Chlamydia Detection during the Menstrual Cycle: A Cross-Sectional Study of Women Attending a Sexual Health Service

Background

We investigated the detection of chlamydia at different stages of the menstrual cycle.

Methods

Electronic medical records for women attending Melbourne Sexual Health Centre between March 2011 and 31^st December 2012, who were tested for chlamydia by nucleic acid amplification of high vaginal, cervical, or urinary samples, and who recorded a date of last normal menstrual period (LNMP) between 0–28 days were included in the analysis. Logistic regression was used to calculate adjusted odds ratio (aOR) and 95% confidence intervals (CI) for the association of chlamydia with menstrual cycle adjusted by demographics and behavioural variables. Chlamydia and beta globin load were determined on those with stored samples.

Results

Of the 10,017 consultations that included a test for chlamydia and a valid LNMP, there were 417 in which chlamydia was detected. The proportion of samples with chlamydia was greater in the luteal phase (4.8%, 184/3831) than in the follicular phase (3.4%, 233/6816) both in the crude (OR 1.29 95%CI 1.1–1.6, p = 0.01) and adjusted odds ratio (aOR) 1.4 (95%CI 1.1–1.8, p = 0.004). Among women using hormonal contraception, there was no significant association with the luteal phase of the menstrual cycle (aOR 1.3, 95%CI 0.9, 1.8, p = 0.18). Among women not using hormonal contraception, there was a significant association with the luteal phase (aOR 1.6, (95% CI 1.1–2.3, p = 0.007). The chlamydia load was not significantly different in the 329 positive stored samples in weeks 3 and 4 vs weeks 1 and 2 for any site (P>0.12).

Conclusions

The higher detection of chlamydia detection in the luteal phase of the menstrual cycle in only those not taking hormonal contraception suggest that hormonal factors influence chlamydia detection. The absence of a significantly highly chlamydia load in women during the luteal phase raises questions about the mechanism.     

Copeptin Levels Remain Unchanged during the Menstrual Cycle

Background

Copeptin, a surrogate marker for arginin vasopressin production, is evaluated as an osmo-dependent stress and inflammatory biomarker in different diseases. We investigated copeptin during the menstrual cycle and its relationship to sex hormones, markers of subclinical inflammation and estimates of body fluid.

Methods

In 15 healthy women with regular menstrual cycles, blood was drawn on fifteen defined days of their menstrual cycle and was assayed for copeptin, progesterone, estradiol, luteinizing hormone, high-sensitive C-reactive protein, tumor necrosis factor-alpha and procalcitonin. Symptoms of fluid retention were assessed on each visit, and bio impedance analysis was measured thrice to estimate body fluid changes. Mixed linear model analysis was performed to assess the changes of copeptin across the menstrual cycle and the relationship of sex hormones, markers of subclinical inflammation and estimates of body fluid with copeptin.

Results

Copeptin levels did not significantly change during the menstrual cycle (p = 0.16). Throughout the menstrual cycle, changes in estradiol (p = 0.002) and in the physical premenstrual symptom score (p = 0.01) were positively related to copeptin, but changes in other sex hormones, in markers of subclinical inflammation or in bio impedance analysis-estimated body fluid were not (all p = ns).

Conclusion

Although changes in estradiol and the physical premenstrual symptom score appear to be related to copeptin changes, copeptin does not significantly change during the menstrual cycle.     

A Mathematical Model of the Human Menstrual Cycle

A mathematical model for the hormonal interactions of the human menstrual cycle is presented. The feedback effects of estrogen on the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are considered, including a mechanism describing the midcycle LH peak. Computer simulation with this model yields results which are periodic and in good agreement with physiological data.     

Reference Charts for Fetal Cerebellar Vermis Height: A Prospective Cross-Sectional Study of 10605 Fetuses

Objective

To establish reference charts for fetal cerebellar vermis height in an unselected population.

