Effect of DMPA on IL-1 Alpha in Serum of Women with Endometrioma

Objective: To study the effect of DMPA on serum IL-1α in women with endometrioma undergoing the conservative surgery.Materials and methods:A randomized clinical trial was performed in thirty-five women with endometrioma who underwent conservative surgery in Reproductive Endocrinology and Laparoscopy clinic in Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital. These patients were randomly assigned to one of the following treatments: group A surgery and postoperative treatment with DMPA 150 mg intramuscular or group B surgery alone. Serum IL-1α level was measured by enzyme-linked immunosorbent assay (ELISA) in both groups. Pain scores were evaluated using a visual analog scale (VAS) at 2 and 12 weeks after the operation.Results: There was no significant difference in IL-1α serum levels between both groups at 2 weeks and 12 weeks after the surgery (p = 0.06 and 0.86 respectively). There was no significant difference in pre and postoperative IL-1α level between both group (p = 0.23 and 1.00 respectively). Pain scores of both groups were significantly decreased at 2 weeks and 12 weeks after the surgery (p < 0.001). The patients in DMPA group had significantly less pain scores at 12 weeks after the surgery (p = 0.01). Conclusion: The current study demonstrated that no significant change of IL-1α serum level in women with endometrioma before and after the surgery, with or without postoperative treatment with DMPA. We found decreasing of pain score in both group after surgery and less pain score in DMPA group

The Retention of Accuracy of Visual Estimation of Blood Loss by Qualified Nurses at 1 and 3 Months following Education Program

Objective: To assess the retention of accuracy of estimation of blood loss at 1 and 3 months following education program. Study design: Clinical trial. Subjects: Sixty qualified nurses from operative and delivery wards during January – June 2008. Intervention: The nurses were recruited for blood loss estimation education program. Gauzes and swabs soaked with fixed amount of pack red cells were used for estimation of blood loss at 6 stations. Follow up tests was performed by all of the participants with the same 6 stations at 1 and 3 months later. The accuracy of estimation was defined as within twenty percents of actual blood volume used. Main outcomes: Percentage of nurses who estimated accurately at least 3 in 6 stations (proficient nurses) at 1 and 3 months after education program. Results: There were no significant decrease in accuracy of visual estimation of blood loss at 1 and 3 months following education program (p= 0.13). The accuracy of estimation was not associated with years of experience (p= 0.62) and working wards (p= 0.19). Conclusion: The accuracy of visual estimation of blood loss still retained at 3 months which was not different from 1 month

Using principal component analysis to develop a single-parameter screening tool for metabolic syndrome

Abstract Background Metabolic syndrome (MS) is an important current public health problem faced worldwide. To prevent an "epidemic" of this syndrome, it is important to develop an easy single-parameter screening technique (such as waist circumference (WC) determination recommended by the International Diabetes Federation). Previous studies proved that age is a chief factor corresponding to central obesity. We intended to present a new index based on the linear combination of body mass index, and age, which could enhance the area under the receiver operating characteristic curves (AUCs) for assessing the risk of MS. Methods The labour law of the Association of Labor Standard Law, Taiwan, states that employers and employees are respectively obligated to offer and receive routine health examination periodically. Secondary data analysis and subject's biomarkers among five high-tech factories were used in this study between 2007 and 2008 in northern Taiwan. The subjects included 4712 males and 4196 females. The first principal component score (FPCS) and equal-weighted average (EWA) were determined by statistical analysis. Results Most of the metabolic and clinical characteristics were significantly higher in males than in females, except high-density lipoprotein cholesterol level. The older group (>45 years) had significantly lower values for height and high-density lipoprotein cholesterol level than the younger group. The AUCs of FPCS and EWA were significantly larger than those of WC and waist-to-height ratio. The low specificities of EWA and FPCS were compensated for by their substantially high sensitivities. FPCS ≥ 0.914 (15.4%) and EWA ≥ 8.8 (6.3%) were found to be the most prevalent cut off points in males and females, respectively. Conclusions The Bureau of Health Promotion, Department of Health, Taiwan, had recommended the use of WC ≥ 90 cm for males and ≥ 80 cm for females as singular criteria for the determination of central obesity instead of multiple parameters. The present investigation suggests that FPCS or EWA is a good predictor of MS among the Taiwanese. However, the use of FPCS is not computationally feasible in practice. Therefore, we suggest that EWA be used in clinical practice as a simple parameter for the identification of those at risk of MS.</p

