Low risk of pelvic inflammatory disease in young never-pregnant women using GravigardR

The present four-center investigation involves 516 never-pregnant women in whom a copper-7-intrauterine device (Cu-7-IUD) was inserted. Out of these patients 173 were teenagers at the time of insertion. A “small-sized” Cu-7-IUD (Cu-7-Nullip) — designed for nulliparous women — was randomely used instead of the commercially available Cu-7-IUD (Gravigard^R) in 76 — 44 of whom were teenagers — out of the 516 women. The incidence of pelvic inflammatory disease (PID) of 9,080 woman-months was reviewed. In the present study the incidence of PID varied from one center to another between 0.9 and 1.4 per cent/ year in women wearing Cu-IUDs. When comparing these figures with the estimated incidence (1.2%) in the population of fertile-aged women, it was concluded that the risk for PID was not increased in neverpregnant women using Cu-IUDs, including teenagers as well as women of 20 years of age or more. No difference in the incidence of PID was observed between the Gravigard^R and the Cu-7-Nullip.     

Association between immigrant status and history of compulsory treatment in a national sample of individuals assessed for drug use disorders through the Swedish public welfare system

In-person interview data from 13,903 individuals assessed for a drug use disorder in the Swedish welfare system from 2002-2008, were analyzed using logistic regression methods. Second generation immigrants with non-Scandinavian parents were 41% more likely to report a history of compulsory treatment compared to those born in Sweden to Swedish parents after controlling for age, gender, education, mental health treatment homeless status history, and criminal justice history. Implications include the need to study acculturation, stigma, and discrimination-related factors as well as to promote culturally competent outreach to immigrant populations.     

The Adolescent Drug Abuse Diagnosis Composite Scores in Swedish Normal and Antisocial Adolescents

The present study evaluates the utility and issues around the composite scores in Adolescent Drug Abuse Diagnosis (ADAD). Participants were Swedish normal adolescents (121) and adolescents manifesting antisocial problems (1,168), ages 10 to 21. The results show that the interviewer severity ratings seem to be the most appropriate outcome when the objective is to differentiate between normal and antisocial adolescents. The composite scores appear to function as an indicator of current problems in all areas except for Medical and Alcohol sections. The critical items within the Medical and Alcohol composite scores are explored and discussed.     

Baseline characteristics and effects of ten years of growth hormone (GH) replacement therapy in adults previously treated with pituitary irradiation

ContextLittle is known of the importance of previous irradiation therapy for baseline characteristics and responsiveness to GH replacement in GH deficient (GHD) adults.Objective/design/patientsIn this prospective, single-centre, open-label study, the effects of 10-year GH replacement were determined in 18 GHD adults that had previously received conventional external fractionated pituitary irradiation therapy (IRR group) and 18 non-irradiated GHD patients (non-IRR group). All patients had adult onset disease and complete deficiency of anterior pituitary hormones and both groups were comparable in terms of age, gender, body mass index (BMI), and waist:hip ratio.ResultsAt baseline, IRR patients had higher serum triglyceride (TG) and insulin levels and lower high density lipoprotein (HDL)-cholesterol (HDL-C) level than non-IRR patients (all p < 0.05). The 10-year GH replacement improved body composition, bone mass and serum lipid profile without any between-group differences, except for a marginally more beneficial response in serum TG level in the IRR patients. After 10 years, there was no between-group difference in any variable after correction for a higher replacement dose of glucocorticoids in the IRR patients at study end using an analysis of covariance. During the 10-year GH replacement, 5 IRR patients suffered from vascular events (2 fatal) whereas only one non-fatal vascular event occurred in the non-IRR patients.ConclusionsIRR patients with GHD display a more severely impaired cardiovascular risk profile at baseline, which was reversed by the 10-year GH replacement after correction for the higher glucocorticoid dose at study end. However, vascular events occurred more frequently in the IRR patients.     