Methods

A prospective cross-sectional study between September 2009 and December 2014 was carried out at ALTAMEDICA Fetal–Maternal Medical Centre, Rome, Italy. Of 25203 fetal biometric measurements, 12167 (48%) measurements of the cerebellar vermis were available. After excluding 1562 (12.8%) measurements, a total of 10605 (87.2%) fetuses were considered and analyzed once only. Parametric and nonparametric quantile regression models were used for the statistical analysis. In order to evaluate the robustness of the proposed reference charts regarding various distributional assumptions on the ultrasound measurements at hand, we compared the gestational age-specific reference curves we produced through the statistical methods used. Normal mean height based on parametric and nonparametric methods were defined for each week of gestation and the regression equation expressing the height of the cerebellar vermis as a function of gestational age was calculated. Finally the correlation between dimension/gestation was measured.

Results

The mean height of the cerebellar vermis was 12.7mm (SD, 1.6mm; 95% confidence interval, 12.7–12.8mm). The regression equation expressing the height of the CV as a function of the gestational age was: height (mm) = -4.85+0.78 x gestational age. The correlation between dimension/gestation was expressed by the coefficient r = 0.87.

Conclusion

This is the first prospective cross-sectional study on fetal cerebellar vermis biometry with such a large sample size reported in literature. It is a detailed statistical survey and contains new centile-based reference charts for fetal height of cerebellar vermis measurements.     

Mood and the Menstrual Cycle: A Review of Prospective Data Studies

BackgroundThe human menstrual cycle (MC) has historically been the focus of myth and misinformation, leading to ideas that constrain women's activities.ObjectivesWe wished to examine one pervasive idea, that the MC is a cause of negative mood, by studying the scientific literature as a whole. We briefly reviewed the history of the idea of premenstrual syndrome and undertook a systematic review of quality studies.MethodsWe searched PubMed, PsycINFO, and article bibliographies for published studies using non-help–seeking samples with daily mood data collected prospectively for a minimum of 1 complete MC. We critiqued their methodologies and tabulated the key findings.ResultsOf 47 English language studies identified, 18 (38.3%) found no association of mood with any MC phase; 18 found an association of negative mood in the premenstrual phase combined with another MC phase; and only 7 (14.9%) found an association of negative mood and the premenstrual phase. Finally, the remaining 4 studies (8.5%) showed an association between negative mood and a non-premenstrual phase. Considering the only 41 adequately powered studies, the same phase links were reported by 36.6%, 41.5%, and 13.5% of studies, respectively. Their diversity of methods (sampling, instruments, and cycle phase definitions) precluded a meta-analysis.ConclusionsTaken together, these studies failed to provide clear evidence in support of the existence of a specific premenstrual negative mood syndrome in the general population. This puzzlingly widespread belief needs challenging, as it perpetuates negative concepts linking female reproduction with negative emotionality.     

Uterine Artery Suture: A Preventive Approach for Pernicious Placenta Previa

Pernicious placenta previa is an obstetric complication that results in a crisis situation for many patients. Most existing options deal with the problems after delivery leading to unfavorable outcomes. To circumvent this situation, a few preventive simple surgical options have been discussed in this paper. The highlight of the approach is the application of ascending uterine artery suture that drastically reduced the amount of bleeding as compared to that observed in regular surgeries. Combined with the placenta accrete location, wedge resection and ‘patch’ homeostasis of the serous membrane, the surgical modifications adopted effectively reduced the need for hysterectomy thus preserving the fertility of the patients for the future. Since fetuses were safely removed within 1–2 min, the Apgar scores of the neonates were also largely unaffected.     

Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study

To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE) at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale) score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05–2.11, p<0.001). Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery.     

