Correlation of human decidual and cord blood mononuclear cell cytokine production

Human decidua has been shown to produce a number of cytokines. We hypothesized that decidual cytokine production influences cord blood mononuclear cell (CBMC) cytokine production and that cytokine profiles of decidua from allergic women differ from those of decidua from nonallergic women. Using enzyme-linked immunosorbent assay, we measured unstimulated and concanavalin A/phorbol myristate acetate-stimulated production of interleukin-4 (IL-4), IL-5, IL-10, IL-13 and interferon- gamma (IFN-gamma) by decidual explants from 59 healthy women delivered by unlabored cesarean section and from corresponding CBMCs in 39 of the 59. Except for IL-10, there was little or no unstimulated cytokine production. There was a strong correlation between stimulated decidual and stimulated CBMC IFN-gamma production (p = 0.01). In allergic women the ratio of IL-13 to IL-4 production was increased in stimulated explants (p = 0.03). Stimulated CBMCs from infants of allergic mothers were more likely to produce detectable levels of IL-5 than those from infants of nonallergic mothers (p = 0.04) and had a tendency toward higher IL-13 levels as well (p = 0.07). These results suggest that maternal and fetal IFN-gamma production is closely linked and that maternal allergy appears to influence cytokine production in the neonate for IL-5 and possibly IL-13.     

Exercise Improves Self-Reported Sexual Function Among Physically Active Adults

BackgroundSexual dysfunction is common among adults and takes a toll on quality of life for both men and women.AimTo determine whether higher levels of weekly cardiovascular exercise are protective against self-reported sexual dysfunction among men and women.MethodsWe conducted an international online, cross-sectional survey of physically active men and women between April and December 2016, assessing exercise activity categorized into sextiles of weekly metabolic equivalent-hours. Odds ratios (ORs) of sexual dysfunction for each activity sextile compared with the lowest sextile were calculated using multivariable logistic regression, controlling for age, body mass index, diabetes mellitus, tobacco/alcohol use, sport, and marital status.Main Outcome MeasuresFemale sexual dysfunction was defined as a score ≤26.55 on the Female Sexual Function Inventory and erectile dysfunction (ED) was defined as a score ≤21 on the Sexual Health Inventory for Men.Results3,906 men and 2,264 women (median age 41–45 and 31–35 years, respectively) met the inclusion criteria for the study. Men in sextiles 2–6 had reduced odds of ED compared with the reference sextile in adjusted analysis (P_trend = .03), with an OR of 0.77 (95% CI = 0.61–0.97) for sextile 4 and 0.78 (95% CI = 0.62–0.99) for sextile 6, both statistically significant. Women in higher sextiles had a reduced adjusted OR of female sexual dysfunction (P_trend = .02), which was significant in sextile 4 (OR = 0.70; 95% CI = 0.51–0.96). A similar pattern held true for orgasm dissatisfaction (P_trend < .01) and arousal difficulty (P_trend < .01) among women, with sextiles 4–6 reaching statistical significance in both.Clinical ImplicationsMen and women at risk for sexual dysfunction regardless of physical activity level may benefit by exercising more rigorously.Strengths & LimitationsStrengths include using a large international sample of participants with a wide range of physical activity levels. Limitations include the cross-sectional design, and results should be interpreted in context of the study population of physically active adults.ConclusionHigher cardiovascular exercise levels in physically active adults are inversely associated with ED by self-report in men and protective against female sexual dysfunction in women.Fergus KB, Gaither TW, Baradaran N, et al. Exercise Improves Self-Reported Sexual Function Among Physically Active Adults. J Sex Med 2019;16:1236–1245.     

Correlation of serum magnesium with dyslipidemia in maintenance hemodialysis patients

One of the factors involved in accelerated atherosclerosis in hemodialysis patients is dyslipidemia. In this study we considered factors involved in intensification of dyslipidemia in hemodialysis patients. This study was done on 36 maintenance hemodialysis patients. Serum lipoprotein (a), Triglyceride, Cholesterol, HDL-C,LDL-C and also serum Intact parathormone(iPTH), Calcium, Phosphorus, Magnesium were measured. In statistical analysis there was not any correlation between serum lipids and iPTH. There was not correlation between serum calcium with serum lipids (p > 0.05). There was not correlation between CaxP product with serum lipids (p > 0.05). There was a positive correlation between serum Magnesium and Lipoprotein(a) (P < 0.05) and also positive correlation between serum magnesium with triglyceride level (P < 0.05) was seen too. Magnesium doesn't increase the lipoprotein synthesis. It may involve in the regulation of some enzymes responsible for lipoprotein synthesis. Correlation of serum magnesium with serum triglycerides can be due to changes in hepatic triglyceride metabolism. Lipoprotein(a) is a non traditional factor of premature atherosclerosis, its association with serum magnesium needs more attention in hemodialysis patients.     

