Endomyocardial fibrosis mimicking right ventricular mass

Endomyocardial fibrosis is a disorder of the tropical/subtropical regions of the world, of unknown etiology, characterized by the development of restrictive cardiomyopathy involving the ventricles. We report the case of a 65-year-old Brazilian woman with dyspnea and abdominal distension. Delayed contrast enhanced cardiac MRI showed apical obliteration of both ventricles with a lesion in the right ventricle free wall mimicking a mass protruding into the ventricular cavity.     

The effect of total knee arthroplasty design on extensor mechanism function

The effect of total knee arthroplasty design on extensor mechanism function was evaluated prospectively in a consecutive, single-surgeon series. Group 1 knees (n = 83) were implanted with a prosthesis that has a multiradius femoral component, and group 2 knees (n = 101) were implanted with a femoral prosthesis that has a single flexion-extension axis. Group 2 knees gained flexion more rapidly: At 6 weeks, the average flexion for was 94.5 degrees for group 1 and 107.1 degrees for group 2 (P<.001). Significantly more patients with group 2 knees were able to arise from a 16-inch (low) chair without using their arms starting at 6 weeks, and a difference was maintained through 2 years (90% vs 73%; P=.003). Patients with group 2 knees had significantly less anterior knee pain when rising from a seated position starting at 6 weeks, and a difference was maintained through 2 years (1% vs 22%; P=.001).     

Activity of in vitro forms of dentifrices containing the hydroalcoholic extract of the ripe fruit of Eugenia uniflora L. (Surinam cherry) on cariogenic bacteria

The aim of this study was to evaluate the in vitro activity of dentifrices containing the hydroalcoholic extract of the ripe fruit of Eugenia uniflora L. (Surinam cherry) on Streptococcus oralis (ATCC 10557) and Lactobacillus casei (ATCC 7469). Five dentifrices were used: D1: containing hydroalcoholic extract of Eugenia uniflora L.; D2: containing fluoride and hydroalcoholic extract of Eugenia uniflora L.; D3: containing triclosan and hydroalcoholic extract of Eugenia uniflora L; D4: containing triclosan, fluoride and hydroalcoholic extract of Eugenia uniflora L.; D5: positive control (Colgate Total 12). To determine the antibacterial activity, the technique used was the minimum inhibitory concentration by the diffusion method in solid culture medium. At the concentration 0.05 g/mL, the best results were achieved with D1 (18 mm) and D4 (24 mm) on L.casei, and with D3 (19 mm) on S. oralis. The dentifrices D3 and D4 were found to have greater activity on the Streptococcus oralis, while D4 and D1 were found to have greater activity on Lactobaccilus casei. It is concluded that dentifrices with Eugenia uniflora L. have antimicrobial activity, suggesting that clinical trials should be conducted.     

Beyond Reproductive Health: Listening to Women About Their Health in Disadvantaged Beirut Neighborhoods

In this article, we aim to contextualize gynecological problems within a broader health and social context, expanding the lens beyond reproductive health. Questionnaires were administered to 1,869 ever-married women aged 15 to 59 that included questions on living, general health, and gynecological problems. These questions were open-ended, allowing women to respond in their own words. Women reported a multitude of health problems, indicating competing priorities. Musculoskeletal complaints emerged as the most prevalent and most important health problem. One in four women reported a gynecological problem, mainly reproductive tract infections (RTIs), when asked directly. Selected quotes provide clues about the complex relationship between women's lives and health.     

Abnormal inhibin A and inhibin B secretion in obese women with and without insulin resistance

Aim.?The present study aimed to establish inhibin A and B serum levels during the menstrual cycle of obese women, and its usefulness as an index of luteal-phase follicular development.

Materials and methods.?Twenty-one obese patients (mean body mass index: 34.9?±?3.7?kg/m²; range: 30.0–45.0?kg/m²) were submitted to basal hormonal measurements and an oral glucose tolerance test after challenge with 75?g glucose. Progesterone and inhibin A and B levels were determined 5–7 days after the menstrual cycle and 7 days prior to expected menses.

Results.?As expected, an increase in inhibin A and a decrease in inhibin B were observed when first-phase samples were compared with samples obtained after 15–20 days. On the other hand, the percentage variation of both inhibin A and B was at least four times smaller than the values for normal women described previously by other authors employing the same enzyme-linked immunosorbent assays. A small number of obese women presented ovulatory cycles characterized by progesterone concentration higher than 5.8?ng/ml. The percentage elevation (?>?190%) of inhibin A in the second samples was in agreement with the progesterone levels, but it seemed to be more sensitive for the detection of follicle luteinization.

Conclusion.?We conclude that obese women present less percentage variation of both inhibin A and B during the menstrual cycle, associated with a low frequency of ovulatory cycles. In obese women, the percentage increase of inhibin A can represent an additional marker to recognize follicle luteinization.     

Estrogen deficiency accelerates progression of glomerulosclerosis in susceptible mice

Estrogen deficiency may contribute to the development and progression of glomerulosclerosis in postmenopausal women. The responsiveness to estrogens could be controlled by genetic traits related to those that determine the susceptibility to glomerular scarring. This study was undertaken to determine whether the intensity of the sclerotic response was modified by the estrogen status in sclerosis-prone ROP Os/+ mice. Ovariectomized ROP Os/+ mice developed more severe renal dysfunction and glomerulosclerosis than intact, ie, estrogen sufficient age-matched female mice. Ovariectomized ROP Os/+ exhibited increased accumulation of extracellular matrix, predominantly of laminin, and a marked distortion of the glomerular architecture. We found an increase in macrophage infiltration in the mesangium of ovariectomized ROP Os/+. Estrogen deficiency decreased glomerular estrogen receptor expression in ROP Os/+ mice, which we had previously found to be low in the parental ROP strain. Thus, although physiological estrogen levels in young ROP Os/+ mice could not prevent the development of glomerulosclerosis, estrogen deficiency accelerated the progression of glomerular scarring in this mouse strain. This suggests that estrogen replacement will slow but not prevent the progression of glomerulosclerosis. It underscores the importance of the genetic composition of individuals that determines the susceptibility to diseases as well as the response to treatment.