cardiometabolic health after pregnancies complicated by severe fetal growth restriction (FGR) is independent of the co-occurrence of hypertension. Materials and Methods: In a prospective cohort of women with a pregnancy complicated by early FGR (delivery <34 weeks gestation), with or without concomitant hypertension, cardiometabolic risk factors were assessed after delivery. A population-based reference cohort was used for comparison, and analyses were adjusted for age, current body mass index (BMI), smoking habits, and hormonal contraceptive use. Results: Median time from delivery to assessment was 4 months in both the Ht (N = 115) and normotensive (Nt) (N = 42) FGR groups. Compared with the reference group (N = 380), in both FGR groups lipid profile and glucose homeostasis at assessment were unfavorable. Women with Ht-FGR had the least favorable cardiometabolic profile, with higher prevalence ratios (PRs) for diastolic blood pressure >85 mmHg (PR 4.0, 95% confidence interval [CI] 2.1-6.7), fasting glucose levels >5.6 mmol/L (PR 2.9, 95% CI 1.4-5.6), and total cholesterol levels >6.21 mmol/L (PR 4.5, 95% CI 1.9-8.8), compared with the reference group. Women with Nt-FGR more often had a BMI >30 kg/m2 (PR 2.5, 95% CI 1.2-4.7) and high-density lipoprotein-cholesterol levels <1.29 mmol/L (PR 2.4, 95% CI 1.4-3.5), compared with the reference group. Conclusions: Women with a history of FGR showed unfavorable short-term cardiometabolic profiles in comparison with a reference group, independent of the co-occurrence of hypertension. Therefore, women with a history of FGR may benefit from cardiovascular risk factor assessment and subsequent risk reduction strategies.

Hereditary Breast and Ovarian Cancer Screening Syndrome Profile in Women Diagnosed with Breast Cancer from Paraná State Southwest.

This study evaluated the risk of the hereditary breast and ovarian cancer (HBOC) syndrome in patients with breast cancer by using the Family History Screening 7 (FHS-7) tool, a validated low-cost questionnaire with high sensitivity able to screen the HBOC risk in the population. Women diagnosed with breast cancer (n = 101) assisted by the Unified Health System at the 8th Regional Health Municipal Office of the state of Paraná answered the FHS-7, and the results were analyzed using IBM SPSS Statistics for Windows, Version 25.0. software (IBM Corp., Armonk, NY, USA). The risk of HBOC was 19.80% (n = 20). Patients at risk exhibited aggressive tumor characteristics, such as high-grade tumors (30%), presence of angiolymphatic emboli (35%), and premenopausal at diagnosis (50%). Significant associations between the prevalence of high-grade tumors were observed in women younger than 50 years at diagnosis with HBOC (p = 0.003). Our findings suggest a possible family inheritance associated with worse clinical features in women with breast cancer in this population, indicating that HBOC investigation can be initially performed with low-cost instruments such as FHS-7.

Women's participation in MOOCs in the IT area

In the paper, we investigated if women's student profile, persistence and grades differ from those of men, using log data from 4.452 students (women = 30%) enrolled in four MOOCs (Massive Open Online Courses) with technological themes from a Brazilian platform. The student profile, which included survey data on intention to finish the MOOC, liking the subject matter, time spent on the course, educational level and age group, indicated no significant difference. Additionally, a cluster analysis identified similar groups for men and women: each gender had a group with “high performance students”, with high grades and persistence, plus groups with low grades and persistence, but with varied compositions regarding age and educational level. Persistence and grade were significantly different in favour of men in the Sentiment Analysis MOOC, and persistence in the Arduino MOOC was also significant, in favour of men. However, considering the four courses, the distribution of persistence and grade is the same for men and women. We consider these positive results, as it points to an equal profile of participation and performance of both genders in courses where women are underrepresented, what might indicate a change in the trend of participation of women in IT courses. However, it is important to highlight that women's enrollment were much lower, and that enrollees of both genders represents a privileged Brazilian sub population - students who have at least a bachelor's degree - what defies the view that MOOCs are a democratizing educational technology.

Multi-Location External Workload Profile in Women's Basketball Players. A Case Study at the Semiprofessional-Level.

