Progestin effect on cell proliferation and 17 beta-hydroxysteroid dehydrogenase activity in normal human breast cells in culture

In contrast to cancer cell lines, normal human breast epithelial cells are infrequently studied. Such cells, now routinely cultured in our laboratory from tissue obtained at the time of reduction mammoplasty, were used to study the actions of estradiol (E2), the progestin promegestone (R5020), and the antiprogesterone RU486 on cell growth and progesterone-dependent 17 beta-hydroxysteroid dehydrogenase (E2DH) activity, which is considered good marker of epithelial differentiation as well as progesterone dependency. The studies were carried out using secondary cultures to assure equal initial cell distribution. Cell growth was estimated daily by a histometric method providing a growth index and DNA assay. E2 stimulation of cell growth was not found when the cells were grown in our usual culture medium, but E2 dose-dependent growth stimulation occurred in medium minimally supplemented with serum (1%), insulin; and epidermal growth factor. R5020 inhibited cell growth and stimulated E2DH activity in a dose-dependent manner. RU486 behaved as a pure but low potent progestin agonist concerning E2DH stimulation, but as an agonist with partial antagonist properties concerning cell growth inhibition. In conclusion, E2 stimulated proliferation of human breast epithelial cells in culture, whereas the progestin R5020 inhibited cell multiplication and favored differentiation. The antiprogesterone RU486 had a biphasic effect acting both as progestin agonist and partial antagonist.     

Comparing the alcohol-related problems survey (ARPS) to traditional alcohol screening measures in elderly outpatients

Older drinkers may incur alcohol-related risks at low consumption levels, but commonly used screening measures do not address alcohol's effects among persons with declining health and increased medication use. We compared the newly developed Alcohol-Related Problems Survey (ARPS) to three validated alcohol screens: the Cut down, Annoyed, Guilty, Eye-opener (CAGE), Short-Michigan Alcohol Screening Test (SMAST), and Alcohol-Use Identification Test (AUDIT). The ARPS classifies drinking as non-hazardous, hazardous or harmful. Non-hazardous drinking is defined as consumption with no known risks for adverse physical or psychological health events. Hazardous drinking is consumption with such risks. Harmful drinking results in adverse events. The AUDIT screens for hazardous and harmful drinking; the CAGE and SMAST identify abusive (e.g. failure to fulfill social obligations) and dependent (e.g. having withdrawal symptoms) drinkers. In this study of 574 current drinkers 65 years and older who completed the ARPS and AUDIT in primary care clinics, half were randomly assigned to complete the CAGE and half, the SMAST. Drinkers who screened positive on the CAGE, SMAST or AUDIT were correctly classified by the ARPS as hazardous or harmful drinkers 91, 75, and 100% of the time, respectively. The majority of ARPS-identified hazardous or harmful drinkers did not screen positive on the CAGE, SMAST or AUDIT. These drinkers had medical conditions or used medications that placed them at risk for adverse health events, none of which was addressed in these three screens. In this study, the ARPS identified nearly all drinkers detected by the CAGE, SMAST, and AUDIT and detected hazardous and harmful drinkers not identified by these measures.     

Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

There is a need for a psychometrically sound measure of the stigma experienced by diverse persons living with HIV/AIDS (PLHA). The goal of this study was to develop and evaluate a multidimentional measure of internalized HIV stigma that captures stigma related to treatment and other aspects of the disease among sociodemographically diverse PLHA. We developed a 28-item measure of internalized HIV stigma composed of four scales based on previous qualitative work. Internal consistency reliability estimates in a sample of 202 PLHA was 0.93 for the overall measure, and exceeded 0.85 for three of the four stigma scales. Items discriminated well across scales, and correlations of the scales with shame, social support, and mental health supported construct validity. This measure should prove useful to investigators examining in the role of stigma in HIV treatment and health outcomes, and evaluating interventions designed to mitigate the impacts of stigma on PLHA.     

