Sex effect on insulin secretion and mitochondrial function in pancreatic beta cells of elderly Wistar rats

AIMS/HYPOTHESIS

Glucose tolerance progressively declines with age, and there is a high prevalence of type 2 diabetes in the elderly people. Previous studies have reported the sex differences in risk for type 2 diabetes, especially in the elderly people, whereas reasons for these sex differences remain poorly understood. This study aims to evaluate the effect of sex on glucose-stimulated insulin secretion and mitochondrial function in pancreatic beta cells of Wistar rats.

METHODS

3-month-old and 18-month-old Wistar rats of both sexes were used. Insulin secretion of islets was analyzed by glucose-stimulated insulin secretion and islet perifusion assays; ATP content and oxygen consumption rate of islets were determined to evaluate the mitochondrial function.

RESULTS

Insulin secretion of islets under high glucose conditions declined significantly with age in both sexes. Glucose-stimulated insulin secretion of elderly female groups was markedly higher than that of male groups under high glucose conditions. Importantly, islets from elderly female groups showed higher mitochondrial function compared with male counterparts, evidenced by higher ATP content and oxygen consumption rate under high glucose conditions. It was also noted that mitochondrial biogenesis of islets from elderly female rats was significant higher compared with male rats. There were notable increases in expression of genes involved in mitochondrial biogenesis in islets from elderly female rats compared with male rats.

CONCLUSION

This study demonstrates a sex dimorphism in the age-associated impairment of pancreatic beta cell function in elderly rats, while the potential mechanism may be related to the sexual differences in mitochondrial biogenesis and function.

Neuroprotective mechanism of Coenzyme Q10 (CoQ10) against PTZ induced kindling and associated cognitive dysfunction: Possible role of microglia inhibition

BACKGROUND

Neuroinflammation, oxidative stress and mitochondrial dysfunction play a significant role to explain the pathophysiology of epilepsy. Neuroinflammation through microglia activation has been documented in epileptogenesis. Compounds which inhibit activation of glial cells have been suggested as one of the treatment approaches for the effective treatment of epilepsy. The present study has been designed to investigate the role of coenzyme Q10 and its interaction with minocycline (microglia inhibitor) against pentylenetetrazol (PTZ) induced kindling epilepsy.

METHODS

Laca mice received Coenzyme Q10 and minocycline for a period of 29 days. PTZ (40mg/kg ip) injection has been given on alternate days. Various behavioural parameters (kindling score and elevated plus maze), biochemical parameters (lipid peroxidation, superoxide dismutase, reduced glutathione, catalase, nitrite and acetylcholinesterase) and mitochondrial enzyme complex activities of (I, II and IV) were assessed in the discrete areas of the brain.

RESULTS

Administration of a subconvulsive dose of PTZ (40mg/kg) repeatedly increased significantly kindling score, oxidative damage and impaired mitochondrial enzyme complex activities (I, II and IV) and pro-inflammatory marker (TNF-α) as compared to naive animals. Coenzyme Q10 (10, 20 and 40mg/kg) and minocycline (50 and 100mg/kg) for a duration of 29days significantly attenuated kindling score, reversed oxidative damage, TNF-α and restored mitochondrial enzyme complex activities (I, II and IV) as compared to control. Further, combinations of CoQ10 (10, 20mg/kg) with minocycline (50 and 100mg/kg) significantly modulate the protective effect of CoQ10 which was significant as compared to their effect per se in PTZ treated animals.

CONCLUSION

The present study suggests the involvement of microglia inhibition in the protective effect of CoQ10 in PTZ induced kindling in mice.

Aberrant post-translational protein modifications in the pathogenesis of alcohol-induced liver injury

It is likely that the majority of proteins will undergo post-translational modification, be it enzymatic or non-enzymatic. These modified protein(s) regulate activity, localization and interaction with other cellular molecules thereby maintaining cellular hemostasis. Alcohol exposure significantly alters several of these post-translational modifications leading to impairments of many essential physiological processes. Here, we present new insights into novel modifications following ethanol exposure and their role in the initiation and progression of liver injury. This critical review condenses the proceedings of a symposium at the European Society for the Biomedical Research on Alcoholism Meeting held September 12-15, 2015, in Valencia, Spain.

