The Interaction of Type II Diabetes and Gonadal Steroids on Cognition in Middle-Aged Women

Diabetes is not commonly thought to be a women’s health issue, however, it appears to have an association with increased cognitive impairment in women during menopause as compared to women without diabetes (Espeland et al., 2011). The present study investigated the effects of type II diabetes and menopause on cognition in women between the ages of 46 and 55 years. To assess cognition, participants performed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Randolph 1998), Letter Number Sequencing Test (Wechsler, 1997), Trail Making Test (Delis, 2001), Verbal Fluency Test (Delis, 2001), Wechsler Test of Adult Reading (Wechsler, 2001), and the Buschke Selective Reminding and Delayed Recall Tests (Buschke, 1974). Participants also answered questionnaires on mood, diabetes, and hormone and reproductive history. No premenopausal women or perimenopausal women with diabetes participated. Women were divided into the following groups to examine the interactions of diabetes and hormones on cognition: perimenopausal women without diabetes, postmenopausal women with diabetes, and postmenopausal women without diabetes. It was predicted that women with diabetes would score lower on all tests, with an emphasis on difficulties with executive function and memory. Postmenopausal women with diabetes showed lower scores in working memory, executive control, visual attention, task switching, and episodic memory as seen in data from the Letter Number Sequencing Test, Verbal Fluency Test, Trail Making Test, and Buschke Selective Reminding and Delayed Recall Tests, respectively. Perimenopausal women without diabetes showed lower scores than postmenopausal women with and without diabetes on verbal memory and executive control. The sample of eight women was small, though there were indications of differences between groups highlighting the need for further research

Diagnostic accuracy of sonohysterography vs hysteroscopy in benign uterine endocavitary findings

OBJECTIVE: To compare diagnostic accuracy of sonohysterography vs hysteroscopy in patients with benign uterine endocavitary findings. PATIENTS AND METHODS: This retrospective study evaluated 202 patients submitted to sonohysterography after transvaginal ultrasound examination suspicious for uterine endocavitary findings. Cytological sample was taken and analyzed from the fluid used to distend the uterine cavity. Of 202 patients enrolled for this study, 86 patients underwent gynaecological surgery, of whom 77 were treated with operative hysteroscopy and 9 with other gynaecological surgical techniques. Statistical analysis was performed to evaluate diagnostic agreement between sonohysterography vs hysteroscopy and cytology vs histology. RESULTS: Diagnostic concordance between sonohysterography and hysteroscopy was significant (k value 0.87). The correlation between cytological and histological findings had a moderate level of concordance (k value 0.49).CONCLUSIONS: Sonohysterography provides a diagnostic accuracy as well as hysteroscopy, therefore, it could be considered an alternative procedure in the diagnosis of benign uterine endocavitary findings

Comparison of anogenital distance and correlation with vulvo-vaginal atrophy: a pilot study on premenopausal and postmenopausal women

OBJECTIVES: Anogenital distance (AGD) represents the space between labia posterior commissure and anus. This was pilot study to investigate how menopause and so lack of oestrogens affects AGD. METHODS: A total of 109 patients were enrolled. AGD was measured in lithotomy position using sterile paper ruler. Anogenital index (AGI) was used to control 2 variables of height and weight (body mass index, kg/m2). Vaginal health index (VHI) was used to evaluate vaginal wellness. Female sexual function index (FSFI) questionnaire was administered to all women to evaluate the impact of menopause on their sexual function. RESULTS: AGD (30.87 ± 2.98 vs. 17.57 ± 2.18; P = 0.0001) and AGI (1.40 ± 0.21 vs. 0.70 ± 0.15; P = 0.0001) were both significantly lower in the postmenopausal group. Postmenopausal women were affected by vulvovaginal atrophy (VVA) significantly. Thus, VHI scores were dramatically worse in postmenopausal group (23.95 ± 1.28 vs. 10.75 ± 3.41; P = 0.0001) as well as FSFI results (32.68 ± 2.25 vs. 19.78 ± 5.46; P = 0.0001). CONCLUSIONS: This study confirms that AGD in post-menopausal women was significantly shorter than AGD in premenopausal women, correlating with an increase of VVA and sexual impairment. Changes of AGD and AGI demonstrated to predict hormonal changes that may occur after menopause

Perceived control over menopausal hot flushes: Exploring the correlates of a standardised measure

