High rates of anorectal chlamydia in women:Cross-sectional study in general practice

BACKGROUND: Genital and anorectal Chlamydia trachomatis frequently present together in sexually transmitted infection clinics. AIM: This study aimed to investigate the prevalence of co-occurrent genital and anorectal chlamydia infection, and to study whether sexual behavior is associated with anorectal infection. DESIGN & SETTING: A cross-sectional study in general practices in the north of the Netherlands. METHOD: Women attending general practice with an indication for genital chlamydia testing were included and asked to complete a structured questionnaire on sexual behaviour. Anorectal infection prevalence was compared according to testing indications: standard vs experimental (ie, based on questionnaire answers). Variables associated with anorectal chlamydia were analysed by univariate and multivariate logistic regression analyses. RESULTS: Data could be analysed for 497 of 515 included women. Overall, 17.8% (87/490) were positive for C. trachomatis; of these, 72.4% (63/87) had co-occurrent genital and anorectal infection, 13.8% (12/87) had genital infection only, and 12.6% (11/87) had anorectal infection only. Rectal infection was missed in 69.3% of cases using the standard indication alone, while adding the sexual history still missed 20.0%. Age was the only variable significantly associated with anorectal infection. CONCLUSIONS: The prevalence of anorectal disease is high among women who visit their general practitioner with an indication for genital C. trachomatis testing. Many anorectal infections are missed despite taking comprehensive sexual histories, meaning that standard treatment of genital infection with azithromycin may result in rectal persistence. Performing anorectal testing in all women with an indication for genital C. trachomatis testing is therefore recommended

Pregnancy outcome in women with polycystic ovary syndrome comparing the effects of laparoscopic ovarian drilling and clomiphene citrate stimulation in women pre-treated with metformin: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Ovarian stimulation in women with polycystic ovary syndrome (PCOS) increases the risk for perinatal complications. Ovulation induction by laparoscopic ovarian drilling (LOD) might improve the overall pregnancy outcomes. The aim of our study was to assess the adverse events or effects on pregnancy of LOD and clomiphene citrate (CC) stimulation in patients who received metformin.</p> <p>Methods</p> <p>Setting: Academic research institution. We retrospectively analyzed the courses of 40 spontaneous pregnancies after LOD for CC-resistance, 40 pregnancies after CC stimulation, and 40 pregnancies after metformin treatment alone. Patients in the LOD and the CC groups had been pre-treated with Metformin. Primary outcome parameters were: the rate of multiple pregnancies; the rate of early pregnancy losses/miscarriages; the development of gestational diabetes, pregnancy-induced hypertension, and preeclampsia/HELLP-syndrome; premature delivery; and birth weight.</p> <p>Results</p> <p>The rate of twin pregnancies did not differ between the CC group (12.5%), the LOD group (7.5%), and the metformin only group (2.5%, p = 0.239). Seventeen women suffered an early miscarriage. There were no differences with regard to the rates of gestational diabetes, pregnancy-induced hypertension, preeclampsia, and preterm delivery. By analyzing all pregnancy complications together, the overall pregnancy complication rate was highest in the CC group (70.0%, 28/40), followed by the LOD group (45.0%, 18/40), and the metformin only group (47.5%, 19/40; p = 0.047).</p> <p>Conclusions</p> <p>CC, but not LOD, increases the complication rate in pregnant patients who received metformin.</p

The 492 GHz emission of Sgr A* constrained by ALMA

We report linearly polarized continuum emission properties of Sgr A* at $\sim$492 GHz, based on the Atacama Large Millimeter Array (ALMA) observations. We used the observations of the likely unpolarized continuum emission of Titan, and the observations of C\textsc{i} line emission, to gauge the degree of spurious polarization. The Stokes I flux of 3.6$\pm$0.72 Jy during our run is consistent with extrapolations from the previous, lower frequency observations. We found that the continuum emission of Sgr A* at $\sim$492 GHz shows large amplitude differences between the XX and the YY correlations. The observed intensity ratio between the XX and YY correlations as a function of parallactic angle may be explained by a constant polarization position angle of $\sim$158$^{\circ}$$\pm$3$^{\circ}$. The fitted polarization percentage of Sgr A* during our observational period is 14\%$\pm$1.2\%. The calibrator quasar J1744-3116 we observed at the same night can be fitted to Stokes I = 252 mJy, with 7.9\%$\pm$0.9\% polarization in position angle P.A. = 4.1$^{\circ}$$\pm$4.2$^{\circ}$. The observed polarization percentage and polarization position angle in the present work appear consistent with those expected from longer wavelength observations in the period of 1999-2005. In particular, the polarization position angle at 492 GHz, expected from the previously fitted 167$^{\circ}$$\pm$7$^{\circ}$ intrinsic polarization position angle and (-5.6$\pm$0.7)$\times$10$^{5}$ rotation measure, is 155$^{+9}_{-8}$, which is consistent with our new measurement of polarization position angle within 1$\sigma$. The polarization percentage and the polarization position angle may be varying over the period of our ALMA 12m Array observations, which demands further investigation with future polarization observations.Comment: 10 pages, 6 figures, 1st referee report received and revise

