Characterization of the Role of NKA in the Control of Puberty Onset and Gonadotropin Release in the Female Mouse.

The tachykinin neurokinin B (NKB, Tac2) is critical for proper GnRH release in mammals, however, the role of the other tachykinins, such as substance P (SP) and neurokinin A (NKA) in reproduction, is still not well understood. In this study, we demonstrate that NKA controls the timing of puberty onset (similar to NKB and SP) and stimulates LH release in adulthood through NKB-independent (but kisspeptin-dependent) mechanisms in the presence of sex steroids. Furthermore, this is achieved, at least in part, through the autosynaptic activation of Tac1 neurons, which express NK2R (Tacr2), the receptor for NKA. Conversely, in the absence of sex steroids, as observed in ovariectomy, NKA inhibits LH through a mechanism that requires the presence of functional receptors for NKB and dynorphin (NK3R and KOR, respectively). Moreover, the ability of NKA to modulate LH secretion is absent in Kiss1KO mice, suggesting that its action occurs upstream of Kiss1 neurons. Overall, we demonstrate that NKA signaling is a critical component in the central control of reproduction, by contributing to the indirect regulation of kisspeptin release

Biomarkers of Nutrition for Development (BOND)—Iron Review

This is the fifth in the series of reviews developed as part of the Biomarkers of Nutrition for Development (BOND) program. The BOND Iron Expert Panel (I-EP) reviewed the extant knowledge regarding iron biology, public health implications, and the relative usefulness of currently available biomarkers of iron status from deficiency to overload. Approaches to assessing intake, including bioavailability, are also covered. The report also covers technical and laboratory considerations for the use of available biomarkers of iron status, and concludes with a description of research priorities along with a brief discussion of new biomarkers with potential for use across the spectrum of activities related to the study of iron in human health. The I-EP concluded that current iron biomarkers are reliable for accurately assessing many aspects of iron nutrition. However, a clear distinction is made between the relative strengths of biomarkers to assess hematological consequences of iron deficiency versus other putative functional outcomes, particularly the relationship between maternal and fetal iron status during pregnancy, birth outcomes, and infant cognitive, motor and emotional development. The I-EP also highlighted the importance of considering the confounding effects of inflammation and infection on the interpretation of iron biomarker results, as well as the impact of life stage. Finally, alternative approaches to the evaluation of the risk for nutritional iron overload at the population level are presented, because the currently designated upper limits for the biomarker generally employed (serum ferritin) may not differentiate between true iron overload and the effects of subclinical inflammation

The value of transvaginal ultrasonography in postmenopausal uterine bleeding

Objective: Endometrial carcinoma is the most common gynecologic malignancy and usually present with postmenopausal bleeding. For invastigating postmenopausal bleeding there is a trend to less invasiv procedures without compromising efficacy and safety. Transvaginal ultrasonography was suggested as a first-step procedure in evaluating women with postmenopausal bleeding. The aim of this study to evaluate the diagnostic accuracy of transvaginal ultrasonography and endometrial histopathology findings in patients presenting with postmenopausal bleeding. Material and Methods: This cross-sectional retrospective study was conducted in Bolu İzzet Baysal State Hospital Obstetric and Gynecology outpatient clinic with the complaint of postmenopausal bleeding of 1856 patients' records.within the date of January 2011 - January 2013. Bleeding occurring at least 12 months after amenorhe is defined as postmenaupausal bleeding. A total of 312 patients, who had hystopathologic results, whose endometrial thicknes was measured by TvUSG and who did not use hornonal drug were enrolled in the study. Results: Histological diagnosis of 312 women included in this study; were in atrophy (39.1%) and hyperplasia (simple 18.2% + atypical 6%, respectively) were the most common encountered normal and abnormal endometrial findings. The prevalence of endometrial cancer and atypical hyperplasia was 6.4% (n=20) and 6% (n=19) respectively. Endometrial thickness was significantly higher in the pathologic lesion group than in control (p0.001). When the cut-off value for endometrial thickness was accepted 5 mm, sensitivity, specifity, positive predictive value and negative predictive value was found 96.45%, 76.02%, 76.8% and 96.3% respectively. Conclusion: Endometrial thickness measurement with transvaginal ultrasonography when a cut off value of >5 mm is used is a valuable and safe method in evaluation of patients with postmenopausal bleeding. Endometrial curettage is needed in the cases having endometrial thickness above the 5 mm. Copyright © 2013 by Tükiye Klinikleri

postoperative maternal health

To investigate the efficacy of bupivacaine-soaked spongostan in cesarean section wound for postoperative anxiety level, satisfaction and early postpartum depression rate.A total of 121 women, American Society of Anesthesiologists physical status I-II, scheduled to undergo general anesthesia and elective cesarean section were recruited and randomized into a study group (n = 61) or a control group (n = 60). In the spongostan group, bupivacaine-soaked spongostan was placed in the cesarean section wound. The control group did not receive spongostan, but only general postoperative care. Maternal health was assessed using a visual analog scale for satisfaction, a visual analog scale for anxiety and the Edinburgh Postpartum Depression Scale for postpartum depression. Also, first breast-feeding time, first mobilization time and opioid consumption were recorded and compared.The anxiety level of the spongostan group was lower than that of the control group and the difference was statistically significant at all time intervals (1, 6, 12, 18, 24, 30, 36 and 48 h, p < 0.001, respectively). Postpartum depression rate again was significantly lower in the spongostan group both on postoperative day 2 and day 9 (p a parts per thousand currency sign 0.01). All satisfaction scores were significantly higher in the spongostan group than in the control group (p < 0.001). Additionally, first breast-feeding and first mobilization times were significantly shorter and opioid consumption was lower in the spongostan group (p < 0.001).Placement of bupivacaine-soaked spongostan into the cesarean section wound resulted in decreased postoperative anxiety level and postpartum depression rate and increased satisfaction