Paradoxical effect of imipramine in hyperprolactinemic female rats exposed to the forced swimming test

This study was designed to investigate the effect of hyperprolactinemia, with high or low estrogen levels, on the response to imipramine in the forced swimming test. Three groups of female rats were studied: (1) ovariectomized controls, with low serum prolactin (PRL) and estrogen levels, (2) ovariectomized, estrogen-treated rats, with high PRL and high estrogen levels, and (3) pituitary-grafted rats, with high PRL and low estrogen levels. The hyperprolactinemic groups did not show significant behavioral changes in the forced swimming test preceded by saline injection. Imipramine decreased the immobility time by 37.5% in ovariectomized controls but not in the pituitary-grafted group, and there was an increment of 48.4% in immobility time following imipramine administration in the estrogen-treated group (p<0.05). This paradoxical response to imipramine was significantly correlated with serum PRL (r = 0.59, p<0.01) but not with estradiol levels. These findings suggest that, at least in female rats submitted to the forced swimming model, PRL may induce reversed behavioral effects in response to imipramine, independently of circulating estrogen levels.     

Endometrial assessment in women using tibolone or placebo: 1-year randomized trial and 2-year observational study

OBJECTIVE: To assess the effects of tibolone on the endometrium of postmenopausal women. DESIGN: A 1-year randomized, double-blind, placebo-controlled clinical trial and a 2-year open clinical trial. The placebo-controlled trial included 40 participants: 20 in the placebo group and 20 in the tibolone group; in the open trial, 17 participants receiving tibolone were assessed over 24 months. Transvaginal ultrasonography was carried out to assess endometrial thickness, and endometrial appearance was assessed on hysteroscopy. In addition, endometrial samples were submitted to histological examination. The occurrence of uterine bleeding and other adverse effects was also assessed. RESULTS: Results suggest that tibolone does not exert a stimulatory effect on the endometrium: unaltered endometrial thickness, atrophic appearance of most endometria on hysteroscopy, and endometrial histology classified as atrophic, hypotrophic with incipient secretion, or hypotrophic with weak proliferation (one case). Tibolone was effective in the treatment of climacteric symptoms, and only 8.7% of the participants presented uterine bleeding during treatment. CONCLUSIONS: Tibolone seems to be an effective option for the treatment of climacteric symptoms in postmenopausal women, especially in women who do not want to experience uterine bleeding again.     

Relevance of the determination of ovarian volume in adolescent girls with menstrual disorders

Pelvic ultrasound and hormonal studies were performed in 29 adolescent patients, aged 12 to 20 years, to evaluate menstrual irregularities. Patients were divided in three groups according to ultrasound ovarian volumes: group I (n = 16) both ovaries <10 cm³; group II (n = 8) one of the ovaries ≥ 10cm³; and group III (n = 5) both ovaries ≥10 cm³. Serum levels of LH, LH:FSH ratio, testosterone, and androstenedione were significantly higher (p < .05) in group III. Positive predictive value of both ovarian volumes ≥10 cm³ in terms of polycystic ovary syndrome (PCOS) was 100%, negative predictive value was 81%, sensitivity was 63%, and specificity was 100%. These data suggest that, in adolescent patients with menstrual disorders, bilateral ovarian volumes of higher than 10 cm³ are correlated with the diagnosis of PCOS. © 1996 John Wiley & Sons, Inc.     

Prophylactic penicillin versus penicillin taken at the first sign of swelling in cases of asymptomatic pulpal-periapical lesions: a comparative analysis

In order to ascertain whether the time of administration of an antibiotic affects the occurrence of flare-ups and non-flare-up-associated swelling and pain, an analysis of components of two prospective endodontic studies on patients having asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL) was done. In the first study, prophylactic penicillin was used. In the second study, penicillin (or erythromycin for patients allergic to penicillin) was taken by the patient at the first sign of swelling (patient controlled). For the patient-controlled group, as compared to the prophylactic penicillin group, there was statistically significantly more (1) incidence of flare-ups (p less than 0.05); (2) non-flare-up-associated swelling (p less than 0.001); (3) non-flare-up-associated pain (p less than 0.05); (4) combined moderate and severe pain (p less than 0.05); (5) combined incidence of flare-ups and swelling (p less than 0.001); (6) combined incidence of flare-ups and pain (p less than 0.01); and (7) combined incidence of flare-ups and both swelling and pain (p less than 0.001). There were statistically significantly fewer instances of (1) no patient post-treatment problems (p less than 0.001) and (2) combined mild pain and no patient post-treatment problems (p less than 0.001). Hence, for asymptomatic teeth with PN/PL, it appears that prophylactic antibiotics are preferable to antibiotics taken by the patient at the first sign of swelling.