Altered Cytokine Gene Expression in Peripheral Blood Monocytes across the Menstrual Cycle in Primary Dysmenorrhea: A Case-Control Study

Primary dysmenorrhea is one of the most common gynecological complaints in young women, but potential peripheral immunologic features underlying this condition remain undefined. In this paper, we compared 84 common cytokine gene expression profiles of peripheral blood mononuclear cells (PBMCs) from six primary dysmenorrheic young women and three unaffected controls on the seventh day before (secretory phase), and the first (menstrual phase) and the fifth (regenerative phase) days of menstruation, using a real-time PCR array assay combined with pattern recognition and gene function annotation methods. Comparisons between dysmenorrhea and normal control groups identified 11 (nine increased and two decreased), 14 (five increased and nine decreased), and 15 (seven increased and eight decreased) genes with ≥2-fold difference in expression (P<0.05) in the three phases of menstruation, respectively. In the menstrual phase, genes encoding pro-inflammatory cytokines (IL1B, TNF, IL6, and IL8) were up-regulated, and genes encoding TGF-β superfamily members (BMP4, BMP6, GDF5, GDF11, LEFTY2, NODAL, and MSTN) were down-regulated. Functional annotation revealed an excessive inflammatory response and insufficient TGF-β superfamily member signals with anti-inflammatory consequences, which may directly contribute to menstrual pain. In the secretory and regenerative phases, increased expression of pro-inflammatory cytokines and decreased expression of growth factors were also observed. These factors may be involved in the regulation of decidualization, endometrium breakdown and repair, and indirectly exacerbate primary dysmenorrhea. This first study of cytokine gene expression profiles in PBMCs from young primary dysmenorrheic women demonstrates a shift in the balance between expression patterns of pro-inflammatory cytokines and TGF-β superfamily members across the whole menstrual cycle, underlying the peripheral immunologic features of primary dysmenorrhea.     

子宫动脉栓塞术治疗子宫肌瘤的临床应用价值

目的：研究子宫动脉栓塞术（UAE）治疗子宫肌瘤的安全性和临床应用价值,材料和方法：25例经临床,B超证实的子宫肌瘤患者,平均年龄43．5岁,主要临床表现为月经量增多21例,贫血16例,有压迫症状4例,选择性双侧子宫动脉插管造影,用聚己烯已醇海绵（PVA）颗粒栓塞该动脉。结果：UAE后第3,6个月随访,所有患者月经量均恢复正常,15例贫血,4例压迫症状者均缓解,第3,6个月B超复查子宫肌瘤体积分别缩小47．37％和51．31％,与UAE产比较有显著差异（P＜0．01）,缺血性盆腔疼痛（92％）是最常见的副反应,UAE后卵巢体积均无显著缩小（P＞0．05）,结论：介入性双侧子宫动脉栓塞术治疗子宫肌瘤是一种微创,安全的手术,可保留子宫及其功能,其近期疗效显著,子宫动脉栓塞治疗子宫肌瘤具有重要的临床应用价值。     

Body Mass Index Is Associated with Physical Performance in Suburb-Dwelling Older Chinese: A Cross-Sectional Study

Background

Physical performance is reported to have various beneficial effects on human health, especially in older individuals. Although such effects are associated with body mass index (BMI), the relationship between BMI and physical performance has not been clarified.

Design

We conducted a cross-sectional study of 966 suburb-dwelling Tianjin individuals aged ≥ 60 years (average age 67.5±6.02, men 435, women 531). Mobility, balance, and muscle strength were assessed by walking speed, timed up-and-go test (TUGT), and grip strength, respectively. The subjects were categorized into three groups based on BMI (kg/m²) as follows: normal weight, 18.5 ≤ BMI ≤ 23.9; overweight, 24.0 ≤ BMI ≤ 27.9; and obese, BMI ≥ 28.0.

Result

After adjusting for all other variables, relative grip strength decreased when BMI increased in both men and women (P for trend <0.001 and <0.001, respectively). BMI may be negatively associated with TUGT performance in the women only. There was no apparent association between walking speed and BMI in either sex, but after adjusting for age, walking speed was faster when BMI increased in women (P for trend= 0.0162).