The external workload measured in one anatomical location does not determine the total load supported by the human body. Therefore, the purpose of the present study was to characterize the multi-location external workload through PlayerLoadRT of 13 semi-professional women’s basketball players, as well as to analyze differences among anatomical locations (inter-scapulae line, lumbar region, 2× knee, 2× ankle) and laterality (left vs. right) during five tests that represent the most common movements in basketball—(a) linear locomotion, 30-15 IFT; (b) acceleration and deceleration, 16.25-m RSA (c) curvilinear locomotion, 6.75-m arc (d) jump, Abalakov test (e) small-sided game, 10’ 3 vs. 3 10 × 15-m. Statistical analysis was composed of a repeated-measures t-test and eta partial squared effect size. Regarding laterality, differences were found only in curvilinear locomotion, with a higher workload in the outer leg (p < 0.01; ηp2 = 0.33–0.63). In the vertical profile, differences among anatomical locations were found in all tests (p < 0.01; ηp2 = 0.56–0.98). The nearer location to ground contact showed higher values except between the scapulae and lumbar region during jumps (p = 0.83; ηp2 = 0.00). In conclusion, the multi-location assessment of external workload through a previously validated test battery will make it possible to understand the individual effect of external workload in each anatomical location that depends on the type of locomotion. These results should be considered when designing specific strategies for training and injury prevention.

Ethnic Disparities in Cardio-Metabolic and Reproductive Profiles in Women With Polycystic Ovary Syndrome per the New International Guideline: A United-States Based Multi-Center Study

The magnitude and direction to which cardio-metabolic and reproductive aberrations may disproportionately impact diverse populations of women with PCOS are relevant yet unclear. The uncertainty stems, in part, from heterogeneity in PCOS diagnostic criteria used and technical challenges in the reliable assessment of this clinical population. We evaluated whether cardio-metabolic (abdominal adiposity, hypertension, impaired glucoregulatory status) and reproductive (hyperandrogenism, polycystic ovarian morphology [PCOM], menstrual irregularity) outcomes were different in PCOS (n = 120, 18-36 yrs.) across 4 groups: (1) Non-Hispanic White (n = 76); (2) Non-Hispanic Black (n = 14); (3) Non-Hispanic Asian (n = 15); and, (4) Hispanic White (n = 15). Women were prospectively recruited across 3 academic medical centers in New York State and were matched for age and body mass index. PCOS was defined by the Rotterdam criteria using the recommended thresholds of the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS. Concerning abdominal adiposity, the Asian group (mean ± standard deviation; 0.78 ± 0.06) had a lower waist to hip ratio (WHR) compared to the White group (0.85 ± 0.09; P = 0.01). Also, the Asian group had a higher sex hormone binding globulin (SHBG, 65.9 ± 23.4 nmol/L) compared to all other groups (White [40.5 ± 22.3]; Black [43.8 ± 21.9]; Hispanic [36.8 ± 18.8] nmol/L; All: P < 0.04). In contrast, the White group were most hyperandrogenic, evidenced by their higher modified Ferriman-Gallwey (mFG) scores (10 ± 4) compared to other groups (Black [4 ± 0]; Asian [2 ± 0]; Hispanic [4 ± 1]; All: P ≤ 0.001). Consistently, the White group (1.0 ± 0.5 ng/dL) exhibited increased free testosterone (FT) compared to other groups (Black [0.5 ± 0]; Asian [0.4 ± 0]; Hispanic [0.6 ± 0.1] ng/dL; All: P ≤ 0.001), unlike total testosterone (P = 0.12). Regarding PCOM, the White group exhibited higher follicle numbers per ovary (FNPO 2-9 mm, 48 ± 22) compared to other groups (Black [30 ± 16]; Asian [26 ± 5]; Hispanic [22 ± 17]; All: P ≤ 0.05). Unlike Black (12.4 ± 1.3 mm; P = 0.05) and Hispanic (13.5 ± 1.1 mm; P = 0.89) groups, the White group (13.9 ± 2.1 mm) also exhibited larger ovarian volume (OV) compared to Asian group (12.4 ± 1.5 mm; P = 0.03). Women had comparable blood pressure (systolic, diastolic), fasting glucose, homeostatic model assessment of insulin resistance, or intermenstrual interval length (All: P ≥ 0.09). Overall, Asian women in the US likely exhibit the mildest PCOS metabolic (decreased WHR, increased SHBG) phenotype, whereas White women show the most severe reproductive (increased mFG, FT, FNPO, OV) phenotype. If confirmed by larger studies, our observations warrant additional population-specific diagnostic considerations to prevent and manage PCOS cardio-metabolic (e.g., metabolic syndrome risk) and reproductive (e.g., hirsutism, PCOM) complications across ethnicities.