Understanding child directed caregiver aggression: An examination of characteristics and predictors associated with perpetration

Child physical abuse presents a substantial public health concern with lasting negative consequences for victims. Understanding the variables associated with perpetration can help inform prevention and intervention efforts. The current study examined background and clinical variables in a sample of 195 help-seeking caregivers who were at risk for or had been identified as having engaged in child directed aggression or abuse. We found that caregivers who did (vs. did not) report severe child directed aggression had poorer parenting and reported more drug use. Having a recent allegation of child physical abuse (vs. no allegation) based on official child welfare records was unrelated to parenting, drug and alcohol use, negative affect, parenting stress, or neglect. Structural equation modeling was used to examine the influence of parenting stress on child directed aggression and its effects through negative affect and positive parenting. We found that parenting stress predicted higher negative affect, which was related to greater child directed aggression. Additionally, parenting stress predicted lower positive parenting, which in turn predicted lower child directed aggression. A model including drug and alcohol use did not add to the prediction of child directed aggression. Prediction of neglect using similar variables found that only positive parenting was of import and that parenting stress and negative affect did not contribute to neglect. Implications for future prevention and treatment development efforts with abusive/aggressive caregivers are discussed.

Effectiveness of pelvic floor muscle training in treating urinary incontinence in women: A current review

OBJECTIVE

To analyse the content of various published studies related to physical exercise and its effects on urinary incontinence and to determine the effectiveness of pelvic floor training programmes.

METHOD

We conducted a search in the databases of PubMed, CINAHL, the Cochrane Plus Library, The Cochrane Library, WOS and SPORTDiscus and a manual search in the Google Scholar metasearcher using the search descriptors for documents published in the last 10 years in Spanish or English. The documents needed to have an abstract or complete text on the treatment of urinary incontinence in female athletes and in women in general.

RESULTS

We selected 3 full-text articles on treating urinary incontinence in female athletes and 6 full-text articles and 1 abstract on treating urinary incontinence in women in general. The 9 studies included in the review achieved positive results, i.e., there was improvement in the disease in all of the studies.

CONCLUSIONS

Physical exercise, specifically pelvic floor muscle training programmes, has positive effects on urinary incontinence. This type of training has been shown to be an effective programme for treating urinary incontinence, especially stress urinary incontinence.

Defining immunological dysfunction in sepsis: A requisite tool for precision medicine

OBJECTIVES

Immunological dysregulation is now recognised as a major pathogenic event in sepsis. Stimulation of immune response and immuno-modulation are emerging approaches for the treatment of this disease. Defining the underlying immunological alterations in sepsis is important for the design of future therapies with immuno-modulatory drugs.

METHODS

Clinical studies evaluating the immunological response in adult patients with Sepsis and published in PubMed were reviewed to identify features of immunological dysfunction. For this study we used key words related with innate and adaptive immunity.

RESULTS

Ten major features of immunological dysfunction (FID) were identified involving quantitative and qualitative alterations of [antigen presentation](FID1), [T and B lymphocytes] (FID2), [natural killer cells] (FID3), [relative increase in T regulatory cells] (FID4), [increased expression of PD-1 and PD-ligand1](FID5), [low levels of immunoglobulins](FID6), [low circulating counts of neutrophils and/or increased immature forms in non survivors](FID7), [hyper-cytokinemia] (FID8), [complement consumption] (FID9), [defective bacterial killing by neutrophil extracellular traps](FID10).

CONCLUSIONS

This review article identified ten major features associated with immunosuppression and immunological dysregulation in sepsis. Assessment of these features could help in utilizing precision medicine for the treatment of sepsis with immuno-modulatory drugs.

The Impact of Liver and Renal Dysfunction on the Pharmacokinetics and Pharmacodynamics of Sedative and Analgesic Drugs in Critically Ill Adult Patients

The use of sedative and analgesic drug therapy is often necessary for the care of critically ill patients. Renal and hepatic dysfunction, which occurs frequently in this patient population, can significantly alter drugs' pharmacokinetic and pharmacodynamics properties. By anticipating how these medications may be affected by liver or kidney dysfunction, health care practitioners may be able to provide tailored dosing regimens that ensure optimal comfort while minimizing the risk of adverse events.