Conclusion

This study suggests that in older individuals, higher BMI is associated with poor muscle strength in both sexes.     

Relationship between Chronic Short Sleep Duration and Childhood Body Mass Index: A School-Based Cross-Sectional Study

Objective

To assess relationship between obesity and chronic shorter sleep duration in children and to determine if lack of sleep represents an independent determinant of childhood Body Mass Index.

Methods

This cross-sectional study was conducted in all children enrolled in the fifth class (approximately 10 years of age) of all public primary schools in Catanzaro (Southern Italy). The overall response rate was 62% resulting in 542 participating children. Parents completed a questionnaire with information on their demographics and socio-economic characteristics, their health status, characteristics of their child birth and health status. The sleeping habits were investigated in the 3 months preceding the consultation and parents were asked to indicate hours of bedtime and wake-up of their children. Multivariate linear regression analysis was performed to examine the association between child BMI and chronic lack of sleep.

Results

36.7% of the children surveyed were overweight or obese. A quarter of children did not routinely play sports and many of them spent more than an hour a day watching TV (60.7%) and using videogames or computer (51.1%). Widespread dietary habits were inadequate, especially concerning vegetables and fruit intake with more than 95% of children who consumed insufficient amounts. The average duration of sleep was equal to 9.4 (SD = ±0.6) hours, and the short-sleepers accounted for 38.9% of the total sample. The results of multivariate analysis showed a significant 0.77 Kg/m² increase of BMI for children classified as short compared to normal sleepers (95%CI = 0.16–1.38, p = 0.01).

Conclusions

Chronic lack of sleep appears to be associated to higher BMI even in middle childhood and strongly suggests that public health strategies, focused on promoting healthy lifestyles should include an innovative approach to ensure an adequate duration of sleep at night especially in children, alongside more traditional approaches.     

Comparison of Risk Factor between Lacunar Stroke and Large Artery Atherosclerosis Stroke: A Cross-Sectional Study in China

Background

Stroke is the second most common cause of mortality in China. Although most subtypes of ischemic stroke share similar risk factors, they have different etiologies. Our study aimed to evaluate the different risk factor profiles between the stroke subtypes, lacunar infarcts (LI) and large-artery atherosclerosis (LAA), and clarify the characteristics of current acute ischemic stroke in China.

Methods

In this cross-sectional study, we analyzed the clinical characteristics of 1982 patients with acute ischemic stroke who were admitted to the neurology department at the Peking University First Hospital between 2007 and 2014. Ischemic stroke was further classified into LAA, LI, cardioembolism (CE) and undetermined causes of infarction (UDI) according to TOAST classification. Demographic characteristics, risk factors, as well as the findings of laboratory and imaging tests of 1773 patients with LAA and LI, were analyzed by univariate and multivariate logistic analysis.

Results

Of the 1982 ischemic stroke patients included in this study, 1207 were diagnosed with LAA, 566 with LI, 173 with cardioembolism (CE) and 36 with undetermined causes of infarction (UDI). By comparing the risk factors in multivariate logistic regression analysis, hypertension [odds ratio (OR) = 1.832] and white matter leukoaraiosis (WML) (OR = 1.865) were found to be more strongly correlated with LI than LAA. Low density lipoprotein- cholesterol (LDL-c) (OR = 0.774) were more strongly related to LAA than LI.

Conclusions

This study found that hypertension and WML were more strongly correlated with LI than LAA. LDL-c was more strongly related to LAA than LI.     