Lifestyle, Anxiety,Depression, and Clinical Profile in Women With Polycystic Ovary Syndrome: Initial Results From the Brazilian PCOS Study

Brazil is a large country with rich cultural and ethnic diversity among its different regions. In this ongoing nationwide collaborative study, we are evaluating modifiable lifestyle factors, metabolic and reproductive abnormalities and prevalence of anxiety/depression in a less-well represented population of women with PCOS from Brazil. The design of the Brazilian PCOS study has been published previously1. Briefly, the study is being conducted in the outpatient clinics of university hospitals within the public health care network (Unified Health System - SUS) across the country. The sample includes women with PCOS diagnosed according to Rotterdam criteria and a control group of healthy women matched by age and geographic region. Collected data are being incorporated into a unified cloud database. Two hundred five participants have been enrolled thus far (17% of an expected sample size of 1,200 women). Age, years of formal education and socioeconomic class were similar among PCOS phenotypes and the control group. The prevalence of PCOS phenotypes in this sample was 64.7% for phenotypes A + B, 25% for phenotype C, and 10.3% for phenotype D. Phenotypes A + B and D had higher prevalence of obesity (BMI>30) (p=0.001) and metabolic syndrome as compared to the other groups (32.4% in A + B and 50% in D vs. 16% in C and 5.9% in controls; p=0.002). Total testosterone levels, determined by mass spectrometry were higher in PCOS A+B than in the other phenotypes, even after adjustment for BMI (p<0.001). Sedentariness (<150 min/week of physical activity) was present in more than 60% of participants in all PCOS phenotypes and in controls, with no difference between the groups. More than 70% of participants in all PCOS phenotypes had a fruit and vegetable intake below 5 portions/day. Anxiety/depression (SRQ-20) was frequent in phenotypes A + B (41.6%) and D (56.3%) vs. phenotype C (23.1%) and controls (28.6%) (p=0.062). These initial results suggest that PCOS participants, besides often presenting metabolic abnormalities have an unhealthy lifestyle and high prevalence of psychological distress. Analysis of the full study sample will be useful to guide specific public strategies for primary and secondary prevention of psychological, metabolic and reproductive comorbidities in the PCOS population of Brazil. 1Spritzer PM, et al. BMJ Open. 2019; 9:e029191.

The Effects of Nordic Walking Compared to Conventional Walking on Aerobic Capacity and Lipid Profile in Women Over 55 Years of Age.

The purpose of this study was to investigate the effects of Nordic Walking compared to conventional walking on aerobic capacity, the lipid profile, left ventricular ejection fraction, body mass, and body mass index in women over 55years old. The study was comprised of 74 women over 55years of age. Participants were randomized to the Nordic Walking (n = 38) or conventional walking (n = 36) training groups. The echocardiogram, treadmill exercise stress test, lipid profile, and body mass were assessed at baseline (pretest) and after 12weeks (posttest). The authors found a significant main effect over time in duration (effect size [ES] = 0.59, P < .0001), distance covered (ES = 0.56, P < .0001), peak oxygen consumption (ES = 0.43, P < .0001), metabolic equivalent (ES = 0.29, P < .0001), peak heart rate (ES = 0.2, P < .0001), peak diastolic blood pressure (ES = 0.11, P = .0045), total cholesterol (ES = 0.26, P < .0001), and low-density lipoprotein cholesterol (ES = 0.16, P = .0005). The authors did not observe a time versus group interaction or the effect between groups. Post hoc tests revealed significant pretraining to posttraining differences in low-density lipoprotein cholesterol after the Nordic Walking training program and in peak diastolic blood pressure after the conventional walking training program. The heart rate, systolic blood pressure, and diastolic blood pressure at rest, peak diastolic blood pressure, somatic parameters (body mass and body mass index), and left ventricular ejection fraction did not change in either group. Both training programs resulted in increases in aerobic capacity and decreases in total cholesterol.