Transcription factor Ets-1 links glucotoxicity to pancreatic beta cell dysfunction through inhibiting PDX-1 expression in rodent models

AIMS/HYPOTHESIS

'Glucotoxicity' is a term used to convey the negative effect of hyperglycaemia on beta cell function; however, the underlying molecular mechanisms that impair insulin secretion and gene expression are poorly defined. Our objective was to define the role of transcription factor v-ets avian erythroblastosis virus E26 oncogene homologue 1 (Ets-1) in beta cell glucotoxicity.

METHODS

Primary islets and Min6 cells were exposed to high glucose and Ets-1 expression was measured. Recombinant adenovirus and transgenic mice were used to upregulate Ets-1 expression in beta cells in vitro and in vivo, and insulin secretion was assessed. The binding activity of H3/H4 histone on the Ets-1 promoter, and that of forkhead box (FOX)A2, FOXO1 and Ets-1 on the Pdx-1 promoter was measured by chromatin immunoprecipitation and quantitative real-time PCR assay.

RESULTS

High glucose induced upregulation of Ets-1 expression and hyperacetylation of histone H3 and H4 at the Ets-1 gene promoter in beta cells. Ets-1 overexpression dramatically suppressed insulin secretion and biosynthesis both in vivo and in vitro. Besides, Ets-1 overexpression increased the activity of FOXO1 but decreased that of FOXA2 binding to the pancreatic and duodenal homeobox 1 (PDX-1) homology region 2 (PH2), resulting in inhibition of Pdx-1 promoter activity and downregulation of PDX-1 expression and activity. In addition, high glucose promoted the interaction of Ets-1 and FOXO1, and the activity of Ets-1 binding to the Pdx-1 promoter. Importantly, PDX-1 overexpression reversed the defect in pancreatic beta cells induced by Ets-1 excess, while knockdown of Ets-1 prevented hyperglycaemia-induced dysfunction of pancreatic beta cells.

CONCLUSIONS/INTERPRETATION

Our observations suggest that Ets-1 links glucotoxicity to pancreatic beta cell dysfunction through inhibiting PDX-1 expression in type 2 diabetes.

Docosahexaenoic acid prevented tumor necrosis factor alpha-induced endothelial dysfunction and senescence

We investigated how docosahexaenoic acid (DHA) regulated tumor necrosis factor-alpha (TNF-α)-induced senescence and dysfunction in endothelial cells (EC). We used RT-PCR to examine the expression of several genes related to senescence and dysfunction in EC. TNF-α-induced p21 protein levels were investigated by Western blot (WB) and fluorescence antibody techniques. TNF-α induced the senescence marker β-galactosidase and the expression of several senescence and endothelial dysfunction-related genes, e.g., CDKN1A, SHC1 and GLB1. DHA attenuated TNF-α-induced senescence-related gene expression and p21 protein expression. DHA attenuated TNF-α-induced gene expression related to dysfunction of EC, such as plasminogen activator inhibitor 1 (SERPINE1), lectin-like oxidized low-density lipoprotein receptor-1 (OLR1), thromboxane A2 receptor (TXA2R) and p38 MAPK (MAPK14). DHA reversed the TNF-α-mediated reduction of endothelial nitric oxide synthase (NOS3) gene expression. TNF-α-mediated upregulation of these genes was inhibited by allopurinol and apocynin. These results indicated that DHA regulated the expression of several genes that are associated with senescence and dysfunction of EC.

