Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Sexual function of women with premature ovarian failure

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Objective: The aim of this study was to evaluate the sexual function of women with premature ovarian failure (POF). Methods: A cross-sectional study was performed to evaluate 58 women with a diagnosis of POF compared with a control group composed of 58 women of reproductive age with normal ovarian function, paired for age (+/- 2 y). Sexual function was evaluated in the two groups using the Female Sexual Function Index (FSFI). Results: The mean +/- SD age of the women in the POF and control groups was 39.4 +/- 6.5 and 39.0 +/- 6.8 years, respectively. Mean +/- SD FSFI score was 24.0 +/- 6.0 and 27.3 +/- 4.8 in the POF and control groups, respectively. The prevalence of sexual dysfunction (total FSFI score <= 26.55) in the POF group was 62.1% (n = 36) compared with 37.8% (n = 22) in the control group (P = 0.0093). In the analysis of domains, the only domain in which no statistically significant difference was found between the two groups was desire. For the domains of arousal, lubrication, orgasm, satisfaction, and pain, scores were significantly lower, hence poorer, in the group of women with POF compared with the control group. Belonging to the POF group increased a woman's likelihood of having sexual dysfunction by 2.8-fold (OR = 2.78, IC 1.29 to 5.98, P < 0.05). Conclusions: Women with POF had a higher prevalence of sexual dysfunction compared with women with normal gonadal function and more difficulties in relation to satisfaction, lubrication, orgasm, pain, and arousal; however, there were no differences between the two groups with respect to desire.183262266Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Quality of life in women with premature ovarian failure

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)A cross-sectional and case-control study with a matching for age was performed to evaluate quality of life in 58 women with a diagnosis of premature ovarian failure (POF) and 58 women with normal ovarian function paired for age (+/- 2 years) (control group). In both groups were excluded women with chronic diseases and iatrogenic or genetic causes. Quality of life was evaluated using the WHOQOL-BREF. Although there were no statistically significant differences in quality of life in general between the two groups, there were statistically significant differences in mean scores in the physical health [61.3 +/- 18.0 and 72.8 +/- 16.4 for the POF and control groups, respectively (p < 0.0001)] and psychological domains [64.2 +/- 16.7 and 69.3 +/- 14.1, respectively (p = 0.0455)]. Having POF represented an approximately 2.5-fold greater risk of scoring poorly in the physical health and psychological domains. No statistically significant differences were found between the groups with respect to the social relationships or environment domains or for overall health. Women with POF have more difficulty with respect to their physical health and psychological aspects, indicating a need to provide adequate psychosocial and clinical support for these women to minimize the repercussion of this diagnosis on their activities and quality of life.279645649Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Ministry of Education, BrazilCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Subclinical hypothyroidism in young women with polycystic ovary syndrome: an analysis of clinical, hormonal, and metabolic parameters

Objective: To analyze the relationship between selected clinical and metabolic parameters in young women with polycystic ovary syndrome (PCOS) and normal thyroid function or subclinical hypothyroidism (SCH). Design: A cross-sectional cohort study. Setting: Tertiary care clinic. Patient(s): Women diagnosed with PCOS according to the Rotterdam criteria (n = 168). Intervention(s): Clinical, hormonal, and metabolic parameters were evaluated. SCH was defined as TSH levels of 4.5-10 mIU/L. Main Outcome Measure(s): Separately, PCOS and SCH exert adverse effects on metabolic parameters; however, in conjunction their effect is unclear. This study evaluated whether SCH in women with PCOS affects clinical, hormonal, and metabolic parameters. Result(s): The mean age of the 168 women was 24 +/- 5.8 years. Mean body mass index was 33.4 +/- 8.2 kg/m(2). Thyroid function was normal in 149 women, and 19 had SCH. Only serum low-density lipoprotein cholesterol and PRL levels were significantly higher in the women with SCH (122.6 +/- 25.6 mg/dL and 17.7 +/- 7.7 ng/mL, respectively) compared with those with normal thyroid function (105.6 +/- 33 mg/dL and 14 +/- 10.3 ng/mL, respectively). Conclusion(s): In young women with PCOS, SCH is associated with higher low-density lipoprotein cholesterol levels, albeit with no changes in other lipid profile parameters, insulin resistance, or phenotypic manifestations. This study adds to current evidence supporting an association between PCOS and SCH. (Fertil Steril (R) 2013; 99: 588-92. (C) 2013 by American Society for Reproductive Medicine.)99258859

Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women

BACKGROUND: The study aim was to assess the time elapsed between onset of symptoms and diagnosis of endometriosis, and,to identify the factors associated with diagnostic delay in a group of Brazilian women. METHODS: In this retrospective cohort study, 200 women with surgically confirmed endometriosis were interviewed at an endometriosis outpatient clinic. RESULTS: The median (interquartile range) time elapsed from onset of symptoms until diagnosis of endometriosis was 7.0 (range 3.5-12.1) years. The younger the women at onset of symptoms, the longer the period for diagnosis to be made: the median delay was 12.1 (range 8.0-17.2) years in women aged less than or equal to19 years, and 3.3 (range 2.0-5.5) years in women aged greater than or equal to30 years. The median time period between onset of symptoms and diagnosis was 4.0 (2.0-6.0) years for women whose main complaint was infertility, but 7.4 (3.6-13.0) years for those with pelvic pain. CONCLUSIONS: The delay in diagnosis of endometriosis was considered to be long, and especially so for young women with pelvic pain. More information relating to endometriosis should be offered to general physicians and gynaecologists in order to reduce the time taken to diagnose this condition.18475675