Objectives: A substantial minority of women report considerable distress during hot flushes. Coping with various chronic health problems has been related to perceived control in previous studies. Hence this study developed a standardised measure to investigate whether perceived control is associated with less distress during menopausal hot flushes. Method: The study presented a suitably re-worded 15-item scale (the Arthritis Helplessness Index, originally developed by Nicassio et al (1985). Scoring was reversed so that high scores signified greater perceived control. A volunteer sample of 43 women (mean age 51 years) completed the scale together with several further measures. Thirty five women returned 12 month follow-up questionnaires. Results: the Perceived Control Index (PCI) scores correlated with standardised measures of self-esteem and simple self-ratings (0-100) of perceived control, and remained very stable over 12 months. Self-rated distress during flush episodes was more closely related to perceived control than to more objective factors such as flush frequency and chronicity. Conclusion: These findings support further investigation into whether subjective coping with flushes may be improved by psychological interventions that enhance perceived control and self-esteem

Depression und Östrogene: Besteht eine kausale Beziehung?

Zusammenfassung: Über Rezeptoren im Zentralnervensystem haben Östrogene modulierende Effekte auf die Stimmungslage sowie auf mentale und kognitive Funktionen. Die Inzidenz von Depressionen ist bei Frauen erheblich höher als bei Männern. Bei Frauen mit besonderer Vulnerabilität kann die menopausale Übergangszeit eine depressive Störung auslösen. Es gibt solide Evidenz aus klinischen Studien dafür, dass eine Östrogengabe während der menopausalen Übergangszeit die Stimmungslage anheben kann, besonders bei Frauen mit vasomotorischen Beschwerden. Für Frauen mit klimakterischen Beschwerden können Östrogene daher als Behandlungsoption bei leichter depressiver Symptomatik angesehen werden. Weiterhin gibt es Daten, die darauf hinweisen, dass Östrogene als adjuvante Therapie die Wirkung von Antidepressiva potenzieren können bei der Behandlung von depressiven Störungen in der Perimenopause und in der frühen Postmenopause sowie - in besonderen Situationen - bei einer schweren Depression in der späten Postmenopause. Keinen positiven Einfluss haben Östrogene auf leichtere Ausprägungen von Depression in der späten Postmenopause. Nicht erwiesen ist, dass Patientinnen mit schweren Depressionen auf Östrogene ansprechen. Ob eine Östrogentherapie kognitive Funktionen verbessern kann, wird noch kontrovers diskutier

Deteksi Inkontinensia Urin Pada Usia Post Menopause Dengan Menggunakan Kuesioner IIQ-7 Dan UDI-6 “Urinary Incontinence Detection in Post-Menopause Age Using IIQ-7 and UDI-6”

Keluhan inkontinensia urin banyak didapat pada wanita  usia post menopause. Penelitian ini bertujuan untuk mengetahui angka kejadian inkontinensia urin pada usia postmenopause berdasarkan kuesioner Incontinence Impact Questionnaire (IIQ-7) dan Urinary Distress Inventory (UDI-6) di Bagian Obstetri & Ginekologi, FK Unsrat/RSU Prof. Dr. R.D. Kandou,  Manado. Penelitian menggunakan metode deskriptif observasional dengan cara wanita usia postmenopause diminta kesediaannya mengisi kuesioner. Subjek penelitian ini adalah 75 wanita postmenopause dengan umur rerata 56 tahun. Berdasarkan Indeks Massa Tubuh didapatkan 61,3% wanita dengan postur tubuh normal; 5,3% kurus; 29,3% gemuk dan 4,0% obesitas.   Sebesar  6,7% responden dengan riwayat histerektomi dan 5.3% dengan riwayat stroke. Dari keseluruhan responden 92% mengeluhkan inkontinensia urin dan 90,7% terganggu aktifitas hidupnya. Terbanyak pada kelompok umur 50 – 54 tahun. Keluhan inkontinensia ditemukan pada kelompok dengan berat badan normal (57,3%). Terdapat 3 wanita dengan obesitas, semuanya mengalami inkontinensia urin. Pada kelompok kawin lebih sering (88,0%) ditemukan keluhan inkontinensia urin. Pada penelitian ini didapatkan semua wanita dengan 3 anak atau lebih mengeluh inkontinensia urin.  Simpulan penelitian ini adalah keluhan inkontinensia urin terbanyak ditemukan pada kelompok umur 50-54 tahun. Berdasarkan indeks massa tubuh didapatkan wanita dengan postur tubuh normal, riwayat histerektomi, dan riwayat stroke tidak bermakna mengalami keluhan inkontinensia urin. Ibu dengan 3 anak atau lebih pada penelitian ini didapatkan angka kejadian inkontinensia yang tinggi

