"You are so strict..."

Bacheloroppgave sykepleie, 2014Introduksjon: Nyresvikt er et økende helseproblem. Gjennom denne oppgaven ønsker vi å lære hvordan sykepleier kan benytte motiverende intervju (MI) som tilnærmingsmåte til pasienter med alvorlig kronisk nyresvikt, ved å bidra til at pasientene får motivasjon til livsstilsendring. Hensikt: Vår hensikt er å finne ut om MI kan bidra til livsstilsendring hos en pasient med alvorlig kronisk nyresvikt, ved å styrke pasientens egen motivasjon og mestring. Metode: Dette er et litteraturstudie som er basert på fem forskningsartikler, en fagartikkel og annen relevant faglitteratur. Alle artiklene er engelskspråklige. Vi har benyttet pensumlitteratur og selvvalgt litteratur. Resultat/Konklusjon: MI er en god tilnærmingsmåte i møte med en alvorlig kronisk nyresviktpasient, dersom tid og rom er til stede for samtale. Det kan være utfordrende å ta i bruk MI som tilnærmingsmåte på bakgrunn av at pasientene har levd med kronisk nyresvikt over lang tid. Vi ser det slik at MI vil være mest hensiktsmessig i startfasen av dialysebehandling. MI bevisstgjør pasientens medbestemmelsesrett, som bidrar til å styrke pasientens mestring og troen på seg selv. Pasienten blir motivert til å gjennomføre den livsstilsendringen som trengs for at han selv kan få bedre livskvalitet og for å kunne leve best mulig med alvorlig kronisk nyresvikt

Leukocytes are primed in peripheral blood for activation during term and preterm labour†

We hypothesized that the priming and activation of maternal leukocytes in peripheral blood is a key component of parturition, and that inappropriate preterm priming of leukocytes might initiate preterm labour and delivery. The purpose of this study was to characterize peripheral blood leukocyte activation during human term and preterm labour. We obtained blood samples from pregnant women at term and preterm, both in labour and not in labour. Leukocytes were characterized according to cell subtype and cell surface marker expression. Additionally, we quantified leukocyte cytokine mRNA production, migratory ability and reactive oxygen species production of neutrophils and macrophages. We found that both term and preterm labour were associated with an increase in monocyte and neutrophil proportion or number—neutrophil migratory ability and cell surface marker expression indicating activation. Messenger RNA expression of IL-1β and IL-8, MCP-1 and TLR-2 was also increased. We conclude that leukocytes in peripheral blood are primed in preparation for activation during term and preterm labour, and that this may contribute to the pathophysiological events of parturition. These data may lead to novel therapies and diagnostic tools for the prevention and/or diagnosis of preterm birth

Normo- and hyperandrogenic women with polycystic ovary syndrome exhibit an adverse metabolic profile through life

Objective: To compare the metabolic profiles of normo- and hyperandrogenic women with polycystic ovary syndrome (PCOS) with those of control women at different ages during reproductive life. Design: Case-control study. Setting: Not applicable. Patient(s): In all, 1,550 women with normoandrogenic (n = 686) or hyperandrogenic (n = 842) PCOS and 447 control women were divided into three age groups: 39 years). Interventions(s): None. Main Outcome Measure(s): Body mass index (BMI), waist circumference, blood pressure, glucose, insulin, cholesterol, lipoproteins, triglycerides and high-sensitivity C-reactive protein. Result(s): Both normo- and hyperandrogenic women with PCOS were more obese, especially abdominally. They had increased serum levels of insulin (fasting and in oral glucose tolerance tests), triglycerides, low-density lipoprotein, and total cholesterol, higher blood pressure, and lower high-density lipoprotein levels independently from BMI compared with the control population as early as from young adulthood until menopause. The prevalence of metabolic syndrome was two-to fivefold higher in women with PCOS compared with control women, depending on age and phenotype, and the highest prevalence was observed in hyperandrogenic women with PCOS at late reproductive age. Conclusion(s): When evaluating metabolic risks in women with PCOS, androgenic status, especially abdominal obesity and age, should be taken into account, which would allow tailored management of the syndrome from early adulthood on. (C) 2016 by American Society for Reproductive Medicine.Peer reviewe

Higher blood pressure in normal weight women with PCOS compared to controls

Objective: Obesity is considered to be the strongest predictive factor for cardio-metabolic risk in women with polycystic ovary syndrome (PCOS). The aim of the study was to compare blood pressure (BP) in normal weight women with PCOS and controls matched for age and BMI. Methods: From a Nordic cross-sectional base of 2615 individuals of Nordic ethnicity, we studied a sub cohort of 793 normal weight women with BMI = 140/90 mmHg was 11.1% (57/ 512) in women with PCOS vs 1.8% (5/281) in controls, P = 35 years the prevalence of BP >= 140/90 mmHg was comparable in women with PCOS and controls (12.7% vs 9.8%, P = 0.6). Using multiple regression analyses, the strongest association with BP was found for age, waist circumference, and total cholesterol in women with PCOS. Conclusions: Normal weight women with PCOS have higher BP than controls. BP and metabolic screening are relevant also in young normal weight women with PCOS.Peer reviewe

Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe

cited By 0Peer reviewe

Marriage and motherhood are associated with lower testosterone concentrations in women

