EAR General Assembly,Vienna, 8 March, 1995

News of the EAR

EAR General Assembly, Vienna, 8 March 1995President's Report     

Adolescent pregnancy. Teen perspectives on prevention

PURPOSE: To elicit the views of teens concerning effective strategies to prevent pregnancy. DESIGN: Qualitative methods and a focus group approach were used. METHOD: The sample consisted of male and female adolescents, 14 to 19 years of age, in grades 9 to 12, who volunteered to participate in the study. Seven groups of teens met with the investigator twice over 2 consecutive weeks. Instruments included a Screening Questionnaire and Focus Group Discussion Guidelines. RESULTS: Teens were concerned about teen pregnancy, and supported a comprehensive approach to sex education beginning in the early elementary grades, with age and developmentally appropriate content and reinforcement from late grade school through high school. Generally, teens thought that teaching abstinence in grade school followed by contraception education in junior high and high school was a realistic strategy for pregnancy prevention. They wanted to discuss sexual feelings as well as the mechanical aspects of sex. Finally, they did not want to be told not to have sex, but rather wanted to be guided in their own decision making. Teens wanted parents and other adults to be involved in helping them understand sexuality and make decisions about sexual behavior. CLINICAL IMPLICATIONS: Nurses who work with families need to understand why teens are becoming pregnant, provide opportunities for teens to discuss sexual behavior, and educate parents on sexual development and parent-child communication. Nurses also need to let parents and teens know that they are a resource for information, guidance, and health services related to sexual development and behavior.     

Gene transfer in the RPE65 null mutation dog: relationship between construct volume,visual behavior and electroretinographic (ERG) results

In vivo gene transfer in a large group of RPE65 null mutation dogs have been recently performed. The present study was aimed at determining, through visual behavioral and electroretinographic (ERG) testing, if there is a volume effect of the gene construct administered. Eleven Beagle-Briard dogs homozygous for the RPE65 null mutation and two unaffected control dogs were included. Affected animals were unilaterally treated with either a high (70–100 l; N = 6) or a low volume (30–60 l; N = 5) of subretinally injected rAAV.RPE65 construct, at the age of 4 months to 2.5 years. Fellow eyes were treated with a subretinal injection of rAAV.GFP or sham operated and used as internal controls. Retinal function was measured pre- and 10–12 weeks post-surgically, using simultaneous bilateral full-field flash ERGs. A significant improvement in all ERG responses studied was identified for the high volume treated group compared to pre-surgical parameters. A significant improvement for the high intensity scotopic a-wave response for the low volume rAAV.RPE65 treated group was also found. Objective and subjective dim and day light visual maze testing, in eight of the affected treated animals, and the two control dogs, revealed better vision in daylight than in dim light for all animals. Vision in dogs treated with the high volume of gene construct was significantly better in day light than in dim light. No significant difference was noted between day and dim light testing for the control group or those animals treated with a low volume of the gene construct. Significantly better vision was noted in the control group when compared with the low volume group under dim light conditions, and the high volume group under day light conditions. No significant difference in functional vision could be identified between the high volume treated animals and control animals in day light conditions. These findings support the hypothesis that functional vision is improved by subretinal rAAV.RPE65 injection in a volume-dependent manner.     

A whole genome association study in Icelandic multiple sclerosis patients with 4804 markers

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system (CNS) with a complex genetic background. Here we use a genome-wide association strategy with 4804 microsatellite markers successfully typed in separately pooled DNA from 200 patients and 200 controls. A total of 91 markers showed evidence of association. When compared to our in-house physical map of the genome, six 2-Mb regions containing at least two of these markers were detected. Of those, three regions have one or more markers among the 20 most strongly associated: chromosomes 3q25, 6p21.3 (the MHC region) and 19q13.     

A whole genome association study in multiple sclerosis patients from north Portugal

Genetic factors are known to influence susceptibility to multiple sclerosis (MS) but the genes involved are largely undefined. Here, we report an association study based on 200 patients and 200 controls from the Porto region in Portugal. A total of 3974 markers were successfully typed from which we have identified 46 markers showing evidence of association. When compared to a physical map three regions were found with two of these markers less than 1.5 Mb apart: chromosomes 6p21.3 (the MHC region), 6q14.1 and 7q34.     

Interval training compared with continuous training in patients with COPD

The aim of this study was to compare the effects of interval training (3-min intervals) with continuous training on peak exercise capacity (W peak), physiological response, functional capacity, dyspnoea, mental health and health-related quality of life (HRQoL) in patients with moderate or severe COPD. Sixty patients exercised twice weekly for 16 weeks after randomisation to interval- or continuous training. Target intensity was 80% of baseline W peak in the interval group (I-group) and 65% in the continuous group (C-group). Patients were tested by spirometry, ergometer cycle test, cardiopulmonary test and a 12 min walk test. Dyspnoea was measured by the dyspnoea scale from Chronic Obstructive Disease Questionnaire (CRDQ), mental health by Hospital Anxiety and Depression scale (HAD) and HRQoL by the Medical Outcomes Survey Short Form 36 (SF-36). After training, W peak, peak oxygen uptake (VO(2) peak) and exhaled carbon dioxide (VCO(2) peak) increased significantly in both groups, no significant differences between the groups. Minute ventilation (V(E) peak) increased only in the C-group. At identical work rates (isotime) VO(2), VCO(2) and V(E) were significantly more decreased in the I-group than in the C-group (p<0.05). Functional capacity, dyspnoea, mental health, and HRQoL improved significantly in both groups, no difference between the groups. Interval training and continuous training were equally potent in improving peak exercise capacity, functional exercise capacity, dyspnoea, mental health and HRQoL in patients with moderate or severe COPD. At isotime, the physiological response to training differed between the groups, in favour of the interval training.     

Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

Research questionDo women with polycystic ovary syndrome (PCOS) have higher testosterone levels during pregnancy and what role does high testosterone play in the development of obstetric complications?DesignRetrospective cohort study from Uppsala University Hospital, Sweden. The study population consisted of women with PCOS (n = 159) and a comparison group of women without PCOS matched for body mass index (n = 320). Plasma testosterone levels were measured in the early second trimester by liquid chromatography with tandem mass spectrometry, and women with PCOS were grouped into tertiles according to their testosterone levels. Possible associations with obstetric complications, maternal metabolic factors and offspring birth weight were explored by multivariable logistic and linear regression models.ResultsCompared with women who do not have PCOS, women with PCOS had higher total testosterone (median 1.94, interquartile range [IQR] 1.21–2.64 versus 1.41, IQR 0.89–1.97; P < 0.001), and free androgen index (median 0.25, IQR 0.15–0.36 versus 0.18, IQR 0.11–0.28; P < 0.001). Women with PCOS who had the highest levels of testosterone had increased risk for preeclampsia, even when adjusted for age, parity, country of birth and smoking (adjusted OR 6.16, 95% CI 1.82 to 20.91). No association was found between high testosterone in women with PCOS and other obstetric complications.ConclusionsWomen with PCOS have higher levels of total testosterone and free androgen index during pregnancy than women without PCOS matched for body mass index. Preliminary evidence shows that women with PCOS and the highest maternal testosterone levels in early second trimester had the highest risk of developing preeclampsia. This finding, however, is driven by a limited number of cases and should be interpreted with caution.