Case report of Graves’ disease manifesting with odynophagia and heartburn

Graves’ disease is an autoimmune disease, which can manifest with a variety of extrathyroidal clinical syndromes like ophthalmopathy, pretibial myxedema (dermopathy), acropathy, cardiomyopathy, and encephalopathy. Though quite rare, this disease can also manifest with gastrointestinal symptoms such as dysphagia, heartburn, nausea, vomiting and diarrhea. We report a clinical case of Graves’ disease manifesting with dysfunction of the esophagus and heartburn in a 61-year-old man. In the muscular layer of the esophagus we found dystrophic changes led to its atony, which was documented by endoscopy and high-resolution manometry. The pathology features of esophageal symptoms were: focal proliferation of the basal cells, vascular distension, and dystrophy of the epithelial cells. Antithyroid treatment led to decrease of all clinical symptoms after 5 d of Thiamazole administration. Complete restoration of peristalsis in the esophagus, according to manometry, was observed in 1 mo after initiation of treatment.

Safety, complications and outcome of large volume paracentesis with or without albumin therapy in children with severe ascites due to liver disease

BACKGROUND & AIMS

There are currently no published data on post-paracentesis circulatory dysfunction (PPCD) or its prevention in children. Our study was aimed to analyze the safety and complications of large volume paracentesis (LVP) in children with severe ascites due to chronic liver disease with or without albumin therapy.

METHODS

A prospective longitudinal observational study enrolled children with severe ascites who underwent single time LVP at admission. They were divided into albumin infused (AI) and albumin non-infused (ANI) groups. Hemodynamic monitoring and laboratory parameters including plasma renin activity (PRA) were compared between baseline, 48 h and day 6 of LVP. Their outcome at 3 months and maximal follow-up were noted.

RESULTS

32 children (AI, n=17; ANI, n=15) had comparable baseline characteristics and 90.6% had high PRA at onset. The incidence of PPCD was 37.5% (ANI: 67%; AI: 12%, p=0.003), occurred if ascitic fluid extraction was >197.5 ml/kg (sensitivity: 90%; specificity: 50%, p=0.01) and if flow rate was higher in ANI group (1224 ± 476 vs. 678 ± 214 ml/h, p=0.009). ANI patients were susceptible to asymptomatic, persistent hyponatremia (baseline vs. day 6, 131 ± 4 vs. 128 ± 6 mEq/L; p=0.04) and had higher rates of recurrent ascites (42%) and hospital readmission (67%) within 3 months. No survival benefit among the AI or non-PPCD groups was demonstrated.

CONCLUSIONS

LVP is safe in all age groups, best performed under albumin cover to overcome the problems of PPCD and hyponatremia. It is prudent to restrict volume extraction to less than 200 ml/kg actual dry weight for all and flow rate of 680 ml/h in ANI.

Fluoride-induced oxidative stress is involved in the morphological damage and dysfunction of liver in female mice

Fluoride (F), one of the most toxic environmental and industrial pollutants, is known to exert hepatotoxicity. The contribution of oxidative stress to the F tolerance of liver remains largely unknown. In this study, the morphological and ultrastructural characteristics of liver were observed using hematoxylin and eosin staining and transmission electron microscopy (TEM), respectively. Oxidative-stress participations was analysed and the mRNA expression levels of catalase (Cat), glutathione peroxidase 1 (GSH-Px1), nitric oxide synthase 2 (NOS2), and superoxide dismutase 1 (SOD1) were investigated by real-time PCR. Changes in liver-function parameters were also detected. Results showed that the reactive content of reactive oxygen species increased significantly, whereas SOD and GSH-Px activities, as well as total anti-oxidising capability (T-AOC), decreased significantly, with increased nitric oxide (NO) and malondialdehyde (MDA) contents in liver and serum after 70days of F treatment. The mRNA expression levels of Cat, GSH-Px1, and SOD were significantly downregulated, whereas NOS2 mRNA expression level was up upregulated, after F treatment for 70days. Light microscopy also revealed that hepatocytes were fused into pieces; cell boundaries were unclear, and nuclei were lightly stained. TEM further showed that hepatocytes were characterised by vague nuclear and mitochondrial membranes, dilated endoplasmic reticulum, and aggravated vacuolar degeneration. Activities of alanine transaminase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase, as well as the level of total bilirubin in serum increased. Overall, these results indicated that F interfered with the balance of antioxidase activity and morphological changes in liver, which were involved in mouse liver dysfunction.

