Efficacy of a therapeutic wand in addition to physiotherapy for treating bladder pain syndrome in women: a pilot randomized controlled trial

YesThe aim of this study was to assess the feasibility of a randomized controlled trial (PFM) treatment in women with bladder pain syndrome (BPS). Prolonged PFM tension contributes to the bladder pain, urinary frequency and urgency associated with BPS. Pelvic health physiotherapists routinely provide intravaginal myofascial release (MFR) to the PFMs in order to effectively reduce symptoms. Rapid access A TW was designed so as to allow men with chronic pelvic pain to self- treat, and this may be effective in women with BPS. For 6 weeks, two groups received weekly physiotherapist- provided MFR, and were monitored for a further 6- week follow- up period. One group also used a TW at home three times a week throughout the pilot. Weekly outcome measures of BPS symptoms and quality of life were recorded. A clinically meaningful difference in Interstitial Cystitis Symptoms Index and Interstitial Cystitis Problem Index score changes between groups was group = 6.20 ± 0.83 and 5.00 ± 1.41, respectively), and a difference was observed during the follow- up period (control group = 4.50 ± 1.73 and 4.00 ± 2.44, respecevents. Using the TW appears to have enhanced physiotherapy treatment during the initial 6 weeks, and improved symptoms during the 6- week follow- up period. The TW may be a clinically useful tool for long- term management of BPS. The feasibility of the study method was proven, some alterations were recommended and an RCT is now warranted

Recovery of menses after functional hypothalamic amenorrhoea: if, when and why

BACKGROUND Prolonged amenorrhoea occurs as a consequence of functional hypothalamic amenorrhoea (FHA) which is most often induced by weight loss, vigorous exercise or emotional stress. Unfortunately, removal of these triggers does not always result in the return of menses. The prevalence and conditions underlying the timing of return of menses vary strongly and some women report amenorrhoea several years after having achieved and maintained normal weight and/or energy balance. A better understanding of these factors would also allow improved counselling in the context of infertility. Although BMI, percentage body fat and hormonal parameters are known to be involved in the initiation of the menstrual cycle, their role in the physiology of return of menses is currently poorly understood. We summarise here the current knowledge on the epidemiology and physiology of return of menses. OBJECTIVE AND RATIONALE The aim of this review was to provide an overview of (i) factors determining the recovery of menses and its timing, (ii) how such factors may exert their physiological effects and (iii) whether there are useful therapeutic options to induce recovery. SEARCH METHODS We searched articles published in English, French or German language containing keywords related to return of menses after FHA published in PubMed between 1966 and February 2020. Manuscripts reporting data on either the epidemiology or the physiology of recovery of menses were included and bibliographies were reviewed for further relevant literature. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria served to assess quality of observational studies. OUTCOMES Few studies investigate return of menses and most of them have serious qualitative and methodological limitations. These include (i) the lack of precise definitions for FHA or resumption of menses, (ii) the use of short observation periods with unsatisfactory descriptions and (iii) the inclusion of poorly characterised small study groups. The comparison of studies is further hampered by very inhomogeneous study designs. Consequently, the exact prevalence of resumption of menses after FHA is unknown. Also, the timepoint of return of menses varies strongly and reliable prediction models are lacking. While weight, body fat and energy availability are associated with the return of menses, psychological factors also have a strong impact on the menstrual cycle and on behaviour known to increase the risk of FHA. Drug therapies with metreleptin or naltrexone might represent further opportunities to increase the chances of return of menses, but these require further evaluation

The Sensitivity of Auditory-Motor Representations to Subtle Changes in Auditory Feedback While Singing

Singing requires accurate control of the fundamental frequency (F0) of the voice. This study examined trained singers’ and untrained singers’ (nonsingers’) sensitivity to subtle manipulations in auditory feedback and the subsequent effect on the mapping between F0 feedback and vocal control. Participants produced the consonant-vowel /ta/ while receiving auditory feedback that was shifted up and down in frequency. Results showed that singers and nonsingers compensated to a similar degree when presented with frequency-altered feedback (FAF); however, singers’ F0 values were consistently closer to the intended pitch target. Moreover, singers initiated their compensatory responses when auditory feedback was shifted up or down 6 cents or more, compared to nonsingers who began compensating when feedback was shifted up 26 cents and down 22 cents. Additionally, examination of the first 50 ms of vocalization indicated that participants commenced subsequent vocal utterances, during FAF, near the F0 value on previous shift trials. Interestingly, nonsingers commenced F0 productions below the pitch target and increased their F0 until they matched the note. Thus, singers and nonsingers rely on an internal model to regulate voice F0, but singers’ models appear to be more sensitive in response to subtle discrepancies in auditory feedback