Safety and Reactogenicity of Canarypox ALVAC-HIV (vCP1521) and HIV-1 gp120 AIDSVAX B/E Vaccination in an Efficacy Trial in Thailand

A prime-boost vaccination regimen with ALVAC-HIV (vCP1521) administered intramuscularly at 0, 4, 12, and 24 weeks and gp120 AIDSVAX B/E at 12 and 24 weeks demonstrated modest efficacy of 31.2% for prevention of HIV acquisition in HIV-uninfected adults participating in a community-based efficacy trial in Thailand.Reactogenicity was recorded for 3 days following vaccination. Adverse events were monitored every 6 months for 3.5 years, during which pregnancy outcomes were recorded. Of the 16,402 volunteers, 69% of the participants reported an adverse event any time after the first dose. Only 32.9% experienced an AE within 30 days following any vaccination. Overall adverse event rates and attribution of relatedness did not differ between groups. The frequency of serious adverse events was similar in vaccine (14.3%) and placebo (14.9%) recipients (p = 0.33). None of the 160 deaths (85 in vaccine and 75 in placebo recipients, p = 0.43) was assessed as related to vaccine. The most common cause of death was trauma or traffic accident. Approximately 30% of female participants reported a pregnancy during the study. Abnormal pregnancy outcomes were experienced in 17.1% of vaccine and 14.6% (p = 0.13) of placebo recipients. When the conception occurred within 3 months (estimated) of a vaccination, the majority of these abnormal outcomes were spontaneous or elective abortions among 22.2% and 15.3% of vaccine and placebo pregnant recipients, respectively (p = 0.08). Local reactions occurred in 88.0% of vaccine and 61.0% of placebo recipients (p<0.001) and were more frequent after ALVAC-HIV than AIDSVAX B/E vaccination. Systemic reactions were more frequent in vaccine than placebo recipients (77.2% vs. 59.8%, p<0.001). Local and systemic reactions were mostly mild to moderate, resolving within 3 days.The ALVAC-HIV and AIDSVAX B/E vaccine regimen was found to be safe, well tolerated and suitable for potential large-scale use in Thailand.ClinicalTrials.govNCT00223080

Effect of simvastatin on monocyte chemoattractant protein-1 expression in endometriosis patients: a randomized controlled trial

Abstract Background Simvastatin is a promising new drug for the treatment of endometriosis. It is a cholesterol-lowering drug that acts by inhibiting HMG-CoA reductase, resulting in a decrease in mevalonate, a precursor of cholesterol and monocyte chemoattractant protein-1 (MCP-1). This study investigated the effect of pre-operative oral simvastatin administration on MCP-1 gene expression and serum MCP-1 protein levels in patients with endometriosis. Methods A prospective, randomized, controlled study was conducted at the Reproductive Endocrinology Unit of the Department of Obstetrics and Gynecology at the Faculty of Medicine Ramathibodi Hospital. Forty women (mean age: 18–45 years) scheduled for laparoscopic surgery who had been diagnosed with endometriosis were recruited and randomly assigned to either a treatment group (20 mg/d of orally administered simvastatin for 2 weeks before surgery) or an untreated control group. Serum was collected before and after treatment and protein levels of MCP-1 were determined. MCP-1 and CD68 transcript levels were also quantified using real-time PCR on endometriotic cyst tissues. Results MCP-1 gene expression on endometriotic cyst was not significantly different between the simvastatin-treated and untreated groups (P = 0.99). CD68 expression was higher in the treatment group compared to the control group, but this was not statistically significant (P = 0.055). Serum MCP-1 levels following simvastatin treatment were higher than in samples obtained before treatment (297.89 ± 70.77 and 255.51 ± 63.79 pg/ml, respectively) (P = 0.01). Conclusions Treatment with 20 mg/d of simvastatin for 2 weeks did not reduce the expression of either the chemokine MCP-1 gene or macrophage-specific genes. Cumulatively, this suggests that simvastatin is not ideal for treating endometriosis because a higher dose of simvastatin (40–100 mg/d) would be needed to achieve the target outcome, which would significantly increase the risk of myopathy in patients. Trial registration Thai Clinical Trials Registry TCTR20130627003 Registered: June 27, 2013