The Effectiveness of Acceptance and Commitment Therapy and Combined with Aerobic Training on Anxiety Symptoms, Insulin Resistance and Lipid Profile in Women with Type 2 Diabetes

Objective: The aim of the present study was to examine the effectiveness of Acceptance and Commitment Therapy (ACT) combined with aerobic exercise (AE) on anxiety symptoms, insulin resistance (IR) and lipid profile in women with T2DMmellitus (T2DM). Materials and Methods: In the present study, 60 T2DM women with a mean age of 33.5 (± 3.52) years were selected from the patients who were referred to the specialized clinic Petroleum Industry in summer 2020. They were randomly divided into four groups of ACT (n=15), AE (n=15), ACT combined with AE (n=15), and the control group (n=15). Intervention programs were performed for 10 weeks, and then indices were collected before and after the intervention using blood tests and Beck Depression Inventory. Results: ACT led to a significant decrease in anxiety and LDL (P-value: 0.001). Moreover, AE significantly reduced the anxiety index and increased HDL (P-value: 0.001). In addition, the effect of ACT and exercise significantly reduced anxiety (P-value: 0.001) and LDL index (P-value: 0.03) and also increased HDL (P-value: 0.03). However, indices of blood glucose, insulin, insulin resistance, total cholesterol, and triglycerides did not indicate any significant changes in the intervention groups as compared with the control group (P-value&lt;0.05). Conclusion: According to the obtained findings, the use of psychological intervention along with AE could lead to a significant change in the symptoms of anxiety and some lipid indices in T2DM women. Also caused a non-significant improvement in glycemic index and can be regarded as a solution for diabetics.

O PERFIL DE LIDERANÇA DA MULHER NEGRA NO PÓS-COLONIALISMO

This paper aims to problematize marginalized minorities, highlighting the black community of the periphery, candomblé, axé, a minority still more invisible by classism, racism, and religious intolerance. This condition started with the extermination of its history by the dominant elite, especially the European, white, and enslaving elite that endures today, causing a lack of knowledge of many people of their origin and their descendants. This writing explores to praise and enhance this community's history, visualizing the black race and culture, taking into consideration, mainly its ancestry, since to speak of people, it is necessary to know its roots, past, and history. Black women's leadership profile was traced back to the colonial period when there was no distinction between black women and black men's work. Many women became leaders precisely because of these conditions. It was a resistance that became a legacy because today we know about these women, protagonists of their stories, and our history.

Evaluation of the Sleep Profile in Women with Severe Obesity

Background: Sleep disturbance has been strongly related to uncontrolled food intake and complications of obesity, such as glycemic control. Objective: To evaluate excessive daytime sleepiness with the glycemic profile of women with severe obesity. Methods: Cross-sectional study with 43 volunteers. The anthropometric assessment consisted of weight, height, waist, hip and neck circumference. The blood was collected for biochemical analysis. The HOMA-IR and HOMA-beta were calculated. The volunteers were grouped according to the presence or absence of sleepiness. The tests were performed in accordance with normality, with p <0.05. The comparison between the group means was performed using the simple Generalized Linear Model (GLM) test. Correlation was performed between neck circumference (CP) and blood glucose, insulin, HOMA-IR and HOMA-beta values. The linear regression was performed for the analyses between the CP and insulin values. Results: The majority of the studied population (74.42%) presented medium or severe sleepiness. The sleepiness group had a higher mean for age (p = 0.022) and a lower mean for weight (p = 0.047). No difference was found between groups in the glycemic profile. However, significant values were observed when correlating CP with insulin values (p = 0.012) and HOMA-IR (p = 0.004) in the group with sleepiness. Linear regression demonstrated that CP is an independent factor for circulating insulin levels (p = 0.012 and R = 0.194). Conclusion: Women with severe obesity have a high prevalence of excessive daytime sleepiness and in this group, CP seems to be a good indirect indicator of the glycemic response.

Injury Profile in Women's Football: A Systematic Review and Meta-Analysis.

Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women. The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football. A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sportdiscus and the Cochrane Library databases. Twenty-two studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model. The overall incidence of injuries in female football players was 6.1 injuries/1000h of exposure. Match injury incidence (19.2 injuries/1000h of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000h of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000h of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000h of exposure) and joint (non-bone) and ligament (1.5 injuries/1000h of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1-3days of time loss) were the most common. The incidence rate of injuries during matches in the top five world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000h of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6-1.7) whereby on average players sustained more than one injury per season. Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. To markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics to make football players more capable of responding to the challenges that they have to deal with during match play. This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152).

Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Women with polycystic ovary syndrome (PCOS) exhibit cardiometabolic (e.g., insulin resistance) and associated reproductive disruptions. Lifestyle modification (e.g., diet) is recommended as the first-line therapy to manage PCOS; however, a favorable dietary regimen remains unclear beyond energy restriction. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize evidence on impacts of dietary glycemic index (GI) or glycemic load (GL) on cardiometabolic and reproductive profiles to update the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Cochrane, Web of Science, and Scopus were searched through 30 October 2019, and confirmed on 25 March 2020, to identify RCTs (≥8 wk) comparing the effects of diets with lower (LGI/LGL) and higher (HGI/HGL) GI/GL on glucoregulatory outcomes, lipid profile, anthropometrics, and androgen status in PCOS. The primary outcome was HOMA-IR. Data were pooled by random-effects models and expressed as weighted mean differences and 95% CIs. The risk of bias was assessed by the Cochrane tool. Ten RCTs (n=403) were eligible. Eight evaluated LGI and 2 LGL diets. LGI diets decreased HOMA-IR (-0.78; -1.20, -0.37; I2=86.6%), fasting insulin (-2.39; -4.78, 0.00 μIU/mL; I2=76.8%), total cholesterol (-11.13; -18.23, -4.04 mg/dL; I2=0.0%), LDL cholesterol (-6.27; -12.01, -0.53 mg/dL; I2=0.0%), triglycerides (-14.85; -28.75, -0.95 mg/dL; I2=31.0%), waist circumference (-2.81; -4.40, -1.23 cm; I2=53.9%), and total testosterone (-0.21; -0.32, -0.09 nmol/L; I2=8.6%) compared with HGI diets (all: P≤0.05) without affecting fasting glucose, HDL cholesterol, weight, or free androgen index (all: P≥0.07). Some results were contradictory and only described narratively for 2 RCTs that evaluated LGL diets, since inclusion in meta-analyses was not possible. LGI diets improved glucoregulatory outcomes (HOMA-IR, insulin), lipid profiles, abdominal adiposity, and androgen status, conceivably supporting their inclusion for dietary management of PCOS. Further RCTs should confirm these observations and address whether LGI diets improve more patient-pressing complications, including ovulatory cyclicity, infertility, and cardiovascular disease risk in this high-risk population. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42020175300.

Cardiometabolic and Thrombotic Risk Profile in Women Undergoing Oocyte Donation for Assisted Reproduction.

Background: The last two decades have seen a growing number of pregnancies in women who needed the donation of oocytes. With oocyte donation pregnancies, studies on obstetric outcomes among these women revealed an increased incidence of pre-eclampsia and pregnancy-induced hypertension. Furthermore, several studies have found a higher incidence of low birth weight, preterm birth, and delivery by cesarean section in oocyte donation rather than in women subjected to assisted reproduction techniques (ART) with autologous oocytes. Numerous studies have also shown a deep connection between cardiovascular and thrombotic risk factors and adverse pregnancy outcomes. In this setting, to strictly assess the preconceptional risk for women who undergo egg donation to achieve pregnancy, the aim of our study is to draw a detailed assessment of the vascular risk profile of patients with gamete donation ART indications through the evaluation of comorbidities and cardiometabolic and thrombophilic markers Materials and Methods: Patients undergoing ART with oocyte or sperm donation or double donation of gametes underwent a careful clinical assessment through a detailed personal and family anamnesis and they were evaluated for cardiometabolic and thrombophilic profile. Clinical and demographic characteristics, comorbidities, and biohumoral parameters were collected. The study was approved by the Regional Ethical Committee(Em 2018-017 CINECA 10189). Results: We evaluated 525 women. Around 73.1% were >40 years and 35% of them were older than 45 years. There was a high prevalence of dyslipidemias (58.1%), smoking habit (24.6%), a body mass index >25 in 28.6% of patients, a high abdominal circumference in 58.1% of cases, a prevalence of acquired thrombophilia in about 7% and hereditary of 19.2%. Around 39.2% of patients had total cholesterol >200 mg/dL, 19.5% had high-density lipoprotein <48 mg/dL and 43.6% had low-density lipoprotein >115 mg/dL, and 6.9% had triglyceride values >150 mg/dL. Conclusions: A careful assessment of the preconceptional status of patients undergoing ART programs with oocyte donation can be highly recommended.

Differences in the Coagulation Profile in Women with Mild and Severe Preeclampsia