Neuromuscular Blockade with Rocuronium Bromide Increases the Tolerance of Acute Normovolemic Anemia in Anesthetized Pigs

Background: The patient's individual anemia tolerance is pivotal when blood transfusions become necessary, but are not feasible for some reason. To date, the effects of neuromuscular blockade (NMB) on anemia tolerance have not been investigated. Methods: 14 anesthetized and mechanically ventilated pigs were randomly assigned to the Roc group (3.78 mg/kg rocuronium bromide followed by continuous infusion of 1 mg/kg/min, n = 7) or to the Sal group (administration of the corresponding volume of normal saline, n = 7). Subsequently, acute normovolemic anemia was induced by simultaneous exchange of whole blood for a 6% hydroxyethyl starch solution (130/0.4) until a sudden decrease of total body O-2 consumption (VO2) indicated a critical limitation of O-2 transport capacity. The Hb concentration quantified at this time point (Hb(crit)) was the primary end-point of the protocol. Secondary endpoints were parameters of hemodynamics, O-2 transport and tissue oxygenation. Results: Hb(crit) was significantly lower in the Roc group (2.4 +/- 0.5 vs. 3.2 +/- 0.7 g/dl) reflecting increased anemia tolerance. NMB with rocuronium bromide reduced skeletal muscular VO2 and total body O-2 extraction rate. As the cardiac index increased simultaneously, total body VO2 only decreased marginally in the Roc group (change of VO2 relative to baseline -1.7 +/- 0.8 vs. 3.2 +/- 1.9% in the Sal group, p < 0.05). Conclusion: Deep NMB with rocuronium bromide increases the tolerance of acute normovolemic anemia. The underlying mechanism most likely involves a reduction of skeletal muscular VO2. During acellular treatment of an acute blood loss, NMB might play an adjuvant role in situations where profound stages of normovolemic anemia have to be tolerated (e.g. bridging an unexpected blood loss until blood products become available for transfusion). Copyright (C) 2011 S. Karger AG, Base

Early differentiation of magmatic iron meteorite parent bodies from Mn–Cr chronometry

Magmatic iron meteorite groups such as IIAB, IIIAB and IVA, represent the largest sampling of extraterrestrial core material from the earliest accreted distinct planetary bodies in the solar system. Chromium isotope compositions of chromite/daubréelite from seven samples, translated into 53Cr/52Cr model ages, provide robust time information on planetary core formation. These ages are within ∼1.5 Ma after formation of calcium-aluminium-rich inclusions (CAIs) and define the time of metal core formation in the respective parent bodies, assuming metal–silicate separation was an instantaneous event that induced strong chemical fractionation of Mn from the more siderophile Cr. The early core formation ages support accretion and differentiation of the magmatic iron meteorite parent bodies to have occurred prior to the chondrule formation interval. The calibration of Mn–Cr ages with established Hf–W ages of samples from the same magmatic iron meteorite groups constrains the initial ɛ53Cr of the solar system to −0.30 ± 0.05, and thus lower than previously estimated

Time and duration of chondrule formation: Constraints from 26Al-26Mg ages of individual chondrules