Grit and Work Engagement: A Cross-Sectional Study

Grit, defined as perseverance of effort and consistency of interest, has attracted attention as a predictor of success in various fields beyond IQ and the Big Five personality dimension of Conscientiousness. The purpose of the current study was to examine previously uninvestigated questions regarding grit using a cross-sectional design among a large number of working adults in Japan. First, we tested geographical generalizability of associations between grit and orientations towards happiness by comparing previous studies in the U.S. and the current study in Japan. It was confirmed that orientation towards meaning rather than orientation towards engagement had a stronger positive correlation with grit in our sample of Japanese people. This result is inconsistent with previous studies in the U.S. Furthermore, the Big Five dimension of Openness to Experience was newly confirmed as having a positive association with grit. Second, we examined the association between grit and work engagement, which is considered as an outcome indicator for work performance. In this analysis, grit was a strong predictor for work performance as well as academic performance.     

The Effects of Sex Hormonal Fluctuations during Menstrual Cycle on Cortical Excitability and Manual Dexterity (a Pilot Study)

Aim

To investigate whether hormonal fluctuations during the menstrual cycle affect corticospinal excitability, intracortical inhibition (ICI) or facilitation (ICF) in primary motor cortex, and also whether the hormonal fluctuations have any effect on manual dexterity in neurologically intact women.

Materials and Methods

Twenty volunteers (10 Female, 10 Male) were included in this study. The levels of progesterone and estradiol were measured from saliva during the women’s menstrual follicular, ovulation and mid-luteal phases. Motor evoked potentials were recorded from the right first dorsal interosseous muscle. Single and paired-pulse Transcranial Magnetic Stimulation (TMS) were delivered in a block of 20 stimuli. With paired-pulse technique, 3ms and 10ms inter-stimulus intervals were used to assess ICI and ICF, respectively. The Grooved Pegboard Test (GPT) was completed in each session before the TMS assessments. Male participants were tested at similar time intervals as female participants.

Results

Mixed design ANOVA revealed that GPT score in female participants was significantly lower at the mid-luteal phase compared to the ovulation phase (p = 0.017). However, it was not correlated with progesterone or estrogen fluctuations during the menstrual cycle. The results also showed that the effect of phase, sex and the interaction of phase by sex for resting motor threshold, ICI or ICF were not significant (p > 0.05).

Conclusion

Manual dexterity performance fluctuates during the menstrual cycle in neurologically intact women, which might be due to the balance of the neuromodulatory effects of P4 and E2 in the motor cortex during different phases.     

The Relationship between Body Mass Index and Post-Cessation Weight Gain in the Year after Quitting Smoking: A Cross-Sectional Study

Introduction

There is wide variability in the amount of weight gained when quitting smoking, but little is known about key predictors of weight gain. We examined the impact of body mass index (BMI) category and sociodemographic variables on post-cessation weight gain.

Materials and Methods

We utilized National Health and Nutrition Examination Survey data from five consecutive cycles of data collection from 2003–2004 to 2011–2012 to estimate post-cessation weight gain by BMI category among recent quitters (n = 654). We analyzed data on their “current weight” and their “past year weight”. We also compared the recent quitters with current smokers, in order to estimate the amount of weight that could be attributed to quitting smoking.

Results

Recent quitters gained 1.4 kg (95% CI: 0.8 to 2.0), while current smokers had a non-significant weight change (-0.01 kg (95% CI: -0.3 to 0.2). Weight gain was significant for those in the normal weight (3.1 kg, 95% CI: 2.3 to 3.9) and overweight BMI categories (2.2 kg, 95% CI: 1.1 to 3.2).

Conclusions

BMI category is a key factor in the extent of post-cessation weight gain, with normal and overweight recent quitters gaining significant amounts of weight.     

Intraoperative Blood Loss in Female Patients with Adolescent Idiopathic Scoliosis during Different Phases of the Menstrual Cycle

Background

The vast majority of AIS patients who require surgical intervention are women. Blood loss is a major concern during the operation.

