NEW THERAPEUTIC OPTION AND INSIGHTS INTO THE IMPACT OF SYMPTOM SEVERITY ON QUALITY OF LIFE IN WOMEN WITH INTERSTITIAL CYSTITIS

Background: Interstitial Cystitis (IC) is a poorly understood condition of urinary bladder characterized by pelvic pain, urinary frequency, urgency and nocturia in the absence of other obvious pathology. The public health significance of IC is related to its profound impact on patients' physical and emotional Quality of Life (QOL). The actual prevalence rate is unknown, and estimates range widely from 67/100,000 to 575/100,000. The majority of IC cases are females in the midlife age. This research addressed 1) the extent to which socio-demographic and clinical factors affect both symptom severity and QOL in IC patients, 2) the impact of symptom severity on QOL and 3) the efficacy of a combination of oral and intravesical Pentosan Polysulfate Sodium (PPS) as a new therapeutic option for IC. Methods: Forty one women with IC (age 20-71 years) were studied. Demographic, reproductive and clinical characteristics as well as QOL measures were evaluated in a cross-sectional design to assess the first two aims. To examine the third aim, participants were randomized to receive either a combination of oral plus intravesical PPS (treatment group) or oral PPS plus intravesical placebo (placebo group) in a clinical trial design. The main outcomes were the changes in subjective and objective measures of symptom severity, QOL and sexual functions. Results: Unmarried patients reported more severe symptoms compared to married patients. Being unemployed, obese, currently unmarried and never pregnant were associated with a decrement in at least one QOL domain. Moreover, symptom severity was associated with worse QOL on 4 domains, (p<0.05). On the other hand, the results from the clinical trial showed a greater significant reduction in symptom severity among the treatment group compared to the placebo group (46% reduction vs. 24% reduction respectively, p=0.04) and significant improvement in all QOL domains in the treatment group compared to the baseline (p<0.05). Conclusion: Being unmarried and symptom severity are important factors that may disturb the QOL in IC patients. Moreover, the use of intravesical PPS simultaneously with oral PPS is an effective therapeutic option. The findings of this research will open a new option for IC patients to reduce their devastating symptoms and to improve their quality of life

Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study.

BackgroundVolumes of paracardial adipose tissue (PAT) and epicardial adipose tissue (EAT) are greater after menopause. Interestingly, PAT but not EAT is associated with estradiol decline, suggesting a potential role of menopause in PAT accumulation. We assessed whether volumes of heart fat depot (EAT and PAT) were associated with coronary artery calcification (CAC) in women at midlife and whether these associations were modified by menopausal status and estradiol levels.Methods and resultsEAT and PAT volumes and CAC were measured using electron beam computed tomography scans. CAC was evaluated as (1) the presence of CAC (CAC Agatston score ≥10) and (2) the extent of any CAC (log CAC Agatston score &gt;0). The study included 478 women aged 50.9&nbsp;years (58% pre- or early perimenopausal, 10% late perimenopausal, and 32% postmenopausal). EAT was significantly associated with CAC measures, and these associations were not modified by menopausal status or estradiol. In contrast, associations between PAT and CAC measures were modified by menopausal status (interaction-P≤0.01). Independent of study covariates including other adiposity measures, each 1-SD unit increase in log PAT was associated with 102% higher risk of CAC presence (P=0.04) and an 80% increase in CAC extent (P=0.008) in postmenopausal women compared with pre- or early perimenopausal women. Additional adjustment for estradiol and hormone therapy attenuated these differences. Moreover, the association between PAT and CAC extent was stronger in women with lower estradiol levels (interaction P=0.004).ConclusionsThe findings suggest that PAT is a potential menopause-specific coronary artery disease risk marker, supporting the need to monitor and target this fat depot for intervention in women at midlife

Is race or ethnicity associated with under‐utilization of statins among women in the United States: The study of women's health across the nation

BACKGROUND: Rates of statin use among minority women are unclear. HYPOTHESIS: We hypothesized that statin use would vary by race/ethnicity with lower rates among minority women compared with Whites. METHODS: Data from the study of women's health across the nation, a multiethnic cohort of women collected between 2009 to 2011 were used to examine reported statin use by race/ethnicity and risk profile. Multivariable logistic modeling was performed to estimate the odds ratio (OR) of statin treatment. RESULTS: Of the 2399 women included, 234 had a diagnosis of atherosclerotic disease (ASCVD), 254 were diabetic (without ASCVD), 163 had an LDL ≥190 mg/dL, and 151 had a 10 year ASCVD pooled risk score ≥7.5%. Statins were used by 49.6% of women with CVD; 59.8% of women with diabetes without known ASCVD; 42.3% of women with an LDL ≥190 mg/dL; and 19.9% of women with an ASCVD risk ≥7.5%. Rates of statin use were 43.8% for women with ≥ two prior ASCVD events and 69.4% for women with ≥ one prior ASCVD event plus multiple high-risk conditions. Among women eligible for statins, Black women had a significantly reduced adjusted odds of being on a statin (OR 0.53, 95% confidence interval [CI] 0.36-0.78) compared with White women. CONCLUSIONS: In this cohort of multiethnic women, rates of statin use among women who would benefit were low, with Black women having lower odds of statin use than White women