Diabetes-related dysfunction of the small intestine and the colon: focus on motility

In contrast to gastric dysfunction, diabetes-related functional impairments of the small and large intestine have been studied less intensively. The gastrointestinal tract accomplishes several functions, such as mixing and propulsion of luminal content, absorption and secretion of ions, water, and nutrients, defense against pathogens, and elimination of waste products. Diverse functions of the gut are regulated by complex interactions among its functional elements, including gut microbiota. The network-forming tissues, the enteric nervous system) and the interstitial cells of Cajal, are definitely impaired in diabetic patients, and their loss of function is closely related to the symptoms in diabetes, but changes of other elements could also play a role in the development of diabetes mellitus-related motility disorders. The development of our understanding over the recent years of the diabetes-induced dysfunctions in the small and large intestine are reviewed in this article.

Functional assessment of transplanted kidneys with magnetic resonance imaging

Kidney transplantation has emerged as the treatment of choice for many patients with end-stage renal disease, which is a significant cause of morbidity and mortality. Given the shortage of clinically available donor kidneys and the significant incidence of allograft dysfunction, a noninvasive and accurate assessment of the allograft renal function is critical for postoperative management. Prompt diagnosis of graft dysfunction facilitates clinical intervention of kidneys with salvageable function. New advances in magnetic resonance imaging (MRI) technology have enabled the calculation of various renal parameters that were previously not feasible to measure noninvasively. Diffusion-weighted imaging provides information on renal diffusion and perfusion simultaneously, with quantification by the apparent diffusion coefficient, the decrease of which reflects renal function impairment. Diffusion-tensor imaging accounts for the directionality of molecular motion and measures fractional anisotropy of the kidneys. Blood oxygen level-dependent MR evaluates intrarenal oxygen bioavailability, generating the parameter of R2* (reflecting the concentration of deoxyhemoglobin). A decrease in R2* could happen during acute rejection. MR nephro-urography/renography demonstrates structural data depicting urinary tract obstructions and functional data regarding the glomerular filtration and blood flow. MR angiography details the transplant vasculature and is particularly suitable for detecting vascular complications, with good correlation with digital subtraction angiography. Other functional MRI technologies, such as arterial spin labeling and MR spectroscopy, are showing additional promise. This review highlights MRI as a comprehensive modality to diagnose a variety of etiologies of graft dysfunction, including prerenal (e.g., renal vasculature), renal (intrinsic causes) and postrenal (e.g., obstruction of the collecting system) etiologies.

Posttraumatic olfactory dysfunction

Impairment of smell may occur following injury to any portion of the olfactory tract, from nasal cavity to brain. A thorough understanding of the anatomy and pathophysiology combined with comprehensively obtained history, physical exam, olfactory testing, and neuroimaging may help to identify the mechanism of dysfunction and suggest possible treatments. Although most olfactory deficits are neuronal mediated and therefore currently unable to be corrected, promising technology may provide novel treatment options for those most affected. Until that day, patient counseling with compensatory strategies and reassurance is essential for the maintenance of safety and QoL in this unique and challenging patient population.

Preadipocyte proliferation is elevated by calcium sensing receptor activation

Obesity is a major worldwide problem, despite considerable efforts against it. While excess body fat defines obesity, adipose tissue quality and functionality are key to whether cardiovascular and metabolic comorbidities develop. Adipose tissue cellular composition can vary considerably, and excess adipocyte progenitors (preadipocytes) is associated with obesity. We have proposed that calcium sensing receptor (CaSR) activation in adipose tissue leads to dysfunction. This study evaluated whether CaSR activation elevates preadipocyte proliferation. Human LS14 preadipocytes were exposed to CaSR activators cinacalcet (2 µM), GdCl3 (5 µM) and spermine (1 µM), and cell viability was evaluated after 72h. CaSR activators elevated proliferation by 19-24%, and CaSR silencing (siRNA) abolished the effect. Cinacalcet elevated phospho-ERK1/2 content, and upstream inhibition of ERK1/2 phosphorylation reverted cinacalcet-induced proliferation. Cinacalcet also elevated expression of the proinflammatory factors IL1β, IL6 and CCL2. The results suggest that CaSR induces preadipocyte proliferation, partly through ERK1/2 activation. Considering reported proinflammatory and adipogenic CaSR effects, excess preadipocyte proliferation further supports the dysfunctional effect of CaSR in obesity.

