Hormone replacement therapy at women with fertility problems and proofs of hypergonadotropic hypoovarism

The premature ovarian failure (POF), is the main precondition for the origin and the progress of the hypergonadotropic hypoovarism in part of the women with infertility. The significant decrease of the ovarian reserve, makes the treatment of these patients very difficult and problematic, still pregnancy is observed at 5-10% of them. Objective of the research: To study the effect of the Hormone Replacement Therapy (HRT) on the values of FSH before and after the treatment of women with POF, as well as its effect on the percentage of effective pregnancy. 47 infertile women with high values of FSH were included in the study and they followed a 2-4 month treatment with Trisequens tabl. The results of the ART were reported after the reduction of the FSH levels to the normal values. At the end of the treatment followed, the values of the FSH of 41 from 47 patients (87,23%), were reduced to normal range and necessary reproductive procedures were performed. Dividing the patients in 5 groups by age, it was found that the results depend to the greatest extend on this factor. In the group of women up to 30, pregnancy occurred in 25%, between 30 and 35 years this percentage decreased to 22,2%; in the group 35-40 years it sharply decreased to 10% and over 40 years the percentage was 0%. The total percentage of conceived patients for the whole last contingent is 13,4%. The patients with POF and high levels of FSH are worth to follow a Hormone Replacement Therapy before undertaking the oocyte donation.     

Anxiety and physical health problems increase the odds of women having more severe symptoms of depression

Severely depressed women incur substantial disability and suicide risk, necessitating an understanding of factors that may contribute to severe depression. The purpose of this research was to determine the degree to which age, physical morbidity, anxiety, and hormonal status predict the likelihood of severe depression among women with mood disorders (n?=?298). Data arose from a standardized battery of measures in a multi-center clinical registry of patients with mood disorders. The women were being treated at 17 participating sites of the National Network of Depression Centers. Results of logistic regression analyses indicate that a woman’s level of anxiety was the strongest predictor of her likelihood of having severe depression (Exp(B)?=?1.33, p?=?.000), including thoughts of death or suicide. The number of physical health problems that a woman reported was also a significant predictor (Exp(B)?=?1.09, p?=?.04). Neither age nor hormonal status was significant in the final model, although a trend was observed for women with surgically induced menopause to have more severe depression. Findings support the need to work closely with medical practitioners to address physical health problems as part of the treatment plan for depression and to give comorbid anxiety and depression equal priority in symptom management.     

Glucose utilization in relation to insulin secretion in NZO and C57Bl mouse islets

Further studies of insulin secretion from isolated pancreatic islets of the NZO strain of obese hyperglycemic mouse have shown markedly impaired insulin secretory responses to D-glucose in islets from fasted or fed mice. NZO islets at a low glucose concentration (3.3 mM) showed a significant insulin secretory response to 0.5 mM 3-isobutyl-1-methylxanthine (IBMX), a phosphodiesterase inhibitor, but in the presence of this agent showed no significant additional response to increased glucose concentration. This contrasted with the situation in islets from an arbitrarily chosen control strain of mouse (C57Bl) which showed a small or insignificant response to 0.5 mM IBMX at a low glucose concentration, but a greatly enhanced response to glucose in the presence of IBMX. In contrast to the relative refractoriness of the NZO islets to glucose, they showed a large response to D,L-glyceraldehyde, at least equal to that found in the control islets. Glucose utilization was studied by measuring the conversion of D-[5-3H]glucose to [3H]H2O. In islets from both fasted and fed NZO mice, glucose utilization, when calculated on the basis of islet DNA content, was markedly reduced at high glucose concentrations compared to that in islets from the control strain. It is concluded that the relative unresponsiveness of NZO islets to glucose is associated with, and perhaps due to, a decreased rate of glucose utilization. The preserved responsiveness to glyceraldehyde suggests that the reduced glucose utilization may be due to a partial metabolic block before the triose phosphate step in the islet glycolytic pathway.     

Interleukin-6 treatment augments cutaneous wound healing in immunosuppressed mice.