A longitudinal examination of the associations between mothers' and sons' attributions and their aggression

This study tested an integrative, multipathway model designed to explain bidirectional effects of the attributions and coercive behaviors of mothers and sons in the context of a longitudinal study. Subjects were 246 mothers and sons who were 7-9 years of age. Mothers' and sons' attributions about one another's intent were significantly related to the aggressiveness of the behavior that each of them directed toward the other. Boys' earlier aggression did not significantly predict the mothers' subsequent attributions, whereas mothers' negative behavior indeed predicted subsequent negative attributions on the part of the boys. Even after considering children's earlier negative behavior, children's negative attributions about their mothers helped explain the aggressiveness of their subsequent behavior. The same was not true for mothers whose earlier attributions indirectly influenced their subsequent aggressive behavior.     

Albendazole versus placebo in treatment of echinococcosis

Echinococcus granulosus infection can have multiorgan involvement, and is common in Third-World countries. Uncontrolled studies show that albendazole can be effective in its treatment, but there are also reports of spontaneous resolutions. We therefore undertook a placebo-controlled double-blind parallel-group randomized study in Iran to evaluate the effect of albendazole on hydatid cysts. Twenty-nine patients with 240 cysts entered the study in 1994-95 and received either albendazole (400 mg twice a day, in 3 cycles of 6 weeks with 2 weeks between cycles) or placebo. At study completion, 172 and 31 cysts in the albendazole and placebo groups, respectively, were evaluable. In the treatment arm, 134 cysts showed improvement or cure compared to 4 in the placebo group (P < 0.001). Eighteen (82%) of 22 patients in the treatment arm showed either cure (8 patients) or improvement (10 patients); in the placebo group only 1 (14%) of 7 showed spontaneous improvement but no cure. Some patients with liver cysts after treatment showed increasing heterogeneity and density suggestive of inactive cysts. Patients with larger cysts and those with pulmonary involvement were better responders. Age and gender had no effect on outcome. The observed results are encouraging, showing albendazole has good effect on hydatid cysts and should be offered to patients before surgical treatment is considered.     

Knowledge and practice of foot care in Iranian people with type 2 diabetes

The aim of this study was to determine the knowledge and practice of foot care in people with type 2 diabetes. We carried out a cross-sectional study. A questionnaire was completed by 148 patients with type 2 diabetes in Tehran, Iran. Knowledge score was calculated and the current practice was determined. The mean knowledge score was 6.6 (standard deviation +/-3.0) out of a possible 16. Illiterate patients were the least knowledgeable (P= 0.008). Lack of adequate knowledge includes the following: 56% not aware of the effect of smoking on the circulation to the feet, 60% failed to inspect their feet and 42% did not know to trim their toenails. High risk practices including use of irritants to water (66.5%) and walking barefoot (62%). The results of this study highlight the patients' inadequate knowledge of self-care about their foot and lack of optimal podiatry service in Iran. These findings have implications for further evaluation, planning and management of patient care in diabetic foot disease.     

Vaginoplasty in the female exstrophy population: Outcomes and complications

ObjectiveVaginal stenosis is a common sequela in adolescents who have undergone reconstruction for classic bladder exstrophy in infancy. We sought to determine the incidence of vaginal stenosis in our patient population and the outcome of treatment in the first three decades of life.Patients and MethodsAn institutional review board approved bladder exstrophy database was used to identify and retrospectively review classic female bladder exstrophy patients aged 12–30 years treated at the authors' institution. Patients who underwent vaginoplasty were identified and the following outcomes were measured: age at surgery, method used for the reconstruction, complications and incidence of re-stenosis.ResultsNinety-one female classic bladder exstrophy patients were identified. Twenty-nine patients (31.8%) underwent vaginoplasty because of vaginal stenosis at a mean (SD) age of 15 (3) years. Twenty-four patients underwent perineal flap vaginoplasty, three posterior cut-back vaginoplasty and two YV vaginoplasty. One patient developed wound infection and dehiscence which required reoperation (3.4%). No patient experienced vaginal re-stenosis.Conclusionsvaginal stenosis is common after reconstruction of female classic bladder exstrophy. Vaginoplasty is highly successful in the exstrophy population when performed in the second or third decade of life with a low risk of complications.