We describe a case of cerebral trichomoniasis in a neonate in whom seizures and multiorgan failure developed during treatment for staphylococcal sepsis. Brain abscesses were identified with cranial ...sonography, and Trichomonas vaginalis was isolated from cerebrospinal fluid samples. The patient died despite metronidazole therapy.
The aim of this study was to examine the relationships between endogenous estrogens and adiposity, bone markers, and leptin in post-menopausal (PM) women.
Seventy-three post-menopausal (PM) women ...participated in a clinical correlational study. Weight, height, waist–hip ratio, fasted morning serum and first morning voided urine samples were obtained to compare body mass index (BMI), waist–hip ratio, endogenous estrogens, leptin, and bone markers. Serum estradiol, estrone (E1), estrone sulfate (E1S), leptin, osteocalcin, and urinary deoxypyridinoline (Dpd) were determined.
Significant positive relationships were found between BMI and estradiol, E1, and E1S (
r
=
0.52, 0.38, and 0.29;
P
≤
0.001, 0.001, and 0.013 respectively). Significant relationships between leptin and estrogens were revealed, but were not significant when BMI was used as a covariate. Although many subjects revealed elevated bone marker levels, no correlation between estrogens or BMI and bone markers (Dpd and osteocalcin) was found.
There are significant positive correlations between estrogens and BMI in PM women. Increasing levels of estradiol, E1, and E1S with increasing BMI may be an indicator of adiposity, but are without effect as a stimulatory factor on leptin production. Waist–hip ratio did not significantly affect leptin concentrations when accounting for BMI. Due to assay sensitivity in the present study, data represent a more precise representation of these relationships. The lack of correlation between estrogens and bone marker levels may have been due to low estrogen levels in PM women.
To examine the variability of serum estrogens in response to transdermal estrogen replacement therapy (ET), and to determine the effects on androgens and sex hormone binding globulin (SHBG).
...Randomized, double-blind, placebo-controlled study.
Women’s hospital.
Two groups of postmenopausal women: 1 21 women not on ET enrolled and 17 completed the study; 2 19 women on continuous transdermal ET enrolled and 13 completed the study.
Women not on ET were administered a placebo patch or a newly initiated estrogen patch, then crossed over to the alternate treatment. Serum samples were obtained at baseline and the subsequent 3 days from the placebo and new-patch groups and from a separate group of women receiving continuous estrogen patch treatment.
Estradiol (E
2), estrone, estrone sulfate, T, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione, free androgen index, and SHBG.
There was considerable intrapatient and interpatient variability in the estrogen response to identical treatment doses, with E
2 values differing between women as much as 138 pg/mL and E
2 increases above baseline differing as much as 90 pg/mL. Continuous treatment increased SHBG and decreased androstenedione levels; however, levels of T, DHEA, DHEAS, and free androgen index did not change.
There is great variability of estrogen in response to transdermal ET, but minimal effect on circulating androgens.
We prospectively evaluated differences in fasting- and oral glucose tolerance test (OGTT)-derived indices of insulin action in Caucasian (Cau) and African-American (AA) pregnant women and compared ...them with obstetric outcomes.
IRB-approved prospective study in 171 pregnant women undergoing a 3-h OGTT. Mathematical modeling was used to evaluate insulin response, insulin activity and glucose tolerance in fasting and postglucose ingestion state. Insulin sensitivity indices derived from fasting (HOMA-IR) and glucose-stimulated values (SIOGTT) were compared. An insulin sensitivity-secretion index (IS-SI) was calculated from the product of the SIOGTT and early-phase insulin secretion.
Forty-nine patients had gestational diabetes (GDM), 28 had gestational impaired glucose tolerance (GIGT) and 94 had normal glucose tolerance after an abnormal glucose challenge test (NGT-abnGCT). Insulin sensitivity was lowest in women with GDM. In all groups, pregnant AA women were significantly more insulin resistant than Cau women, based on both HOMA-IR and SIOGTT, but had enhanced insulin secretion compared to their Cau counterparts. The mean IS-SI progressively improved for all women from GDM to GIGT to NGT-abnGCT. Women with NGT-abnGCT had a higher prevalence of large-for-gestational age (LGA) newborns and significantly higher cesarean section rate.