Introduction:Different coagulations abnormalities have been referred in women with early oncet preeclampsia (EOP), but there are only few studies comparing those changes regarding to the severity of the disease. Aim:In this study we aimed to investigate the differences between the coagulation profile in women with mild and severe preeclampsia. Methods:This is an observational retrospective case-control study. Plasma samples were collected from 84 women divided into three groups, the healthy pregnant (HP) group (n=35), the mild preeclampsia (MP) group (n=34) and the severe preeclampsia (SP) group (n=15). The study population general characteristics are shown in Table 1. We studied the following biomarkers of hypercoagulability and endothelial cell activation: Tissue factor activity (TFa), Procoagulant phospholipid activity (PPL), Protein S, D-Dimers, Antithrombin, thrombomodulin, TFPI levels. All women were assessed with classic coagulation tests (aPTT and PT) fibrinogen levels and hemogram. Statistical analysis was performed using the PASW Statistics 17.0.2 (SPSS Inc.) for Windows. Results:Women with preeclampsia - mild or severe- showed significant increase of TFPI, TFa and TMa levels as compared to healthy pregnant women. No significant difference of TFPI, TFa was observed between MP and SP groups. In contrast, TMa levels were significantly increased in SP as compared to MP group. The ratio TFa/TFPI was also lower in SP as compared to MP-group. Women in MP or SP group had similarly shorter PPL clotting time as compared to HP group. D-dimer levels were increased in women with preeclampsia as compared to the HP group. D-Dimer levels were significantly higher in SP as compared to MP group. The levels of free PS activity in HP as well as MP and SP groups were lower than normal range in non-pregnant women and the value in MP was significantly lower than that of the HP or SP. Fibrinogen levels were not significantly different in the three studied groups of pregnant women. Prothrombin time was found to be increased in cases as compared to that in the controls. The mean value of prothrombin time in mild preeclampsia was 13.24±0.80 seconds and in severe preeclampsia it was seconds 14.77±0.96 and in pregnant controls 12.23±0.59 seconds (p&amp;lt;0.05 and p&amp;lt;0.001 respectively). The mean prothrombin time was found to increase with increasing severity of disease (p&amp;lt;0.001). The mean activated partial thromboplastin time were increased in mild preeclampsia and was 32.64±1.83 seconds and in severe preeclampsia it was 35.59±1.53 seconds and in pregnant controls 29.53±1.62 seconds (p&amp;lt;0.001). The activated partial thromboplastin time was found to increase with increasing severity of disease (p&amp;lt;0.001). The antithrombin III decreased in severe SP and MP or compared to pregnant controls (76.33±4.32 and 88.06±9.68 versus 95.40±0.36 respectively; p&amp;lt;0.001). This decrease is more pronounced in SP compared to MP (p&amp;lt;0.001). Conclusions:Preeclampsia is associated with endothelial cell activation as documented by the increase of TFa, soluble TM levels and TFPI levels in plasma. Release of soluble thrombomoduline and TFPI rather than TFa by endothelial cells appear to be related with degree of preeclampsia severity. Women with preeclampsia showed marked decrease of PPL clotting time indicating enhanced platelet activation that was independent of the severity of preeclampsia. In contrast, women with severe preeclampsia showed signs of enhanced hypercoagulability documented by the increase of D-dimer levels consumption of natural coagulation inhibitors and particularly of AT. This phenomenon tended to be reflected on the prolongation of PT and aPTT in women with severe preeclampsia. Disclosures No relevant conflicts of interest to declare.

Characteristics of Anxiety Manifestations and Hormonal Profile of Women with Threatened Interruption of Pregnancy, Living in Lugansk Region

The threatened interruption of pregnancy (TIP) is the most common pregnancy complication that occurs in 15-20% of cases of ongoing pregnancy. The aim of the study was to identify the prevalence and severity of anxiety, the hormonal profile of in pregnant women with threatened interruption of pregnancy in the I and II trimesters, living in the Lugansk region in the area of armed conflict in Eastern Ukraine, to improve treatment and prophylactic measures and prevent obstetric and perinatal complications in such women. Material and methods. The study included 67 pregnant women who were hospitalized regarding TIP to the hospitals, located in the Lugansk region (group I). The control group consisted of 30 pregnant women with non-complicated obstetric anamnesis and physiological course of pregnancy with similar gestational period of pregnancy and place of residence (group II). Spielberger State-Trait Anxiety Inventory was used to assess the level of anxiety, quantitative assessment of concentration of estradiol, progesterone, prolactin, cortisol in blood plasma was determined. Results and discussion. Prevalence of anxiety disorders among pregnant women with TIP living in the armed conflict area was in 2.4 times more often than healthy pregnant women and made up 68,60%. They have significantly higher levels of state and trait anxiety; a positive correlation between the level of state anxiety and concentrations of cortisol, prolactin were found. Conclusions. Antenatal study of levels of anxiety, hormonal homeostasis in pregnant women with TIP living in the armed conflict area allowed to individualize the approach to the management of pregnancy and if needed to timely develop rehabilitating activities, that will contribute to a successful outcome of the pregnancy and affect the health of the mother and her offspring.