Association between serum tumor necrosis factor-alpha and corticotropin-releasing hormone levels in women with preterm labor

Aim: To evaluate the association of serum corticotropin-releasing hormone (CRH) and tumor necrosis factor-alpha (TNF-alpha) in preterm labor. Methods: Forty-nine primigravidas with a singleton viable pregnancy between 28 and 34 weeks of gestation were studied. They were divided into two groups. Group A consisted of 30 pregnant women (mean gestational age: 30.6 week) who presented with preterm labor and group B consisted of 19 pregnant women (mean gestational age: 29.8 week) with normal pregnancies. Results: Women of group A had significantly higher serum CRH levels compared to those of group B (P < 0.01). Similarly, serum TNF-alpha levels were significantly higher in women of group A when compared to women of group B (7.8 +/- 3.72 pg/mL and 5.1 +/- 3.72 pg/mL, respectively). Furthermore, a positive correlation was found between serum CRH and TNF-alpha levels in both groups, which was stronger in women of group A. Conclusions: Our findings suggest that the increased levels of TNF-alpha and CRH found in pregnant women presenting with preterm labor may be involved in the pathophysiological mechanism of the latter. Furthermore, a positive interaction may exist between TNF-alpha and placental CRH, which may lead to enhanced production of the second and, therefore, facilitate the onset of labor

Ovarian endometriosis associated with ovarian cancer and endometrial-endocervical polyps

Aim: To determine the prevalence of ovarian cancer and endometrial polyps in women with moderate and severe ovarian endometriosis. Methods: A retrospective analysis of 667 cases of moderate and severe endometriosis laparoscopically and histologically confirmed during the period 1997-2004. Results: One hundred and ninety-three (29%) of cases were American Fertility Society (AFS) stage III (moderate endometriosis) and 473 (71%) were AFS stage IV (severe endometriosis). Ovarian cancer was diagnosed in 13 cases (2.0%), while an endometrial or endocervical polyp was identified in 35 cases (5.3%). The incidence of endometrial polyps in the group with moderate endometriosis tended to be higher (15/193, 7.8%) than in the group with severe endometriosis (20/473, 4.2%), and the same results were obtained in the ovarian cancer group (moderate: 6/193, 3.1%; severe: 7/473, 1.5%). However, neither of the two differences was statistically significant. Conclusions: Ovarian endometriosis may be associated with an increased incidence of both ovarian cancer and endometrial polyps. Careful evaluation for coexistent pathology should be undertaken in women with symptomatic endometriosis

Prolactin and Preclinical Atherosclerosis in Menopausal Women With Cardiovascular Risk Factors

Hyperprolactinemia has been associated with endothelial dysfunction and an adverse cardiovascular risk profile, possibly as a result of the vasoconstrictive properties of prolactin. In this cross-sectional study, we examined the hypothesis that prolactin contributes to the increased cardiovascular risk occurring in early menopause by studying apparently healthy women without hyperprolactinemia. Prolactin serum levels were measured by immunoassay in 76 women aged 54.4 +/- 4.9 years in menopause for 4.9 +/- 2.8 years, and possible correlations with traditional cardiovascular risk factors and surrogate markers of preclinical atherosclerosis, arterial stiffening, and endothelial and microcirculatory function were examined. Positive correlations between prolactin serum levels and arterial blood pressure, but no other traditional risk factors, were found. Prolactin also correlated with central aortic systolic (r = 0.337; P = 0.002) and diastolic (r = 0.272; P = 0.012) blood pressures and pulse wave velocity (r = 0.264; P = 0.02), a marker of aortic stiffness, but not with endothelial or microcirculatory function or carotid intima-media thickness. By multivariate regression analysis, prolactin levels determined, independent of traditional risk factors, both blood pressures and aortic stiffness. Notably, prolactin correlated with European Society of Cardiology HeartScore (r = 0.364; P = 0.002), a composite index that predicts 10-year cardiovascular mortality. Prolactin levels >8.0 ng/mL had 100% sensitivity to predict a high peripheral blood pressure. Prolactin may play a role in accelerated arteriosclerosis in early menopause by affecting central/peripheral blood pressure and arterial stiffness. In contrast, no correlation was observed with other risk factors or surrogate markers of atherosclerosis. Prospective studies to assess whether prolactin is an additional hormone increasing cardiovascular risk are warranted. (Hypertension. 2009; 54: 98-105.

Quality of life and psychological symptoms in Greek postmenopausal women: Association with hormone therapy

Quality of life (QoL) in menopause is influenced by many parameters, including vasomotor symptoms, psychological status and culture. The aim of the present study was to examine the association of hormone therapy (HT) with QoL and psychological symptoms in Greek postmenopausal women. The study assessed 216 postmenopausal women (mean age 54.5 years) attending a university menopause clinic in Greece. Fifty-three were users of HT and 163 were not. QoL was evaluated by the Utian Quality of Life Scale (UQOL) and psychological symptoms were assessed by the Symptom Checklist-90-R (SCL-90-R). Women on HT were younger and more educated than women not using HT. Adjusting the analysis for the women’s characteristics, HT users had better total UQOL scores than non-users (p < 0.05). Marital status and education had independent effects on QoL, with married and more educated women scoring higher (p < 0.05). Assessment of psychological symptomatology, after adjustment for sociodemographic variables across the different dimensions, revealed that HT users had better SCL-90-R scores than non-users for obsessionality, interpersonal sensitivity and for the general index (p < 0.05). Concluding, even though the impact of sociodemographic and lifestyle variables must be factored into the assessment of QoL, HT use is independently related to an improvement in the total score and in most domains of QoL, and has a significant positive effect on many aspects of psychological well-being in Greek postmenopausal women