Insulin measures along with glucose determinations during OGTT testing in pregnant women at risk for diabetes provide valuable information that varies according to race. We observed that pregnant women with a lesser degree of glucose tolerance abnormality during pregnancy who receive no intervention have a higher risk for LGA infants and significantly increased C-section rate (ClinicalTrials.gov number, NCT006874791).
This investigation evaluated bone density in 36 premenopausal women (mean +/- SD age = 29.5 +/- 8.4 years) an average of 11.4 years after diagnosis for anorexia nervosa. Twenty-nine women were aged ...20-45 years, and seven were aged 16-19 years. Body composition, age of menarche, length of amenorrhea, estrogen exposure, and lumbar spine and proximal femur bone density were determined. Average appendicular bone density for those > or = 20 years was found to meet World Health Organization T score criteria for osteopenia: total femur T = -1.22 and femoral neck T = -1.33. The average total lumbar Z score for all 36 participants was -0.95, which was 90% of the mean for their age, and the mean Z scores for adolescent subjects were within 91% of the mean for their age (Z = -0.84). Years of estrogen exposure were correlated with lumbar mineral content (r = 0.50, p = 0.002). A modest but significant inverse relationship was observed between length of amenorrhea and femoral and lumbar bone density. The total proximal femur and trochanteric bone densities were best predicted, using stepwise regression, by the number of years after diagnosis and years of amenorrhea, respectively (R2 = 0.23, p = 0.02 and R2 = 0.21, p = 0.04). Lumbar density was best predicted by years of amenorrhea and current percent of ideal body weight (%IBW)(R2 = 0.25, p = 0.02). Length of amenorrhea, estrogen exposure, and %IBW independently contribute to axial and appendicular bone density. Because of risk for compromised bone density, women with a history of anorexia nervosa should be followed longitudinally to maximize premenopausal bone replacement.
New Findings
What is the topic of this review?
The potential role of nutrition in exertional heat stroke.
What advances does it highlight?
Certain nutritional and dietary strategies used by athletes ...and workers may exert a protective effect the pathophysiological processes of exertional heat stroke, whereas others may be detrimental. While current evidence suggests that some of these practices may be leveraged as a potential countermeasure to exertional heat stroke, further research on injury‐related outcomes in humans is required.
Exertional heat stroke (EHS) is a life‐threatening illness and an enduring problem among athletes, military servicemen and ‐women, and occupational labourers who regularly perform strenuous activity, often under hot and humid conditions or when wearing personal protective equipment. Risk factors for EHS and mitigation strategies have generally focused on the environment, health status, clothing, heat acclimatization and aerobic conditioning, but the potential role of nutrition is largely underexplored. Various nutritional and dietary strategies have shown beneficial effects on exercise performance and health and are widely used by athletes and other physically active populations. There is also evidence that some of these practices may dampen the pathophysiological features of EHS, suggesting possible protection or abatement of injury severity. Promising candidates include carbohydrate ingestion, appropriate fluid intake and glutamine supplementation. Conversely, some nutritional factors and low energy availability may facilitate the development of EHS, and individuals should be cognizant of these. Therefore, the aims of this review are to present an overview of EHS along with its mechanisms and pathophysiology, discuss how selected nutritional considerations may influence EHS risk focusing on their impact on the key pathophysiological processes of EHS, and provide recommendations for future research. With climate change expected to increase EHS risk and incidence in the coming years, further investigation on how diet and nutrition may be optimized to protect against EHS would be highly beneficial.
Interrupted Life Solinger, Rickie; Johnson, Paula C; Raimon, Martha L ...
12/2009
eBook
Interrupted Lifeis a gripping collection of writings by and about imprisoned women in the United States, a country that jails a larger percentage of its population than any other nation in the world. ...This eye-opening work brings together scores of voices from both inside and outside the prison system including incarcerated and previously incarcerated women, their advocates and allies, abolitionists, academics, and other analysts. In vivid, often highly personal essays, poems, stories, reports, and manifestos, they offer an unprecedented view of the realities of women's experiences as they try to sustain relations with children and family on the outside, struggle for healthcare, fight to define and achieve basic rights, deal with irrational sentencing systems, remake life after prison; and more. Together, these powerful writings are an intense and visceral examination of life behind bars for women, and, taken together, they underscore the failures of imagination and policy that have too often underwritten our current prison system.
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