Dysfunction of Rice Mitochondrial Membrane Induced by Yb3+

Ytterbium (Yb), a widely used rare earth element, is treated as highly toxic to human being and adverseness to plant. Mitochondria play a significant role in plant growth and development, and are proposed as a potential target for ytterbium toxicity. In this paper, the biological effect of Yb(3+) on isolated rice mitochondria was investigated. We found that Yb(3+) with high concentrations (200 ~ 600 μM) not only induced mitochondrial membrane permeability transition (mtMPT), but also disturbed the mitochondrial ultrastructure. Moreover, Yb(3+) caused the respiratory chain damage, ROS formation, membrane potential decrease, and mitochondrial complex II activity reverse. The results above suggested that Yb(3+) with high concentrations could induce mitochondrial membrane dysfunction. These findings will support some valuable information to the safe application of Yb-based agents.

Psychiatrists and Their Role in an Integrative Approach to Sexual Problems

Sexuality is a unit part of humans that has been evaluated as several fragmented particles for years. Although many biomedical and psychosocial approaches have been developed in the field of sex, these approaches usually have not been led to the complete satisfaction of the patients. It seems that for a comprehensive evaluation and management of the sexual problems, the unity of sex should be respected and the biopsychosocial multilayer aspects of the sex should be apprehended. Psychiatry is a unique point that both biomedical and psychosocial sciences reach each other. Therefore, psychiatrists should play a critical role as a modulator in the multidisciplinary team for management of the sexual problems. In this regard, comprehensive training of psychiatrists is highly recommended. One of the primary steps could be developing the psychosexual fellowship.

Stage I and II Posterior Tibial Tendon Dysfunction: Return to Running?

Posterior tibial tendon dysfunction can be a difficult entity to treat in the athletic population. Understanding the deformity components allows the physician to maximize nonoperative intervention with orthotics and physical therapy. Not all patients improve with nonoperative treatment, and surgical intervention can be successful in minimizing symptoms. Although return to full athletic activity is not universally possible, an active lifestyle is possible for many after surgical reconstruction.

Chronic symptoms and pulmonary dysfunction in post-tuberculosis Brazilian patients

Background

Questionnaire and spirometry were applied to post-tuberculosis indigenous and non-indigenous individuals from Dourados, Brazil, to investigate the prevalence of chronic respiratory symptoms and pulmonary dysfunction.

Methods

This was a cross-sectional study in cured tuberculosis individuals as reported in the National System on Reportable Diseases (SINAN) from 2002 to 2012.

Results

One hundred and twenty individuals were included in the study and the prevalence of chronic respiratory symptoms was 45% (95% CI, 34–59%). Respiratory symptoms included cough (28%), sputum (23%), wheezing (22%) and dyspnea (8%). These symptoms were associated with alcoholism, AOR: 3.1 (1.2–8.4); less than 4 years of schooling, AOR: 5.0 (1.4–17.7); and previous pulmonary diseases, AOR: 5.4 (1.7–17.3). Forty-one percent (95% CI, 29–56) had pulmonary disorders, of which the most prevalent were obstructive disorders (49%), followed by obstructive disorder with reduced forced vital capacity disorders (46%) and restrictive disorders (5%). The lifestyle difference could not explain differences in chronic symptoms and/or the prevalence of pulmonary dysfunction.

Conclusion

The high prevalence of chronic respiratory symptoms and pulmonary dysfunction in post-tuberculosis patients indicates a need for further interventions to reduce social vulnerability of patients successfully treated for tuberculosis.

Assessment of unhealthy days among Iranian reproductive age women in 2012

Background:

Unhealthy days are defined as the number of days during the past 30 days that a woman has not had a feeling of wellbeing. Wellbeing includes the woman’s judgments about the level of satisfaction and quality in her life. Assessment of a woman’s perception of unhealthy days can be used to help her determine the extent of the burdens associated with mental and physical feelings that things are not going well in her life, job and relationship. This study was conducted to measure unhealthy days and the general health status in Iranian women of reproductive age based on their own perceptions.

