Pelvic floor muscle function in a general female population in relation with age and parity and the relation between voluntary and involuntary contractions of the pelvic floor musculature

Introduction and hypothesis  

The objective of this study is to describe pelvic floor muscle function (PFMF) in relation to age and parity in a general female population and to test whether strength/endurance measurements represent all functions of the pelvic floor musculature.     

Sensitivity for Cues Predicting Reward and Punishment in Young Women with Eating Disorders

Increasing evidence shows that sensitivity to reward (SR) and punishment (SP) may be involved in eating disorders (EDs). Most studies used self‐reported positive/negative effect in rewarding/punishing situations, whereas the implied proneness to detect signals of reward/punishment is largely ignored. This pilot study used a spatial orientation task to examine transdiagnostic and interdiagnostic differences in SR/SP. Participants (14–29 years) were patients with anorexia nervosa of restricting type (AN‐R, n = 20), binge/purge ED group [AN of binge/purge type and bulimia nervosa (n = 16)] and non‐symptomatic individuals (n = 23). Results revealed stronger difficulties to redirect attention away from signals of rewards in AN‐R compared with binge/purge EDs, and binge/purge EDs showed stronger difficulties to direct attention away from signals of punishment compared with AN‐R. Findings demonstrate interdiagnostic differences and show that the spatial orientation task is sensitive for individual differences in SP/SR within the context of EDs, thereby sustaining its usefulness as behavioural measure of reinforcement sensitivity. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

Yellow fever vaccines and international travelers

The growth of air travel has diminished the barriers to the spread of yellow fever, posing a threat to regions that have not previously been reached by the disease but are considered receptive, including the Middle East, coastal East Africa, the Indian subcontinent, Asia and Australia. For many decades, vaccination against yellow fever has been required for travelers entering many countries with receptive mosquito vectors in order to prevent the importation of yellow fever virus from a country that had ongoing transmission. Each year, approximately 9 million tourists travel to countries where yellow fever is endemic; the number of tourists who visit yellow fever-endemic regions within these countries may exceed 3 million. Risk estimates of yellow fever to travelers are extremely difficult to ascertain due to fluctuation of the disease by year and season, incomplete surveillance data, and lack of accurate data regarding vaccine coverage of the local population. The 17D live yellow fever vaccine has been widely acknowledged as one of the most effective and safe vaccines in use. Recently, however, reports of severe and previously unrecognized significant adverse events linked to the 17D vaccine have caused major concern. Some have called for the development of new inactivated yellow fever vaccines for travelers. A new approach for manufacturing the live 17D vaccine involves using a full-length cDNA clone of 17D-204 virus. This new method allows production in a cell culture system and potentially reduces the risk of adventitious viruses and selection of a subpopulation during replication, thereby increasing safety.     

Depressive symptoms in peripheral arterial disease: a follow-up study on prevalence, stability, and risk factors

BACKGROUND: Depressive symptoms are associated with poor prognosis in coronary artery disease, but there is a paucity of research on these symptoms in peripheral arterial disease (PAD). We examined the clinical correlates and 18-month course of depressive symptoms in PAD patients. METHODS: 166 patients with symptomatic lower-extremity PAD (39% women; M age=64.9 +/- 10 years) completed the 10-item Center for Epidemiological Studies Depression scale. A score > or =4 indicates clinically relevant depressive symptoms. Depressive symptoms were re-assessed at 6, 12, and 18 months follow-up. Ankle-brachial index (ABI) and treadmill walking distance were used to assess PAD severity. RESULTS: At baseline, depressive symptoms (CES-D > or =4) were present in 16% of the patients. Depressed patients performed worse regarding pain free (p=0.003) and maximum (p=0.005) walking distance. After adjusting for age, sex, education, ABI, psychotropic medication use, cardiovascular risk factors, and comorbidity, depressive symptoms remained stable in initially depressed patients. Using mixed modelling, three subgroups were identified in the total sample. The majority of PAD patients did not have depressive symptoms (58%), but there were two groups who persistently experienced either subclinical (27%) or clinically manifest (15%) depressive symptoms. LIMITATIONS: Only baseline data of ABI and treadmill walking performance were available. CONCLUSIONS: Depressive symptomatology was present in a substantial number of PAD patients, tended to be stable, and was associated with reduced walking distance. These apparently evident results are overlooked thus far in this patient group and deserve further attention in research and clinical care.