Chondrules from unequilibrated ordinary and carbonaceous chondrites belong to the oldest and most primitive materials from the early solar system and record chemical and isotopic signatures relating to their formation and evolution. These signatures allow tracing protoplanetary disk processes that eventually led to the formation of planetary building blocks and rocky planets. 26Al-26Mg ages based on mineral-mesostasis isochrons of 31 porphyritic ferromagnesian chondrules, that belong mainly to type-II, constrain the time of chondrule melting prior to incorporation into the respective chondrite parent bodies. For this study chondrules from the unequilibrated L, L(LL) and LL ordinary chondrites (UOCs) NWA 5206, NWA 8276, MET 96503, MET 00452, MET 00526, NWA 7936 and QUE 97008 were selected, which are of petrologic types 3.00-3.15 and were thus least metamorphosed after formation. Magnesium and Al isotopes were measured in-situ by Secondary Ion Mass Spectrometry (SIMS) using a CAMECA 1280 ims. 26Mg excess from in-situ decay of 26Al correlating with 27Al/24Mg has been detected in the mesostasis of all but one chondrule. The initial Al isotopic compositions (26Al/27Al)0 and 26Mg/24Mg ratios (d26Mg*0) deduced from internal mineral isochron regressions range from (9.5 ± 2.8) × 10-6 to (3.1 ± 1.2) × 10-6 and -0.020 ± 0.028‰ to 0.011 ± 0.039‰, respectively. The corresponding chondrule ages (∆tCAI), calculated relative to calcium-aluminum-rich inclusions (CAIs) using the canonical 26Al/27Al = (5.23 ± 0.13) × 10-5, are between 1.76_(-0.27)^(+0.36) and 2.92_(-0.34)^(+0.51) Ma and date the melt formation and thus primary chondrule formation from dust-like precursors or reprocessing of older chondrules. The age range agrees with those acquired with different short-lived chronometers and with published 26Al-26Mg ages, the majority of which were obtained for chondrules from the Bishunpur and Semarkona meteorites, although no chondrule with (26Al/27Al)0 > 10-5 was found. Chondrules in single chondrite samples or between different chondrite groups show no distinct age distributions. The initial 26Al/27Al of the oldest chondrules in the L(LL)/LL and L chondrite samples are identical within their 1σ uncertainties and yield a mean age of 1.99_(-0.08)^(+0.08) Ma and 1.81_(-0.10)^(+0.11) Ma, respectively. The oldest chondrules from six of the seven studied samples record a mean age of 1.94_(-0.06)^(+0.07) Ma. Since heating events in the protoplanetary disk could have partially reset the Al-Mg systematics in pre-existing chondrules and this would have shifted recorded 26Al-26Mg ages toward younger dates, the oldest mean age of 1.81_(-0.10)^(+0.11) Ma recorded in L chondrite chondrules is interpreted to date the rapid and punctuated onset of chondrule formation. The density distribution of chondrule ages from this study, which comprises the largest single dataset of OC chondrule ages, combined with published ages for chondrules from ordinary and carbonaceous chondrites reveals major age peaks for OC chondrules at 2.0 and 2.3 Ma. Chondrules in ordinary and carbonaceous chondrites formed almost contemporaneously (with a possible distinction between CC groups) in two chemically distinct reservoirs, probably in density-enriched regions at the edges of Jupiter’s orbit. The young formation ages of chondrules suggest that they do not represent precursors but rather by-products of planetesimal accretion

Early differentiation of magmatic iron meteorite parent bodies from Mn–Cr chronometry

Magmatic iron meteorite groups such as IIAB, IIIAB and IVA, represent the largest sampling of extraterrestrial core material from the earliest accreted distinct planetary bodies in the solar system. Chromium isotope compositions of chromite/daubréelite from seven samples, translated into 53Cr/52Cr model ages, provide robust time information on planetary core formation. These ages are within ∼1.5 Ma after formation of calcium-aluminium-rich inclusions (CAIs) and define the time of metal core formation in the respective parent bodies, assuming metal–silicate separation was an instantaneous event that induced strong chemical fractionation of Mn from the more siderophile Cr. The early core formation ages support accretion and differentiation of the magmatic iron meteorite parent bodies to have occurred prior to the chondrule formation interval. The calibration of Mn–Cr ages with established Hf–W ages of samples from the same magmatic iron meteorite groups constrains the initial ɛ53Cr of the solar system to −0.30 ± 0.05, and thus lower than previously estimated

Amygdalar MicroRNA-15a Is Essential for Coping with Chronic Stress.

MicroRNAs are important regulators of gene expression and associated with stress-related psychiatric disorders. Here, we report that exposing mice tochronic stress led to a specific increase in microRNA-15a levels in the amygdala-Ago2 complex and a concomitant reduction in the levels of its predicted target, FKBP51, which is implicated in stress-related psychiatric disorders. Reciprocally, mice expressing reduced levels of amygdalar microRNA-15a following exposure to chronic stress exhibited increased anxiety-like behaviors. In humans, pharmacological activation of the glucocorticoid receptor, as well as exposure to childhood trauma, was associated with increased microRNA-15a levels in peripheral blood. Taken together, our results support an important role for microRNA-15ain stress adaptation and the pathogenesis of stress-related psychopathologies