Abnormal expression of p27kip1 protein in levator ani muscle of aging women with pelvic floor disorders – a relationship to the cellular differentiation and degeneration

BACKGROUND: Pelvic floor disorders affect almost 50% of aging women. An important role in the pelvic floor support belongs to the levator ani muscle. The p27/kip1 (p27) protein, multifunctional cyclin-dependent kinase inhibitor, shows changing expression in differentiating skeletal muscle cells during development, and relatively high levels of p27 RNA were detected in the normal human skeletal muscles. METHODS: Biopsy samples of levator ani muscle were obtained from 22 symptomatic patients with stress urinary incontinence, pelvic organ prolapse, and overlaps (age range 38–74), and nine asymptomatic women (age 31–49). Cryostat sections were investigated for p27 protein expression and type I (slow twitch) and type II (fast twitch) fibers. RESULTS: All fibers exhibited strong plasma membrane (and nuclear) p27 protein expression. cytoplasmic p27 expression was virtually absent in asymptomatic women. In perimenopausal symptomatic patients (ages 38–55), muscle fibers showed hypertrophy and moderate cytoplasmic p27 staining accompanied by diminution of type II fibers. Older symptomatic patients (ages 57–74) showed cytoplasmic p27 overexpression accompanied by shrinking, cytoplasmic vacuolization and fragmentation of muscle cells. The plasma membrane and cytoplasmic p27 expression was not unique to the muscle cells. Under certain circumstances, it was also detected in other cell types (epithelium of ectocervix and luteal cells). CONCLUSIONS: This is the first report on the unusual (plasma membrane and cytoplasmic) expression of p27 protein in normal and abnormal human striated muscle cells in vivo. Our data indicate that pelvic floor disorders are in perimenopausal patients associated with an appearance of moderate cytoplasmic p27 expression, accompanying hypertrophy and transition of type II into type I fibers. The patients in advanced postmenopause show shrinking and fragmentation of muscle fibers associated with strong cytoplasmic p27 expression

Epidemiology of non-steroidal anti-inflammatory drugs consumption in Spain. The MCC-Spain study

This work was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007; The Instituto de Salud Carlos III-FEDER [PI08/1770, PI08/0533, PI08/1359, PI09/00773-Cantabria, PI09/01286-León, PI09/01903-Valencia, PI09/02078-Huelva, PI09/01662-Granada, PI11/01403, PI11/01889-FEDER, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/0613, PI15/00069, PI15/00914, PI15/01032]; The Fundación Marqués de Valdecilla [API 10/09]; The ICGC International Cancer Genome Consortium CLL (The ICGC CLL-Genome Project is funded by Spanish Ministerio de Economía y Competitividad (MINECO) through the Instituto de Salud Carlos III (ISCIII) and Red Temática de Investigación del Cáncer (RTICC) del ISCIII (RD12/0036/0036)); The Junta de Castilla y León [LE22A10–2]; The Consejería de Salud of the Junta de Andalucía [2009-S0143]; The Conselleria de Sanitat of the Generalitat Valenciana [AP_061/10]; The Recercaixa [2010ACUP 00310]; The Regional Government of the Basque Country; The Consejería de Sanidad de la Región de Murcia; The European Commission [grants FOODCT-2006-036224-HIWATE]; The Spanish Association Against Cancer (AECC) Scientific Foundation; The Catalan Government DURSI [grant 2014SGR647]; The Fundación Caja de Ahorros de Asturias; and the University of Oviedo. The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.Gómez-Acebo, I., Dierssen-Sotos, T., De Pedro, M., Pérez-Gómez, B., Castaño-Vinyals, G., Fernández-Villa, T., Palazuelos-Calderón, C., Amiano, P., Etxeberria, J., Benavente, Y., Fernández-Tardón, G., Salcedo-Bellido, I., Capelo, R., Peiró, R., Marcos-Gragera, R., Huerta, J.M., Tardón, A., Barricarte, A., Altzibar, J.-M., Alonso-Molero, J., Dávila-Batista, V., Aragonés, N., Pollán, M., Kogevinas, M., Llorca, J