Testosterone has been hypothesized to modulate the trade-off between mating and parenting effort in males. Indeed, evidence from humans and other pair-bonded species suggests that fathers and men in committed relationships have lower testosterone levels than single men and men with no children. To date, only one published study has examined testosterone in relation to motherhood, finding that mothers of young children have lower testosterone than non-mothers. Here, we examine this question in 195 reproductive-age Norwegian women. Testosterone was measured in morning serum samples taken during the early follicular phase of the menstrual cycle, and marital and maternal status were assessed by questionnaire. Mothers of young children (age ≤ 3) had 14% lower testosterone than childless women and 19% lower testosterone than women who only had children over age 3. Among mothers, age of the youngest child strongly predicted testosterone levels. There was a trend towards lower testosterone among married women compared to unmarried women. All analyses controlled for body mass index (BMI), age, type of testosterone assay, and time of serum sample collection. This is the first study to look at testosterone concentrations in relation to marriage and motherhood in Western women, and it suggests that testosterone may differ with marital and maternal status in women, providing further corroboration of previous findings in both sexes.Anthropolog

Monocytes and macrophages in pregnancy and pre-eclampsia

Preeclampsia is an important complication in pregnancy, characterized byhypertension and proteinuria in the second half of pregnancy. Generalizedactivation of the inflammatory response is thought to play a role in thepathogenesis of preeclampsia. Monocytes may play a central role in thisinflammatory response. Monocytes are short lived cells, that mature in thecirculation and invade into tissues upon an inflammatory stimulus anddevelop into macrophages. Macrophages are abundantly present in theendometrium and play a role in implantation and placentation in normalpregnancy. In preeclampsia, these macrophages appear to be present in largernumbers and are also activated. In the present review we focused on the roleof monocytes and macrophages in the pathophysiology of preeclampsia

Decidual-Secreted Factors Alter Invasive Trophoblast Membrane and Secreted Proteins Implying a Role for Decidual Cell Regulation of Placentation

Inadequate or inappropriate implantation and placentation during the establishment of human pregnancy is thought to lead to first trimester miscarriage, placental insufficiency and other obstetric complications. To create the placental blood supply, specialized cells, the ‘extravillous trophoblast’ (EVT) invade through the differentiated uterine endometrium (the decidua) to engraft and remodel uterine spiral arteries. We hypothesized that decidual factors would regulate EVT function by altering the production of EVT membrane and secreted factors. We used a proteomics approach to identify EVT membrane and secreted proteins regulated by decidual cell factors. Human endometrial stromal cells were decidualized in vitro by treatment with estradiol (10−8 M), medroxyprogesterone acetate (10−7 M) and cAMP (0.5 mM) for 14 days. Conditioned media (CM) was collected on day 2 (non-decidualized CM) and 14 (decidualized CM) of treatment. Isolated primary EVT cultured on Matrigel™ were treated with media control, non-decidualized or decidualized CM for 16 h. EVT CM was fractionated for proteins <30 kDa using size-exclusion affinity nanoparticles (SEAN) before trypsin digestion and HPLC-MS/MS. 43 proteins produced by EVT were identified; 14 not previously known to be expressed in the placenta and 12 which had previously been associated with diseases of pregnancy including preeclampsia. Profilin 1, lysosome associated membrane glycoprotein 1 (LAMP1), dipeptidyl peptidase 1 (DPP1/cathepsin C) and annexin A2 expression by interstitial EVT in vivo was validated by immunhistochemistry. Decidual CM regulation in vitro was validated by western blotting: decidualized CM upregulated profilin 1 in EVT CM and non-decidualized CM upregulated annexin A2 in EVT CM and pro-DPP1 in EVT cell lysate. Here, non-decidualized factors induced protease expression by EVT suggesting that non-decidualized factors may induce a pro-inflammatory cascade. Preeclampsia is a pro-inflammatory condition. Overall, we have demonstrated the potential of a proteomics approach to identify novel proteins expressed by EVT and to uncover the mechanisms leading to disease states

"Dere er så strenge..."

Introduksjon: Nyresvikt er et økende helseproblem. Gjennom denne oppgaven ønsker vi å lære hvordan sykepleier kan benytte motiverende intervju (MI) som tilnærmingsmåte til pasienter med alvorlig kronisk nyresvikt, ved å bidra til at pasientene får motivasjon til livsstilsendring. Hensikt: Vår hensikt er å finne ut om MI kan bidra til livsstilsendring hos en pasient med alvorlig kronisk nyresvikt, ved å styrke pasientens egen motivasjon og mestring. Metode: Dette er et litteraturstudie som er basert på fem forskningsartikler, en fagartikkel og annen relevant faglitteratur. Alle artiklene er engelskspråklige. Vi har benyttet pensumlitteratur og selvvalgt litteratur. Resultat/Konklusjon: MI er en god tilnærmingsmåte i møte med en alvorlig kronisk nyresviktpasient, dersom tid og rom er til stede for samtale. Det kan være utfordrende å ta i bruk MI som tilnærmingsmåte på bakgrunn av at pasientene har levd med kronisk nyresvikt over lang tid. Vi ser det slik at MI vil være mest hensiktsmessig i startfasen av dialysebehandling. MI bevisstgjør pasientens medbestemmelsesrett, som bidrar til å styrke pasientens mestring og troen på seg selv. Pasienten blir motivert til å gjennomføre den livsstilsendringen som trengs for at han selv kan få bedre livskvalitet og for å kunne leve best mulig med alvorlig kronisk nyresvikt