Methods:

The participants of this study were women of reproductive age who were referred to health centers in Mashhad, Iran, in 2012. With the stratified random sampling method, 220 women were included in the study. The health-related quality of life-4 (HRQOL-4) questionnaire was used to assess the women’s self-perceived unhealthy days. The data that were collected were analyzed by Kruskal-Wallis, chi-squared, Pearson correlation, and logistic linear regression tests with SPSS 11.5.

Results:

The mean age of the participants was 32.6 years, and the median number of the self-perceived unhealthy days was 7.1 days (per month). In the domains of physical, mental, and disability unhealthy days, the data indicated 2 days, 2.1 days, and 0.1 day in a month, respectively. Also, nearly half of the participants reported that their general health status was poor to fair. The Kruskal-Wallis test showed that there was a significant difference between unhealthy days in the different age groups (p=0.01) as well as for the physical (p=0.02) and mental domains (p=0.4). The results of the regression analysis showed that the number of physical unhealthy days increased with age, number of children, and education. The number of mental unhealthy days increased with age, and the number of disability days increased as the age at which they were married decreased (p<0.05). A significant inverse relationship was observed between physical unhealthy days and education, with the number of physical unhealthy days decreasing as the years of education increased (r=−0.19, p=0.005).

Conclusion:

Women with less education who were older than 40, who married at an early age, and had more children reported more unhealthy days. These results emphasize the importance of preventive and educational health interventions in these vulnerable groups based on their physical and mental needs.

A state of reversible compensated ventricular dysfunction precedes pathological remodelling in response to cardiomyocyte-specific activity of angiotensin II type-1 receptor in mice

Cardiac dysfunction is commonly associated with high-blood-pressure-induced cardiomyocyte hypertrophy, in response to aberrant renin-angiotensin system (RAS) activity. Ensuing pathological remodelling promotes cardiomyocyte death and cardiac fibroblast activation, leading to cardiac fibrosis. The initiating cellular mechanisms that underlie this progressive disease are poorly understood. We previously reported a conditional mouse model in which a human angiotensin II type-I receptor transgene (HART) was expressed in differentiated cardiomyocytes after they had fully matured, but not during development. Twelve-month-old HART mice exhibited ventricular dysfunction and cardiomyocyte hypertrophy with interstitial fibrosis following full receptor stimulation, without affecting blood pressure. Here, we show that chronic HART activity in young adult mice causes ventricular dysfunction without hypertrophy, fibrosis or cardiomyocyte death. Dysfunction correlated with reduced expression of pro-hypertrophy markers and increased expression of pro-angiogenic markers in the cardiomyocytes experiencing increased receptor load. This stimulates responsive changes in closely associated non-myocyte cells, including the downregulation of pro-angiogenic genes, a dampened inflammatory response and upregulation of Tgfβ. Importantly, this state of compensated dysfunction was reversible. Furthermore, increased stimulation of the receptors on the cardiomyocytes caused a switch in the secondary response from the non-myocyte cells. Progressive cardiac remodelling was stimulated through hypertrophy and death of individual cardiomyocytes, with infiltration, proliferation and activation of fibroblast and inflammatory cells, leading to increased angiogenic and inflammatory signalling. Together, these data demonstrate that a state of pre-hypertrophic compensated dysfunction can exist in affected individuals before common markers of heart disease are detectable. The data also suggest that there is an initial response from the housekeeping cells of the heart to signals emanating from distressed neighbouring cardiomyocytes to suppress those changes most commonly associated with progressive heart disease. We suggest that the reversible nature of this state of compensated dysfunction presents an ideal window of opportunity for personalised therapeutic intervention.

Highlighted Article: A novel conditional mouse model was used to investigate early initiating stages of heart disease that are commonly overlooked, and identifies a ‘window of opportunity’ for personalised therapeutic intervention.