The reduction in visceral fat mass in response to growth hormone is more marked in men than in oestrogen-deficient women

ContextWomen with severe growth hormone (GH) deficiency have a less marked response to GH replacement than men. This has mostly been attributed to the attenuating effects of oestrogen replacement therapy.ObjectiveTo study gender related differences in the response to GH treatment in men and postmenopausal women.MethodsFifteen men and 15 age- and BMI-matched women with abdominal obesity (mean age: 58; range 51–64 years) were treated for one year with similar doses (0.47 vs. 0.51 mg/day) of GH. All women were postmenopausal not receiving oestrogen treatment. Insulin sensitivity was assessed using a hyperinsulinemic euglycemic clamp and body composition by computed tomography (CT) scans and from total body potassium, K⁴⁰.ResultsMen and women were comparable at baseline in terms of waist circumference, IGF-1 and lipid levels. After one year of GH treatment, there was a 18% reduction in visceral adipose tissue (VAT) in men and a 5% reduction in women (P = 0.0001 men vs. women). Although the magnitude of the difference was small, men increased more in thigh muscle mass (P < 0.0001 vs. women). A reduction in thigh intermuscular adipose tissue (IMAT) and diastolic blood pressure was seen only in men (both p < 0.05 vs. baseline). A decrease in LDL cholesterol, and an increase in serum insulin, was observed only in women (both p < 0.05 vs. baseline).ConclusionLow dose GH treatment reduced VAT more markedly in men as compared with women. As all women were postmenopausal and oestrogen-deficient, this gender difference in responsiveness was not due to an antagonistic effect of oestrogen on peripheral GH action.     

Outcome after cup hemiarthroplasty in the rheumatoid shoulder: A retrospective evaluation of 39 patients followed for 2-6 years

33 rheumatoid patients, treated with hemispherical cup resurfacing hemiarthroplasty of the shoulder without medullary fixation (6 bilaterally), were reviewed after mean 4.4 (2-6) years. The median Constant score was 30 (15-79), mean proximal migration of the humerus 5.5 (SD 5.2) mm and mean glenoid erosion 2.6 (SD 1.7) mm. Proximal migration and glenoid erosion did not correlate with shoulder function or pain. Radiographic signs of loosening (changes in cup inclination combined with changes in cup distance above the greater tuberosity) occurred in one quarter of the shoulders. At follow-up, 26 patients were satisfied with the procedure, despite poor shoulder function and radiographic deterioration.     

A multidisciplinary perspective on the complex interactions between sleep,circadian, and metabolic disruption in cancer patients

Cancer and Metastasis Reviews - Sleep is a basic need that is frequently set aside in modern societies. This leads to profound but complex physiological maladaptations in the body commonly referred...     

The use of rapid and cost-effective blood-based biomarkers in combination with tumour TNM stage for individual head and neck cancer patient treatment selection

Head and neck (H&N) cancer is an aggressive disease and the incidence has increased in younger population worldwide. Tumour TNM staging is the main basis for treatment decision despite significant variation in clinical outcome. Survival time of these patients has marginally improved during the last 30 years. Various biomarkers with cumbersome analysis, high cost, time consumption and requirement of special laboratory facilities have been investigated. However, none of these biomarkers have been shown to be suitable to use for individual H&N cancer patient treatment selection in the clinic. For practical use in clinical settings, the given biomarkers must be simple to analyse, rapid, cost effective and available in routine laboratories. With this intension, we suggested the combination of standard TNM staging and biomarkers associated with inflammation such as neutrophils, neutrophil to lymphocyte ratio, plasma C-reactive protein or plasma tumour necrosis factor alpha (TNFa) and single-nucleotide polymorphism in TNFa rs1800629 using blood-based analysis. The optimal treatment outcome of H&N cancer by using combination of TNM stage and these blood-based biomarkers for individual patient selection need further investigation.     

Inhibition of IgE-mediated histamine release from human leukocytes by a new xanthine derivative,D 4026

Pretreatment of human leukocytes with the new xanthine compound, 3,7-dihydro-1,8-dimethyl-3-phenyl-1H-purine-2,6-dione (D 4026), induced a dose-dependent and statistically significant inhibition of immunoglobulin E-mediated histamine release in the concentration interval 0·1–1000 M. Histamine release elicited with suboptimum amounts of the triggering agent (anti-IgE or antigen) was inhibited to a greater extent than a release initiated with optimum amounts. At a concentration of 10 M, D 4026 had at least the same inhibitory effect as 100 M theophylline. When leukocytes were incubated simultaneously with D 4026 and a histamine H-2 receptorstimulating drug (histamine or clonidine), the two drugs combined induced an inhibition significantly greater than the sum of their individual inhibitory effects. Only pure additive inhibitory effects were, however, obtained during simultaneous treatment of leukocytes with theophylline and histamine .Subsidiary of AB Astra, Sweden.