17-hydroxyprogesterone deficiency as a cause of sexual infantilism and arterial hypertension: Laboratory and molecular diagnosis - a case report

The differential diagnosis of hypertension associated with hypokalemia in infancy and adolescence should necessarily include deficiency of the 17 alpha-hydroxylase enzyme, a rare form of congenital adrenal hyperplasia (CAH). In addition to hypertension, the classic syndrome caused by this deficiency is characterized by suppressed production of sex hormones and consequently sexual infantilism. Although rare (1% of all forms of CAH), there appears to be a higher incidence of this syndrome in some population groups. This is a case report on two sisters followed up at the Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), who were both found to have the 46,XY genotype with homozygosis for W406R, exon 7 of the CYP17 gene (OMIM 202110). The condition was diagnosed only at puberty when hypergonadotropic hypogonadism resulted in sexual infantilism; however, arterial hypertension had been present since infancy and late diagnosis and lack of timely adequate treatment resulted in complications.232949

Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment

Aim: To evaluate the frequency of complications and factors associated with the recurrence of endometriosis in women with deep infiltrating endometriosis (DIE) undergoing surgical treatment. Methods: A retrospective observational cohort study with 72 women who underwent surgery and followed up by DIE at the University of Campinas from 2007 to 2017. The variables analyzed were clinical characteristics, use and type of drug treatment before and after surgery, operative time and complications inherent to the procedure, as well as the recurrence of lesions on imaging. Results: The mean age of women was 39.7 ± 6.3 years and the mean follow-up was 4.56 ± 2.60 years. Complications were reported in 16.6% of surgeries and recurrence of lesions in 34.7%. The risk of intraoperative complications was higher in the presence of lesions of the bowel and in those who used intramuscular progestin before surgery. A higher risk of recurrence was observed among those who did not use hormonal treatment or used a levonorgestrel-releasing intrauterine device (LNG-IUD) in the postoperative period. Conclusion: Women with DIE have a high rate of complications during surgical treatment and a higher risk of recurrence when they did not receive hormonal treatment or when treated with LNG-IUD after surgery

Factors associated with the reduction of bone density in patients with gonadal dysgenesis

Objective: To correlate bone mineral density (BMD) in women with primary hypoestrogenism caused by 46,XX pure gonadal dysgenesis or Turner's syndrome with age, age at estrogen therapy initiation, length of estrogen use, and body mass index (BMI). Design: Cross-sectional study. Setting: Academic tertiary-care hospital. Patient(s): Thirty-eight women, aged 16 to 35 years (mean, 24.6 years), affected by these genetic disorders. Intervention(s): Measurement of lumbar spine and femoral neck BMD using double x-ray absorptiometry. The results were correlated with the control variables by using Pearson's coefficient of correlation. Variables associated with BMD were evaluated by multiple linear regression analysis. Main Outcome Measure(s): Bone mineral density. Result(s): Bone mineral density of the lumbar spine showed that 90% of the women presented osteopenia or osteoporosis. The femoral neck was affected in 55% of these women. The length of estrogen therapy and the BMI showed a positive association with BMD at the lumbar spine and femoral neck, respectively. Conclusion(s): Women affected by pure gonadal dysgenesis or Turner's syndrome presented a marked decrease in BMD of the lumbar spine and femoral neck. Medical attention for their diagnosis and early hormone replacement therapy are advised. (C) 2002 by American Society for Reproductive Medicine.77357157

Breast density in women with premature ovarian failure using hormone therapy

Background. Women with premature ovarian failure (POF) are treated with estrogen-progestin therapy; however, doubts remain regarding the effect of this therapy on the breasts of women with POF. Objective. To evaluate the breast density of women with POF using estrogen-progestin therapy compared with normally menstruating women. Methods. A cross-sectional study was performed in 31 women with POF using conjugated equine estrogens and medroxyprogesterone acetate and a control group of 31 normally menstruating women, paired by age. All underwent mammography, analyzed by digitization and Wolfe's classification, the latter defined as non-dense (N1 and P1) or dense (P2 and Dy). Parity, breastfeeding and body mass index were evaluated, as well as duration of hormone use and ovarian failure in the POF group. Results. Digitization revealed no difference in mean breast density between the groups: 24.1 +/- 14.6% and 21.8 +/- 11.3% for POF and control groups, respectively. The Wolfe classification also failed to detect any significant difference between the groups, dense breasts being detected in 51.6% and 35.5% of cases in the POF and control groups, respectively. Conclusion. Periods of hypoestrogenism followed by hormone therapy resulted in no changes in breast density in women with POF, compared with normally menstruating women of the same age.241404