Sexual Dysfunction and Help Seeking Behaviors in Newly Married Men in Sari City: a Descriptive

INTRODUCTION

Sexual dysfunction is a major concern for people's general health. The aim of this study was to determine the status of sexual function and help-seeking behaviors in newly married men.

METHODS

This descriptive study was conducted on 363 newly married men. Simple random sampling was used according to premarital counseling offices in the health center of Sari city. Data collection instruments included personal and social characteristics, Arizona Sexual Experience Scale (ASEX), and help-seeking behaviors questionnaires. In order to determine the relationship between characteristics and sexual function, general linear model and also between socio-demographic characteristics and receiving or lack of receiving help, multivariate logistic regression test were used.

RESULTS

The mean of sexual function score was 21.3 (2.7) out of possible 5-30, and 26% of men suffered sexual dysfunction. The highest prevalence (27.2%) of dysfunction was in the dimension of sexual stimulation, and the lowest (15.7%) in maintaining erection. For the treatment of sexual dysfunction, only 32% men had sought help, and 40% of them had visited specialists. The most frequent reasons for not seeking help were feeling uncomfortable with doctor, and their belief that doctor is not able to do much. 65% of men desired to be treated.

CONCLUSION

The results demonstrated relatively high prevalence of sexual dysfunction among men, and unfortunately, most of them did not seek help for their sexual problem. Since Sexual dysfunction can leave damaging effects on the quality of life and marital relationship, interventions to deal with these challenges and screening to identify such problems appear necessary.

Pressure Overload Creates Right Ventricular Diastolic Dysfunction in a Mouse Model: Assessment by Echocardiography

BACKGROUND

Noninvasive diagnostic tools for right ventricular (RV) dysfunction measurements are increasingly being used, although their association with the pathologic mechanisms of dysfunction is poorly understood. Although investigations have focused mainly on RV systolic function, RV diastolic function remains mostly neglected. The aim of this study was to test which echocardiographic parameters best reflect RV diastolic function in mice.

METHODS

Pulmonary artery banding (PAB) was used to induce RV pressure overload in mice. Transthoracic echocardiography and invasive hemodynamic measurements were performed after 3 weeks in PAB and sham-operated mice. Subsequently, the hearts were investigated by histology and analyzed for gene expression.

RESULTS

PAB-induced pressure overload (RV systolic pressure PAB 52.6 ± 11.8 mm Hg vs sham 27.0 ± 2.7 mm Hg) resulted in RV hypertrophy and remodeling, as reflected by increased Fulton index (PAB 0.37 ± 0.05 vs sham 0.25 ± 0.02, P = .001). Masson's trichrome staining revealed increased interstitial fibrosis (PAB 12.25 ± 3.12% vs sham 3.97 ± 1.58%, P = .002). This was associated with significant systolic RV dysfunction as demonstrated by reduced contractility index and diastolic dysfunction as demonstrated by end-diastolic pressure (PAB 2.66 ± 0.83 mm Hg vs sham 1.49 ± 0.50 mm Hg, P < .001) and τ (PAB 40.0 ± 16.1 msec vs sham 13.0 ± 3.5 msec, P < .001). Messenger ribonucleic acid expression of β-myosin heavy chain, atrial and brain natriuretic peptides, collagen family members was elevated, and the sarco/endoplasmic reticulum Ca(2+)-ATPase was decreased. Echocardiography revealed significant increases in RV free wall thickness and isovolumic relaxation time and a decrease in left ventricular eccentricity index, E', and tricuspid annular plane systolic excursion. Isovolumic relaxation time and E' were significantly correlated with end-diastolic pressure (rs = 0.511 and -0.451) and τ (rs = 0.739 and -0.445, respectively). Moreover, E' was negatively correlated with the degree of RV fibrosis (rs = -0.717).

CONCLUSIONS

Within 3 weeks, PAB causes pressure overload-induced RV hypertrophy and remodeling with compensated systolic and diastolic dysfunction in mice. RV free wall thickness, tricuspid annular plane systolic excursion, E', E/E' ratio, and isovolumic relaxation time appear to be the most reliable echocardiographic parameters for the assessment of RV dysfunction.