Evaluation of the role of STAP1 in Familial Hypercholesterolemia

Familial hypercholesterolemia (FH) is characterised by elevated serum levels of low-density lipoprotein cholesterol (LDL-C) and a substantial risk for cardiovascular disease. The autosomal-dominant FH is mostly caused by mutations in LDLR (low density lipoprotein receptor), APOB (apolipoprotein B), and PCSK9 (proprotein convertase subtilisin/kexin). Recently, STAP1 has been suggested as a fourth causative gene. We analyzed STAP1 in 75 hypercholesterolemic patients from Berlin, Germany, who are negative for mutations in canonical FH genes. In 10 patients with negative family history, we additionally screened for disease causing variants in LDLRAP1 (low density lipoprotein receptor adaptor protein 1), associated with autosomal-recessive hypercholesterolemia. We identified one STAP1 variant predicted to be disease causing. To evaluate association of serum lipid levels and STAP1 carrier status, we analyzed 20 individuals from a population based cohort, the Cooperative Health Research in South Tyrol (CHRIS) study, carrying rare STAP1 variants. Out of the same cohort we randomly selected 100 non-carriers as control. In the Berlin FH cohort STAP1 variants were rare. In the CHRIS cohort, we obtained no statistically significant differences between carriers and non-carriers of STAP1 variants with respect to lipid traits. Until such an association has been verified in more individuals with genetic variants in STAP1, we cannot estimate whether STAP1 generally is a causative gene for FH

Pregnancy rates after slow-release insemination (SRI) and standard bolus intrauterine insemination (IUI) – A multicentre randomised, controlled trial

Abstract: This multicentre, randomised, controlled cross-over trial was designed to investigate the effect of intra-uterine slow-release insemination (SRI) on pregnancy rates in women with confirmed infertility or the need for semen donation who were eligible for standard bolus intra-uterine insemination (IUI). Data for a total of 182 women were analysed after randomisation to receive IUI (n = 96) or SRI (n = 86) first. The primary outcome was serological pregnancy defined by a positive beta human chorionic gonadotropin test, two weeks after insemination. Patients who did not conceive after the first cycle switched to the alternative technique for the second cycle: 44 women switched to IUI and 58 switched to SRI. In total, there were 284 treatment cycles (IUI: n = 140; SRI: n = 144). Pregnancy rates following SRI and IUI were 13.2% and 10.0%, respectively, which was not statistically significant (p = 0.202). A statistically significant difference in pregnancy rates for SRI versus IUI was detected in women aged under 35 years. In this subgroup, the pregnancy rate with SRI was 17% compared to 7% with IUI (relative risk 2.33; p = 0.032) across both cycles. These results support the hypothesis that the pregnancy rate might be improved with SRI compared to standard bolus IUI, especially in women aged under 35 years

Inducible chromatin priming is associated with the establishment of immunological memory in T cells

Immunological memory is a defining feature of vertebrate physiology, allowing rapid responses to repeat infections. However, the molecular mechanisms required for its establishment and maintenance remain poorly understood. Here, we demonstrated that the first steps in the acquisition of T-cell memory occurred during the initial activation phase of naïve T cells by an antigenic stimulus. This event initiated extensive chromatin remodeling that reprogrammed immune response genes toward a stably maintained primed state, prior to terminal differentiation. Activation induced the transcription factors NFAT and AP-1 which created thousands of new DNase I-hypersensitive sites (DHSs), enabling ETS-1 and RUNX1 recruitment to previously inaccessible sites. Significantly, these DHSs remained stable long after activation ceased, were preserved following replication, and were maintained in memory-phenotype cells. We show that primed DHSs maintain regions of active chromatin in the vicinity of inducible genes and enhancers that regulate immune responses. We suggest that this priming mechanism may contribute to immunological memory in T cells by facilitating the induction of nearby inducible regulatory elements in previously activated T cells

The Molecular ISM in the Super Star Clusters of the Starburst NGC 253

We present submillimeter spectra of the (proto-)super star cluster (SSC) candidates in the starbursting center of the nearby galaxy NGC 253 identified by Leroy et al. (2018). The 2.5pc resolution of our ALMA cycle 3 observations approach the size of the SSCs and allows the study of physical and chemical properties of the molecular gas in these sources. In the 14 SSC sources and in the frequency ranges 342.0-345.8 GHz and 353.9-357.7 GHz we detect 55 lines belonging to 19 different chemical species. The SSCs differ significantly in chemical complexity, with the richest clusters showing 19 species and the least complex showing 4 species. We detect HCN isotopologues and isomers (H$^{13}$CN, HC$^{15}$N, H$^{15}$NC), abundant HC$_3$N, SO and S$^{18}$O, SO$_2$, and H$_2$CS. The gas ratios CO/HCN, CO/HCO$^+$ are low, ~1-10, implying high dense gas fractions in the SSCs. Line ratio analyses suggests chemistry consistent with photon-dominated regions and mechanical heating. None of the SSCs near the galaxy center show line ratios that imply an X-ray dominated region, suggesting that heating by any (still unknown) AGN does not play a major role. The gas temperatures are high in most sources, with an average rotational temperature of ~130 K in SO$_2$. The widespread existence of vibrationally excited HCN and HC$_3$N transitions implies strong IR radiation fields, potentially trapped by a greenhouse effect due to high continuum opacities.Comment: 20 pages, 4 figures, 6 tables; accepted for publication in the Astrophysical Journa