Methods

The medical records of all female AIS patients who underwent posterior correction and fusion operations using the all-pedicle screw system from January 2012 to January 2014 were reviewed. Patients with irregular menstruation; underwent osteotomy; use coagulants were excluded from the study. The remaining patients were divided into 4 groups according to the operation date in the menstrual cycle (A: premenstrual group, 24–30 d; B: follicle group, 6–11 d; C: ovulatory group, 12–17 d; D: luteal group, 18–23 d). The information of patients from the 4 groups was reviewed. The data was analyzed using analysis of variance, the Student-Newman-Keels test and Kruskal-Wallis Test.

Results

A total of 161 patients were included in this study. There were 40 patients included in group A, 38 patients in group B, 41 patients in group C and 42 patients in group D. The 4 groups were matched in age (P = 0.238), body height (P = 0.291), body weight (P = 0.756), Risser sign (P = 0.576), mean curve Cobb angle (P = 0.520), and bending flexibility index (P = 0.547), the number of levels fused (P = 0.397). The activated partial thromboplastin time (P = 0.235) and prothrombin time (P = 0.074) tended to be higher in group A, but the difference was not statistically significant. The fibrinogen level was lower in group B than the other 3 groups (P = 0.039). Blood loss and normalized intraoperative blood loss (NBL) was significantly higher in group A than the other 3 groups (P<0.01).

Conclusions

The hemostatic function tended to be lower in the premenstrual phase. The fibrinogen level was lowest in the mid-follicle phase. Female AIS patients tended to endure more intraoperative blood loss when the operation was performed in the premenstrual phase during the menstrual cycle.     

The Unique Impact of Menstruation on the Female Voice: Implications for the Evolution of Menstrual Cycle Cues

Research shows that hormonal changes in women across the menstrual cycle affect vocal production. Most work has documented shifts at high fertility times (i.e., ovulation) or during premenstruation. However, hormonal changes at menstruation also affect female physiology and behavior and could affect vocal production. The present studies investigated perceptual differences in voices recorded during menstruation compared with recordings taken at other times of the menstrual cycle. Results show that male raters could reliably identify voices recorded during menstruation with or without the presence of a voice recorded closest to ovulation. In addition, voices recorded at menstruation were identified as being the most unattractive. These findings indicate that voice recordings taken at times of lowest fertility may uniquely impact women’s vocal production and that perceptions of voice based on cycle phase are not specific to the time of heightened fertility. Implications for the evolution of human menstrual cycle cues are discussed.     

Alcohol Misuse among University Staff: A Cross-Sectional Study

Objectives

To examine the prevalence of hazardous drinking among staff in a UK university and its association with key socio-demographic features.

Design

A cross-sectional study.

Setting

A university in the UK.

Participants

All employees on the university employee database were eligible to participate. Those who completed and returned the questionnaire were included in the sample. Respondents were 131 university employees.

Primary and Secondary Outcome Measures

An AUDIT cut-off score of ≥8 was used as a measure of hazardous drinking. AUDIT total score as well as a score of ≥1 in each of the three conceptual domains of alcohol consumption (questions 1–3), dependence symptoms (questions 4–6) and alcohol-related problems (questions 7–10) were used as indicators of levels of drinking and alcohol-related consequences. Secondary outcomes were employees'' demographics.

Results

Over one third (35%) of respondents were classified as hazardous drinkers. Twenty three per cent reported having blackouts after drinking and 14% had injuries or had injured someone. The odds of being a hazardous drinker for an employee in central departments (Human Resources, Registry etc) is only one third of that of an employee in science and health-related departments (OR = 0.35, 95% CI = 0.14 to 0.91). The proportion of hazardous drinkers was higher in males compared to females (43% and 30% respectively), part-time compared to full-time (46% and 34% respectively), and academic compared to non-academic employees (39% and 32% respectively), although these were not statistically significant (p>0.05). Furthermore, age, religion and ethnic origin were not found to be significantly associated with hazardous drinking, although total scores were significantly lower for ethnic minorities compared to white employees (p = 0.019).

Conclusions

In this study, hazardous drinking was highly prevalent among university employees. However, overt recruiting of staff to address sensitive issues such as alcohol misuse is problematic.