It has been postulated that the inflammatory response that occurs after cutaneous wounding is a prerequisite for healing and that inflammatory cytokines, such as interleukin-6 (IL-6) are involved in this process. We showed previously that IL-6-deficient mice display delayed wound healing, which could be reversed by administration of a murine IL-6 expression plasmid or recombinant murine IL-6 (rMuIL-6). In the present study, we observed that delayed cutaneous wound healing, which occurs as a result of glucocorticoid-induced immunosuppression, can also be reversed by rMuIL-6, as evidenced by epithelialization, granulation tissue formation, and wound closure. In vehicle control mice, rMuIL-6 did not augment healing but rather delayed the process. Immunochemical studies indicated that the expression of matrix metalloproteinase-10 (MMP-10) was increased in dexamethasone-treated mice and that rMuIL-6 treatment reduced its expression, indicating that IL-6 may influence dermal matrix formation and, specifically, collagen synthesis. These results demonstrate that IL-6 can restore abnormal wound repair that occurs in immunodeficiency and suggest its use as a potential therapy.     

Intensity modulated radiosurgery of brain metastases with flattening filter-free beams

Purpose

Flattening filter free (FFF) irradiation potentially reduces treatment delivery time in radiosurgery thus eliminating intrafraction motion and increasing patient comfort. We compared plan quality and efficiency of VMAT and IMRT plans for FFF- and standard delivery for brain metastases with single fraction doses of 20 Gy and validated the dosimetric accuracy of the FFF delivery.

Material and Methods

CT data of 15 patients with brain metastases were included in this study. For every patient, 2 IMRT- and 2 VMAT-plans were created using a high-resolution MLC with two different delivery modes (6 MV standard vs. 6 MV FFF). Plan quality and efficiency was assessed by analysis of conformity, homogeneity, dose gradients, treatment delivery time and number of monitor units (MU). Dosimetric evaluation was performed for 10 FFF plans with radiochromic film and ion chamber.

Results

Plan quality was similar for both approaches. FFF provided a mean treatment time reduction of 51.5% with similar MU for VMAT and IMRT for this low-modulation paradigm. The dosimetric validations showed an absolute dose deviation of +0.93 ± 0.99% and γ-index analysis (3%/3 mm and 3%/1 mm) resulted in agreement of 99.08 ± 1.58% respectively 93.46 ± 2.41%.

Conclusion

FFF radiosurgery is an efficient technique for intensity modulated hypofractionated or single fraction treatments with similar plan quality when compared to flattened beams at reduced treatment time.     

Helicobacter pylori oipA genetic diversity and its associations with both disease and cagA, vacA s, m, and i alleles among Bulgarian patients

Prevalence of outer inflammatory protein (oipA) gene functional status in Helicobacter pylori strains from Southeastern Europe is still unclear. H. pylori strains from 70 symptomatic patients were polymerase chain reaction (PCR) assessed for cagA and vacA types, and oipA gene functional status was evaluated by PCR and sequencing. Our results demonstrated a high prevalence of strains with oipA status “on” genes (81%) and strong association between them and peptic ulcers, cagA, and vacA s1 and s1/m1 genotypes, regardless of the patient gender, place of residence, and age. Importantly, most vacA i1 strains (93%) harbored oipA status “on” versus only 57% of those with vacA i2 type. The vacA i1 genotype was less frequent (66%) than both cagA and vacA s1 types. The virulent strains with cagA⁺ and vacA s1, m1, and i1 were detected in 35% as a predominant genotype and almost all (96%) of these strains harbored oipA status “on”. In conclusion, the high prevalence of in-frame oipA gene strains (81%), associated with peptic ulcers and cagA⁺, vacA s1, m1, m2, and, importantly, i1 genotypes, indicates a strong synergistic activity of H. pylori virulence factors.     

VIM-15 and VIM-16, two new VIM-2-like metallo-beta-lactamases in Pseudomonas aeruginosa isolates from Bulgaria and Germany

Two Pseudomonas aeruginosa urine isolates from Bulgaria and Germany produced two new VIM-2 variants. VIM-15 had one amino acid substitution (Tyr218Phe) which caused a significant increase in hydrolytic efficiency. The substitution Ser54Leu, characterizing VIM-16, showed no influence on enzyme activity. Both genes were part of class I integrons located in the chromosome.