The quantity and quality of cardiovascular fat at mid‐life and future cognitive performance among women: The SWAN cardiovascular fat ancillary study

IntroductionCardiovascular fat is a novel risk factor that may link to dementia. Fat volume and radiodensity are measurements of fat quantity and quality, respectively. Importantly, high fat radiodensity could indicate healthy or adverse metabolic processes.MethodsThe associations of cardiovascular fat (including epicardial, paracardial, and thoracic perivascular adipose tissue [PVAT]) quantity and quality assessed at mean age of 51 with subsequent cognitive performance measured repeatedly over 16 years of follow-up were examined using mixed models among 531 women.ResultsHigher thoracic PVAT volume was associated with a higher future episodic memory (β[standard error (SE)]&nbsp;=&nbsp;0.08 [0.04], P&nbsp;=&nbsp;0.033), while higher thoracic PVAT radiodensity with lower future episodic (β[SE]&nbsp;=&nbsp;-0.06 [0.03], P&nbsp;=&nbsp;0.045) and working (β[SE]&nbsp;=&nbsp;-0.24 [0.08], P&nbsp;=&nbsp;0.003) memories. The latter association is prominent at higher volume of thoracic PVAT.DiscussionMid-life thoracic PVAT may have a distinct contribution to future cognition possibly due to its distinct adipose tissue type (brown fat) and anatomical proximity to the brain circulation.HighlightsHigher mid-life thoracic perivascular adipose tissue (thoracic PVAT) volume is related to a better future episodic memory in women. Higher mid-life thoracic PVAT radiodensity is related to worse future working and episodic memories. Negative association of high thoracic PVAT radiodensity with working memory is prominent at higher thoracic PVAT volume. Mid-life thoracic PVAT is linked to future memory loss, an early sign of Alzheimer's disease. Mid-life women's epicardial and paracardial fat are not related to future cognition

NAMS 2021 Utian Translational Science Symposium September 2021, Washington, DC - \u3eCharting the path to health in midlife and beyond: The biology and practice of wellness

Charting the Path to Health in Midlife and Beyond: The Biology and Practice of Wellness was a Translational Science Symposium held on Tuesday, September 21, 2021. Foundational psychosocial and behavioral approaches to promote healthy aging and strategies to disseminate this information were discussed. The following synopsis documents the conversation, describes the state of the science, and outlines a path forward for clinical practice. Wellness, in its broadest sense, prioritizes an orientation toward health, and an embrace of behaviors that will promote it. It involves a journey to improve and maintain physical and mental health and overall well-being to fully engage and live one\u27s best life. It is more about recognizing and optimizing what one can do than what one cannot do and emphasizes the individual\u27s agency over changing what they are able to change. Wellness is therefore not a passive state but rather an active goal to be sought continually. When viewed in this fashion, wellness is accessible to all. The conference addressed multiple aspects of wellness and embraced this philosophy throughout

Protocol for a global menopause priority setting partnership

Introduction: All those born with functioning ovaries will eventually experience menopause, and many will be symptomatic. However, significant gaps in the evidence base for menopause care remain. This National Institute for Health and Care Research James Lind Alliance Menopause Priority Setting Partnership (MAPS) will engage with clinicians and those with lived experience globally to determine the leading priorities for future menopause research. Methods and analysis: MAPS will follow the established James Lind Alliance methodology which has already resulted in over 100 ‘top 10’ research priorities across health domains. It will be led by a steering group comprised of clinicians and lived experience members. Leveraging the networks of steering group members and partner organisations, the priority setting partnership will identify evidence uncertainties using an online survey. Evidence checking will be undertaken to determine which questions have already been answered. Prioritisation will be done in two stages, initially by online survey and then at a face-to-face workshop. Ethics and dissemination: Ethical approval was not required. The final top 10 priorities for menopause, as ranked by stakeholders at the final consensus workshop, will be disseminated in the relevant peer-reviewed journals. A final report will be available on the MAPS and James Lind Alliance websites. The leading priorities will inform the future global research agenda for menopause